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Bilal M, Ullah S, Jaehde U, Trueck C, Zaremba D, Wachall B, Wargenau M, Scheidel B, Wiesen MHJ, Gazzaz M, Chen C, Büsker S, Fuhr U, Taubert M, Dokos C. Assessment of body mass-related covariates for rifampicin pharmacokinetics in healthy Caucasian volunteers. Eur J Clin Pharmacol 2024; 80:1271-1283. [PMID: 38722350 PMCID: PMC11303472 DOI: 10.1007/s00228-024-03697-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/29/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE Currently, body weight-based dosing of rifampicin is recommended. But lately, fat-free mass (FFM) was reported to be superior to body weight (BW). The present evaluation aimed to assess the influence of body mass-related covariates on rifampicin's pharmacokinetics (PK) parameters in more detail using non-linear mixed effects modeling (NLMEM). METHODS Twenty-four healthy Caucasian volunteers were enrolled in a bioequivalence study, each receiving a test and a reference tablet of 600 mg of rifampicin separated by a wash-out period of at least 9 days. Monolix version 2023R1 was used for NLMEM. Monte Carlo simulations (MCS) were performed to visualize the relationship of body size descriptors to the exposure to rifampicin. RESULTS A one-compartment model with nonlinear (Michaelis-Menten) elimination and zero-order absorption kinetics with a lag time best described the data. The covariate model including fat-free mass (FFM) on volume of distribution (V/F) and on maximum elimination rate (Vmax/F) lowered the objective function value (OFV) by 56.4. The second-best covariate model of sex on V/F and Vmax/F and BW on V/F reduced the OFV by 51.2. The decrease in unexplained inter-individual variability on Vmax/F in both covariate models was similar. For a given dose, MCS showed lower exposure to rifampicin with higher FFM and accordingly in males compared to females with the same BW and body height. CONCLUSION Our results indicate that beyond BW, body composition as reflected by FFM could also be relevant for optimized dosing of rifampicin. This assumption needs to be studied further in patients treated with rifampicin.
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Affiliation(s)
- Muhammad Bilal
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
- Department of Clinical Pharmacy, Institute of Pharmacy, University of Bonn, Bonn, Germany.
| | - Sami Ullah
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrich Jaehde
- Department of Clinical Pharmacy, Institute of Pharmacy, University of Bonn, Bonn, Germany
| | - Christina Trueck
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dario Zaremba
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Bertil Wachall
- InfectoPharm Arzneimittel Und Consilium GmbH, 64646, Heppenheim, Germany
| | | | | | - Martin H J Wiesen
- Pharmacology at the Laboratory Diagnostics Centre, Faculty of Medicine, University Hospital Cologne, University of Cologne, Therapeutic Drug Monitoring, Cologne, Germany
| | - Malaz Gazzaz
- Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Chunli Chen
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical Development, College of Veterinary Medicine, Northeast Agricultural University, 600 Changjiang Road, Xiangfang District, Harbin, 150030, People's Republic of China
| | - Sören Büsker
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Uwe Fuhr
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Max Taubert
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Charalambos Dokos
- Department I of Pharmacology, Center for Pharmacology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Monaiar LR, D'Avila KG, Soccol EB, Santos AK, de Braga RSL, Filho FFD, Silva DR. Impact of COVID-19 Pandemic on Tuberculosis and Latent Tuberculosis Infection Diagnosis in Healthcare Workers. J Occup Environ Med 2024; 66:659-661. [PMID: 38664957 DOI: 10.1097/jom.0000000000003127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
OBJECTIVE The aim of the study is to compare the prevalence of latent tuberculosis infection and tuberculosis (TB) in the prepandemic period (2017-2019) with the pandemic period (2020-2022), in a group of healthcare workers (HCWs). METHODS This is a retrospective study. Data on TB diagnosis was retrieved from the hospital information system database. All HCWs who underwent tuberculin skin test (TST) from January 2017 to December 2022 were included in the study. RESULTS In the prepandemic period (2017-2019), 163 HCWs out of 710 were TST positive (22.9%), and in the pandemic period (2020-2022), 85 HCWs out of 449 were TST positive (18.9%) ( P = 0.11). There were 10 HCWs diagnosed with TB in the prepandemic period (incidence: 41.7/100,000) and 2 in the pandemic period (incidence: 8.3/100,000) ( P < 0.0001). CONCLUSIONS This study showed that TB incidence was reduced during the pandemic period in HCWs. TST positivity was also reduced, though not statistically significant.
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Affiliation(s)
- Luciana Rott Monaiar
- From the Programa de Pós-Graduação em Ciências Pneumológicas da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil (L.R.M., K.G.D'A., E.B.S., F.F.D.F., D.R.S.); Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil (L.R.M., K.G.D'A., E.B.S., F.F.D.F., D.R.S.); and Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil (A.K.S., R.S.L.d.B., D.R.S.)
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Marco MH, Ahmedov S, Castro KG. The global impact of COVID-19 on tuberculosis: A thematic scoping review, 2020-2023. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003043. [PMID: 38959278 PMCID: PMC11221697 DOI: 10.1371/journal.pgph.0003043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/25/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND This thematic scoping review of publications sought to understand the global impact of COVID-19 on tuberculosis (TB), interpret the scope of resonating themes, and offer policy recommendations to stimulate TB recovery and future pandemic preparedness. DATA SOURCES Publications were captured from three search engines, PubMed, EBSCO, and Google Scholar, and applicable websites written in English from January 1, 2020, to April 30, 2023. STUDY SELECTION Our scoping review was limited to publications detailing the impact of COVID-19 on TB. Original research, reviews, letters, and editorials describing the deleterious and harmful--yet sometimes positive--impact of COVID-19 (sole exposure) on TB (sole outcome) were included. The objective was to methodically categorize the impacts into themes through a comprehensive review of selected studies to provide significant health policy guidance. DATA EXTRACTION Two authors independently screened citations and full texts, while the third arbitrated when consensus was not met. All three performed data extraction. DATA SYNTHESIS/RESULTS Of 1,755 screened publications, 176 (10%) covering 39 countries over 41 months met the inclusion criteria. By independently using a data extraction instrument, the three authors identified ten principal themes from each publication. These themes were later finalized through a consensus decision. The themes encompassed TB's care cascade, patient-centered care, psychosocial issues, and health services: 1) case-finding and notification (n = 45; 26%); 2) diagnosis and laboratory systems (n = 19; 10.7%) 3) prevention, treatment, and care (n = 22; 12.2%); 4) telemedicine/telehealth (n = 12; 6.8%); 5) social determinants of health (n = 14; 8%); 6) airborne infection prevention and control (n = 8; 4.6%); 7) health system strengthening (n = 22; 13%); 8) mental health (n = 13; 7.4%); 9) stigma (n = 11; 6.3%); and 10) health education (n = 10; 5.7%). LIMITATIONS Heterogeneity of publications within themes. CONCLUSIONS We identified ten globally generalizable themes of COVID-19's impact on TB. The impact and lessons learned from the themed analysis propelled us to draft public health policy recommendations to direct evidence-informed guidance that strengthens comprehensive global responses, recovery for TB, and future airborne pandemic preparedness.
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Affiliation(s)
- Michael H. Marco
- TB Division, Office of Infectious Diseases, Bureau for Global Health, United States Agency for International Development, Washington, District of Columbia, United States of America
- Global Health Technical Assistance and Mission Support, Vienna, Virginia, United States of America
| | - Sevim Ahmedov
- TB Division, Office of Infectious Diseases, Bureau for Global Health, United States Agency for International Development, Washington, District of Columbia, United States of America
| | - Kenneth G. Castro
- TB Division, Office of Infectious Diseases, Bureau for Global Health, United States Agency for International Development, Washington, District of Columbia, United States of America
- Rollins School of Public Health, School of Medicine, Emory/Georgia TB Research Advancement Center, Atlanta, Georgia, United States of America
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Kerschberger B, Daka M, Shongwe B, Dlamini T, Ngwenya S, Danbakli C, Mamba B, Nxumalo B, Sibanda J, Dube S, Dlamini LM, Mabhena E, Mukooza E, Crumley I, Ciglenecki I, Vambe D. The introduction of video-enabled directly observed therapy (video-DOT) for patients with drug-resistant TB disease in Eswatini amid the COVID-19 pandemic - a retrospective cohort study. BMC Health Serv Res 2024; 24:699. [PMID: 38831356 PMCID: PMC11145825 DOI: 10.1186/s12913-024-11151-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 05/28/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Video-enabled directly observed therapy (video-DOT) has been proposed as an additional option for treatment provision besides in-person DOT for patients with drug-resistant TB (DRTB) disease. However, evidence and implementation experience mainly originate from well-resourced contexts. This study describes the operationalization of video-DOT in a low-resourced setting in Eswatini facing a high burden of HIV and TB amid the emergence of the COVID-19 pandemic. METHODS This is a retrospectively established cohort of patients receiving DRTB treatment during the implementation of video-DOT in Shiselweni from May 2020 to March 2022. We described intervention uptake (vs. in-person DOT) and assessed unfavorable DRTB treatment outcome (death, loss to care) using Kaplan-Meier statistics and multivariable Cox-regression models. Video-related statistics were described with frequencies and medians. We calculated the fraction of expected doses observed (FEDO) under video-DOT and assessed associations with missed video uploads using multivariable Poisson regression analysis. RESULTS Of 71 DRTB patients eligible for video-DOT, the median age was 39 (IQR 30-54) years, 31.0% (n = 22) were women, 67.1% (n = 47/70) were HIV-positive, and 42.3% (n = 30) were already receiving DRTB treatment when video-DOT became available. About half of the patients (n = 37; 52.1%) chose video-DOT, mostly during the time when COVID-19 appeared in Eswatini. Video-DOT initiations were lower in new DRTB patients (aHR 0.24, 95% CI 0.12-0.48) and those aged ≥ 60 years (aHR 0.27, 95% CI 0.08-0.89). Overall, 20,634 videos were uploaded with a median number of 553 (IQR 309-748) videos per patient and a median FEDO of 92% (IQR 84-97%). Patients aged ≥ 60 years were less likely to miss video uploads (aIRR 0.07, 95% CI 0.01-0.51). The cumulative Kaplan-Meier estimate of an unfavorable treatment outcome among all patients was 0.08 (95% CI 0.03-0.19), with no differences detected by DOT approach and other baseline factors in multivariable analysis. CONCLUSIONS Implementing video-DOT for monitoring of DRTB care provision amid the intersection of the HIV and COVID-19 pandemics seemed feasible. Digital health technologies provide additional options for patients to choose their preferred way to support treatment taking, thus possibly increasing patient-centered health care while sustaining favorable treatment outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Bheki Mamba
- National TB Control Programme (NTCP), Manzini, Eswatini
| | | | - Joyce Sibanda
- National TB Control Programme (NTCP), Manzini, Eswatini
| | - Sisi Dube
- National TB Control Programme (NTCP), Manzini, Eswatini
| | | | | | | | | | | | - Debrah Vambe
- National TB Control Programme (NTCP), Manzini, Eswatini
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Kılıç A, Clarke AL, Moon Z, Hamada Y, Chan AHY, Rahman A, Layton C, Griffiths CJ, Zenner D, Powell E, Kunst H, Lipman M, Mandelbaum M, Papineni P, Tattersall T, Duong T, Abubakar I, Rangaka MX, Horne R. Health and illness beliefs in adults with tuberculosis infection during the COVID-19 pandemic in the UK. DIALOGUES IN HEALTH 2024; 4:100162. [PMID: 38516222 PMCID: PMC10953974 DOI: 10.1016/j.dialog.2023.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 03/23/2024]
Abstract
Background COVID-19 disrupted the TB prevention programme in the UK, especially for TB infection (TBI) care. We explore whether experience of the COVID-19 pandemic impacted on patients' perceptions of TBI and its treatment. Methods Semi-structured interviews were conducted as part of the Research to Improve Detection and Treatment of TBI (RID-TB) programme, exploring perceptual and practical barriers to TBI treatment. Nineteen people diagnosed with TBI were interviewed between August 2020 and April 2021. Recordings were transcribed and analysed using a constant comparative approach, allowing for a dynamic and iterative exploration of themes. Themes are organised using the Perceptions and Practicalities Approach. Findings Some participants perceived TBI as a risk factor for increased susceptibility to COVID-19, while some thought that treatment for TBI might protect against COVID-19 or mitigate its effects. Adaptations to TB services (e.g., remote follow-up) and integrated practices during the COVID-19 restrictions (e.g., medication being posted) addressed some practical barriers to TBI treatment. However, we identified beliefs about TBI and COVID-19 that are likely to act as barriers to engagement with TBI treatment, including: interpreting service delays as an indication of TBI not being serious enough for treatment and concerns about contracting COVID-19 in TB clinics. Interpretation COVID-19 and TBI service delays influence people's perceptions and practical barriers to TBI treatment adherence. Failure to address these beliefs may lead to people's concerns about their treatment not being fully addressed. Utilised service adaptations like remote consultations to address practical barriers may be relevant beyond COVID-19. Funding NIHR RID-TB Program (RP-PG-0217-20009).
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Affiliation(s)
- Ayşenur Kılıç
- School of Pharmacy, University College London, London, UK
| | - Amy L. Clarke
- School of Pharmacy, University College London, London, UK
| | - Zoe Moon
- School of Pharmacy, University College London, London, UK
| | - Yohhei Hamada
- Institute for Global Health, University College London, London, UK
| | - Amy Hai Yan Chan
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Ananna Rahman
- Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
| | | | - Chris J. Griffiths
- Centre for Primary Care, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Dominik Zenner
- Centre for Primary Care, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ellen Powell
- MRC Clinical Trials Unit, University College London, UK
| | - Heinke Kunst
- Respiratory Medicine, Queen Mary University of London, London, UK
| | - Marc Lipman
- Royal Free London NHS Foundation Trust, London, UK
- UCL-TB and UCL Respiratory, University College London, London, UK
| | | | | | | | - Trinh Duong
- MRC Clinical Trials Unit, University College London, UK
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Molebogeng X. Rangaka
- Institute for Global Health, University College London, London, UK
- Division of Epidemiology and Biostatistics & CIDRI-AFRICA, University of Cape Town, Cape Town, South Africa
| | - Robert Horne
- School of Pharmacy, University College London, London, UK
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Ahmad S, Singh AP, Bano N, Raza K, Singh J, Medigeshi GR, Pandey R, Gautam HK. Integrative analysis discovers Imidurea as dual multitargeted inhibitor of CD69, CD40, SHP2, lysozyme, GATA3, cCBL, and S-cysteinase from SARS-CoV-2 and M. tuberculosis. Int J Biol Macromol 2024; 270:132332. [PMID: 38768914 DOI: 10.1016/j.ijbiomac.2024.132332] [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: 01/29/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
Two of the deadliest infectious diseases, COVID-19 and tuberculosis (TB), have combined to establish a worldwide pandemic, wreaking havoc on economies and claiming countless lives. The optimised, multitargeted medications may diminish resistance and counter them together. Based on computational expression studies, 183 genes were co-expressed in COVID-19 and TB blood samples. We used the multisampling screening algorithms on the top ten co-expressed genes (CD40, SHP2, Lysozyme, GATA3, cCBL, SIVmac239 Nef, CD69, S-adenosylhomocysteinase, Chemokine Receptor-7, and Membrane Protein). Imidurea is a multitargeted inhibitor for COVID-19 and TB, as confirmed by extensive screening and post-filtering utilising MM\GBSA algorithms. Imidurea has shown docking and MM\GBSA scores of -8.21 to -4.75 Kcal/mol and -64.16 to -29.38 Kcal/mol, respectively. The DFT, pharmacokinetics, and interaction patterns suggest that Imidurea may be a drug candidate, and all ten complexes were tested for stability and bond strength using 100 ns for all MD atoms. The modelling findings showed the complex's repurposing potential, with a cumulative deviation and fluctuation of <2 Å and significant intermolecular interaction, which validated the possibilities. Finally, an inhibition test was performed to confirm our in-silico findings on SARS-CoV-2 Delta variant infection, which was suppressed by adding imidurea to Vero E6 cells after infection.
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Affiliation(s)
- Shaban Ahmad
- Computational Intelligence and Bioinformatics Lab, Department of Computer Science, Jamia Millia Islamia, New Delhi 110025, India.
| | - Akash Pratap Singh
- Division of Immunology and Infectious Disease Biology, Institute of Genomics and Integrative Biology (IGIB), Mathura Road, New Delhi 110025, India; Academy of Innovative and Scientific Research (AcSIR), Ghaziabad 201002, India; Department of Botany, Maitreyi College, University of Delhi, New Delhi 110021, India.
| | - Nagmi Bano
- Computational Intelligence and Bioinformatics Lab, Department of Computer Science, Jamia Millia Islamia, New Delhi 110025, India.
| | - Khalid Raza
- Computational Intelligence and Bioinformatics Lab, Department of Computer Science, Jamia Millia Islamia, New Delhi 110025, India.
| | - Janmejay Singh
- Bioassay Laboratory, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India.
| | - Guruprasad R Medigeshi
- Bioassay Laboratory, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India.
| | - Rajesh Pandey
- Academy of Innovative and Scientific Research (AcSIR), Ghaziabad 201002, India; Division of Immunology and Infectious Disease Biology, INtegrative GENomics of HOst-PathogEn (INGEN-HOPE), Institute of Genomics and Integrative Biology (IGIB), Mall Road, New Delhi 110007, India.
| | - Hemant K Gautam
- Division of Immunology and Infectious Disease Biology, Institute of Genomics and Integrative Biology (IGIB), Mathura Road, New Delhi 110025, India; Academy of Innovative and Scientific Research (AcSIR), Ghaziabad 201002, India.
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Shapiro AN, Dolynska M, Chiang SS, Rybak N, Petrenko V, Horsburgh CR, Kobe J, Terleieva I, Sakalska O, Jenkins HE. The impact of the COVID-19 pandemic on TB notifications in Ukraine in 2020. IJTLD OPEN 2024; 1:258-265. [PMID: 39021447 PMCID: PMC11249659 DOI: 10.5588/ijtldopen.24.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/08/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND We assessed the impact of the COVID-19 pandemic on TB notifications in Ukraine, stratified by multiple subgroups. DESIGN/METHODS We analyzed data from Ukraine's National TB Program from January 2015 to December 2020 using interrupted time series models. We compared observed cases to counterfactual estimated cases had the pandemic not occurred and estimated trends through December 2020 nationally and by various demographics. We compared the proportions of individuals who underwent drug susceptibility testing (DST) in February 2020 and April 2020 to assess the pandemic impact on drug resistance testing. RESULTS In April 2020, there were 39% (95% CI 36-42) fewer TB notifications than the estimated counterfactual (3,060 estimated; 95% CI 2,918-3,202; 1,872 observed). We observed a greater decrease in notifications among refugees/migrants compared with non-refugees/migrants (64%, 95% CI 60-67 vs. 39%, 95% CI 36-42), and individuals aged <15 years compared with those aged ≥15 years (60%, 95% CI 57-64 vs. 38%, 95% CI 36-41). We also observed a decrease in the proportion of individuals receiving DST for several drugs. CONCLUSIONS These findings underscore the challenges to TB prevention and care during disruption and may be generalizable to the current wartime situation, especially considering the substantial increase in refugees within and leaving Ukraine.
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Affiliation(s)
- A N Shapiro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - M Dolynska
- NGO Infection Control Ukraine, Kyiv, Ukraine
| | - S S Chiang
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for International Health Research, Rhode Island Hospital, Providence, RI, USA
| | - N Rybak
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - V Petrenko
- Bogomolets National Medical University, Kyiv, Ukraine
| | - C R Horsburgh
- Departments of Global Health, Epidemiology, Biostatistics and Medicine, Boston University, Boston, MA, USA
| | - J Kobe
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - I Terleieva
- Public Health Center of the Ministry of Health, Kyiv City, Ukraine
| | - O Sakalska
- Public Health Center of the Ministry of Health, Kyiv City, Ukraine
| | - H E Jenkins
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
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Mihuta C, Socaci A, Hogea P, Tudorache E, Mihuta MS, Oancea C. Colliding Challenges: An Analysis of SARS-CoV-2 Infection in Patients with Pulmonary Tuberculosis versus SARS-CoV-2 Infection Alone. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:823. [PMID: 38793006 PMCID: PMC11123355 DOI: 10.3390/medicina60050823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: The concurrent occurrence of tuberculosis and COVID-19 coinfection poses significant clinical complexities, warranting a nuanced approach to diagnosis, management, and patient care. Materials and Methods: A retrospective, cross-sectional study was conducted on two groups: one comprising 32 patients with pulmonary TB (PTB) and COVID-19 co-infection, and one including 100 patients with COVID-19 alone. Data was collected from medical records, including patient history, clinical parameters, laboratory, imaging results, and patient outcome. Results: A lower BMI emerges as a significant marker suggesting underlying PTB in patients with SARS-CoV-2 co-infection. Type 2 diabetes mellitus increases the risk of death in PTB-SARS-CoV-2 co-infection. Co-infected patients show lymphocytopenia and higher neutrophil levels, CRP, transaminases, and D-dimer levels. Elevated CRP and ALT levels are linked to increased co-infection likelihood. Certain parameters like SpO2, CRP, ALT, AST, and D-dimer effectively differentiate between co-infected and COVID-19 patients. Platelet-to-lymphocyte ratio is notably higher in co-infected individuals. Lesion severity on imaging is significantly associated with co-infection, highlighting imaging's diagnostic importance. Longer hospital stays are linked to co-infection but not significantly to death risk. Conclusions: Certain clinical and biological factors may serve as potential indicators of PTB co-infection in patients with SARS-CoV-2.
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Affiliation(s)
- Camil Mihuta
- Department of Doctoral Studies, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Clinical Hospital for Infectious Diseases and Pneumology “Dr. Victor Babes”, 300041 Timisoara, Romania; (P.H.); (E.T.); (C.O.)
| | - Adriana Socaci
- Clinical Hospital for Infectious Diseases and Pneumology “Dr. Victor Babes”, 300041 Timisoara, Romania; (P.H.); (E.T.); (C.O.)
- Department of Biology and Life Sciences, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Patricia Hogea
- Clinical Hospital for Infectious Diseases and Pneumology “Dr. Victor Babes”, 300041 Timisoara, Romania; (P.H.); (E.T.); (C.O.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Pulmonology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Emanuela Tudorache
- Clinical Hospital for Infectious Diseases and Pneumology “Dr. Victor Babes”, 300041 Timisoara, Romania; (P.H.); (E.T.); (C.O.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Pulmonology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Monica Simina Mihuta
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Cristian Oancea
- Clinical Hospital for Infectious Diseases and Pneumology “Dr. Victor Babes”, 300041 Timisoara, Romania; (P.H.); (E.T.); (C.O.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Pulmonology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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9
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Calles-Cabanillas LE, Aguillón-Durán GP, Ayala D, Caso JA, Garza M, Joya-Ayala M, Cruz-Gonzalez AM, Loera-Salazar R, Prieto-Martinez E, Rodríguez-Herrera JE, Garcia-Oropesa EM, Thomas JM, Lee M, Torrelles JB, Restrepo BI. Interaction between type 2 diabetes and past COVID-19 on active tuberculosis. RESEARCH SQUARE 2024:rs.3.rs-3989104. [PMID: 38559235 PMCID: PMC10980154 DOI: 10.21203/rs.3.rs-3989104/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND The global setback in tuberculosis (TB) prevalence and mortality in the post-COVID-19 era have been partially attributed to pandemic-related disruptions in healthcare systems. The additional biological contribution of COVID-19 to TB is less clear. The goal of this study was to determine if there is an association between COVID-19 in the past 18 months and a new TB episode, and the role played by type 2 diabetes mellitus (DM) comorbidity in this relationship. METHODS A cross-sectional study was conducted among 112 new active TB patients and 373 non-TB controls, identified between June 2020 and November 2021 in communities along the Mexican border with Texas. Past COVID-19 was based on self-report or positive serology. Bivariable/multivariable analysis were used to evaluate the odds of new TB in hosts with past COVID-19 and/or DM status. RESULTS The odds of new TB were higher among past COVID-19 cases vs. controls, but only significant among DM patients (aOR 2.3). The odds of TB given DM was 2.7-fold among participants without past COVID-19 and increased to 7.9-fold among those with past COVID-19. CONCLUSION DM interacts with past COVID-19 synergistically to magnify the risk of TB. Latent TB screening and prophylactic treatment, if positive, is recommended in this COVID-19/DM/latent TB high-risk group.
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Affiliation(s)
| | | | - Doris Ayala
- University of Texas Health Science Center at Houston
| | - José A Caso
- University of Texas Health Science Center at Houston
| | - Miguel Garza
- University of Texas Health Science Center at Houston
| | | | | | | | | | | | | | | | - Miryoung Lee
- University of Texas Health Science Center at Houston
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Oga-Omenka C, Rosapep L, Baruwa E, Huria L, Vasquez NA, Faleye BO, Kafi MAH, Sassi A, Nwosu C, Johns B, Adamu A, Chijioke-Akaniro O, Anyaike C, Pai M. Individual journeys to tuberculosis care in Nigeria's private sector during the COVID-19 pandemic. BMJ Glob Health 2024; 9:e013124. [PMID: 38195153 PMCID: PMC10806899 DOI: 10.1136/bmjgh-2023-013124] [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: 06/14/2023] [Accepted: 10/16/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Pre-COVID-19, individuals with tuberculosis (TB) in Nigeria were often underdiagnosed and untreated. TB services were mostly in the public sector with only 15% of new cases in 2019 reported from the private sector. Reports highlighted challenges in accessing care in the private sector, which accounted for 67% of all initial care-seeking. Our study examined patients' health seeking pathways for TB in Nigeria's private sector and explored any changes to care pathways during COVID-19. METHODS We conducted 180 cross-sectional surveys and 20 in-depth interviews with individuals having chest symptoms attending 18 high-volume private clinics and hospitals in Kano and Lagos States. Questions focused on sociodemographic characteristics, health-seeking behaviour, and pathways to care during the COVID-19 pandemic. All surveys and interviews were conducted in May 2021. RESULTS Most participants were male (111/180), with an average age of 37. Half (96/180) sought healthcare within a week of symptoms, while few (20/180) waited over 2 months. Individuals testing positive for TB had more health-seeking delays, and those testing negative for TB had more provider delays. On average, participants visited two providers in Kano and 1.69 in Lagos, with 61 of 180 in Kano and 48 of 180 in Lagos visiting other providers before the recruitment facility. Private providers were the initial encounters for most participants (60/180 in Kano, 83/180 in Lagos). Most respondents (164/180) experienced short-lived pandemic-related restrictions, affecting access to transportation, and closed facilities. CONCLUSIONS This study showed a few challenges in accessing TB care, necessitating continued investment in healthcare infrastructure and resources, particularly in the private sector. Understanding the different care pathways and delays in care provides opportunities for targeted interventions to improve deployment of services closer to where patients first seek care.
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Affiliation(s)
- Charity Oga-Omenka
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- McGill International TB Center, McGill University Health Centre, Montreal, Vendôme, Canada
| | - Lauren Rosapep
- ABT Associates Inc Bethesda, Bethesda, Maryland, USA
- Sustaining Health Outcomes through the Private Sector (SHOPS) Plus, Abuja, Nigeria
| | - Elaine Baruwa
- ABT Associates Inc Bethesda, Bethesda, Maryland, USA
- Sustaining Health Outcomes through the Private Sector (SHOPS) Plus, Abuja, Nigeria
| | - Lavanya Huria
- McGill International TB Center, McGill University Health Centre, Montreal, Vendôme, Canada
- Faculty of Medicine and Health Sciences, Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Nathaly Aquilera Vasquez
- McGill International TB Center, McGill University Health Centre, Montreal, Vendôme, Canada
- Faculty of Medicine and Health Sciences, Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | | | - Md Abdullah Heel Kafi
- McGill International TB Center, McGill University Health Centre, Montreal, Vendôme, Canada
| | - Angelina Sassi
- McGill International TB Center, McGill University Health Centre, Montreal, Vendôme, Canada
- Faculty of Medicine and Health Sciences, Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Chimdi Nwosu
- VizSight Analytics Inc, Vancouver, British Columbia, Canada
| | | | - Abdu Adamu
- Sustaining Health Outcomes through the Private Sector (SHOPS) Plus, Abuja, Nigeria
| | | | | | - Madhukar Pai
- McGill International TB Center, McGill University Health Centre, Montreal, Vendôme, Canada
- Faculty of Medicine and Health Sciences, Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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11
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Riccardi N, Occhineri S, Vanino E, Antonello RM, Pontarelli A, Saluzzo F, Masini T, Besozzi G, Tadolini M, Codecasa L. How We Treat Drug-Susceptible Pulmonary Tuberculosis: A Practical Guide for Clinicians. Antibiotics (Basel) 2023; 12:1733. [PMID: 38136767 PMCID: PMC10740448 DOI: 10.3390/antibiotics12121733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide and pulmonary TB (PTB) is the main variant responsible for fueling transmission of the infection. Effective treatment of drug-susceptible (DS) TB is crucial to avoid the emergence of Mycobacterium tuberculosis-resistant strains. In this narrative review, through a fictional suggestive case of DS PTB, we guide the reader in a step-by-step commentary to provide an updated review of current evidence in the management of TB, from diagnosis to post-treatment follow-up. World Health Organization and Centre for Diseases Control (CDC) guidelines for TB, as well as the updated literature, were used to support this manuscript.
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Affiliation(s)
- Niccolò Riccardi
- StopTB Italia ODV, 20159 Milan, Italy
- Infectious Diseases Unit, Azienda Ospedaliera Universitaria Pisana, 56124 Pisa, Italy
| | - Sara Occhineri
- StopTB Italia ODV, 20159 Milan, Italy
- Infectious Diseases Unit, Azienda Ospedaliera Universitaria Pisana, 56124 Pisa, Italy
| | - Elisa Vanino
- StopTB Italia ODV, 20159 Milan, Italy
- Infectious Diseases Unit, Santa Maria delle Croci Hospital, AUSL Romagna, 48100 Ravenna, Italy
| | | | - Agostina Pontarelli
- StopTB Italia ODV, 20159 Milan, Italy
- Unit of Respiratory Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy
| | - Francesca Saluzzo
- StopTB Italia ODV, 20159 Milan, Italy
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute, San Raffaele University, 20132 Milan, Italy
| | | | | | - Marina Tadolini
- StopTB Italia ODV, 20159 Milan, Italy
- Infectious Disease Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Luigi Codecasa
- StopTB Italia ODV, 20159 Milan, Italy
- Regional TB Reference Centre, Villa Marelli Institute, ASST Grande Ospedale Metropolitano Niguarda, 20159 Milan, Italy
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12
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Sentís A, Prats-Uribe A, Peixoto VR, Caylà JA, Gomes MD, Sousa S, Duarte R, Carvalho I, Carvalho C. Decline of tuberculosis notification rate in different populations and regions in Portugal, 2010-2017. Pulmonology 2023; 29 Suppl 4:S36-S43. [PMID: 34544672 DOI: 10.1016/j.pulmoe.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) incidence declined in Portugal in recent decades, but trends differ between regions and population subgroups. We investigated these differences to inform prevention and control programmes. METHODS We extracted TB notifications from the Portuguese National TB Surveillance System (SVIG-TB) in 2010-2017, disaggregated by region, age group, nationality and HIV status. We calculated notification rates using denominators from the Portuguese National Institute of Statistics and the Joint United Nations Programme on HIV/AIDS and performed stratified time series analysis. We estimated interannual decline percentages and 95% confidence intervals (CI) using Poisson and binomial negative regression models. RESULTS The overall TB notification rate decreased from 25.7 to 17.5/100,000 population from 2010 to 2017 (5.2%/year) in Portugal. Interannual decline did not differ significantly between regions, but it was smaller amongst non-Portuguese nationals (-1.57% [CI: -4.79%, 1.75%] vs -5.85% [CI: -6.98%, -4.70%] in Portuguese nationals); children under five years of age (+1.77% [CI: -4.61%, 8.58%] vs -5.38% [CI: -6.33%, -4.42%] in other age groups); and HIV-negative people (-6.47% [CI: -9.10%, -3.77%] vs -11.29% [CI; -17.51%, -4.60%] in HIV-positive). CONCLUSIONS The decline in TB notification rates in Portugal during the study period has been steady. However, the decline amongst non-Portuguese nationals, children under five years of age and non-infected-HIV patients was lower. No significant differences were observed between regions. Changes in TB epidemiology in specific risk groups and geographical areas should be closely monitored to achieve the objectives of the End TB Strategy. We recommend intensifying screening of TB in the subpopulations identified.
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Affiliation(s)
- A Sentís
- Epiconcept, Epidemiology Department, Paris, France; Pompeu Fabra University (UPF), Barcelona, Spain
| | - A Prats-Uribe
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, United Kingdom
| | - V R Peixoto
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal; Comprehensive Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
| | - J A Caylà
- Foundation of Tuberculosis Research Unit of Barcelona, Spain
| | - M D Gomes
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal; National Tuberculosis Programme, Directorate-General of Health, Lisbon, Portugal
| | - S Sousa
- National Tuberculosis Programme, Directorate-General of Health, Lisbon, Portugal; Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - R Duarte
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal; Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal; Pulmonology Department, Hospital Centre of Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal
| | - I Carvalho
- National Tuberculosis Programme, Directorate-General of Health, Lisbon, Portugal; Pediatric Department, Hospital Centre of Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal
| | - C Carvalho
- Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
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Williams V, Vos-Seda AG, Calnan M, Mdluli-Dlamini L, Haumba S, Grobbee DE, Klipstein-Grobusch K, Otwombe K. Tuberculosis services during the COVID-19 pandemic: A qualitative study on the impact of COVID-19 and practices for continued services delivery in Eswatini. PUBLIC HEALTH IN PRACTICE 2023; 6:100405. [PMID: 38099086 PMCID: PMC10719405 DOI: 10.1016/j.puhip.2023.100405] [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: 01/13/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 12/17/2023] Open
Abstract
Objectives To describe the impact of the COVID-19 pandemic on tuberculosis services and the different approaches healthcare workers adopted to ensure continued tuberculosis service delivery in Eswatini. Study design This is a qualitative study with a cross-sectional design. Methods Thirteen nurses and 9 doctors who provide tuberculosis care from 10 health facilities participated in an in-depth interview to describe how the COVID-19 pandemic affected tuberculosis services and the approaches adopted to ensure continued patient care. Twenty in-person and 2 telephone interviews were conducted. The participating facilities were selected based on a ranking criterion of the number of patients seen. Data were analyzed using thematic content analysis. NVivo 12 software was used for qualitative analysis, and the Consolidated Criteria guided the study for Reporting Qualitative research (COREQ). Results Two major themes emerged: COVID-19 impacted services delivery and access; and best practices that ensured healthcare services delivery. Six sub-themes describe how COVID-19 impacted services: all attention focused on COVID-19; COVID worsened the health system challenges; COVID hindered patients from accessing care; patients defaulted due to the lockdown; COVID impacted the quality of care and increased the risk of infection among healthcare workers. Five sub-themes describe best practices that ensure continued service delivery: Home-based care, Patient support, Patient Education, Integrated Services, and Staff rotation. Conclusion While various strategies were adopted globally to mitigate the impact of the COVID-19 pandemic, these strategies need contextualization to be effective and sustainably incorporated into routine care to ensure continuity of and access to TB and other healthcare services.
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Affiliation(s)
- Victor Williams
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- National Tuberculosis Control Program, Manzini, Eswatini
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alinda G. Vos-Seda
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Samson Haumba
- Center for Global Health Practice and Impact, Georgetown University Medical Center, Washington, DC, USA
| | - Diederick E. Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Kennedy Otwombe
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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14
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Morena D, Campos C, Castillo M, Alonso M, Benavent M, Izquierdo JL. Impact of the COVID-19 Pandemic on the Epidemiological Situation of Pulmonary Tuberculosis-Using Natural Language Processing. J Pers Med 2023; 13:1629. [PMID: 38138856 PMCID: PMC10744898 DOI: 10.3390/jpm13121629] [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: 10/14/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND We aimed to analyze the impact of the COVID-19 pandemic on pulmonary tuberculosis (TB) using artificial intelligence. To do so, we compared the real-life situation during the pandemic with the pre-2020 situation. METHODS This non-interventional, retrospective, observational study applied natural language processing to the electronic health records of the Castilla-La Mancha region of Spain. The analysis was conducted from January 2015 to December 2020. RESULTS A total of 2592 patients were diagnosed with pulmonary tuberculosis; 64.6% were males, and the mean age was 53.5 years (95%CI 53.0-54.0). In 2020, pulmonary tuberculosis diagnoses dropped by 28% compared to 2019. In total, 62 (14.2%) patients were diagnosed with COVID-19 and pulmonary tuberculosis coinfection in 2020, with a mean age of 52.3 years (95%CI 48.3-56.2). The main symptoms in these patients were dyspnea (27.4%) and cough (35.5%), although their comorbidities were no greater than patients with isolated TB. The female sex was more frequently affected, representing 53.4% of this patient subgroup. CONCLUSIONS During the first year of the COVID-19 pandemic, a decrease was observed in the incidence of pulmonary tuberculosis. Women presented a significantly higher risk for pulmonary tuberculosis and COVID-19 coinfection, although the symptoms were not more severe than patients diagnosed with pulmonary tuberculosis alone.
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Affiliation(s)
- Diego Morena
- Servicio de Neumología, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (C.C.); (M.C.); (M.A.); (J.L.I.)
- Programa de Doctorado en Ciencias de la Salud, Universidad de Alcalá, 28801 Madrid, Spain
| | - Carolina Campos
- Servicio de Neumología, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (C.C.); (M.C.); (M.A.); (J.L.I.)
| | - María Castillo
- Servicio de Neumología, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (C.C.); (M.C.); (M.A.); (J.L.I.)
| | - Miguel Alonso
- Servicio de Neumología, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (C.C.); (M.C.); (M.A.); (J.L.I.)
| | | | - José Luis Izquierdo
- Servicio de Neumología, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain; (C.C.); (M.C.); (M.A.); (J.L.I.)
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, 28801 Madrid, Spain
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Casco N, Jorge AL, Palmero DJ, Alffenaar JW, Fox GJ, Ezz W, Cho JG, Denholm J, Skrahina A, Solodovnikova V, Arbex MA, Alves T, Rabahi MF, Pereira GR, Sales R, Silva DR, Saffie MM, Salinas NE, Miranda RC, Cisterna C, Concha C, Fernandez I, Villalón C, Vera CG, Tapia PG, Cancino V, Carbonell M, Cruz A, Muñoz E, Muñoz C, Navarro I, Pizarro R, Cristina Sánchez GP, Vergara Riquelme MS, Vilca E, Soto A, Flores X, Garavagno A, Bahamondes MH, Merino LM, Pradenas AM, Revillot ME, Rodriguez P, Salinas AS, Taiba C, Valdés JF, Subiabre JN, Ortega C, Palma S, Castillo PP, Pinto M, Bidegain FR, Venegas M, Yucra E, Li Y, Cruz A, Guelvez B, Victoria Plaza R, Tello Hoyos KY, Cardoso-Landivar J, Van Den Boom M, Andréjak C, Blanc FX, Dourmane S, Froissart A, Izadifar A, Rivière F, Schlemmer F, Manika K, Diallo BD, Hassane-Harouna S, Artiles N, Mejia LA, Gupta N, Ish P, Mishra G, Patel JM, Singla R, Udwadia ZF, Alladio F, Angeli F, Calcagno A, Centis R, Codecasa LR, De Lauretis A, Esposito SMR, Formenti B, Gaviraghi A, Giacomet V, Goletti D, Gualano G, Matteelli A, Migliori GB, Motta I, Palmieri F, Pontali E, Prestileo T, Riccardi N, Saderi L, Saporiti M, Sotgiu G, Spanevello A, Stochino C, Tadolini M, Torre A, Villa S, Visca D, Kurhasani X, Furjani M, Rasheed N, Danila E, Diktanas S, Ridaura RL, Luna López FL, Torrico MM, Rendon A, Akkerman OW, Chizaram O, Al-Abri S, Alyaquobi F, Althohli K, Aguirre S, Teixeira RC, De Egea V, Irala S, Medina A, Sequera G, Sosa N, Vázquez F, Llanos-Tejada FK, Manga S, Villanueva-Villegas R, Araujo D, Sales Marques RD, Socaci A, Barkanova O, Bogorodskaya M, Borisov S, Mariandyshev A, Kaluzhenina A, Vukicevic TA, Stosic M, Beh D, Ng D, Ong CWM, Solovic I, Dheda K, Gina P, Caminero JA, De Souza Galvão ML, Dominguez-Castellano A, García-García JM, Pinargote IM, Fernandez SQ, Sánchez-Montalvá A, Huguet ET, Murguiondo MZ, Bart PA, Mazza-Stalder J, D'Ambrosio L, Kamolwat P, Bakko F, Barnacle J, Bird S, Brown A, Chandran S, Killington K, Man K, Papineni P, Ritchie F, Tiberi S, Utjesanovic N, Zenner D, Hearn JL, Heysell S, Young L. Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort. Eur Respir J 2023; 62:2300925. [PMID: 37827576 PMCID: PMC10627308 DOI: 10.1183/13993003.00925-2023] [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: 06/01/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. METHODS We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. RESULTS Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53). CONCLUSIONS In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.
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Wu D, Jin Y, Xing Y, Abate MD, Abbasian M, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abd-Allah F, Abdelmasseh M, Abdollahifar MA, Abdulah DM, Abedi A, Abedi V, Abidi H, Aboagye RG, Abolhassani H, Abuabara K, Abyadeh M, Addo IY, Adeniji KN, Adepoju AV, Adesina MA, Sakilah Adnani QE, Afarideh M, Aghamiri S, Agodi A, Agrawal A, Aguilera Arriagada CE, Ahmad A, Ahmad D, Ahmad S, Ahmad S, Ahmadi A, Ahmed A, Ahmed A, Aithala JP, Ajadi AA, Ajami M, Akbarzadeh-Khiavi M, Alahdab F, AlBataineh MT, Alemi S, Saeed Al-Gheethi AA, Ali L, Alif SM, Almazan JU, Almustanyir S, Alqahtani JS, Alqasmi I, Khan Altaf IU, Alvis-Guzman N, Alvis-Zakzuk NJ, Al-Worafi YM, Aly H, Amani R, Amu H, Amusa GA, Andrei CL, Ansar A, Ansariniya H, Anyasodor AE, Arabloo J, Arefnezhad R, Arulappan J, Asghari-Jafarabadi M, Ashraf T, Atata JA, Athari SS, Atlaw D, Wahbi Atout MM, Aujayeb A, Awan AT, Ayatollahi H, Azadnajafabad S, Azzam AY, Badawi A, Badiye AD, Bagherieh S, Baig AA, Bantie BB, Barchitta M, Bardhan M, Barker-Collo SL, Barone-Adesi F, Batra K, Bayileyegn NS, Behnoush AH, Belgaumi UI, Bemanalizadeh M, Bensenor IM, Beyene KA, Bhagavathula AS, Bhardwaj P, Bhaskar S, Bhat AN, Bitaraf S, Bitra VR, Boloor A, Bora K, Botelho JS, Buchbinder R, Calina D, Cámera LA, Carvalho AF, Kai Chan JS, Chattu VK, Abebe EC, Chichagi F, Choi S, Chou TC, Chu DT, Coberly K, Costa VM, Couto RA, Cruz-Martins N, Dadras O, Dai X, Damiani G, Dascalu AM, Dashti M, Debela SA, Dellavalle RP, Demetriades AK, Demlash AA, Deng X, Desai HD, Desai R, Rahman Dewan SM, Dey S, Dharmaratne SD, Diaz D, Dibas M, Dinis-Oliveira RJ, Diress M, Do TC, Doan DK, Dodangeh M, Dodangeh M, Dongarwar D, Dube J, Dziedzic AM, Ed-Dra A, Edinur HA, Eissazade N, Ekholuenetale M, Ekundayo TC, Elemam NM, Elhadi M, Elmehrath AO, Abdou Elmeligy OA, Emamverdi M, Emeto TI, Esayas HL, Eshetu HB, Etaee F, Fagbamigbe AF, Faghani S, Fakhradiyev IR, Fatehizadeh A, Fathi M, Feizkhah A, Fekadu G, Fereidouni M, Fereshtehnejad SM, Fernandes JC, Ferrara P, Fetensa G, Filip I, Fischer F, Foroutan B, Foroutan M, Fukumoto T, Ganesan B, Belete Gemeda BN, Ghamari SH, Ghasemi M, Gholamalizadeh M, Gill TK, Gillum RF, Goldust M, Golechha M, Goleij P, Golinelli D, Goudarzi H, Guan SY, Guo Y, Gupta B, Gupta VB, Gupta VK, Haddadi R, Hadi NR, Halwani R, Haque S, Hasan I, Hashempour R, Hassan A, Hassan TS, Hassanzadeh S, Hassen MB, Haubold J, Hayat K, Heidari G, Heidari M, Heidari-Soureshjani R, Herteliu C, Hessami K, Hezam K, Hiraike Y, Holla R, Hosseini MS, Huynh HH, Hwang BF, Ibitoye SE, Ilic IM, Ilic MD, Iranmehr A, Iravanpour F, Ismail NE, Iwagami M, Iwu CC, Jacob L, Jafarinia M, Jafarzadeh A, Jahankhani K, Jahrami H, Jakovljevic M, Jamshidi E, Jani CT, Janodia MD, Jayapal SK, Jayaram S, Jeganathan J, Jonas JB, Joseph A, Joseph N, Joshua CE, Vaishali K, Kaambwa B, Kabir A, Kabir Z, Kadashetti V, Kaliyadan F, Kalroozi F, Kamal VK, Kandel A, Kandel H, Kanungo S, Karami J, Karaye IM, Karimi H, Kasraei H, Kazemian S, Kebede SA, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khamesipour F, Khan EA, Khan IA, Khan M, Khan MJ, Khan MA, Khan MA, Khatatbeh H, Khatatbeh MM, Khateri S, Khayat Kashani HR, Kim MS, Kisa A, Kisa S, Koh HY, Kolkhir P, Korzh O, Kotnis AL, Koul PA, Koyanagi A, Krishan K, Kuddus M, Kulkarni VV, Kumar N, Kundu S, Kurmi OP, La Vecchia C, Lahariya C, Laksono T, Lám J, Latief K, Lauriola P, Lawal BK, Thu Le TT, Bich Le TT, Lee M, Lee SW, Lee WC, Lee YH, Lenzi J, Levi M, Li W, Ligade VS, Lim SS, Liu G, Liu X, Llanaj E, Lo CH, Machado VS, Maghazachi AA, Mahmoud MA, Mai TA, Majeed A, Sanaye PM, Makram OM, Rad EM, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mansournia MA, Mantovani LG, Martorell M, Masoudi S, Masoumi SZ, Mathangasinghe Y, Mathews E, Mathioudakis AG, Maugeri A, Mayeli M, Carabeo Medina JR, Meles GG, Mendes JJ, Menezes RG, Mestrovic T, Michalek IM, Micheletti Gomide Nogueira de Sá AC, Mihretie ET, Nhat Minh LH, Mirfakhraie R, Mirrakhimov EM, Misganaw A, Mohamadkhani A, Mohamed NS, Mohammadi F, Mohammadi S, Mohammed S, Mohammed S, Mohan S, Mohseni A, Mokdad AH, Momtazmanesh S, Monasta L, Moni MA, Moniruzzaman M, Moradi Y, Morovatdar N, Mostafavi E, Mousavi P, Mukoro GD, Mulita A, Mulu GB, Murillo-Zamora E, Musaigwa F, Mustafa G, Muthu S, Nainu F, Nangia V, Swamy SN, Natto ZS, Navaraj P, Nayak BP, Nazri-Panjaki A, Negash H, Nematollahi MH, Nguyen DH, Hien Nguyen HT, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Nikolouzakis TK, Nnyanzi LA, Noreen M, Nzoputam CI, Nzoputam OJ, Oancea B, Oh IH, Okati-Aliabad H, Okonji OC, Okwute PG, Olagunju AT, Olatubi MI, Olufadewa II, Ordak M, Otstavnov N, Owolabi MO, Mahesh P, Padubidri JR, Pak A, Pakzad R, Palladino R, Pana A, Pantazopoulos I, Papadopoulou P, Pardhan S, Parthasarathi A, Pashaei A, Patel J, Pathan AR, Patil S, Paudel U, Pawar S, Pedersini P, Pensato U, Pereira DM, Pereira J, Pereira MO, Pereira RB, Peres MF, Perianayagam A, Perna S, Petcu IR, Pezeshki PS, Pham HT, Philip AK, Piradov MA, Podder I, Podder V, Poddighe D, Sady Prates EJ, Qattea I, Radfar A, Raee P, Rafiei A, Raggi A, Rahim F, Rahimi M, Rahimifard M, Rahimi-Movaghar V, Rahman MO, Ur Rahman MH, Rahman M, Rahman MA, Rahmani AM, Rahmani M, Rahmani S, Rahmanian V, Ramasubramani P, Rancic N, Rao IR, Rashedi S, Rashid AM, Ravikumar N, Rawaf S, Mohamed Redwan EM, Rezaei N, Rezaei N, Rezaei N, Rezaeian M, Ribeiro D, Rodrigues M, Buendia Rodriguez JA, Roever L, Romero-Rodríguez E, Saad AM, Saddik B, Sadeghian S, Saeed U, Safary A, Safdarian M, Safi SZ, Saghazadeh A, Sagoe D, Sharif-Askari FS, Sharif-Askari NS, Sahebkar A, Sahoo H, Sahraian MA, Sajid MR, Sakhamuri S, Sakshaug JW, Saleh MA, Salehi L, Salehi S, Farrokhi AS, Samadzadeh S, Samargandy S, Samieefar N, Samy AM, Sanadgol N, Sanjeev RK, Sawhney M, Saya GK, Schuermans A, Senthilkumaran S, Sepanlou SG, Sethi Y, Shafie M, Shah H, Shahid I, Shahid S, Shaikh MA, Sharfaei S, Sharma M, Shayan M, Shehata HS, Sheikh A, Shetty JK, Shin JI, Shirkoohi R, Shitaye NA, Shivakumar K, Shivarov V, Shobeiri P, Siabani S, Sibhat MM, Siddig EE, Simpson CR, Sinaei E, Singh H, Singh I, Singh JA, Singh P, Singh S, Siraj MS, Al Mamun Sohag A, Solanki R, Solikhah S, Solomon Y, Soltani-Zangbar MS, Sun J, Szeto MD, Tabarés-Seisdedos R, Tabatabaei SM, Tabish M, Taheri E, Tahvildari A, Talaat IM, Lukenze Tamuzi JJ, Tan KK, Tat NY, Oliaee RT, Tavasol A, Temsah MH, Thangaraju P, Tharwat S, Tibebu NS, Vera Ticoalu JH, Tillawi T, Tiruye TY, Tiyuri A, Tovani-Palone MR, Tripathi M, Tsegay GM, Tualeka AR, Ty SS, Ubah CS, Ullah S, Ullah S, Umair M, Umakanthan S, Upadhyay E, Vahabi SM, Vaithinathan AG, Tahbaz SV, Valizadeh R, Varthya SB, Vasankari TJ, Venketasubramanian N, Verras GI, Villafañe JH, Vlassov V, Vo DC, Waheed Y, Waris A, Welegebrial BG, Westerman R, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Woldegeorgis BZ, Woldemariam M, Xiao H, Yada DY, Yahya G, Yang L, Yazdanpanah F, Yon DK, Yonemoto N, You Y, Zahir M, Zaidi SS, Zangiabadian M, Zare I, Zeineddine MA, Zemedikun DT, Zeru NG, Zhang C, Zhao H, Zhong C, Zielińska M, Zoladl M, Zumla A, Guo C, Tam LS. Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019. EClinicalMedicine 2023; 64:102193. [PMID: 37731935 PMCID: PMC10507198 DOI: 10.1016/j.eclinm.2023.102193] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of -0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = -0.41), inflammatory bowel disease (AAPC = -0.72), multiple sclerosis (AAPC = -0.26), psoriasis (AAPC = -0.77), and atopic dermatitis (AAPC = -0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).
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Ledesma JR, Basting A, Chu HT, Ma J, Zhang M, Vongpradith A, Novotney A, Dalos J, Zheng P, Murray CJL, Kyu HH. Global-, Regional-, and National-Level Impacts of the COVID-19 Pandemic on Tuberculosis Diagnoses, 2020-2021. Microorganisms 2023; 11:2191. [PMID: 37764035 PMCID: PMC10536333 DOI: 10.3390/microorganisms11092191] [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: 07/31/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Evaluating cross-country variability on the impact of the COVID-19 pandemic on tuberculosis (TB) may provide urgent inputs to control programs as countries recover from the pandemic. We compared expected TB notifications, modeled using trends in annual TB notifications from 2013-2019, with observed TB notifications to compute the observed to expected (OE) ratios for 170 countries. We applied the least absolute shrinkage and selection operator (LASSO) method to identify the covariates, out of 27 pandemic- and tuberculosis-relevant variables, that had the strongest explanatory power for log OE ratios. The COVID-19 pandemic was associated with a 1.55 million (95% CI: 1.26-1.85, 21.0% [17.5-24.6%]) decrease in TB diagnoses in 2020 and a 1.28 million (0.90-1.76, 16.6% [12.1-21.2%]) decrease in 2021 at a global level. India, Indonesia, the Philippines, and China contributed the most to the global declines for both years, while sub-Saharan Africa achieved pre-pandemic levels by 2021 (OE ratio = 1.02 [0.99-1.05]). Age-stratified analyses revealed that the ≥ 65-year-old age group experienced greater relative declines in TB diagnoses compared with the under 65-year-old age group in 2020 (RR = 0.88 [0.81-0.96]) and 2021 (RR = 0.88 [0.79-0.98]) globally. Covariates found to be associated with all-age OE ratios in 2020 were age-standardized smoking prevalence in 2019 (β = 0.973 [0.957-990]), school closures (β = 0.988 [0.977-0.998]), stay-at-home orders (β = 0.993 [0.985-1.00]), SARS-CoV-2 infection rate (β = 0.991 [0.987-0.996]), and proportion of population ≥65 years (β = 0.971 [0.944-0.999]). Further research is needed to clarify the extent to which the observed declines in TB diagnoses were attributable to disruptions in health services, decreases in TB transmission, and COVID-19 mortality among TB patients.
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Affiliation(s)
- Jorge R. Ledesma
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02912, USA
| | - Ann Basting
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
| | - Huong T. Chu
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
- Department of Health Metrics Sciences, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA
| | - Jianing Ma
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, 1800 Cannon Drive, Columbus, OH 43210, USA;
| | - Meixin Zhang
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
| | - Avina Vongpradith
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
| | - Amanda Novotney
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
| | - Jeremy Dalos
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
- Department of Health Metrics Sciences, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
- Department of Health Metrics Sciences, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA
| | - Hmwe H. Kyu
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA; (J.R.L.); (A.B.); (H.T.C.); (M.Z.); (A.V.); (A.N.); (J.D.); (P.Z.); (C.J.L.M.)
- Department of Health Metrics Sciences, University of Washington, 3980 15th Ave. NE, Seattle, WA 98195, USA
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Teo AKJ, Morishita F, Islam T, Viney K, Ong CW, Kato S, Kim H, Liu Y, Oh KH, Yoshiyama T, Ohkado A, Rahevar K, Kawatsu L, Yanagawa M, Prem K, Yi S, Tran HTG, Marais BJ. Tuberculosis in older adults: challenges and best practices in the Western Pacific Region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100770. [PMID: 37547037 PMCID: PMC10398605 DOI: 10.1016/j.lanwpc.2023.100770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/18/2023] [Accepted: 04/02/2023] [Indexed: 08/08/2023]
Abstract
The Western Pacific has one of the fastest-growing older adult populations globally, and tuberculosis (TB) remains one of the foremost infectious causes of disease and death in the region. Older adults are at higher risk of TB due to immunosenescence, comorbidities, and increased institutionalisation. Atypical symptoms and reduced access to health services may delay care-seeking and TB diagnosis, while co-morbidity and increased risk of adverse drug reactions complicate TB treatment. Post-TB sequelae and socioeconomic challenges may decrease the quality of life after TB treatment completion. Despite their high disease burden and special challenges, there is a lack of regionally coordinated policies and guidelines to manage TB among older adults. Routine TB screening at aged-care facilities, age-friendly infrastructure and services, awareness of atypical TB features, integration of TB and non-communicable diseases services, and person-centred approaches to treatment support could improve TB management among older adults. Addressing these challenges and adopting the best practices identified should inform policy formulation and implementation. Funding This project was funded by 1) the World Health Organization Regional Office for the Western Pacific, with financial contributions from the Government of the Republic of Korea through the Korean Disease Control and Prevention Agency and the Government of Japan through the Ministry of Health, Labour and Welfare, and 2) NUS Start-up Grant. The funders had no role in the paper design, collection, analysis, and interpretation of data and in writing of the paper.
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Affiliation(s)
- Alvin Kuo Jing Teo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The University of Sydney Institute for Infectious Diseases (Sydney ID) and the Centre of Research Excellence in Tuberculosis (TB-CRE), Sydney, NSW, Australia
| | - Fukushi Morishita
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Tauhid Islam
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Kerri Viney
- World Health Organization, Global Tuberculosis Programme, Geneva, Switzerland
| | - Catherine W.M. Ong
- Infectious Diseases Translational Research Programme, Department of Medicine, National University of Singapore, Singapore, Singapore
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore, Singapore
- Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Seiya Kato
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - HeeJin Kim
- Korean National Tuberculosis Association, Seoul, Republic of Korea
| | - Yuhong Liu
- Beijing Chest Hospital, Capital Medical University, Beijing, China
| | - Kyung Hyun Oh
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Takashi Yoshiyama
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Akihiro Ohkado
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kalpeshsinh Rahevar
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Lisa Kawatsu
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Manami Yanagawa
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Kiesha Prem
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Center for Global Health Research, Public Health Program, Touro University California, Vallejo, CA, USA
| | - Huong Thi Giang Tran
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Ben J. Marais
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The University of Sydney Institute for Infectious Diseases (Sydney ID) and the Centre of Research Excellence in Tuberculosis (TB-CRE), Sydney, NSW, Australia
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Swanepoel J, van der Zalm MM, Preiser W, van Zyl G, Whittaker E, Hesseling AC, Moore DAJ, Seddon JA. SARS-CoV-2 infection and pulmonary tuberculosis in children and adolescents: a case-control study. BMC Infect Dis 2023; 23:442. [PMID: 37386354 DOI: 10.1186/s12879-023-08412-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic has had an impact on the global tuberculosis (TB) epidemic but evidence on the possible interaction between SARS-CoV-2 and TB, especially in children and adolescents, remains limited. We aimed to evaluate the relationship between previous infection with SARS-CoV-2 and the risk of TB in children and adolescents. METHODS An unmatched case-control study was conducted using SARS-CoV-2 unvaccinated children and adolescents recruited into two observational TB studies (Teen TB and Umoya), between November 2020 and November 2021, in Cape Town, South Africa. Sixty-four individuals with pulmonary TB (aged < 20 years) and 99 individuals without pulmonary TB (aged < 20 years) were included. Demographics and clinical data were obtained. Serum samples collected at enrolment underwent quantitative SARS-CoV-2 anti-spike immunoglobulin G (IgG) testing using the Abbott SARS-CoV-2 IgG II Quant assay. Odds ratios (ORs) for TB were estimated using unconditional logistic regression. RESULTS There was no statistically significant difference in the odds of having pulmonary TB between those who were SARS-CoV-2 IgG seropositive and those who were seronegative (adjusted OR 0.51; 95% CI: 0.23-1.11; n = 163; p = 0.09). Of those with positive SARS-CoV-2 serology indicating prior infection, baseline IgG titres were higher in individuals with TB compared to those without TB (p = 0.04) and individuals with IgG titres in the highest tertile were more likely to have pulmonary TB compared to those with IgG levels in the lowest tertile (OR: 4.00; 95%CI: 1.13- 14.21; p = 0.03). CONCLUSIONS Our study did not find convincing evidence that SARS-CoV-2 seropositivity was associated with subsequent pulmonary TB disease; however, the association between magnitude of SARS-CoV-2 IgG response and pulmonary TB warrants further investigation. Future prospective studies, evaluating the effects of sex, age and puberty on host immune responses to M. tuberculosis and SARS-CoV-2, will also provide more clarity on the interplay between these two infections.
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Affiliation(s)
- Jeremi Swanepoel
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
- TB Centre, London School of Hygiene and Tropical Medicine, London, UK.
| | - Marieke M van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Wolfgang Preiser
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Academic Hospital, Cape Town, South Africa
| | - Gert van Zyl
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Academic Hospital, Cape Town, South Africa
| | | | - Anneke C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - David A J Moore
- TB Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - James A Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Department of Infectious Disease, Imperial College London, London, UK
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Grifoni A, Alonzi T, Alter G, Noonan DM, Landay AL, Albini A, Goletti D. Impact of aging on immunity in the context of COVID-19, HIV, and tuberculosis. Front Immunol 2023; 14:1146704. [PMID: 37292210 PMCID: PMC10246744 DOI: 10.3389/fimmu.2023.1146704] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/11/2023] [Indexed: 06/10/2023] Open
Abstract
Knowledge of aging biology needs to be expanded due to the continuously growing number of elderly people worldwide. Aging induces changes that affect all systems of the body. The risk of cardiovascular disease and cancer increases with age. In particular, the age-induced adaptation of the immune system causes a greater susceptibility to infections and contributes to the inability to control pathogen growth and immune-mediated tissue damage. Since the impact of aging on immune function, is still to be fully elucidated, this review addresses some of the recent understanding of age-related changes affecting key components of immunity. The emphasis is on immunosenescence and inflammaging that are impacted by common infectious diseases that are characterized by a high mortality, and includes COVID-19, HIV and tuberculosis.
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Affiliation(s)
- Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Tonino Alonzi
- Translational Research Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
| | - Galit Alter
- Ragon Institute of Massachusetts General Hospital (MGH), Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA, United States
| | - Douglas McClain Noonan
- Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Alan L. Landay
- Department of Internal Medicine, Rush Medical College, Chicago, IL, United States
| | | | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
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Latham AS, Geer CE, Ackart DF, Anderson IK, Vittoria KM, Podell BK, Basaraba RJ, Moreno JA. Gliosis, misfolded protein aggregation, and neuronal loss in a guinea pig model of pulmonary tuberculosis. Front Neurosci 2023; 17:1157652. [PMID: 37274195 PMCID: PMC10235533 DOI: 10.3389/fnins.2023.1157652] [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: 02/02/2023] [Accepted: 04/24/2023] [Indexed: 06/06/2023] Open
Abstract
Tuberculosis, caused by Mycobacterium tuberculosis infection, is an ongoing epidemic with an estimated ten million active cases of the disease worldwide. Pulmonary tuberculosis is associated with cognitive and memory deficits, and patients with this disease are at an increased risk for Parkinson's disease and dementia. Although epidemiological data correlates neurological effects with peripheral disease, the pathology in the central nervous system is unknown. In an established guinea pig model of low-dose, aerosolized Mycobacterium tuberculosis infection, we see behavior changes and memory loss in infected animals. We correlate these findings with pathological changes within brain regions related to motor, cognition, and sensation across disease progression. This includes microglial and astrocytic proliferation and reactivity. These cellular changes are followed by the aggregation of neurotoxic amyloid β and phosphorylated tau and, ultimately, neuronal degeneration in the hippocampus. Through these data, we have obtained a greater understanding of the neuropathological effects of a peripheral disease that affects millions of persons worldwide.
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Affiliation(s)
- Amanda S. Latham
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Brain Research Center, Colorado State University, Fort Collins, CO, United States
| | - Charlize E. Geer
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - David F. Ackart
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Isla K. Anderson
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Biomedical Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Kaley M. Vittoria
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Brendan K. Podell
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Randall J. Basaraba
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Julie A. Moreno
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Brain Research Center, Colorado State University, Fort Collins, CO, United States
- Center for Healthy Aging, Colorado State University, Fort Collins, CO, United States
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22
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Lo Vecchio A, Scarano SM, Amato C, Spagnuolo MI, Bruzzese E, Guarino A. Effects of COVID-19 pandemic on pediatric tuberculosis: decrease in notification rates and increase in clinical severity. Eur J Pediatr 2023:10.1007/s00431-023-04981-7. [PMID: 37160429 PMCID: PMC10166681 DOI: 10.1007/s00431-023-04981-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/28/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
The outbreak of COVID-19 resulted in a decrease in tuberculosis notification rates globally. We compared tuberculosis incidence rates and disease severity in children seen in our centre prior and during COVID-19 pandemic.We performed a cohort study enrolling children aged under 18 years who received a diagnosis of tuberculosis (January 1st, 2010-December 31st, 2021) at our Pediatric Infectious Diseases Unit. Disease severity was evaluated based on: the classification proposed by Wiseman et al., smear positivity, presence of symptoms at presentation, lung cavitation, extrapulmonary disease, respiratory failure and need for intensive care support. Overall, 168 children (50.6% female, median age 69 months, IQR 95.4) received a diagnosis of tuberculosis, 156 (92.8%) between 2010-2019, before COVID-19 outbreak, and 12 (7.2%) between 2020-2021, during the pandemic. The annual tuberculosis notification rate dropped by 73% in 2021 (0.38/100000, 95%CI 0.1-0.96) compared with 2019 (1.46/100000, 95%CI 0.84-2.37). Compared to the pre-pandemic period, the proportion of children classified as severe was higher in 2020-2021 (5, 41.6% vs 23, 15.7%, p = 0.006) with a higher rate of respiratory failure (2, 16.7%, vs 4, 2.6%, p = 0.01) and an increased need for intensive care support (1, 8.3% vs 1, 0.6%, p = 0.01). Conclusion: During COVID-19 pandemic we observed a reduction in tuberculosis notification rate in pediatric population and a significant increase in disease severity. This scenario may be the consequence of a delay in diagnosis and an underreporting of cases, rather than the effect of a reduced transmission of tuberculosis. Children reached health-care services only in the need of urgent medical attention. What is Known: • COVID-19 pandemic had a huge impact on national health care systems, resulting in a reduction of access to medical care. What is New: • In Campania Region, Italy, a low tuberculosis incidence country, we witnessed a 75% reduction in tuberculosis notification rate during pandemic. In parallel we demonstrated a significant increase in disease severity, suggesting that the reduction in notification rate may be attributed to an underreporting of cases and consequential diagnostic delay, rather than a reduced transmission of infection.
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Affiliation(s)
- Andrea Lo Vecchio
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy.
| | - Sara Maria Scarano
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Chiara Amato
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Maria Immacolata Spagnuolo
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Eugenia Bruzzese
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
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Kessel B, Heinsohn T, Ott JJ, Wolff J, Hassenstein MJ, Lange B. Impact of COVID-19 pandemic and anti-pandemic measures on tuberculosis, viral hepatitis, HIV/AIDS and malaria-A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001018. [PMID: 37126484 PMCID: PMC10150989 DOI: 10.1371/journal.pgph.0001018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/27/2023] [Indexed: 05/02/2023]
Abstract
COVID-19 pandemic puts an enormous strain on health care systems worldwide and may have a detrimental effect on prevention, treatment and outcomes of tuberculosis (TB), viral hepatitis, HIV/AIDS and malaria, whose ending is part of the United Nations 2030 Agenda for Sustainable Development. We conducted a systematic review of scientific and grey literature in order to collect wide-ranging evidence with emphasis on quantification of the projected and actual indirect impacts of COVID-19 on the four infectious diseases with a global focus. We followed PRISMA guidelines and the protocol registered for malaria (CRD42021234974). We searched PubMed, Scopus, preView (last search: January 13, 2021) and websites of main (medical) societies and leading NGOs related to each of the four considered infectious diseases. From modelling studies, we identified the most impactful disruptions; from surveys and other quantitative studies (based e.g. on surveillance or program data), we assessed the actual size of the disruptions. The identified modelling studies warned about under-diagnosis (TB), anti-retroviral therapy interruption/decrease in viral load suppression (HIV), disruptions of insecticide-treated nets (ITN) distribution and access to effective treatment (malaria), and treatment delays and vaccination interruptions (viral hepatitis). The reported disruptions were very heterogeneous both between and within countries. If observed at several points in time, the initial drops (partly dramatic, e.g. TB notifications/cases, or HIV testing volumes decreased up to -80%) were followed by a gradual recovery. However, the often-missing assessment of the changes against the usual pre-pandemic fluctuations hampered the interpretation of less severe ones. Given the recurring waves of the pandemic and the unknown mid- to long-term effects of adaptation and normalisation, the real consequences for the fight against leading infectious diseases will only manifest over the coming years.
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Affiliation(s)
- Barbora Kessel
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
| | - Torben Heinsohn
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
| | - Jördis J. Ott
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
- Hannover Medical School (MHH), Hannover, Germany
| | - Jutta Wolff
- Hannover Medical School (MHH), Hannover, Germany
| | - Max J. Hassenstein
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
- PhD Programme “Epidemiology”, Braunschweig, Hannover, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
- German Center for Infection research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
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24
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Ojo MM, Peter OJ, Goufo EFD, Nisar KS. A mathematical model for the co-dynamics of COVID-19 and tuberculosis. MATHEMATICS AND COMPUTERS IN SIMULATION 2023; 207:499-520. [PMID: 36691571 PMCID: PMC9850643 DOI: 10.1016/j.matcom.2023.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/02/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
In this study, we formulated and analyzed a deterministic mathematical model for the co-infection of COVID-19 and tuberculosis, to study the co-dynamics and impact of each disease in a given population. Using each disease's corresponding reproduction number, the existence and stability of the disease-free equilibrium were established. When the respective threshold quantities R C , and R T are below unity, the COVID-19 and TB-free equilibrium are said to be locally asymptotically stable. The impact of vaccine (i.e., efficacy and vaccinated proportion) and the condition required for COVID-19 eradication was examined. Furthermore, the presence of the endemic equilibria of the sub-models is analyzed and the criteria for the phenomenon of backward bifurcation of the COVID-19 sub-model are presented. To better understand how each disease condition impacts the dynamics behavior of the other, we investigate the invasion criterion of each disease by computing the threshold quantity known as the invasion reproduction number. We perform a numerical simulation to investigate the impact of threshold quantities ( R C , R T ) with respect to their invasion reproduction number, co-infection transmission rate ( β c t ) , and each disease transmission rate ( β c , β t ) on disease dynamics. The outcomes established the necessity for the coexistence or elimination of both diseases from the communities. Overall, our findings imply that while COVID-19 incidence decreases with co-infection prevalence, the burden of tuberculosis on the human population increases.
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Affiliation(s)
- Mayowa M Ojo
- Department of Mathematical Sciences, University of South Africa, Florida, South Africa
- Thermo Fisher Scientific, Microbiology Division, Lenexa, KS, USA
| | - Olumuyiwa James Peter
- Department of Mathematical and Computer Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
- Department of Epidemiology and Biostatistics, School of Public Health, University of Medical Sciences, Ondo City, Ondo State, Nigeria
| | | | - Kottakkaran Sooppy Nisar
- Department of Mathematics, College of Arts and Sciences, Prince Sattam bin Abdulaziz University, Wadi Aldawaser, Saudi Arabia
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25
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MacLean ELH, Villa-Castillo L, Espinoza-Lopez P, Caceres T, Sulis G, Kohli M, Pai M, Ugarte-Gil C. Integrating tuberculosis and COVID-19 molecular testing in Lima, Peru: a cross-sectional, diagnostic accuracy study. THE LANCET. MICROBE 2023:S2666-5247(23)00042-3. [PMID: 37068500 PMCID: PMC10105319 DOI: 10.1016/s2666-5247(23)00042-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/23/2022] [Accepted: 02/07/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND Integrated molecular testing could be an opportunity to detect and provide care for both tuberculosis and COVID-19. Many high tuberculosis burden countries, such as Peru, have existing GeneXpert systems for tuberculosis testing with GeneXpert Xpert MTB/RIF Ultra (Xpert Ultra), and a GeneXpert SARS-CoV-2 assay, GeneXpert Xpert Xpress SARS-CoV-2 (Xpert Xpress), is also available. We aimed to assess the feasibility of integrating tuberculosis and COVID-19 testing using one sputum specimen with Xpert Ultra and Xpert Xpress in Lima, Peru. METHODS In this cross-sectional, diagnostic accuracy study, we recruited adults presenting with clinical symptoms or suggestive history of tuberculosis or COVID-19, or both. Participants were recruited from a total of 35 primary health facilities in Lima, Peru. Participants provided one nasopharyngeal swab and one sputum sample. For COVID-19, we tested nasopharyngeal swabs and sputum using Xpert Xpress; for tuberculosis, we tested sputum using culture and Xpert Ultra. We compared diagnostic accuracy of sputum testing using Xpert Xpress with nasopharyngeal swab testing using Xpert Xpress. Individuals with positive Xpert Xpress nasopharyngeal swab results were considered COVID-19 positive, and a positive culture indicated tuberculosis. To assess testing integration, the proportion of cases identified in sputum by Xpert Xpress was compared with Xpert Xpress on nasopharyngeal swabs, and sputum by Xpert Ultra was compared with culture. FINDINGS Between Jan 11, 2021, and April 26, 2022, we recruited 600 participants (312 [52%] women and 288 [48%] men). In-study prevalence of tuberculosis was 13% (80 participants, 95% CI 11-16) and of SARS-CoV-2 was 35% (212 participants, 32-39). Among tuberculosis cases, 13 (2·2%, 1·2-3·7) participants were concurrently positive for SARS-CoV-2. Regarding the diagnostic yield of integrated testing, Xpert Ultra detected 96% (89-99) of culture-confirmed tuberculosis cases (n=77), and Xpert Xpress-sputum detected 67% (60-73) of COVID-19 cases (n=134). All five study staff reported that integrated molecular testing was easy and acceptable. INTERPRETATION The diagnostic yield of Xpert Xpress on sputum was moderate, but integrated testing for tuberculosis and COVID-19 with GeneXpert was feasible. However, systematic testing for both diseases might not be the ideal approach for everyone presenting with presumptive tuberculosis or COVID-19, as concurrent positive cases were rare during the study period. Further research might help to identify when integrated testing is most worthwhile and its optimal implementation. FUNDING Canadian Institutes of Health Research and International Development Research Centre. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Emily Lai-Ho MacLean
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Luz Villa-Castillo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia Lima, Peru
| | - Patricia Espinoza-Lopez
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia Lima, Peru
| | - Tatiana Caceres
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia Lima, Peru
| | - Giorgia Sulis
- McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, QC, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Madhukar Pai
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - César Ugarte-Gil
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia Lima, Peru; School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Buonsenso D, Delogu G, del Carmen Pereyra Boza M, De Maio F, Palucci I, Martino L, Pata D, Sanguinetti M, Valentini P, Sali M. Commercially available CD4 + and CD8 + IFN-γ release assays combined with an HBHA-induced IGRA improve the characterization of the tuberculosis spectrum and monitoring of treatment in children. Eur J Pediatr 2023; 182:2155-2167. [PMID: 36847873 PMCID: PMC9969014 DOI: 10.1007/s00431-023-04844-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/25/2022] [Accepted: 01/23/2023] [Indexed: 03/01/2023]
Abstract
Commercially available Interferon-γ release assays (IGRAs), including the last-generation QuantiFERON TB-Plus (QFT-Plus), are effective in aiding the diagnosis of tuberculosis (TB) infection but cannot distinguish latent TB subjects from active TB patients. The aim of this study was to prospectively evaluate the performance of an HBHA-based IGRA, combined with commercially available IGRAs, to assess their usefulness as a prognostic biomarkers and aid in the monitoring of TB treatment in children. Following clinical, microbiological, and radiological assessment, children younger than 18 years of age classified as either LTBI or active TB were tested at baseline and during treatment by the QuantiFERON TB-Plus (QFT) assay and an aliquot of whole-blood was stimulated with HBHA. Among the 655 children evaluated, 559 (85.3%) were classified as "Non TB", 44 patients (6.7%) with active TB, and 52 (7.9%) with LTBI. The median HBHA-IGRA IFN-gamma responses were able to discriminate active TB from LTBI (0.13 IU/ml vs 1.995, (p < 0,0001), those with asymptomatic TB from those with symptomatic TB (1.01 IU/ml vs 0.115 IU/ml, p 0.017), or more severe TB (p 0.022), and significantly raised during successful TB treatment (p < 0.0001). Conversely, CD4 + and CD8 + responses were similar in all groups of patients, although active TB patients had higher CD4 + responses and LTBI higher CD8 + responses. Conclusion: HBHA-based IGRA, combined with CD4 + and CD8 + responses assessed by commercially available IGRAs, is a useful support in the characterization of the TB spectrum in children and monitoring of TB-therapy. What is Known: • Current immune diagnostics are not able to discriminate active and latent Ttuberculosis, including the recently approved QFT-PLUS.. • New immunological assays with prognostic value are highly needed. What is New: • HBHA-based IGRA, combined with CD4+ and CD8+ responses assessed by commercially available IGRAs, is a useful support for the differentiation of active and latent TB in children.. • HBHA-based IGRA, combined with CD4+ and CD8+ responses assessed by commercially available IGRAs, is a useful support in the monitoring of TBtherapy in children..
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Delogu
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
| | - Maria del Carmen Pereyra Boza
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Flavio De Maio
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ivana Palucci
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
| | - Laura Martino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Davide Pata
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
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Cola JP, do Prado TN, Campos BA, Borges BJP, Alves BMCS, de Jezus SV, Sales CMM, de Araújo WN, Tavares NUL, Noia Maciel EL. Protocol for pragmatic randomized clinical trial to evaluate the completion of treatment of latent Mycobacterium tuberculosis infection with Isoniazid in the 300 mg formulation. PLoS One 2023; 18:e0281638. [PMID: 36802383 PMCID: PMC9942980 DOI: 10.1371/journal.pone.0281638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 01/24/2023] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION It is essential to strengthen the treatment of latent tuberculosis infection (LTBI) to break the chain of transmission. The drug used worldwide for the treatment of LTBI is Isoniazid. A clinical trial conducted in Brazil has demonstrated the bioequivalence of Isoniazid in the 300 mg formulation with 3 tablets in the 100 mg formulation. Further studies are needed to evaluate the completion of treatment with Isoniazid 300 mg single tablet. OBJECTIVE Describing a protocol for a clinical trial to evaluate the completion of treatment of LTBI with the drug Isoniazid in 300 mg tablet formulation compared to the use of Isoniazid in 100 mg tablet formulation. METHODS This is a pragmatic, multicenter, randomized, open-label clinical trial registered on the Rebec RBR-2wsdt6 platform. Individuals 18 years of age or older with an indication for treatment of LTBI will be included, with only 1 individual per family nucleus. Individuals whose index case of active TB is categorized as retreatment, multidrug-resistant and extremely resistant, individuals transferred from the original center two or more weeks after the onset of treatment, and persons deprived of liberty will be excluded. The study intervention will be the treatment of LTBI with 1 tablet of Isoniazid 300 mg. The control group will receive the treatment of LTBI with 3 tablets of Isoniazid 100 mg. Follow-up will be performed at month 1, month 2 and at the end of treatment. The primary outcome will be completion of treatment. CONCLUSION It is expected that with the treatment with the 300 mg formulation, more patients will complete the treatment based on the complexity index of pharmacotherapy. Our study intends to substantiate theoretical and operational strategies that respond to the demand for incorporation of a new formulation of the drug for the treatment of LTBI in the Unified Health System network.
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Affiliation(s)
- João Paulo Cola
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Thiago Nascimento do Prado
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Bárbara Almeida Campos
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Bárbara Juliana Pinheiro Borges
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | - Sonia Vivian de Jezus
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Carolina Maia Martins Sales
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | - Noemia Urruth Leão Tavares
- Postgraduate Program in Pharmaceutical Sciences, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Ethel Leonor Noia Maciel
- Postgraduate Program in Collective Health, Laboratory of Epidemiology, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
- * E-mail:
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28
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Jeong Y, Min J. Impact of COVID-19 Pandemic on Tuberculosis Preventive Services and Their Post-Pandemic Recovery Strategies: A Rapid Review of Literature. J Korean Med Sci 2023; 38:e43. [PMID: 36747365 PMCID: PMC9902666 DOI: 10.3346/jkms.2023.38.e43] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/14/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) pandemic has disrupted tuberculosis (TB) care and prevention around the world. The aim of this study is to review literature on the impact of COVID-19 on TB preventive services and discuss their policy options during and after the pandemic. METHODS We conducted a rapid review of scientific literature on the impact of COVID-19 on TB preventive services and their recovery strategies. After conducting a line-by-line open coding, their codes were applied in the descriptive theme building process, which was guided by the End TB strategy. TB preventive measures were selected and classified into five analytical categories: 1) vaccination against TB, 2) detection and treatment of latent TB infection (LTBI), 3) screening and diagnostics, 4) active case finding and contact tracing, and 5) surveillance. RESULTS We identified 93 articles, of which 65 were research articles. During the pandemic, we observed decrease in Bacillus Calmette-Guérin (BCG) coverage, TB diagnostic services, case finding activities, and LTBI management. TB case detection was declined, which was not resumed to the pre-pandemic level after loosening the lock-down. Several recommendations were highlighted: 1) secure BCG stocks and its supply chains, 2) consider catch-up activities of routine immunization and LTBI screening, 3) maintain minimal TB health services, infection prevention and control, and surveillance, 4) leverage laboratory capacity and contact tracing mechanisms, 5) consider simultaneous testing for TB and COVID-19, and 6) Incorporate digital health technologies. CONCLUSIONS Our findings and lessons learnt from the pandemic can aid in the development of future national TB control program.
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Affiliation(s)
| | - Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Haakenstad A, Yearwood JA, Fullman N, Bintz C, Bienhoff K, Weaver MR, Nandakumar V, LeGrand KE, Knight M, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abeldaño Zuñiga RA, Adedeji IA, Adekanmbi V, Adetokunboh OO, Afzal MS, Afzal S, Agudelo-Botero M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed A, Ahmed Rashid T, Aji B, Akande-Sholabi W, Alam K, Al Hamad H, Alhassan RK, Ali L, Alipour V, Aljunid SM, Ameyaw EK, Amin TT, Amu H, Amugsi DA, Ancuceanu R, Andrade PP, Anjum A, Arabloo J, Arab-Zozani M, Ariffin H, Arulappan J, Aryan Z, Ashraf T, Atnafu DD, Atreya A, Ausloos M, Avila-Burgos L, Ayano G, Ayanore MA, Azari S, Badiye AD, Baig AA, Bairwa M, Bakkannavar SM, Baliga S, Banik PC, Bärnighausen TW, Barra F, Barrow A, Basu S, Bayati M, Belete R, Bell AW, Bhagat DS, Bhagavathula AS, Bhardwaj P, Bhardwaj N, Bhaskar S, Bhattacharyya K, Bhurtyal A, Bhutta ZA, Bibi S, Bijani A, Bikbov B, Biondi A, Bolarinwa OA, Bonny A, Brenner H, Buonsenso D, Burkart K, Busse R, Butt ZA, Butt NS, Caetano dos Santos FL, Cahuana-Hurtado L, Cámera LA, Cárdenas R, Carneiro VLA, Catalá-López F, Chandan JS, Charan J, Chavan PP, Chen S, Chen S, Choudhari SG, Chowdhury EK, Chowdhury MAK, Cirillo M, Corso B, Dadras O, Dahlawi SMA, Dai X, Dandona L, Dandona R, Dangel WJ, Dávila-Cervantes CA, Davletov K, Deuba K, Dhimal M, Dhimal ML, Djalalinia S, Do HP, Doshmangir L, Duncan BB, Effiong A, Ehsani-Chimeh E, Elgendy IY, Elhadi M, El Sayed I, El Tantawi M, Erku DA, Eskandarieh S, Fares J, Farzadfar F, Ferrero S, Ferro Desideri L, Fischer F, Foigt NA, Foroutan M, Fukumoto T, Gaal PA, Gaihre S, Gardner WM, Garg T, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gilani SA, Gill PS, Goharinezhad S, Golechha M, Guadamuz JS, Guo Y, Gupta RD, Gupta R, Gupta VK, Gupta VB, Hamiduzzaman M, Hanif A, Haro JM, Hasaballah AI, Hasan MM, Hasan MT, Hashi A, Hay SI, Hayat K, Heidari M, Heidari G, Henry NJ, Herteliu C, Holla R, Hossain S, Hossain SJ, Hossain MBH, Hosseinzadeh M, Hostiuc S, Hoveidamanesh S, Hsieh VCR, Hu G, Huang J, Huda MM, Ifeagwu SC, Ikuta KS, Ilesanmi OS, Irvani SSN, Islam RM, Islam SMS, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Jahani MA, Jahanmehr N, Jain R, Jakovljevic M, Janodia MD, Jayapal SK, Jayaram S, Jha RP, Jonas JB, Joo T, Joseph N, Jürisson M, Kabir A, Kalankesh LR, Kalhor R, Kamath AM, Kamenov K, Kandel H, Kantar RS, Kapoor N, Karanikolos M, Katikireddi SV, Kavetskyy T, Kawakami N, Kayode GA, Keikavoosi-Arani L, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khammarnia M, Khan MN, Khan MAB, Khan M, Khezeli M, Kim MS, Kim YJ, Kisa S, Kisa A, Klymchuk V, Koly KN, Korzh O, Kosen S, Koul PA, Kuate Defo B, Kumar GA, Kusuma D, Kyu HH, Larsson AO, Lasrado S, Lee WC, Lee YH, Lee CB, Li S, Lucchetti G, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Malta DC, Mansournia MA, Mantovani LG, Martinez-Valle A, Martins-Melo FR, Masoumi SZ, Mathur MR, Maude RJ, Maulik PK, McKee M, Mendoza W, Menezes RG, Mensah GA, Meretoja A, Meretoja TJ, Mestrovic T, Michalek IM, Mirrakhimov EM, Misganaw A, Misra S, Moazen B, Mohammadi M, Mohammed S, Moitra M, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moradi G, Moreira RS, Mosser JF, Mostafavi E, Mouodi S, Nagarajan AJ, Nagata C, Naghavi M, Nangia V, Narasimha Swamy S, Narayana AI, Nascimento BR, Nassereldine H, Nayak BP, Nazari J, Negoi I, Nepal S, Neupane Kandel S, Ngunjiri JW, Nguyen HLT, Nguyen CT, Ningrum DNA, Noubiap JJ, Oancea B, Oghenetega OB, Oh IH, Olagunju AT, Olakunde BO, Omar Bali A, Omer E, Onwujekwe OE, Otoiu A, Padubidri JR, Palladino R, Pana A, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Pasupula DK, Pathak PK, Patton GC, Pawar S, Pereira J, Pilania M, Piroozi B, Podder V, Pokhrel KN, Postma MJ, Prada SI, Quazi Syed Z, Rabiee N, Radhakrishnan RA, Rahman MM, Rahman M, Rahman M, Rahman MHU, Rahmani AM, Ranabhat CL, Rao CR, Rao SJ, Rasella D, Rawaf S, Rawaf DL, Rawal L, Renzaho AM, Reshmi B, Resnikoff S, Rezapour A, Riahi SM, Ripon RK, Sacco S, Sadeghi M, Saeed U, Sahebkar A, Sahiledengle B, Sahoo H, Sahu M, Salama JS, Salamati P, Samy AM, Sanabria J, Santric-Milicevic MM, Sathian B, Sawhney M, Schmidt MI, Seidu AA, Sepanlou SG, Seylani A, Shaikh MA, Sheikh A, Shetty A, Shigematsu M, Shiri R, Shivakumar KM, Shokri A, Singh JA, Sinha DN, Skryabin VY, Skryabina AA, Sofi-Mahmudi A, Sousa RARC, Stephens JH, Sun J, Szócska M, Tabarés-Seisdedos R, Tadbiri H, Tamiru AT, Thankappan KR, Topor-Madry R, Tovani-Palone MR, Tran MTN, Tran BX, Tripathi N, Tripathy JP, Troeger CE, Uezono DR, Ullah S, Ullah A, Unnikrishnan B, Vacante M, Valadan Tahbaz S, Valdez PR, Vasic M, Veroux M, Vervoort D, Violante FS, Vladimirov SK, Vlassov V, Vo B, Waheed Y, Wamai RG, Wang YP, Wang Y, Ward P, Wiangkham T, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yaya S, Yazdi-Feyzabadi V, Yi S, Yiğit V, Yonemoto N, Younis MZ, Yu C, Yunusa I, Zaman SB, Zastrozhin MS, Zhang ZJ, Zhong C, Zuniga YMH, Lim SS, Murray CJL, Lozano R. Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Glob Health 2022; 10:e1715-e1743. [PMID: 36209761 PMCID: PMC9666426 DOI: 10.1016/s2214-109x(22)00429-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/13/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. METHODS We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. FINDINGS Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. INTERPRETATION Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. FUNDING Bill & Melinda Gates Foundation.
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Gijsbers A, Eymery M, Gao Y, Menart I, Vinciauskaite V, Siliqi D, Peters PJ, McCarthy A, Ravelli RBG. The crystal structure of the EspB-EspK virulence factor-chaperone complex suggests an additional type VII secretion mechanism in Mycobacterium tuberculosis. J Biol Chem 2022; 299:102761. [PMID: 36463964 PMCID: PMC9811218 DOI: 10.1016/j.jbc.2022.102761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Pathogenic species from the Mycobacterium genus are responsible for a number of adverse health conditions in humans and animals that threaten health security and the economy worldwide. Mycobacteria have up to five specialized secretion systems (ESX-1 to ESX-5) that transport virulence factors across their complex cell envelope to facilitate manipulation of their environment. In pathogenic species, these virulence factors influence the immune system's response and are responsible for membrane disruption and contributing to cell death. While structural details of these secretion systems have been recently described, gaps still remain in the structural understanding of the secretion mechanisms of most substrates. Here, we describe the crystal structure of Mycobacterium tuberculosis ESX-1 secretion-associated substrate EspB bound to its chaperone EspK. We found that EspB interacts with the C-terminal domain of EspK through its helical tip. Furthermore, cryogenic electron microscopy, size exclusion chromatography analysis, and small-angle X-ray scattering experiments show that EspK keeps EspB in its secretion-competent monomeric form and prevents its oligomerization. The structure presented in this study suggests an additional secretion mechanism in ESX-1, analogous to the chaperoning of proline-glutamate (PE)-proline-proline-glutamate (PPE) proteins by EspG, where EspK facilitates the secretion of EspB in Mycobacterium species.
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Affiliation(s)
- Abril Gijsbers
- Division of Nanoscopy, Maastricht Multimodal Molecular Imaging Institute (M4i), Maastricht University, Maastricht, the Netherlands
| | | | - Ye Gao
- Division of Nanoscopy, Maastricht Multimodal Molecular Imaging Institute (M4i), Maastricht University, Maastricht, the Netherlands
| | - Isabella Menart
- Division of Nanoscopy, Maastricht Multimodal Molecular Imaging Institute (M4i), Maastricht University, Maastricht, the Netherlands
| | - Vanesa Vinciauskaite
- Division of Nanoscopy, Maastricht Multimodal Molecular Imaging Institute (M4i), Maastricht University, Maastricht, the Netherlands
| | - Dritan Siliqi
- Istituto di Cristallografia, Consiglio Nazionale delle Ricerche, Bari, Italy
| | - Peter J Peters
- Division of Nanoscopy, Maastricht Multimodal Molecular Imaging Institute (M4i), Maastricht University, Maastricht, the Netherlands
| | | | - Raimond B G Ravelli
- Division of Nanoscopy, Maastricht Multimodal Molecular Imaging Institute (M4i), Maastricht University, Maastricht, the Netherlands.
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Chiumia IK, Mosiwa BA, Nkhonjera J, Kazanga B, Mukondiwa AS, Twalibu A, Phuka J, Lucero‐Prisno DE. Emerging public health challenges during the COVID‐19 pandemic in Malawi: A review. PUBLIC HEALTH CHALLENGES 2022; 1:e40. [PMID: 37519312 PMCID: PMC9877808 DOI: 10.1002/puh2.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/28/2022] [Indexed: 06/28/2023]
Abstract
The ongoing COVID‐19 pandemic has posed new and has aggravated already existing public health challenges in Malawi and worldwide. Having a better understanding of these challenges can help facilitate the identification of solutions and designing further public health interventions and policies for effective management of the COVID‐19 pandemic. This article presents an overview of the situation of COVID‐19 in Malawi and identifies emerging public health challenges that the country is facing amidst this pandemic. It is based on a review of relevant key policy documents, reports, and publications. Some of the key emerging challenges identified in Malawi are worsening population health and socio‐economic status; health system challenges like inadequate financing and human resources, disruption of essential health services; a rise in mental health conditions and suicide rates; teenage pregnancies and early marriages; and changes in some health policies. The findings point to the need to invest more in strategies for health promotion, health system strengthening and avoiding disruptions and recovery of services. These should include COVID‐19 vaccination promotion campaigns, improvement of the public health surveillance system, strengthening the health workforce, implementation of health financing strategies, procurement of adequate essential medicines and supplies, and strengthening of youth‐friendly reproductive health services, community health services and community engagement. These will ensure that the health system in Malawi is well‐equipped to deliver resilient, sustainable and quality health services amidst and beyond the COVID‐19 pandemic thereby promoting progress toward the achievement of Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs) in Malawi.
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Affiliation(s)
| | | | - Joe Nkhonjera
- Ministry of HealthPhalombe District HospitalPhalombeMalawi
| | - Betty Kazanga
- IRD, INSERMAix Marseille Univ, SESSTIM, ISSPAMMarseilleFrance
| | | | - Aisha Twalibu
- Schulich School of Medicine and DentistryUniversity of Western OntarioOntarioCanada
| | - John Phuka
- School of Global and Public HealthKamuzu College of Health ScienceLilongweMalawi
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Nuraini N, Fauzi IS, Lestari BW, Rizqina S. The Impact of COVID-19 Quarantine on Tuberculosis and Diabetes Mellitus Cases: A Modelling Study. Trop Med Infect Dis 2022; 7:tropicalmed7120407. [PMID: 36548662 PMCID: PMC9782997 DOI: 10.3390/tropicalmed7120407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
COVID-19 has currently become a global pandemic and caused a high number of infected people and deaths. To restrain the coronavirus spread, many countries have implemented restrictions on people’s movement and outdoor activities. The enforcement of health emergencies such as quarantine has a positive impact on reducing the COVID-19 infection risk, but it also has unwanted influences on health, social, and economic sectors. Here, we developed a compartmental mathematical model for COVID-19 transmission dynamic accommodating quarantine process and including tuberculosis and diabetic people compartments. We highlighted the potential negative impact induced by quarantine implementation on the increasing number of people with tuberculosis and diabetes. The actual COVID-19 data recorded in Indonesia during the Delta and Omicron variant attacks were well-approximated by the model’s output. A positive relationship was indicated by a high value of Pearson correlation coefficient, r=0.9344 for Delta and r=0.8961 for Omicron with a significance level of p<0.05. By varying the value of the quarantine parameter, this study obtained that quarantine effectively reduces the number of COVID-19 but induces an increasing number of tuberculosis and diabetic people. In order to minimize these negative impacts, increasing public awareness about the dangers of TB transmission and implementing a healthy lifestyle were considered the most effective strategies based on the simulation. The insights and results presented in this study are potentially useful for relevant authorities to increase public awareness of the potential risk of TB transmission and to promote a healthy lifestyle during the implementation of quarantine.
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Affiliation(s)
- Nuning Nuraini
- Department of Mathematics, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia
- Center for Mathematical Modeling and Simulation, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | - Ilham Saiful Fauzi
- Department of Accounting, Politeknik Negeri Malang, Malang 65141, Indonesia
- Correspondence:
| | - Bony Wiem Lestari
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Sila Rizqina
- Department of Mathematics, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia
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The Effect of the COVID-19 Pandemic on Pulmonary Tuberculosis Control in the Selected Upazila Health Complexes of Dhaka Division, Bangladesh. Trop Med Infect Dis 2022; 7:tropicalmed7110385. [DOI: 10.3390/tropicalmed7110385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Despite the enormous disruption of tuberculosis (TB) services reported globally, Bangladesh’s impact is not well documented. We aimed to assess the effect of the COVID-19 pandemic on the TB control program in Bangladesh from patients’ and service providers’ perspectives. We conducted a cross-sectional study from November–December 2021 at six conveniently selected Upazila Health Complexes (UHC) of the Dhaka division, Bangladesh. We conducted face-to-face interviews among 180 pulmonary TB service recipients and all TB service providers working in the selected UHC. We also reviewed TB registries from each UHC. All data were summarized using descriptive statistics tools. We found a 31% reduction in presumptive TB cases during 2021 compared to 2020. Other TB services, such as testing, were reduced by 16–36% during the same period. Service receivers reported a lack of transportation (95%), and a lack of adequate human resources (89%) as critical barriers to receiving and providing TB service, respectively. The findings of our study showed substantial interruption of TB service delivery during the COVID-19 pandemic, threatening the recent progress and pushback from achieving the 2035 End TB targets. Early mitigation of TB service delivery through adopting remote follow-ups using digital health technology and integrating COVID-19 and TB screening is essential for the continuity of essential TB services and achieving global TB targets.
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Almatrafi MA, Awad K, Alsahaf N, Tayeb S, Alharthi A, Rabie N, Fadag R, Alwafi H, Salawati R, Alhindi AK, Salawati E, Samannodi M. Disseminated Tuberculosis Post COVID-19 Infection: A Case Report. Cureus 2022; 14:e31489. [DOI: 10.7759/cureus.31489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
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Alexandrino de Souza Pinheiro1 M, Baroni Aurilio1 R, Alice Amaral Ibiapina Parente1,2 A, de Fátima Bazhuni Pombo Sant’Anna2 M, Cristina Cisne Frota1 A, Barroso Hofer2 C, Fernandes de Abreu2 T, Ferreira2 S, Couto Sant’Anna2 C. Clinical forms and diagnosis of tuberculosis in children and adolescents during the COVID-19 pandemic. J Bras Pneumol 2022; 48:e20220240. [DOI: 10.36416/1806-3756/e20220240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The present study aimed to describe the clinical forms and the time taken to diagnose new tuberculosis cases and to statistically analyze the isolated and combined forms of the disease in children and adolescents treated at a university hospital in Rio de Janeiro during the first year of the COVID-19 pandemic in Brazil. Methods: This was a cross-sectional study that used retrospective data on children (0-9 years old) and adolescents (10-18 years old) with pulmonary (PTB), extrapulmonary (EPTB), and combined tuberculosis (PTB + EPTB) followed up at the outpatient clinic from January 2019 to March 2021. Categorical data were analyzed by descriptive statistics and expressed as frequency and proportions. Categorical variables were compared using the Chi-square test, and numerical variables using Student's T-test. Results: A total of 51 cases were included, 63% (32/51) of which comprised patients in the year of the pandemic (group A), while 37% (19/51) were patients attended in previous years (group B). In group A, 19% (6/32) of the patients presented PTB, 59% (16/32) had EPTB, and 31% (10/32) had PTB+EPTB. In group B, 42% (8/19) of the patients presented PTB, 42% (8/19) had EPTB, and 16% (3/19) had PTB+EPTB. Conclusion: Our study revealed more tuberculosis cases in the first year of the pandemic than in the same period of the previous year, with greater variation of sites affected by the disease, including rarer and more severe forms.
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Affiliation(s)
| | - Rafaela Baroni Aurilio1
- 1. Instituto de Puericultura e Pediatria Martagão Gesteira. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | - Ana Alice Amaral Ibiapina Parente1,2
- 1. Instituto de Puericultura e Pediatria Martagão Gesteira. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil. 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | | | - Ana Cristina Cisne Frota1
- 1. Instituto de Puericultura e Pediatria Martagão Gesteira. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | - Cristina Barroso Hofer2
- 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | | | - Sidnei Ferreira2
- 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
| | - Clemax Couto Sant’Anna2
- 2. Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brasil
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Buonsenso D, Mariani F, Biala J, Goletti D. COVID-19 effect on tuberculosis care in Sierra Leone: Are we in the recovery phase? Pulmonology 2022; 29:244-246. [PMID: 36473827 PMCID: PMC9618437 DOI: 10.1016/j.pulmoe.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- D. Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italia,Corresponding author at:
| | - F. Mariani
- Pediatric Resident, Università Cattolica del Sacro Cuore, Rome, Italy
| | - J.S. Biala
- Tuberculosis Unit, Tombo Community Health Centre, Western Rural Area, Sierra Leone
| | - D. Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases-IRCCS L. Spallanzani, Rome, Italy
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Hildebrand RE, Chandrasekar SS, Riel M, Touray BJB, Aschenbroich SA, Talaat AM. Superinfection with SARS-CoV-2 Has Deleterious Effects on Mycobacterium bovis BCG Immunity and Promotes Dissemination of Mycobacterium tuberculosis. Microbiol Spectr 2022; 10:e0307522. [PMID: 36200898 PMCID: PMC9603897 DOI: 10.1128/spectrum.03075-22] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/19/2022] [Indexed: 01/04/2023] Open
Abstract
An estimated one-third of the world's population is infected with Mycobacterium tuberculosis, with the majority being vaccinated with Mycobacterium bovis BCG. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a threat, and we must understand how SARS-CoV-2 can modulate both BCG immunity and tuberculosis pathogenesis. Interestingly, neither BCG vaccination nor tuberculosis infection resulted in differences in clinical outcomes associated with SARS-CoV-2 in transgenic mice. Surprisingly, earlier M. tuberculosis infection resulted in lower SARS-CoV-2 viral loads, mediated by the heightened immune microenvironment of the murine lungs, unlike vaccination with BCG, which had no impact. In contrast, M. tuberculosis-infected tissues had increased bacterial loads and decreased histiocytic inflammation in the lungs following SARS-CoV-2 superinfection. SARS-CoV-2 modulated BCG-induced type 17 responses while decreasing type 1 and increasing type 2 cytokines in M. tuberculosis-infected mice. These findings challenge initial findings of BCG's positive impact on SARS-CoV-2 infection and suggest potential ramifications for M. tuberculosis reactivation upon SARS-CoV-2 superinfection. IMPORTANCE Prior to SARS-CoV-2, M. tuberculosis was the leading infectious disease killer, with an estimated one-third of the world's population infected and 1.7 million deaths a year. Here, we show that SARS-CoV-2 superinfection caused increased bacterial dissemination in M. tuberculosis-infected mice along with immune and pathological changes. SARS-CoV-2 also impacted the immunity of BCG-vaccinated mice, resulting in decreased interleukin-17 (IL-17) levels, while offering no protective effect against SARS-CoV-2. These results demonstrate that SARS-CoV-2 may have a deleterious effect on the ongoing M. tuberculosis pandemic and potentially limit BCG's efficacy.
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Affiliation(s)
- Rachel E. Hildebrand
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Shaswath Sekar Chandrasekar
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Mariah Riel
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Bubacarr J. B. Touray
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Sophie A. Aschenbroich
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
| | - Adel M. Talaat
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin—Madison, Madison, Wisconsin, USA
- Pan Genome Systems, Madison, Wisconsin, USA
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Russotto Y, Micali C, Pellicanò GF, Nunnari G, Venanzi Rullo E. HIV and Mediterranean Zoonoses: A Review of the Literature. Infect Dis Rep 2022; 14:694-709. [PMID: 36136825 PMCID: PMC9498920 DOI: 10.3390/idr14050075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/21/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
A zoonosis is an infectious disease that has jumped from a non-human animal to humans. Some zoonoses are very common in the Mediterranean area and endemic in specific regions, so they represent an important problem for public health. Human Immunodeficiency Virus (HIV) is a virus that has originated as a zoonosis and is now diffused globally, with the most significant numbers of infected people among the infectious diseases. Since the introduction of antiretroviral therapy (ART), the history for people living with HIV (PLWH) has changed drastically, and many diseases are now no different in epidemiology and prognosis as they are in not-HIV-infected people. Still, the underlying inflammatory state that is correlated with HIV and other alterations related to the infection itself can be a risk factor when infected with other bacteria, parasites or viruses. We reviewed the literature for infection by the most common Mediterranean zoonoses, such as Campylobacter, Salmonella, Brucella, Rickettsia, Borrelia, Listeria and Echinococcus, and a possible correlation with HIV. We included Monkeypox, since the outbreak of cases is becoming a concern lately. We found that HIV may be related with alterations of the microbiome, as for campylobacteriosis, and that there are some zoonoses with a significant prevalence in PLWH, as for salmonellosis.
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Affiliation(s)
- Ylenia Russotto
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
| | - Cristina Micali
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
- Correspondence: ; Tel.: +39-09-0221-2032
| | - Giovanni Francesco Pellicanò
- Department of Human Pathology of the Adult and the Developmental Age “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
| | - Emmanuele Venanzi Rullo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
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Berra TZ, Ramos ACV, Alves YM, Tavares RBV, Tartaro AF, do Nascimento MC, Moura HSD, Delpino FM, de Almeida Soares D, Silva RVDS, Gomes D, Monroe AA, Arcêncio RA. Impact of COVID-19 on Tuberculosis Indicators in Brazil: A Time Series and Spatial Analysis Study. Trop Med Infect Dis 2022; 7:tropicalmed7090247. [PMID: 36136658 PMCID: PMC9500936 DOI: 10.3390/tropicalmed7090247] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/29/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background: We aimed to visualize and classify the time series of COVID-19, tuberculosis (TB) notification, and TB outcomes (cure, treatment abandonment, and death), verify the impact of the new coronavirus pandemic on these indices in Brazil, and verify the presence of spatial autocorrelation between COVID-19 and TB. Methods: This was an ecological time series study that considered TB and COVID-19 cases. Seasonal Trend Decomposition using Loess (STL) was used to trace the temporal trend, Prais–Winsten was used to classify the temporal trend, Interrupted Time Series (ITS) was used to verify the impact of COVID-19 on TB rates, and the Bivariate Moran Index (Global and Local) was used to verify the spatial autocorrelation of events. Results: Brazil and its macro-regions showed an increasing temporal trend for the notification of TB in the pre-pandemic period. Only the Northeast Region showed a decreasing temporal trend for cured cases. For treatment abandonment, all regions except for the Northeast showed an increasing temporal trend, and regarding death, Brazil and the Northeast Region showed an increasing temporal trend. With the ITS, COVID-19 caused a decline in TB notification rates and TB outcome rates. With the global spatial analysis, it was possible to identify the existence of spatial autocorrelation between the notification rate of COVID-19 and the TB notification rate and deaths. With the local analysis, it was possible to map the Brazilian municipalities and classify them according to the relationship between the rates of both diseases and space. Conclusions: COVID-19 influenced the follow-up of and adherence to TB treatment and intensified social vulnerability and, consequently, affected the notification of TB since the relationship between the disease and social determinants of health is already known. The restoration and strengthening of essential services for the prevention and detection of cases and treatment of TB in endemic environments such as Brazil have been oriented as a priority in the global health agenda.
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Affiliation(s)
- Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
- Correspondence: ; Tel.: +55-1633151408
| | - Antônio Carlos Vieira Ramos
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Yan Mathias Alves
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Reginaldo Bazon Vaz Tavares
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Ariela Fehr Tartaro
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Murilo César do Nascimento
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Heriederson Sávio Dias Moura
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Felipe Mendes Delpino
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Débora de Almeida Soares
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Ruan Víctor dos Santos Silva
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Dulce Gomes
- Mathematics Department, University of Évora, 7000-671 Évora, Portugal
| | - Aline Aparecida Monroe
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
| | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil
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Addo J, Pearce D, Metcalf M, Lundquist C, Thomas G, Barros-Aguirre D, Koh GCKW, Strange M. Living with tuberculosis: a qualitative study of patients’ experiences with disease and treatment. BMC Public Health 2022; 22:1717. [PMID: 36085073 PMCID: PMC9462890 DOI: 10.1186/s12889-022-14115-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 08/30/2022] [Indexed: 02/06/2023] Open
Abstract
Abstract
Background
Although tuberculosis (TB) is a curable disease, treatment is complex and prolonged, requiring considerable commitment from patients. This study aimed to understand the common perspectives of TB patients across Brazil, Russia, India, China, and South Africa throughout their disease journey, including the emotional, psychological, and practical challenges that patients and their families face.
Methods
This qualitative market research study was conducted between July 2020 and February 2021. Eight TB patients from each country (n = 40) completed health questionnaires, video/telephone interviews, and diaries regarding their experiences of TB. Additionally, 52 household members were interviewed. Patients at different stages of their TB treatment journey, from a range of socioeconomic groups, with or without TB risk factors were sought. Anonymized data underwent triangulation and thematic analysis by iterative coding of statements.
Results
The sample included 23 men and 17 women aged 13–60 years old, with risk factors for TB reported by 23/40 patients. Although patients were from different countries and cultural backgrounds, experiencing diverse health system contexts, five themes emerged as common across the sample. 1) Economic hardship from loss of income and medical/travel expenses. 2) Widespread stigma, delaying presentation and deeply affecting patients’ emotional wellbeing. 3) TB and HIV co-infection was particularly challenging, but increased TB awareness and accelerated diagnosis. 4) Disruption to family life strained relationships and increased patients’ feelings of isolation and loneliness. 5) The COVID-19 pandemic made it easier for TB patients to keep their condition private, but disrupted access to services.
Conclusions
Despite disparate cultural, socio-economic, and systemic contexts across countries, TB patients experience common challenges. A robust examination of the needs of individual patients and their families is required to improve the patient experience, encourage adherence, and promote cure, given the limitations of current treatment.
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Magassouba AS, Bassirou SM, Touré AA, Diallo BD, Alphazazi S, Cissé D, Keita MS, Seyabatou ES, Bangoura AM, Traoré HA, Decroo T, Campbell JR, Veronese V, Merle CSC. Evaluating the Effectiveness of a Novel Systematic Screening Approach for Tuberculosis among Individuals Suspected or Recovered from COVID-19: Experiences from Niger and Guinea. Trop Med Infect Dis 2022; 7:tropicalmed7090228. [PMID: 36136639 PMCID: PMC9504611 DOI: 10.3390/tropicalmed7090228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Evidence suggests that the COVID-19 pandemic negatively impacts tuberculosis (TB) activities. As TB and COVID-19 have similar symptoms, we assessed the effectiveness of integrated TB/COVID-19 screening in Guinea and Niger. From May to December 2020, TB screening was offered to symptomatic patients after a negative COVID-19 PCR test or after recovery from COVID-19 in Guinea. From December 2020 to March 2021, all presumptive COVID-19 patients with respiratory symptoms were tested simultaneously for COVID-19 and TB in Niger. We assessed the TB detection yield and used micro-costing to estimate the costs associated with both screening algorithms. A total of 863 individuals (758 in Guinea, and 105 in Niger), who were mostly male (60%) and with a median age of 34 (IQR: 26–45), were screened for TB. Reported symptoms were cough ≥2 weeks (49%), fever (45%), and weight loss (30%). Overall, 61 patients (7%) tested positive for COVID-19 (13 in Guinea, 48 in Niger) and 43 (4.9%) were diagnosed with TB disease (35 or 4.6% in Guinea, and 8 or 7.6% in Niger). The cost per person initiating TB treatment was USD $367 in Guinea and $566 in Niger. Overall, the yield of both approaches was high, and the cost was modest. Optimizing integrated COVID-19/TB screening may support maintaining TB detection during the ongoing pandemic.
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Affiliation(s)
- Aboubacar Sidiki Magassouba
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry BP 1147, Guinea
- National TB Programme, Conakry BP 1147, Guinea
- Correspondence: (A.S.M.); (S.M.B.)
| | | | - Almamy Amara Touré
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry BP 1147, Guinea
- Department of Public Health, Kofi Annan University of Guinea, Conakry BP 1367, Guinea
- National Centre of Training and Recherche in Rural Health of Mafèrinyah, Forécariah BP 2649, Guinea
| | | | | | - Diao Cissé
- National Centre of Training and Recherche in Rural Health of Mafèrinyah, Forécariah BP 2649, Guinea
| | - Mohamed Sitan Keita
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry BP 1147, Guinea
| | | | | | - Hugues Asken Traoré
- The Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, 1211 Geneva, Switzerland
| | - Tom Decroo
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerpen, Belgium
| | - Jonathon R. Campbell
- Department of Epidemiology, Biostatistics and Occupational Health and The McGill International TB Centre, McGill University, 5252 Blvd de Maisonneuve West, Montreal, QC H4A 3S5, Canada
| | - Vanessa Veronese
- The Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, 1211 Geneva, Switzerland
| | - Corinne Simone Collette Merle
- The Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, 1211 Geneva, Switzerland
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Canetti D, Antonello RM, Saderi L, Giro M, Goletti D, Sarmati L, Rodari P, Bocchino M, Schirò M, Riccardi N, Sotgiu G. Impact of SARS-CoV-2 infection on tuberculosis outcome and follow-up in Italy during the first COVID-19 pandemic wave: a nationwide online survey. LE INFEZIONI IN MEDICINA 2022; 30:418-426. [PMID: 36148161 PMCID: PMC9448321 DOI: 10.53854/liim-3003-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND SARS-CoV-2 pandemic affected tuberculosis (TB) management. This Italian nationwide survey assessed COVID-19 impact on TB care and outcomes. MATERIALS AND METHODS Twenty-one hospitals or referral centres fulfilled an online survey. Primary objective was to describe clinical features, outcomes and retention in care in subjects with latent TB infection (LTBI) or disease over the first wave of COVID-19 pandemic. Secondary objectives were the assessment of risk factors, co-morbidities, diagnostics, radiological findings, and outcomes of COVID-19 in the study population. RESULTS 254 patients with LTBI or active TB were included. In co-infected (SARS-CoV-2, LTBI/TB) patients, recovery occurred in 29/32 (90.6%) cases, death in one case. High retention in care was preserved. CONCLUSION in our cohort, outcomes did not seem to be adversely conditioned by incident COVID-19.
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Affiliation(s)
- Diana Canetti
- StopTB Italia Onlus, Milan, Italy
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | | | - Delia Goletti
- StopTB Italia Onlus, Milan, Italy
- National Institute for Infectious Diseases (INMI) “L. Spallanzani” - IRCCS, Rome, Italy
| | | | - Paola Rodari
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Marialuisa Bocchino
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, Naples, Italy
| | - Miriam Schirò
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, Naples, Italy
| | - Niccolò Riccardi
- StopTB Italia Onlus, Milan, Italy
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - Giovanni Sotgiu
- StopTB Italia Onlus, Milan, Italy
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
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Jones AJ, Jones-López EC, Butler-Wu SM, Wilson ML, Rodman J, Flors L, Voyageur C, Jones BE. Impact of COVID-19 on diagnosis and testing for TB in a high-resource, low-burden setting. Int J Tuberc Lung Dis 2022; 26:888-890. [PMID: 35996281 PMCID: PMC9423020 DOI: 10.5588/ijtld.22.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- A J Jones
- Martin Luther King Jr. Center for Public Health, Los Angeles, CA
| | - E C Jones-López
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - S M Butler-Wu
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - M L Wilson
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - J Rodman
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - L Flors
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - C Voyageur
- Los Angeles County and University of Southern California (LAC +USC) Medical Center, Los Angeles, CA, USA
| | - B E Jones
- Keck School of Medicine, University of Southern California, Los Angeles, CA
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Baral S, Rao A, Rwema JOT, Lyons C, Cevik M, Kågesten AE, Diouf D, Sohn AH, Phaswana-Mafuya RN, Kamarulzaman A, Millett G, Marcus JL, Mishra S. Competing health risks associated with the COVID-19 pandemic and early response: A scoping review. PLoS One 2022; 17:e0273389. [PMID: 36037216 PMCID: PMC9423636 DOI: 10.1371/journal.pone.0273389] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. OBJECTIVES We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. METHODS A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from November 1st, 2019 to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English. RESULTS A total of 1604 published papers and 205 preprints were retrieved in the search. Overall, 8.0% (129/1604) of published studies and 10.2% (21/205) of preprints met the inclusion criteria and were included in this review: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (19/183) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. DISCUSSION COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.
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Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Amrita Rao
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Jean Olivier Twahirwa Rwema
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, St. Andrews, Scotland
| | - Anna E. Kågesten
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | | | - Annette H. Sohn
- TREAT Asia, amfAR, The Foundation for AIDS Research, Bangkok, Thailand
| | - Refilwe Nancy Phaswana-Mafuya
- South African Medical Research Council/University of Johannesburg Pan African Centre for Epidemics Research Extramural Unit, Johannesburg, South Africa
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Adeeba Kamarulzaman
- Department of Medicine and Infectious Diseases, University of Malaya, Kuala Lumpur, Malaysia
| | - Gregorio Millett
- Public Policy Office, amfAR, Washington, District of Columbia, United States of America
| | - Julia L. Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States of America
| | - Sharmistha Mishra
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, Canada
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Tuberculosis in Poland: Epidemiological and Molecular Analysis during the COVID-19 Pandemic. Diagnostics (Basel) 2022; 12:diagnostics12081883. [PMID: 36010233 PMCID: PMC9406582 DOI: 10.3390/diagnostics12081883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
The COVID-19 pandemic may have a negative impact on the proper implementation of TB control programmes and may increase TB incidence rates in the near future. The aim of this study was to perform an epidemiological and molecular analysis of Mycobacterium tuberculosis strains cultured from tuberculosis patients in Poland in 2020 and to compare the results of monitoring drug-resistant tuberculosis in Poland with previous studies in 2012 and 2016. The analysis was based on questionnaires and strains sent by regional laboratories during the 12 months of 2020. Molecular analysis was performed by spoligotyping 20% of the strains sensitive to the four primary antimycobacterial drugs and all of the drug-resistant strains. The number of strains sent for analysis dropped threefold, from 4136 in 2012 to 1383 in 2020. The incidence of tuberculosis among men was higher than among women. There was an increase in strains’ resistance to antimycobacterial drugs in both newly diagnosed patients, from 4.4% in 2012 to 6.1% in 2020, and previously treated patients, from 11.7% to 12.3%. Four-year resistance increased to 1% and 2.1%, respectively. The spoligotype SIT1 was the most abundant among the resistant strains (17%), and SIT53 (13.9%) was the most common among susceptible strains.
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Trajman A, Felker I, Alves LC, Coutinho I, Osman M, Meehan SA, Singh UB, Schwartz Y. The COVID-19 and TB syndemic: the way forward. Int J Tuberc Lung Dis 2022; 26:710-719. [PMID: 35898126 PMCID: PMC9341497 DOI: 10.5588/ijtld.22.0006] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Together, SARS-CoV-2 and M. tuberculosis have killed approximately 5.7 million people worldwide over the past 2 years. The COVID-19 pandemic, and the non-pharmaceutical interventions to mitigate COVID-19 transmission (including social distancing regulations, partial lockdowns and quarantines), have disrupted healthcare services and led to a reallocation of resources to COVID-19 care. There has also been a tragic loss of healthcare workers who succumbed to the disease. This has had consequences for TB services, and the fear of contracting COVID-19 may also have contributed to reduced access to TB services. Altogether, this is projected to have resulted in a 5-year setback in terms of mortality from TB and a 9-year setback in terms of TB detection. In addition, past and present TB disease has been reported to increase both COVID-19 fatality and incidence. Similarly, COVID-19 may adversely affect TB outcomes. From a more positive perspective, the pandemic has also created opportunities to improve TB care. In this review, we highlight similarities and differences between these two infectious diseases, describe gaps in our knowledge and discuss solutions and priorities for future research.
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Affiliation(s)
- A Trajman
- Departamento de Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil, Montreal Chest Institute & McGill International TB Centre, McGill University, Montreal, QC, Canada
| | - I Felker
- WHO Collaborating Centre, Novosibirsk Tuberculosis Research Institute, Novosibirsk, Russian Federation
| | - L C Alves
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA
| | - I Coutinho
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - M Osman
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, School of Human Sciences, Faculty of Education, Health & Human Sciences, University of Greenwich, London, UK
| | - S-A Meehan
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - U B Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Y Schwartz
- WHO Collaborating Centre, Novosibirsk Tuberculosis Research Institute, Novosibirsk, Russian Federation
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Muñiz-Salazar R, Le T, Cuevas-Mota J, González-Fagoaga JE, Zapata-Garibay R, Ruiz-Tamayo PS, Robles-Flores J, Garfein RS. Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México. Front Public Health 2022; 10:921596. [PMID: 35942259 PMCID: PMC9356343 DOI: 10.3389/fpubh.2022.921596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
In 2020, Mexico reported the lowest tuberculosis (TB) incidence on record, and it is unclear to what extent COVID-19 has impacted TB surveillance, diagnosis, and treatment. It is important to understand COVID-19's impact in Baja California (BC), which has the highest TB burden in Mexico. With the increasing number of migrants and asylum seekers arriving in BC, limited resources and crowded living conditions increase the risk of TB transmission. The purpose of this study was to assess the impact of COVID-19 on TB diagnosis and treatment in BC. We were also interested in health disparities experienced by migrants in BC. We conducted a mixed methods analysis using quantitative surveillance data obtained from the Mexico National TB Program (NTP) and qualitative data collected through in-depth interviews and focus group discussions with TB program directors and personnel in BC's four provincial health jurisdictions. Compared to the year prior, surveillance data from March 2020 - February 2021 revealed that TB incidence in BC declined by 30.9% and favorable TB outcomes (TB cure or treatment completion) declined by 49.8%. Elucidating differences by migrant status was complicated by the lack of standardized collection of migrant status by the NTP. Qualitative analysis revealed that TB diagnostic and treatment supplies and services became limited and disproportionately accessible across jurisdictions since the pandemic began; however, favorable adaptations were also reported, such as increased telemedicine use and streamlined care referral processes. Participants shared that migrant status is susceptible to misclassification and that TB care is difficult due to the transitory nature of migrants. This study did not identify major differences in TB service delivery or access between migrants and non-migrants in BC; however, migrant status was frequently missing. COVID-19 has overwhelmed health systems worldwide, disrupting timely TB diagnostic and treatment services, and potentially caused underdiagnosis of TB in BC. TB programs in BC should quickly restore essential services that were disrupted by COVID-19 while identifying and preserving beneficial program adaptations, such as telemedicine and streamlined care referral processes. Improved methods for documenting migrant status of TB cases are also needed.
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Affiliation(s)
- Raquel Muñiz-Salazar
- Escuela de Ciencias de la Salud, Universidad Autónoma de Baja California, Ensenada, Mexico
- *Correspondence: Raquel Muñiz-Salazar
| | - Tina Le
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
| | - Jazmine Cuevas-Mota
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
| | - Jesús Eduardo González-Fagoaga
- Healthy Border Program, US-Mexico Border Heath Commission, Tijuana, Mexico
- Facultad de Humanidades y Ciencias Sociales, Universidad Autónoma de Baja California, Tijuana, Mexico
| | - Rogelio Zapata-Garibay
- Healthy Border Program, US-Mexico Border Heath Commission, Tijuana, Mexico
- Facultad de Humanidades y Ciencias Sociales, Universidad Autónoma de Baja California, Tijuana, Mexico
| | | | - Javier Robles-Flores
- Escuela de Ciencias de la Salud, Universidad Autónoma de Baja California, Ensenada, Mexico
| | - Richard S. Garfein
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
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48
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Sotgiu G, Mondoni M. TB/Covid-19: An Underestimated Risk? Arch Bronconeumol 2022; 58:742-743. [PMID: 35908987 PMCID: PMC9305372 DOI: 10.1016/j.arbres.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022]
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49
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Souza MDR, da Paz WS, Sales VBDS, de Jesus GFH, Tavares DDS, Lima SVMA, Sousa ÁFL, de Melo EV, do Carmo RF, de Souza CDF, Bezerra-Santos M. Impact of the COVID-19 Pandemic on the Diagnosis of Tuberculosis in Brazil: Is the WHO End TB Strategy at Risk? Front Pharmacol 2022; 13:891711. [PMID: 35847020 PMCID: PMC9277074 DOI: 10.3389/fphar.2022.891711] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background: In 2014, the World Health Organization (WHO) launched the “post-2015 End TB strategy”, that aims to end the global tuberculosis (TB) epidemic by 2030. However, the COVID-19 pandemic has severely impacted global public health and the strict measures to control the coronavirus spread can affect the management of other diseases, such as TB. Herein, we aimed to assess the impact of the COVID-19 pandemic on the diagnosis of TB in Brazil, during 2020.Methods: We carried out an ecological and population-based study, using spatial analysis techniques. The variables used were the new cases of TB, pulmonary tuberculosis (PTB), and also baciloscopy-positive (BP) cases in Brazil between 2015 and 2020. The percentage of changes (% change) was calculated to verify if there was an increase or decrease of TB cases in 2020, along with time trend analyses given by Joinpoint regression model. Also, interrupted time series analyses were used to assess the trend of TB diagnosis before and after the onset of the COVID-19 in Brazil. Spatial distribution maps were elaborated, considering the % change of each Brazilian state.Findings: Data analyses showed a reduction in the diagnosis of TB (−8.3%) and PTB (−8.1%) in Brazil after the irruption of the COVID-19 pandemic. Likewise, 22 states depicted a reduction in TB diagnosis. An expressive reduction of BP cases (−17.1%) was also observed. Interestingly, interrupted time series analysis showed decline in TB and PTB diagnoses from March 2020. Spatial analyses revealed that all states had a progressive reduction of TB, PTB and PB cases, from March on, with the highest percentages of reduction in December (−100% to −75%).Interpretation: Taken together, our analyses demonstrated a reduction in TB diagnosis after the irruption of the COVID-19 pandemic in Brazil and its regions, signaling a serious impact on the WHO “End TB Strategy” global plan.
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Affiliation(s)
- Mariana do Rosário Souza
- Health Science Graduate Program, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Parasitic Biology Graduate Program, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Wandklebson Silva da Paz
- Parasitic Biology Graduate Program, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Tropical Medicine Graduate Program, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | | | | | - Álvaro Francisco Lopes Sousa
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
- *Correspondence: Álvaro Francisco Lopes Sousa,
| | | | - Rodrigo Feliciano do Carmo
- College of Pharmaceutical Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Brazil
| | | | - Márcio Bezerra-Santos
- Health Science Graduate Program, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Parasitic Biology Graduate Program, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Department of Morphology, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Laboratory of Immunology and Molecular Biology, University Hospital, Universidade Federal de Sergipe, Aracaju, Brazil
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50
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Shah T, Shah Z, Yasmeen N, Baloch Z, Xia X. Pathogenesis of SARS-CoV-2 and Mycobacterium tuberculosis Coinfection. Front Immunol 2022; 13:909011. [PMID: 35784278 PMCID: PMC9246416 DOI: 10.3389/fimmu.2022.909011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/23/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, is an infectious disease that poses severe threats to global public health and significant economic losses. The COVID-19 global burden is rapidly increasing, with over 246.53 million COVID-19 cases and 49.97 million deaths reported in the WHO 2021 report. People with compromised immunity, such as tuberculosis (TB) patients, are highly exposed to severe COVID-19. Both COVID-19 and TB diseases spread primarily through respiratory droplets from an infected person to a healthy person, which may cause pneumonia and cytokine storms, leading to severe respiratory disorders. The COVID-19-TB coinfection could be fatal, exacerbating the current COVID-19 pandemic apart from cellular immune deficiency, coagulation activation, myocardial infarction, and other organ dysfunction. This study aimed to assess the pathogenesis of SARS-CoV-2-Mycobacterium tuberculosis coinfections. We provide a brief overview of COVID19-TB coinfection and discuss SARS-CoV-2 host cellular receptors and pathogenesis. In addition, we discuss M. tuberculosis host cellular receptors and pathogenesis. Moreover, we highlight the impact of SARS-CoV-2 on TB patients and the pathological pathways that connect SARS-CoV-2 and M. tuberculosis infection. Further, we discuss the impact of BCG vaccination on SARS-CoV-2 cases coinfected with M. tuberculosis, as well as the diagnostic challenges associated with the coinfection.
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Affiliation(s)
- Taif Shah
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Zahir Shah
- College of Veterinary Sciences, The University of Agriculture Peshawar, Peshawar, Pakistan
| | - Nafeesa Yasmeen
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
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