BACKGROUND Directly observed treatment, short-course (DOTS) is the current mainstay to control tuberculosis (TB) worldwide. Context-specific adaptations of DOTS have impending implications in the fight against TB. In Ethiopia, there is a national TB control programme with the goal to eliminate TB, but uneven distribution across lifestyle gradients remains a challenge. Notably, the mobile pastoralist communities in the country are disproportionately left uncovered. The aim of this study was to summarize the evidence base from published literature to guide TB control strategy for mobile pastoralist communities in Ethiopia. MAIN TEXT We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and systematically reviewed articles in seven electronic databases: Excerptra Medical Database, African Journal Online, PubMed, Google Scholar, Centre for Agriculture and Bioscience International Direct, Cochrane Library and Web of Science. The databases were searched from inception to December 31, 2018, with no language restriction. We screened 692 items of which 19 met our inclusion criteria. Using a meta-ethnographic method, we identified six themes: (i) pastoralism in Ethiopia; (ii) pastoralists' livelihood profile; (iii) pastoralists' service utilisation; (iv) pastoralists' knowledge and awareness on TB control services; (v) challenges of TB control in pastoral settings; and (vi) equity disparities affecting pastoralists. Our interpretation triangulates the results across all included studies and shows that TB control activities observed in pastoralist regions of Ethiopia are far fewer than elsewhere in the country. CONCLUSIONS This systematic review and meta-synthesis shows that TB control in Ethiopia does not align well with the pastoralist lifestyle. Inaccessibility and lack of acceptability of TB care are the key bottlenecks to pastoralist TB service provision. Targeting these two parameters holds promise to enhance effectiveness of an intervention.

中文翻译：

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牧民流动对埃塞俄比亚结核病控制的影响：系统评价和综合综合。

背景直接观察治疗，短程（DOTS）是目前世界范围内控制结核病（TB）的主流。DOTS 的特定环境适应对抗击结核病具有迫在眉睫的影响。在埃塞俄比亚，有一个旨在消除结核病的国家结核病控制计划，但生活方式梯度的分布不均仍然是一个挑战。值得注意的是，该国的流动牧民社区被不成比例地暴露在外。本研究的目的是总结已发表文献中的证据基础，以指导埃塞俄比亚流动牧民社区的结核病控制策略。正文 我们遵循系统评价和元分析 (PRISMA) 指南的首选报告项目，并系统评价了七个电子数据库中的文章：Excerptra Medical Database，非洲期刊在线、PubMed、谷歌学术、农业和生物科学中心国际直销、Cochrane 图书馆和 Web of Science。检索数据库的时间为 2018 年 12 月 31 日，没有语言限制。我们筛选了 692 个项目，其中 19 个符合我们的纳入标准。使用元民族志方法，我们确定了六个主题：（i）埃塞俄比亚的畜牧业；(ii) 牧民的生计概况；(iii) 牧民的服务利用；(iv) 牧民对结核病控制服务的了解和认识；(v) 牧区结核病控制的挑战；(vi) 影响牧民的公平差距。我们的解释对所有纳入研究的结果进行了三角测量，并表明在埃塞俄比亚牧区观察到的结核病控制活动远少于该国其他地方。结论 本系统评价和综合综合表明，埃塞俄比亚的结核病控制与牧民生活方式并不相符。结核病护理的不可及性和不可接受性是牧民结核病服务提供的关键瓶颈。针对这两个参数有望提高干预的有效性。