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Pulmonary tuberculosis among tribals in India: A systematic review & meta-analysis.

Thomas BE, Adinarayanan S, Manogaran C, Swaminathan S - Indian J. Med. Res. (2015)

Bottom Line: References cited in the articles retrieved were also reviewed, and those found relevant were selected.The associated heterogeneity measures in terms of Cochran's Q was significant ( p=0 0.08 <0.1) and I [2] was moderate at 48 per cent.The moderate level of heterogeneity found across the studies suggests that the pooled-estimate needs to be treated with caution.

View Article: PubMed Central - PubMed

Affiliation: National Institute for Research in Tuberculosis (ICMR), Chennai, India.

ABSTRACT

Background & objectives: There has been limited investigation on the prevalence of tuberculosis (TB) in tribal communities in India, a vulnerable section of Indian society. The lack of a population-based estimate prompted us to conduct a meta-analysis of existing studies to provide a single, population-based estimate of the TB prevalence for tribals.

Methods: Literature search was conducted in PubMed using the keywords - "tuberculosis", "tribals", "India", "prevalence", and "survey". References cited in the articles retrieved were also reviewed, and those found relevant were selected. TB prevalence rates estimated by the studies were used for our calculation of a pooled-estimate.

Results: The pooled estimate, based on the random effects model, was 703 per 100,000 population with a 95 % CI of 386-1011. The associated heterogeneity measures in terms of Cochran's Q was significant ( p=0 0.08 <0.1) and I [2] was moderate at 48 per cent.

Interpretation & conclusions: The meta-analysis demonstrated a large variability in pulmonary TB prevalence estimates among the different studies with poor representation of the various tribal groups. The moderate level of heterogeneity found across the studies suggests that the pooled-estimate needs to be treated with caution. Our findings also highlight the need to assess the pulmonary TB burden in India.

No MeSH data available.


Related in: MedlinePlus

Forest plot of meta-analysis of the TB prevalence among tribals based on seven studies.
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Figure 1: Forest plot of meta-analysis of the TB prevalence among tribals based on seven studies.

Mentions: Overall estimate - The pooled estimate, based on the random effects model, was 703 per 100,000 population with a 95% CI of 386-1011. The heterogeneity measure of Cochran's Q of 11.0 was significant, resulting in a P value of 0.08 and an I2 of 48 per cent (with a 95% UI of 0-78%). A power analysis of the effect size by the random effects model showed this study had 51 per cent power. A forest plot with the pooled estimated (marked as a diamond with a vertical dotted line) with a 95% CI, as obtained from the random effects model, is displayed in Fig. 1. Also depicted are the TB prevalence estimates from the individual studies (marked as circles) along with their 95% CIs. Our calculations indicated that 48 per cent of the variation observed in the pooled estimate was due to heterogeneity among the studies, suggesting that there were inconsistencies across the studies included in this analysis. Subgroup analyses to determine possible causes of heterogeneity and publication bias could not be performed, given the limited number of studies.


Pulmonary tuberculosis among tribals in India: A systematic review & meta-analysis.

Thomas BE, Adinarayanan S, Manogaran C, Swaminathan S - Indian J. Med. Res. (2015)

Forest plot of meta-analysis of the TB prevalence among tribals based on seven studies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4510760&req=5

Figure 1: Forest plot of meta-analysis of the TB prevalence among tribals based on seven studies.
Mentions: Overall estimate - The pooled estimate, based on the random effects model, was 703 per 100,000 population with a 95% CI of 386-1011. The heterogeneity measure of Cochran's Q of 11.0 was significant, resulting in a P value of 0.08 and an I2 of 48 per cent (with a 95% UI of 0-78%). A power analysis of the effect size by the random effects model showed this study had 51 per cent power. A forest plot with the pooled estimated (marked as a diamond with a vertical dotted line) with a 95% CI, as obtained from the random effects model, is displayed in Fig. 1. Also depicted are the TB prevalence estimates from the individual studies (marked as circles) along with their 95% CIs. Our calculations indicated that 48 per cent of the variation observed in the pooled estimate was due to heterogeneity among the studies, suggesting that there were inconsistencies across the studies included in this analysis. Subgroup analyses to determine possible causes of heterogeneity and publication bias could not be performed, given the limited number of studies.

Bottom Line: References cited in the articles retrieved were also reviewed, and those found relevant were selected.The associated heterogeneity measures in terms of Cochran's Q was significant ( p=0 0.08 <0.1) and I [2] was moderate at 48 per cent.The moderate level of heterogeneity found across the studies suggests that the pooled-estimate needs to be treated with caution.

View Article: PubMed Central - PubMed

Affiliation: National Institute for Research in Tuberculosis (ICMR), Chennai, India.

ABSTRACT

Background & objectives: There has been limited investigation on the prevalence of tuberculosis (TB) in tribal communities in India, a vulnerable section of Indian society. The lack of a population-based estimate prompted us to conduct a meta-analysis of existing studies to provide a single, population-based estimate of the TB prevalence for tribals.

Methods: Literature search was conducted in PubMed using the keywords - "tuberculosis", "tribals", "India", "prevalence", and "survey". References cited in the articles retrieved were also reviewed, and those found relevant were selected. TB prevalence rates estimated by the studies were used for our calculation of a pooled-estimate.

Results: The pooled estimate, based on the random effects model, was 703 per 100,000 population with a 95 % CI of 386-1011. The associated heterogeneity measures in terms of Cochran's Q was significant ( p=0 0.08 <0.1) and I [2] was moderate at 48 per cent.

Interpretation & conclusions: The meta-analysis demonstrated a large variability in pulmonary TB prevalence estimates among the different studies with poor representation of the various tribal groups. The moderate level of heterogeneity found across the studies suggests that the pooled-estimate needs to be treated with caution. Our findings also highlight the need to assess the pulmonary TB burden in India.

No MeSH data available.


Related in: MedlinePlus