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Xu W, Bao X, Lou X, Liu X, Chen Y, Zhao X, Zhang C, Pan C, Liu W, Liu F. Feature fusion method for pulmonary tuberculosis patient detection based on cough sound. PLoS One 2024; 19:e0302651. [PMID: 38743758 PMCID: PMC11093322 DOI: 10.1371/journal.pone.0302651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
Since the COVID-19, cough sounds have been widely used for screening purposes. Intelligent analysis techniques have proven to be effective in detecting respiratory diseases. In 2021, there were up to 10 million TB-infected patients worldwide, with an annual growth rate of 4.5%. Most of the patients were from economically underdeveloped regions and countries. The PPD test, a common screening method in the community, has a sensitivity of as low as 77%. Although IGRA and Xpert MTB/RIF offer high specificity and sensitivity, their cost makes them less accessible. In this study, we proposed a feature fusion model-based cough sound classification method for primary TB screening in communities. Data were collected from hospitals using smart phones, including 230 cough sounds from 70 patients with TB and 226 cough sounds from 74 healthy subjects. We employed Bi-LSTM and Bi-GRU recurrent neural networks to analyze five traditional feature sets including the Mel frequency cepstrum coefficient (MFCC), zero-crossing rate (ZCR), short-time energy, root mean square, and chroma_cens. The incorporation of features extracted from the speech spectrogram by 2D convolution training into the Bi-LSTM model enhanced the classification results. With traditional futures, the best TB patient detection result was achieved with the Bi-LSTM model, with 93.99% accuracy, 93.93% specificity, and 92.39% sensitivity. When combined with a speech spectrogram, the classification results showed 96.33% accuracy, 94.99% specificity, and 98.13% sensitivity. Our findings underscore that traditional features and deep features have good complementarity when fused using Bi LSTM modelling, which outperforms existing PPD detection methods in terms of both efficiency and accuracy.
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Affiliation(s)
- Wenlong Xu
- College of Information Engineering, China Jiliang University, Hangzhou, Zhejiang, China
| | - Xiaofan Bao
- College of Information Engineering, China Jiliang University, Hangzhou, Zhejiang, China
| | - Xiaomin Lou
- Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Xiaofang Liu
- College of Information Engineering, China Jiliang University, Hangzhou, Zhejiang, China
| | - Yuanyuan Chen
- Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | | | - Chenlu Zhang
- Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Chen Pan
- College of Information Engineering, China Jiliang University, Hangzhou, Zhejiang, China
| | - Wenlong Liu
- College of Information Engineering, China Jiliang University, Hangzhou, Zhejiang, China
| | - Feng Liu
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Queensland, Australia
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Petersen E, Al-Abri S, Al-Jardani A, Memish ZA, Aklillu E, Ntoumi F, Mwaba P, Wejse C, Zumla A, Al-Yaquobi F. Screening for latent tuberculosis in migrants-status quo and future challenges. Int J Infect Dis 2024; 141S:107002. [PMID: 38479577 DOI: 10.1016/j.ijid.2024.107002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES To review the evidence that migrants from tuberculosis (TB) high-incidence countries migrating to TB low-incidence countries significantly contribute to active TB cases in the counties of destination, primarily through reactivation of latent TB. METHODS This is a narrative review. The different screening programs in the countries of destination are reviewed either based on screening and preventive treatment of latent TB pre or more commonly - post arrival. RESULTS Screening can be performed using interferon-gamma release assays (IGRA) or tuberculin skin tests (TST). Preventive treatment of latent TB is using either monotherapy with isoniazid, or in combination with rifampicin or rifapentine. We discuss the ethical issues of preventive treatment in asymptomatic individuals and how these are addressed in different screening programs. CONCLUSION Screening migrants from TB high endemic countries to TB low endemic countries is beneficial. There is a lack of standardization and agreement on screening protocols, follow up and treatment.
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Affiliation(s)
- Eskild Petersen
- PandemiX Center of Excellence, Roskilde University, Roskilde, Denmark; European Society for Clinical Microbiology and Infectious Diseases Task Force for Emerging Infections, Basel, Switzerland; International Society for Infectious Diseases, Boston, MA, USA
| | - Seif Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman.
| | - Amina Al-Jardani
- Central Public Health Laboratory, Ministry of Health, Muscat, Oman
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health & College of Medicine, Al Faisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Eleni Aklillu
- Department of Global Public Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, People's Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Peter Mwaba
- UNZA-UCLMS Research and Training Program, UTH, Lusaka, Zambia; Lusaka Apex Medical University, Faculty of Medicine, Lusaka, Zambia
| | - Christian Wejse
- Department of Public Health, Faculty of Health Science, Aarhus University, Aarhus, Denmark
| | - Alimuddin Zumla
- Department of Infection, Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, United Kingdom; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
| | - Fatma Al-Yaquobi
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
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Østergaard AA, Lillebaek T, Petersen I, Fløe A, Bøkan EHW, Hilberg O, Holden IK, Larsen L, Colic A, Wejse C, Ravn P, Nørgård BM, Bjerrum S, Johansen IS. Prevalence estimates of tuberculosis infection in adults in Denmark: a retrospective nationwide register-based cross-sectional study, 2010 to 2018. Euro Surveill 2024; 29:2300590. [PMID: 38516789 PMCID: PMC11063675 DOI: 10.2807/1560-7917.es.2024.29.12.2300590] [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: 10/26/2023] [Accepted: 01/12/2024] [Indexed: 03/23/2024] Open
Abstract
BackgroundTuberculosis (TB) elimination requires identifying and treating persons with TB infection (TBI).AimWe estimate the prevalence of positive interferon gamma release assay (IGRA) tests (including TB) and TBI (excluding TB) in Denmark based on TBI screening data from patients with inflammatory bowel disease (IBD) or inflammatory rheumatic disease (IRD).MethodsUsing nationwide Danish registries, we included all patients with IBD or IRD with an IGRA test performed between 2010 and 2018. We estimated the prevalence of TBI and positive IGRA with 95% confidence intervals (CI) in adolescents and adults aged 15-64 years after sample weighting adjusting for distortions in the sample from the background population of Denmark for sex, age group and TB incidence rates (IR) in country of birth.ResultsIn 13,574 patients with IBD or IRD, 12,892 IGRA tests (95.0%) were negative, 461 (3.4%) were positive and 221 (1.6%) were indeterminate, resulting in a weighted TBI prevalence of 3.2% (95% CI: 2.9-3.5) and weighted positive IGRA prevalence of 3.8% (95% CI: 3.5-4.2) among adults aged 15-64 years in the background population of Denmark. Unweighted TBI prevalence increased with age and birthplace in countries with a TB IR higher than 10/100,000 population.ConclusionEstimated TBI prevalence is low in Denmark. We estimate that 200,000 persons have TBI and thus are at risk of developing TB. Screening for TBI and preventive treatment, especially in persons born in high TB incidence countries or immunosuppressed, are crucial to reduce the risk of and eliminate TB.
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Affiliation(s)
- Anne Ahrens Østergaard
- Department of Infectious Diseases and Mycobacterial Centre for Research Southern Denmark, MyCRESD, Odense University Hospital, Denmark
- Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark
| | - Troels Lillebaek
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Denmark
- Department of Public Health, University of Copenhagen, Denmark
| | - Inge Petersen
- Department of Infectious Diseases and Mycobacterial Centre for Research Southern Denmark, MyCRESD, Odense University Hospital, Denmark
| | - Andreas Fløe
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Eliza H Worren Bøkan
- Department of Infectious Diseases and Mycobacterial Centre for Research Southern Denmark, MyCRESD, Odense University Hospital, Denmark
| | - Ole Hilberg
- Department of Medicine, Vejle Hospital, Hospital Lillebælt, Vejle, Denmark
| | - Inge K Holden
- Department of Infectious Diseases and Mycobacterial Centre for Research Southern Denmark, MyCRESD, Odense University Hospital, Denmark
- Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark
| | - Lone Larsen
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Center for Molecular Prediction of Inflammatory Bowel Disease, PREDICT, Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Denmark
| | - Ada Colic
- Department of Rheumatology, Zealand University Hospital, Køge, Denmark
| | - Christian Wejse
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- GloHAU, Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Pernille Ravn
- Section for Infectious Diseases, Department of Medicine, Herlev and Gentofte Hospital, Copenhagen, University of Copenhagen, Gentofte, Denmark
| | - Bente Mertz Nørgård
- Center of Clinical Epidemiology, Odense University Hospital and Research Unit of Clinical Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Stephanie Bjerrum
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark
| | - Isik Somuncu Johansen
- Department of Infectious Diseases and Mycobacterial Centre for Research Southern Denmark, MyCRESD, Odense University Hospital, Denmark
- Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark
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Yang M, Li P, Liu H, Zhu X, Zhu G, Zhang P, Deng G. The association between type 2 diabetes and pulmonary cavitation revealed among IGRA-positive tuberculosis patients. Front Med (Lausanne) 2023; 10:1245316. [PMID: 38126070 PMCID: PMC10731020 DOI: 10.3389/fmed.2023.1245316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023] Open
Abstract
The co-occurrence of tuberculosis (TB) and diabetes mellitus (DM) presents a significant obstacle to TB eradication. Pulmonary cavitation can occur in severe cases of TB, particularly in patients with DM. From 1 May 2014 through 30 June 2019, we conducted a cross-sectional study of 1,658 smear- or culture-confirmed pulmonary TB (PTB) patients at the Second Department of Pulmonary Medicine and Tuberculosis, Shenzhen, China. A total of 861 participants who satisfied the criteria (chest CT scan for cavitation, interferon-gamma release assay (IGRA), diagnosis of diabetes mellitus), with the median age of 36.7 years, 63.6% of male, 79.7% IGRA positive, 13.8% with diabetes, and 40.8% with pulmonary cavitation, were included in the study. The association between diabetes and pulmonary cavitation was confirmed in these TB patients (adjusted OR, 2.54; 95% CI, 1.66-3.94; p < 0.001). No associations were observed between diabetes and IGRA, as well as between lung cavitary and IGRA. Based on the criteria of IGRA+/-, pulmonary cavitation+/-, and DM+/-, the further analysis with univariate and multivariate logistic regression were conducted in six subgroups. The significant association between diabetes and pulmonary cavitation was further confirmed in the IGRA+ subgroup (adjusted OR, 3.07; 95% CI, 1.86-5.16; p < 0.001) but not observed in IGRA- individuals. This observation suggests that different immunological mechanisms of pulmonary cavitary/DM may be employed in IGRA+ TB patients from IGRA- TB patients.
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Affiliation(s)
- Min Yang
- Department of Pulmonary Medicine and Tuberculosis, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, Shenzhen, China
| | - Pei Li
- Department of Pulmonary Medicine and Tuberculosis, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, Shenzhen, China
| | - Han Liu
- Department of Pulmonary Medicine and Tuberculosis, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, Shenzhen, China
| | - Xiaojie Zhu
- China Institute of Veterinary Drug Control, Beijing, China
| | - Guofeng Zhu
- Department of Pulmonary Medicine and Tuberculosis, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, Shenzhen, China
| | - Peize Zhang
- Department of Pulmonary Medicine and Tuberculosis, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, Shenzhen, China
| | - Guofang Deng
- Department of Pulmonary Medicine and Tuberculosis, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, Shenzhen, China
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Wu Y, Zhu P, Jiang Y, Zhang X, Wang Z, Xie B, Song T, Zhang F, Luo A, Li S, Xiong X, Han J. Topological insulator Bi 2Se 3 based electrochemical aptasensors for the application of sensitive detection of interferon-γ. J Mater Chem B 2023; 11:631-639. [PMID: 36537727 DOI: 10.1039/d2tb01760a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Interferon-γ (IFN-γ) is one of the crucial inflammatory cytokines as an early indicator of multiple diseases. A fast, simple, sensitive and reliable IFN-γ detection method is valuable for early diagnosis and monitoring of treatment. In this work, we creatively developed an electrochemical aptasensor based on the topological material Bi2Se3 for sensitive IFN-γ quantification. The high-quality Bi2Se3 sheet was directly exfoliated from a single crystal, which immobilized the synthesized IFN-γ aptamer. Under optimal conditions, the electrochemical signal revealed a wide linear relation along with the logarithmic concentration of IFN-γ from 1.0 pg mL-1 to 100.0 ng mL-1, with the limit of detection as low as 0.5 pg mL-1. The topological material Bi2Se3 with Dirac surface states improved the electrochemical signal/noise ratio and thus the sensitivity of the sensors. Furthermore, this electrochemical aptasensor exhibited excellent specificity and stability, which could be attributed to the large-scale smooth surface of the Bi2Se3 sheet with few defects decreasing the non-specific absorption. The developed biosensor has the same good performance as the ELISA method for detecting the real serum samples. Our work demonstrates that the developed electrochemical aptasensors based on topological materials have great potential in the field of clinical determination.
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Affiliation(s)
- Yetong Wu
- Centre for Quantum Physics, Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement (MOE), School of Physics, Beijing Institute of Technology, Beijing 100081, China. .,Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing, 314019, China.,Beijing Key Lab of Nanophotonics and Ultrafine Optoelectronic Systems, School of Physics, Beijing Institute of Technology, Beijing 100081, China
| | - Peng Zhu
- Centre for Quantum Physics, Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement (MOE), School of Physics, Beijing Institute of Technology, Beijing 100081, China. .,Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing, 314019, China.,Beijing Key Lab of Nanophotonics and Ultrafine Optoelectronic Systems, School of Physics, Beijing Institute of Technology, Beijing 100081, China
| | - Yujiu Jiang
- Centre for Quantum Physics, Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement (MOE), School of Physics, Beijing Institute of Technology, Beijing 100081, China. .,Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing, 314019, China.,Beijing Key Lab of Nanophotonics and Ultrafine Optoelectronic Systems, School of Physics, Beijing Institute of Technology, Beijing 100081, China
| | - Xu Zhang
- Centre for Quantum Physics, Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement (MOE), School of Physics, Beijing Institute of Technology, Beijing 100081, China. .,Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing, 314019, China.,Beijing Key Lab of Nanophotonics and Ultrafine Optoelectronic Systems, School of Physics, Beijing Institute of Technology, Beijing 100081, China
| | - Zhiwei Wang
- Centre for Quantum Physics, Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement (MOE), School of Physics, Beijing Institute of Technology, Beijing 100081, China. .,Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing, 314019, China.,Beijing Key Lab of Nanophotonics and Ultrafine Optoelectronic Systems, School of Physics, Beijing Institute of Technology, Beijing 100081, China
| | - Bingteng Xie
- Key Laboratory of Molecular Medicine and Biological Diagnosis and Treatment (Ministry of Industry and Information Technology), School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Tinglu Song
- Experimental Centre of Advanced Materials School of Materials Science & Engineering, Beijing Institute of Technology, Beijing 100081, China
| | - Fulai Zhang
- Key Laboratory of Molecular Medicine and Biological Diagnosis and Treatment (Ministry of Industry and Information Technology), School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Aiqin Luo
- Key Laboratory of Molecular Medicine and Biological Diagnosis and Treatment (Ministry of Industry and Information Technology), School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Shanshan Li
- Department of Rheumatology, China-Japan Friendship Hospital, 100029, Beijing, China.
| | - Xiaolu Xiong
- Centre for Quantum Physics, Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement (MOE), School of Physics, Beijing Institute of Technology, Beijing 100081, China. .,Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing, 314019, China.,Beijing Key Lab of Nanophotonics and Ultrafine Optoelectronic Systems, School of Physics, Beijing Institute of Technology, Beijing 100081, China
| | - Junfeng Han
- Centre for Quantum Physics, Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement (MOE), School of Physics, Beijing Institute of Technology, Beijing 100081, China. .,Yangtze Delta Region Academy of Beijing Institute of Technology, Jiaxing, 314019, China.,Beijing Key Lab of Nanophotonics and Ultrafine Optoelectronic Systems, School of Physics, Beijing Institute of Technology, Beijing 100081, China
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