| Title |
Multidrug-resistant tuberculosis treatment adherence in migrants: a systematic review and meta-analysis
|
|---|---|
| Published in |
BMC Medicine, February 2018
|
| DOI | 10.1186/s12916-017-1001-7 |
| Pubmed ID | |
| Authors |
Laura B. Nellums, Kieran Rustage, Sally Hargreaves, Jon S. Friedland |
| Abstract |
Multidrug-resistant tuberculosis (MDR-TB) is a growing concern in meeting global targets for TB control. In high-income low-TB-incidence countries, a disproportionate number of MDR-TB cases occur in migrant (foreign-born) populations, with concerns about low adherence rates in these patients compared to the host non-migrant population. Tackling MDR-TB in this context may, therefore, require unique approaches. We conducted a systematic review and meta-analysis to identify and synthesise data on MDR-TB treatment adherence in migrant patients to inform evidence-based strategies to improve care pathways and health outcomes in this group. This systematic review and meta-analysis was conducted in line with PRISMA guidelines (PROSPERO 42017070756). The databases Embase, MEDLINE, Global Health and PubMed were searched to 24 May 2017 for primary research reporting MDR-TB treatment adherence and outcomes in migrant populations, with no restrictions on dates or language. A meta-analysis was conducted using random-effects models. From 413 papers identified in the database search, 15 studies reporting on MDR-TB treatment outcomes for 258 migrants and 174 non-migrants were included in the systematic review and meta-analysis. The estimated rate of adherence to MDR-TB treatment across migrant patients was 71% [95% confidence interval (CI) = 58-84%], with non-adherence reported among 20% (95% CI = 4-37%) of migrant patients. A key finding was that there were no differences in estimated rates of adherence [risk ratio (RR) = 1.05; 95% CI = 0.82-1.34] or non-adherence (RR = 0.97; 95% CI = 0.79-1.36) between migrants and non-migrants. MDR-TB treatment adherence rates among migrants in high-income low-TB-incidence countries are approaching global targets for treatment success (75%), and are comparable to rates in non-migrants. The findings highlight that only just over 70% of migrant and non-migrant patients adhere to MDR-TB treatment. The results point to the importance of increasing adherence in all patient groups, including migrants, with an emphasis on tailoring care based on social risk factors for poor adherence. We believe that MDR-TB treatment targets are not ambitious enough. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 2 | 29% |
| Unknown | 5 | 71% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 71% |
| Practitioners (doctors, other healthcare professionals) | 2 | 29% |
Mendeley readers
The data shown below were compiled from readership statistics for 197 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 197 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 38 | 19% |
| Student > Ph. D. Student | 19 | 10% |
| Student > Bachelor | 19 | 10% |
| Researcher | 17 | 9% |
| Other | 11 | 6% |
| Other | 24 | 12% |
| Unknown | 69 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 37 | 19% |
| Medicine and Dentistry | 35 | 18% |
| Pharmacology, Toxicology and Pharmaceutical Science | 9 | 5% |
| Immunology and Microbiology | 6 | 3% |
| Agricultural and Biological Sciences | 5 | 3% |
| Other | 29 | 15% |
| Unknown | 76 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 March 2024.
All research outputs
#4,798,818
of 25,530,891 outputs
Outputs from BMC Medicine
#2,363
of 4,043 outputs
Outputs of similar age
#87,412
of 344,645 outputs
Outputs of similar age from BMC Medicine
#34
of 47 outputs
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