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Semnani K, Sohrabi M, Alavijeh PE, SeyedAlinaghi S, Esmaeili S, Halabchi F, Alizadeh Z, Salami A, Khaneshan AS. Prior COVID-19 infection among newly diagnosed tuberculosis patients in a tertiary care center in Tehran: A case-control study. Immun Inflamm Dis 2024; 12:e1275. [PMID: 38804889 PMCID: PMC11131933 DOI: 10.1002/iid3.1275] [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: 12/01/2023] [Revised: 04/14/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE To assess the risk of developing pulmonary tuberculosis (TB) in accordance with prior history of COVID-19 infection. BACKGROUND Since the advent of the COVID-19 pandemic much discussion has been had on the possible role it might play on global efforts to combat TB; most, focusing on the pandemic's impact on health care systems' capabilities to manage TB cases. Mechanisms have also been proposed by which the COVID-19 infection may directly affect individuals' chance of developing TB infection. Cases have been reported with a history of COVID-19 infection preceding a diagnosis of TB, evidencing its possible role as a risk factor for the disease. METHODS A case-control study was conducted enrolling patients diagnosed with pulmonary TB in the absence of major risk factors previous history of TB, (HIV) human immunodeficiency virus infection), end-stage renal disease, organ transplants, and use of immunosuppressive agents) for developing TB. Each patient was age and sex matched with one healthy control. Data regarding prior COVID-19 infection, diabetes, and smoking status as well as the use of corticosteroids and Tocilizumab for the treatment of COVID-19 infection was obtained. Bivariate analysis was conducted and variables with a likely association with TB status were entered in a multivariate model. RESULTS Bivariate analysis demonstrated a significant relationship between prior COVID-19 infection and TB (95% confidence interval = 1.1-22.8, odds ratio [OR] = 5). Among other variables the severity of COVID-19 infection was found to have a likely association with TB status (p = .125). In a multivariate model, prior COVID-19 infection per se, was not found to be significantly associated with TB (p = .12, OR = 4.5). CONCLUSIONS There seems to be an association between prior history of COVID-19 and a future diagnosis of TB partially linked to the severity of disease. The findings of the current study may serve as a basis for further studies to determine the need for and efficacy of measures to follow-up COVID-19 patients at an increased risk for developing TB.
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Affiliation(s)
- Kiavash Semnani
- Tehran University of Medical Sciences School of MedicineTehranIran
| | - Marjan Sohrabi
- Department of Infectious Diseases, Tehran University of Medical SciencesImam Khomeini Hospital Complex, Tohid SqureTehranIran
| | - Parvaneh Ebrahimi Alavijeh
- Department of Infectious Diseases, Tehran University of Medical SciencesArash Women's HospitalTehranIran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Tehran University of Medical SciencesIranian Institute for Reduction of High Risk BehaviorsTehranIran
| | - Shirin Esmaeili
- Tehran University of Medical Sciences School of MedicineTehranIran
| | - Farzin Halabchi
- Department of Sports and Exercise MedicineTehran University of Medical SciencesTehranIran
| | - Zahra Alizadeh
- Department of Sports and Exercise MedicineTehran University of Medical SciencesTehranIran
| | - Amir Salami
- Student Research CommitteeIran University of Medical Sciences School of Medicine, Hemmat HwyTehranIran
| | - Arezoo Salami Khaneshan
- Department of Infectious Diseases, Tehran University of Medical SciencesImam Khomeini Hospital Complex, Tohid SqureTehranIran
- Iranian Research Center for HIV/AIDS, Tehran University of Medical SciencesIranian Institute for Reduction of High Risk BehaviorsTehranIran
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Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K. Sarcoidosis in first- and second-generation immigrants: a cohort study of all adults 18 years of age and older in Sweden. Int Health 2024:ihae030. [PMID: 38606589 DOI: 10.1093/inthealth/ihae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/22/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND There is a lack of studies on sarcoidosis among immigrants, which is of interest as there may be genetic and environmental characteristics affecting immigrants from certain countries. We aimed to study hazard ratios (HRs) of sarcoidosis in first- and second-generation immigrants, comparing them with native Swedes in the total adult Swedish population. METHODS We conducted a nationwide study of individuals ≥18 y of age. Sarcoidosis was defined as at least two registered diagnoses in the National Patient Register between 1 January 1998 and 31 December 2018. Cox regression analysis was used to estimate HRs with 99% confidence intervals (CIs) of first registration of sarcoidosis in first- and second-generation immigrants compared with native Swedes. The Cox regression models were stratified by sex and adjusted for age, comorbidities and sociodemographic characteristics. RESULTS In total, 6 175 251 were included in the first-generation study, with 12 617 cases of sarcoidosis, and 4 585 529 in the second-generation study, with 12 126 cases. The overall sarcoidosis risk was lower in foreign-born men (fully adjusted HR 0.63 [99% CI 0.57 to 0.69]) but not in foreign-born women (fully adjusted HR 0.98 [99% CI 0.90 to 1.06]). The overall risk was slightly lower in second-generation immigrants (HR 0.82 [99% CI 0.78 to 0.88]). Women from Asia exhibited a higher risk (HR 1.25 [99% CI 1.02 to 1.53)], while a potential trend was observed among women from Africa (HR 1.47 [99% CI 0.99 to 2.19]). CONCLUSIONS Sarcoidosis risk was lower in foreign-born men but not in women and also lower in second-generation immigrants.
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Affiliation(s)
- Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge 141 83, Sweden
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö 205 02, Lund University, Malmö, Sweden
| | - Xinjun Li
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö 205 02, Lund University, Malmö, Sweden
| | - Axel C Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge 141 83, Sweden
- Academic Primary Health Care Centre, Stockholm Region, Stockholm 113 65, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö 205 02, Lund University, Malmö, Sweden
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue 690-8504, Japan
- University Clinic Primary Care Skåne, Region Skåne 20502, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö 205 02, Lund University, Malmö, Sweden
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue 690-8504, Japan
- University Clinic Primary Care Skåne, Region Skåne 20502, Sweden
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de Lima RS, da Silva RN, André SR, Pinheiro AKC, Sousa AI, da Silva IFS, dos Santos J, Nogueira LMV, Zeitoune RCG. Mycobacterium tuberculosis latent infection in healthcare students: systematic review of prevalence. Rev Esc Enferm USP 2024; 58:e20230238. [PMID: 38488508 PMCID: PMC10941757 DOI: 10.1590/1980-220x-reeusp-2023-0238en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/12/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE The aim of this study was to synthesize the evidence on the prevalence of latent Mycobacterium tuberculosis infection (LTBI) among undergraduate health care students. METHODS A systematic review of prevalence with meta-analysis was conducted. Prospective and retrospective cohorts and cross-sectional studies involving probable exposure to M. tuberculosis during undergraduate education, along with the tuberculin skin test (TST) or interferon-γ release assay (IGRA) for investigation of latent tuberculosis were searched. Searches were conducted in MEDLINE, CINAHL, EMBASE, LILACS, Scopus, and Web of Science databases. Independent reviewers were responsible for the selection and inclusion of studies. Data were extracted, critically appraised, and synthesized using the JBI approach. PRISMA was used to report the study. RESULTS Twenty-two studies were analyzed. The overall prevalence in healthcare undergraduate students was 12.53%. CONCLUSION The prevalence of LTBI in undergraduate health students was high for such a highly educated population. Screening with TST and/or IGRA and chemoprophylaxis, when necessary, should be provided to undergraduate health students when in contact with respiratory symptomatic patients.
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Affiliation(s)
- Renata Silva de Lima
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Suzana Rosa André
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Ana Inês Sousa
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
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Badawi MM, SalahEldin MA, Idris AB, Idris EB, Mohamed SG. Tuberculosis in Sudan: systematic review and meta analysis. BMC Pulm Med 2024; 24:51. [PMID: 38263137 PMCID: PMC10807179 DOI: 10.1186/s12890-024-02865-6] [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: 05/07/2023] [Accepted: 01/17/2024] [Indexed: 01/25/2024] Open
Abstract
Every year, 10 million people fall ill with tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year -making it the world's top infectious disease. TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance. Its presumed that TB was the cause of 1% of the total deaths among inpatients in Sudan in 2017. The current study is aimed to provide pooled prevalence of Mycobacterium tuberculosis among Sudanese as well as to determine any socio-cultural risk factors associated. A systematic review of the literature was conducted and regulated in accordance with the PRISMA Statement. After abstract and full text screening only twenty-six articles met our inclusion criteria and passed the quality assessment procedure. Pulmonary tuberculosis prevalence was assessed in sixteen included studies among participants from Khartoum, Gezira, Kassala, Blue Nile, River Nile, White Nile, Gadarif, Red sea, North Kordofan, Northern State, Sennar and West Darfur States, representing a total sample size of 11,253 participants of suspected individuals such as febrile outpatients, TB patients' contacts and other groups such as HIV/AIDS patients, hemodialysis patients, School adolescents as well as pregnant women. The pooled prevalence was 30.72% [CI: 30.64, 30.81]. Moreover, Khartoum State recorded the highest pooled prevalence as 41.86% [CI: 14.69, 69.02] based on a total sample size of 2,737 participants. Furthermore, male gender and rural residence were found to be significantly associated with TB infection. Further research with larger sample sizes targeting prevalence and risk factors of TB among Sudanese population is needed to be conducted.
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Affiliation(s)
- M M Badawi
- Higher Academy for Strategic and Security Studies, Khartoum, Sudan.
| | - M A SalahEldin
- Medical Microbiology Department, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - A B Idris
- General Surgery Resident, Medical Specialization Board, Khartoum, Sudan
| | - E B Idris
- Department of medical microbiology, Rashid Medical Complex, Riyadh, Saudi Arabia
| | - S G Mohamed
- Medical Microbiology Department, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
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Al Nokhatha S, AlKindi F, Alfalasi M, Abdelsalhen M, AlKhyeli F, Alsaber AR. Prevalence of Latent Tuberculosis Infection Among Rheumatology Patients and Management Practices in the United Arab Emirates: A Single-Center Retrospective Cohort Study. Cureus 2023; 15:e50581. [PMID: 38222154 PMCID: PMC10788094 DOI: 10.7759/cureus.50581] [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: 12/15/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction Prior to immunosuppression, rheumatology patients are routinely screened for latent tuberculosis (TB) infection using interferon-gamma release assays (IGRAs). Variability in the management of latent and indeterminate IGRA results across institutions limited long-term outcome data. A retrospective study was conducted at Tawam Hospital, United Arab Emirates, to investigate the incidence and management protocols associated with positive and indeterminate IGRA results, as well as TB infection, among patients with rheumatic conditions. Methods A single-center retrospective observational study was performed at Tawam Hospital, Abu Dhabi, UAE. Ethical approval for this study was obtained from the Tawam Human Research Ethics Committee. Laboratory records and the hospital's electronic medical system were used to obtain information about IGRA results over a 12-year period (April 2010-April 2022). The hospital's electronic medical system was used to obtain patient information and subsequent management approaches of positive and indeterminate IGRAs. Moreover, long-term follow-up data were collected to determine the risk of TB reactivation in the cohort. Results We found a total of 1,012 positive and 223 indeterminate IGRA test results within the 12-year period. Within the rheumatology department, 123 positive and 39 indeterminate IGRA results were identified. In the indeterminate IGRA group, the majority were women (n = 24, 61.5%) and UAE nationals (n = 22, 56.4%), and their mean age was 38.6 years. Systemic lupus erythematosus was the most prevalent rheumatologic condition (n = 21, 53.8%). Thirteen (33.3%) were on disease-modifying anti-rheumatic drugs (DMARDs) and 26 (66.7%) were on corticosteroids during IGRA testing. A total of eight patients (20.5%) received anti-TB medications. In the positive IGRA group, the mean age was 55.7 years and the female-to-male ratio was 3:1. The most common rheumatologic condition was rheumatoid arthritis (n = 69, 56%). Sixty-five (52.8%) patients were on conventional DMARDs, 43 (34.9%) were on corticosteroids during IGRA testing, and 74 (60%) received anti-TB medications. Two cases (1.6%) of active TB infections were detected among patients with positive IGRA tests, both of whom were receiving anti-tumor necrosis factor alpha inhibitor treatment in combination with methotrexate. No cases of active TB infection were observed in the indeterminate IGRA group. Conclusion Long-term data on the risk of TB activation in positive and indeterminate IGRA results for rheumatological conditions are low. It is recommended to reassess the choice of using anti-TNF-α, with a positive IGRA result if no other feasible alternatives can be offered. Our findings stress the importance of age, underlying diseases, and immunosuppressive treatments in interpreting IGRA results and guiding patient management. A large multicenter study is needed to understand the differences and outcomes of such patients in TB endemic and nonendemic geographical areas.
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Affiliation(s)
- Shamma Al Nokhatha
- Rheumatology, Tawam Hospital, Al Ain, ARE
- Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
| | | | | | | | | | - Ahmad R Alsaber
- College of Business and Economics, American University of Kuwait, Kuwait, KWT
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Teshima A, Shatnawi AA, Satyanarayana S, Khader YS, Maia IF, Wilson NC. High prevalence of current tobacco smoking among patients with tuberculosis and people living with HIV in Jordan: A cross-sectional survey. Tob Induc Dis 2023; 21:136. [PMID: 37869614 PMCID: PMC10587893 DOI: 10.18332/tid/171551] [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] [Received: 05/12/2023] [Revised: 08/19/2023] [Accepted: 08/24/2023] [Indexed: 10/24/2023] Open
Abstract
INTRODUCTION Continued smoking by patients with tuberculosis (TB) and people living with HIV (PLHIV) leads to adverse treatment outcomes. Estimates of tobacco use among the population are scarce in the Eastern Mediterranean region, where the burden of TB and HIV is also low but highly variable. This study determined the prevalence of current smoking and assessed factors associated with current smoking among patients with TB and PLHIV in Jordan. METHODS We analyzed data from the Jordan Knowledge, Attitude, and Practices survey in 2021. Information on current tobacco use, including products and frequency of smoking, was collected from 452 patients with TB and 152 PLHIV. We performed multivariable logistic regression to assess the sociodemographic characteristics independently associated with current smoking. RESULTS Prevalence of current smoking was 43.8% among TB patients and 67.8 % among PLHIV, and conventional cigarettes were the most used tobacco products. The prevalence of current smoking among patients with TB was higher among males (AOR=8.20; 95% CI: 5.05-13.32), Jordanians (AOR=5.37; 95% CI: 2.66-10.86) and Syrians (AOR=4.13; 95% CI: 1.60-10.67), and those experiencing financial difficulties (AOR=2.83; 95% CI: 1.69-4.74). The prevalence of current smoking among PLHIV was higher in those with financial difficulties (AOR=3.13; 95% CI: 1.19-8.27). CONCLUSIONS Nearly half of the patients with TB and PLHIV were current tobacco smokers, higher than the general population. There is an urgent need to investigate the reasons for such a high smoking prevalence and introduce and strengthen smoking cessation services under the TB and HIV control programs.
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Affiliation(s)
- Ayaka Teshima
- Tobacco Control Unit, Department of Cancer Epidemiology and Prevention, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ayah A. Shatnawi
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
| | - Srinath Satyanarayana
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
| | - Yousef S. Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ibrahim F. Maia
- Department of Chest Diseases and Migrant Health, Ministry of Health, Amman, Jordan
| | - Nevin C. Wilson
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
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Sehat M, Razzaghi R, Ghamsary M, Faghir Ganji M, Sehat M. Changes in the rate of bacillus tuberculosis infection in health workers in the first year of the COVID-19 epidemic in Kashan- Iran. Heliyon 2023; 9:e20560. [PMID: 37829797 PMCID: PMC10565687 DOI: 10.1016/j.heliyon.2023.e20560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 09/15/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
Objective This cohort study aimed to determine the prevalence and risk factors of latent tuberculosis infection among healthcare workers during the COVID-19 pandemic. Methods A one-year cohort study was conducted in a referral hospital in Kashan, involving 176 medical, educational, and cleaning personnel. Initial evaluations and tuberculin skin tests were performed, followed by a one-year follow-up period. Data were analyzed using SPSS version 26 software. Results Among the participants, 26.1% (46 individuals) tested positive for latent tuberculosis infection. Age was a significant risk factor, with a 3.6% increase in latent tuberculosis infection risk with each advancing year. Men had 2.19 times (1.10-4.35) the chance of having a latent infection compared to women. Hospital staff were 3.7 times more at risk of tuberculosis infection than students. Among the hospital job categories, nursing assistants had the highest chance of tuberculosis infection, 6.77 times higher than medical students, followed by cleaning staff and nurses. The ICU, General, and Obstetrics and Gynecology departments had an infection chance of 2.46 (1.11-5.46) compared to other departments. No new positive cases were detected during the follow-up period. Conclusion This study contributes to the understanding of latent tuberculosis infection prevalence and its risk factors among healthcare workers during the COVID-19 pandemic. The findings highlight the importance of infection control measures and targeted interventions to protect healthcare workers from occupational tuberculosis exposure.
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Affiliation(s)
- Mojgan Sehat
- Department of Infectious Diseases, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Reza Razzaghi
- Department of Infectious Diseases, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mark Ghamsary
- Loma Linda University (retired), School of Public Health, Department of Epidemiology and Biostatistics, California, USA
| | - Monireh Faghir Ganji
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Sehat
- Trauma Research Center, Department of Community Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Gupta M, Srikrishna G, Klein SL, Bishai WR. Genetic and hormonal mechanisms underlying sex-specific immune responses in tuberculosis. Trends Immunol 2022; 43:640-656. [PMID: 35842266 PMCID: PMC9344469 DOI: 10.1016/j.it.2022.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022]
Abstract
Tuberculosis (TB), the world's deadliest bacterial infection, afflicts more human males than females, with a male/female (M/F) ratio of 1.7. Sex disparities in TB prevalence, pathophysiology, and clinical manifestations are widely reported, but the underlying biological mechanisms remain largely undefined. This review assesses epidemiological data on sex disparity in TB, as well as possible underlying hormonal and genetic mechanisms that might differentially modulate innate and adaptive immune responses in males and females, leading to sex differences in disease susceptibility. We consider whether this sex disparity can be extended to the efficacy of vaccines and discuss novel animal models which may offer mechanistic insights. A better understanding of the biological factors underpinning sex-related immune responses in TB may enable sex-specific personalized therapies for TB.
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Ding C, Hu M, Guo W, Hu W, Li X, Wang S, Shangguan Y, Zhang Y, Yang S, Xu K. Prevalence trends of latent tuberculosis infection at the global, regional, and country levels from 1990-2019. Int J Infect Dis 2022; 122:46-62. [PMID: 35577247 DOI: 10.1016/j.ijid.2022.05.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES To track the prevalence trends of latent tuberculosis infection (LTBI) at the global, regional, and national levels. METHODS Data on the prevalence of LTBI were extracted from the Global Burden of Disease database. The average annual percent change (AAPC) was estimated by joinpoint regression and was used to evaluate the epidemic of the disease. RESULTS Globally, the prevalence rate of LTBI decreased from 30.66% in 1990 to 23.67% in 2019, with an AAPC of -0.9%. The prevalence rate of LTBI varied from 5.02% (Jordan) to 48.35% (Uganda) in 1990 and from 2.51% (Jordan) to 43.75% (Vietnam) in 2019 at the country level. The prevalence decreased in all the six World Health Organization (WHO) regions and in most countries, with the AAPC ranging from -0.5% in the Western Pacific Region to -2.1% in the European Region and from -4.3% (Bhutan) to -0.1% (Malaysia, Myanmar, South Africa, Tokelau, and Vietnam), respectively. Disparities were also observed among different sex and age groups. CONCLUSION The prevalence of LTBI decreased slightly worldwide in the last three decades, but the decrease is slow and not sufficient to meet the targets of WHO tuberculosis elimination. Much more effort and progress should be made in order to decrease the prevalence of LTBI.
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Affiliation(s)
- Cheng Ding
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China
| | - Ming Hu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China
| | - Wanru Guo
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China
| | - Wenjuan Hu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China
| | - Xiaomeng Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China
| | - Shuting Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China
| | - Yanwan Shangguan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China
| | - Ying Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China.
| | - Shigui Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China.
| | - Kaijin Xu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, China.
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10
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Bongomin F, Ssekamatte P, Nattabi G, Olum R, Ninsiima S, Kyazze AP, Nabakka W, Kukunda R, Cose S, Kibirige D, Batte C, Kaddumukasa M, Kirenga BJ, Nakimuli A, Baluku JB, Andia-Biraro I. Latent Tuberculosis Infection Status of Pregnant Women in Uganda Determined Using QuantiFERON TB Gold-Plus. Open Forum Infect Dis 2021; 8:ofab241. [PMID: 34113689 PMCID: PMC8186242 DOI: 10.1093/ofid/ofab241] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022] Open
Abstract
Background The risk of progression of latent tuberculosis infection (LTBI) to active disease increases with pregnancy. This study determined the prevalence and risk factors associated with LTBI among pregnant women in Uganda. Methods We enrolled 261 pregnant women, irrespective of gestational age. Participants who had known or suspected active tuberculosis (TB) on the basis of clinical evaluation or who had recently received treatment for TB were excluded. LTBI was defined as an interferon-γ concentration ≥0.35 IU/mL (calculated as either TB1 [eliciting CD4+ T-cell responses] or TB2 [eliciting CD8+ T-cell responses] antigen minus nil) using QuantiFERON TB Gold-Plus (QFT-plus) assay. Results LTBI prevalence was 37.9% (n = 99) (95% confidence interval [CI], 32.3–44.0). However, 24 (9.2%) subjects had indeterminate QFT-plus results. Among participants with LTBI, TB1 and TB2 alone were positive in 11 (11.1%) and 18 (18.2%) participants, respectively. In multivariable analysis, human immunodeficiency virus (HIV) infection (adjusted odds ratio [aOR], 4.4 [95% confidence interval {CI}, 1.1–18.0]; P = .04) and age 30–39 years (aOR, 4.0 [95% CI, 1.2–12.7]; P = .02) were independently associated with LTBI. Meanwhile, smoking status, alcohol use, nature of residence, crowding index, and TB contact were not associated with LTBI. Conclusions Our findings are in keeping with the evidence that HIV infection and advancing age are important risk factors for LTBI in pregnancy. In our setting, we recommend routine screening for LTBI and TB preventive therapy among eligible pregnant women.
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Affiliation(s)
- Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.,Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Phillip Ssekamatte
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Gloria Nattabi
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda
| | - Ronald Olum
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sandra Ninsiima
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Andrew Peter Kyazze
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Winnie Nabakka
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda
| | - Rebecca Kukunda
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Davis Kibirige
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda.,Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Charles Batte
- Lung Institute, Makerere University, Kampala, Uganda
| | - Mark Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Bruce J Kirenga
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Lung Institute, Makerere University, Kampala, Uganda
| | - Annettee Nakimuli
- Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joseph Baruch Baluku
- Division of Pulmonology, Kiruddu National Referral Hospital, Kampala, Uganda.,Directorate of Programs, Mildmay Uganda, Wakiso, Uganda
| | - Irene Andia-Biraro
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,Department of Clinical Research, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
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