Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis
Abstract Background Gastrointestinal strictures impact clinical presentation in abdominal tuberculosis and are associated with significant morbidity. Aim To conduct a systematic review of the prevalence of stricturing disease in abdominal and gastrointestinal tuberculosis and response to antitubercu...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-023-02682-x |
| _version_ | 1797864551652261888 |
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| author | Anuraag Jena Ritin Mohindra Kirtan Rana Pardhu B. Neelam Dhuni Chand Thakur Harjeet Singh Pankaj Gupta Vikas Suri Vishal Sharma |
| author_facet | Anuraag Jena Ritin Mohindra Kirtan Rana Pardhu B. Neelam Dhuni Chand Thakur Harjeet Singh Pankaj Gupta Vikas Suri Vishal Sharma |
| author_sort | Anuraag Jena |
| collection | DOAJ |
| description | Abstract Background Gastrointestinal strictures impact clinical presentation in abdominal tuberculosis and are associated with significant morbidity. Aim To conduct a systematic review of the prevalence of stricturing disease in abdominal and gastrointestinal tuberculosis and response to antitubercular therapy (ATT). Methods We searched Pubmed and Embase on 13th January 2022, for papers reporting on the frequency and outcomes of stricturing gastrointestinal tuberculosis. The data were extracted, and pooled prevalence of stricturing disease was estimated in abdominal tuberculosis and gastrointestinal (intestinal) tuberculosis. The pooled clinical response and stricture resolution (endoscopic or radiologic) rates were also estimated. Publication bias was assessed using the Funnel plot and Egger test. The risk of bias assessment was done using a modified Newcastle Ottawa Scale. Results Thirty-three studies reporting about 1969 patients were included. The pooled prevalence of intestinal strictures in abdominal tuberculosis and gastrointestinal TB was 0.12 (95%CI 0.07–0.20, I2 = 89%) and 0.27 (95% CI 0.21–0.33, I2 = 85%), respectively. The pooled clinical response of stricturing gastrointestinal tuberculosis to antitubercular therapy was 0.77 (95%CI 0.65–0.86, I2 = 74%). The pooled stricture response rate (endoscopic or radiological) was 0.66 (95%CI 0.40–0.85, I2 = 91%). The pooled rate of need for surgical intervention was 0.21 (95%CI 0.13–0.32, I2 = 70%), while endoscopic dilatation was 0.14 (95%CI 0.09–0.21, I2 = 0%). Conclusion Stricturing gastrointestinal tuberculosis occurs in around a quarter of patients with gastrointestinal tuberculosis, and around two-thirds of patients have a clinical response with antitubercular therapy. A subset of patients may need endoscopic or surgical intervention. The estimates for the pooled prevalence of stricturing disease and response to ATT had significant heterogeneity. |
| first_indexed | 2024-04-09T22:53:44Z |
| format | Article |
| id | doaj.art-3f748e499a9645a399ac385a6f3dd4f7 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-09T22:53:44Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-3f748e499a9645a399ac385a6f3dd4f72023-03-22T11:23:16ZengBMCBMC Gastroenterology1471-230X2023-02-0123111410.1186/s12876-023-02682-xFrequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysisAnuraag Jena0Ritin Mohindra1Kirtan Rana2Pardhu B. Neelam3Dhuni Chand Thakur4Harjeet Singh5Pankaj Gupta6Vikas Suri7Vishal Sharma8Department of Gastroenterology, Postgraduate Institute of Medical Education and ResearchDepartment of Internal Medicine, Postgraduate Institute of Medical Education and ResearchDepartment of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and ResearchDepartment of Gastroenterology, Postgraduate Institute of Medical Education and ResearchDepartment of Internal Medicine, Postgraduate Institute of Medical Education and ResearchDepartment of Surgical Gastroenterology, Postgraduate Institute of Medical Education and ResearchDepartment of Radiodiagnosis, Postgraduate Institute of Medical Education and ResearchDepartment of Internal Medicine, Postgraduate Institute of Medical Education and ResearchDepartment of Gastroenterology, Postgraduate Institute of Medical Education and ResearchAbstract Background Gastrointestinal strictures impact clinical presentation in abdominal tuberculosis and are associated with significant morbidity. Aim To conduct a systematic review of the prevalence of stricturing disease in abdominal and gastrointestinal tuberculosis and response to antitubercular therapy (ATT). Methods We searched Pubmed and Embase on 13th January 2022, for papers reporting on the frequency and outcomes of stricturing gastrointestinal tuberculosis. The data were extracted, and pooled prevalence of stricturing disease was estimated in abdominal tuberculosis and gastrointestinal (intestinal) tuberculosis. The pooled clinical response and stricture resolution (endoscopic or radiologic) rates were also estimated. Publication bias was assessed using the Funnel plot and Egger test. The risk of bias assessment was done using a modified Newcastle Ottawa Scale. Results Thirty-three studies reporting about 1969 patients were included. The pooled prevalence of intestinal strictures in abdominal tuberculosis and gastrointestinal TB was 0.12 (95%CI 0.07–0.20, I2 = 89%) and 0.27 (95% CI 0.21–0.33, I2 = 85%), respectively. The pooled clinical response of stricturing gastrointestinal tuberculosis to antitubercular therapy was 0.77 (95%CI 0.65–0.86, I2 = 74%). The pooled stricture response rate (endoscopic or radiological) was 0.66 (95%CI 0.40–0.85, I2 = 91%). The pooled rate of need for surgical intervention was 0.21 (95%CI 0.13–0.32, I2 = 70%), while endoscopic dilatation was 0.14 (95%CI 0.09–0.21, I2 = 0%). Conclusion Stricturing gastrointestinal tuberculosis occurs in around a quarter of patients with gastrointestinal tuberculosis, and around two-thirds of patients have a clinical response with antitubercular therapy. A subset of patients may need endoscopic or surgical intervention. The estimates for the pooled prevalence of stricturing disease and response to ATT had significant heterogeneity.https://doi.org/10.1186/s12876-023-02682-xIntestinal tuberculosisCrohn's diseaseTuberculous peritonitisPeritoneal tuberculosisGastrointestinal tuberculosisAbdominal tuberculosis |
| spellingShingle | Anuraag Jena Ritin Mohindra Kirtan Rana Pardhu B. Neelam Dhuni Chand Thakur Harjeet Singh Pankaj Gupta Vikas Suri Vishal Sharma Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis BMC Gastroenterology Intestinal tuberculosis Crohn's disease Tuberculous peritonitis Peritoneal tuberculosis Gastrointestinal tuberculosis Abdominal tuberculosis |
| title | Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis |
| title_full | Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis |
| title_fullStr | Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis |
| title_full_unstemmed | Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis |
| title_short | Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis |
| title_sort | frequency outcomes and need for intervention in stricturing gastrointestinal tuberculosis a systematic review and meta analysis |
| topic | Intestinal tuberculosis Crohn's disease Tuberculous peritonitis Peritoneal tuberculosis Gastrointestinal tuberculosis Abdominal tuberculosis |
| url | https://doi.org/10.1186/s12876-023-02682-x |
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