A protocol for a systematic review and meta-analysis of tuberculosis care around the time of pregnancy.

ABSTRACT

Background: Tuberculosis is estimated to cause 1.5 million deaths annually and is most common during the reproductive years. Despite that fact, we found that tuberculosis screening, prevention or care recommendations for people around the time of pregnancy were absent from some national policy recommendations and varied in others. Objectives: To address the apparent gaps and inconsistencies in policy, we aim to design a systematic review and meta-analysis of the original research evidence informing tuberculosis care around the time of pregnancy. Methods: With assistance from librarians at the Biomedical library of the University of Gothenburg, Pubmed, CINAHL and Scopus databases will be searched. Search terms will aim to identify studies generating original research evidence informing care for tuberculosis around the time of pregnancy. Evidence may include the outcome of TB and/or of pregnancy; the cost-effectiveness or acceptability of any intervention; the sensitivity and specificity of any assessment, selection, diagnostic or test criterion. The output from these literature searches will be screened by two independent reviewers to select the eligible studies for inclusion. Discrepancies will be resolved with a third reviewer. Firstly, publications that provide contextual data will be tabulated, summarising their main contributions. Secondly, studies that provide evidence directly guiding patient care will be our focus and will be considered to be key. The key studies will be subject to quality assessment, data extraction and when possible, meta-analysis. Conclusions: This systematic review and meta-analysis aims to guide policy, practice and future research priorities concerning tuberculosis care around the time of pregnancy.

Tuberculosis is a leading infectious cause of death and is most common during the reproductive years. To address gaps and inconsistencies in policy, we aim to review original research evidence informing tuberculosis care around the time of pregnancy. Evidence may include the outcome of TB and/or the outcome of pregnancy; the cost-effectiveness or acceptability of any intervention; the reliability (sensitivity and specificity) of any assessment, selection, diagnostic or test criterion. First, publication databases (Pubmed, CINAHL and Scopus) will be searched to identify evidence. The output from these literature searches will then be screened to select eligible studies Next, publications that provide contextual data will be tabulated, summarising their main contributions. After this, studies that provide evidence directly guiding patient care will be our focus and will be considered to be key. The key studies will be subject to formal quality assessment, data extraction and when possible, meta-analysis to assess and summarise their findings. In conclusion, this systematic review and meta-analysis aims to guide policy, practice and future research priorities concerning tuberculosis care around the time of pregnancy.