{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:42:24Z","timestamp":1791312144759,"version":"4.3.1"},"reference-count":92,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,20]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To summarise treatment success rate (TSR) among adult bacteriologically confirmed pulmonary tuberculosis (BC-PTB) patients in sub-Saharan Africa (SSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We searched MEDLINE, EMBASE, Google Scholar and Web of Science electronic databases for eligible studies published in the decade between 1 July 2008 and 30 June 2018. Two independent reviewers extracted data and disagreements were resolved by consensus with a third reviewer. We used random-effects model to pool TSR in Stata V.15, and presented results in a forest plot with 95% CIs and predictive intervals. We assessed heterogeneity with Cochrane\u2019s (Q) test and quantified with I-squared values. We checked publication bias with funnel plots and Egger\u2019s test. We performed subgroup, meta-regression, sensitivity and cumulative meta-analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>SSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults 15 years and older, new and retreatment BC-PTB patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>TSR measured as the proportion of smear-positive TB cases registered under directly observed therapy in a given year that successfully completed treatment, either with bacteriologic evidence of success (cured) or without (treatment completed).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      31 studies (2 cross-sectional, 1 case\u2013control, 17 retrospective cohort, 6 prospective cohort and 5 randomised controlled trials) involving 18\u2009194 participants were meta-analysed. 28 of the studies had good quality data. Egger\u2019s test indicated no publication bias, rather small study effect. The pooled TSR was 76.2% (95% CI 72.5% to 79.8%; 95% prediction interval, 50.0% to 90.0%, I\n                      <jats:sup>2<\/jats:sup>\n                      statistics=96.9%). No single study influenced the meta-analytical results or conclusions. Between 2008 and 2018, a gradual but steady decline in TSR occurred in SSA but without statistically significant time trend variation (p=0.444). The optimum TSR of 90% was not achieved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Over the past decade, TSR was heterogeneous and suboptimal in SSA, suggesting context and country-specific strategies are needed to end the TB epidemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42018099151.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029400","type":"journal-article","created":{"date-parts":[[2019,9,7]],"date-time":"2019-09-07T07:25:17Z","timestamp":1567841117000},"page":"e029400","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["Treatment success rate among adult pulmonary tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"9","author":[{"given":"Jonathan","family":"Izudi","sequence":"first","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-213X","authenticated-orcid":false,"given":"Daniel","family":"Semakula","sequence":"additional","affiliation":[{"name":"African Centre for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sennono","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imelda K","family":"Tamwesigire","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Bajunirwe","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,6]]},"reference":[{"key":"2025121514330857000_9.9.e029400.1","unstructured":"World Health Organization . 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