Drug-resistant tuberculosis case-finding strategies: a scoping review protocol

Background Transmission of drug-resistant tuberculosis (TB) is ongoing, and many households face catastrophic costs when a member is diagnosed and treated for drug-resistant TB. Finding individuals with drug-resistant TB and initiating treatment as early as possible is important to improve patient clinical outcomes and to break the chain of transmission to help control the pandemic. To our knowledge systematic reviews assessing effectiveness, cost-effectiveness, acceptability and feasibility of different drug-resistant TB case-finding strategies to inform research, policy and practice, have not been conducted and it is unknown whether enough research exists to conduct such reviews. It is also unknown whether case-finding strategies are similar for drug-resistant TB and drug-susceptible TB and whether we can draw on findings from drug-susceptible reviews to inform decisions on drug-resistant TB case-finding strategies. Methods The question for our review is: what literature is available on drug-resistant TB case finding and which case-finding strategies are described? We will look at studies that have sought to improve drug-resistant TB case detection. We will search the academic databases of CENTRAL, MEDLINE and EMBASE using no language or date restrictions. We will apply broad criteria for screening titles, abstracts and full text articles. A data extraction form will be developed in excel and applied to all primary research reports to collect standard information on each study. We will provide a narrative report with supporting figures and/or tables to summarize the data. A systems-based logic model, developed from a synthesis of drug-susceptible TB case-finding strategies, will be used as a framework to describe different strategies, resulting pathways and enhancements of pathways. Discussion This scoping review will chart existing literature on drug-resistant TB case finding and identify priority question(s) for a systematic review. It will also describe drug-resistant TB case-finding strategies and how they fit into a model of drug-susceptible TB case-finding pathways. The review will guide further research to inform decisions on drug-resistant TB case finding policy and practice. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This manuscript was produced by H3TB which is part of the EDCTP2 programme supported by the European Union (grant number TMA2018SF-2462). The views and opinions of authors expressed herein do not necessarily state or reflect those of EDCTP. The work is supported jointly by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth & Development Office (FCDO) under the MRC/FCDO Concordat agreement. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: N/A I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes This is a protocol and data have not yet been finalised. * TB : tuberculosis M. tb : Mycobaterium tuberculosis (M. tb) RR : rifampicin-resistant MDR-TB : multidrug-resistant tuberculosis PRISMA-ScR : PRISMA extension for scoping reviews HIV : human immunodeficiency virus PLHIV : people living with human immunodeficiency virus