{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:19:38Z","timestamp":1787840378299,"version":"build-2784847793"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Delayed tuberculosis (TB) care can have adverse effects on both patients and the community. Such delays can perpetuate transmission within the community and disrupt ongoing efforts to eliminate TB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The primary objective of this meta-analysis was to estimate the pooled proportion of pulmonary TB (P-TB) cases experiencing delays in seeking care across high-burden countries worldwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Data extraction was conducted using three databases: PubMed, Scopus and DOAJ. This study was conducted as an extension of a scoping review, with the meta-analysis specifically aimed at estimating the pooled proportion of P-TB cases experiencing delays through quantitative data. The pooled proportion was calculated with a 95% confidence interval (CI) using a random-effects model, taking potential heterogeneity into account.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thirty-two full-text articles, selected from 831 articles, were included in the meta-analysis, representing China, India, Myanmar, South Africa and Nigeria. The total sample used across all the studies was 184,242 with a mean (standard deviation [SD]) of 5758 (17,236) and (median \u2013 491, interquartile range \u2013 271\u20131563). The highest total sample was from China (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 176,642), and the lowest total sample was from Nigeria (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 160). The pooled proportion of P-TB cases experiencing delays in China, India, Myanmar, South Africa and Nigeria was 50% (95% CI: 41\u201359), 50% (95% CI: 36-63), 38% (95% CI: 3\u201382), 47% (95% CI: 37\u201356) and 42% (95% CI: 34\u201350), respectively. The overall global proportion was 48% (95% CI: 41\u201355), with significant heterogeneity (\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 99.85%) observed among the studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study estimated that half of the global P-TB cases experienced delayed care, which is concerning and necessitates a multi-faceted approach to support TB elimination efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/npmj.npmj_269_25","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T06:00:30Z","timestamp":1761544830000},"page":"273-283","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Global Burden of Delayed 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