Background Multidrug-resistant tuberculosis (MDR-TB) threatens to reverse recent reductions in global tuberculosis (TB) incidence. Although children under 15 years of age constitute >25% of the worldwide population, the global incidence of MDR-TB disease in children has never been quantified. Methods Our approach for estimating regional and global annual incidence of MDR-TB in children required development of two models: one to estimate the setting-specific risk of MDR-TB among child TB cases, and a second to estimate the setting-specific incidence of TB disease in children. The model for MDR-TB risk among children with TB required a systematic literature review. We multiplied the setting-specific estimates of MDR-TB risk and TB incidence to estimate regional and global incidence of MDR-TB disease in children in 2010. Findings We identified 3,403 papers, of which 97 studies met inclusion criteria for the systematic review of MDR-TB risk. Thirty-one studies reported the risk of MDR-TB among both children and treatment-naïve adults with TB and were used for evaluating the linear association between MDR-TB risk in these two patient groups. We found that the setting-specific risk of MDR-TB was nearly identical in children and treatment-naïve adults with TB, consistent with the assertion that MDR-TB in both groups reflects the local risk of transmitted MDR-TB. Applying these calculated risks, we estimated that around 1,000,000 (95% Confidence Interval: 938,000 – 1,055,000) children developed TB disease in 2010, among whom 32,000 (95% Confidence Interval: 26,000 – 39,000) had MDR-TB. Interpretation Our estimates highlight a massive detection gap for children with TB and MDR-TB disease. Future estimates can be refined as more and better TB data and new diagnostic tools become available.

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Quality of life (QOL) has been recognized as a crucial domain of outcome in schizophrenia treatment, and yet its determinants are not well understood. Recent meta-analyses suggest that symptoms have only a modest relationship to QOL (Eack SM, Newhill CE. Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis. Schizophr Bull. 2007;33:1225-1237). Individuals with schizophrenia show 1-2 SD deficits on measures of elementary neurocognition, and links between these deficits and objective measures of community functioning (eg, employment and independent living) are well established. While objective measures of community functioning and measures of QOL would appear to be closely related, studies investigating the ability of neurocognitive variables to predict QOL in individuals with schizophrenia have yielded conflicting results. One potential explanation for opposing findings in the schizophrenia literature is the interchangeable use of objective and subjective indices of QOL. This study used quantitative methods of meta-analysis to clarify the relationship between neurocognitive determinants of objective QOL (ie, observable, clinician-rated) and subjective QOL (ie, patient satisfaction) separately in individuals with schizophrenia. A total of 20 studies (10 objective and 10 subjective) consisting of 1615 clients were aggregated from relevant databases. Weighted effect size analysis revealed that there were small-moderate relationships (d ≤ 0.55) between crystallized verbal ability, working memory verbal list learning, processing speed, and executive function and objective indices of QOL. In contrast, results revealed either nonsignificant or inverse relationships for the vast majority of neurocognitive measures and measures of subjective QOL. Moderating variables and implications for future research and treatment development are discussed.