{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:34:00Z","timestamp":1787070840686,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>\n                    Tuberculosis (TB) is the leading infectious cause of mortality in sub-Saharan Africa (SSA); the high prevalence of TB in this region is due to human immunodeficiency virus (HIV)-coinfection. Despite the advent of modalities to diagnose TB, undiagnosed TB-related deaths among HIV-infected patients remain significantly high. This systematic review aims at characterizing missed TB cases from postmortem studies. This review informs on the burden of TB missed diagnosis and highlights the need of improving TB case-finding strategies, especially among the high-risk groups and early TB therapy initiation to keeping in with the World Health Organization\u2019s end TB strategy. We searched PubMed, Cochrane, Web of Science, and African journals online for studies that looked into missed TB cases following postmortem using the following key terms: postmortem, TB diagnosis, and HIV; we included cross-sectional and cohorts from 1980 in the English language that were carried out in SSA among adults\u2019 population. Authors used the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for reporting, the quality of the included studies was assessed using the Newcastle\u2013Ottawa Scale for observational studies, and STATA 17.0 software was used for analysis. This study was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024507515. The combined prevalence of postmortem missed TB diagnosis among the 6025 participants was 27.13% (95% confidence interval [CI] =14.52\u201341.89), with a high level of heterogeneity at 98.65% (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). The prevalence varied significantly across the included studies, ranging from 1.21% (95% CI = 0.93\u20131.59) in the general population to 66.67% (95% CI = 50.98\u201379.37) in people living with HIV (PLWHIV). This current literature suggests that SSA is a region with a high prevalence of missed TB cases but with significant variations between countries. In addition, this study confirms a high number of missed TB infections within the PLWHIV. These results highlight the immediate need for targeted screening and diagnosis strategies and relevant policies.\n                  <\/jats:p>","DOI":"10.4103\/ijmy.ijmy_41_24","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T15:00:24Z","timestamp":1718722824000},"page":"126-132","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Postmortem for Intensified Missed Tuberculosis Case Finding in High Human Immunodeficiency Virus and Tuberculosis-burdened Settings in Sub-Saharan Africa among Adults\u2019 Population: Systematic Review and Meta-analysis"],"prefix":"10.4103","volume":"13","author":[{"given":"Emmanuel M.","family":"Sindato","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdallah","family":"Mlwati","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania"},{"name":"Department of Chest Diseases, Alexandria University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylivia Sarah","family":"Swai","sequence":"additional","affiliation":[{"name":"Department of Demand Planning, Global Health Supply Chain-Technical Assistance Project, Dar-es-Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6122-3828","authenticated-orcid":false,"given":"Violet Dismas","family":"Kajogoo","sequence":"additional","affiliation":[{"name":"Department of Clinical Trials, Tanzania Diabetes Association, Dar-es-Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"issue":"9","key":"R1-20240902","first-page":"1689","article-title":"WHO Global Report. 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