N=277 (out of 346 identified and positive culture for MTB reference ≤ 1 month contacts) delay Exclusion 44 did not comply with Analysis of clinical risk Patients with HIV and their contacts protocol factors No written informed consent 25 refused consent ORs and their 95%CIs Failure to comply with study protocol were calculated by means of univariate and multivariate logistic regression Golub et al. () Prospective cohort N=124 total patients with Inclusion Treatment delay Treatment delay Number of contacts study pulmonary TB included either: > 60 days infected TST-positive Maryland, USA All verified pulmonary TB patients (tested at baseline and Level: III-2 34 excluded due to no who reported to the Maryland ≤ 60 days or Treatment delay 10–12 weeks later) Department of Health and Mental contacts identified/tested > 90 days Quality: 16/26 ≤ 90 days Hygiene between 1 June 2000 and N=54 (44%) born in USA Delay treated as a High risk of bias 30 November 2001 and their close US patients: dichotomous contacts variable, analysed 65% male Close contacts included those living for cut-offs of 60 72% black in the same household, working in a and 90 days 59% < 50 years of age closed environment with patient, and Total treatment 57% AFB sputum-positive reported close friends and relatives delay defined as 19% chest X-ray with Exclusion interval from first cavitation No contacts identified or no contacts TB symptoms to 385 contacts, of whom 310 tested initiation of (81%) skin tested treatment for TB Van der Oest, Kelly & Retrospective N=244 (189 new cases, 37 Inclusion No diagnostic Increasing Favourable treatment Hood () cohort study relapse cases, 18 delay diagnostic delay outcome as defined by All notified cases of TB who were unclassified): WHO (i.e. cure or Waikato Health District, Level: III-2 residing in the Waikato Health District Delay defined as treatment completed) New Zealand 52% male at the time of notification from 1 time between Quality: 11/26 January 1992 to 31 December 2001 development of Statistical analysis 110 (45%) Maori High risk of bias symptoms and Logistic regression was 46 (19%) non-Indigenous used for multivariate New Zealanders of the case and univariate 81 (33%) born overseas, comparisons 40 of whom were refugees Chi-square test number with length of
N=277 (out of 346 identified contacts) 44 did not comply with protocol 25 refused consent and positive culture for MTB Exclusion Patients with HIV and their contacts No written informed consent Failure to comply with study protocol reference ≤ 1 month delay Analysis of clinical risk factors ORs and their 95%CIs were calculated by means of univariate and multivariate logistic regression Golub et al. () Maryland, USA Prospective cohort study Level: III-2 Quality: 16/26 High risk of bias N=124 total patients with pulmonary TB included 34 excluded due to no contacts identified/tested N=54 (44%) born in USA US patients: 65% male 72% black 59% < 50 years of age 57% AFB sputum-positive 19% chest X-ray with cavitation 385 contacts, of whom 310 (81%) skin tested Inclusion All verified pulmonary TB patients who reported to the Maryland Department of Health and Mental Hygiene between 1 June 2000 and 30 November 2001 and their close contacts Close contacts included those living in the same household, working in a closed environment with patient, and reported close friends and relatives Exclusion No contacts identified or no contacts tested Treatment delay either: ≤ 60 days or ≤ 90 days Delay treated as a dichotomous variable, analysed for cut-offs of 60 and 90 days Total treatment delay defined as interval from first TB symptoms to initiation of treatment for TB Treatment delay > 60 days Treatment delay > 90 days Number of contacts infected TST-positive (tested at baseline and 10–12 weeks later) Van der Oest, Kelly & Hood () Waikato Health District, New Zealand Retrospective cohort study Level: III-2 Quality: 11/26 High risk of bias N=244 (189 new cases, 37 relapse cases, 18 unclassified): 52% male 110 (45%) Maori 46 (19%) non-Indigenous New Zealanders 81 (33%) born overseas, 40 of whom were refugees number with length of Inclusion All notified cases of TB who were residing in the Waikato Health District at the time of notification from 1 January 1992 to 31 December 2001 No diagnostic delay Delay defined as time between development of symptoms and of the case Increasing diagnostic delay Favourable treatment outcome as defined by WHO (i.e. cure or treatment completed) Statistical analysis Logistic regression was used for multivariate and univariate comparisons Chi-square test
1234_FinalAssessmentReport-accessible.docx