Imperial College London
Alternate

ProfessorJonFriedland

Faculty of Medicine, Department of Infectious Disease

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 3313 8521j.friedland Website

 
 
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Assistant

 

Ms Teyanna Gaeta +44 (0)20 3313 1943

 
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Location

 

8N21ACommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Nellums:2018:10.1186/s12916-017-1001-7,
author = {Nellums, LB and Rustage, K and Hargreaves, S and Friedland, JS},
doi = {10.1186/s12916-017-1001-7},
journal = {BMC Medicine},
title = {Multidrug-resistant tuberculosis treatment adherence in migrants: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1186/s12916-017-1001-7},
volume = {16},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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 jus
AU  - Nellums,LB
AU  - Rustage,K
AU  - Hargreaves,S
AU  - Friedland,JS
DO  - 10.1186/s12916-017-1001-7
PY  - 2018///
SN  - 1741-7015
TI  - Multidrug-resistant tuberculosis treatment adherence in migrants: a systematic review and meta-analysis
T2  - BMC Medicine
UR  - http://dx.doi.org/10.1186/s12916-017-1001-7
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29466983
UR  - http://hdl.handle.net/10044/1/57517
VL  - 16
ER  -
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