SYSTEMATIC REVIEW article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1635053
This article is part of the Research TopicWorld TB Day 2025: Yes! We Can End TB: Commit, Invest, DeliverView all 5 articles
PREVALENCE OF TUBERCULOSIS AMONG PEOPLE WHO USE DRUGS (PWUD) 2000-2024: A SYSTEMATIC REVIEW AND META-ANALYSIS
Provisionally accepted
- Zhejiang Chinese Medical University, Hangzhou, China
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Abstract Background People who use drugs (PWUD) are at a higher risk of developing tuberculosis (TB); however, there is no clear evidence to determine the prevalence of TB in this group accurately. This study aimed to systematically review the prevalence of tuberculosis (TB) among PWUD across studies conducted in different countries. Methods An electronic search for original articles on the prevalence of TB among People Who Use Drugs (PWUD) was conducted in PubMed, Web of Science, and Science Direct. The reference lists of included studies were manually screened to identify omitted eligible studies. Extracted data were imported into a Microsoft Excel sheet. The random-effects model was employed to estimate the pooled prevalence of TB among People Who Use Drugs (PWUD), with effect size (ES) reported as point estimates and 95% confidence interval (CI). Subgroup analysis and sensitivity tests were also performed. All analyses were performed in STATA version 18. Results A total of 2085 articles were retrieved from the search. After removing duplicates, screening titles and abstracts, and excluding non-eligible articles, 23 studies involving 164,121 patients met the inclusion criteria for the analysis. The average estimated prevalence of tuberculosis among People Who Use Drugs (PWUD) was 25% (95% CI: 0.21, 0.35). The prevalence of tuberculosis among PWUD was higher in Asia (32%) and North America (28%) compared to South America (10%) and Africa (5%). Additionally, the average prevalence of tuberculosis among PWUD was 36% in case-control studies, 26% in cohort studies, and 23% in cross-sectional studies. Conclusion This review highlighted a high pooled prevalence of tuberculosis among People Who Use Drugs (PWUD), which varies across continents, study types, drug categories, and assessment tools. This emphasizes the need to integrate screening and prevention strategies into programs for PWUDs, address systemic inequities to reduce transmission, improve data reporting, and conduct more research in under-reported regions such as Africa and South Asia.
Keywords: tuberculosis (TB), people who use drugs (PWUD), People who inject drugs (PWID), Meta - analysis, system evaluation
Received: 25 May 2025; Accepted: 11 Sep 2025.
Copyright: © 2025 Ji, Ngowi, Mandizadza, Shao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Conghua Ji, Zhejiang Chinese Medical University, Hangzhou, China
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