Prevalence of tuberculosis-related chest radiographic abnormalities among individuals with latent tuberculosis infection in Gulf Cooperation Council countries: A systematic review and meta-analysis

Background: Chest radiography is routinely used during latent tuberculosis infection (LTBI) evaluation to exclude active disease. Methods: PubMed and google scholar were searched for studies reporting chest radiographic abnormalities among individuals with LTBI in Gulf Cooperation Council (GCC) countries. Random-effects meta-analyses were conducted to estimate pooled prevalence. Subgroup and meta-regression analyses were performed to explore heterogeneity. Publication bias was assessed funnel plot, Egger's regression and Begg's rank correlation tests. Meta-analysis was performed using OpenMeta Analyst software and Comprehensive meta-analysis version 3. Results: < 0.001). By country, the highest and lowest prevalence estimates were 6.1% in Saudi Arabia and 2.4% in Qatar, respectively. By population group, higher prevalence was observed among kidney transplant recipients 37.1%, while prisoners demonstrated very low prevalence 0.1%. Prevalence was 8.0% in hospitals and 0.1% in prisons. Chest X-ray was the predominant imaging modality (5.6%). Meta-regression identified population group and study setting as significant sources of heterogeneity. Conclusion: Chest radiographic abnormalities occur in a minority of LTBI individuals in GCC countries, with substantial variation across populations and settings.