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Wang Z, Guo T, Xu L, Liu J, Hou Y, Jin J, Zhang Q, Jiang T, Zhao Z, Xue Y. Regional differences of Mycobacterium tuberculosis complex infection and multidrug resistance epidemic in Luoyang. BMC Infect Dis 2024; 24:578. [PMID: 38862881 PMCID: PMC11167740 DOI: 10.1186/s12879-024-09395-w] [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: 12/09/2023] [Accepted: 05/09/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a global public health event of great concern, however epidemic data on TB covering entire areas during the special period of the COVID-19 epidemic have rarely been reported. We compared the dissemination and multidrug-resistance patterns of Mycobacterium tuberculosis complex (MTBC) in the main urban area of Luoyang City, China (including six municipal jurisdictions) and nine county and township areas under its jurisdiction, aimed to establish the epidemiology of TB in this region and to provide reference for precision anti-TB in places with similar settings. METHODS From 2020 to 2022, sputum samples were collected from 18,504 patients with confirmed, suspected and unexcluded TB in 10 designated TB medical institutions. Insertion sequence 6110 was amplified by PCR (rpoB gene detection if necessary) to confirm the presence of MTBC. PCR-positive specimens were analyzed by multicolor melting curve analysis to detect multidrug resistance. RESULTS Among the 18,504 specimens, 2675 (14.5%) were MTBC positive. The positive rate was higher in the main urban area than in the county and township areas (29.8% vs. 10.9%, p < 0.001). Male, re-treated and smear-positive groups were high-burden carriers of MTBC. Individuals aged > 60 years were the largest group infected with MTBC in the main urban area, compared with individuals aged < 61 years in the county and township areas. The detection of multidrug-resistant TB (MDR-TB) was higher in the main urban area than in the county and township areas (13.9% vs. 7.8%, p < 0.001). In all areas, MDR-TB groups were dominated by males, patients with a history of TB treatment, and patients aged < 61 years. Stratified analysis of MDR-TB epidemiology showed that MDR4 (INH þ RIF þ EMB þ SM) was predominant in the main urban area, while MDR3 (INH þ RIF þ SM) was predominant in the county and township areas. MDR-TB detection rate and epidemiology differed among the county and township areas. CONCLUSIONS For local TB control, it is necessary to plan more appropriate and accurate prevention and control strategies according to the regional distribution of MTBC infection.
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Affiliation(s)
- Zhenzhen Wang
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China
| | - Tengfei Guo
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Liyang Xu
- Luoyang Center for Disease Control and Prevention, Luoyang, China
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China
| | - Jinwei Liu
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Yi Hou
- Luoyang Center for Disease Control and Prevention, Luoyang, China
| | - Junrong Jin
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Qing Zhang
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Tao Jiang
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Zhanqin Zhao
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, China.
| | - Yun Xue
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China.
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Deku JG, Aninagyei E, Bedzina I, Nudo G, Ativi E, Mensah P, Wireko S, Osei-Tutu A, Duker E, Afeke I. Trends of Mycobacterium tuberculosis and rifampicin resistance at the Ho Teaching Hospital in Ghana. PLoS One 2024; 19:e0305161. [PMID: 38857257 PMCID: PMC11164350 DOI: 10.1371/journal.pone.0305161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/24/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Tuberculosis remains a major public health threat worldwide, causing significant morbidity and mortality, particularly in low- and middle-income countries. In recent years, efforts to combat tuberculosis have focused on strengthening healthcare systems and increasing access to diagnostics and treatment services. There is scarcity of data on the prevalence of Mycobacterium tuberculosis and rifampicin-resistant tuberculosis in the Volta region of Ghana. Therefore, the aim of this study was to determine the trends of Mycobacterium tuberculosis and rifampicin resistance in a major teaching hospital in Ghana spanning a six-year period. METHODOLOGY A retrospective cross-sectional hospital study was conducted at Ho Teaching Hospital, Ho, Ghana. Study data included archived results on tuberculosis testing using GeneXpert from 2016-2021. Archived data on tuberculosis testing were collected and entered using Microsoft Excel 2019. IBM SPSS (v26) was used for a statistical analysis of the prevalence of tuberculosis. P-value <0.05 was considered statistically significant. RESULTS The study included 5128 presumptive tuberculosis cases from 2016 to 2021, of which 552 were positive, revealing an overall prevalence of 10.76%. Males exhibited a significantly higher prevalence of tuberculosis (14.20%) compared to females (7.48%), with a male-to-female ratio of 2:1. The burden of tuberculosis varied significantly between age groups, with those aged 30-45 years and 46-60 years facing twice the risk compared to those under 15 years (p<0.001). Rainy seasons correlated with heightened tuberculosis occurrences (12.12%) compared to dry seasons (8.84%) (p = 0.008). Rifampicin-resistant tuberculosis was prevalent at 3.45%, slightly higher in women, particularly in the 45-59 age group (5.97%). In particular, tuberculosis prevalence exhibited fluctuations, peaking in 2016 (17.1%) and 2020 (11.5%), with a trough in 2019 (4.6%). CONCLUSION The overall prevalence of laboratory confirmed tuberculosis was 10.76%, and resistance to rifampicin, 3.45%, indicating high infection and possible treatment failure. Considering its infectious nature, this calls for concerted efforts to curb the spread of the infection.
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Affiliation(s)
- John Gameli Deku
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Enoch Aninagyei
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Israel Bedzina
- Reinbee Medical Laboratory and Wellness Center, Ho, Ghana
| | - Gameli Nudo
- Laboratory Department, Ho Teaching Hospital, Ho, Ghana
| | | | | | - Solomon Wireko
- Department of Laboratory Technology, Kumasi Technical University, Kumasi, Ghana
| | - Aaron Osei-Tutu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Duker
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Innocent Afeke
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
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Wang Z, Hou Y, Guo T, Jiang T, Xu L, Hu H, Zhao Z, Xue Y. Epidemiological characteristics and risk factors of multidrug-resistant tuberculosis in Luoyang, China. Front Public Health 2023; 11:1117101. [PMID: 37228738 PMCID: PMC10203519 DOI: 10.3389/fpubh.2023.1117101] [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: 12/07/2022] [Accepted: 04/03/2023] [Indexed: 05/27/2023] Open
Abstract
Objective We aimed to examine the prevalence of multidrug-resistant tuberculosis (MDR-TB) in Luoyang, China, identify related risk factors, inform clinical practices, and establish standardized anti-tubercular treatment regimens. Methods We conducted a retrospective analysis of high-resolution melting curve (HRM) data from 17,773 cases (2,748 of which were positive) between June 2019 and May 2022 to assess the prevalence of MDR-TB and to identify its associated risk factors. Results Between June 2019 and May 2022, out of the 17,773 HRM results, 2,748 were HRM-positive, and 312 were MDR-TB cases. The detection rates for HRM-positive and MDR-TB were 17.0 and 12.1% for males, and 12.4 and 8.2% for females, respectively. The MDR-TB detection rate was higher in the urban areas (14.6%) than in the rural areas (10.6%) and more common among individuals under 51 years of age (14.1%) than those over 50 years of age (9.3%). Notably, the rate of detecting MDR-TB was 18.3% higher in new male patients than in new female patients, which was at 10.6%, and this difference was statistically significant (p < 0.001). Moreover, the rate of MDR detection in females who had received anti-tuberculosis treatment (21.3%) was higher than that in males (16.9%). In the multivariate model that considered the results of the sputum smear and detection time, MDR-TB was positively correlated with a history of tuberculosis (TB) treatment, being male, being younger than 51 years, and living in urban areas. Conclusion Local TB infections are complex and diverse; therefore, more comprehensive monitoring methods are needed to curb the spread of MDR-TB.
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Affiliation(s)
- Zhenzhen Wang
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China
| | - Yi Hou
- Luoyang Center for Disease Control and Prevention, Luoyang, China
| | - Tengfei Guo
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Tao Jiang
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Liang Xu
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China
- Luoyang Center for Disease Control and Prevention, Luoyang, China
| | - Hongxia Hu
- The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Zhanqin Zhao
- Animal Science and Technology, Henan University of Science and Technology, Luoyang, China
| | - Yun Xue
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China
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Ren Y, Chen B, Zhao J, Tan X, Chen X, Zhou L, Wang F, Peng Y, Jiang J. Trends of Rifampicin Resistance in Patients with Pulmonary Tuberculosis: A Longitudinal Analysis Based on Drug Resistance Screening in Eastern China Between 2015 and 2019. Infect Drug Resist 2022; 15:7707-7717. [PMID: 36597456 PMCID: PMC9805726 DOI: 10.2147/idr.s394089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022] Open
Abstract
Objective To understand the trend of overall rifampicin resistance rates for tuberculosis in Zhejiang Province between 2015 and 2019. Methods The basic demographic information of patients with tuberculosis who were screened for drug resistance in Zhejiang Province between January 1, 2015 and December 31, 2019 was collected through the national Tuberculosis Information Management System. The data were processed and analyzed using IBM SPSS 26.0 and GeoDa 1.14 software. Results The total rifampicin resistance rate was 5.9% in 53,893 validated cases of drug resistance screening conducted in patients with pulmonary tuberculosis in Zhejiang Province during the study period. There was a decreasing trend in the rifampicin resistance rate in both initial and re-treated patients (P<0.001), but the rifampicin resistance rate was higher in re-treated TB patients than in TB patients receiving their initial treatment (11.4% vs 4.2%). The rate of drug resistance steadily decreased in all prefectures, and there was a significant upward trend in the use of the Xpert MTB/RIF rapid assay. An increasing trend was also identified in the rate of rifampicin and ofloxacin co-resistance (P<0.001). Conclusion The overall rate of rifampin resistance in patients with tuberculosis in Zhejiang Province in the past five years has shown a decreasing trend, but the rate of resistance to ofloxacin was high. Resistance testing to fluoroquinolones should be carried out as early as possible in patients whose diagnosis results indicate rifampin resistance, and more effective second-line treatment plans should be developed based on the results of this testing.
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Affiliation(s)
- Yanli Ren
- School of Public Health, Hangzhou Normal University, Hangzhou, People’s Republic of China
| | - Bin Chen
- Zhejiang Center for Disease Control and Prevention, Hangzhou, People’s Republic of China
| | - Jiaying Zhao
- School of Public Health, Xiamen University, Fujian, People’s Republic of China
| | - Xiaohua Tan
- School of Public Health, Hangzhou Normal University, Hangzhou, People’s Republic of China
| | - Xinyi Chen
- Zhejiang Center for Disease Control and Prevention, Hangzhou, People’s Republic of China
| | - Lin Zhou
- Zhejiang Center for Disease Control and Prevention, Hangzhou, People’s Republic of China
| | - Fei Wang
- Zhejiang Center for Disease Control and Prevention, Hangzhou, People’s Republic of China
| | - Ying Peng
- Zhejiang Center for Disease Control and Prevention, Hangzhou, People’s Republic of China,Correspondence: Ying Peng; Jianmin Jiang, Email ;
| | - Jianmin Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou, People’s Republic of China,Zhejiang Center for Disease Control and Prevention, Hangzhou, People’s Republic of China
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Wang Z, Guo T, Jiang T, Zhao Z, Zu X, li L, Zhang Q, Hou Y, Song K, Xue Y. Regional distribution of Mycobacterium tuberculosis infection and resistance to rifampicin and isoniazid as determined by high-resolution melt analysis. BMC Infect Dis 2022; 22:812. [PMCID: PMC9620668 DOI: 10.1186/s12879-022-07792-7] [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: 06/27/2022] [Revised: 09/29/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Identifying the transmission mode and resistance mechanism of Mycobacterium tuberculosis (MTB) is key to prevent disease transmission. However, there is a lack of regional data. Therefore, the aim of this study was to identify risk factors associated with the transmission of MTB and regional patterns of resistance to isoniazid (INH) and rifampicin (RFP), as well as the prevalence of multidrug-resistant tuberculosis (MDR-TB). Methods High-resolution melt (HRM) analysis was conducted using sputum, alveolar lavage fluid, and pleural fluid samples collected from 17,515 patients with suspected or confirmed MTB infection in the downtown area and nine counties of Luoyang City from 2019 to 2021. Results Of the 17,515 patients, 82.6% resided in rural areas, and 96.0% appeared for an initial screening. The HRM positivity rate was 16.8%, with a higher rate in males than females (18.0% vs. 14.1%, p < 0.001). As expected, a positive sputum smear was correlated with a positive result for HRM analysis. By age, the highest rates of MTB infection occurred in males (22.9%) aged 26–30 years and females (28.1%) aged 21–25. The rates of resistance to RFP and INH and the incidence of MDR were higher in males than females (20.5% vs. 16.1%, p < 0.001, 15.9% vs. 12.0%, p < 0.001 and 12.9% vs. 10.2%, p < 0.001, respectively). The HRM positivity rate was much higher in previously treated patients than those newly diagnosed for MTB infection. Notably, males at the initial screening had significantly higher rates of HRM positive, INH resistance, RFP resistance, and MDR-TB than females (all, p < 0.05), but not those previously treated for MTB infection. The HRM positivity and drug resistance rates were much higher in the urban vs. rural population. By multivariate analyses, previous treatment, age < 51 years, residing in an urban area, and male sex were significantly and positively associated with drug resistance after adjusting for smear results and year of testing. Conclusion Males were at higher risks for MTB infection and drug resistance, while a younger age was associated with MTB infection, resistance to INH and RFP, and MDR-TB. Further comprehensive monitoring of resistance patterns is needed to control the spread of MTB infection and manage drug resistance locally.
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Affiliation(s)
- Zhenzhen Wang
- grid.453074.10000 0000 9797 0900The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, 471000 Luo Yang, China ,grid.453074.10000 0000 9797 0900School of Medical Technology and Engineering, Henan University of Science and Technology, Luo Yang, 471000 China
| | - Tengfei Guo
- grid.453074.10000 0000 9797 0900The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, 471000 Luo Yang, China
| | - Tao Jiang
- grid.453074.10000 0000 9797 0900The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, 471000 Luo Yang, China
| | - Zhanqin Zhao
- grid.453074.10000 0000 9797 0900Animal Science and Technology, Henan University of Science and Technology, Luo Yang, 471000 China
| | - Xiangyang Zu
- grid.453074.10000 0000 9797 0900School of Medical Technology and Engineering, Henan University of Science and Technology, Luo Yang, 471000 China
| | - Long li
- grid.453074.10000 0000 9797 0900The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, 471000 Luo Yang, China
| | - Qing Zhang
- grid.453074.10000 0000 9797 0900The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, 471000 Luo Yang, China
| | - Yi Hou
- Luoyang City CDC, Luo Yang, 471000 China
| | - Kena Song
- grid.453074.10000 0000 9797 0900School of Medical Technology and Engineering, Henan University of Science and Technology, Luo Yang, 471000 China
| | - Yun Xue
- grid.453074.10000 0000 9797 0900School of Medical Technology and Engineering, Henan University of Science and Technology, Luo Yang, 471000 China
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Burger Z, Aung HT, Seifert M, Mar TT, Harris V, Colman RE, Rodwell TC, Aung ST. Contributions of GeneXpert ® to TB diagnosis in Myanmar. Int J Tuberc Lung Dis 2022; 26:875-879. [PMID: 35996278 PMCID: PMC9423018 DOI: 10.5588/ijtld.22.0009] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Xpert® MTB/RIF, a rapid, molecular TB diagnostic assay, can detect Mycobacterium tuberculosis and rifampin resistance directly from clinical sputum samples in <2 h with high sensitivity and specificity. The added diagnostic value of Xpert over smear microscopy at a national level in Myanmar has not been previously reported.METHODS: We evaluated 339,358 Xpert and demographic records captured from January 2015 to December 2018 as part of the Myanmar National TB Program Data Utilization and Connectivity Project to examine the additional diagnostic yield of Xpert relative to smear for the detection of M. tuberculosis for TB diagnosis in Myanmar, with a focus on people living with HIV (PLHIV) and sample type.RESULTS: Use of Xpert increased TB case detection by 40% compared to smear microscopy results. Among PLHIV, use of Xpert increased TB case detection by almost 100% compared to smear microscopy results.CONCLUSION: Xpert testing identified more patients with TB than smear microscopy alone, particularly in cohorts with significant proportions of PLHIV. The use of Xpert as a screening tool in countries with a high burden of TB could lead to significantly increased diagnosis of TB at a regional and national level.
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Affiliation(s)
- Z Burger
- University of California San Diego, La Jolla, CA, USA
| | - H T Aung
- Clinton Health Access Initiative, Yangon, Myanmar
| | - M Seifert
- University of California San Diego, La Jolla, CA, USA
| | - T T Mar
- Ministry of Health and Sports, Naypyitaw, Myanmar
| | - V Harris
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - R E Colman
- University of California San Diego, La Jolla, CA, USA
| | - T C Rodwell
- University of California San Diego, La Jolla, CA, USA
| | - S T Aung
- Ministry of Health and Sports, Naypyitaw, Myanmar
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Sui J, Qiao W, Xiang X, Luo Y. Epigenetic Changes in Mycobacterium tuberculosis and its Host Provide Potential Targets or Biomarkers for Drug Discovery and Clinical Diagnosis. Pharmacol Res 2022; 179:106195. [DOI: 10.1016/j.phrs.2022.106195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/14/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
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