PRISMA-P-checklist - A protocol for a systematic review and meta-analysis of strategies to quantify or eliminate catastrophic costs due to tuberculosis

Background: The World Health Organization strategy to “End TB” by 2030 includes the milestone of no affected households facing catastrophic costs due to tuberculosis (TB). Costs due to TB are usually defined as catastrophic if they exceed 20% of the pre-disease annual household income. Several countries have conducted national TB cost surveys but strategies to quantify and eliminate catastrophic costs are incompletely defined. Methods: Publications related to strategies to quantify and eliminate catastrophic costs will be identified by searching three electronic databases (PubMed - Medline, Scopus, and Web of Science) together with reference lists from pertinent publications. We will screen eligible studies, extract data, and assess the risk of bias with the quality assessment tool from the National Heart, Lung, and Blood Institute. Discrepancies will be resolved by discussion between the reviewers. If we find sufficient comparable studies quantifying strategies to eliminate catastrophic costs then a meta-analysis will be performed. This systematic review and meta-analysis is registered with the PROSPERO database (CRD42022292410). Conclusion: This systematic review and meta-analysis aims to rigorously assess the evidence for strategies to quantify or eliminate catastrophic costs due to TB.