1
|
Mia MM, Hasan M, Pory FS. Occupational exposure to livestock and risk of tuberculosis and brucellosis: A systematic review and meta-analysis. One Health 2022; 15:100432. [DOI: 10.1016/j.onehlt.2022.100432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 11/30/2022] Open
|
2
|
Santos JA, Santos DT, Arcencio RA, Nunes C. Space-time clustering and temporal trends of hospitalizations due to pulmonary tuberculosis: potential strategy for assessing health care policies. Eur J Public Health 2021; 31:57-62. [PMID: 32989451 DOI: 10.1093/eurpub/ckaa161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) causes pressure on healthcare resources, especially in terms of hospital admissions, despite being considered an ambulatory care-sensitive condition for which timely and effective care in ambulatory setting could prevent the need for hospitalization. Our objectives were to describe the spatial and temporal variation in pulmonary tuberculosis (PTB) hospitalizations, identify critical geographic areas at municipality level and characterize clusters of PTB hospitalizations to help the development of tailored disease management strategies that could improve TB control. METHODS Ecologic study using sociodemographic, geographical and clinical information of PTB hospitalization cases from continental Portuguese public hospitals, between 2002 and 2016. Descriptive statistics, spatiotemporal cluster analysis and temporal trends were conducted. RESULTS The space-time analysis identified five clusters of higher rates of PTB hospitalizations (2002-16), including the two major cities in the country (Lisboa and Porto). Globally, we observed a -7.2% mean annual percentage change in rate with only one of the identified clusters (out of six) with a positive trend (+4.34%). In the more recent period (2011-16) was obtained a mean annual percentage change in rate of -8.12% with only one cluster identified with an increase trend (+9.53%). CONCLUSIONS Our results show that space-time clustering and temporal trends analysis can be an invaluable resource to monitor the dynamic of the disease and contribute to the design of more effective, focused interventions. Interventions such as enhancing the detection of active and latent infection, improving monitoring and evaluation of treatment outcomes or adjusting the network of healthcare providers should be tailored to the specific needs of the critical areas identified.
Collapse
Affiliation(s)
- João Almeida Santos
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal.,Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Lisboa, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Danielle T Santos
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal.,Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Sao Paulo, Brasil
| | - Ricardo A Arcencio
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Sao Paulo, Brasil
| | - Carla Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal
| |
Collapse
|
3
|
El Malik ARA, El Wahab AEEA, Eltrawy HH. Retrospective study of pulmonary and extrapulmonary tuberculosis cases in Giza Governorate during the period of 2014–2018. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2021. [DOI: 10.1186/s43168-021-00072-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Tuberculosis in Egypt is a main public health problem. Egypt is categorized among the mid-level incidence countries. The objective of this work is to study the epidemiology of TB in Giza Governorate during the period from 2014 to 2018.
Results
This study revealed that the total number of TB cases in Giza Governorate during the period from 2014 to 2018 was 3357 (2035 males and 1322 females including 199 children) with the highest number of cases in 2017 (n=770 cases). The highest incidence occurred in the age group 18–65 years (86.3%%, 78.8%, 83.8%, 84.2%, and 87.1%) and male gender (56.8%, 62.8%, 59.9%, 61.3%, and 61.5%) during the study period, respectively, and in urban residence, the higher percentage occurred in PTB than EPTB in 2014, 2015, 2016, and 2018 (66.2%, 58.9%, 57.3%, and 55.5%), respectively, while the incidence of the extra PTB was higher than PTB in 2017 (51.6% versus 48.4%). The increased incidence of new cases (92.9%, 89.6%, 92.7%, 91.8%, and 92.9%) during the 5 studied years are smear-positive and cure outcome (86.3%, 87.7%, 88.7%, 83.4%, and 83.4%, respectively)
Conclusion
Young, middle-aged male, and new smear-positive cases were highest in percentage. The highest percentage of PTB (66.2%) was registered in 2014, and the highest percentage of EPTB (51.6%) was registered in 2017. The increased percentage of cure outcome was during the period from 2014 to 2018 in Giza Governorate.
Collapse
|
4
|
Millet JP. Basic characteristics for a good tuberculosis prevention and control programmes currently in Spain. ACTA ACUST UNITED AC 2021; 23:6-8. [PMID: 33847705 PMCID: PMC8278170 DOI: 10.18176/resp.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J P Millet
- Epidemiology Service. Public Health Agency of Barcelona. Barcelona.,Co-medical director at Serveis Clinics. Centro de Investigación Biomédica en Red (CIBER) of Epidemiology and Public Health. Barcelona
| |
Collapse
|
5
|
Brugueras S, Molina VI, Casas X, González YD, Forcada N, Romero D, Rodés A, Altet MN, Maldonado J, Martin-Sánchez M, Caylà JA, Orcau À, Rius C, Millet JP. Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia. PLoS One 2020; 15:e0227291. [PMID: 31940383 PMCID: PMC6961944 DOI: 10.1371/journal.pone.0227291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 12/16/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Patients with a history of tuberculosis (TB) have a high probability of recurrence because long-term cure is not always maintained in successfully treated patients. The aim of this study was to identify the probability of TB recurrence and its predictive factors in a cohort of socially vulnerable patients who completed treatment in the TB referral center in Catalonia, which acts as the center for patients with social and health problems. METHODS This retrospective open cohort study included all patients diagnosed with TB who were admitted and successfully treated in Serveis Clínics between 2000 and 2016 and who remained disease-free for a minimum of 1 year after treatment completion. We calculated the incidence density of TB recurrences per person-years of follow-up. We also estimated the cumulative incidence of TB recurrence at 1, 2, 5, and 10 years of follow-up. Bivariate analysis was conducted using Kaplan-Meier curves. Multivariate analysis was conducted using Cox regression. Hazard ratios (HR) were calculated with their 95% confidence intervals (95%CI). RESULTS There were 839 patients and 24 recurrences (2.9%), representing 0.49 per 100 person-years. The probability of a recurrence was 0.63% at 1 year of follow-up, 1.35% at 2 years, and 3.69% at 5 years. The multivariate analysis showed that the predictive factors of recurrence were age older than 34 years (aHR = 3.90; CI = 1.06-14.34 at age 35-45 years and aHR = 3.88; CI = 1.02-14.80 at age >45 years) and resistance to at least one anti-TB drug (aHR = 2.91; CI = 1.11-7.65). CONCLUSIONS Attention should be paid to socially vulnerable persons older than 34 years with a previous episode of resistant TB. Surveillance resources should be directed toward adequately treated patients who nevertheless have a high risk of recurrence.
Collapse
Affiliation(s)
- Sílvia Brugueras
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | | | | | | | | | - Anna Rodés
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | | | | | - Mario Martin-Sánchez
- Preventive Medicine and Public Health Training Unit Parc de Salut Mar–Pompeu Fabra University—Public Health Agency of Barcelona (PSMar-UPF-ASPB), Barcelona, Spain
| | - Joan A. Caylà
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Àngels Orcau
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Cristina Rius
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Joan-Pau Millet
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Serveis Clínics, Barcelona, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| |
Collapse
|
6
|
Organization of Tuberculosis Control in Spain: Evaluation of a Strategy Aimed at Promoting the Accreditation of Tuberculosis Units. Arch Bronconeumol 2019; 56:90-98. [PMID: 31171411 DOI: 10.1016/j.arbres.2019.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/03/2019] [Accepted: 04/26/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Well-coordinated multidisciplinary teams are essential for better tuberculosis (TB) control. Our objective was to evaluate the impact of Spanish Society of Pneumology (SEPAR) accreditation of TB Units (TBU) and to determine differences between the accredited and non-accredited centers. MATERIAL AND METHODS DESIGN Observational descriptive study based on a self-administered survey from October 2014 to February 2018 completed by 139 heads of respiratory medicine departments collected by SEPAR, before and after TBU accreditation. VARIABLES demographic, epidemiological and contact tracing (CT) variables, among others. ANALYSIS basic descriptive analysis, and calculation of medians for continuous variables and proportions for categorical variables. The variables were compared using the Chi-squared test and logistic regression. RESULTS The response rate was 54.7% and 43.2% in the pre- and post-TBU accreditation period, respectively. No differences were observed in the care and coordination variables between the pre- and post-accreditation survey, nor in the organization when only accredited centers were analyzed. When we compared the accredited and non-accredited centers, significant differences were detected in the collection of the final conclusion, management of resistance, coordination with other departments, contact tracing, and directly observed treatment. CONCLUSIONS The approach of different professionals with regard to TB has been addressed. Positive aspects and areas for improvement have been detected, and better results were observed in the accredited versus non-accredited centers. A closer supervision of TBUs is necessary to improve their effectiveness.
Collapse
|
7
|
Martin-Sanchez M, Brugueras S, de Andrés A, Simon P, Gorrindo P, Ros M, Masdeu E, Millet JP, Caylà JA, Orcau À. Tuberculosis incidence among infected contacts detected through contact tracing of smear-positive patients. PLoS One 2019; 14:e0215322. [PMID: 30986227 PMCID: PMC6464217 DOI: 10.1371/journal.pone.0215322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/29/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The contacts of people with pulmonary tuberculosis (PTB) have a high risk of becoming infected and developing tuberculosis (TB). Our aim was to determine the incidence of TB and its risk factors in a cohort of contacts with latent TB infection (LTBI) detected through contact tracing of smear-positive PTB cases. METHODS AND FINDINGS We performed a population-based retrospective cohort study including contacts that had LTBI, and were contacts of people with PTB who started treatment between 2008 and 2014. We followed up contacts until they developed TB or until the end date for follow-up (31st December 2016). We used Kaplan-Meier curves to compute incidence at 2 and 5 years, and Cox regression to compute hazard ratios (HR) and their 95% confidence intervals (CI). We analyzed 3097 close contacts of 565 PTB cases. After exclusion of 81 co-prevalent TB cases, 953 contacts had LTBI, of which 14 developed TB. Their risk of developing TB after two and five years was 0.7% (CI: 0.3-1.6) and 1.8% (CI: 1.1-3.1) respectively. Contacts who had not been referred for LTBI treatment had a 1.0% (CI: 0.2-4.0) risk at 5 years. Risk of developing TB at 5 years was 1.2% (CI: 0.5-3.0) among people who completed treatment, and 11.1% (CI: 5.1-23.3) for those who did not. Risk factors for TB were not completing LTBI treatment (HR 9.4, CI: 2.9-30.8) and being female (HR 3.5, CI: 1.1-11-3). CONCLUSIONS LTBI treatment plays a fundamental role in decreasing the risk of developing TB. It is necessary to achieve a maximum contact tracing coverage and the highest possible compliance with LTBI treatment.
Collapse
Affiliation(s)
- Mario Martin-Sanchez
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Preventive Medicine and Public Health Training Unit Parc de Salut Mar–Pompeu Fabra University—Agència de Salut Pública de Barcelona (PSMar-UPF-ASPB), Barcelona, Spain
| | - Silvia Brugueras
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- The Biomedical Research Center Network of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna de Andrés
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Pere Simon
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Pilar Gorrindo
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Miriam Ros
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Eva Masdeu
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Joan-Pau Millet
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- The Biomedical Research Center Network of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Joan A. Caylà
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Àngels Orcau
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- The Biomedical Research Center Network of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | | |
Collapse
|
8
|
Ospina JE, Orcau À, Millet JP, Ros M, Gil S, Caylà JA. Epidemiology of Tuberculosis in Immigrants in a Large City with Large-Scale Immigration (1991-2013). PLoS One 2016; 11:e0164736. [PMID: 27749904 PMCID: PMC5066941 DOI: 10.1371/journal.pone.0164736] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/29/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The increase in immigration in Barcelona between 2000 and 2008 forced a reorganization of the control of tuberculosis (TB). TB clinical units (TBCU) were created and community health workers (CHW) were gradually included. OBJECTIVE To understand trends in the incidence of TB among immigrants, their main characteristics and treatment compliance during the period 1991-2013. DESIGN We conducted a cross-sectional population-based study of cases detected among immigrants by the Tuberculosis Program in Barcelona, Spain. Sociodemographic, clinical characteristics and risk factors were described. The annual incidence was calculated for various periods and geographical areas of origin. In the linear trend analysis, a p-value of <0.05 was considered statistically significant. RESULTS We detected 3,284 cases. Incidence decreased from 144.8/100,000 inhabitants in 1991 to 53.4/100,000 in 2013. Individuals born in Pakistan-India-Bangladesh had the highest average annual incidence (675/100,000). In all, 2,156 cases (65.7%) were male. 2,272 (69.2%) had pulmonary TB, of which 48.2% were smear-positive. 33% of the cases (1,093) lived in the inner city. Contact tracing (CT) coverage in smear-positive individuals rose from 56.8% in 1991-1999 to 81.4% in 2000-2013 (p<0.01); this value was less than 50% in people from Africa and Eastern European countries. The case fatality rate was 3.6% overall and 9.8% among those born in high-income countries (p<0.01). The highest rate of treatment default (12.8%) was observed among cases from the Maghreb. The rate of successful treatment increased from 69.9% in 1991-1999 to 87.5% in 2000-2013 (p<0.01). CONCLUSION The incidence of TB in immigrants is decreasing in Barcelona. Organizational actions, such as incorporating CHWs and TBCUs, have been decisive for the observed improvements.
Collapse
Affiliation(s)
- Jesús E. Ospina
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
- Departamento de Pediatria, Ginecología y Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Àngels Orcau
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Joan-Pau Millet
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Miriam Ros
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
| | - Sonia Gil
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
| | - Joan A. Caylà
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | |
Collapse
|
9
|
Sobh E, Kinawy SAE, Abdelkarim YMA, Arafa MA. The pattern of tuberculosis in Aswan Chest Hospital, Egypt. Int J Mycobacteriol 2016; 5:333-340. [PMID: 27847020 DOI: 10.1016/j.ijmyco.2016.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 08/06/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE/BACKGROUND Tuberculosis (TB) is a major health problem. The aim of this study was to examine the pattern of TB in Aswan Chest Hospital, Aswan, Egypt. METHODS This cross-sectional study was carried out using medical records from the TB registry in Aswan Chest Hospital. The investigated variables included demographic characteristics, type of TB infection, and affected organs. All data were coded and statistically analyzed. RESULTS The average age of the 557 patients infected with TB was 40.31±18.87years; 58.2% of the cases were men and 41.8% were women. In both sexes, the highest number of TB patients was from the reproductive age groups. During the 5-year study period, the highest percentage of cases were new cases and the highest frequency of cases was during 2011 and the lowest frequency was during 2015. Pulmonary TB cases showed a sharp decline; however, there was a decrease in extrapulmonary TB cases during 2012 and 2013, with a slight rise in 2014 and 2015. Of the pulmonary TB cases, 82.5% were smear-positive TB. CONCLUSION There was a decline in the total number of TB cases across the studied years and the most studied cases were pulmonary smear-positive and new cases. Younger people represented a large percentage of reported cases.
Collapse
Affiliation(s)
- Eman Sobh
- Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
| | | | | | - Mahmoud Ahmed Arafa
- Chest Diseases Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| |
Collapse
|
10
|
La hospitalización terapéutica obligatoria en el control de la tuberculosis. GACETA SANITARIA 2016; 30:144-7. [DOI: 10.1016/j.gaceta.2015.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 12/09/2015] [Accepted: 12/16/2015] [Indexed: 11/23/2022]
|
11
|
Marx FM, Fiebig L, Hauer B, Brodhun B, Glaser-Paschke G, Magdorf K, Haas W. Higher Rate of Tuberculosis in Second Generation Migrants Compared to Native Residents in a Metropolitan Setting in Western Europe. PLoS One 2015; 10:e0119693. [PMID: 26061733 PMCID: PMC4465484 DOI: 10.1371/journal.pone.0119693] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 05/14/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Western Europe, migrants constitute an important risk group for tuberculosis, but little is known about successive generations of migrants. We aimed to characterize migration among tuberculosis cases in Berlin and to estimate annual rates of tuberculosis in two subsequent migrant generations. We hypothesized that second generation migrants born in Germany are at higher risk of tuberculosis compared to native (non-migrant) residents. METHODS A prospective cross-sectional study was conducted. All tuberculosis cases reported to health authorities in Berlin between 11/2010 and 10/2011 were eligible. Interviews were conducted using a structured questionnaire including demographic data, migration history of patients and their parents, and language use. Tuberculosis rates were estimated using 2011 census data. RESULTS Of 314 tuberculosis cases reported, 154 (49.0%) participated. Of these, 81 (52.6%) were first-, 14 (9.1%) were second generation migrants, and 59 (38.3%) were native residents. The tuberculosis rate per 100,000 individuals was 28.3 (95CI: 24.0-32.6) in first-, 10.2 (95%CI: 6.1-16.6) in second generation migrants, and 4.6 (95%CI: 3.7-5.6) in native residents. When combining information from the standard notification variables country of birth and citizenship, the sensitivity to detect second generation migration was 28.6%. CONCLUSIONS There is a higher rate of tuberculosis among second generation migrants compared to native residents in Berlin. This may be explained by presumably frequent contact and transmission within migrant populations. Second generation migration is insufficiently captured by the surveillance variables country of birth and citizenship. Surveillance systems in Western Europe should allow for quantifying the tuberculosis burden in this important risk group.
Collapse
Affiliation(s)
- Florian M. Marx
- Department of Pediatric Pneumology and Immunology, Charité –Universitätsmedizin, Berlin, Germany
- Division of Global Health Equity, Brigham and Women’s Hospital and Harvard Medical School, Boston, United States of America
- * E-mail:
| | - Lena Fiebig
- Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Barbara Hauer
- Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Bonita Brodhun
- Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Klaus Magdorf
- Department of Pediatric Pneumology and Immunology, Charité –Universitätsmedizin, Berlin, Germany
| | - Walter Haas
- Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
12
|
Abstract
BACKGROUND There have been few studies on risk factors and treatment outcomes of isoniazid (H)-resistant tuberculosis (TB), and optimal treatment regimens are debated. AIM : To identify risk factors for H-resistant TB, describe treatment regimens and compare these to national guidelines and describe short-term outcomes of H-resistant TB in Birmingham, UK. DESIGN Retrospective case series. METHODS Cases of H-resistant tuberculosis in Birmingham between January 1999 and December 2010 (n = 89) were compared with drug-susceptible cases (n = 2497). Treatment regimens and outcomes at 12 months from diagnosis were evaluated by case note review. RESULTS No independent predictors for H-resistant TB were found. For 76/89 (85%) patients with full treatment details available, median treatment duration was 11 months (interquartile range 9-12 months). Only 27/72 (38%) patients with H-monoresistance were treated in line with national guidelines. A further 14/72 (19%) were treated according to other recognized guidelines. Overall treatment success was 75/89 (84%). Treatment failure occurred in 6/89 (7%) patients, all developed multi-drug resistance. Poor adherence was documented in these patients and use of a non-standard regimen in one patient was not thought to have contributed to treatment failure. CONCLUSIONS No discriminating risk factors for early detection of H-resistant TB were found. Treatment regimens in clinical practice were highly varied. H-resistance can drive MDR-TB when there is evidence or suspicion of poor adherence. A low threshold for enhanced case management with directly observed therapy is warranted in this group.
Collapse
Affiliation(s)
- M L Munang
- From the Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, West Midlands and Department of Sexual Health, Upton Hospital, Slough, UK
| | - M Kariuki
- From the Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, West Midlands and Department of Sexual Health, Upton Hospital, Slough, UK
| | - M Dedicoat
- From the Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, West Midlands and Department of Sexual Health, Upton Hospital, Slough, UK
| |
Collapse
|
13
|
Chuang TL, Chang CC, Chu-Su Y, Wei SC, Zhao XH, Hsueh PR, Lin CW. Disposable surface plasmon resonance aptasensor with membrane-based sample handling design for quantitative interferon-gamma detection. LAB ON A CHIP 2014; 14:2968-2977. [PMID: 24931052 DOI: 10.1039/c4lc00249k] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
ELISA and ELISPOT methods are utilized for interferon-gamma (IFN-γ) release assays (IGRAs) to detect the IFN-γ secreted by T lymphocytes. However, the multi-step protocols of the assays are still performed with laboratory instruments and operated by well-trained people. Here, we report a membrane-based microfluidic device integrated with a surface plasmon resonance (SPR) sensor to realize an easy-to-use and cost effective multi-step quantitative analysis. To conduct the SPR measurements, we utilized a membrane-based SPR sensing device in which a rayon membrane was located 300 μm under the absorbent pad. The basic equation covering this type of transport is based on Darcy's law. Furthermore, the concentration of streptavidin delivered from a sucrose-treated glass pad placed alongside the rayon membrane was controlled in a narrow range (0.81 μM ± 6%). Finally, the unbound molecules were removed by a washing buffer that was pre-packed in the reservoir of the chip. Using a bi-functional, hairpin-shaped aptamer as the sensing probe, we specifically detected the IFN-γ and amplified the signal by binding the streptavidin. A high correlation coefficient (R(2) = 0.995) was obtained, in the range from 0.01 to 100 nM. A detection limit of 10 pM was achieved within 30 min. Thus, the SPR assay protocols for IFN-γ detection could be performed using this simple device without an additional pumping system.
Collapse
Affiliation(s)
- Tsung-Liang Chuang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, 10617, Taiwan
| | | | | | | | | | | | | |
Collapse
|
14
|
Lange C, Abubakar I, Alffenaar JWC, Bothamley G, Caminero JA, Carvalho ACC, Chang KC, Codecasa L, Correia A, Crudu V, Davies P, Dedicoat M, Drobniewski F, Duarte R, Ehlers C, Erkens C, Goletti D, Günther G, Ibraim E, Kampmann B, Kuksa L, de Lange W, van Leth F, van Lunzen J, Matteelli A, Menzies D, Monedero I, Richter E, Rüsch-Gerdes S, Sandgren A, Scardigli A, Skrahina A, Tortoli E, Volchenkov G, Wagner D, van der Werf MJ, Williams B, Yew WW, Zellweger JP, Cirillo DM. Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement. Eur Respir J 2014; 44:23-63. [PMID: 24659544 PMCID: PMC4076529 DOI: 10.1183/09031936.00188313] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) substantially challenges TB control, especially in the European Region of the World Health Organization, where the highest prevalence of MDR/XDR cases is reported. The current management of patients with MDR/XDR-TB is extremely complex for medical, social and public health systems. The treatment with currently available anti-TB therapies to achieve relapse-free cure is long and undermined by a high frequency of adverse drug events, suboptimal treatment adherence, high costs and low treatment success rates. Availability of optimal management for patients with MDR/XDR-TB is limited even in the European Region. In the absence of a preventive vaccine, more effective diagnostic tools and novel therapeutic interventions the control of MDR/XDR-TB will be extremely difficult. Despite recent scientific advances in MDR/XDR-TB care, decisions for the management of patients with MDR/XDR-TB and their contacts often rely on expert opinions, rather than on clinical evidence. This document summarises the current knowledge on the prevention, diagnosis and treatment of adults and children with MDR/XDR-TB and their contacts, and provides expert consensus recommendations on questions where scientific evidence is still lacking. TBNET consensus statement on the management of patients with MDR/XDR-TB has been released in theEur Respir Jhttp://ow.ly/uizRD
Collapse
Affiliation(s)
- Christoph Lange
- For the authors' affiliations see the Acknowledgements section
| | | | | | | | - Jose A Caminero
- For the authors' affiliations see the Acknowledgements section
| | | | - Kwok-Chiu Chang
- For the authors' affiliations see the Acknowledgements section
| | - Luigi Codecasa
- For the authors' affiliations see the Acknowledgements section
| | - Ana Correia
- For the authors' affiliations see the Acknowledgements section
| | - Valeriu Crudu
- For the authors' affiliations see the Acknowledgements section
| | - Peter Davies
- For the authors' affiliations see the Acknowledgements section
| | - Martin Dedicoat
- For the authors' affiliations see the Acknowledgements section
| | | | - Raquel Duarte
- For the authors' affiliations see the Acknowledgements section
| | - Cordula Ehlers
- For the authors' affiliations see the Acknowledgements section
| | - Connie Erkens
- For the authors' affiliations see the Acknowledgements section
| | - Delia Goletti
- For the authors' affiliations see the Acknowledgements section
| | - Gunar Günther
- For the authors' affiliations see the Acknowledgements section
| | - Elmira Ibraim
- For the authors' affiliations see the Acknowledgements section
| | - Beate Kampmann
- For the authors' affiliations see the Acknowledgements section
| | - Liga Kuksa
- For the authors' affiliations see the Acknowledgements section
| | - Wiel de Lange
- For the authors' affiliations see the Acknowledgements section
| | - Frank van Leth
- For the authors' affiliations see the Acknowledgements section
| | - Jan van Lunzen
- For the authors' affiliations see the Acknowledgements section
| | | | - Dick Menzies
- For the authors' affiliations see the Acknowledgements section
| | | | - Elvira Richter
- For the authors' affiliations see the Acknowledgements section
| | | | | | - Anna Scardigli
- For the authors' affiliations see the Acknowledgements section
| | - Alena Skrahina
- For the authors' affiliations see the Acknowledgements section
| | - Enrico Tortoli
- For the authors' affiliations see the Acknowledgements section
| | | | - Dirk Wagner
- For the authors' affiliations see the Acknowledgements section
| | | | - Bhanu Williams
- For the authors' affiliations see the Acknowledgements section
| | - Wing-Wai Yew
- For the authors' affiliations see the Acknowledgements section
| | | | | | | |
Collapse
|
15
|
van Hest NA, Aldridge RW, de Vries G, Sandgren A, Hauer B, Hayward A, Arrazola de Oñate W, Haas W, Codecasa LR, Caylà JA, Story A, Antoine D, Gori A, Quabeck L, Jonsson J, Wanlin M, Orcau Å, Rodes A, Dedicoat M, Antoun F, van Deutekom H, Keizer S, Abubakar I. Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement. ACTA ACUST UNITED AC 2014; 19. [PMID: 24626210 DOI: 10.2807/1560-7917.es2014.19.9.20728] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In low-incidence countries in the European Union (EU), tuberculosis (TB) is concentrated in big cities, especially among certain urban high-risk groups including immigrants from TB high-incidence countries, homeless people, and those with a history of drug and alcohol misuse. Elimination of TB in European big cities requires control measures focused on multiple layers of the urban population. The particular complexities of major EU metropolises, for example high population density and social structure, create specific opportunities for transmission, but also enable targeted TB control interventions, not efficient in the general population, to be effective or cost effective. Lessons can be learnt from across the EU and this consensus statement on TB control in big cities and urban risk groups was prepared by a working group representing various EU big cities, brought together on the initiative of the European Centre for Disease Prevention and Control. The consensus statement describes general and specific social, educational, operational, organisational, legal and monitoring TB control interventions in EU big cities, as well as providing recommendations for big city TB control, based upon a conceptual TB transmission and control model.
Collapse
Affiliation(s)
- N A van Hest
- Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Millet JP, Moreno A, Fina L, del Baño L, Orcau A, de Olalla PG, Caylà JA. Factors that influence current tuberculosis epidemiology. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 22 Suppl 4:539-48. [PMID: 22565801 PMCID: PMC3691414 DOI: 10.1007/s00586-012-2334-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 04/17/2012] [Indexed: 11/30/2022]
Abstract
According to WHO estimates, in 2010 there were 8.8 million new cases of tuberculosis (TB) and 1.5 million deaths. TB has been classically associated with poverty, overcrowding and malnutrition. Low income countries and deprived areas, within big cities in developed countries, present the highest TB incidences and TB mortality rates. These are the settings where immigration, important social inequalities, HIV infection and drug or alcohol abuse may coexist, all factors strongly associated with TB. In spite of the political, economical, research and community efforts, TB remains a major global health problem worldwide. Moreover, in this new century, new challenges such as multidrug-resistance extension, migration to big cities and the new treatments with anti-tumour necrosis alpha factor for inflammatory diseases have emerged and threaten the decreasing trend in the global number of TB cases in the last years. We must also be aware about the impact that smoking and diabetes pandemics may be having on the incidence of TB. The existence of a good TB Prevention and Control Program is essential to fight against TB. The coordination among clinicians, microbiologists, epidemiologists and others, and the link between surveillance, control and research should always be a priority for a TB Program. Each city and country should define their needs according to the epidemiological situation. Local TB control programs will have to adapt to any new challenge that arises in order to respond to the needs of their population.
Collapse
Affiliation(s)
- Juan-Pablo Millet
- />Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps, 1, 08023 Barcelona, Spain
- />CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- />Tuberculosis Investigation Unit of Barcelona (UiTB), Barcelona, Spain
| | - Antonio Moreno
- />Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps, 1, 08023 Barcelona, Spain
- />CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- />Tuberculosis Investigation Unit of Barcelona (UiTB), Barcelona, Spain
| | - Laia Fina
- />Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps, 1, 08023 Barcelona, Spain
- />CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- />Tuberculosis Investigation Unit of Barcelona (UiTB), Barcelona, Spain
| | - Lucía del Baño
- />Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps, 1, 08023 Barcelona, Spain
- />CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- />Tuberculosis Investigation Unit of Barcelona (UiTB), Barcelona, Spain
| | - Angels Orcau
- />Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps, 1, 08023 Barcelona, Spain
- />CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- />Tuberculosis Investigation Unit of Barcelona (UiTB), Barcelona, Spain
| | - Patricia García de Olalla
- />Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps, 1, 08023 Barcelona, Spain
- />CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- />Tuberculosis Investigation Unit of Barcelona (UiTB), Barcelona, Spain
| | - Joan A. Caylà
- />Epidemiology Service, Public Health Agency of Barcelona, Plaza Lesseps, 1, 08023 Barcelona, Spain
- />CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
- />Tuberculosis Investigation Unit of Barcelona (UiTB), Barcelona, Spain
| |
Collapse
|
17
|
Rodrigo T, Caylà JA, Casals M, García-García JM, Caminero JA, Ruiz-Manzano J, Blanquer R, Vidal R, Altet N, Calpe JL, Penas A. A predictive scoring instrument for tuberculosis lost to follow-up outcome. Respir Res 2012; 13:75. [PMID: 22938040 PMCID: PMC3490987 DOI: 10.1186/1465-9921-13-75] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 08/22/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adherence to tuberculosis (TB) treatment is troublesome, due to long therapy duration, quick therapeutic response which allows the patient to disregard about the rest of their treatment and the lack of motivation on behalf of the patient for improved. The objective of this study was to develop and validate a scoring system to predict the probability of lost to follow-up outcome in TB patients as a way to identify patients suitable for directly observed treatments (DOT) and other interventions to improve adherence. METHODS Two prospective cohorts, were used to develop and validate a logistic regression model. A scoring system was constructed, based on the coefficients of factors associated with a lost to follow-up outcome. The probability of lost to follow-up outcome associated with each score was calculated. Predictions in both cohorts were tested using receiver operating characteristic curves (ROC). RESULTS The best model to predict lost to follow-up outcome included the following characteristics: immigration (1 point value), living alone (1 point) or in an institution (2 points), previous anti-TB treatment (2 points), poor patient understanding (2 points), intravenous drugs use (IDU) (4 points) or unknown IDU status (1 point). Scores of 0, 1, 2, 3, 4 and 5 points were associated with a lost to follow-up probability of 2,2% 5,4% 9,9%, 16,4%, 15%, and 28%, respectively. The ROC curve for the validation group demonstrated a good fit (AUC: 0,67 [95% CI; 0,65-0,70]). CONCLUSION This model has a good capacity to predict a lost to follow-up outcome. Its use could help TB Programs to determine which patients are good candidates for DOT and other strategies to improve TB treatment adherence.
Collapse
Affiliation(s)
- Teresa Rodrigo
- Programa Integrado de Investigación en Tuberculosis (PII TB) de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Corris V, Unwin N, Critchley J. Quantifying the association between tuberculosis and diabetes in the US: a case-control analysis. Chronic Illn 2012; 8:121-34. [PMID: 22387690 DOI: 10.1177/1742395312440294] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Historically, an association between tuberculosis and diabetes was recognised clinically, and the recent global rise in diabetes prevalence has reignited interest. We therefore quantified the tuberculosis-diabetes association using US survey data. A case-control analysis was performed using cross-sectional data from the second National Health and Nutrition Examination Survey (1976-1980; civilian non-institutionalised US population aged 20-74). Cases were respondents ever diagnosed with tuberculosis, and controls were respondents who reported never receiving a tuberculosis diagnosis. Exposure to diabetes and intermediate hyperglycaemia was defined using a self-reported measure, an oral glucose tolerance test, or both. We used logistic regression to estimate an adjusted odds ratio, controlling for potential major confounders. In relation to the main exposure measure, the adjusted odds ratio for the association between tuberculosis and diabetes varied between 2.31 (95% confidence interval 1.36-3.93) and 2.36 (95% confidence interval 1.40-3.97), depending on the model. No association was found for intermediate hyperglycaemia, with adjusted odds ratio varying between 1.33 (95% confidence interval 0.49-3.64) and 1.34 (95% confidence interval 0.50-3.62), depending on model. Irrespective of the exposure measure and the confounders controlled for, diabetes was associated with an increased tuberculosis risk. This study may underestimate the true association due to exposure misclassification.
Collapse
|
19
|
Tuberculosis Is Not a Risk Factor for Primary Biliary Cirrhosis: A Review of the Literature. Tuberc Res Treat 2012; 2012:218183. [PMID: 23213506 PMCID: PMC3504403 DOI: 10.1155/2012/218183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 10/03/2012] [Indexed: 11/17/2022] Open
Abstract
Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease characterised serologically by cholestasis and the presence of high-titre antimitochondrial antibodies, and histologically by chronic nonsuppurative cholangitis and granulomata. As PBC is a granulomatous disease andMycobacterium tuberculosisis the most frequent cause of granulomata, a causal relation between tuberculosis and PBC has been suggested. Attempts to find serological evidence of PBC-specific autoantibodies such as AMA have been made and, conversely, granulomatous livers from patients with PBC have been investigated for molecular evidence ofMycobacterium tuberculosis. This paper discusses in detail the reported data in support or against an association betweenMycobacterium tuberculosisinfection and PBC. We discuss the immunological and microbiological data exploring the association of PBC with exposure toMycobacterium tuberculosis. We also discuss the findings of large epidemiologic studies investigating the association of PBC with preexistent or concomitant disorders and the relevance of these findings with tuberculosis. Genome-wide association studies in patients with tuberculosis as well as in patients with PBC provide conclusive hints regarding the assumed association between exposure to this mycobacterium and the induction of PBC. Analysis of these data suggest thatMycobacterium tuberculosisis an unlikely infectious trigger of PBC.
Collapse
|