51
|
Jayanti RP, Long NP, Phat NK, Cho YS, Shin JG. Semi-Automated Therapeutic Drug Monitoring as a Pillar toward Personalized Medicine for Tuberculosis Management. Pharmaceutics 2022; 14:pharmaceutics14050990. [PMID: 35631576 PMCID: PMC9147223 DOI: 10.3390/pharmaceutics14050990] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 12/10/2022] Open
Abstract
Standard tuberculosis (TB) management has failed to control the growing number of drug-resistant TB cases worldwide. Therefore, innovative approaches are required to eradicate TB. Model-informed precision dosing and therapeutic drug monitoring (TDM) have become promising tools for adjusting anti-TB drug doses corresponding with individual pharmacokinetic profiles. These are crucial to improving the treatment outcome of the patients, particularly for those with complex comorbidity and a high risk of treatment failure. Despite the actual benefits of TDM at the bedside, conventional TDM encounters several hurdles related to laborious, time-consuming, and costly processes. Herein, we review the current practice of TDM and discuss the main obstacles that impede it from successful clinical implementation. Moreover, we propose a semi-automated TDM approach to further enhance precision medicine for TB management.
Collapse
Affiliation(s)
- Rannissa Puspita Jayanti
- Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan 47392, Korea; (R.P.J.); (N.P.L.); (N.K.P.); (Y.-S.C.)
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Nguyen Phuoc Long
- Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan 47392, Korea; (R.P.J.); (N.P.L.); (N.K.P.); (Y.-S.C.)
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Nguyen Ky Phat
- Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan 47392, Korea; (R.P.J.); (N.P.L.); (N.K.P.); (Y.-S.C.)
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Yong-Soon Cho
- Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan 47392, Korea; (R.P.J.); (N.P.L.); (N.K.P.); (Y.-S.C.)
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
| | - Jae-Gook Shin
- Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan 47392, Korea; (R.P.J.); (N.P.L.); (N.K.P.); (Y.-S.C.)
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan 47392, Korea
- Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan 47392, Korea
- Correspondence: ; Tel.: +82-51-890-6709; Fax: +82-51-893-1232
| |
Collapse
|
52
|
Gandhi R, Deepak KG, Verma G, Chaubey S, Kumar L, Klinton J, Raj S, Jha P, Vijayan S. Engaging private pharmacies to help end TB in India. Int J Tuberc Lung Dis 2022; 26:457-459. [PMID: 35505482 PMCID: PMC9067430 DOI: 10.5588/ijtld.21.0682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- R Gandhi
- PATH, Mumbai office, Mumbai, India
| | - K G Deepak
- Centre for Health Research and Innovation, Joint Effort for Elimination of TB, New Delhi, India
| | - G Verma
- Centre for Health Research and Innovation, Joint Effort for Elimination of TB, New Delhi, India
| | - S Chaubey
- Centre for Health Research and Innovation, Joint Effort for Elimination of TB, New Delhi, India
| | - L Kumar
- Centre for Health Research and Innovation, Joint Effort for Elimination of TB, New Delhi, India
| | - J Klinton
- McGill International TB Center, TB PPM Learning Network, Montreal, QC, Canada
| | - S Raj
- Centre for Health Research and Innovation, Joint Effort for Elimination of TB, New Delhi, India
| | - P Jha
- PATH, Mumbai office, Mumbai, India
| | | |
Collapse
|
53
|
Rossato Silva1 D, Carvalho de Queiroz Mello2 F, Battista Migliori3,4 G. Effects of COVID-19 on tuberculosis control: past, present, and future. J Bras Pneumol 2022; 48:e20220102. [PMID: 35584470 PMCID: PMC9064613 DOI: 10.36416/1806-3756/e20220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Denise Rossato Silva1
- 1. Faculdade de Medicina, Universidade Federal do Rio Grande do Sul – UFRGS – Porto Alegre (RS) Brasil
| | | | - Giovanni Battista Migliori3,4
- 3. Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri – IRCCS – Tradate, Italia. 4. Blizard Institute, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
54
|
Migliori GB, Thong PM, Alffenaar JW, Denholm J, Tadolini M, Alyaquobi F, Al-Abri S, Blanc FX, Buonsenso D, Chakaya J, Cho JG, Codecasa LR, Danila E, Duarte R, Dukpa R, García-García JM, Gualano G, Kurhasani X, Manika K, Mello FCDQ, Pahl K, Rendon A, Sotgiu G, Souleymane MB, Thomas TA, Tiberi S, Kunst H, Udwadia ZF, Goletti D, Centis R, D’Ambrosio L, Silva DR. Country-specific lockdown measures in response to the COVID-19 pandemic and its impact on tuberculosis control: a global study. J Bras Pneumol 2022; 48:e20220087. [PMID: 35475873 PMCID: PMC9064628 DOI: 10.36416/1806-3756/e20220087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/13/2022] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to describe country-specific lockdown measures and tuberculosis indicators collected during the first year of the COVID-19 pandemic. Data on lockdown/social restrictions (compulsory face masks and hand hygiene; international and local travel restrictions; restrictions to family visits, and school closures) were collected from 24 countries spanning five continents. The majority of the countries implemented multiple lockdowns with partial or full reopening. There was an overall decrease in active tuberculosis, drug-resistant tuberculosis, and latent tuberculosis cases. Although national lockdowns were effective in containing COVID-19 cases, several indicators of tuberculosis were affected during the pandemic.
Collapse
Affiliation(s)
| | - Pei Min Thong
- . National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Jan-Willem Alffenaar
- . The University of Sydney, Pharmacy School, Sydney (NSW) Australia
- . The University of Sidney at Westmead Hospital, Sydney (NSW) Australia
- . Sydney Institute for Infectious Diseases, The University of Sydney, Sydney (NSW) Australia
| | - Justin Denholm
- . Melbourne Health Victorian Tuberculosis Program, Melbourne (VIC) Australia
- . Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne (VIC) Australia
| | - Marina Tadolini
- . Infectious Diseases Unit, Istituti Clinici Scientifici Maugeri - IRCCS - Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italia
- . Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Fatma Alyaquobi
- . TB and Acute Respiratory Diseases Section, Department of Communicable Diseases, Directorate General of Disease Surveillance and Control, National TB Programme, MoH Oman, Muscat, Sultanate of Oman
| | - Seif Al-Abri
- . Directorate General for Disease Surveillance and Control, MoH Oman, Muscat, Sultanate of Oman
| | - François-Xavier Blanc
- . Nantes Université, CHU Nantes, Service de Pneumologie, L’Institut du Thorax, Nantes, France
| | - Danilo Buonsenso
- . Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli - IRCCS - Roma, Italia
| | - Jeremiah Chakaya
- . Department of Medicine, Dermatology and Therapeutics, Kenyatta University, Nairobi, Kenya
- . Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jin-Gun Cho
- . The University of Sidney at Westmead Hospital, Sydney (NSW) Australia
- . Parramatta Chest Clinic, Parramatta (NSW) Australia
| | - Luigi Ruffo Codecasa
- . TB Reference Centre of Villa Marelli Institute, Niguarda Hospital, Milano, Italia
| | - Edvardas Danila
- . Vilnius University Hospital Santaros Kilinkos, Vilinius, Lithuania
| | - Raquel Duarte
- . National Reference Centre for MDR-TB, Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal e Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Rada Dukpa
- . National TB Control Program, Ministry of Health, Timbu, Bhutan
| | - José-María García-García
- . Programa Integrado de Investigación en Tuberculosis - PII-TB - Sociedad Española de Neumología y Cirugía Torácica - SEPAR - Barcelona, España
| | - Gina Gualano
- . Istituto Nazionale per le Malattie Infettive “Lazzaro Spallanzani” - INMI - IRCCS, Roma, Italia
| | - Xhevat Kurhasani
- . UBT - Higher Education Institution, Prishtina, Kosovo
- . NGO KeA, Prishtina, Kosovo
| | - Katerina Manika
- . Pulmonary Department, Aristotle University of Thessaloniki, “G. Papanikolaou” Hospital, Thessaloniki, Greece
| | | | - Kristin Pahl
- . Clinton Health Access Initiative, Phnom Penh, Cambodia
| | - Adrian Rendon
- . Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias -CIPTIR - Hospital Universitario de Monterrey, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Giovanni Sotgiu
- . Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Tania A. Thomas
- . Division of Infectious Diseases and International Health, University of Virginia, Charlottesville (VA) USA
| | - Simon Tiberi
- . Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- . Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Heinke Kunst
- . Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- . Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Zarir F. Udwadia
- . P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - Delia Goletti
- . Istituto Nazionale per le Malattie Infettive “Lazzaro Spallanzani” - INMI - IRCCS, Roma, Italia
| | - Rosella Centis
- . Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia
| | | | - Denise Rossato Silva
- . Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS- Porto Alegre, Brasil
| |
Collapse
|
55
|
Godoy P, Parrón I, Barrabeig I, Caylà JA, Clotet L, Follia N, Carol M, Orcau A, Alsedà M, Ferrús G, Plans P, Jane M, Millet JP, Domínguez A. Impact of the COVID-19 pandemic on contact tracing of patients with pulmonary tuberculosis. Eur J Public Health 2022; 32:643-647. [PMID: 35325093 PMCID: PMC8992232 DOI: 10.1093/eurpub/ckac031] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background The COVID-19 pandemic could have negative effects on tuberculosis (TB) control. The objective was to assess the impact of the pandemic in contact tracing, TB and latent tuberculosis infection (LTBI) in contacts of patients with pulmonary TB in Catalonia (Spain). Methods Contact tracing was carried out in cases of pulmonary TB detected during 14 months in the pre-pandemic period (1 January 2019 to 28 February 2020) and 14 months in the pandemic period (1 March 2020 to 30 April 2021). Contacts received the tuberculin skin test and/or interferon gamma release assay and it was determined whether they had TB or LTBI. Variables associated with TB or LTBI in contacts (study period and sociodemographic variables) were analyzed using adjusted odds ratio (aOR) and the 95% confidence intervals (95% CI). Results The pre-pandemic and pandemic periods showed, respectively: 503 and 255 pulmonary TB reported cases (reduction of 50.7%); and 4676 and 1687 contacts studied (reduction of 36.1%). In these periods, the proportion of TB cases among the contacts was 1.9% (84/4307) and 2.2% (30/1381) (P = 0.608); and the proportion of LTBI was 25.3% (1090/4307) and 29.2% (403/1381) (P < 0.001). The pandemic period was associated to higher LTBI proportion (aOR = 1.3; 95% CI 1.1–1.5), taking into account the effect on LTBI of the other variables studied as sex, age, household contact and migrant status. Conclusions COVID-19 is affecting TB control due to less exhaustive TB and LTBI case detection. An increase in LTBI was observed during the pandemic period. Efforts should be made to improve detection of TB and LTBI among contacts of TB cases.
Collapse
Affiliation(s)
- Pere Godoy
- Agència de Salut Pública Catalunya, Barcelona, Spain.,Institut de Recerca Biomédica de Lleida (IRBLleida), Lleida, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ignasi Parrón
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | | | - Joan A Caylà
- Foundation of the Tuberculosis Research Unit of Barcelona, Barcelona, Spain
| | - Laura Clotet
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Núria Follia
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Monica Carol
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Angels Orcau
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Miquel Alsedà
- Agència de Salut Pública Catalunya, Barcelona, Spain.,Institut de Recerca Biomédica de Lleida (IRBLleida), Lleida, Spain
| | - Gloria Ferrús
- Agència de Salut Pública Catalunya, Barcelona, Spain
| | - Pere Plans
- Agència de Salut Pública Catalunya, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mireia Jane
- Agència de Salut Pública Catalunya, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan-Pau Millet
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Angela Domínguez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | | |
Collapse
|
56
|
Wambua S, Malla L, Mbevi G, Kandiah J, Nwosu AP, Tuti T, Paton C, Wambu B, English M, Okiro EA. Quantifying the indirect impact of COVID-19 pandemic on utilisation of outpatient and immunisation services in Kenya: a longitudinal study using interrupted time series analysis. BMJ Open 2022; 12:e055815. [PMID: 35273053 PMCID: PMC8914407 DOI: 10.1136/bmjopen-2021-055815] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE In this study, we assess the indirect impact of COVID-19 on utilisation of immunisation and outpatient services in Kenya. DESIGN Longitudinal study. SETTING Data were analysed from all healthcare facilities reporting to Kenya's health information system from January 2018 to March 2021. Multiple imputation was used to address missing data, interrupted time series analysis was used to quantify the changes in utilisation of services and sensitivity analysis was carried out to assess robustness of estimates. EXPOSURE OF INTEREST COVID-19 outbreak and associated interventions. OUTCOME MEASURES Monthly attendance to health facilities. We assessed changes in immunisation and various outpatient services nationally. RESULTS Before the first case of COVID-19 and pursuant intervention measures in March 2020, uptake of health services was consistent with historical levels. There was significant drops in attendance (level changes) in April 2020 for overall outpatient visits for under-fives (rate ratio, RR 0.50, 95% CI 0.44 to 0.57), under-fives with pneumonia (RR 0.43, 95% CI 0.38 to 0.47), overall over-five visits (RR 0.65, 95% CI 0.57 to 0.75), over-fives with pneumonia (RR 0.62, 95% CI 0.55 to 0.70), fourth antenatal care visit (RR 0.86, 95% CI 0.80 to 0.93), total hypertension (RR 0.89, 95% CI 0.82 to 0.96), diabetes cases (RR 0.95 95% CI, 0.93 to 0.97) and HIV testing (RR 0.97, 95% CI 0.94 to 0.99). Immunisation services, first antenatal care visits, new cases of hypertension and diabetes were not affected. The post-COVID-19 trend was increasing, with more recent data suggesting reversal of effects and health services reverting to expected levels as of March 2021. CONCLUSION COVID-19 pandemic has had varied indirect effects on utilisation of health services in Kenya. There is need for proactive and targeted interventions to reverse these effects as part of the pandemic's response to avert non-COVID-19 indirect mortality.
Collapse
Affiliation(s)
- Steven Wambua
- Population Health Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Lucas Malla
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - George Mbevi
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Joel Kandiah
- Mathematics Institute, University of Warwick, Coventry, UK
| | - Amen-Patrick Nwosu
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| | - Timothy Tuti
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Chris Paton
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| | - Bernard Wambu
- Division of Neonatal and Child Health, Kenya Ministry of Health, Nairobi, Kenya
| | - Mike English
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| | - Emelda A Okiro
- Population Health Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Oxford Centre for Global Health Research, Oxford, UK
| |
Collapse
|
57
|
Rocha CADO, Santana GBDA, Leal TC, de Paiva JPS, da Silva LF, Santos LG, Nunes BEBR, do Carmo RF, de Souza CDF. Impact of the COVID-19 pandemic on compulsory notification of meningitis during the first wave of the pandemic in Brazil: an ecological study using P-score. SAO PAULO MED J 2022; 140:305-309. [PMID: 35239835 PMCID: PMC9610245 DOI: 10.1590/1516-3180.2021.0732.15092021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/15/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Meningitis is listed as one of the diseases requiring compulsory notification in Brazil. It can affect all age groups and also has no seasonality. Cases can be recorded in all months of the year and in all states of Brazil. Despite its importance, the obligation of immediate notification may have been compromised by the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE To analyze the immediate impact of the COVID-19 pandemic on compulsory notifications of meningitis in Brazil and its states during the first wave of the pandemic. DESIGN AND SETTING This was an ecological study involving all confirmed cases of meningitis in Brazil, in its regions and in its states. METHODS Data for the months from 2015 to 2020 were obtained from the database of the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação, SINAN), in the Department of Informatics of the National Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS). The P-score was used to obtain the percentage change in the numbers of cases reported in 2020. RESULTS A 45.7% reduction in notifications of meningitis in Brazil was observed. Regarding the regions and the states, with the exception of Roraima, all of them showed a negative P-score, with decreasing curves each month. CONCLUSION The pandemic caused a negative impact on meningitis notifications in Brazil.
Collapse
Affiliation(s)
- Carlos Alberto de Oliveira Rocha
- Undergraduate Student, Department of Medicine, Center for Studies on Social and Preventive Medicine, Universidade Federal de Alagoas, Arapiraca (AL), Brazil.
| | - Gibson Barros de Almeida Santana
- Undergraduate Student, Department of Medicine, Center for Studies on Social and Preventive Medicine, Universidade Federal de Alagoas, Arapiraca (AL), Brazil.
| | - Thiago Cavalcanti Leal
- Undergraduate Student, Department of Medicine, Center for Studies on Social and Preventive Medicine, Universidade Federal de Alagoas, Arapiraca (AL), Brazil.
| | - João Paulo Silva de Paiva
- Undergraduate Student, Department of Medicine, Center for Studies on Social and Preventive Medicine, Universidade Federal de Alagoas, Arapiraca (AL), Brazil.
| | - Leonardo Feitosa da Silva
- Undergraduate Student, Department of Medicine, Center for Studies on Social and Preventive Medicine, Universidade Federal de Alagoas, Arapiraca (AL), Brazil.
| | - Lucas Gomes Santos
- Undergraduate Student, Department of Medicine, Center for Studies on Social and Preventive Medicine, Universidade Federal de Alagoas, Arapiraca (AL), Brazil.
| | - Bruno Eduardo Basto Rolim Nunes
- Undergraduate Student, Department of Medicine, Center for Studies on Social and Preventive Medicine, Universidade Federal de Alagoas, Arapiraca (AL), Brazil.
| | - Rodrigo Feliciano do Carmo
- PhD. Adjunct Professor, College of Pharmaceutical Sciences; and Adjunct Professor, Postgraduate Program on Biosciences, Health and Biological Sciences, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.
| | - Carlos Dornels Freire de Souza
- PhD. Adjunct Professor, Department of Medicine; and Professor, Postgraduate Program on Family Health, Universidade Federal de Alagoas (UFAL), Arapiraca (AL), Brazil.
| |
Collapse
|
58
|
Ramakrishnan S, Beaufils F, De Brandt J, Viney K, Bradley C, Cottin V, Hassan M, Cruz J. European Respiratory Society International Congress 2021: highlights from best-abstract awardees. Breathe (Sheff) 2022; 18:210176. [PMID: 36338250 PMCID: PMC9584552 DOI: 10.1183/20734735.0176-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/11/2022] [Indexed: 12/26/2022] Open
Abstract
This article provides an overview of some of the highlights of the @EuroRespSoc Congress 2021 from the perspective of the best-abstract awardees of the ERS Assemblies @EarlyCareerERS @OrphaLung https://bit.ly/3JCjHYS.
Collapse
Affiliation(s)
- Sanjay Ramakrishnan
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia,These authors contributed equally
| | - Fabien Beaufils
- Univ. Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, INSERM U1045, Bordeaux Imaging Center, Bordeaux, France,CHU Bordeaux, Service d'Exploration Fonctionnelle Respiratoire, Bordeaux, France,These authors contributed equally
| | - Jana De Brandt
- Faculty of Rehabilitation Sciences, Rehabilitation Research Center REVAL, Biomedical Research Institute BIOMED, Hasselt University, Hasselt, Belgium,Faculty of Medicine, Dept of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden,These authors contributed equally
| | - Kerri Viney
- Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland,These authors contributed equally
| | - Claire Bradley
- Leeds Teaching Hospitals, Leeds, UK,These authors contributed equally
| | - Vincent Cottin
- National French Reference Coordinating Center for Rare Pulmonary Diseases, Louis Pradel Hospital and Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, INRAE, member of ERN-LUNG, Lyon, France,These authors contributed equally
| | - Maged Hassan
- Chest Diseases Dept, Alexandria University Faculty of Medicine, Alexandria, Egypt,These authors contributed equally
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal,Corresponding author: Joana Cruz ()
| |
Collapse
|
59
|
Tang HJ, Lai CC, Chao CM. Changing Epidemiology of Respiratory Tract Infection during COVID-19 Pandemic. Antibiotics (Basel) 2022; 11:antibiotics11030315. [PMID: 35326778 PMCID: PMC8944752 DOI: 10.3390/antibiotics11030315] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
The outbreak of COVID-19 has significantly changed the epidemiology of respiratory tract infection in several ways. The implementation of non-pharmaceutical interventions (NPIs) including universal masking, hand hygiene, and social distancing not only resulted in a decline in reported SARS-CoV-2 cases but also contributed to the decline in the non-COVID-19 respiratory tract infection-related hospital utilization. Moreover, it also led to the decreased incidence of previous commonly encountered respiratory pathogens, such as influenza and Streptococcus pneumoniae. Although antimicrobial agents are essential for treating patients with COVID-19 co-infection, the prescribing of antibiotics was significantly higher than the estimated prevalence of bacterial co-infection, which indicated the overuse of antibiotics or unnecessary antibiotic use during the COVID-19 pandemic. Furthermore, inappropriate antimicrobial exposure may drive the selection of drug-resistant microorganisms, and the disruption of infection control in COVID-19 setting measures may result in the spread of multidrug-resistant organisms (MDROs). In conclusion, NPIs could be effective in preventing respiratory tract infection and changing the microbiologic distribution of respiratory pathogens; however, we should continue with epidemiological surveillance to establish updated information, antimicrobial stewardship programs for appropriate use of antibiotic, and infection control prevention interventions to prevent the spread of MDROs during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Hung-Jen Tang
- Department of Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan;
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 710, Taiwan;
| | - Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan 73657, Taiwan
- Correspondence:
| |
Collapse
|
60
|
Scarim CB, Pavan FR. Recent advancement in drug development of nitro(NO 2 )-heterocyclic compounds as lead scaffolds for the treatment of Mycobacterium tuberculosis. Drug Dev Res 2022; 83:842-858. [PMID: 35106801 DOI: 10.1002/ddr.21921] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/26/2021] [Accepted: 01/13/2022] [Indexed: 11/11/2022]
Abstract
Tuberculosis (TB) is an infectious disease caused predominantly by Mycobacterium tuberculosis (Mtb). It was responsible for approximately 1.4 million deaths worldwide in 2019. The lack of new drugs to treat drug-resistant strains is a principal factor for the slow rise in TB infections. Our aim is to aid the development of new TB treatments by describing improvements (last decade, 2011-2021) to nitro(NO2 )-based compounds that have shown activity or pharmacological properties (e.g., anti-proliferative, anti-kinetoplastid) against Mtb. For all compounds, we have included final correlations of minimum inhibitory concentrations against Mtb (H37 Rv).
Collapse
Affiliation(s)
- Cauê Benito Scarim
- Department of Cell and Molecular Biology, University of Mississippi Medical Center (UMMC), Jackson, Mississippi, USA
| | - Fernando Rogério Pavan
- School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
| |
Collapse
|
61
|
|
62
|
Impact of the COVID-19 pandemic on tuberculosis services. Pulmonology 2022; 28:210-219. [PMID: 35219624 PMCID: PMC8818351 DOI: 10.1016/j.pulmoe.2022.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 01/04/2023] Open
Abstract
Background In Portugal, Outpatient Tuberculosis Centres (OTBC) are responsible for the diagnosis, treatment, screening and prevention of tuberculosis (TB), and only severe or resistant cases are hospitalized. Aim To understand how infection control norms and standards were applied and how these centres responded during the pandemic. Method We sent an electronic questionnaire to all coordinators of OTBC. The questionnaire included questions on infection control during the COVID-19 pandemic and evaluation of the functioning of the OTBC in two periods: during the 1st National State of Emergency and after 1 year. Results Thirty-two responses were obtained (52.5%). The infection control norms were globally applied; diagnosis, treatment, and prevention were kept, and contact screening was only affected during the 1st State of Emergency. However, half of the respondents (53.1%) believed that there were diagnostic delays during the 1st State of Emergency, rising to 68.8% after 1 year. Only 31.3% performed Directly Observed Therapy (DOT) in all patients during the 1st State of Emergency, and 59.4% after 1 year. Half the inquiries expected an increase in TB incidence in the near future. Conclusion The pandemic affected OTBC functioning, although the services were kept open; diagnostic delay and DOT appliance were the most affected.
Collapse
|
63
|
Arentz M, Ma J, Zheng P, Vos T, Murray CJL, Kyu HH. The impact of the COVID-19 pandemic and associated suppression measures on the burden of tuberculosis in India. BMC Infect Dis 2022; 22:92. [PMID: 35086472 PMCID: PMC8792515 DOI: 10.1186/s12879-022-07078-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/17/2022] [Indexed: 12/27/2022] Open
Abstract
Background Tuberculosis (TB) is a major cause of death globally. India carries the highest share of the global TB burden. The COVID-19 pandemic has severely impacted diagnosis of TB in India, yet there is limited data on how TB case reporting has changed since the pandemic began and which factors determine differences in case notification. Methods We utilized publicly available data on TB case reporting through the Indian Central TB Division from January 2017 through April of 2021 (prior to the first COVID-19 related lockdown). Using a Poisson model, we estimated seasonal and yearly patterns in TB case notification in India from January 2017 through February 2020 and extended this estimate as the counterfactual expected TB cases notified from March 2020 through April 2021. We characterized the differences in case notification observed and those expected in the absence of the pandemic by State and Territory. We then performed a linear regression to examine the relationship between the logit ratio of reported TB to counterfactual cases and mask use, mobility, daily hospitalizations/100,000 population, and public/total TB case reporting. Results We found 1,320,203 expected cases of TB (95% uncertainty interval (UI) 1,309,612 to 1,330,693) were not reported during the period from March 2020 through April 2021. This represents a 63.3% difference (95% UI 62.8 to 63.8) in reporting. We found that mobility data and average hospital admissions per month per population were correlated with differences in TB case notification, compared to the counterfactual in the absence of the pandemic (p > 0.001). Conclusion There was a large difference between reported TB cases in India and those expected in the absence of the pandemic. This information can help inform the Indian TB program as they consider interventions to accelerate case finding and notification once the pandemic related TB service disruptions improve. Mobility data and hospital admissions are surrogate measures that correlate with a greater difference in reported/expected TB cases and may correlate with a disruption in TB diagnostic services. However, further research is needed to clarify this association and identify other key contributors to gaps in TB case notifications in India. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07078-y.
Collapse
Affiliation(s)
- Matthew Arentz
- Department of Global Health, University of Washington, Seattle, USA.
| | - Jianing Ma
- Institute for Health Metrics and Evaluation, Seattle, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, Seattle, USA.,Department of Health Metrics Sciences, University of Washington, Seattle, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, USA.,Department of Health Metrics Sciences, University of Washington, Seattle, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, Seattle, USA.,Department of Health Metrics Sciences, University of Washington, Seattle, USA
| | - Hmwe H Kyu
- Institute for Health Metrics and Evaluation, Seattle, USA.,Department of Health Metrics Sciences, University of Washington, Seattle, USA
| |
Collapse
|
64
|
Scarim CB, Pavan FR. An overview of sulfonamide-based conjugates: Recent advances for tuberculosis treatment. Drug Dev Res 2022; 83:567-577. [PMID: 35040503 DOI: 10.1002/ddr.21913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/29/2021] [Accepted: 01/04/2022] [Indexed: 11/11/2022]
Abstract
In 2019, tuberculosis (TB) caused approximately 1.4 million deaths around the world. TB is an infectious respiratory disease mainly caused by Mycobacterium tuberculosis. The lack of new drugs to treat drug-resistant strains is a principal factor for the continuous slow rise in TB infections. Sulfonamides are active moieties in various drugs used against several sicknesses, including TB. Our aim is to aid the development of new TB treatments and drugs by describing recent improvements (2011-2021) to sulfonamide-based compounds.
Collapse
Affiliation(s)
- Cauê Benito Scarim
- Department of Cell and Molecular Biology, University of Mississippi Medical Center (UMMC), Jackson, Mississippi, USA
| | - Fernando Rogério Pavan
- School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil
| |
Collapse
|
65
|
Mariani F, Valentini P, Yamba M, Turay AS, Bulubisi H, Moscato U, Raffaelli F, Iodice F, Buonsenso D. Changes in Childhood Immunizations and Intermittent Preventive Malaria Treatment in a Peripheral, Referral Immunization Center During the First 12 Months of COVID-19 Pandemic in Sierra Leone, Western Africa. Front Pediatr 2022; 10:774281. [PMID: 35425724 PMCID: PMC9002134 DOI: 10.3389/fped.2022.774281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 02/21/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND There is increasing evidence that the COVID-19 pandemic disrupted childhood immunization services. However, detailed reports on immunizations and preventive antimalarial prophylactic treatments delivered and how the trends changed in referral centers in low-income countries are still missing. METHODS We performed a retrospective cross-sectional study. Data for vaccinations administered to children <5 years of age, according to the local vaccination schedule, were extracted from the official records of the Kent Community Health Post, Sierra Leone, in the period between April 2019 and March 2021. We compared the vaccinations performed in the first year, considered as a pre-Covid period, with the second year, post-Covid period. Both the period was then divided in four trimester each and the same analysis was operated for each trimester. A Chi-square goodness of fit test was performed to compare the number of vaccinations performed both in the 2 years and in the 8 trimesters. FINDINGS Seven thousand two hundred and eighty-three vaccinations were administered: 4,641 in the period between April 2019 and March 2020 and 2,642 between April 2020 and March 2021. The drop in immunizations performed began as soon as the first cases were described in China. The drops were statistically significant when the first three trimesters of the two study periods were compared, while no statistically significant differences were observed for all the vaccines performed in the 4th trimesters. Vaccines administered at birth (BCG) were less affected compared to booster vaccinations. CONCLUSIONS Immunizations administered in a referral health center in Sierra Leone significantly declined during the pandemic. Although the decline was less pronounced in the last months of the pandemic, we don't think that the small increase would indicate the recovery of previously missed vaccinations. These findings open new public health challenges for the coming years.
Collapse
Affiliation(s)
- Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matilda Yamba
- Bureh Town Community Health Center, Bureh Town, Sierra Leone
| | | | - Hazel Bulubisi
- Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Umberto Moscato
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Raffaelli
- Dipartimento Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Iodice
- Bureh Town Community Health Center, Bureh Town, Sierra Leone.,Neurology Unit, Istituto di Ricovero e Cura a Carattere Scientifico S San Raffaele Pisana, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Rome, Italy.,Bureh Town Community Health Center, Bureh Town, Sierra Leone.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
66
|
The Cavity as a Lasting Abode for Tuberculous Bacilli: An Observational Study. SN COMPREHENSIVE CLINICAL MEDICINE 2022; 4:40. [PMID: 35071986 PMCID: PMC8762190 DOI: 10.1007/s42399-021-01098-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/30/2022]
Abstract
The aim of this study was to determine the factors associated with persistent sputum positivity at the end of 2 months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi. A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi, over 6 months. A sample of 73 consenting, newly diagnosed, smear-positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, BMI, socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at 2 months of treatment with a sputum smear. Data analysis was done on SPSS (Statistical Package for Social Sciences-version 20.0). Rate of sputum positivity after 2 months of anti-tubercular drug treatment was 17.8%. None of the above-mentioned demographic and clinical factors was associated with persistence of sputum positivity except for the presence of CXR cavities, which made it 5.5 times more likely that the patient would remain smear-positive at 2 months (p = 0.035). The finding of chest radiograph cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavorable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and therefore pay particular attention to such patients in terms of stringent monitoring and directly observed treatment short-course (DOTS) provision. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s42399-021-01098-6.
Collapse
|
67
|
Geric C, Saroufim M, Landsman D, Richard J, Benedetti A, Batt J, Brode SK, Ahmad Khan F. Impact of Covid-19 on Tuberculosis Prevention and Treatment in Canada: a multicentre analysis of 10,833 patients. J Infect Dis 2021; 225:1317-1320. [PMID: 34919700 PMCID: PMC8755327 DOI: 10.1093/infdis/jiab608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022] Open
Abstract
We assessed the Covid-19 pandemic's impact on treatment of latent tuberculosis, and of active tuberculosis, at three centres in Montreal and Toronto, using data from 10,833 patients (8685 with latent tuberculosis infection, 2148 with active tuberculosis). Observation periods prior to declarations of Covid-19 public health emergencies ranged from 219 to 744 weeks, and post-declarations, from 28 to 33 weeks. In the latter period, reductions in latent tuberculosis infection treatment initiation rates ranged from 30% to 66%. At two centres, active tuberculosis treatment rates fell by 16% and 29%. In Canada, cornerstone measures for tuberculosis elimination weakened during the Covid-19 pandemic.
Collapse
Affiliation(s)
- Coralie Geric
- McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Mariane Saroufim
- McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - David Landsman
- MAP Center for Urban Health Solution, Li Ka Shing Knowledge Institute, St Michaels Hospital, Unity Health Toronto, Toronto, Canada
| | - Jonathan Richard
- Montreal Chest Institute, McGill University Health Centre, Montreal, Canada
| | - Andrea Benedetti
- McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Jane Batt
- Division of Respirology TB Program and Keenan Research Center for Biomedical Sciences, St Michaels Hospital, Unity Health Toronto, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Sarah K Brode
- Department of Medicine, University of Toronto, Toronto, Canada.,Toronto Western Hospital, University Health Network, Toronto, Canada.,West Park Healthcare Centre, Toronto, Canada
| | - Faiz Ahmad Khan
- McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, Canada.,Montreal Chest Institute, McGill University Health Centre, Montreal, Canada
| |
Collapse
|
68
|
Baral S, Rao A, Twahirwa Rwema JO, Lyons C, Cevik M, Kågesten AE, Diouf D, Sohn AH, Phaswana-Mafuya N, Kamarulzaman A, Millett G, Marcus JL, Mishra S. Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.01.07.21249419. [PMID: 33442703 PMCID: PMC7805463 DOI: 10.1101/2021.01.07.21249419] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. OBJECTIVES We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. METHODS A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from January 1st to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English. RESULTS A total of 1604 published papers and 205 preprints met inclusion criteria, including 8.2% (132/1604) of published studies and 10.2% (21/205) of preprints: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (13/166) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. DISCUSSION COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.
Collapse
Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Amrita Rao
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | | | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, Scotland
| | - Anna E Kågesten
- Department of Global Public Health, Karolinska Institutet, Sweden
| | | | - Annette H Sohn
- TREAT Asia, amfAR, the Foundation for AIDS Research, Bangkok, Thailand
| | - Nancy Phaswana-Mafuya
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg
| | | | | | - Julia L Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Sharmistha Mishra
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada
| |
Collapse
|
69
|
Fekadu G, Jiang X, Yao J, You JHS. Cost-effectiveness of video-observed therapy for ambulatory management of active tuberculosis during the COVID-19 pandemic in a high-income country. Int J Infect Dis 2021; 113:271-278. [PMID: 34688946 PMCID: PMC8530791 DOI: 10.1016/j.ijid.2021.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The coronavirus 2019 (COVID-19) pandemic caused suspension of directly observed therapy (DOT) for patients with active tuberculosis (TB). This study aimed to estimate the outcomes of pandemic-related DOT suspension and the cost-effectiveness of video-observed therapy (VOT) during the pandemic. METHODS A decision-analytic model was constructed to project outcomes of adult patients with active TB from the perspective of a US healthcare provider. Two model-based analyses were conducted: (1) before (with DOT) and during [with self-administered therapy (SAT)] the pandemic; and (2) VOT vs SAT during the pandemic. The primary outcome measures were direct medical costs and disability-adjusted life years (DALYs). RESULTS In the base-case analysis, care during the pandemic (with SAT) increased the cost (by US$285 per patient) and DALYs (by 0.2155 per patient) in comparison with DOT. Care with VOT reduced DALYs (by 0.4870) and costs (by US$1797) in comparison with SAT. On probabilistic sensitivity analysis, care during the pandemic (with SAT) increased DALYs in 100% of 10,000 simulations, and increased costs in 55.52% of instances. Care with VOT reduced DALYs and costs in 99.7% and 68.79% of instances, respectively. The probability of VOT being cost-effective was 99.4% at the willingness-to-pay threshold of 50,000 US$/DALY. CONCLUSION Suspension of DOT during the COVID-19 pandemic worsened treatment outcomes. VOT was found to be a cost-effective option for active TB care in an outpatient setting.
Collapse
Affiliation(s)
- Ginenus Fekadu
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xinchan Jiang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jiaqi Yao
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joyce H S You
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
70
|
Petrone L, Petruccioli E, Vanini V, Cuzzi G, Gualano G, Vittozzi P, Nicastri E, Maffongelli G, Grifoni A, Sette A, Ippolito G, Migliori GB, Palmieri F, Goletti D. Coinfection of tuberculosis and COVID-19 limits the ability to in vitro respond to SARS-CoV-2. Int J Infect Dis 2021; 113 Suppl 1:S82-S87. [PMID: 33713816 PMCID: PMC7944764 DOI: 10.1016/j.ijid.2021.02.090] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The interaction of COVID-19 and tuberculosis (TB) are still poor characterized. Here we evaluated the immune response specific for Micobacterium tuberculosis (Mtb) and SARS-CoV-2 using a whole-blood-based assay-platform in COVID-19 patients either with TB or latent TB infection (LTBI). METHODS We evaluated IFN-γ level in plasma from whole-blood stimulated with Mtb antigens in the Quantiferon-Plus format or with peptides derived from SARS-CoV-2 spike protein, Wuhan-Hu-1 isolate (CD4-S). RESULTS We consecutively enrolled 63 COVID-19, 10 TB-COVID-19 and 11 LTBI-COVID-19 patients. IFN-γ response to Mtb-antigens was significantly associated to TB status and therefore it was higher in TB-COVID-19 and LTBI-COVID-19 patients compared to COVID-19 patients (p ≤ 0.0007). Positive responses against CD4-S were found in 35/63 COVID-19 patients, 7/11 LTBI-COVID-19 and only 2/10 TB-COVID-19 patients. Interestingly, the responders in the TB-COVID-19 group were less compared to COVID-19 and LTBI-COVID-19 groups (p = 0.037 and 0.044, respectively). Moreover, TB-COVID-19 patients showed the lowest quantitative IFN-γ response to CD4-S compared to COVID-19-patients (p = 0.0336) and LTBI-COVID-19 patients (p = 0.0178). CONCLUSIONS Our data demonstrate that COVID-19 patients either TB or LTBI have a low ability to build an immune response to SARS-CoV-2 while retaining the ability to respond to Mtb-specific antigens.
Collapse
Affiliation(s)
- Linda Petrone
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Elisa Petruccioli
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Valentina Vanini
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Gilda Cuzzi
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Pietro Vittozzi
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Emanuele Nicastri
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Gaetano Maffongelli
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Giuseppe Ippolito
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Giovanni Battista Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.
| |
Collapse
|
71
|
Yadav P, Vohra C, Gopalakrishnan M, Garg MK. Integrating health planning and primary care infrastructure for COVID-19 and tuberculosis care in India: Challenges and opportunities. Int J Health Plann Manage 2021; 37:632-642. [PMID: 34820907 PMCID: PMC9015569 DOI: 10.1002/hpm.3393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/08/2021] [Accepted: 11/15/2021] [Indexed: 11/21/2022] Open
Abstract
Tuberculosis (TB) is the leading cause of death from a single infectious agent worldwide. The COVID‐19 pandemic has overburdened healthcare services around the world especially in resource constrained settings. It has shaken already unstable foundation of TB control programs in India and other high burden states. A 25% decline is expected in TB detection while estimates suggest 13% increase in TB deaths due to the impact of the pandemic. However, the significant intersections between the two diseases perhaps offer potential opportunities for consolidating the efforts to tackle both. The widespread implementation and acceptance of universal masking and social distancing in India has helped limit transmission of both diseases. Integrating the capacity building strategies for the two diseases, optimizing the existing the surveillance and monitoring systems which have been achieved over the years will result in a single vertically integrated national program addressing both, rather than multiple parallel program which utilize the already sparse primary care manpower and infrastructure. In this article, we explore the impact of the COVID‐19 pandemic on tuberculosis in India and offer suggestions on how effective health planning can efficiently integrate infrastructure and manpower at primary level to provide care for both COVID‐19 and tuberculosis. Tuberculosis deaths are on the rise for the first time in more than a decade due to the COVID‐19 pandemic. There is an urgent need to evolve an integrated service delivery addressing both diseases. This article highlights the challenges that COVID‐19 has posed for TB care in India. We propose a unified inclusive primary care delivery model which integrates care for both TB and COVID‐19 at the level of surveillance, diagnosis, management, and preventive care. The challenges in implementing this model and possible solutions are discussed.
Collapse
Affiliation(s)
- Prakrati Yadav
- Department of MedicineAll India Institute of Medical SciencesJodhpurIndia
| | - Chirag Vohra
- Department of MedicineAll India Institute of Medical SciencesJodhpurIndia
| | | | | |
Collapse
|
72
|
Garg R, Khurana AK, Khadanga S. The Monster Tuberculosis in India, Impending Epidemic in COVID-19 Era. J Lab Physicians 2021; 14:99-100. [PMID: 36186254 PMCID: PMC9519258 DOI: 10.1055/s-0041-1736479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Rahul Garg
- Section of Infectious Diseases, Department of General Medicine, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India
| | - Alkesh Kumar Khurana
- Department of Pulmonary Medicine & TB, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India
| | - Sagar Khadanga
- Section of Infectious Diseases, Department of General Medicine, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India
| |
Collapse
|
73
|
Tok PSK, Kamarudin N'A, Jamaludin M, Ab Razak MF, Ahmad MAS, Abu Bakar FA, Rosli N, Toha HR. Effect of COVID-19 on tuberculosis notification in Johor Bahru, Malaysia. Infect Dis (Lond) 2021; 54:235-237. [PMID: 34772327 DOI: 10.1080/23744235.2021.2000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Peter Seah Keng Tok
- Johor Bahru District Health Office, Ministry of Health, Johor Bahru, Malaysia.,Institute for Clinical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia.,Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Mazurah Jamaludin
- Johor Bahru District Health Office, Ministry of Health, Johor Bahru, Malaysia
| | | | | | | | - Norli Rosli
- Johor Bahru District Health Office, Ministry of Health, Johor Bahru, Malaysia
| | - Haidar Rizal Toha
- Johor Bahru District Health Office, Ministry of Health, Johor Bahru, Malaysia
| |
Collapse
|
74
|
Tuberculosis and COVID-19 co-infection: description of the global cohort. Eur Respir J 2021; 59:13993003.02538-2021. [PMID: 34764184 PMCID: PMC8588566 DOI: 10.1183/13993003.02538-2021] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023]
Abstract
Background Information on tuberculosis (TB) and coronavirus disease 2019 (COVID-19) is still limited. The aim of this study was to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multicountry register-based cohort with special focus on the determinants of mortality and other outcomes. Methods We enrolled all patients of any age with either active TB or previous TB and COVID-19. 172 centres from 34 countries provided individual data on 767 TB-COVID-19 co-infected patients, (>50% population-based). Results Of 767 patients, 553 (74.0%) out of 747 had TB before COVID-19 (including 234 out of 747 with previous TB), 71 (9.5%) out of 747 had COVID-19 first and 123 (16.5%) out of 747 had both diseases diagnosed within the same week (n=35 (4.6%) on the same day). 85 (11.08%) out of 767 patients died (41 (14.2%) out of 289 in Europe and 44 (9.2%) out of 478 outside Europe; p=0.03): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, one (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, male gender, having more than one comorbidity, diabetes mellitus, cardiovascular disease, chronic respiratory disease, chronic renal disease, presence of key symptoms, invasive ventilation and hospitalisation due to COVID-19. The final multivariable logistic regression model included age, male gender and invasive ventilation as independent contributors to mortality. Conclusion The data suggest that TB and COVID-19 are a “cursed duet” and need immediate attention. TB should be considered a risk factor for severe COVID disease and patients with TB should be prioritised for COVID-19 preventative efforts, including vaccination. High mortality (11%) was observed with COVID-19/TB co-infection associated with older age, male gender and invasive ventilation. Efforts to avoid SARS-CoV-2 infection in TB patients are recommended to prevent excess morbidity and mortality.https://bit.ly/3mSylCK
Collapse
|
75
|
Shaikh N, Pelzer PT, Thysen SM, Roy P, Harris RC, White RG. Impact of COVID-19 Disruptions on Global BCG Coverage and Paediatric TB Mortality: A Modelling Study. Vaccines (Basel) 2021; 9:1228. [PMID: 34835161 PMCID: PMC8624525 DOI: 10.3390/vaccines9111228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
The impact of COVID-19 disruptions on global Bacillus Calmette-Guérin (BCG) coverage and paediatric tuberculosis (TB) mortality is still unknown. To fill this evidence-gap and guide mitigation measures, we estimated the impact of COVID-19 disruptions on global BCG coverage and paediatric TB mortality. First, we used data from multiple sources to estimate COVID-19-disrupted BCG vaccination coverage. Second, using a static mathematical model, we estimated the number of additional paediatric TB deaths in the first 15 years of life due to delayed/missed vaccinations in 14 scenarios-varying in duration of disruption, and magnitude and timing of catch-up. We estimated a 25% reduction in global BCG coverage within the disruption period. The best-case scenario (3-month disruption, 100% catch-up within 3 months) resulted in an additional 886 (0.5%) paediatric TB deaths, and the worst-case scenario (6-month disruption with no catch-up) resulted in an additional 33,074 (17%) deaths. The magnitude of catch-up was found to be the most influential variable in minimising excess paediatric TB mortality. Our results show that ensuring catch-up vaccination of missed children is a critical priority, and delivery of BCG alongside other routine vaccines may be a feasible way to achieve catch-up. Urgent action is required to support countries with recovering vaccination coverages to minimise paediatric deaths.
Collapse
Affiliation(s)
- Nabila Shaikh
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.C.H.); (R.G.W.)
| | - Puck T. Pelzer
- Technical Division, KNCV Tuberculosis, Maanweg 174, 2516 AB The Hague, The Netherlands;
| | - Sanne M. Thysen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, 2004 Frederiksberg, Denmark;
- Bandim Health Project, Apartado 861, Bissau 1004, Guinea-Bissau
| | - Partho Roy
- Immunisation and Countermeasures, National Infection Service, Public Health England, London NW9 5EQ, UK;
| | - Rebecca C. Harris
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.C.H.); (R.G.W.)
- Sanofi Pasteur, South Beach Tower 18-11, Singapore 189767, Singapore
| | - Richard G. White
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.C.H.); (R.G.W.)
| |
Collapse
|
76
|
Oxlade O, den Boon S, Menzies D, Falzon D, Lane MY, Kanchar A, Zignol M, Matteelli A. TB preventive treatment in high- and intermediate-incidence countries: research needs for scale-up. Int J Tuberc Lung Dis 2021; 25:823-831. [PMID: 34615579 DOI: 10.5588/ijtld.21.0293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND: In 2018, the WHO Member States committed to providing TB preventive treatment (TPT) to at least 30 million people by 2022. However, only 6.3 million people had initiated TPT by the end of 2019. Major knowledge gaps and research needs in diagnosis, treatment and the programmatic management of TPT (PMTPT) require to be addressed urgently.METHODS: In September 2019, a group of stakeholders involved in PMTPT in high TB burden countries met to develop an action agenda to support the global expansion of PMTPT.RESULTS: Barriers at the health system level, and priorities for research to overcome these, were identified for each step of the PMTPT cascade. The need for data on TPT financing, gaps and coverage under national health insurance schemes, as well as the need for mathematical and cost-effectiveness modelling of the impact of TPT on TB incidence and mortality were highlighted. Specific research needs were identified for high-risk populations such as household contacts of any age and people living with HIV, as well as other people at risk.CONCLUSIONS: The meeting facilitated agreement on a set of actions needed to ensure that PMTPT continues to expand to achieve the End TB Strategy targets.
Collapse
Affiliation(s)
- O Oxlade
- McGill International TB Centre, Montreal, QC, Canada
| | - S den Boon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - D Menzies
- McGill International TB Centre, Montreal, QC, Canada, McGill University, Montreal, QC, Canada
| | - D Falzon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - M Y Lane
- McGill International TB Centre, Montreal, QC, Canada, McGill University, Montreal, QC, Canada
| | - A Kanchar
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - M Zignol
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - A Matteelli
- WHO Collaborating Centre for TB/HIV co-infection and for TB Elimination Strategy, University of Brescia, Brescia, Italy
| |
Collapse
|
77
|
SARS-Cov-2 and Mycobacterium tuberculosis: A Mini Review. JOURNAL OF CLINICAL AND BASIC RESEARCH 2021. [DOI: 10.52547/jcbr.5.3.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
78
|
Alves A, Aguiar A, Migliori GB, Duarte R. COVID-19 Related Hospital Re-organization and Trends in Tuberculosis Diagnosis and Admissions: Reflections From Portugal. Arch Bronconeumol 2021; 58:S0300-2896(21)00323-9. [PMID: 35312615 PMCID: PMC8464021 DOI: 10.1016/j.arbres.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 01/17/2023]
Affiliation(s)
- Adelaide Alves
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ana Aguiar
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Giovanni Battista Migliori
- Servizio di Epidemiologia e Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Via Roncaccio 16, Tradate, Varese 21049, Italy.
| | - Raquel Duarte
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Unidade de Investigação Clínica da ARS Norte, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS-UP), Porto, Portugal.
| |
Collapse
|
79
|
Teng VYM, Chua YT, Lai EEN, Mukherjee S, Michaels J, Wong CS, Shen L, Leo YS, Young B, Archuleta S, Ong CWM. Lack of latent tuberculosis (TB) screening and delay in anti-retroviral therapy initiation in HIV-TB co-infection: an 11-year study in an intermediate TB-burden country. Int J Infect Dis 2021; 113:178-183. [PMID: 34563709 DOI: 10.1016/j.ijid.2021.09.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To examine the prevalence and characteristics of HIV-tuberculosis (TB) co-infected patients in Singapore, an intermediate TB-burden country. METHODS Retrospective data across 11 years was obtained from the National University Hospital (NUH), a quaternary hospital and the National Centre for Infectious Diseases (NCID), the national HIV center. RESULTS From December 2005 to December 2016, 4015 HIV-infected patients were managed at NUH and NCID, of whom, respectively, 48 and 272 were diagnosed with active TB disease. Only 2 patients (0.6%) were screened for latent TB infection on HIV diagnosis. Mean CD4 count at TB diagnosis was 125.0 ± 153.9 cells/mm3. More patients with HIV diagnosed ≥6 weeks before TB (41%) were associated with CD4 counts >200 cells/mm3 than patients with TB diagnosed ≥6 weeks before HIV (2%). Of 124 (38.6%) HIV-TB patients with CD4 count ≤50 cells/mm3, only 18 (14.2%) started anti-retroviral therapy (ART) in <2 weeks. Of patients with pulmonary TB, 33.5% had normal chest x-ray. CONCLUSIONS Latent TB infection screening in HIV-infected patients is low, and ART initiation is delayed in HIV-TB patients with CD4 ≤50 cells/mm3. Pulmonary TB patients with HIV can be infectious despite normal chest x-ray. Clinical practices can be further improved to benefit HIV-TB patients.
Collapse
Affiliation(s)
- Vannesa Yue May Teng
- Department of Medicine, National University Hospital, National University Health System Singapore.
| | - Yan Ting Chua
- Department of Medicine, National University Hospital, National University Health System Singapore
| | - Eunice En Ni Lai
- Department of Medicine, National University Hospital, National University Health System Singapore
| | - Shilpa Mukherjee
- Department of Medicine, National University Hospital, National University Health System Singapore
| | - Jessica Michaels
- Department of Medicine, National University Hospital, National University Health System Singapore
| | - Chen Seong Wong
- National Centre for Infectious Disease, Singapore; Department of Infectious Disease, Tan Tock Seng Hospital, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore
| | - Yee Sin Leo
- National Centre for Infectious Disease, Singapore; Department of Infectious Disease, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Barnaby Young
- National Centre for Infectious Disease, Singapore; Department of Infectious Disease, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Sophia Archuleta
- Department of Medicine, National University Hospital, National University Health System Singapore; Infectious Disease Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
| | - Catherine W M Ong
- Department of Medicine, National University Hospital, National University Health System Singapore; Infectious Disease Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute for Health Innovation & Technology, National University of Singapore.
| |
Collapse
|
80
|
One year of COVID-19 and its impact on private provider engagement for TB: A rapid assessment of intermediary NGOs in seven high TB burden countries. J Clin Tuberc Other Mycobact Dis 2021; 25:100277. [PMID: 34545343 PMCID: PMC8444472 DOI: 10.1016/j.jctube.2021.100277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The COVID-19 pandemic has impacted health systems and health programs across the world. For tuberculosis (TB), it is predicted to set back progress by at least twelve years. Public private mix (PPM)has made a vital contribution to reach End TB targets with a ten-fold rise in TB notifications from private providers between 2012 and 2019. This is due in large part to the efforts of intermediary agencies, which aggregate demand from private providers. The COVID-19 pandemic has put these gains at risk over the past year. In this rapid assessment, representatives of 15 intermediary agencies from seven countries that are considered the highest priority for PPM in TB care (the Big Seven) share their views on the impact of COVID-19 on their programs, the private providers operating under their PPM schemes, and their private TB clients. All intermediaries reported a drop in TB testing and notifications, and the closure of some private practices. While travel restrictions and the fear of contracting COVID-19 were the main contributing factors, there were also unanticipated expenses for private providers, which were transferred to patients via increased prices. Intermediaries also had their routine activities disrupted and had to shift tasks and budgets to meet the new needs. However, the intermediaries and their partners rapidly adapted, including an increased use of digital tools, patient-centric services, and ancillary support for private providers. Despite many setbacks, the COVID-19 pandemic has underlined the importance of effective private sector engagement. The robust approach to fight COVID-19 has shown the possibilities for ending TB with a similar approach, augmented by the digital revolution around treatment and diagnostics and the push to decentralize health services.
Collapse
|
81
|
Heffernan C, Rowe BH, Long R. Engaging frontline providers: an important key to eliminating tuberculosis in Canada, and other high-income countries. Canadian Journal of Public Health 2021; 112:872-876. [PMID: 34515944 PMCID: PMC8436580 DOI: 10.17269/s41997-021-00556-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/17/2021] [Indexed: 01/14/2023]
Abstract
The greatest human cost of the rapidly moving pandemic of SARS-CoV-2 may be due to its impact on the response to other diseases. One such other disease is tuberculosis (TB). All indications suggest that COVID-19-related diversions of healthcare resources and disruptions to public health programming will exacerbate the slower moving pandemic of TB. This is expected to set back TB elimination efforts by years. This is a prediction that is especially relevant to Canada, which has repeatedly failed to meet pre-set targets for the elimination of TB even before the COVID-19 pandemic began. A collaborative approach to achieve TB elimination, one that engages all care providers, has recently been emphasized by the STOP-TB Partnership. Among TB elimination strategies, frontline providers (e.g., family physicians, emergency room physicians, and others) are well positioned to identify candidates for the treatment of latent TB infection, and make the diagnosis of infection-spreading cases of TB in a timely manner, thereby interrupting forward-moving chains of transmission. Electronic medical records offer the promise of automating these processes. In this commentary, we promote broader engagement of the workforce across multiple sectors of medicine to reduce TB associated morbidity and mortality, interrupt transmission, and shrink the reservoir of latent TB infection.
Collapse
Affiliation(s)
- Courtney Heffernan
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Brian H Rowe
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.,Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Long
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. .,School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
82
|
Mohr-Holland E, Hacking D, Daniels J, Scott V, Mudaly V, Furin J, Pfaff C, Reuter A. Diagnosis patterns for rifampicin-resistant TB after onset of COVID-19. Int J Tuberc Lung Dis 2021; 25:772-775. [PMID: 34802503 PMCID: PMC8412107 DOI: 10.5588/ijtld.21.0340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/11/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- E Mohr-Holland
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa, MSF Southern Africa Medical Unit, Cape Town, South Africa
| | - D Hacking
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - J Daniels
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - V Scott
- City of Cape Town Department of Health, Eastern Area, Cape Town, South Africa
| | - V Mudaly
- Provincial Government of the Western Cape, Cape Town, South Africa
| | - J Furin
- Harvard Medical School, Boston, MA, USA
| | - C Pfaff
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - A Reuter
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| |
Collapse
|
83
|
Szlósarczyk M, Piech R, Milc A, Hubicka U. Fast and Sensitive Voltammetric Method for the Determination of Rifampicin on Renewable Amalgam Film Electrode. SENSORS (BASEL, SWITZERLAND) 2021; 21:5792. [PMID: 34502683 PMCID: PMC8433623 DOI: 10.3390/s21175792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022]
Abstract
In this work, a new sensitive voltammetric method for the determination of rifampicin without time-consuming preconcentration is presented. The objective was to develop a simple, fast and sensitive voltammetric procedure for the analysis of rifampicin in pharmaceutical products. The cyclic renewable mercury film silver-based electrode (Hg(Ag)FE) was applied as a working electrode for this purpose. The optimal conditions for the determination of rifampicin were defined, in terms of the composition of supporting electrolyte (including pH) and instrumental parameters (potential and time of deposition, step potential, pulse height). The method was validated resulting in a satisfactory linearity range of 0.4-250.0 µgmL-1; the limits of detection and quantification are 0.12 µgmL-1 and 0.4 µgmL-1, respectively; and the repeatability of the method expressed as RSD is 4.1% (n = 6) with a surface area of 10.9 mm2. The proposed method was successfully applied in the analysis of rifampicin in simple and composed pharmaceutical formulations.
Collapse
Affiliation(s)
- Marek Szlósarczyk
- Department of Inorganic and Analytical Chemistry, Medical College, Jagiellonian University, Medyczna 9, 30-688 Kraków, Poland; (A.M.); (U.H.)
| | - Robert Piech
- Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059 Kraków, Poland;
| | - Anna Milc
- Department of Inorganic and Analytical Chemistry, Medical College, Jagiellonian University, Medyczna 9, 30-688 Kraków, Poland; (A.M.); (U.H.)
| | - Urszula Hubicka
- Department of Inorganic and Analytical Chemistry, Medical College, Jagiellonian University, Medyczna 9, 30-688 Kraków, Poland; (A.M.); (U.H.)
| |
Collapse
|
84
|
Migliori GB, Thong PM, Alffenaar JW, Denholm J, Tadolini M, Alyaquobi F, Blanc FX, Buonsenso D, Cho JG, Codecasa LR, Danila E, Duarte R, García-García JM, Gualano G, Rendon A, Silva DR, Souleymane MB, Tham SM, Thomas TA, Tiberi S, Udwadia ZF, Goletti D, Centis R, D'Ambrosio L, Sotgiu G, Ong CWM. Gauging the impact of the COVID-19 pandemic on tuberculosis services: a global study. Eur Respir J 2021; 58:13993003.01786-2021. [PMID: 34446465 PMCID: PMC8581650 DOI: 10.1183/13993003.01786-2021] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
The effects of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) disease and TB services emerged in the beginning of 2020 [1, 2]. Epidemiological and clinical studies, including mortality rates of the first cohort of patients with COVID-19 and TB co-infection were described [3, 4]. Several reports from individual countries suggested that the COVID-19 pandemic significantly affected TB services [5–9], including validation by modelling studies [10]. The Global Tuberculosis Network (GTN) reported that the COVID-19 pandemic affected TB services in 33 TB centres from 16 countries in the first 4 months of 2020 [11]. An increased use of telehealth during the COVID-19 pandemic was observed in some TB centres [11]. The major limitations of that study were the short period of observation (January to April 2020 compared to the same period in 2019) and the limited number of variables analysed [11–14]. This global study of 43 TB centres from 19 countries demonstrates the impact of COVID-19 pandemic on TB services. Newly diagnosed TB disease, drug-resistant TB, TB deaths, outpatient clinic attendances and newly diagnosed TB infection were reduced.https://bit.ly/3sdHbfk
Collapse
Affiliation(s)
| | - Pei Min Thong
- Dept of Medicine, Infectious Disease Translational Research Programme, National University of Singapore, Yong Loo Lin School of Medicine, Singapore
| | - Jan-Willem Alffenaar
- The University of Sydney, Pharmacy School, Sydney, Australia.,Westmead Hospital, Sydney, Australia.,Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | - Justin Denholm
- Melbourne Health Victorian Tuberculosis Program, Melbourne, Australia.,Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
| | - Marina Tadolini
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.,Dept of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Fatma Alyaquobi
- TB and Acute Respiratory Diseases Section, Dept of Communicable Diseases, Directorate General of Disease Surveillance and Control, Ministry of Health, Oman
| | | | - Danilo Buonsenso
- Dept of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jin-Gun Cho
- Westmead Hospital, Sydney, Australia.,Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.,Parramatta Chest Clinic, Parramatta, Australia
| | | | - Edvardas Danila
- Clinic of Chest Diseases, Immunology and Allergology, Vilnius University Medical Faculty, Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Raquel Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Dept of Pneumology, Public Health Science and Medical Education Dept, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Gina Gualano
- National Institute for Infectious Diseases (INMI) 'L. Spallanzani' - IRCCS, Rome, Italy
| | - Adrian Rendon
- Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias CIPTIR, University Hospital of Monterrey UANL (Universidad Autonoma de Nuevo Leon) Monterrey, Monterrey, Mexico
| | - Denise Rossato Silva
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brasil
| | | | - Sai Meng Tham
- Division of Infectious Diseases, Dept of Medicine, National University Hospital, Singapore
| | - Tania A Thomas
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Simon Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London, UK.,Royal London Hospital, Barts Health National Health Service Trust, London, UK
| | - Zarir F Udwadia
- P.D. Hinduja National Hospital and Medical research Centre, Mumbai, India
| | - Delia Goletti
- National Institute for Infectious Diseases (INMI) 'L. Spallanzani' - IRCCS, Rome, Italy
| | - Rosella Centis
- Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Catherine W M Ong
- Dept of Medicine, Infectious Disease Translational Research Programme, National University of Singapore, Yong Loo Lin School of Medicine, Singapore .,Division of Infectious Diseases, Dept of Medicine, National University Hospital, Singapore.,National University of Singapore Institute for Health Innovation & Technology (iHealthtech), Singapore
| | | |
Collapse
|
85
|
Affiliation(s)
- K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India; Indian Journal of Tuberculosis, India.
| | - S Matta
- New Delhi Tuberculosis Centre, New Delhi, India
| | - V K Arora
- TB Association of India, India; Indian Journal of Tuberculosis, India
| |
Collapse
|
86
|
Pavlovic JM, Pesut DP, Stosic MB. Influence of the COVID-19 pandemic on the incidence of tuberculosis and influenza. Rev Inst Med Trop Sao Paulo 2021; 63:e53. [PMID: 34190955 PMCID: PMC8231979 DOI: 10.1590/s1678-9946202163053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 12/30/2022] Open
Abstract
We examined whether the COVID-19 pandemic has affected the incidence of
tuberculosis (TB) and influenza in Serbia, a Southeast European country with a
low TB incidence rate and a mandatory BCG vaccination at birth. The first case
of COVID-19 was registered on March 6, 2020. Despite the need for a sudden
adaptation of the health care system, routines of mycobacterial laboratories
have never stopped. In 2020, the number of newly diagnosed TB patients was
significantly lower than expected (p = 0.04), but the number of patients with
influenza increased when compared to 2019. Although many patients with influenza
A H1N1 were observed before the beginning of the COVID-19 pandemic, the
increment of cases could also be a consequence of cases of influenza with
COVID-like symptoms detected thereafter. It may also be attributed to
misclassification of clinical cases that were negative for SARS-CoV-2 and
reported as influenza. Difficulties to seek medical attention because of the
COVID-19 pandemic and possible underreporting are considered as reasons for the
decline in the incidence rate of TB. On the other hand, individual and social
measures to prevent the spread of SARS-CoV-2 such as wearing face masks, social
distancing, lockdown, which were strictly applied to COVID-19 patients, health
care staffs and most of the population, could have hindered TB infections more
than the two viral diseases, which appear to be more contagious. The increased
motivation of the population to protect their health during the COVID-19
pandemic provided an opportunity for their effective education. This is crucial
in further combating TB as a preventable disease.
Collapse
Affiliation(s)
| | - Dragica Petar Pesut
- University of Belgrade, Faculty of Medicine, Internal Medicine Department, Belgrade, Serbia.,University Clinical Center of Serbia, Teaching Hospital of Pulmonology, Belgrade, Serbia
| | - Maja Borivoje Stosic
- Public Health Institute of Serbia "Dr Milan Jovanović Batut", Department of HIV, Hepatitis, STDs and TB, Belgrade, Serbia
| |
Collapse
|
87
|
Knoll KE, Lindeque Z, Adeniji AA, Oosthuizen CB, Lall N, Loots DT. Elucidating the Antimycobacterial Mechanism of Action of Decoquinate Derivative RMB041 Using Metabolomics. Antibiotics (Basel) 2021; 10:693. [PMID: 34200519 PMCID: PMC8228794 DOI: 10.3390/antibiotics10060693] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), still remains one of the leading causes of death from a single infectious agent worldwide. The high prevalence of this disease is mostly ascribed to the rapid development of drug resistance to the current anti-TB drugs, exacerbated by lack of patient adherence due to drug toxicity. The aforementioned highlights the urgent need for new anti-TB compounds with different antimycobacterial mechanisms of action to those currently being used. An N-alkyl quinolone; decoquinate derivative RMB041, has recently shown promising antimicrobial activity against Mtb, while also exhibiting low cytotoxicity and excellent pharmacokinetic characteristics. Its exact mechanism of action, however, is still unknown. Considering this, we used GCxGC-TOFMS and well described metabolomic approaches to analyze and compare the metabolic alterations of Mtb treated with decoquinate derivative RMB041 by comparison to non-treated Mtb controls. The most significantly altered pathways in Mtb treated with this drug include fatty acid metabolism, amino acid metabolism, glycerol metabolism, and the urea cycle. These changes support previous findings suggesting this drug acts primarily on the cell wall and secondarily on the DNA metabolism of Mtb. Additionally, we identified metabolic changes suggesting inhibition of protein synthesis and a state of dormancy.
Collapse
Affiliation(s)
- Kirsten E. Knoll
- Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
| | - Zander Lindeque
- Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
| | - Adetomiwa A. Adeniji
- Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
| | - Carel B. Oosthuizen
- Department of Plant and Soil Sciences, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa; (C.B.O.); (N.L.)
| | - Namrita Lall
- Department of Plant and Soil Sciences, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa; (C.B.O.); (N.L.)
- School of Natural Resources, University of Missouri, Columbia, MO 65211, USA
| | - Du Toit Loots
- Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
| |
Collapse
|
88
|
RICCARDI NICCOLÒ, RODARI PAOLA, DURANTI SILVIA, VILLA SIMONE, ASSANTE LUCAROSARIO, CASTELLOTTI PAOLA, FERRARESE MAURIZIO, MARTINI MARIANO, ZUPPINI TERESA, TESSARI ROBERTO, CALZA CRISTINA, CODECASA LUIGI, BESOZZI GIORGIO, ANGHEBEN ANDREA. How to improve TB outpatient service in a TB low-endemic country during SARS-CoV-2 pandemic. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E50-E52. [PMID: 34622084 PMCID: PMC8452285 DOI: 10.15167/2421-4248/jpmh2021.62.1s3.2008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/17/2021] [Indexed: 11/05/2022]
Abstract
Despite notable progresses in the recent decades, tuberculosis (TB) continues to remain a public health concern even in Europe. TB prevention and care should be people-centred, improving ambulatory models across countries, in order to expand access to diagnosis and treatment for both TB infection and disease. Even more, during emergencies such as the current pandemic, when seeking of TB care has been replaced by the fear of coronavirus disease 2019 (COVID-19), TB patient’s care is fundamental. In this short communication, we document how was possible to implement a TB outpatient service meanwhile a local outbreak of SARS-CoV-2 transmission was ongoing.
Collapse
Affiliation(s)
- NICCOLÒ RICCARDI
- StopTB Italia, Milan, Italy
- Department of Infectious, Tropical Diseases & Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - PAOLA RODARI
- Department of Infectious, Tropical Diseases & Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - SILVIA DURANTI
- StopTB Italia, Milan, Italy
- Department of Infectious, Tropical Diseases & Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - SIMONE VILLA
- StopTB Italia, Milan, Italy
- Centre for Multidisciplinary Research in Health Science, University of Milan, Italy
| | - LUCA ROSARIO ASSANTE
- Division of Pulmonology and Thoracic Endoscopy, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar-Verona, Italy
| | - PAOLA CASTELLOTTI
- StopTB Italia, Milan, Italy
- Regional TB Reference Centre, Istituto Villa Marelli, Niguarda Hospital, Milan, Italy
| | - MAURIZIO FERRARESE
- StopTB Italia, Milan, Italy
- Regional TB Reference Centre, Istituto Villa Marelli, Niguarda Hospital, Milan, Italy
| | - MARIANO MARTINI
- StopTB Italia, Milan, Italy
- Department of Health Sciences, University of Genoa, Italy
- Correspondence: Mariano Martini, Department of Health Sciences, University of Genoa, largo R. Benzi 10 Pad. 3, 16132 Genoa, Italy - Tel./Fax: 010.353.85.02 - E-mail: /
| | - TERESA ZUPPINI
- Service of Hospital Pharmacy, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - ROBERTO TESSARI
- Service of Hospital Pharmacy, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - CRISTINA CALZA
- Service of Hospital Pharmacy, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - LUIGI CODECASA
- StopTB Italia, Milan, Italy
- Regional TB Reference Centre, Istituto Villa Marelli, Niguarda Hospital, Milan, Italy
| | | | - ANDREA ANGHEBEN
- Department of Infectious, Tropical Diseases & Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| |
Collapse
|
89
|
Maurer FP, Shubladze N, Kalmambetova G, Felker I, Kuchukhidze G, Drobniewski F, Yedilbayev A, Ehsani S. Impact of the COVID-19 pandemic on tuberculosis national reference laboratory services in the WHO European Region, March to November 2020. Euro Surveill 2021; 26:2100426. [PMID: 34142651 PMCID: PMC8212594 DOI: 10.2807/1560-7917.es.2021.26.24.2100426] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/17/2021] [Indexed: 12/12/2022] Open
Abstract
We assessed the impact of COVID-19 on diagnostic services for tuberculosis (TB) by national reference laboratories in the WHO European Region. Of 35 laboratories, 30 reported declines in TB sample numbers, amounting up to > 50% of the pre-COVID-19 volumes. Sixteen reported reagent or consumable shortages. Nineteen reallocated ressources to SARS-CoV-2 testing, resulting in an overall increase in workload, largely without a concomitant increase in personnel (n = 14). This poses a risk to meeting the 2025 milestones of the End TB Strategy.
Collapse
Affiliation(s)
- Florian P Maurer
- National and WHO Supranational Reference Laboratory for Mycobacteria, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Natalia Shubladze
- National Reference Laboratory, National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia
| | | | - Irina Felker
- Scientific department, Novosibirsk Tuberculosis Research Institute, Novosibirsk, Russia
| | - Giorgi Kuchukhidze
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Francis Drobniewski
- Infectious Diseases, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Askar Yedilbayev
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Soudeh Ehsani
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| |
Collapse
|
90
|
McQuaid CF, Vassall A, Cohen T, Fiekert K, White RG. The impact of COVID-19 on TB: a review of the data. Int J Tuberc Lung Dis 2021; 25:436-446. [PMID: 34049605 PMCID: PMC8171247 DOI: 10.5588/ijtld.21.0148] [Citation(s) in RCA: 147] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
Early in the COVID-19 pandemic, models predicted hundreds of thousands of additional TB deaths as a result of health service disruption. To date, empirical evidence on the effects of COVID-19 on TB outcomes has been limited. Here we summarise the evidence available at a country level, identifying broad mechanisms by which COVID-19 may modify TB burden and mitigation efforts. From the data, it is clear that there have been substantial disruptions to TB health services and an increase in vulnerability to TB. Evidence for changes in Mycobacterium tuberculosis transmission is limited, and it remains unclear how the resources required and available for the TB response have changed. To advocate for additional funding to mitigate the impact of COVID-19 on the global TB burden, and to efficiently allocate resources for the TB response, requires a significant improvement in the TB data available.
Collapse
Affiliation(s)
- C F McQuaid
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - A Vassall
- Department of Global Health Development, Faculty of Public Health and Policy, LSHTM, London, UK
| | - T Cohen
- Yale School of Public Health, Laboratory of Epidemiology and Public Health, New Haven, CT, USA
| | - K Fiekert
- KNCV Tuberculosefonds, The Hague, the Netherlands
| | - R G White
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| |
Collapse
|
91
|
Vázquez-Temprano N, Ursúa-Díaz MI, Salgado-Barreira Á, Vázquez-Gallardo R, Bastida VT, Anibarro L. [Decline of tuberculosis rates and Covid-19 pandemic. Fact or fiction?]. Arch Bronconeumol 2021; 58:272-274. [PMID: 34092895 PMCID: PMC8168331 DOI: 10.1016/j.arbres.2021.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Nuria Vázquez-Temprano
- Unidad de tuberculosis. Servicio de Medicina Interna. Complexo Hospitalario Universitario de Pontevedra, España
| | - María Isabel Ursúa-Díaz
- Programa gallego de tuberculosis. Dirección General de Salud Pública. Xunta de Galicia, Santiago de Compostela, España.,Grupo de Trabajo del Programa de Prevención y Control de la Tuberculosis de Galicia, España
| | - Ángel Salgado-Barreira
- Unidad de Metodología y Estadística. Instituto de Investigación Sanitaria Galicia Sur, Vigo, España
| | - Rafael Vázquez-Gallardo
- Unidad de tuberculosis. Servicio de Neumología. Complexo Hospitalario Universitario de Vigo, España.,Grupo de Trabajo del Programa de Prevención y Control de la Tuberculosis de Galicia, España
| | - Victoria Túñez Bastida
- Unidad de tuberculosis. Servicio de Medicina Preventiva. Hospital Clínico Universitario de Santiago de Compostela, A Coruña, España.,Grupo de Trabajo del Programa de Prevención y Control de la Tuberculosis de Galicia, España
| | - Luis Anibarro
- Unidad de tuberculosis. Servicio de Medicina Interna. Complexo Hospitalario Universitario de Pontevedra, España.,Grupo de Trabajo del Programa de Prevención y Control de la Tuberculosis de Galicia, España.,Grupo de investigación en Inmunología. Instituto de investigación Sanitaria Galicia Sur, Vigo, España
| | | |
Collapse
|
92
|
Knoll KE, Lindeque Z, Adeniji AA, Oosthuizen CB, Lall N, Loots DT. Elucidating the Antimycobacterial Mechanism of Action of Ciprofloxacin Using Metabolomics. Microorganisms 2021; 9:microorganisms9061158. [PMID: 34071153 PMCID: PMC8228629 DOI: 10.3390/microorganisms9061158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/12/2021] [Accepted: 05/18/2021] [Indexed: 12/21/2022] Open
Abstract
In the interest of developing more effective and safer anti-tuberculosis drugs, we used a GCxGC-TOF-MS metabolomics research approach to investigate and compare the metabolic profiles of Mtb in the presence and absence of ciprofloxacin. The metabolites that best describe the differences between the compared groups were identified as markers characterizing the changes induced by ciprofloxacin. Malic acid was ranked as the most significantly altered metabolite marker induced by ciprofloxacin, indicative of an inhibition of the tricarboxylic acid (TCA) and glyoxylate cycle of Mtb. The altered fatty acid, myo-inositol, and triacylglycerol metabolism seen in this group supports previous observations of ciprofloxacin action on the Mtb cell wall. Furthermore, the altered pentose phosphate intermediates, glycerol metabolism markers, glucose accumulation, as well as the reduction in the glucogenic amino acids specifically, indicate a flux toward DNA (as well as cell wall) repair, also supporting previous findings of DNA damage caused by ciprofloxacin. This study further provides insights useful for designing network whole-system strategies for the identification of possible modes of action of various drugs and possibly adaptations by Mtb resulting in resistance.
Collapse
Affiliation(s)
- Kirsten E. Knoll
- Department of Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
| | - Zander Lindeque
- Department of Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
| | - Adetomiwa A. Adeniji
- Department of Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
| | - Carel B. Oosthuizen
- Department of Plant and Soil Sciences, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa; (C.B.O.); (N.L.)
| | - Namrita Lall
- Department of Plant and Soil Sciences, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa; (C.B.O.); (N.L.)
- School of Natural Resources, University of Missouri, Columbia, MO 65211, USA
| | - Du Toit Loots
- Department of Human Metabolomics, North-West University, Private Bag x6001, Box 269, Potchefstroom 2531, South Africa; (K.E.K.); (Z.L.); (A.A.A.)
- Correspondence: ; Tel.: +27-(0)18-299-1818
| |
Collapse
|
93
|
Wee LE, Goh KCM, Conceicao EP, Tan JBX, Sng LH, Venkatachalam I. Increased detection of pulmonary tuberculosis amongst hospitalised inpatients during the COVID-19 pandemic. Eur Respir J 2021; 57:57/5/2100616. [PMID: 34016605 DOI: 10.1183/13993003.00616-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Liang En Wee
- Dept of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| | | | - Edwin Philip Conceicao
- Dept of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore, Singapore
| | - Jamie Bee Xian Tan
- Dept of Microbiology, Singapore General Hospital, Singapore, Singapore.,Central Tuberculosis Laboratory, Singapore General Hospital, Singapore, Singapore
| | - Li-Hwei Sng
- Central Tuberculosis Laboratory, Singapore General Hospital, Singapore, Singapore
| | - Indumathi Venkatachalam
- Dept of Infectious Diseases, Singapore General Hospital, Singapore, Singapore.,Dept of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
94
|
Zokufa N, Lebelo K, Hacking D, Tabo L, Runeyi P, Malabi N, Sibanda SB, Cassidy T, Makanda G, Norman B, Khuzani S, Furin J, Jonker C, Nkasana B, Scott V, Pfaff C. Community-based TB testing as an essential part of TB recovery plans in the COVID-19 era. Int J Tuberc Lung Dis 2021; 25:406-408. [PMID: 33977911 PMCID: PMC8091909 DOI: 10.5588/ijtld.21.0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- N Zokufa
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - K Lebelo
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - D Hacking
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - L Tabo
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - P Runeyi
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - N Malabi
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - S B Sibanda
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - T Cassidy
- Médecins Sans Frontières, Khayelitsha, South Africa, Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - G Makanda
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - B Norman
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - S Khuzani
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - J Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - C Jonker
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - B Nkasana
- City of Cape Town, Department of Health, Cape Town, South Africa
| | - V Scott
- City of Cape Town, Department of Health, Cape Town, South Africa
| | - C Pfaff
- Médecins Sans Frontières, Khayelitsha, South Africa
| |
Collapse
|
95
|
Furtado I, Aguiar A, Duarte R. Getting back on the road towards tuberculosis elimination: lessons learnt from the COVID-19 pandemic. J Bras Pneumol 2021; 47:e20210123. [PMID: 33950099 PMCID: PMC8332847 DOI: 10.36416/1806-3756/e20210123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Isabel Furtado
- . Serviço de Infeciologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Ana Aguiar
- . EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Raquel Duarte
- . EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,. Unidade de Investigação Clínica da Administração Regional de Saúde Norte, Porto, Portugal.,. Departamento de Ciências de Saúde Pública, Ciências Forenses e Educação Médica, Universidade do Porto, Porto, Portugal.,. Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| |
Collapse
|
96
|
Silva DR, Mello FCDQ, D’Ambrosio L, Centis R, Dalcolmo MP, Migliori GB. Tuberculosis and COVID-19, the new cursed duet: what differs between Brazil and Europe? J Bras Pneumol 2021; 47:e20210044. [PMID: 33950095 PMCID: PMC8332832 DOI: 10.36416/1806-3756/e20210044] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
Abstract
On April 1st, 2020, COVID-19 surpassed tuberculosis regarding the number of deaths per day worldwide. The combination of tuberculosis and COVID-19 has great potential for morbidity and mortality. In addition, the COVID-19 pandemic has had a significant impact on the diagnosis and treatment of tuberculosis. In this review article, we address concurrent tuberculosis and COVID-19, with particular regard to the differences between Brazil and Europe. In addition, we discuss priorities in clinical care, public health, and research.
Collapse
Affiliation(s)
- Denise Rossato Silva
- . Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | | | - Lia D’Ambrosio
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italia
| | - Rosella Centis
- . Blizard Institute, Queen Mary University of London, London, United Kingdom
| | | | - Giovanni Battista Migliori
- . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italia
- . Blizard Institute, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
97
|
Aznar ML, Espinosa-Pereiro J, Saborit N, Jové N, Sánchez Martinez F, Pérez-Recio S, Vitoria A, Sanjoaquin I, Gallardo E, Llenas-García J, Pomar V, García IO, Cacho J, Goncalves De Freitas L, San Martin JV, García Rodriguez JF, Jiménez-Fuentes MÁ, De Souza-Galvao ML, Tórtola T, Zules R, Molina I, Sánchez-Montalvá A. Impact of the COVID-19 pandemic on tuberculosis management in Spain. Int J Infect Dis 2021; 108:300-305. [PMID: 33930543 PMCID: PMC8078060 DOI: 10.1016/j.ijid.2021.04.075] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/22/2022] Open
Abstract
Background The impact of COVID-19 on the diagnosis and management of tuberculosis (TB) patients is unknown. Methods Participating centres completed a structured web-based survey regarding changes to TB patient management during the COVID-19 pandemic. The study also included data from participating centres on patients aged ≥18 diagnosed with TB in 2 periods: March 15 to June 30, 2020 and March 15 to June 30, 2019. Clinical variables and information about patient household contacts were retrospectively collected. Results A total of 7 (70%) TB units reported changes in their usual TB team operations. Across both periods of study, 169 patients were diagnosed with active TB (90 in 2019, 79 in 2020). Patients diagnosed in 2020 showed more frequent bilateral lesions in chest X-ray than patients diagnosed in 2019 (P = 0.004). There was a higher percentage of latent TB infection and active TB among children in households of patients diagnosed in 2020, compared with 2019 (P = 0.001). Conclusions The COVID-19 pandemic has caused substantial changes in TB care. TB patients diagnosed during the COVID-19 pandemic showed more extended pulmonary forms. The increase in latent TB infection and active TB in children of patient households could reflect increased household transmission due to anti-COVID-19 measures.
Collapse
Affiliation(s)
- M L Aznar
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Mycobacteria Infection Study Group (GEIM, Spanish acronym) from Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, Spanish acronym), Spain.
| | - J Espinosa-Pereiro
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Saborit
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Jové
- Unitat Clínica de Tuberculosis, Hospital del Mar, Barcelona, Spain
| | | | - S Pérez-Recio
- Tuberculosis Unit, Service of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - A Vitoria
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - I Sanjoaquin
- Infectious Diseases Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - E Gallardo
- Internal Medicine Department, Hospital Vega Baja-FISABIO Orihuela (Alicante, Spain), Clinical Medicine Department, Miguel Hernández University, Elche, Alicante, Spain
| | - J Llenas-García
- Internal Medicine Department, Hospital Vega Baja-FISABIO Orihuela (Alicante, Spain), Clinical Medicine Department, Miguel Hernández University, Elche, Alicante, Spain
| | - V Pomar
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Av. Sant Antoni Mª Claret, 167, 08025 Barcelona, Spain
| | - I O García
- Microbiology and Infection's Control Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - J Cacho
- Microbiology Department, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
| | | | - J V San Martin
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - J F García Rodriguez
- Infectious Diseases Unit, Complexo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | | | | | - T Tórtola
- Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Zules
- Preventive Medicine and Epidemiology Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Mycobacteria Infection Study Group (GEIM, Spanish acronym) from Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, Spanish acronym), Spain
| |
Collapse
|
98
|
Koshy M, Mische L, Rizza S, Mahmood M, Bedimo R, Bhatia R, El Atrouni W, Curran J, Temesgen Z. Point-of-care program in HIV, tuberculosis, and associated conditions: A virtual global technical assistance platform to strengthen HIV and tuberculosis workforce capacity. J Clin Tuberc Other Mycobact Dis 2021; 23:100238. [PMID: 33997312 PMCID: PMC8102617 DOI: 10.1016/j.jctube.2021.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A global multi-disciplinary faculty was established to work collaboratively and provide virtual technical assistance, using a point-of-care continuing education model, to clinicians across the world engaged in the care of patients with either HIV infection or tuberculosis. Ancillary offerings included live or virtual lectures, case-based conferences, and courses. In spite of the considerable disruption of the program due to the COVID-19 pandemic, we engaged and assisted a substantial number of clinicians across the world and provided meaningful contributions to their continuous professional development and patient care. In light of the ongoing pandemic, virtual technical assistance models such as this should be scaled to continue essential high-quality HIV/TB services.
Collapse
Affiliation(s)
- Maria Koshy
- Internal Medicine, Bridgeport Hospital, Yale New Haven Health, CT, USA
| | | | - Stacey Rizza
- Mayo Clinic Center for Tuberculosis, Mayo Clinic HIV Program, Division of Infectious Diseases, Mayo Clinic, USA
| | - Maryam Mahmood
- Mayo Clinic Center for Tuberculosis, Mayo Clinic HIV Program, Division of Infectious Diseases, Mayo Clinic, USA
| | - Roger Bedimo
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, USA
| | - Ramona Bhatia
- Department of Infectious Diseases, University of Illinois at Chicago, Chicago, IL, USA
| | - Wissam El Atrouni
- The University of Kansas School of Medicine, Division of Infectious Diseases, Kansas City, KS, USA
| | - Jennifer Curran
- Mayo Clinic School of Continuous Professional Development, USA
| | - Zelalem Temesgen
- Mayo Clinic Center for Tuberculosis, Mayo Clinic HIV Program, Division of Infectious Diseases, Mayo Clinic, USA
| |
Collapse
|
99
|
Patients' perceptions regarding multidrug-resistant tuberculosis and barriers to seeking care in a priority city in Brazil during COVID-19 pandemic: A qualitative study. PLoS One 2021; 16:e0249822. [PMID: 33836024 PMCID: PMC8034748 DOI: 10.1371/journal.pone.0249822] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/26/2021] [Indexed: 12/29/2022] Open
Abstract
This study aimed to analyze the discourses of patients who were diagnosed with multidrug-resistant tuberculosis, the perception of why they acquired this health condition and barriers to seeking care in a priority city in Brazil during the COVID-19 pandemic. This was an exploratory qualitative study, which used the theoretical-methodological framework of the Discourse Analysis of French matrix, guided by the Consolidated Criteria for Reporting Qualitative Research. The study was conducted in Ribeirão Preto, São Paulo, Brazil. Seven participants were interviewed who were undergoing treatment at the time of the interview. The analysis of the participants' discourses allowed the emergence of four discursive blocks: (1) impact of the social determinants in the development of multidrug-resistant tuberculosis, (2) barriers to seeking care and difficulties accessing health services, (3) perceptions of the side effects and their impact on multidrug-resistant tuberculosis treatment, and (4) tuberculosis and COVID-19: a necessary dialogue. Through discursive formations, these revealed the determinants of multidrug-resistant tuberculosis. Considering the complexity involved in the dynamics of multidrug-resistant tuberculosis, advancing in terms of equity in health, that is, in reducing unjust differences, is a challenge for public policies, especially at the current moment in Brazil, which is of accentuated economic, political and social crisis. The importance of psychosocial stressors and the lack of social support should also be highlighted as intermediary determinants of health. The study has also shown the situation of COVID-19, which consists of an important barrier for patients seeking care. Many patients reported fear, insecurity and worry with regard to returning to medical appointments, which might contribute to the worsening of tuberculosis in the scenario under study.
Collapse
|
100
|
Zahid A, Iqbal N, Moeen S, Irfan M. Post COVID-19 tuberculosis: An emerging threat of pandemic. Monaldi Arch Chest Dis 2021; 91. [PMID: 33794593 DOI: 10.4081/monaldi.2021.1749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/26/2021] [Indexed: 11/22/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) pandemic has hit the world hard. Millions of people have died due to the infection and several have suffered with what are now known as post COVID-19 squeal. Among these squeals one is immunosuppression which leaves patients prone to severe opportunistic infection. We here report a case of young female who was infected by COVID-19 and later developed cavitary pneumonia which upon investigation turned out to be due to mycobacterium tuberculosis. Through this report we aim to highlight the importance of high index of suspicion for infection like Mycobacterium tuberculosis after COVID-19 infection which developed in a healthy immunocompetent patient.
Collapse
Affiliation(s)
- Aqusa Zahid
- Department of Medicine, Section of Pulmonology and Critical Care, Aga Khan University Hospital, Karachi.
| | - Nousheen Iqbal
- Department of Medicine, Section of Pulmonology and Critical Care, Aga Khan University Hospital, Karachi; Jinnah Medical and Dental College, Karachi .
| | - Sarosh Moeen
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi.
| | - Muhammad Irfan
- Department of Medicine, Section of Pulmonology and Critical Care, Aga Khan University Hospital, Karachi.
| |
Collapse
|