Research Protocol
Proportion of Tuberculosis Patients Incurring Catastrophic Health Expenditure in India: A Systematic Review and Meta-analysis Research Protocol
LK01-LK04
Correspondence
Shraddha Bhatia,
7/212, Ground Floor, Sai Leela Apartment, Swaroop Nagar, Kanpur-208002, Uttar Pradesh, India.
E-mail: bhatia10893@gmail.com
Introduction: Globally and at the national level in India, Tuberculosis (TB) programs aim to achieve zero Catastrophic Health Expenditure (CHE) on TB. However, there is evidence through the observational studies reporting CHE incurred by Indian families on TB. Furthermore, the contribution of India to the global TB burden is high both in morbidity and mortality.
Need of the study: A systematic review and meta-analysis will be conducted to estimate the proportion of Indian patients who incur the CHE among Indian TB patients.
Aim: This study aimed to determine the proportion of Indian TB patients incurring CHE, identify factors contributing to CHE among these patients and estimate the mean/median CHE amounts nationally and regionally due to TB in India.
Materials and Methods: Three databases, PubMed, Embase and Scopus, will be used to search for English-language studies reporting the proportion, determinants and mean/median CHE among Indian TB patients. Grey literature will be identified through Google searches and reference screening. Two independent reviewers will screen studies, with disagreements resolved by a senior researcher. Risk of bias will be assessed using the Newcastle-Ottawa Scale (NOS) and the Mixed Methods Appraisal Tool. The review will estimate CHE proportions with 95% confidence intervals and examine predictors, with subgroup, sensitivity and publication bias analyses (I², Egger’s, Begg’s, trim-and-fill). Results will be presented using forest, funnel, Galbraith and leave-one-out plots. Evidence quality will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool.