Forest plots of acquired (A) and primary (B) MDR-TB prevalence ratios by HIV status and corresponding 95% confidence intervals^*.

<p>^*Clark O; Djulbegovic B. Forest plots in excel software (Data sheet). 2001. Available at <a href="http://www.evidencias.com" target="_blank">www.evidencias.com</a>.</p

MDR-TB prevalence by HIV status in 32 studies.

*<p>includes patients with unknown HIV status.</p>**<p>all patients have unknown HIV status.</p

Search strategy.

<p>Search strategy.</p

MDR-TB Prevalence ratio by HIV prevalence among study participants and by region^*.

<p>^*One outlier from the Latin American region (HIV Prevalence: 0.20, Prevalence Ratio: 45) is not presented.</p

Forest plot of mortality relative risks reported by 22 studies.

<p>The relative risks correspond to the estimated effect of receiving vs. not receiving TB treatment at the time of cART initiation on subsequent mortality among HIV-infected adults. Estimates are ordered according to length of follow-up time. Estimates were abstracted according to the precision used by the original authors; estimates calculated using available data are reported to 2 decimal places. Abbreviations: cART, combination antiretroviral therapy; CI, confidence interval; HIV, human immunodeficiency virus; RR, relative risk; TB, tuberculosis. </p

Identification and selection of eligible studies.

<p>Identification and selection of eligible studies.</p

The Effect of Tuberculosis Treatment at Combination Antiretroviral Therapy Initiation on Subsequent Mortality: A Systematic Review and Meta-Analysis

<div><p>Objective</p><p>We aimed to perform a systematic review and meta-analysis examining the impact of TB treatment at the time of combination antiretroviral therapy (cART) initiation on subsequent mortality.</p> <p>Methods</p><p>We searched PubMed, EMBASE, and selected conference proceedings for studies that report adult mortality on cART, stratified by TB treatment status at cART initiation. Stratified random-effects and meta-regression analyses were used to examine the influence of study and population characteristics.</p> <p>Results</p><p>22 eligible cohort studies reported data on 98,350 (range 74-15,225) adults, of whom 14,779 (15%) were receiving TB treatment at cART initiation. Studies of those receiving vs. not receiving TB treatment had an average mortality relative risk of 1.10 (95% confidence interval 0.87-1.40) at 1-3 months (based upon 8 estimates), 1.15 (0.94-1.41) at 6-12 months (11 estimates), and 1.33 (1.02-1.75) at 18-98 months (10 estimates) following cART initiation. However, there was a wide range of estimates and those at later time points were markedly heterogeneous. Meta-regression identified factors associated with elevated average risk estimates: lower median baseline CD4 counts and adjustment for baseline hemoglobin at 1-3 months; longer length of follow-up and women-only studies at 6-12 months; and not adjusting for BMI/weight at 18-98 months.</p> <p>Conclusions</p><p>Patients receiving TB treatment at cART initiation did not have a statistically significant estimated increase in short-term risk of all-cause mortality as compared to those not receiving TB treatment. TB treatment was significantly associated with increased mortality after about a year of cART, suggesting that patients with concurrent TB treatment at cART initiation may benefit from continued support after TB treatment completion.</p> </div

Distribution of outcomes in case of exposure.

<p>Distribution of outcomes in case of contact with an infectious person according to immunological status. Values for susceptible, immune and natural waning are taken from <i>Van Rie et al.</i><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006284#pone.0006284-Coudeville1" target="_blank">[25]</a>. Values for vaccine-related compartments are estimated using <i>Bisgard et al.</i><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006284#pone.0006284-Bisgard2" target="_blank">[<i>31</i>]</a> and <i>Ward et al.</i><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006284#pone.0006284-Ward1" target="_blank">[10]</a>. Figures in parentheses define the range used in the sensitivity analysis.</p

Variation in pertussis incidence and costs according to the age at which the adult booster dose is administered (Childhood vaccination+adolescent+cocoon+1 booster dose for adult vaccination - steady-state situation).

<p>Variation in pertussis incidence and costs according to the age at which the adult booster dose is administered (Childhood vaccination+adolescent+cocoon+1 booster dose for adult vaccination - steady-state situation).</p

Average annual predicted costs of pertussis and vaccination from 2006 to 2106.

<p>Average annual predicted costs of pertussis and vaccination from 2006 to 2106.</p