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Ran F, Wang Y, Zhang G, Guo H, Li J, Zhang X, Wu Z, Bi L. Whole-transcriptome sequencing of phagocytes reveals a ceRNA network contributing to natural resistance to tuberculosis infection. Microb Pathog 2024; 192:106681. [PMID: 38754565 DOI: 10.1016/j.micpath.2024.106681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/14/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
Tuberculosis (TB) is a major fatal infectious disease globally, exhibiting high morbidity rates and impacting public health and other socio-economic factors. However, some individuals are resistant to TB infection and are referred to as "Resisters". Resisters remain uninfected even after exposure to high load of Mycobacterium tuberculosis (Mtb). To delineate this further, this study aimed to investigate the factors and mechanisms influencing the Mtb resistance phenotype. We assayed the phagocytic capacity of peripheral blood mononuclear cells (PBMCs) collected from Resisters, patients with latent TB infection (LTBI), and patients with active TB (ATB), following infection with fluorescent Mycobacterium bovis Bacillus Calmette-Guérin (BCG). Phagocytosis was stronger in PBMCs from ATB patients, and comparable in LTBI patients and Resisters. Subsequently, phagocytes were isolated and subjected to whole transcriptome sequencing and small RNA sequencing to analyze transcriptional expression profiles and identify potential targets associated with the resistance phenotype. The results revealed that a total of 277 mRNAs, 589 long non-coding RNAs, 523 circular RNAs, and 35 microRNAs were differentially expressed in Resisters and LTBI patients. Further, the endogenous competitive RNA (ceRNA) network was constructed from differentially expressed genes after screening. Bioinformatics, statistical analysis, and quantitative real-time polymerase chain reaction were used for the identification and validation of potential crucial targets in the ceRNA network. As a result, we obtained a ceRNA network that contributes to the resistance phenotype. TCONS_00034796-F3, ENST00000629441-DDX43, hsa-ATAD3A_0003-CYP17A1, and XR_932996.2-CERS1 may be crucial association pairs for resistance to TB infection. Overall, this study demonstrated that the phagocytic capacity of PBMCs was not a determinant of the resistance phenotype and that some non-coding RNAs could be involved in the natural resistance to TB infection through a ceRNA mechanism.
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Affiliation(s)
- Fanlei Ran
- Key Laboratory of Epigenetic Regulation and Intervention, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China; Guangzhou National Laboratory, Guangzhou, 510005, China
| | - Yaguo Wang
- Key Laboratory of Epigenetic Regulation and Intervention, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China; TB Healthcare Co., Ltd., Foshan, 528300, China
| | - Guoqin Zhang
- Key Laboratory of Epigenetic Regulation and Intervention, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Haiyan Guo
- Department of Geriatrics, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518107, China; Shenzhen Key Laboratory for Systems Medicine in Inflammatory Diseases, School of Medicine, Shenzhen Campus of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518107, China
| | - Jinlong Li
- TB Healthcare Co., Ltd., Foshan, 528300, China
| | - Xilin Zhang
- Foshan Fourth People's Hospital, Foshan, 528000, China.
| | - Zhilong Wu
- Foshan Fourth People's Hospital, Foshan, 528000, China.
| | - Lijun Bi
- Key Laboratory of Epigenetic Regulation and Intervention, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China; Guangzhou National Laboratory, Guangzhou, 510005, China.
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Thomas SM, Muruganantham JK, Veerabathiran R. Meta-analysis of interleukin-10 gene polymorphisms and tuberculosis susceptibility: Insights from recent studies. Hum Antibodies 2024:HAB240024. [PMID: 39031350 DOI: 10.3233/hab-240024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
BACKGROUND Tuberculosis (TB) remains a universal health problem with significant morbidity and mortality. Understanding the genetic factors affecting TB susceptibility is crucial for effective prevention and treatment. Interleukin-10 (IL-10), a regulatory cytokine, may influence TB pathogenesis through genetic variations. METHODS The PubMed, Embase, and Google Scholar databases were searched to find studies on the relationship between IL-10 gene variants and tuberculosis. Relevant studies from 2016 to 2024 were identified through database searches. The selected case-control studies met the inclusion criteria. Software such as Review Manager was used to analyze quantitative data, with statistical significance set at p< 0.05. We calculated odds ratios and their respective confidence intervals to evaluate the associations. RESULTS Nine studies examined IL-10 gene polymorphisms (rs1800871 and rs1800872) in TB susceptibility. The present study did not show a notable association between IL-10 gene polymorphisms and TB among all genetic models (allelic, homozygote, heterozygote, dominant, and recessive). The obtained p-value > 0.05 indicates an insignificant association between both gene polymorphisms of IL-10. An OR-1.13; 95% CI-0.85, 1.50 was obtained for the SNP rs1800871, whereas an OR-1.02; 95% CI-0.75, 1.40 was obtained for the SNP rs1800872. CONCLUSION Our meta-analysis revealed no significant association between IL-10 gene polymorphisms and TB susceptibility, suggesting that these variations may not significantly contribute to TB susceptibility. Further research with a larger sample size and diverse ethnicities is needed to explore additional genetic variations and their implications in TB pathogenesis.
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Banerjee U, Borbora SM, Guha M, Yadav V, Sanjay V, Singh A, Balaji KN, Chandra N. Inhibition of leukotriene-B4 signalling-mediated host response to tuberculosis is a potential mode of adjunctive host-directed therapy. Immunology 2024; 172:392-407. [PMID: 38504502 DOI: 10.1111/imm.13781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/04/2024] [Indexed: 03/21/2024] Open
Abstract
Treatment of tuberculosis (TB) is faced with several challenges including the long treatment duration, drug toxicity and tissue pathology. Host-directed therapy provides promising avenues to find compounds for adjunctively assisting antimycobacterials in the TB treatment regimen, by promoting pathogen eradication or limiting tissue destruction. Eicosanoids are a class of lipid molecules that are potent mediators of inflammation and have been implicated in aspects of the host response against TB. Here, we have explored the blood transcriptome of pulmonary TB patients to understand the activity of leukotriene B4, a pro-inflammatory eicosanoid. Our study shows a significant upregulation in the leukotriene B4 signalling pathway in active TB patients, which is reversed with TB treatment. We have further utilized our in-house network analysis algorithm, ResponseNet, to identify potential downstream signal effectors of leukotriene B4 in TB patients including STAT1/2 and NADPH oxidase at a systemic as well as local level, followed by experimental validation of the same. Finally, we show the potential of inhibiting leukotriene B4 signalling as a mode of adjunctive host-directed therapy against TB. This study provides a new mode of TB treatment along with mechanistic insights which can be further explored in pre-clinical trials.
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Affiliation(s)
- Ushashi Banerjee
- Department of Biochemistry, Indian Institute of Science, Bengaluru, India
| | - Salik Miskat Borbora
- Department of Microbiology and Cell Biology, Indian Institute of Science, Bengaluru, India
| | - Madhura Guha
- Department of Microbiology and Cell Biology, Indian Institute of Science, Bengaluru, India
- Center for Infectious Disease Research, Indian Institute of Science, Bengaluru, India
| | - Vikas Yadav
- Department of Microbiology and Cell Biology, Indian Institute of Science, Bengaluru, India
- Center for Infectious Disease Research, Indian Institute of Science, Bengaluru, India
| | - V Sanjay
- Center for Infectious Disease Research, Indian Institute of Science, Bengaluru, India
| | - Amit Singh
- Department of Microbiology and Cell Biology, Indian Institute of Science, Bengaluru, India
- Center for Infectious Disease Research, Indian Institute of Science, Bengaluru, India
| | | | - Nagasuma Chandra
- Department of Biochemistry, Indian Institute of Science, Bengaluru, India
- Center for Biosystems Science and Engineering, Indian Institute of Science, Bengaluru, India
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Ma Z, Duan S, Wang W, Liu R, Li S, Shang Y, Zhang X, Yuan J, Gao M, Pang Y. Surveillance of close contacts of patients with infectious tuberculosis: a prospective cohort study. Antimicrob Resist Infect Control 2024; 13:59. [PMID: 38853242 PMCID: PMC11163748 DOI: 10.1186/s13756-024-01419-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/02/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND A long-term follow-up of close contacts to monitor their infection status is essential to formulate a promising screening strategy. The study aimed to assess the dynamics of tuberculosis (TB) infection using Interferon-γ release assay (IGRA) and determine risk factors associated with TB infection. METHODS Definite TB patients were interviewed and their household contacts were screened for TB infection by IGRA during 12-month longitudinal investigation. RESULTS We included in our analyses 184 household contacts of 92 index TB patients. 87 individuals (47.3%) in contact group progressed to TB infection, of whom 86 developed into IGRA positive within 24 weeks. Close contacts with a higher age and comorbidities are easier to exhibit TB infection. Analysis showed that risk factors for becoming IGRA-positive individuals included residence, older age, comorbidities, BCG scar and high bacterial load. Contacts with BCG scar had a lower IGRA-positive rate. CONCLUSION IGRA conversion generally occurs within 24 weeks after exposure. The TB transmission happens since subclinical TB stage and the presence of BCG scar is an independent protective factor reducing risk of TB infection among close contacts. Repeated IGRA tests are sensible to conducted among close contacts at 24 weeks after exposure to identify the IGRA-positive individuals.
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Affiliation(s)
- Zichun Ma
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Shujuan Duan
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Wei Wang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Rongmei Liu
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Shanshan Li
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Yuanyuan Shang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Xuxia Zhang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Jinfeng Yuan
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Mengqiu Gao
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China.
| | - Yu Pang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China.
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Kim TH, Krichen M, Ojo S, Alamro MA, Sampedro GA. TSSG-CNN: A Tuberculosis Semantic Segmentation-Guided Model for Detecting and Diagnosis Using the Adaptive Convolutional Neural Network. Diagnostics (Basel) 2024; 14:1174. [PMID: 38893700 PMCID: PMC11172024 DOI: 10.3390/diagnostics14111174] [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: 05/04/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Tuberculosis (TB) is an infectious disease caused by Mycobacterium. It primarily impacts the lungs but can also endanger other organs, such as the renal system, spine, and brain. When an infected individual sneezes, coughs, or speaks, the virus can spread through the air, which contributes to its high contagiousness. The goal is to enhance detection recognition with an X-ray image dataset. This paper proposed a novel approach, named the Tuberculosis Segmentation-Guided Diagnosis Model (TSSG-CNN) for Detecting Tuberculosis, using a combined semantic segmentation and adaptive convolutional neural network (CNN) architecture. The proposed approach is distinguished from most of the previously proposed approaches in that it uses the combination of a deep learning segmentation model with a follow-up classification model based on CNN layers to segment chest X-ray images more precisely as well as to improve the diagnosis of TB. It contrasts with other approaches like ILCM, which is optimized for sequential learning, and explainable AI approaches, which focus on explanations. Moreover, our model is beneficial for the simplified procedure of feature optimization from the perspectives of approach using the Mayfly Algorithm (MA). Other models, including simple CNN, Batch Normalized CNN (BN-CNN), and Dense CNN (DCNN), are also evaluated on this dataset to evaluate the effectiveness of the proposed approach. The performance of the TSSG-CNN model outperformed all the models with an impressive accuracy of 98.75% and an F1 score of 98.70%. The evaluation findings demonstrate how well the deep learning segmentation model works and the potential for further research. The results suggest that this is the most accurate strategy and highlight the potential of the TSSG-CNN Model as a useful technique for precise and early diagnosis of TB.
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Affiliation(s)
- Tae Hoon Kim
- School of Information and Electronic Engineering, Zhejiang University of Science and Technology, No. 318, Hangzhou 310023, China
| | - Moez Krichen
- ReDCAD Laboratory, University of Sfax, Sfax 3038, Tunisia
| | - Stephen Ojo
- Department of Electrical and Computer Engineering, College of Engineering, Anderson University, Anderson, SC 29621, USA;
| | - Meznah A. Alamro
- Department of Information Technology, College of Computer & Information Science, Princess Nourah Bint Abdul Rahman University, Riyadh 11564, Saudi Arabia;
| | - Gabriel Avelino Sampedro
- Faculty of Information and Communication Studies, University of the Philippines Open University, Los Baños 4031, Philippines;
- Gokongwei College of Engineering, De La Salle University, 2401 Taft Ave., Malate, Manila 1004, Philippines
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Barker EN, O'Halloran C, Gunn-Moore DA. Review canine tuberculosis - An emerging concern. Vet J 2024; 305:106111. [PMID: 38604331 DOI: 10.1016/j.tvjl.2024.106111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
Canine mycobacterial disease was first recognised over 100 years ago but is now an emerging concern. All reported cases of tuberculous disease in dogs have been caused by infection with one of three Mycobacterium tuberculosis-complex (MTBC) organisms (M. tuberculosis, Mycobacterium bovis, and Mycobacterium microti). Molecular PCR and interferon-gamma release assays offer alternative or complementary diagnostic pathways to that of specialist culture, which is limited by availability, sensitivity, and the time it takes to get a result. Optimised triple antimicrobial protocols offer an excellent chance of a successful outcome in dogs where treatment can be considered and is attempted. In this review, the clinical presentation, diagnosis, treatment, and prognosis of canine tuberculosis are discussed.
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Affiliation(s)
- Emi N Barker
- Langford Vets, University of Bristol, Langford BS40 5DU, United Kingdom; Bristol Veterinary School, University of Bristol, Langford BS40 5DU, United Kingdom.
| | - Conor O'Halloran
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, United Kingdom
| | - Danièlle A Gunn-Moore
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, United Kingdom
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Su Y, Chang Q, Chen R, Chen Z, Lin J, Fu H, Cao Z, Li L, Liu S. Impact of COVID-19 pandemic responses on tuberculosis incidence: insights from Shantou, China. BMC Public Health 2024; 24:1454. [PMID: 38816699 PMCID: PMC11140913 DOI: 10.1186/s12889-024-18956-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Various measures taken against the COVID-19 pandemic are not only effective in reducing the spread of the disease, but also lead to some unexpected results. This article regarded these measures as an intervention and explored their impact on the incidence of tuberculosis in Shantou, China. METHODS The incidence rate and the surveillance data of tuberculosis from January 1st, 2018 to December 31st, 2021 were provided by the Shantou Tuberculosis Prevention and Control Institute. Data were divided into pre-pandemic period (January 1st, 2018 - December 31st, 2019) and pandemic periods (January 1st, 2020 - December 31st, 2021). The Interrupted Time Series (ITS) was used to analyze the trend of tuberculosis incidence prior to and during the COVID-19 epidemic. RESULTS The results showed that the incidence of tuberculosis cases in Shantou decreased significantly (p < 0.05) during the pandemic as compared to that prior to the pandemic. Among them, the 45-64 age group and the 65 + age group have statistically significant declines. When patients were stratified by occupation, the unemployed and those working in agriculture reduced the most. CONCLUSIONS In response to the pandemic, measures like lockdowns and quarantines seem to have reduced tuberculosis incidence. However, this does not imply a true decrease. Underlying causes for the reduced true incidence need further scrutiny. Findings offer a preliminary exploration of interventions designed for one disease but functioning as unexpected results for another.
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Affiliation(s)
- Yaqian Su
- School of Public Health, Shantou University, 234 Daxue Road, Shantou, 515063, China
| | - Qiaocheng Chang
- School of Public Health, Shantou University, 234 Daxue Road, Shantou, 515063, China
| | - Ruiming Chen
- Shantou Tuberculosis Prevention and Control Institute, Shantou, China
| | - Zhuanghao Chen
- Shantou Tuberculosis Prevention and Control Institute, Shantou, China
| | - Jianxiong Lin
- Shantou Tuberculosis Prevention and Control Institute, Shantou, China
| | - Hui Fu
- Shantou Tuberculosis Prevention and Control Institute, Shantou, China
| | - Zicheng Cao
- School of Public Health, Shantou University, 234 Daxue Road, Shantou, 515063, China
| | - Liping Li
- School of Public Health, Shantou University, 234 Daxue Road, Shantou, 515063, China
| | - Suyang Liu
- School of Public Health, Shantou University, 234 Daxue Road, Shantou, 515063, China.
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AlOsaimi HM, Alshammari MK, Almijlad GK, Alotaibi NM, Alqahtani DA, Alshamrani MM, Shutur TA, Alhazmi MF, Hurubi MA, ALShammari KS, Alzahrani KM, Aldaghriri HM, Alshammari AA, Alatawi OS, Alharbi RA. Prevalence, Clinical Characteristics and Determinants of Unsuccessful Treatment Outcomes Among Pulmonary Tuberculosis Patients: A 5-Year Registry-Based Retrospective Cohort Study. Patient Relat Outcome Meas 2024; 15:187-198. [PMID: 38803383 PMCID: PMC11129759 DOI: 10.2147/prom.s463396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose Despite the existence of effective medications, pulmonary tuberculosis (PTB) remains a significant global public health concern, The evaluation and feedback of national TB control programs are crucial, requiring diligent monitoring of TB treatment outcomes and analysis of the factors influencing these outcomes. This study aims to provide valuable insights into the challenges faced by TB patients, which can inform better strategies for treatment and management in the future. Patients and Methods We conducted a study in King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia (KSA), from January 1, 2018 to December 31, 2023. The study was a registry-based retrospective cohort study. Patients' data were sourced from the National Tuberculosis Registry database of Saudi Arabia. Treatment outcomes were determined as either success or failure, considering clinical evaluation, changes in chest X-rays, and the results of subsequent sputum examinations during follow-up. To evaluate the data, SPSS version 28.0 was used. Results A total of 427 PTB patients participated in the study. The results show successful treatment outcomes among 88.5% of patients. Among the patients, males exhibited a higher likelihood of treatment failure as compared to females (aOR 1.3; 95%Cl 1.2-1.5, p < 0.001). Patients with positive sputum smear (aOR 1.3; 95%Cl 1.1-1.3 p < 0.00) and the presence of cough were associated with an increased risk of treatment failure (aOR1.5; 95%Cl 1.1-1.4, p < 0.001). Conclusion This study shows that the percentage of unsuccessful treatment outcomes is high, ie, 11.5%, due to patients' deaths and loss to follow-up. Enhanced supervision and treatment monitoring for tuberculosis patients at high risk of treatment failure can lead to improved treatment success rates in Saudi Arabia.
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Affiliation(s)
- Hind M AlOsaimi
- Department of Pharmacy Services Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed K Alshammari
- Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ghadah K Almijlad
- Department of Clinical Pharmacy, Northern Border University, Rafha, Kingdom of Saudi Arabia
| | - Nawaf M Alotaibi
- Department of Clinical Pharmacy, Northern Border University, Rafha, Kingdom of Saudi Arabia
| | - Dhafer A Alqahtani
- Department of Pharmacy, Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed M Alshamrani
- Department of Respiratory Care, Northern Armed Area Forced Hospital, Hafar al Batin, Kingdom of Saudi Arabia
| | - Tariq A Shutur
- Department of Supply and Logistics, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia
| | - Mansior F Alhazmi
- Department of Supply and Logistics, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia
| | - Mohammed A Hurubi
- Department of Supply and Logistics, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia
| | - Kutayd S ALShammari
- Department of Supply and Logistics, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia
| | - Khalid M Alzahrani
- Department of Radiology, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia
| | - Hadeel M Aldaghriri
- Department of Radiology, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia
| | - Anood A Alshammari
- Pharmaceutical Services Department, Northern Area Armed Forces Hospital, King Khalid Military, Hafr Al Batin, Kingdom of Saudi Arabia
| | - Oudah S Alatawi
- Pharmaceutical Services Department, Northern Area Armed Forces Hospital, King Khalid Military, Hafr Al Batin, Kingdom of Saudi Arabia
| | - Reema A Alharbi
- Department of Medicine, University of Tabuk, Tabuk, Saudi Arabia
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Chiyaka TL, Nyawo GR, Naidoo C, Moodley S, Clemente JC, Malherbe ST, Warren R, Ku D, Segal LN, Theron G. A novel aerosol collection method shows the cough aeromicrobiome of people with tuberculosis is phylogenetically distinct from respiratory tract specimens. RESEARCH SQUARE 2024:rs.3.rs-4106141. [PMID: 38659922 PMCID: PMC11042404 DOI: 10.21203/rs.3.rs-4106141/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Tuberculosis (TB), a major cause of disease and antimicrobial resistance, is spread via aerosols. Aerosols have diagnostic potential and airborne-microbes other than Mycobacterium tuberculosis complex (MTBC) may influence transmission. We evaluated whether PneumoniaCheck (PMC), a commercial aerosol collection device, captures MTBC and the aeromicrobiome of people with TB. Methods PMC was done in sputum culture-positive people (≥30 forced coughs each, n=16) pre-treatment and PMC air reservoir (bag, corresponding to upper airways) and filter (lower airways) washes underwent Xpert MTB/RIF Ultra (Ultra) and 16S rRNA gene sequencing (sequencing also done on sputum). In a subset (n=6), PMC microbiota (bag, filter) was compared to oral washes and bronchoalveolar lavage fluid (BALF). Findings 54% (7/13) bags and 46% (6/14) filters were Ultra-positive. Sequencing read counts and microbial diversity did not differ across bags, filters, and sputum. However, microbial composition in bags (Sphingobium-, Corynebacterium-, Novosphingobium-enriched) and filters (Mycobacterium-, Sphingobium-, Corynebacterium-enriched) each differed vs. sputum. Furthermore, sequencing only detected Mycobacterium in bags and filters but not sputum. In the subset, bag and filter microbial diversity did not differ vs. oral washes or BALF but microbial composition differed. Bags vs. BALF were Sphingobium-enriched and Mycobacterium-, Streptococcus-, and Anaerosinus-depleted (Anaerosinus also depleted in filters vs. BALF). Compared to BALF, none of the aerosol-enriched taxa were enriched in oral washes or sputum. Interpretation PMC captures aerosols with Ultra-detectable MTBC and MTBC is more detectable in aerosols than sputum by sequencing. The aeromicrobiome is distinct from sputum, oral washes and BALF and contains differentially-enriched lower respiratory tract microbes.
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10
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Dinkele R, Gessner S, Patterson B, McKerry A, Hoosen Z, Vazi A, Seldon R, Koch A, Warner DF, Wood R. Persistent Mycobacterium tuberculosis bioaerosol release in a tuberculosis-endemic setting. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.02.24305196. [PMID: 38633787 PMCID: PMC11023659 DOI: 10.1101/2024.04.02.24305196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Pioneering studies linking symptomatic disease and cough-mediated release of Mycobacterium tuberculosis (Mtb) established the infectious origin of tuberculosis (TB), simultaneously informing the pervasive notion that pathology is a prerequisite for Mtb transmission. Our prior work has challenged this assumption: by sampling TB clinic attendees, we detected equivalent release of Mtb-containing bioaerosols by confirmed TB patients and individuals not receiving a TB diagnosis, and we demonstrated a time-dependent reduction in Mtb bioaerosol positivity during six-months' follow-up, irrespective of anti-TB chemotherapy. Now, by extending bioaerosol sampling to a randomly selected community cohort, we show that Mtb release is common in a TB-endemic setting: of 89 participants, 79.8% (71/89) produced Mtb bioaerosols independently of QuantiFERON-TB Gold status, a standard test for Mtb infection; moreover, during two-months' longitudinal sampling, only 2% (1/50) were serially Mtb bioaerosol negative. These results necessitate a reframing of the prevailing paradigm of Mtb transmission and infection, and may explain the current inability to elucidate Mtb transmission networks in TB-endemic regions.
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Affiliation(s)
- Ryan Dinkele
- UCT Molecular Mycobacteriology Research Unit, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
| | - Sophia Gessner
- UCT Molecular Mycobacteriology Research Unit, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
| | - Benjamin Patterson
- Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, 1105, The Netherlands
| | - Andrea McKerry
- Aerobiology and TB Research Unit, Desmond Tutu Health Foundation, Cape Town, 7925, South Africa
| | - Zeenat Hoosen
- Aerobiology and TB Research Unit, Desmond Tutu Health Foundation, Cape Town, 7925, South Africa
| | - Andiswa Vazi
- Aerobiology and TB Research Unit, Desmond Tutu Health Foundation, Cape Town, 7925, South Africa
| | - Ronnett Seldon
- Aerobiology and TB Research Unit, Desmond Tutu Health Foundation, Cape Town, 7925, South Africa
| | - Anastasia Koch
- UCT Molecular Mycobacteriology Research Unit, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
| | - Digby F. Warner
- UCT Molecular Mycobacteriology Research Unit, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
| | - Robin Wood
- Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa
- Aerobiology and TB Research Unit, Desmond Tutu Health Foundation, Cape Town, 7925, South Africa
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11
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O'Halloran C, Barker EN, Hope JC, Gunn-Moore DA. Canine tuberculosis: A review of 18 new and 565 previously reported confirmed cases. Vet J 2024; 304:106089. [PMID: 38412886 DOI: 10.1016/j.tvjl.2024.106089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/30/2024] [Accepted: 02/23/2024] [Indexed: 02/29/2024]
Abstract
Cases of canine tuberculosis, a zoonotic infection of significant public health significance, are typically only sporadically reported in the literature. For this observational study, case details were collated both retrospectively and prospectively for dogs infected with Mycobacterium tuberculosis-complex (MTBC) organisms. A total of 18 previously unreported cases as well as 565 historically reported confirmed cases were reviewed. A variety of diagnostic techniques were used to make a confirmed diagnosis of tuberculosis (culture, interferon-gamma release assay [IGRA], and PCR). The reference standard for diagnosis is culture; however, this was negative or not attempted in some dogs. Where fully speciated, all cases were caused by infection with one of three MTBC organisms: M. tuberculosis, Mycobacterium bovis, or Mycobacterium microti. This study includes the first documented canine infections with M. microti in the UK. All cases were assigned to one of four clinical groups based on the presenting signs: 44.1% were primarily pulmonary, 14.5% were primarily abdominal, and the remainder were disseminated or miscellaneous. The development of adjunctive tests remains necessary to support early treatment decisions pending reporting of culture for MTBC organisms, which can take weeks to months. Definitive treatment, where attempted, was successful in most cases. Of the 13 dogs treated by the authors with triple combination antimicrobial therapy, a good clinical outcome was seen in 12 (92%) of them.
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Affiliation(s)
- Conor O'Halloran
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG United Kingdom.
| | - Emi N Barker
- Langford Vets, University of Bristol, Langford BS40 5DU, United Kingdom; Bristol Veterinary School, University of Bristol, Langford BS40 5DU, United Kingdom
| | - Jayne C Hope
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG United Kingdom
| | - Danièlle A Gunn-Moore
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG United Kingdom
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12
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Zheng W, Diao NC, Wang Q, Wang CY, Su N, Yin JY, Tian T, Shi K, Du R. Worldwide Swine Tuberculosis-Positive Rate and Associated Risk Factors, 1966-2020: A Systematic Review and Meta-Analysis. Vector Borne Zoonotic Dis 2024; 24:181-195. [PMID: 38306180 DOI: 10.1089/vbz.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024] Open
Abstract
Background: Tuberculosis (TB) is a chronic, zoonotic infectious disease caused by Mycobacterium tuberculosis that infects not only humans but also animals such as pigs, cows, buffaloes, sheep, and goats. Among them, pigs are one of the main food animals in the world. If pigs are infected with M. tuberculosis, meat products will be negatively affected, causing economic losses to the livestock industry. There is currently no systematic epidemiological assessment of swine TB in the world, so it is important to know the prevalence of swine, and these data are currently lacking, so we performed a statistical analysis. Results: We searched 6791 articles and finally included data from 35,303 pigs from 15 countries or territories, showing a combined prevalence of TB in pigs of 12.1% (95% confidence interval [CI]: 9.2 to 15.9). Among them, the prevalence rate of swine TB in Europe was 15.2% (95% CI: 11.1 to 20.7, 2491/25,050), which was higher compared with other continents, and the difference was significant; the positive rate of PCR method was higher in the detection method subgroup, which was 15.7% (95% CI: 8.0 to 31.0, 376/2261); Mycobacterium bovis was detected in pigs in the M. tuberculosis typing group (9.5%, 95% CI: 6.7 to 13.5, 1364/21,430). The positive rate is higher compared with Mycobacterium capris. Conclusion: This systematic review and meta-analysis is the first to determine the global prevalence of TB in swine herds. Although the seroprevalence of swine TB in this article is very low, the harm of TB cannot be ignored. It is important to take effective control and preventive measures to stop the spread of TB to reduce the impact of diseased pigs on animal husbandry and human health.
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Affiliation(s)
- Wei Zheng
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, P.R. China
| | - Nai-Chao Diao
- College of Chinese Medicine Materials, Jilin Agricultural University, Changchun, P.R. China
| | - Qi Wang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, P.R. China
| | - Chun-Yu Wang
- Jilin Heyuan Bioengineering Co., Ltd., Songyuan, P.R. China
| | - Nuo Su
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, P.R. China
| | - Ji-Ying Yin
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, P.R. China
| | - Tian Tian
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, P.R. China
| | - Kun Shi
- College of Chinese Medicine Materials, Jilin Agricultural University, Changchun, P.R. China
| | - Rui Du
- College of Chinese Medicine Materials, Jilin Agricultural University, Changchun, P.R. China
- Laboratory of Production and Product Application of Sika Deer of Jilin Province, Jilin Agricultural University, Changchun, P.R. China
- Key Lab of Animal Production, Product Quality and Security, Ministry of Education, Jilin Agricultural University, Changchun, P.R. China
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13
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Horne D, Nduba V, Njagi L, Murithi W, Mwongera Z, Logioia G, Peterson G, Segnitz RM, Fennelly K, Hawn T. Tuberculosis Infectiousness is Associated with Distinct Clinical and Inflammatory Profiles. RESEARCH SQUARE 2024:rs.3.rs-3722244. [PMID: 38328225 PMCID: PMC10849670 DOI: 10.21203/rs.3.rs-3722244/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Interrupting transmission events to prevent new acquisition of infection and disease is a critical part of tuberculosis (TB) control efforts. However, knowledge gaps in understanding the biology and determinants of TB transmission, including poor estimates of individual infectiousness and the lack of accurate and convenient biomarkers, undermine efforts to develop interventions. Cough-generated aerosol cultures have been found to predict TB transmission better than any microbiological or clinical markers in cohorts from Uganda and Brazil. We hypothesized that highly infectious individuals with pulmonary TB (defined as positive for cough aerosol cultures) have elevated inflammatory markers and unique transcriptional profiles compared to less infectious individuals (negative for cough aerosol cultures). We performed a prospective, longitudinal study using a cough aerosol sampling system as in other studies. We enrolled 142 participants with treatment-naïve pulmonary TB in Nairobi, Kenya, and assessed the association of clinical, microbiologic, and immunologic characteristics with Mtb aerosolization and transmission in 143 household members. Contacts of the forty-three aerosol culture-positive participants (30%) were more likely to have a positive IGRA (85% vs 53%, P = 0.005) and a higher median IGRA IFNγ level (P < 0.001, median 4.25 IU/ml (0.90-5.91) vs. 0.71 (0.01-3.56)) compared to aerosol culture-negative individuals. We found that higher bacillary burden, younger age, and larger mean upper arm circumference were associated with positive aerosol cultures. In addition, novel host inflammatory profiles, including elevated serum C-reactive protein and sputum cytokines, were associated with aerosol culture status. Notably, we found pre-treatment whole blood transcriptional profiles associated with aerosol culture status, independent of bacillary load. Together, these findings suggest that TB infectiousness is associated with epidemiologic characteristics and inflammatory signatures and that these features may be used to identify highly infectious persons. These results provide new public health tools and insights into TB pathogenesis.
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Affiliation(s)
| | - Videlis Nduba
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute
| | - Lilian Njagi
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute
| | - Wilfred Murithi
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute
| | - Zipporah Mwongera
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute
| | | | | | | | - Kevin Fennelly
- National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH)
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14
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Pentakota P, Rudraraju G, Sripada NR, Mamidgi B, Gottipulla C, Jalukuru C, Palreddy SD, Bhoge NKR, Firmal P, Yechuri V, Jain M, Peddireddi VS, Bhimarasetty DM, Sreenivas S, Prasad K KL, Joshi N, Vijayan S, Turaga S, Avasarala V. Screening COVID-19 by Swaasa AI platform using cough sounds: a cross-sectional study. Sci Rep 2023; 13:18284. [PMID: 37880351 PMCID: PMC10600180 DOI: 10.1038/s41598-023-45104-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023] Open
Abstract
The Advent of Artificial Intelligence (AI) has led to the use of auditory data for detecting various diseases, including COVID-19. SARS-CoV-2 infection has claimed more than six million lives to date and therefore, needs a robust screening technique to control the disease spread. In the present study we created and validated the Swaasa AI platform, which uses the signature cough sound and symptoms presented by patients to screen and prioritize COVID-19 patients. We collected cough data from 234 COVID-19 suspects to validate our Convolutional Neural Network (CNN) architecture and Feedforward Artificial Neural Network (FFANN) (tabular features) based algorithm. The final output from both models was combined to predict the likelihood of having the disease. During the clinical validation phase, our model showed a 75.54% accuracy rate in detecting the likely presence of COVID-19, with 95.45% sensitivity and 73.46% specificity. We conducted pilot testing on 183 presumptive COVID subjects, of which 58 were truly COVID-19 positive, resulting in a Positive Predictive Value of 70.73%. Due to the high cost and technical expertise required for currently available rapid screening methods, there is a need for a cost-effective and remote monitoring tool that can serve as a preliminary screening method for potential COVID-19 subjects. Therefore, Swaasa would be highly beneficial in detecting the disease and could have a significant impact in reducing its spread.
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Affiliation(s)
| | | | | | | | | | - Charan Jalukuru
- Salcit Technologies, Jayabheri Silicon Towers, Hyderabad, India
| | | | | | - Priyanka Firmal
- Salcit Technologies, Jayabheri Silicon Towers, Hyderabad, India
| | - Venkat Yechuri
- Salcit Technologies, Jayabheri Silicon Towers, Hyderabad, India
| | - Manmohan Jain
- Salcit Technologies, Jayabheri Silicon Towers, Hyderabad, India
| | | | | | - S Sreenivas
- Andhra Medical College, Visakhapatnam, India
| | | | | | - Shibu Vijayan
- Qure.Ai Technologies, Oberoi Commerz II, Mumbai, India
| | | | - Vardhan Avasarala
- Otolaryngology - Head and Neck Surgery, Northeast Ohio Medical University, Rootstown, USA
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15
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Pan J, Chang Z, Zhang X, Dong Q, Zhao H, Shi J, Wang G. Research progress of single-cell sequencing in tuberculosis. Front Immunol 2023; 14:1276194. [PMID: 37901241 PMCID: PMC10611525 DOI: 10.3389/fimmu.2023.1276194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023] Open
Abstract
Tuberculosis is a major infectious disease caused by Mycobacterium tuberculosis infection. The pathogenesis and immune mechanism of tuberculosis are not clear, and it is urgent to find new drugs, diagnosis, and treatment targets. A useful tool in the quest to reveal the enigmas related to Mycobacterium tuberculosis infection and disease is the single-cell sequencing technique. By clarifying cell heterogeneity, identifying pathogenic cell groups, and finding key gene targets, the map at the single cell level enables people to better understand the cell diversity of complex organisms and the immune state of hosts during infection. Here, we briefly reviewed the development of single-cell sequencing, and emphasized the different applications and limitations of various technologies. Single-cell sequencing has been widely used in the study of the pathogenesis and immune response of tuberculosis. We review these works summarizing the most influential findings. Combined with the multi-molecular level and multi-dimensional analysis, we aim to deeply understand the blank and potential future development of the research on Mycobacterium tuberculosis infection using single-cell sequencing technology.
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Affiliation(s)
| | | | | | | | | | - Jingwei Shi
- Key Laboratory of Pathobiology Ministry of Education, College of Basic Medical Sciences/China-Japan Union Hospital of Jilin University, Jilin University, Changchun, China
| | - Guoqing Wang
- Key Laboratory of Pathobiology Ministry of Education, College of Basic Medical Sciences/China-Japan Union Hospital of Jilin University, Jilin University, Changchun, China
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16
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He J, Guo X, Pan C, Cheng G, Zheng M, Zi Y, Cui H, Li X. High-output soft-contact fiber-structure triboelectric nanogenerator and its sterilization application. NANOTECHNOLOGY 2023; 34:385403. [PMID: 37339612 DOI: 10.1088/1361-6528/acdfd5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/20/2023] [Indexed: 06/22/2023]
Abstract
Infectious diseases are spreading rapidly with the flow of the world's population, and the prevention of epidemic diseases is particularly important for public and personal health. Therefore, there is an urgent need to develop a simple, efficient and non-toxic method to control the spread of bacteria and viruses. The newly developed triboelectric nanogenerator (TENG) can generate a high voltage, which inhibits bacterial reproduction. However, the output performance is the main factor limiting real-world applications of TENGs. Herein, we report a soft-contact fiber-structure TENG to avoid insufficient friction states and to improve the output, especially at a high rotation speed. Rabbit hair, carbon nanotubes, polyvinylidene difluoride film and paper all contain fiber structures that are used to guarantee soft contact between the friction layers and improve the contact state and abrasion problem. Compared with a direct-contact triboelectric nanogenerator, the outputs of this soft-contact fiber-structure TENG are improved by about 350%. Meanwhile, the open-circuit voltage can be enhanced to 3440 V, which solves the matching problems when driving high-voltage devices. A TENG-driven ultraviolet sterilization system is then developed. The bactericidal rate of this sterilization system can reach 91%, which significantly reduces the risk of disease spread. This work improves a forward-looking strategy to improve the output and service life of the TENG. It also expands the applications of self-powered TENG sterilization systems.
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Affiliation(s)
- Jianwei He
- College of Materials Science and Engineering, Ocean University of China, Qingdao 266100, People's Republic of China
| | - Xuhua Guo
- College of Materials Science and Engineering, Ocean University of China, Qingdao 266100, People's Republic of China
| | - Caofeng Pan
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 101400, People's Republic of China
| | - Gang Cheng
- Key Lab for Special Functional Materials of Ministry of Education, School of Materials Science and Engineering, Henan University, Kaifeng, 475004, People's Republic of China
| | - Mingli Zheng
- Key Lab for Special Functional Materials of Ministry of Education, School of Materials Science and Engineering, Henan University, Kaifeng, 475004, People's Republic of China
| | - Yunlong Zi
- Sustainable Energy and Environment Thrust, Hong Kong University of Science and Technology, Guangzhou, 510000, People's Republic of China
| | - Hongzhi Cui
- College of Materials Science and Engineering, Ocean University of China, Qingdao 266100, People's Republic of China
| | - Xiaoyi Li
- College of Materials Science and Engineering, Ocean University of China, Qingdao 266100, People's Republic of China
- Key Lab for Special Functional Materials of Ministry of Education, School of Materials Science and Engineering, Henan University, Kaifeng, 475004, People's Republic of China
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17
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Avazzadeh Z, Hassani H, Agarwal P, Mehrabi S, Ebadi MJ, Dahaghin MS. An optimization method for studying fractional-order tuberculosis disease model via generalized Laguerre polynomials. Soft comput 2023; 27:9519-9531. [PMID: 37287570 PMCID: PMC10131579 DOI: 10.1007/s00500-023-08086-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 06/09/2023]
Abstract
Tuberculosis (TB) is a deadly contagious disease that affects vital organs of the body, especially the lungs. Although the disease is preventable, there are still concerns about its continued spread. Without effective prevention or appropriate treatment, TB infection can be fatal to humans. This paper presents a fractional-order TB disease (FTBD) model to analyze TB dynamics and a new optimization method to solve it. The method is based on the basis functions of generalized Laguerre polynomials (GLPs) and some new operational matrices of derivatives in the Caputo sense. Finding the optimal solution to the FTBD model is reduced to solving a system of nonlinear algebraic equations with the aid of GLPs using the Lagrange multipliers method. A numerical simulation is also carried out to determine the impact of the presented method on the susceptible, exposed, infected without treatment, infected with treatment, and recovered cases in the population.
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Affiliation(s)
- Z. Avazzadeh
- Department of Mathematical Sciences, University of South Africa, Pretoria, Florida South Africa
| | - H. Hassani
- Department of Mathematics, Anand International College of Engineering, Jaipur, 303012 India
| | - P. Agarwal
- Department of Mathematics, Anand International College of Engineering, Jaipur, 303012 India
| | - S. Mehrabi
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. J. Ebadi
- Department of Mathematics, Chabahar Maritime University, Chabahar, Iran
| | - M. Sh. Dahaghin
- Faculty of Mathematical Sciences, Department of Applied Mathematics, Shahrekord University, Shahrekord, Iran
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18
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Yellapu GD, Rudraraju G, Sripada NR, Mamidgi B, Jalukuru C, Firmal P, Yechuri V, Varanasi S, Peddireddi VS, Bhimarasetty DM, Kanisetti S, Joshi N, Mohapatra P, Pamarthi K. Development and clinical validation of Swaasa AI platform for screening and prioritization of pulmonary TB. Sci Rep 2023; 13:4740. [PMID: 36959347 PMCID: PMC10034902 DOI: 10.1038/s41598-023-31772-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/16/2023] [Indexed: 03/25/2023] Open
Abstract
Acoustic signal analysis has been employed in various medical devices. However, studies involving cough sound analysis to screen the potential pulmonary tuberculosis (PTB) suspects are very few. The main objective of this cross-sectional validation study was to develop and validate the Swaasa AI platform to screen and prioritize at risk patients for PTB based on the signature cough sound as well as symptomatic information provided by the subjects. The voluntary cough sound data was collected at Andhra Medical College-India. An Algorithm based on multimodal convolutional neural network architecture and feedforward artificial neural network (tabular features) was built and validated on a total of 567 subjects, comprising 278 positive and 289 negative PTB cases. The output from these two models was combined to detect the likely presence (positive cases) of PTB. In the clinical validation phase, the AI-model was found to be 86.82% accurate in detecting the likely presence of PTB with 90.36% sensitivity and 84.67% specificity. The pilot testing of model was conducted at a peripheral health care centre, RHC Simhachalam-India on 65 presumptive PTB cases. Out of which, 15 subjects truly turned out to be PTB positive with a positive predictive value of 75%. The validation results obtained from the model are quite encouraging. This platform has the potential to fulfil the unmet need of a cost-effective PTB screening method. It works remotely, presents instantaneous results, and does not require a highly trained operator. Therefore, it could be implemented in various inaccessible, resource-poor parts of the world.
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Affiliation(s)
| | | | | | | | - Charan Jalukuru
- Salcit Technologies, Jayabheri Silicon Towers, Hyderabad, India
| | - Priyanka Firmal
- Salcit Technologies, Jayabheri Silicon Towers, Hyderabad, India
| | - Venkat Yechuri
- Salcit Technologies, Jayabheri Silicon Towers, Hyderabad, India
| | | | | | | | | | - Niranjan Joshi
- Centre for Cellular and Molecular Platforms, Bengaluru, India
| | - Prasant Mohapatra
- Department of Computer Science, University of California, Davis, USA
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19
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Lin EC, Tu HP, Hong CH. Limited effect of reducing pulmonary tuberculosis incidence amid mandatory facial masking for COVID-19. Respir Res 2023; 24:54. [PMID: 36803383 PMCID: PMC9936458 DOI: 10.1186/s12931-023-02365-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 02/11/2023] [Indexed: 02/19/2023] Open
Abstract
Although the incidence and mortality rates associated with tuberculosis (TB) have been decreasing in many countries, TB remains a major public health concern. Obligatory facial masking and reduced health-care capacity because of COVID-19 may substantially influence TB transmission and care. The Global Tuberculosis Report 2021 published by the World Health Organization indicated a TB rebound at the end of 2020, which coincided with the COVID-19 pandemic. We explored this rebound phenomenon in Taiwan by investigating whether TB incidence and mortality are affected by COVID-19 because of their common route of transmission. In addition, we investigated whether the incidence of TB varies across regions with different incidences of COVID-19. Data (2010-2021) regarding annual new cases of TB and multidrug-resistant TB were collected from the Taiwan Centers for Disease Control. TB incidence and mortality were assessed in Taiwan's seven administrative regions. Over the last decade, TB incidence decreased continually, even during 2020 and 2021, the years coinciding with the COVID-19 pandemic. Notably, TB incidence remained high in regions with low COVID-19 incidence. However, the overall decreasing trends of TB incidence and mortality remained unchanged during the pandemic. Facial masking and social distancing may prevent COVID-19 transmission but exhibit limited efficacy in reducing TB transmission. Thus, during health-related policymaking, policymakers must consider TB rebound, even in the post-COVID-19 era.
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Affiliation(s)
- En-Cheng Lin
- grid.415011.00000 0004 0572 9992Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung City, 813414 Taiwan
| | - Hung-Pin Tu
- grid.412019.f0000 0000 9476 5696Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, 807 Taiwan
| | - Chien-Hui Hong
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung City, 813414, Taiwan. .,Department of Dermatology, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, 11221, Taiwan.
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20
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Chalid MT, Puspawaty D, Tahir AM, Najdah H, Massi MN. Tuberculin test versus interferon gamma release assay in pregnant women with household contacts of tuberculosis patients. Int J Mycobacteriol 2022; 11:364-370. [PMID: 36510919 DOI: 10.4103/ijmy.ijmy_112_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Pregnant women who live in tuberculosis (TB)-affected households are more likely to develop latent TB infection (LTBI), which often escapes treatment. This study aims to determine if Interferon-gamma release (IGRA) is reliable in screening for LTBI in pregnant women, compare to the tuberculin skin test (TST). Methods It was a cross-sectional study that involved 60 pregnant women with TB contact history as a proxy for LTBI and 30 pregnant women without contact history. Latent TB was detected using the TST 5 tuberculin units and IGRA using the QuantiFERON Gold Plus TB Test kit (QFT-Plus). The sensitivity and specificity of the two diagnostic methods and the agreement between them were estimated using SPSS version 20.0. Results The sensitivity 95% (95% confidence interval [CI]: 86.08%-98.96%) and specificity 26.7% (95% CI: 12.28%-45.89%) of TST were compared to that of the IGRA with 60% (95% CI: 46.54%-72.44%) and 73.3% (95% CI: 54.11%-87.72%) sensitivity and specificity, respectively in detecting LTBI in pregnancy. Although there was a significant difference (P < 0.05) between TST and IGRA, the agreement was fair (kappa 0.39; 95% CI: 0.24-0.45). Conclusion TST assay is more sensitive than IGRA; however, the specificity of IGRA was superior to the TST method. In this study, a fair agreement of TST and IGRA was observed for detecting latent TB infection in pregnant women with household contact with TB patients.
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Affiliation(s)
- Maisuri Tadjuddin Chalid
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University Hospital, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Dian Puspawaty
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University Hospital, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Andi Mardiah Tahir
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University Hospital, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Hidayah Najdah
- Postgraduate Program, Faculty of Medicine, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Muhammad Nasrum Massi
- Department of Clinical Microbiology, Faculty of Medicine, Hasanuddin University Hospital, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
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21
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Kuan MM. Applying SARIMA, ETS, and hybrid models for prediction of tuberculosis incidence rate in Taiwan. PeerJ 2022; 10:e13117. [PMID: 36164599 PMCID: PMC9508881 DOI: 10.7717/peerj.13117] [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: 04/30/2020] [Accepted: 02/23/2022] [Indexed: 01/12/2023] Open
Abstract
Background Tuberculosis (TB) remained one of the world's most deadly chronic communicable diseases. Future TB incidence prediction is a benefit for intervention options and resource-allocation planning. We aimed to develop rapid univariate prediction models for epidemics forecasting employment. Methods The surveillance data regarding Taiwan monthly TB incidence rates which from January 2005 to June 2017 were utilized for simulation modelling and from July 2017 to December 2020 for model validation. The modeling approaches including the Seasonal Autoregressive Integrated Moving Average (SARIMA), the Exponential Smoothing (ETS), and SARIMA-ETS hybrid algorithms were constructed and compared. The modeling performance of in-sample simulating training sets and pseudo-out-of-sample validating sets were evaluated by metrics of the root mean square error (RMSE), mean absolute percentage error (MAPE), mean absolute error (MAE), and mean absolute scaled error (MASE). Results A total of 191,526 TB cases with a highest incidence rate in 2005 (72.5 per 100,000 person-year) and lowest in 2020 (33.2 per 100,000 person-year), from January-2005 to December-2020 showed a seasonality and steadily declining trend in Taiwan. The monthly incidence rates data were utilized to formulate these forecasting models. Through stepwise screening and assessing of the accuracy metrics, the optimized SARIMA(3,0,0)(2,1,0)12, ETS(A,A,A) and SARIMA-ETS-hybrid models were respectively selected as the candidate models. Regarding the outcome assessment of model performance, the SARIMA-ETS-hybrid model outperformed the ARIMA and ETS in the short term prediction with metrics of RMSE, MAE MAPE, and MASE of 0.084%, 0.067%, 0.646%, and 0.870%, during the pseudo-out-of-sample forecasting period. After projecting ahead to the long term forecasting TB incidence rates, ETS model showed the best performance resulting as a 41.69% (range: 22.1-56.38%) reduction of TB epidemics in 2025 and a 54.48% (range: 33.7-68.7%) reduction in 2030 compared with the 2015 levels. Conclusion This time series modeling might offer us a rapid surveillance tool for facilitating WHO's future TB elimination milestone. Our proposed SARIMA-ETS or ETS model outperformed the SARIMA in predicting less or 12-30 months ahead of epidemics, and all models showed better in short or medium-term forecasting than long-term forecasting.
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22
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Li Q, Ren W, Yuan J, Guo H, Shang Y, Wang W, Pan J, Gao M, Pang Y. Significant difference in Th1/Th2 paradigm induced by tuberculosis-specific antigens between IGRA-positive and IGRA-negative patients. Front Immunol 2022; 13:904308. [PMID: 36119060 PMCID: PMC9471257 DOI: 10.3389/fimmu.2022.904308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
False negative interferon-γ release assay (IGRA) results constitute the major dilemma for the diagnosis of tuberculosis (TB) infections. Herein, we conducted a cohort study to compare the host immunological response to TB-specific antigens between active TB patients with positive and negative IGRA results and control groups. A total of 274 laboratory-confirmed TB patients were included in our analysis, consisting of 221 were IGRA positive and 53 were IGRA negative. Patients with the elderly were identified as an independent risk factor for negative IGRA results. In addition, the elevated level of IL-4 and the decreased levels of IFN-γ, IL-2, IL-6, IL-1β, and IL-12 in IGRA negative TB relative to IGRA positive TB group, demonstrating a significant difference in Th1/Th2 paradigm between two groups. The IFN-γ&IL-2 based assay could correctly identify 247 out of 307 MTB-infected individuals [271 TB patients and 36 individuals with latent TB infection (LTBI)], demonstrating a sensitivity of 80.5%. Then the IFN-γ and IL-4 were applied to distinguish healthy control and IGRA-negative group. When using the stepwise algorithm, the sensitivity for detecting Mycobacterium tuberculosis (MTB) infections was significantly increased from 80.5% to 89.6%. Additionally, patients with negative IGRA results had a conversion to culture-negative status longer than those with positive IGRA results. In conclusion, a stepwise algorithm outperforms IGRA assays to accurately identify MTB infections by the combination IFN-γ, IL-2, and IL-4. Further study is needed to evaluate the accuracy of our diagnostic algorithm in the LTBI population.
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Affiliation(s)
- Qiang Li
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Weicong Ren
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Jinfeng Yuan
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Haiping Guo
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Yuanyuan Shang
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Wei Wang
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Junhua Pan
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
- *Correspondence: Junhua Pan, ; Mengqiu Gao, ; Yu Pang,
| | - Mengqiu Gao
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
- *Correspondence: Junhua Pan, ; Mengqiu Gao, ; Yu Pang,
| | - Yu Pang
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
- *Correspondence: Junhua Pan, ; Mengqiu Gao, ; Yu Pang,
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Chinpong K, Thavornwattana K, Armatrmontree P, Chienwichai P, Lawpoolsri S, Silachamroon U, Maude RJ, Rotejanaprasert C. Spatiotemporal Epidemiology of Tuberculosis in Thailand from 2011 to 2020. BIOLOGY 2022; 11:755. [PMID: 35625483 PMCID: PMC9138531 DOI: 10.3390/biology11050755] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022]
Abstract
Tuberculosis is a leading cause of infectious disease globally, especially in developing countries. Better knowledge of spatial and temporal patterns of tuberculosis burden is important for effective control programs as well as informing resource and budget allocation. Studies have demonstrated that TB exhibits highly complex dynamics in both spatial and temporal dimensions at different levels. In Thailand, TB research has been primarily focused on surveys and clinical aspects of the disease burden with little attention on spatiotemporal heterogeneity. This study aimed to describe temporal trends and spatial patterns of TB incidence and mortality in Thailand from 2011 to 2020. Monthly TB case and death notification data were aggregated at the provincial level. Age-standardized incidence and mortality were calculated; time series and global and local clustering analyses were performed for the whole country. There was an overall decreasing trend with seasonal peaks in the winter. There was spatial heterogeneity with disease clusters in many regions, especially along international borders, suggesting that population movement and socioeconomic variables might affect the spatiotemporal distribution in Thailand. Understanding the space-time distribution of TB is useful for planning targeted disease control program activities. This is particularly important in low- and middle-income countries including Thailand to help prioritize allocation of limited resources.
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Affiliation(s)
- Kawin Chinpong
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
- Department of Computer Engineering, Faculty of Engineering, King Mongkut’s University of technology Thonburi, Bangkok 10140, Thailand
| | - Kaewklao Thavornwattana
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
- Department of Computer Engineering, Faculty of Engineering, King Mongkut’s University of technology Thonburi, Bangkok 10140, Thailand
| | - Peerawich Armatrmontree
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
- Department of Computer Engineering, Faculty of Engineering, King Mongkut’s University of technology Thonburi, Bangkok 10140, Thailand
| | - Peerut Chienwichai
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Udomsak Silachamroon
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Richard J. Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
- Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA 02115, USA
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Road, Oxford OX1 1NF, UK
- The Open University, Milton Keynes MK7 6AA, UK
| | - Chawarat Rotejanaprasert
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
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24
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Copelyn J, Eley B, Cox H, Workman L, Dheda K, Nicol MP, Zar HJ. Treatment Response in Pediatric Pulmonary Tuberculosis-A Prospective Longitudinal Study. J Pediatric Infect Dis Soc 2022; 11:329-336. [PMID: 35462407 PMCID: PMC9302696 DOI: 10.1093/jpids/piac029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/28/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Data are limited on the resolution of symptoms and signs in children treated for pulmonary tuberculosis (PTB) and whether this resolution differs from children with other lower respiratory tract infections (LRTIs). METHODS A prospective study of children ≤ 15 years presenting with features suggestive of PTB was performed. Clinical, microbiological, and radiological investigations were done at enrollment. Symptoms and clinical features were measured 1, 3, and 6 months after enrollment. Participants were categorized into 3 groups based on National Institutes of Health consensus definitions: confirmed PTB, unconfirmed PTB, and unlikely PTB (children with other LRTIs). Univariable and multivariable logistic regression modeling was used to investigate predictors of persistence of symptoms or signs. RESULTS Among 2019 participants, there were 427 (21%) confirmed, 810 (40%) unconfirmed, and 782 (39%) with unlikely PTB. Of 1693/2008 (84%) with cough and 1157/1997 (58%) with loss of appetite at baseline, persistence at 3 months was reported in 24/1222 (2%) and 23/886 (3%), respectively. Of 934/1884 (50%) with tachypnoea and 947/1999 (47%) with abnormal auscultatory findings at baseline, persistence at 3 months occurred in 410/723 (57%) and 216/778 (28%), respectively. HIV infection and abnormal baseline chest radiography were associated with persistence of symptoms or signs at month 3 (adjusted odds ration [aOR] 1.6; 95% confidence interval [CI]: [1.1, 2.3] and aOR 2.3; 95% CI: [1.5, 3.3], respectively]. The resolution of symptoms and signs was similar across categories. CONCLUSIONS Symptoms resolved rapidly in most children with PTB, but signs resolved more slowly. The pattern and resolution of symptoms or signs did not distinguish children with PTB from those with other LRTIs.
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Affiliation(s)
- Julie Copelyn
- Corresponding Author: Julie Copelyn, MPhil, MMed, MBBS, Department of Paediatric Infectious Diseases, Red Cross War Memorial Children’s Hospital, Klipfontein Road, Cape Town, 7700, South Africa. E-mail:
| | - Brian Eley
- Paediatric Infectious Diseases Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa,Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Helen Cox
- Division of Medical Microbiology, Wellcome Centre for Infectious Disease Research and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Lesley Workman
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa,South African Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Keertan Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa,Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark P Nicol
- Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa,Department of Biomedical Sciences, Division of Infection and Immunity, University of Western Australia, Perth, Australia
| | - Heather J Zar
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa,South African Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
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25
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Xu M, Hu P, Chen R, Liu B, Chen H, Hou J, Ke L, Huang J, Ren H, Hu H. Association of long-term exposure to ambient air pollution with the number of tuberculosis cases notified: a time-series study in Hong Kong. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:21621-21633. [PMID: 34767173 DOI: 10.1007/s11356-021-17082-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 10/13/2021] [Indexed: 05/25/2023]
Abstract
To analyze the association of long-term exposure to air pollution and its attributable risks with the number of tuberculosis (TB) cases notified, a quasi-Poisson regression model combined with a distributed lag nonlinear model (DLNM) was constructed using monthly data on air pollution and TB cases notified in Hong Kong from 1999 to 2018. Nonlinear relationships between PM10, PM2.5, and CO and TB cases notified were identified. The concentrations of PM10, PM2.5, and CO corresponding to the minimum numbers of TB cases notified (the minimum TB notification concentrations, MTNCs) were 58.3 μg/m3, 41.7 μg/m3, and 0.1 mg/m3, respectively. Compared with the MTNCs, the overall cumulative numbers of TB cases notified increased by 76.93% (95% CI: 13.08%, 176.83%), 88.81% (95% CI: 26.09%, 182.71%), and 233.43% (95% CI: 13.56%, 879.03%) for the 95th percentiles of PM10 and PM2.5 and for the 97.5th percentiles of CO, respectively. The TB notification rate attributed to concentration ranges above the 97.5th percentile of PM10, PM2.5, and CO was 3.38% (95% empirical confidence intervals [eCI]: 0.93%, 5.61%), 4.73% (95% eCI: 1.87%, 7.15%), and 3.34% (95% eCI: 0.29%, 5.83%), respectively. Long-term exposure to high concentrations of air pollution in Hong Kong may be associated with increases in the number of TB cases notified for this area.
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Affiliation(s)
- Man Xu
- School of Nursing, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan City, 430065, Hubei Province, China
| | - Ping Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Bing Liu
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Hongying Chen
- Biological Products Management Office, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Li Ke
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Jiao Huang
- Center for Evidence-Based and Translational Medicine, Wuhan University Zhongnan Hospital, Wuhan, 430030, Hubei, China
| | - Hairong Ren
- School of Nursing, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan City, 430065, Hubei Province, China.
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan City, 430065, Hubei Province, China.
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26
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Islam MS, Banu S, Tarannum S, Chowdhury KIA, Nazneen A, Islam MT, Shafique SMZ, Islam SMH, Chughtai AA, Seale H. Examining pulmonary TB patient management and healthcare workers exposures in two public tertiary care hospitals, Bangladesh. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000064. [PMID: 36962098 PMCID: PMC10021262 DOI: 10.1371/journal.pgph.0000064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022]
Abstract
Implementation of tuberculosis (TB) infection prevention and control (IPC) guidelines in public tertiary care general hospitals remain challenging due to limited evidence of pulmonary TB (PTB) patients' duration of hospital stay and management. To fill this evidence gap, this study examined adult PTB patient management, healthcare workers' (HCWs) exposures and IPC practices in two public tertiary care hospitals in Bangladesh.Between December 2017 and September 2019, a multidisciplinary team conducted structured observations, a hospital record review, and in-depth interviews with hospital staff from four adult medicine wards.Over 20 months, we identified 1,200 presumptive TB patients through the hospital record review, of whom 263 were confirmed PTB patients who stayed in the hospital, a median of 4.7 days without TB treatment and possibly contaminated the inpatients wards. Over 141 observation hours, we found a median of 3.35 occupants present per 10 m2 of floor space and recorded a total of 17,085 coughs and 316 sneezes: a median of 3.9 coughs or sneezes per 10 m2 per hour per ward. Only 8.4% of coughs and 21% of sneezes were covered by cloths, paper, tissues, or by hand. The HCWs reportedly could not isolate the TB patients due to limited resources and space and could not provide them with a mask. Further, patients and HCWs did not wear any respirators.The study identified that most TB patients stayed in the hospitals untreated for some duration of time. These PTB patients frequently coughed and sneezed without any facial protection that potentially contaminated the ward environment and put everyone, including the HCWs, at risk of TB infection. Interventions that target TB patients screening on admission, isolation of presumptive TB patients, respiratory hygiene, and HCWs' use of personal protective equipment need to be enhanced and evaluated for acceptability, practicality and scale-up.
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Affiliation(s)
- Md Saiful Islam
- Emerging Infections Program, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Sayera Banu
- Emerging Infections Program, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Sayeeda Tarannum
- Emerging Infections Program, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | | | - Arifa Nazneen
- Emerging Infections Program, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | | | - S M Zafor Shafique
- Emerging Infections Program, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - S M Hasibul Islam
- Emerging Infections Program, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Abrar Ahmad Chughtai
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
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27
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Arriaga MB, Rocha MS, Nogueira BMF, Nascimento V, Araújo-Pereira M, Souza AB, Andrade AMS, Costa AG, Gomes-Silva A, Silva EC, Figueiredo MC, Turner MM, Durovni B, Lapa-e-Silva JR, Kritski AL, Cavalcante S, Rolla VC, Cordeiro-Santos M, Sterling TR, Andrade BB. The Effect of Diabetes and Prediabetes on Mycobacterium tuberculosis Transmission to Close Contacts. J Infect Dis 2021; 224:2064-2072. [PMID: 34008010 PMCID: PMC8672762 DOI: 10.1093/infdis/jiab264] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/13/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND It is unknown whether dysglycemia is associated with Mycobacterium tuberculosis transmission. METHODS We assessed epidemiological and clinical characteristics of patients with culture-confirmed pulmonary tuberculosis and their close contacts, enrolled in a multicenter prospective cohort in Brazil. Contacts were investigated at baseline and 6 months after enrollment. QuantiFERON positivity at baseline and conversion (from negative to positive at month 6) were compared between subgroups of contacts according to glycemic status of persons with tuberculosis (PWTB) as diabetes mellitus (DM) or prediabetes. Multivariable mixed-effects logistic regression models were performed to test independent associations with baseline QuantiFERON positive and QuantiFERON conversion. RESULTS There were 592 PWTB (153 DM, 141 prediabetes, 211 normoglycemic) and 1784 contacts, of whom 658 were QuantiFERON-positive at baseline and 106 converters. Multivariable analyses demonstrated that tuberculosis-prediabetes cases, acid-fast bacilli-positive, pulmonary cavities, and living with someone who smoked were independently associated with QuantiFERON positive in contacts at baseline. DM, persistent cough, acid-fast bacilli-positive, and pulmonary cavities in tuberculosis source cases were associated with QuantiFERON conversion. CONCLUSIONS Contacts of persons with pulmonary tuberculosis and dysglycemia were at increased risk of being QuantiFERON positive at baseline or month 6. Increased focus on such close contacts could improve tuberculosis control.
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Affiliation(s)
- María B Arriaga
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Michael S Rocha
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Instituto Brasileiro para Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil
| | - Betânia M F Nogueira
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Brasileiro para Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil
| | - Vanessa Nascimento
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Instituto Brasileiro para Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Mariana Araújo-Pereira
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Alexandra B Souza
- Fundação Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Alice M S Andrade
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
| | - Alysson G Costa
- Fundação Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Adriano Gomes-Silva
- Laboratório de Pesquisa Clínica em Micobacteriose, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| | - Elisangela C Silva
- Programa Acadêmico de Tuberculose da Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marina C Figueiredo
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Megan M Turner
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Betina Durovni
- Secretaria Municipal de Saúde do Rio de Janeiro (Clínica da Família Rinaldo Delamare)-Rocinha, Rio de Janeiro, Brazil
| | - José R Lapa-e-Silva
- Programa Acadêmico de Tuberculose da Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Afrânio L Kritski
- Programa Acadêmico de Tuberculose da Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Solange Cavalcante
- Laboratório de Pesquisa Clínica em Micobacteriose, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
- Secretaria Municipal de Saúde do Rio de Janeiro (Clínica da Família Rinaldo Delamare)-Rocinha, Rio de Janeiro, Brazil
| | - Valeria C Rolla
- Laboratório de Pesquisa Clínica em Micobacteriose, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| | - Marcelo Cordeiro-Santos
- Fundação Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Universidade Nilton Lins, Manaus, Brazil
| | - Timothy R Sterling
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Bruno B Andrade
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Brasileiro para Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Curso de Medicina, Universidade Salvador UNIFACS, Laureate University, Salvador, Brazil
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28
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Osei-Wusu S, Morgan P, Asare P, Adams G, Musah AB, Siam IM, Gillespie SH, Sabiiti W, Yeboah-Manu D. Bacterial Load Comparison of the Three Main Lineages of Mycobacterium tuberculosis Complex in West Africa. Front Microbiol 2021; 12:719531. [PMID: 34777274 PMCID: PMC8578714 DOI: 10.3389/fmicb.2021.719531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Studies have shown an association between bacterial load and virulence; however, not much is known about the diversity in this phenotypic characteristic of Mycobacterium tuberculosis complex (MTBC). This study was therefore aimed to determine the differences in bacterial load of the three most prevalent MTBC genotypes (L4, L5, and L6) in West Africa at the time of diagnosis. A total of 170 paired fresh sputum samples were collected; one part in guanidinium thiocyanate (GTC) was used for RNA extraction and tuberculosis molecular bacterial load assay (TB-MBLA), and the other part without GTC was confirmed for TB positivity using GeneXpert MTB/RIF, smear microscopy grading, and culture on Löwenstein-Jensen media slants. The 170 sputum samples comprised 155 new cases, three follow-up cases, and 12 TB negative sputum samples. The time-to-culture positivity (TTP) and degree of culture positivity (DCP) were recorded. All 122 isolates obtained were spoligotyped for lineage (L) classification, but spoligotypes were obtained from 120 isolates. Of the typed isolates, 70.0, 10.8, 10.8, 4.2, 2.5, 0.8, and 0.8% were lineages 4, 5, 6, 2, 3, 1, and Mycobacterium bovis, respectively. Further analysis of the three most prevalent lineages showed significantly shorter TTP and higher DCP by L4 compared to L5 and L6, respectively: TTP 20.8, vs. 26.5, and 28.2 days; p-value = 0.005 and DCP 1.27, vs. 0.81 and 0.29, p < 0.001. The average TB-MBLA measured bacterial load of L4 was 3.82 Log10eCFU/ml which was not significantly different from 3.81 and 3.80 Log10eCFU/ml of L5 and L6, respectively, p = 0.84. Degrees of smear microscopy L4 = 1.20, L5 = 1.20, and L6 = 0.92 and GeneXpert Cq values L4 = 17.08, L5 = 18.37, and L6 = 17.59 showed no significant difference between the lineages, p = 0.72 and p = 0.48, respectively. Retrospective analysis of a larger sample confirmed the difference in TTP, p < 0.001. In conclusion, the observed shorter TTP and high DCP of L4 could signify high growth rate in culture that is independent of total bacterial load at diagnosis.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,West African Center for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Portia Morgan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Godfrey Adams
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ishaque Mintah Siam
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Stephen Henry Gillespie
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Wilber Sabiiti
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,West African Center for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
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Payros D, Alonso H, Malaga W, Volle A, Mazères S, Déjean S, Valière S, Moreau F, Balor S, Stella A, Combes-Soia L, Burlet-Schiltz O, Bouchez O, Nigou J, Astarie-Dequeker C, Guilhot C. Rv0180c contributes to Mycobacterium tuberculosis cell shape and to infectivity in mice and macrophages. PLoS Pathog 2021; 17:e1010020. [PMID: 34724002 PMCID: PMC8584747 DOI: 10.1371/journal.ppat.1010020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 11/11/2021] [Accepted: 10/08/2021] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium tuberculosis, the main causative agent of human tuberculosis, is transmitted from person to person via small droplets containing very few bacteria. Optimizing the chance to seed in the lungs is therefore a major adaptation to favor survival and dissemination in the human population. Here we used TnSeq to identify genes important for the early events leading to bacterial seeding in the lungs. Beside several genes encoding known virulence factors, we found three new candidates not previously described: rv0180c, rv1779c and rv1592c. We focused on the gene, rv0180c, of unknown function. First, we found that deletion of rv0180c in M. tuberculosis substantially reduced the initiation of infection in the lungs of mice. Next, we established that Rv0180c enhances entry into macrophages through the use of complement-receptor 3 (CR3), a major phagocytic receptor for M. tuberculosis. Silencing CR3 or blocking the CR3 lectin site abolished the difference in entry between the wild-type parental strain and the Δrv0180c::km mutant. However, we detected no difference in the production of both CR3-known carbohydrate ligands (glucan, arabinomannan, mannan), CR3-modulating lipids (phthiocerol dimycocerosate), or proteins in the capsule of the Δrv0180c::km mutant in comparison to the wild-type or complemented strains. By contrast, we established that Rv0180c contributes to the functionality of the bacterial cell envelope regarding resistance to toxic molecule attack and cell shape. This alteration of bacterial shape could impair the engagement of membrane receptors that M. tuberculosis uses to invade host cells, and open a new perspective on the modulation of bacterial infectivity. The epidemic efficiency of tuberculosis bacilli is determined by their capacity to transmit via aerosol. Currently, the bacterial functions that favor Mycobacterium tuberculosis seeding in the lung of naïve host remain mostly unknown. Here we implemented a genome-wide approach to identify M. tuberculosis mutants deficient for seeding and early replication in the lung of mice. In addition to genes known to encode virulence factors, we identified three genes not previously described. We used complementary approaches to characterize the phenotype of a M. tuberculosis mutant with insertion within the rv0180c gene. We found that this mutant is impaired for seeding in the lung of mice and for invasion and replication in human macrophages. In macrophages, the defect relies on a lack of engagement of CR3 receptor. Although we did not detect any difference between the wild type strain and the rv0180c mutant with regard to potential CR3-ligand, we found that the bacterial cell envelope is altered in the rv0180c mutant. Our study provides new insight into bacterial genes required for early interaction of M. tuberculosis with the host and perspective to understand the bacterial functions enhancing infectivity.
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Affiliation(s)
- Delphine Payros
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Henar Alonso
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Wladimir Malaga
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Arnaud Volle
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Serge Mazères
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Sébastien Déjean
- Institut de Mathématiques de Toulouse, UMR5219, Université de Toulouse, CNRS, UPS, Toulouse, France
| | | | - Flavie Moreau
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Stéphanie Balor
- Plateforme de Microscopie Électronique Intégrative (METi), Centre de Biologie Intégrative (CBI), CNRS, Toulouse, France
| | - Alexandre Stella
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Lucie Combes-Soia
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Odile Burlet-Schiltz
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | | | - Jérôme Nigou
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Catherine Astarie-Dequeker
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
- * E-mail: (CAD); (CG)
| | - Christophe Guilhot
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
- * E-mail: (CAD); (CG)
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Lee Y, Seo H, Kim S, Rahim MDA, Yoon Y, Jung J, Lee S, Beom Ryu C, Song HY. Activity of Lactobacillus crispatus isolated from vaginal microbiota against Mycobacterium tuberculosis. J Microbiol 2021; 59:1019-1030. [PMID: 34724180 DOI: 10.1007/s12275-021-1332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/23/2021] [Accepted: 09/29/2021] [Indexed: 10/19/2022]
Abstract
Tuberculosis, an infectious disease, is caused by Mycobacterium tuberculosis. It remains a significant public health issue around the globe, causing about 1.8 million deaths every year. Drug-resistant M. tuberculosis, including multi-drug-resistant (MDR), extremely-drug-resistant (XDR), and totally drug-resistant (TDR) M. tuberculosis, continues to be a threat to public health. In the case of antibiotic-resistant tuberculosis, the treatment effect of conventional antibiotics is low. Side effects caused by high doses over a long period are causing severe problems. To overcome these problems, there is an urgent need to develop a new anti-tuberculosis drug that is different from the existing compound-based antibiotics. Probiotics are defined as live microorganisms conferring health benefits. They can be potential therapeutic agents in this context as the effectiveness of probiotics against different infectious diseases has been well established. Here, we report that Lactobacillus crispatus PMC201 shows a promising effect on tuberculosis isolated from vaginal fluids of healthy Korean women. Lactobacillus crispatus PMC201 reduced M. tuberculosis H37Rv under co-culture conditions in broth and reduced M. tuberculosis H37Rv and XDR M. tuberculosis in macrophages. Lactobacillus crispatus PMC201 was not toxic to a guinea pig model and did not induce dysbiosis in a human intestinal microbial ecosystem simulator. Taken together, these results indicate that L. crispatus PMC201 can be a promising alternative drug candidate in the current tuberculosis drug regime. Further study is warranted to assess the in vivo efficacy and confirm the mode of action of L. crispatus PMC201.
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Affiliation(s)
- Youngkyoung Lee
- Department of Microbiology and Immunology, School of Medicine, Soonchunhyang University, Cheonan, 31151, Republic of Korea
| | - Hoonhee Seo
- Probiotics Microbiome Convergence Center, Soonchunhyang University, Asan, 31538, Republic of Korea
| | - Sukyung Kim
- Probiotics Microbiome Convergence Center, Soonchunhyang University, Asan, 31538, Republic of Korea
| | - M D Abdur Rahim
- Department of Microbiology and Immunology, School of Medicine, Soonchunhyang University, Cheonan, 31151, Republic of Korea
| | - Youjin Yoon
- Department of Microbiology and Immunology, School of Medicine, Soonchunhyang University, Cheonan, 31151, Republic of Korea
| | - Jehee Jung
- Department of Microbiology and Immunology, School of Medicine, Soonchunhyang University, Cheonan, 31151, Republic of Korea
| | - Saebim Lee
- Probiotics Microbiome Convergence Center, Soonchunhyang University, Asan, 31538, Republic of Korea
| | - Chang Beom Ryu
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, 14584, Republic of Korea
| | - Ho-Yeon Song
- Department of Microbiology and Immunology, School of Medicine, Soonchunhyang University, Cheonan, 31151, Republic of Korea.
- Probiotics Microbiome Convergence Center, Soonchunhyang University, Asan, 31538, Republic of Korea.
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Repurposing diphenylbutylpiperidine-class antipsychotic drugs for host-directed therapy of Mycobacterium tuberculosis and Salmonella enterica infections. Sci Rep 2021; 11:19634. [PMID: 34608194 PMCID: PMC8490354 DOI: 10.1038/s41598-021-98980-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/06/2021] [Indexed: 02/08/2023] Open
Abstract
The persistent increase of multidrug-resistant (MDR) Mycobacterium tuberculosis (Mtb) infections negatively impacts Tuberculosis treatment outcomes. Host-directed therapies (HDT) pose an complementing strategy, particularly since Mtb is highly successful in evading host-defense by manipulating host-signaling pathways. Here, we screened a library containing autophagy-modulating compounds for their ability to inhibit intracellular Mtb-bacteria. Several active compounds were identified, including two drugs of the diphenylbutylpiperidine-class, Fluspirilene and Pimozide, commonly used as antipsychotics. Both molecules inhibited intracellular Mtb in pro- as well as anti-inflammatory primary human macrophages in a host-directed manner and synergized with conventional anti-bacterials. Importantly, these inhibitory effects extended to MDR-Mtb strains and the unrelated intracellular pathogen, Salmonella enterica serovar Typhimurium (Stm). Mechanistically Fluspirilene and Pimozide were shown to regulate autophagy and alter the lysosomal response, partly correlating with increased bacterial localization to autophago(lyso)somes. Pimozide's and Fluspirilene's efficacy was inhibited by antioxidants, suggesting involvement of the oxidative-stress response in Mtb growth control. Furthermore, Fluspirilene and especially Pimozide counteracted Mtb-induced STAT5 phosphorylation, thereby reducing Mtb phagosome-localized CISH that promotes phagosomal acidification. In conclusion, two approved antipsychotic drugs, Pimozide and Fluspirilene, constitute highly promising and rapidly translatable candidates for HDT against Mtb and Stm and act by modulating the autophagic/lysosomal response by multiple mechanisms.
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Teo AKJ, Singh SR, Prem K, Hsu LY, Yi S. Duration and determinants of delayed tuberculosis diagnosis and treatment in high-burden countries: a mixed-methods systematic review and meta-analysis. Respir Res 2021; 22:251. [PMID: 34556113 PMCID: PMC8459488 DOI: 10.1186/s12931-021-01841-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 09/08/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Thirty countries with the highest tuberculosis (TB) burden bear 87% of the world's TB cases. Delayed diagnosis and treatment are detrimental to TB prognosis and sustain TB transmission in the community, making TB elimination a great challenge, especially in these countries. Our objective was to elucidate the duration and determinants of delayed diagnosis and treatment of pulmonary TB in high TB-burden countries. METHODS We conducted a systematic review and meta-analysis of quantitative and qualitative studies by searching four databases for literature published between 2008 and 2018 following PRISMA guidelines. We performed a narrative synthesis of the covariates significantly associated with patient, health system, treatment, and total delays. The pooled median duration of delay and effect sizes of covariates were estimated using random-effects meta-analyses. We identified key qualitative themes using thematic analysis. RESULTS This review included 124 articles from 14 low- and lower-middle-income countries (LIC and LMIC) and five upper-middle-income countries (UMIC). The pooled median duration of delays (in days) were-patient delay (LIC/LMIC: 28 (95% CI 20-30); UMIC: 10 (95% CI 10-20), health system delay (LIC/LMIC: 14 (95% CI 2-28); UMIC: 4 (95% CI 2-4), and treatment delay (LIC/LMIC: 14 (95% CI 3-84); UMIC: 0 (95% CI 0-1). There was consistent evidence that being female and rural residence was associated with longer patient delay. Patient delay was also associated with other individual, interpersonal, and community risk factors such as poor TB knowledge, long chains of care-seeking through private/multiple providers, perceived stigma, financial insecurities, and poor access to healthcare. Organizational and policy factors mediated health system and treatment delays. These factors included the lack of resources and complex administrative procedures and systems at the health facilities. We identified data gaps in 11 high-burden countries. CONCLUSIONS This review presented the duration of delays and detailed the determinants of delayed TB diagnosis and treatment in high-burden countries. The gaps identified could be addressed through tailored approaches, education, and at a higher level, through health system strengthening and provision of universal health coverage to reduce delays and improve access to TB diagnosis and care. PROSPERO registration: CRD42018107237.
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Affiliation(s)
- Alvin Kuo Jing Teo
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, #10-01, 12 Science Drive 2, Singapore, 117549, Singapore.
| | - Shweta R Singh
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
| | - Kiesha Prem
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Center for Global Health Research, Touro University California, Vallejo, USA
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Thomas BE, Thiruvengadam K, Vedhachalam C, A S, Rao VG, Vijayachari P, Rajiv Y, V R, Bansal AK, Indira Krishna AK, Joseph A, J AP, Hussain T, Anand P, Das P, John KR, Devi K. R, P S, S A, Dusthakeer A, J B, K. Chadha V, G. S. T, Raghunath D, Das M, Khan AM, Kaur H. Prevalence of pulmonary tuberculosis among the tribal populations in India. PLoS One 2021; 16:e0251519. [PMID: 34086684 PMCID: PMC8177518 DOI: 10.1371/journal.pone.0251519] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/27/2021] [Indexed: 01/10/2023] Open
Abstract
Importance There is no concrete evidence on the burden of TB among the tribal populations across India except for few studies mainly conducted in Central India with a pooled estimation of 703/100,000 with a high degree of heterogeneity. Objective To estimate the prevalence of TB among the tribal populations in India. Design, participants, setting A survey using a multistage cluster sampling design was conducted between April 2015 and March 2020 covering 88 villages (clusters) from districts with over 70% tribal majority populations in 17 States across 6 zones of India. The sample populations included individuals ≥15 years old. Main outcome and measures Eligible participants who were screened through an interview for symptoms suggestive of pulmonary TB (PTB); Two sputum specimens were examined by smear and culture. Prevalence was estimated after multiple imputations for non-coverage and a correction factor of 1.31 was then applied to account for non-inclusion of X-ray screening. Results A total of 74532 (81.0%) of the 92038 eligible individuals were screened; 2675 (3.6%) were found to have TB symptoms or h/o ATT. The overall prevalence of PTB was 432 per 100,000 populations. The PTB prevalence per 100,000 populations was highest 625 [95% CI: 496–754] in the central zone and least 153 [95% CI: 24–281] in the west zone. Among the 17 states that were covered in this study, Odisha recorded the highest prevalence of 803 [95% CI: 504–1101] and Jammu and Kashmir the lowest 127 [95% CI: 0–310] per 100,000 populations. Findings from multiple logistic regression analysis reflected that those aged 35 years and above, with BMI <18.5 Kgs /m2, h/o ATT, smoking, and/or consuming alcohol had a higher risk of bacteriologically positive PTB. Weight loss was relatively more important symptom associated with tuberculosis among this tribal populations followed by night sweats, blood in sputum, and fever. Conclusion and relevance The overall prevalence of PTB among tribal groups is higher than the general populations with a wide variation of prevalence of PTB among the tribal groups at zone and state levels. These findings call for strengthening of the TB control efforts in tribal areas to reduce TB prevalence through tribal community/site-specific intervention programs.
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Affiliation(s)
- Beena E. Thomas
- Department of Social and Behavioral Research, ICMR – National Institute for Research in Tuberculosis, Chennai, India
- * E-mail:
| | - Kannan Thiruvengadam
- Department of Statistics, Epidemiology Unit, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Chandrasekaran Vedhachalam
- Department of Statistics, Epidemiology Unit, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Srividya A
- Department of Biostatistics, ICMR – Vector Control Research Centre, Pondicherry, India
| | - V. G. Rao
- Division of Communicable Diseases, ICMR – National Institute for Research in Tribal Health, Jabalpur, India
| | - Paluru Vijayachari
- ICMR – Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands
| | - Yadav Rajiv
- Division of Communicable Diseases, ICMR – National Institute for Research in Tribal Health, Jabalpur, India
| | - Raghavi V
- Department of Social and Behavioral Research, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Avi Kumar Bansal
- Department of Epidemiology, ICMR – National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | | | - Alex Joseph
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Anil Purty J
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Tahziba Hussain
- ICMR – Regional Medical Research Centre, Bhuvaneshwar, India
| | - Praveen Anand
- Department of Epidemiology, ICMR – Desert Medicine Research Centre, Jodhpur, India
| | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | - K. R. John
- Department of Community Medicine, Apollo Institute of Medical Sciences & Research, Chittoor, India
| | - Rekha Devi K.
- ICMR – Regional Medical Research Centre, Dibrugarh, India
| | - Sunish P
- ICMR – Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands
| | - Azhagendran S
- Department of Social and Behavioral Research, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Azger Dusthakeer
- Department of Bacteriology, ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - Bhat J
- Division of Communicable Diseases, ICMR – National Institute for Research in Tribal Health, Jabalpur, India
| | - Vineet K. Chadha
- Central Leprosy Teaching and Training Institute, Chengalpet, India
| | - Toteja G. S.
- Department of Epidemiology, ICMR – Desert Medicine Research Centre, Jodhpur, India
| | - Dasarathy Raghunath
- Tribal Task Force, ICMR – Former Dean, Armed Forces Medical College, Pune, India
| | - Madhuchhanda Das
- Division of Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
| | - A. M. Khan
- Division of Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
| | - Hapreet Kaur
- Division of Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
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Seki M, Choi H, Kim K, Whang J, Sung J, Mitarai S. Tuberculosis: A persistent unpleasant neighbour of humans. J Infect Public Health 2021; 14:508-513. [PMID: 33743373 DOI: 10.1016/j.jiph.2021.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/06/2020] [Accepted: 01/05/2021] [Indexed: 01/02/2023] Open
Abstract
Mycobacterium tuberculosis, the bacterium that causes tuberculosis, has long been an unpleasant neighbour of humans. Following transmission of the bacterium from patients with active infection, new hosts do not immediately develop symptoms, as M. tuberculosis initially remains quiescent. However, it is eventually triggered, leading to the infection of other individuals. Humans are the exclusive host, and the rapid proliferation of the human population worldwide along with increasing globalisation have contributed to the pathogen's persistence, as have the survival strategies employed by M. tuberculosis, especially its resistance to several antimicrobials. Defeating this enemy will require novel approaches.
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Affiliation(s)
- Mitsuko Seki
- Division of Pediatric Dentistry, Department of Human Development and Fostering, Meikai University School of Dentistry, 1-1, Keyakidai, Sakado, Saitama 350-0283, Japan; Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo 173-8610, Japan.
| | - Hongjo Choi
- Department of Preventive Medicine, College of Medicine, Konyang University, Daejeon, 35365, Republic of Korea
| | - Kyungjong Kim
- Korea Institute of Tuberculosis, Osong, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28158, Republic of Korea
| | - Jake Whang
- Korea Institute of Tuberculosis, Osong, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28158, Republic of Korea
| | - Joohon Sung
- Genome and Health Big Data Laboratory, Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose-shi, Tokyo 204-8533, Japan.
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Ali MA, Farah MA, Lee J, Al-Anazi KM, Al-Hemaid FM. Molecular Insights into the Interaction of Ursolic Acid and Cucurbitacin from Colocynth with Therapeutic Targets of Mycobacterium tuberculosis. LETT DRUG DES DISCOV 2020. [DOI: 10.2174/1570180817999200514102750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aims:
Medicinal plants like Citrullus colocynthis are a potential choice to produce helpful
novel antimycobacterial drugs. The existence of a range of natural products in the plants, especially
Ursolic Acid (UA) and cucurbitacin E 2-0-β-d-glucopyranoside (CEG), with promising antibacterial
activity against a variety of bacteria, prompted the need to check its actions against Mycobacterium
tuberculosis (Mtb).
Background:
Mycobacterium tuberculosis (Mtb), an obligate human pathogen causes tuberculosis
and is one of the major causes of death worldwide. A few combinations of drugs are currently accessible
for treating TB patients, but these are inadequate to tackle worldwide TB cases.
Objective:
The molecular interactions between ursolic acid and cucurbitacin E with the eight potential
Mtb target proteins were investigated with the objective of finding drug-like inhibitors.
Methods:
Avogadro v.1.2.0 and Openbabel v.2.4.1 were used for creating file formats required for
docking analysis. Molecular docking was performed with eight different proteins essential for Mtb
metabolism and survival. AutoDock v.4.2 and AutoDock vina v.1.1.2 were used for docking and
Gromacs 5.1.4 was used for simulation studies.
Results and Discussion:
Among the two ligands used in this research, cucurbitacin E showed a better
docking score relative to the drugs presently available for all the target proteins. Rifampicin showed the
best binding affinity (among known inhibitors) i.e. -10.8 kcal/mol with C terminal caspase recruitment
domain. Moreover, ursolic acid and cucurbitacin E showed uniform binding score (above -7.5
kcal/mol) with all the target proteins, acknowledged its availability as a potential multi-target drug.
Conclusion:
Ursolic acid can be useful in the creation of novel, multi-targeted and effective anti-
TB medicines since it showed stable structure with FabH.
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Affiliation(s)
- Mohammad Ajmal Ali
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammad Abul Farah
- Department of Zoology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Joongku Lee
- Department of Environment and Forest Resources, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea
| | - Khalid M. Al-Anazi
- Department of Zoology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Fahad M.A. Al-Hemaid
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
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37
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Hall JI, Lozano M, Estrada-Petrocelli L, Birring S, Turner R. The present and future of cough counting tools. J Thorac Dis 2020; 12:5207-5223. [PMID: 33145097 PMCID: PMC7578475 DOI: 10.21037/jtd-2020-icc-003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The widespread use of cough counting tools has, to date, been limited by a reliance on human input to determine cough frequency. However, over the last two decades advances in digital technology and audio capture have reduced this dependence. As a result, cough frequency is increasingly recognised as a measurable parameter of respiratory disease. Cough frequency is now the gold standard primary endpoint for trials of new treatments for chronic cough, has been investigated as a marker of infectiousness in tuberculosis (TB), and used to demonstrate recovery in exacerbations of chronic obstructive pulmonary disease (COPD). This review discusses the principles of automatic cough detection and summarises key currently and recently used cough counting technology in clinical research. It additionally makes some predictions on future directions in the field based on recent developments. It seems likely that newer approaches to signal processing, the adoption of techniques from automatic speech recognition, and the widespread ownership of mobile devices will help drive forward the development of real-time fully automated ambulatory cough frequency monitoring over the coming years. These changes should allow cough counting systems to transition from their current status as a niche research tool in chronic cough to a much more widely applicable method for assessing, investigating and understanding respiratory disease.
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Affiliation(s)
- Jocelin Isabel Hall
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Manuel Lozano
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Barcelona, Spain.,Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain.,Department of Automatic Control (ESAII), Universitat Politècnica de Catalunya (UPC)-Barcelona Tech, Barcelona, Spain
| | - Luis Estrada-Petrocelli
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Barcelona, Spain.,Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain.,Facultad de Ingeniería, Universidad Latina de Panamá, Panama City, Panama
| | - Surinder Birring
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK.,Department of Respiratory Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Richard Turner
- Department of Respiratory Medicine, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
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38
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Trauer JM, Dodd PJ, Gomes MGM, Gomez GB, Houben RMGJ, McBryde ES, Melsew YA, Menzies NA, Arinaminpathy N, Shrestha S, Dowdy DW. The Importance of Heterogeneity to the Epidemiology of Tuberculosis. Clin Infect Dis 2020; 69:159-166. [PMID: 30383204 PMCID: PMC6579955 DOI: 10.1093/cid/ciy938] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/31/2018] [Indexed: 12/23/2022] Open
Abstract
Although less well-recognized than for other infectious diseases, heterogeneity is a defining feature of tuberculosis (TB) epidemiology. To advance toward TB elimination, this heterogeneity must be better understood and addressed. Drivers of heterogeneity in TB epidemiology act at the level of the infectious host, organism, susceptible host, environment, and distal determinants. These effects may be amplified by social mixing patterns, while the variable latent period between infection and disease may mask heterogeneity in transmission. Reliance on notified cases may lead to misidentification of the most affected groups, as case detection is often poorest where prevalence is highest. Assuming that average rates apply across diverse groups and ignoring the effects of cohort selection may result in misunderstanding of the epidemic and the anticipated effects of control measures. Given this substantial heterogeneity, interventions targeting high-risk groups based on location, social determinants, or comorbidities could improve efficiency, but raise ethical and equity considerations.
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Affiliation(s)
- James M Trauer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter J Dodd
- Health Economic and Decision Science, University of Sheffield, United Kingdom
| | - M Gabriela M Gomes
- Liverpool School of Tropical Medicine, United Kingdom.,CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Portugal
| | - Gabriela B Gomez
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Rein M G J Houben
- Tuberculosis Centre, London School of Hygiene and Tropical Medicine, United Kingdom.,Infectious Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland
| | - Yayehirad A Melsew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Nicolas A Menzies
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Nimalan Arinaminpathy
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, United Kingdom
| | - Sourya Shrestha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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39
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Maiolini M, Gause S, Taylor J, Steakin T, Shipp G, Lamichhane P, Deshmukh B, Shinde V, Bishayee A, Deshmukh RR. The War against Tuberculosis: A Review of Natural Compounds and Their Derivatives. Molecules 2020; 25:molecules25133011. [PMID: 32630150 PMCID: PMC7412169 DOI: 10.3390/molecules25133011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
Tuberculosis (TB), caused by the bacterial organism Mycobacterium tuberculosis, pose a major threat to public health, especially in middle and low-income countries. Worldwide in 2018, approximately 10 million new cases of TB were reported to the World Health Organization (WHO). There are a limited number of medications available to treat TB; additionally, multi-drug resistant TB and extensively-drug resistant TB strains are becoming more prevalent. As a result of various factors, such as increased costs of developing new medications and adverse side effects from current medications, researchers continue to evaluate natural compounds for additional treatment options. These substances have the potential to target bacterial cell structures and may contribute to successful treatment. For example, a study reported that green and black tea, which contains epigallocatechin gallate (a phenolic antioxidant), may decrease the risk of contracting TB in experimental subjects; cumin (a seed from the parsley plant) has been demonstrated to improve the bioavailability of rifampicin, an important anti-TB medication, and propolis (a natural substance produced by honeybees) has been shown to improve the binding affinity of anti-TB medications to bacterial cell structures. In this article, we review the opportunistic pathogen M. tuberculosis, various potential therapeutic targets, available therapies, and natural compounds that may have anti-TB properties. In conclusion, different natural compounds alone as well as in combination with already approved medication regimens should continue to be investigated as treatment options for TB.
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Affiliation(s)
- Morgan Maiolini
- School of Pharmacy, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA; (M.M.); (S.G.); (J.T.); (T.S.)
| | - Stacey Gause
- School of Pharmacy, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA; (M.M.); (S.G.); (J.T.); (T.S.)
| | - Jerika Taylor
- School of Pharmacy, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA; (M.M.); (S.G.); (J.T.); (T.S.)
| | - Tara Steakin
- School of Pharmacy, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA; (M.M.); (S.G.); (J.T.); (T.S.)
| | - Ginger Shipp
- Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA;
| | - Purushottam Lamichhane
- School of Dental Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA;
| | - Bhushan Deshmukh
- Department of Chemistry, Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon 425 001, Maharashtra, India;
| | - Vaibhav Shinde
- Department of Pharmacognosy, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune-411 038, Maharashtra, India;
| | - Anupam Bishayee
- Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA;
- Correspondence: or (A.B.); (R.R.D.); Tel.: +1-941-782-5950 (A.B.); +1-941-782-5646 (R.R.D.)
| | - Rahul R. Deshmukh
- Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA;
- Correspondence: or (A.B.); (R.R.D.); Tel.: +1-941-782-5950 (A.B.); +1-941-782-5646 (R.R.D.)
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40
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Lee GO, Comina G, Hernandez-Cordova G, Naik N, Gayoso O, Ticona E, Coronel J, Evans CA, Zimic M, Paz-Soldan VA, Gilman RH, Oberhelman R. Cough dynamics in adults receiving tuberculosis treatment. PLoS One 2020; 15:e0231167. [PMID: 32511248 PMCID: PMC7279573 DOI: 10.1371/journal.pone.0231167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/17/2020] [Indexed: 11/19/2022] Open
Abstract
Cough is a characteristic symptom of tuberculosis, is the main cause of transmission, and is used to assess treatment response. We aimed to identify the best measure of cough severity and characterize changes during initial tuberculosis therapy. We conducted a prospective cohort of recently diagnosed ambulatory adult patients with pulmonary tuberculosis in two tertiary hospitals in Lima, Peru. Pre-treatment and five times during the first two months of treatment, a vibrometer was used to capture 4-hour recordings of involuntary cough. A total of 358 recordings from 69 participants were analyzed using a computer algorithm. Total time spent coughing (seconds per hour) was a better predictor of microbiologic indicators of disease severity and treatment response than the frequency of cough episodes or cough power. Patients with prior tuberculosis tended to cough more than patients without prior tuberculosis, and patients with tuberculosis and diabetes coughed more than patients without diabetes co-morbidity. Cough characteristics were similar regardless of HIV co-infection and for drug-susceptible versus drug-resistant tuberculosis. Tuberculosis treatment response may be meaningfully assessed by objectively monitoring the time spent coughing. This measure demonstrated that cough was increased in patients with TB recurrence or co-morbid diabetes, but not because of drug resistance or HIV co-infection.
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Affiliation(s)
- Gwenyth O. Lee
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana, United States of America
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Germán Comina
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana, United States of America
| | - Gustavo Hernandez-Cordova
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana, United States of America
| | - Nehal Naik
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Oscar Gayoso
- Pulmonology Department, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Eduardo Ticona
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, San Marcos, Peru
- Servicio de Enfermedades Infecciosas y Tropicales, Hospital Nacional Dos de Mayo Lima, Mayo, Lima, Perú
| | - Jorge Coronel
- Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carlton A. Evans
- Asociación Benéfica PRISMA, Lima, Perú
- Laboratory of Research and Development, Innovation For Health And Development (IFHAD), Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Mirko Zimic
- Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Valerie A. Paz-Soldan
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana, United States of America
- Asociación Benéfica PRISMA, Lima, Perú
| | - Robert H. Gilman
- Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Asociación Benéfica PRISMA, Lima, Perú
- Department of International Health, Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Richard Oberhelman
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana, United States of America
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41
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Nelson KN, Jenness SM, Mathema B, Lopman BA, Auld SC, Shah NS, Brust JCM, Ismail N, Omar SV, Brown TS, Allana S, Campbell A, Moodley P, Mlisana K, Gandhi NR. Social Mixing and Clinical Features Linked With Transmission in a Network of Extensively Drug-resistant Tuberculosis Cases in KwaZulu-Natal, South Africa. Clin Infect Dis 2020; 70:2396-2402. [PMID: 31342067 PMCID: PMC7245156 DOI: 10.1093/cid/ciz636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/10/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is the leading infectious cause of death globally, and drug-resistant TB strains pose a serious threat to controlling the global TB epidemic. The clinical features, locations, and social factors driving transmission in settings with high incidences of drug-resistant TB are poorly understood. METHODS We measured a network of genomic links using Mycobacterium tuberculosis whole-genome sequences. RESULTS Patients with 2-3 months of cough or who spent time in urban locations were more likely to be linked in the network, while patients with sputum smear-positive disease were less likely to be linked than those with smear-negative disease. Associations persisted using different thresholds to define genomic links and irrespective of assumptions about the direction of transmission. CONCLUSIONS Identifying factors that lead to many transmissions, including contact with urban areas, can suggest settings instrumental in transmission and indicate optimal locations and groups to target with interventions.
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Affiliation(s)
- Kristin N Nelson
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Samuel M Jenness
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Barun Mathema
- Mailman School of Public Health, Columbia University, New York, New York
| | | | - Sara C Auld
- Rollins School of Public Health, Emory University, Atlanta, Georgia
- Emory University School of Medicine, Atlanta, Georgia
| | - N Sarita Shah
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James C M Brust
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Nazir Ismail
- National Institute for Communicable Diseases, Johannesburg, South Africa
- University of Pretoria, South Africa
| | - Shaheed Vally Omar
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Tyler S Brown
- Massachusetts General Hospital, Infectious Diseases Division, Boston
| | - Salim Allana
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Angie Campbell
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Pravi Moodley
- National Health Laboratory Service, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Koleka Mlisana
- National Health Laboratory Service, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Neel R Gandhi
- Rollins School of Public Health, Emory University, Atlanta, Georgia
- Emory University School of Medicine, Atlanta, Georgia
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42
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Affiliation(s)
- Ahmed Ali
- Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, England
| | - Omar Musbahi
- Oxford University Clinical Academic Graduate School, Oxford University, Oxford, England
| | - Veronica L C White
- Department of Respiratory Medicine and Infectious Diseases (V.L.C.W.) and Spinal Department (A.S.M.), Royal London Hospital, London, England
| | - Alexander Sheriff Montgomery
- Department of Respiratory Medicine and Infectious Diseases (V.L.C.W.) and Spinal Department (A.S.M.), Royal London Hospital, London, England
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43
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Ruhl CR, Pasko BL, Khan HS, Kindt LM, Stamm CE, Franco LH, Hsia CC, Zhou M, Davis CR, Qin T, Gautron L, Burton MD, Mejia GL, Naik DK, Dussor G, Price TJ, Shiloh MU. Mycobacterium tuberculosis Sulfolipid-1 Activates Nociceptive Neurons and Induces Cough. Cell 2020; 181:293-305.e11. [PMID: 32142653 PMCID: PMC7102531 DOI: 10.1016/j.cell.2020.02.026] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/13/2020] [Accepted: 02/10/2020] [Indexed: 12/11/2022]
Abstract
Pulmonary tuberculosis, a disease caused by Mycobacterium tuberculosis (Mtb), manifests with a persistent cough as both a primary symptom and mechanism of transmission. The cough reflex can be triggered by nociceptive neurons innervating the lungs, and some bacteria produce neuron-targeting molecules. However, how pulmonary Mtb infection causes cough remains undefined, and whether Mtb produces a neuron-activating, cough-inducing molecule is unknown. Here, we show that an Mtb organic extract activates nociceptive neurons in vitro and identify the Mtb glycolipid sulfolipid-1 (SL-1) as the nociceptive molecule. Mtb organic extracts from mutants lacking SL-1 synthesis cannot activate neurons in vitro or induce cough in a guinea pig model. Finally, Mtb-infected guinea pigs cough in a manner dependent on SL-1 synthesis. Thus, we demonstrate a heretofore unknown molecular mechanism for cough induction by a virulent human pathogen via its production of a complex lipid.
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Affiliation(s)
- Cody R Ruhl
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Breanna L Pasko
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Haaris S Khan
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Lexy M Kindt
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Chelsea E Stamm
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Luis H Franco
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Connie C Hsia
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Min Zhou
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Colton R Davis
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Tian Qin
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Laurent Gautron
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Center for Hypothalamic Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Michael D Burton
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75080, USA; Center for Advanced Pain Studies, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Galo L Mejia
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75080, USA; Center for Advanced Pain Studies, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Dhananjay K Naik
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75080, USA; Center for Advanced Pain Studies, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Gregory Dussor
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75080, USA; Center for Advanced Pain Studies, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Theodore J Price
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75080, USA; Center for Advanced Pain Studies, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Michael U Shiloh
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
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44
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Lee GO, Paz-Soldan VA, Riley-Powell AR, Gómez A, Tarazona-Meza C, Villaizan Paliza K, Ambikapathi R, Ortiz K, Comina G, Hernandez G, Naik N, Oberhelman R, Ugarte-Gil C. Food Choice and Dietary Intake among People with Tuberculosis in Peru: Implications for Improving Practice. Curr Dev Nutr 2020; 4:nzaa001. [PMID: 32025614 PMCID: PMC6992465 DOI: 10.1093/cdn/nzaa001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 12/06/2019] [Accepted: 01/02/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In Peru, tuberculosis (TB) is perceived as a nutritional disease. This perception, alongside factors including household food insecurity, may drive the food choices of people with TB and influence treatment outcomes. OBJECTIVES The objective of this qualitative study was to explore drivers of food choice among adults recently diagnosed with TB. METHODS The study was conducted between April and December 2016 in the Huaycán district of Lima, Peru. Structured questionnaires were administered to 39 adults with TB at the time of diagnosis and after 1 mo of treatment to characterize food security and socioeconomic status. At 1 mo of treatment, 24-h dietary recalls, enhanced by recipes obtained from local street vendors, were administered to examine patterns of food consumption and determine mean daily intake of macro- and micronutrients. Among a subset of 9 participants, in-depth interviews were used to explore dietary beliefs and food choices associated with TB. RESULTS Overall, 13.2% of participants were underweight at baseline, and 10.5% were overweight. At 1 mo of treatment, the mean caloric intake was 600 kcal/d over what was needed to maintain their current weight. Most of these additional kilocalories came from carbohydrates. Patients made active efforts to improve their diets during treatment, and were both receptive to, and actively sought out, nutritional advice. However, many patients reported significant unnecessary spending on questionable commercial products, such as expensive natural remedies and nutritional supplements. CONCLUSIONS The perceived connection between TB and diet creates both opportunities and challenges for treatment providers. Nutritional counseling provided through the national TB program should promote dietary quality through foods that are locally available, inexpensive, and aligned with cultural perceptions of health and wellness.
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Affiliation(s)
- Gwenyth O Lee
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Valerie A Paz-Soldan
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Department of Public Health and Administration, Cayetano Heredia University of Peru, Lima, Peru
| | - Amy R Riley-Powell
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Andrea Gómez
- Department of Anthropology, Autonomous Metropolitan University—Iztapalapa, Mexico City, Mexico
| | | | - Katerine Villaizan Paliza
- Alexander von Humboldt Institute of Tropical Medicine, Cayetano Heredia University of Peru, Lima, Peru
| | - Ramya Ambikapathi
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Katherine Ortiz
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - German Comina
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Engineering Physics Department, Facultad de Ciencias, National Engineering University, Lima, Peru
| | - Gustavo Hernandez
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Nehal Naik
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard Oberhelman
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Cesar Ugarte-Gil
- Alexander von Humboldt Institute of Tropical Medicine, Cayetano Heredia University of Peru, Lima, Peru
- School of Medicine, Cayetano Heredia University of Peru, Lima, Peru
- TB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
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45
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Fellag M, Loukil A, Saad J, Lepidi H, Bouzid F, Brégeon F, Drancourt M. Translocation of Mycobacterium tuberculosis after experimental ingestion. PLoS One 2019; 14:e0227005. [PMID: 31887178 PMCID: PMC6936814 DOI: 10.1371/journal.pone.0227005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/09/2019] [Indexed: 02/04/2023] Open
Abstract
Human tuberculosis is a life-threatening infection following the inhalation of Mycobacterium tuberculosis, while the closely related bacteria Mycobacterium bovis and Mycobacterium canettii are thought to be transmitted by ingestion. To explore whether M. tuberculosis could also infect individuals by ingestion, male BALBc mice were fed 2 x 106 CFUs of M. tuberculosis Beijing or phosphate-buffered saline as a negative control, over a 28-day experiment. While eight negative control mice remained disease-free, M. tuberculosis was identified in the lymph nodes and lungs of 8/14 mice and in the spleens of 4/14 mice by microscopy, PCR-based detection and culture. Whole-genome sequencing confirmed the identity of the inoculum and the tissue isolates. In these genetically identical mice, the dissemination of M. tuberculosis correlated with the results of the culture detection of four intestinal bacteria. These observations indicate that ingested M. tuberculosis mycobacteria can translocate, notably provoking lymphatic tuberculosis.
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Affiliation(s)
- Mustapha Fellag
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Ahmed Loukil
- Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Jamal Saad
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Hubert Lepidi
- Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Fériel Bouzid
- Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Fabienne Brégeon
- Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Michel Drancourt
- Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- * E-mail:
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46
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Methods of Cough Assessment. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:1715-1723. [DOI: 10.1016/j.jaip.2019.01.049] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 12/24/2022]
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Patterson B, Wood R. Is cough really necessary for TB transmission? Tuberculosis (Edinb) 2019; 117:31-35. [PMID: 31378265 PMCID: PMC6688829 DOI: 10.1016/j.tube.2019.05.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/06/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
Cough has long been implicated in the production of infectious aerosol leading to transmission of tuberculosis (TB). However, prevalence studies frequently identify radiographic evidence of TB in subclinical individuals in the absence of reported coughing. Elucidating the role of cough in transmission depends on understanding the physical process of aerosolizing and expelling mycobacterium tuberculosis (Mtb) bacilli. In the last decade, human aerosol studies have progressed with improved precision of particle detection and greater sophistication of experimental protocols. Combining principles of respiratory physiology, the site and mechanism of aerosolization of respiratory lining fluids during phases of the respiratory cycle has been investigated in detail. Additionally, recent success in the direct detection of naturally generated Mtb aerosols has allowed more detailed characterization in terms of their rate of production and size distribution. We propose that TB transmission depends on the coincidence of the site of aerosol generation with the presence of Mtb bacilli. This review will examine the evidence for site of aerosol production during cough and respiratory activities in conjunction with the characteristics of detectable Mtb aerosols and locations of tuberculosis infection. Furthermore, we propose respiratory activities that are likely to optimise aerosol sampling for investigation of transmission.
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Affiliation(s)
- Benjamin Patterson
- University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands; Desmond Tutu HIV Centre, IDM, University of Cape Town, Cape Town, South Africa.
| | - Robin Wood
- Desmond Tutu HIV Centre, IDM, University of Cape Town, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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48
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Peters JS, Andrews JR, Hatherill M, Hermans S, Martinez L, Schurr E, van der Heijden Y, Wood R, Rustomjee R, Kana BD. Advances in the understanding of Mycobacterium tuberculosis transmission in HIV-endemic settings. THE LANCET. INFECTIOUS DISEASES 2019; 19:e65-e76. [PMID: 30554995 PMCID: PMC6401310 DOI: 10.1016/s1473-3099(18)30477-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/28/2022]
Abstract
Tuberculosis claims more human lives than any other infectious disease. This alarming epidemic has fuelled the development of novel antimicrobials and diagnostics. However, public health interventions that interrupt transmission have been slow to emerge, particularly in HIV-endemic settings. Transmission of tuberculosis is complex, involving various environmental, bacteriological, and host factors, among which concomitant HIV infection is important. Preventing person-to-person spread is central to halting the epidemic and, consequently, tuberculosis transmission is now being studied with renewed interest. In this Series paper, we review recent advances in the understanding of tuberculosis transmission, from the view of source-case infectiousness, inherent susceptibility of exposed individuals, appending tools for predicting risk of disease progression, the biophysical nature of the contagion, and the environments in which transmission occurs and is sustained in populations. We focus specifically on how HIV infection affects these features with a view to describing novel transmission blocking strategies in HIV-endemic settings.
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Affiliation(s)
- Julian S Peters
- Department of Science and Technology/National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and the National Health Laboratory Service, Johannesburg, South Africa
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Mark Hatherill
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Sabine Hermans
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa; Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Leonardo Martinez
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Erwin Schurr
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Yuri van der Heijden
- Vanderbilt Tuberculosis Center and Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Robin Wood
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Roxana Rustomjee
- Tuberculosis Clinical Research Branch, Therapeutic Research Program, Division of AIDS National Institute of Allergy and Infectious Diseases, National Institutes of Health, North Bethesda, MD, USA
| | - Bavesh D Kana
- Department of Science and Technology/National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and the National Health Laboratory Service, Johannesburg, South Africa; South African Medical Research Council HIV-TB Pathogenesis and Treatment Research Unit, Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.
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49
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Suzuki T, Shirai T, Hirai K, Tanaka Y, Watanabe H, Endo Y, Shimoda Y, Saigusa M, Akamatsu T, Yamamoto A, Morita S, Asada K. Improved cough- and sputum-related quality of life after initiation of treatment in pulmonary tuberculosis. Respir Investig 2019; 57:252-259. [PMID: 30738923 DOI: 10.1016/j.resinv.2019.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/25/2018] [Accepted: 01/09/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cough and sputum are the major symptoms of pulmonary tuberculosis (TB). However, the relationship between these symptoms and treatment for TB is not fully understood. The aim of this prospective study was to clarify the cough- and sputum-related quality of life (QOL) in patients with pulmonary TB before and after initiation of treatment. METHODS The study included 85 patients with active pulmonary TB who were hospitalized from July 2014 to August 2015. They completed the Leicester Cough Questionnaire (LCQ: range 3-21, the higher the better) and the Cough and Sputum Assessment Questionnaire (CASA-Q: range 0-100, the higher the better) on admission and at discharge after 2 months of treatment. RESULTS The LCQ and CASA-Q scores were reduced on admission. A multivariate linear regression analysis revealed that younger age, more than two cavitary lesions, and the presence of bronchial TB were associated with reduced LCQ total score. However, each score significantly improved at discharge, regardless of the initial grade of the sputum smear, site of the lesion, number of cavitary lesions, and presence of bronchial TB. The change in the mean LCQ total score was 2.28 (95% confidence interval, 1.56-3.00). The changes in the mean CASA-Q cough symptoms, cough impact, sputum symptoms, and sputum impact scores were 22.84 (18.44-27.25), 10.96 (7.20-14.71), 17.25 (13.33-21.18), and 5.25 (2.49-8.00), respectively. CONCLUSIONS Cough- and sputum-related QOL was impaired in patients with pulmonary TB before treatment but improved after initiation of treatment regardless of the clinical characteristics.
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Affiliation(s)
- Takahito Suzuki
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Keita Hirai
- Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan.
| | - Yuko Tanaka
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Hirofumi Watanabe
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Yoshinari Endo
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Yukiko Shimoda
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Mika Saigusa
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Taisuke Akamatsu
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Akito Yamamoto
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Satoru Morita
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
| | - Kazuhiro Asada
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi, Shizuoka, Japan.
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50
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Turner RD. Cough in pulmonary tuberculosis: Existing knowledge and general insights. Pulm Pharmacol Ther 2019; 55:89-94. [PMID: 30716411 DOI: 10.1016/j.pupt.2019.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/27/2019] [Accepted: 01/30/2019] [Indexed: 12/14/2022]
Abstract
Cough is a prominent symptom of pulmonary tuberculosis (TB), one of the oldest and most prevalent infectious diseases. Coughing probably has a pivotal role in transmission of the causative organism Mycobacterium tuberculosis. Despite this, little research to date has addressed this subject. Current knowledge of the mechanisms of cough in TB and how exactly coughing patterns predict infectiousness is scant, but this is changing. This overview summarises the existing evidence for the infectiousness of cough in TB, clinical correlates, and possible causes of cough in TB. Potential unique characteristics of cough in the disease are discussed, as is treatment and the subjective awareness of coughing in the disease.
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