The prevalence of talent tuberculosis infection and associated risk factors among young people in South Africa: a systematic review and meta-analysis

Abstract

Background: Latent tuberculosis infection (LTBI) is a condition whereby people harbour live Mycobacterium tuberculosis (M. tuberculosis) without any evidence of active tuberculosis (TB) infection. The World Health Organisation (WHO) agenda for eradicating TB revolves on screening and treating people with LTBI in high TB prevalent regions. Studies on LTBI claim that by the typical age of sexual debut, about 50% of the young people in South Africa harbour LTBI and roughly 75% by the age of 25 years. It is imperative to contribute to South Africa’s readiness towards WHO agenda for LTBI treatment. Using a Systematic Review and Meta-Analysis, we summed up study measures of effects on LTBI and made a conclusion on the purported prevalence and associated risk factors of LTBI among young people (0-19 years) in South Africa.

Method and analysis: We used studies which estimated the prevalence and risk factors of LTBI among young people (0-19 years) in South Africa as diagnosed by Tuberculin skin test (TST) and InterFERON Gamma Release Assays (IGRAs). Studies were selected using predefined eligibility criteria and quality assessment tools to minimize bias. Random-effects model was used to weight the studies and Heterogeneities were determined using I-squared (I2) heterogeneity statistic. Effect measures were extracted at 95% confidence interval (CI) and the overall estimates pooled using Stata version 14 at 90% CI to accommodate minor variations in the selected studies.

Result: Due to lack of data for all the Provinces, the results obtained in this review are for two Provinces (Western Cape and Gauteng) only. We found the pooled prevalence of LTBI among young people in the two Provinces to be 37% (90% CI: 34%, 41%) using TST and 40% (90% CI: 34%, 46%) using IGRAs. Pooled prevalence for Western Cape is 41% (90% CI: 37%, 44%) and Gauteng is 23% (90% CI: 19%, 26%).

Conclusion: This Systematic review and meta-analysis did not establish the fact that the burden of LTBI among young people in South Africa is high as there were no studies in all the Provinces to back the claim. The available studies on the subject did not represent the national burden of LTBI among the study population given that they covered only two provinces of South Africa.