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Table 2 Grading of the body of evidence for effectiveness of short versus long LTBI treatment. Question: Does short LTBI treatment result in higher initiation, adherence, or completion rates than long LTBI treatment in individuals eligible for LTBI treatment?

From: Interventions for improving adherence to treatment for latent tuberculosis infection: a systematic review

  Quality assessment n/N = %a Effect Quality Importance
No of studies (No of participants) Design Population Intervention Risk of bias Inconsistency Indirectness Imprecision Other considerations Short LTBI treatment OR (95 % CI)b Absolute (per 1000 (95 % CI))c
Long LTBI treatment
Initiation
0 (0) No evidence available Critical
Adherence
2 (822) [21, 50] RCT Case contacts Seriousd Not serious Not serious Not serious None 344/391 = 88 % (range: 82–92 %) 1.5 (1.0–2.3) 55 (4–92) O Moderate Critical
3HR or 2RZ vs. 6H or 9H 353/431 = 82 % (range:7–86 %)
Completion
1 (352) [21] RCT Case contacts Seriouse Not serious Not serious Not serious None 106/153 = 69 % 0.8 (0.5–1.3) −46 (−156-49) O Moderate Critical
2RZ vs. 6H 145/199 = 73 %
1 (7731) [20] RCT Case contacts Very seriousf Not serious Not serious Not serious None 3273/3986 = 82 % 2.1 (1.9–2.3) 134 (119–146)  OO Low Critical
3H + RPT + DOT vs. 9H + SAT 2585/3745 = 69 %
1 (590) [38] RCT Immigrants Seriousg Not serious Not serious Not serious None 213/296 = 72 % 2.5 (1.7–3.6) 206 (125–273) O Moderate Critical
3HR vs. 6H 154/294 = 52 %
3 (1552) [5153] RCT General population Serioush Not serious Not serious Not serious None 568/785 = 72 % (range: 61–91 %) 1.9 (1.1–3.5) 141 (23–241) O Moderate Critical
2RZ or 4R vs. 6H or 9H 459/767 = 60 % (range: 57–76 %)
  1. Bibliography: Spyridis et al. 2007 [50]; Tortajada et al. 2005 [21]; Sterling et al. 2011 [20]; Jimenez-Fuentes et al. 2013 [38]; Menzies et al. 2008 [53]; Menzies et al. 2004 [52]; Jasmer et al. 2002 [51]
  2. n/N No of individuals with LTBI who initiated, or adhered to or completed treatment/total number of subjects; CI confidence interval; DOT directly observed therapy; 3H, 6H, 9H 3, 6 or 9 months isoniazid; 3HR 3 months isoniazid + rifampicin; OR odds ratio; 4R four months rifampin; RCT randomised controlled trial; RPT rifapentine; 2RZ 2 months rifampicin + pyrazinamide; SAT self-administered therapy
  3. aIf >1 articles, weighed pooled point estimates and 95 % CI were calculated
  4. bIf >1 articles, weighed pooled estimates and 95 % CI were calculated using a random effects model (without quality index)
  5. cCalculated via GradePro
  6. dSpyridis et al. 2007 [50]: no blinding. Tortajada et al. 2005 [21]: no blinding; use of unvalidated patient-reported outcomes (pill count and calendar annotations); early termination (due to higher toxicity in 2RZ arm, unplanned interim analysis); dissimilarities between treatment arms (more foreign-born in 2RZ); unequal number of patients in the two groups
  7. eTortajada et al. 2005 [21]: no blinding; use of unvalidated patient-reported outcomes (pill count and calendar annotations); early termination (due to higher toxicity in 2RZ arm, unplanned interim analysis); dissimilarities in treatment groups (more foreign-born in 2RZ); unequal number of patients in the two groups
  8. fSterling et al. 2011 [20]: unclear allocation concealment; no blinding; use of unvalidated patient-reported outcomes (pill count and self-report); dissimilarities between treatment arms (with respect to North American Indians, subjects enrolled in a cluster, homelessness); exposure bias (DOT only in short treatment arm)
  9. gJimenez-Fuentes et al. 2013 [38]: unclear allocation concealment; no blinding; dissimilarities between treatment arms (with respect to sex and undocumented migration status)
  10. hMenzies et al. 2004 [52]: unclear allocation concealment; no blinding. Menzies et al. 2008 [53]: unclear allocation concealment; no blinding; early termination (due to lower toxicity in 4R arm, planned interim analysis). Jasmer et al. 2002 [51]: lack of allocation concealment (alternate weeks); inadequate sequence generation (alternate weeks); no blinding; unclear treatment adherence assessment; dissimilarities between treatment arms (born outside United States, age >35 years)