Chest radiography for active tuberculosis case finding in the homeless: a systematic review and meta-analysis
OBJECTIVE: We performed a systematic review and meta-analysis to evaluate the use of chest X-ray (CXR) screening in ACF for TB in homeless populations.
DESIGN: Articles were identified through EMBASE, Medline and the Cochrane Library. Studies using symptom screens, CXRs, sputum sweeps, tuberculin skin tests and/or interferon-gamma release assays to detect active TB in homeless populations were sought. Data were extracted using a standardised method by two reviewers and validated with an objective tool.
RESULTS: Sixteen studies addressing CXR screening of homeless populations for active TB in low-incidence regions were analysed. The pooled prevalence of active TB in the 16 study cohorts was 931 per 100 000 population screened (95%CI 565–1534) and 782/100 000 CXR performed (95%CI 566–1079). Six of seven longitudinal screening programs reported a reduction in regional TB incidence after implementation of the CXR-based ACF programme.
CONCLUSION: Our data suggest that CXR screening is a good tool for ACF in homeless populations in low-incidence regions.
Keywords: chest X-ray; screening; under-housed
Document Type: Original Article
Affiliations: 1: Department of Paediatrics, University of British Columbia, Vancouver, Canada 2: Department of Medicine, University of British Columbia, Vancouver, Canada 3: Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, British Columbia, Canada
Publication date: 01 October 2014
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