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Hohlfeld, Ameer S J, Mathebula, Lindi, Pienaar, Elizabeth D, Abrams, Amber, Lutje, Vittoria, Ndwandwe, Duduzile and Kredo, Tamara (2021) 'Tuberculosis treatment intervention trials in Africa: A cross-sectional bibliographic study and spatial analysis'. PLoS ONE, Vol 16, Issue 3, e0248621.
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Abstract
Background
Mycobacterium Tuberculosis (TB) poses a substantial burden in sub-Saharan Africa and is the leading cause of death amongst infectious diseases. Randomised controlled trials (RCTs) are regarded as the gold standard for evaluating the effectiveness of interventions. We aimed to describe published TB treatment trials conducted in Africa.
Methods
This is a cross-sectional study of published TB trials conducted in at least one African country. In November 2019, we searched three databases using the validated Africa search filter and Cochrane’s sensitive trial string. Published RCTs conducted in at least one African country were included for analysis. Records were screened for eligibility. Co-reviewers assisted with duplicate data extraction. Extracted data included: the country where studies were conducted, publication dates, ethics statement, trial registration number, participant’s age range. We used Cochrane’s Risk of Bias criteria to assess methodological quality.
Results
We identified 10,495 records; 175 trials were eligible for inclusion. RCTs were published between 1952 and 2019. The median sample size was 206 participants (interquartile range: 73–657). Most trials were conducted in South Africa (n = 83) and were drug therapy trials (n = 130). First authors were from 30 countries globally. South Africa had the most first authors (n = 55); followed by the United States of America (USA) (n = 28) and Great Britain (n = 14) with fewer other African countries contributing to the first author tally. Children under 13 years of age eligible to participate in the trials made up 17/175 trials (9.71%). International governments (n = 29) were the most prevalent funders. Ninety-four trials provided CONSORT flow diagrams. Methodological quality such as allocation concealment and blinding were poorly reported or unclear in most trials.
Conclusions
By mapping African TB trials, we were able to identify potential research gaps. Many of the global north’s researchers were found to be the lead authors in these African trials. Few trials tested behavioural interventions compared to drugs, and far fewer tested interventions on children compared to adults to improve TB outcomes. Lastly, funders and researchers should ensure better methodological quality reporting of trials.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NOT_LSTM |
| Subjects: | QV Pharmacology > Drug Standardization. Pharmacognosy. Medicinal Plants > QV 771 Standardization and evaluation of drugs WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General) WF Respiratory System > Tuberculosis > WF 310 Therapy |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1371/journal.pone.0248621 |
| Depositing User: | Christianne Esparza |
| Date Deposited: | 13 Apr 2021 15:16 |
| Last Modified: | 04 Nov 2024 12:32 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/17463 |
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