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Khursheed S, Wazir S, Saleem MK, Majeed AI, Ahmad M, Khan QU, Jadoon A, Akbar A, Jadoon SK, Tasneem S, Saleem H, Khan MS, Alvi S. Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study. Medicine (Baltimore) 2024; 103:e37787. [PMID: 38608068 PMCID: PMC11018243 DOI: 10.1097/md.0000000000037787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
Tuberculosis (TB) remains a serious problem for public health and a leading cause of death after COVID-19 and superior to even HIV/AIDS. It is a social health issue and can cause stigma and economic loss as the person cannot perform professionally due to lethargy caused by disease. It is a retrospective study done on data from National TB program Muzaffarabad chapter. The details were noted on SPSS and analysis was done to find important demographic characteristics. The total number of patients was 3441; among which 48.76% were males. Most of them (81.11%) belonged to the Muzaffarabad division of Azad Jammu and Kahmir (AJK). The microbiologically or culture positive cases were 440. Rifampicin resistance was present in 147 cases, further categorized as high (n = 143), very high (n = 3), or true positive (n = 1) resistance. Muti drug resistance was found in 19 cases. The microscopy culture is more sensitive (AUC = 0.511) than MTB/RIF or serology (AUC = 0.502) according to ROC. The rate of positive smear results is not very satisfactory in the present study as it cannot detect dormant or latent cases. There is a need to establish more sensitive tests for detection of cases and more research to combat the disease.
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Affiliation(s)
| | - Samia Wazir
- Pakistan Institute of Medical Science, Islamabad, Pakistan
| | - Muhammad Khurram Saleem
- University Hospital, Bristol and Weston NHS Foundation Trust, Royal College of Physicians and Surgeons of Glasgow, Glasgow, UK
| | | | - Mumtaz Ahmad
- Abbas Institute of Medical Sciences, Muzaffarabad, AJK, Pakistan
| | | | - Arzu Jadoon
- Ziauddin University Hospital Karachi, Karachi, Pakistan
| | - Amna Akbar
- CHPE Health Services Academy, Islamabad, Pakistan
| | | | | | | | - Mohammad Saleem Khan
- Chief Consultant Physician/Head of Department of Medicine DHQ Teaching, Hospital Kotli AJK, Kotli, Pakistan
| | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Wu J, Wang K, Tao F, Li Q, Luo X, Xia F. The association of blood metals with latent tuberculosis infection among adults and adolescents. Front Nutr 2023; 10:1259902. [PMID: 38024374 PMCID: PMC10655142 DOI: 10.3389/fnut.2023.1259902] [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: 09/28/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Objective We aimed to investigate the relationship of metal exposure and latent tuberculosis infection (LTBI) among US adults and adolescents. Methods Participants from the National Health and Nutrition Examination Surveys (NHANES 2011 ~ 2012) were included. Multiple logistic regression models were used to explore the associations between metal exposure and LTBI. A total of 5,248 adults and 1,860 adolescents were included in the present analysis. Results For adults, we only found a positive association between total mercury and LTBI (OR: 1.411; 95% CI: 1.164 ~ 1.710) when used as a continuous variable. Compared with Q1, Q4 increased the prevalence of LTBI (2.303; 1.455 ~ 3.644) when used as a quartile. The OR of total mercury and LTBI was higher among females (1.517; 1.009 ~ 2.279), individuals aged 45 ~ 64 (1.457; 1.060 ~ 2.002), and non-Hispanic White individuals (1.773; 1.316 ~ 2.388). A relationship was observed among only participants with obesity (1.553; 1.040 ~ 2.319) or underweight (1.380; 1.076 ~ 1.771), with college or above (1.645; 1.184 ~ 2.286), with PIR > 3.0 (1.701; 1.217 ~ 2.376), reported smoking (1.535; 1.235 ~ 1.907) and drinking (1.464; 1.232 ~ 1.739). For adolescents, blood manganese was positively associated with LTBI. The OR and 95% CIs for each one-unit increase in the log-transformed level of blood manganese with LTBI were 9.954 (1.389 ~ 71.344). Conclusion Significant associations were observed in girls, aged ≥12 years and in the non-Hispanic white population. In conclusion, total mercury is associated with an increased prevalence of LTBI among adults and positive association between blood manganese and LTBI was observed among adolescents. Further studies should be conducted to verify the results and explore potential biological mechanisms.
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Affiliation(s)
| | | | | | | | - Xin Luo
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
| | - Fang Xia
- Department of Public Health, Wuhan Fourth Hospital, Wuhan, China
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Galea JT, Chu AL, Sweetland AC, Jimenez J, Yataco R, Calderón R, Zhang Z, Huang CC, Lecca L, Murray M. Latent TB and depressive symptoms in household contacts of persons with active TB. Int J Tuberc Lung Dis 2023; 27:682-687. [PMID: 37608477 PMCID: PMC10443790 DOI: 10.5588/ijtld.22.0609] [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: 11/12/2022] [Accepted: 03/21/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND: Depression is common among persons with TB and is associated with poor clinical outcomes. However, little is known about the relationship between latent TB infection (LTBI) and depression. We assessed the association between LTBI and depressive symptoms among household contacts (HHCs) of patients receiving TB treatment.METHODS: We enrolled 1,009 HHCs of 307 patients receiving TB treatment in Lima, Peru, during 2016-2018. At enrollment, HHC LTBI status was assessed using the interferon-gamma release assay (IGRA). Depressive symptoms were assessed at baseline and 12 months later using the Patient Health Questionnaire-9 (PHQ-9) with a cut-off of ≥5. We used logistic regression to estimate the odds ratio (OR) for PHQ-9 ≥5, comparing HHCs with and without baseline LTBI.RESULTS: Among 921 HHCs, 374 (41.0%) had LTBI at baseline, and 69 (12.4%) of 567 HHCs had PHQ-9 ≥5. Compared to HHCs without LTBI at enrollment, those with LTBI had almost two times the odds of PHQ-9 ≥5 at follow-up after controlling for potential confounders (adjusted OR 1.93, 95% CI 1.09-3.39); this association was driven by greater severities of depressive symptoms.CONCLUSION: HHCs with LTBI had increased odds of depressive symptoms 1 year later. This population may benefit from mental health screening and interventions integrated into TB programs.
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Affiliation(s)
- J T Galea
- School of Social Work, University of South Florida, Tampa, FL, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
| | - A L Chu
- Department of Medical Education, Dell Medical School at the University of Texas at Austin, Austin, TX
| | - A C Sweetland
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons/New York State Psychiatric Institute, New York, NY, USA
| | | | | | - R Calderón
- Socios En Salud, Lima, Grupo de Investigación en Bioquímica y Biología Sintética, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Z Zhang
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - C-C Huang
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - L Lecca
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, Socios En Salud, Lima
| | - M Murray
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
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Prevalence of suicidal ideations and suicide attempts in patients with tuberculosis: A systematic review and meta-analysis. J Psychosom Res 2023; 167:111171. [PMID: 36753943 DOI: 10.1016/j.jpsychores.2023.111171] [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: 12/14/2022] [Revised: 01/13/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Suicide and suicidal behaviors are reported to be common in patients with Tuberculosis (TB). This systematic review and meta-analysis aimed to quantitively assess the prevalence of suicidality and identify the factors associated with suicidality in patients with TB. METHODS We searched databases PubMed, SCOPUS, Web of Science, PsycINFO, and Google Scholar for studies that reported the prevalence of suicide, suicidal ideations, or suicide attempts in patients with TB. We assessed the quality of studies with the Newcastle Ottawa scale. Random-effects models were used to calculate the pooled prevalence with 95% confidence intervals (CI). RESULTS Nine studies (8770 participants) were included. Pooled prevalence for current suicidal ideations within the last year was 8.5% [95% CI: 5.8%12.3%]. Pooled prevalence for current suicidal attempts within the last year was 3.1% [2.2%- 4.5%]. Suicide was reported in 0.92% of TB patients at the end of 2 years, whereas 2.2% to 8.4% of all TB deaths were reported due to suicide. Factors associated with suicidality were female gender, TB retreatment, comorbid HIV, presence of another chronic medical illness, psychological distress, and comorbid psychiatric illnesses. CONCLUSION The prevalence rates of suicidal ideation and attempts were higher in patients with TB than in the general population. Integrating mental health services with TB programs will help develop interventions for high-risk individuals. Prospero registration number: CRD42021281849.
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Incidence and Risk of Lung Cancer in Tuberculosis Patients, and Vice Versa: A Literature Review of the Last Decade. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1702819. [PMID: 36578803 PMCID: PMC9792248 DOI: 10.1155/2022/1702819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Background The incidence and risk of both lung cancer (LC) and tuberculosis (TB) are increasing rapidly. These two diseases frequently exist together and can influence the incidence and risk of each other. The aim of the current review was to summarize the incidence and risk of LC in TB patients, and vice versa, short out research gap, and contemplate future research perspectives. Methodology. PubMed and Scopus databases, and Google Scholar search engine were searched for epidemiological studies that investigated the incidence and risk of TB and LC, published since January 2011 to April 2022, and written in English. We used the searching keyword "tuberculosis" combined with "lung cancer" and associated medical subject heading (MeSH) to retrieve eligible research articles. We retrieved information's regarding the diagnosis of TB and LC, confounders, the associations of TB and LC, and incidence and risks of each other. Results We found higher incidence rate and risks (1.64 to 6 times higher) of LC in TB patients in comparison to non-TB participants. However, the incidence rate and risks of TB in LC patients were comparatively low. Male patients were exhibited higher risks than female. The medical comorbidities, smoking habits, and age can also influence the associations and risks of LC in TB patients or vice versa. Conclusion Our summarized studies might suggest that existing active TB may increase the incidence and risk of LC. However, large prospective cohort study is warranted to explore the real scenario worldwide.
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Yuan Y, Wang X, Zhou Y, Zhou C, Li S. Prevalence and risk factors of latent tuberculosis infection among college students: a systematic review and meta-analysis. Public Health 2022; 213:135-146. [PMID: 36410119 DOI: 10.1016/j.puhe.2022.10.003] [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: 08/05/2022] [Revised: 09/11/2022] [Accepted: 10/04/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES College students are at increased risk of tuberculosis (TB), which increases their likelihood of developing latent tuberculosis infections (LTBI). This study aimed to estimate the pooled prevalence of LTBI and identify its risk factors. STUDY DESIGN Systematic review and meta-analysis. METHODS We searched PubMed, Embase, Scopus, Web of Science, CNKI, Wanfang and CBM databases (10 March 2022) for studies published in any language. The pooled prevalence of LTBI was estimated using random effects methods. Factors associated with LTBI were evaluated by determining standardised mean difference (SMD) with 95% confidence interval (CI). All analyses were performed using the Stata 15.1. RESULTS A total of 50 studies from 18 countries were included, with 44 tuberculin skin test (n = 623,732) and 19 interferon gamma release assay (n = 38,266) estimates. The prevalence of a positive tuberculin skin test was 20% (95% CI: 17-23%), and the prevalence of a positive interferon gamma release assay was 9% (95% CI: 7%-11%) among college students. Older age (SMD: 1.67, 95% CI: 1.31-2.13), no Bacillus Calmette-Guérin vaccination/scar (SMD: 1.51, 95% CI: 1.06-2.16), contact with TB cases (SMD: 1.34, 95% CI: 1.11-1.62), clinical training (SMD: 1.93, 95% CI: 1.65-2.26) and overweight/obesity (SMD: 1.17, 95% CI: 1.06-1.30) were associated with a higher prevalence of LTBI. Sex was not associated with LTBI prevalence. CONCLUSION College students have an increased risk of LTBI, although it varies by geographical area. This meta-analysis provides evidence of risk factors for LTBI in college students. Infection control measures should be conducted for college students with LTBI.
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Affiliation(s)
- Yemin Yuan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Xiyuan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Yanxin Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
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Wang X, Wu Z, Zeng J, Zhao Y, Zhang C, Yu M, Wang W, Chen X, Chen L, Wang J, Xu L, Zhou J, Tan Q, Wei W, Li Y. Untargeted metabolomics of pulmonary tuberculosis patient serum reveals potential prognostic markers of both latent infection and outcome. Front Public Health 2022; 10:962510. [PMID: 36457328 PMCID: PMC9705731 DOI: 10.3389/fpubh.2022.962510] [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: 06/06/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Currently, there are no particularly effective biomarkers to distinguish between latent tuberculosis infection (LTBI) and active pulmonary tuberculosis (PTB) and evaluate the outcome of TB treatment. In this study, we have characterized the changes in the serum metabolic profiles caused by Mycobacterium tuberculosis (Mtb) infection and standard anti-TB treatment with isoniazid-rifampin-pyrazinamide-ethambutol (HRZE) using GC-MS and LC-MS/MS. Seven metabolites, including 3-oxopalmitic acid, akeboside ste, sulfolithocholic acid, 2-decylfuran (4,8,8-trimethyldecahydro-1,4-methanoazulen-9-yl)methanol, d-(+)-camphor, and 2-methylaminoadenosine, were identified to have significantly higher levels in LTBI and untreated PTB patients (T0) than those in uninfected healthy controls (Un). Among them, akeboside Ste and sulfolithocholic acid were significantly decreased in PTB patients with 2-month HRZE (T2) and cured PTB patients with 2-month HRZE followed by 4-month isoniazid-rifampin (HR) (T6). Receiver operator characteristic curve analysis revealed that the combined diagnostic model showed excellent performance for distinguishing LT from T0 and Un. By analyzing the biochemical and disease-related pathways, we observed that the differential metabolites in the serum of LTBI or TB patients, compared to healthy controls, were mainly involved in glutathione metabolism, ascorbate and aldarate metabolism, and porphyrin and chlorophyll metabolism. The metabolites with significant differences between the T0 group and the T6 group were mainly enriched in niacin and nicotinamide metabolism. Our study provided more detailed experimental data for developing laboratory standards for evaluating LTBI and cured PTB.
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Affiliation(s)
- Xuezhi Wang
- Foshan Fourth People's Hospital, Foshan, China
| | - Zhuhua Wu
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Jincheng Zeng
- Dongguan Key Laboratory of Medical Bioactive Molecular Development and Translational Research, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, China
| | - Yuchuan Zhao
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Chenchen Zhang
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Meiling Yu
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Wei Wang
- Foshan Fourth People's Hospital, Foshan, China
| | - Xunxun Chen
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Liang Chen
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Jiawen Wang
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Liuyue Xu
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Jie Zhou
- Foshan Fourth People's Hospital, Foshan, China
| | - Qiuchan Tan
- Dongguan Key Laboratory of Medical Bioactive Molecular Development and Translational Research, Guangzhou Health Science College, Guangzhou, China,Qiuchan Tan
| | - Wenjing Wei
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China,Wenjing Wei
| | - Yanxia Li
- Foshan Fourth People's Hospital, Foshan, China,*Correspondence: Yanxia Li
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Kua KP, Chongmelaxme B, Lee SWH. Association Between Cytomegalovirus Infection and Tuberculosis Disease: A Systematic Review and Meta-Analysis of Epidemiological Studies. J Infect Dis 2022; 227:471-482. [PMID: 35512129 PMCID: PMC9927079 DOI: 10.1093/infdis/jiac179] [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: 02/27/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tuberculosis is one of the leading causes of mortality worldwide from an infectious disease. This review aimed to investigate the association between prior cytomegalovirus infection and tuberculosis disease. METHODS Six bibliographic databases were searched from their respective inception to 31 December 2021. Data were pooled using random-effects meta-analysis. RESULTS Of 5476 identified articles, 15 satisfied the inclusion criteria with a total sample size of 38 618 patients. Pooled findings showed that individuals with cytomegalovirus infection had a higher risk of tuberculosis disease compared to those not infected with cytomegalovirus (odds ratio [OR], 3.20; 95% confidence interval [CI], 2.18-4.70). Age was the only covariate that exerted a significant effect on the result of the association. Meta-analysis of risk estimates reported in individual studies showed a marked and significant correlation of cytomegalovirus infection with active tuberculosis (adjusted hazard ratio, 2.92; 95% CI, 1.34-4.51; adjusted OR, 1.14; 95% CI, .71-1.57). A clear dose-response relation was inferred between the levels of cytomegalovirus antibodies and the risks of tuberculosis events (OR for high levels of cytomegalovirus antibodies, 4.07; OR for medium levels of cytomegalovirus antibodies, 3.58). CONCLUSIONS The results suggest an elevated risk of tuberculosis disease among individuals with a prior cytomegalovirus infection.
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Affiliation(s)
- Kok Pim Kua
- Pharmacy Unit, Puchong Health Clinic, Petaling District Health Office, Ministry of Health Malaysia, Puchong, Malaysia
| | - Bunchai Chongmelaxme
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Shaun Wen Huey Lee
- Correspondence: S. Lee, MPharm, PhD, GCHE, School of Pharmacy, Monash University, Bandar Sunway, Room 4-4-37, Subang Jaya, Selangor 47500, Malaysia ()
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Tuberculosis amidst COVID-19 in Pakistan: a massive threat of overlapping crises for the fragile healthcare systems. Epidemiol Infect 2022; 150:e41. [PMID: 35190004 PMCID: PMC8886085 DOI: 10.1017/s0950268822000358] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Mycobacterium tuberculosis is the cause of tuberculosis (TB), a granulomatous illness that mostly affects the lungs. Pakistan is one of the eight nations that accounts for two-thirds of all new cases of developing TB. TB has long been an endemic disease in Pakistan. According to the World Health Organization (WHO) estimates, the nation has over 500 000 incident TB infections per year, with a rising number of drug-resistant cases. Recently, the coexistence of COVID-19 and TB in Pakistan has provided doctors with a problem. Fever or chills, cough, shortness of breath or difficulty breathing are all signs of COVID-19. After SARS-CoV-2 infection, cough might persist for weeks or months and it is frequently accompanied by persistent tiredness, cognitive impairment, dyspnoea or pain – a group of long-term consequences known as post-COVID syndrome or protracted COVID. Coughing with mucus or blood, and coughing that continues over 2 months are indications of TB. The same clinical presentation features make it difficult for healthcare personnel to effectively evaluate the illness and prevent the spread of these fatal diseases. Pakistan lacks the necessary healthcare resources to tackle two contagious diseases at the same time. To counteract the sudden increase in TB cases, appropriate management and effective policies must be implemented. Thus, in order to prevent the spread of these infectious diseases, it is critical to recognise and address the problems that the healthcare sector faces, as well as to create an atmosphere in which the healthcare sector can function at its full potential.
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