A META-ANALYSIS AND SYSTEMATIC REVIEW ON TUBERCULOSIS INFECTION PREVALENCE IN INDIA.

Objectives: There exists a gap in understanding TBI prevalence within diverse risk groups in the country. Hence, this comprehensive review and pooled-analysis sought to determine the incidence of tuberculosis infections or TBI in the Indian subcontinent, considering geographical variations, socioeconomic profiles, and specific susceptible groups. Methods: By conducting an extensive review, this study explored Tuberculosis Infection (TBI) prevalence in India from 2013 to 2022. Utilizing databases like Scopus, CINAHL, EMBASE, and MEDLINE, 72 publications underwent an examination adhering to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The comprehensive approach included diverse languages and study settings, providing a thorough understanding of TBI prevalence in India. Results: On reviewing 10,515 documents, 72 studies comprising prevalence studies (approx. 42) and long-term studies (approx. 30) were incorporated for this paper. The overall prevalence of Tuberculosis Infection (TBI) in India, sourced from population-based sample studies, was established at 41%. This percentage held steady at 36 % when eliminating highly susceptible groups from the public at large. Regions grappling with heightened active TB burdens, especially in Tamil Nadu and Delhi, demonstrated a corresponding surge in TBI prevalence. Conclusion: The present comprehensive analysis unveiled the significant pervasiveness of Tuberculosis Infections in India, aligning with proactive TB infections, hinting at the potential transformation from latent form to active TB. Notably, this possibility was pronounced in individuals residing in the southern and parts of the country. Addressing these regional variations is crucial for adapting and prioritizing tailored strategies to effectively manage TBI in India. Recommendation: Our study thus recommends prioritizing Tuberculosis Preventive Treatment (TPT) in high Tuberculosis Infection (TBI) prevalence areas, advocating a 'No test, treat only' approach for resource efficiency to support effective programmatic management in pursuit of India's TB elimination goals.