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Semnani K, Sohrabi M, Alavijeh PE, SeyedAlinaghi S, Esmaeili S, Halabchi F, Alizadeh Z, Salami A, Khaneshan AS. Prior COVID-19 infection among newly diagnosed tuberculosis patients in a tertiary care center in Tehran: A case-control study. Immun Inflamm Dis 2024; 12:e1275. [PMID: 38804889 PMCID: PMC11131933 DOI: 10.1002/iid3.1275] [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: 12/01/2023] [Revised: 04/14/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE To assess the risk of developing pulmonary tuberculosis (TB) in accordance with prior history of COVID-19 infection. BACKGROUND Since the advent of the COVID-19 pandemic much discussion has been had on the possible role it might play on global efforts to combat TB; most, focusing on the pandemic's impact on health care systems' capabilities to manage TB cases. Mechanisms have also been proposed by which the COVID-19 infection may directly affect individuals' chance of developing TB infection. Cases have been reported with a history of COVID-19 infection preceding a diagnosis of TB, evidencing its possible role as a risk factor for the disease. METHODS A case-control study was conducted enrolling patients diagnosed with pulmonary TB in the absence of major risk factors previous history of TB, (HIV) human immunodeficiency virus infection), end-stage renal disease, organ transplants, and use of immunosuppressive agents) for developing TB. Each patient was age and sex matched with one healthy control. Data regarding prior COVID-19 infection, diabetes, and smoking status as well as the use of corticosteroids and Tocilizumab for the treatment of COVID-19 infection was obtained. Bivariate analysis was conducted and variables with a likely association with TB status were entered in a multivariate model. RESULTS Bivariate analysis demonstrated a significant relationship between prior COVID-19 infection and TB (95% confidence interval = 1.1-22.8, odds ratio [OR] = 5). Among other variables the severity of COVID-19 infection was found to have a likely association with TB status (p = .125). In a multivariate model, prior COVID-19 infection per se, was not found to be significantly associated with TB (p = .12, OR = 4.5). CONCLUSIONS There seems to be an association between prior history of COVID-19 and a future diagnosis of TB partially linked to the severity of disease. The findings of the current study may serve as a basis for further studies to determine the need for and efficacy of measures to follow-up COVID-19 patients at an increased risk for developing TB.
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Affiliation(s)
- Kiavash Semnani
- Tehran University of Medical Sciences School of MedicineTehranIran
| | - Marjan Sohrabi
- Department of Infectious Diseases, Tehran University of Medical SciencesImam Khomeini Hospital Complex, Tohid SqureTehranIran
| | - Parvaneh Ebrahimi Alavijeh
- Department of Infectious Diseases, Tehran University of Medical SciencesArash Women's HospitalTehranIran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Tehran University of Medical SciencesIranian Institute for Reduction of High Risk BehaviorsTehranIran
| | - Shirin Esmaeili
- Tehran University of Medical Sciences School of MedicineTehranIran
| | - Farzin Halabchi
- Department of Sports and Exercise MedicineTehran University of Medical SciencesTehranIran
| | - Zahra Alizadeh
- Department of Sports and Exercise MedicineTehran University of Medical SciencesTehranIran
| | - Amir Salami
- Student Research CommitteeIran University of Medical Sciences School of Medicine, Hemmat HwyTehranIran
| | - Arezoo Salami Khaneshan
- Department of Infectious Diseases, Tehran University of Medical SciencesImam Khomeini Hospital Complex, Tohid SqureTehranIran
- Iranian Research Center for HIV/AIDS, Tehran University of Medical SciencesIranian Institute for Reduction of High Risk BehaviorsTehranIran
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Iacoponi N, Del Duca F, Marcacci I, Occhipinti C, Napoletano G, Spadazzi F, La Russa R, Maiese A. Butane-related deaths in post-mortem investigations: A systematic review. Leg Med (Tokyo) 2024; 69:102442. [PMID: 38579662 DOI: 10.1016/j.legalmed.2024.102442] [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: 01/24/2024] [Revised: 02/24/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
Volatile substance abuse is widespread among adolescents due to its easy availability and methods of consumption. Inhalant abuse represents a current problematic issue, causing significant morbidity and mortality due to direct toxicity on several target organs and displacement of gas which results in a lack of oxygen. This review aims to evaluate post-mortem and toxicological investigations in cases of suspected butane intoxication. We performed comprehensive research using the Preferred Reporting Items for Systematic Review (PRISMA) standards. Forty scientific papers fulfilled the inclusion criteria. A total of 58 cases of butane-related deaths were found. Among these, we found 11 cases of suicide (18%), 1 case of homicide (2%), 44 cases of accidental poisoning (76%), and 2 cases of work-related deaths (4%). Autopsy and post-mortem examinations were performed in 54 cases, whereas toxicological analyses were presented in 56 cases. In autopsy, pulmonary edema (51%) and poli-visceral congestion (59%) were the most common findings. When death by butane inhalation is hypothesized, autopsy and histological findings may be nonspecific, therefore toxicological investigations assume a crucial role along with attention to the methods used to collect biological samples.
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Affiliation(s)
- Naomi Iacoponi
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Fabio Del Duca
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy.
| | - Ilaria Marcacci
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Carla Occhipinti
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy.
| | - Gabriele Napoletano
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy.
| | - Federica Spadazzi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy.
| | - Raffaele La Russa
- Department of Clinical Medicine, Public Health, Life Sciences, and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Aniello Maiese
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy.
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Trevisol M, Moreira TP, Sanvezzo GHB, Guedes SJKO, da Silva DRP, Wendt GW, Coelho HC, Ferreto LED. Latent Tuberculosis Infection Diagnosis Using QuantiFERON-TB Gold Plus Kit Among Correctional Workers: A Cross-Sectional Study in Francisco Beltrão-PR, Brazil. J Community Health 2023; 48:600-605. [PMID: 36792835 DOI: 10.1007/s10900-023-01201-z] [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] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
Correctional workers form a high-priority group for tuberculosis control measures because of their high exposure and risk. This cross-sectional study conducted in April and May 2022 included 71 criminal police officers from the State Penitentiary of Francisco Beltrão-PR, Brazil. Their sociodemographic and laboratory data were collected. Latent tuberculosis infection (LTBI) was assessed using a QuantiFERON-TB Gold Plus in-tube test kit. Binary logistic regression was applied to calculate the odds ratios (ORs) and 95% confidence intervals (CI) of the LTBI predictors. The prevalence of LTBI was 22.6% (95% CI, 12.8-32.2%). Factors associated with LTBI were age > 43 years (OR, 0.18; 95% CI, 0.04-0.70; p < 0.014) and the use of medications (OR, 5.13; 95% CI, 1.40-18.87; p < 0.014). The prevalence was close to that estimated worldwide for LTBI in correctional workers, reinforcing the need for occupational health control measures consisting of regular screening and treatment of positive cases of latent infection among correctional workers to reduce the risk of illness and spread of infection in the penitentiary system and community.
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Affiliation(s)
- Maico Trevisol
- Health Sciences Center, Postgraduate Program in Applied Health Sciences, Western Paraná State University (UNIOESTE), Francisco Beltrão, Brazil
| | - Thiago Poss Moreira
- Health Sciences Center, Faculty of Medicine, Public Health Lab and Biosciences and Health Lab, Western Paraná State University (UNIOESTE), Francisco Beltrão, Brazil
| | - Gustavo Henrique Baraca Sanvezzo
- Health Sciences Center, Faculty of Medicine, Public Health Lab and Biosciences and Health Lab, Western Paraná State University (UNIOESTE), Francisco Beltrão, Brazil
| | | | | | - Guilherme Welter Wendt
- Health Sciences Center, Postgraduate Program in Applied Health Sciences, Public Health Lab and Biosciences and Health Lab, Western Paraná State University (UNIOESTE), Francisco Beltrão, Brazil
| | | | - Lirane Elize Defante Ferreto
- Health Sciences Center, Postgraduate Program in Applied Health Sciences, Public Health Lab and Biosciences and Health Lab, Western Paraná State University (UNIOESTE), Francisco Beltrão, Brazil.
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Marín D, Keynan Y, Bangdiwala SI, López L, Rueda ZV. Tuberculosis in Prisons: Importance of Considering the Clustering in the Analysis of Cross-Sectional Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5423. [PMID: 37048037 PMCID: PMC10094442 DOI: 10.3390/ijerph20075423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/15/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
The level of clustering and the adjustment by cluster-robust standard errors have yet to be widely considered and reported in cross-sectional studies of tuberculosis (TB) in prisons. In two cross-sectional studies of people deprived of liberty (PDL) in Medellin, we evaluated the impact of adjustment versus failure to adjust by clustering on prevalence ratio (PR) and 95% confidence interval (CI). We used log-binomial regression, Poisson regression, generalized estimating equations (GEE), and mixed-effects regression models. We used cluster-robust standard errors and bias-corrected standard errors. The odds ratio (OR) was 20% higher than the PR when the TB prevalence was >10% in at least one of the exposure factors. When there are three levels of clusters (city, prison, and courtyard), the cluster that had the strongest effect was the courtyard, and the 95% CI estimated with GEE and mixed-effect models were narrower than those estimated with Poisson and binomial models. Exposure factors lost their significance when we used bias-corrected standard errors due to the smaller number of clusters. Tuberculosis transmission dynamics in prisons dictate a strong cluster effect that needs to be considered and adjusted for. The omission of cluster structure and bias-corrected by the small number of clusters can lead to wrong inferences.
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Affiliation(s)
- Diana Marín
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín 050034, Colombia
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
| | - Shrikant I. Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, McMaster University, Hamilton, ON L8L 2X2, Canada
| | - Lucelly López
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín 050034, Colombia
| | - Zulma Vanessa Rueda
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín 050034, Colombia
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
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Franchi C, Rossi R, Malizia A, Gaudio P, Di Giovanni D. Biological risk in Italian prisons: data analysis from the second to the fourth wave of COVID-19 pandemic. Occup Environ Med 2023; 80:273-279. [PMID: 36927731 DOI: 10.1136/oemed-2022-108599] [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: 08/09/2022] [Accepted: 03/04/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND The management of COVID-19 in Italian prisons triggered considerable concern at the beginning of the pandemic due to numerous riots which resulted in inmate deaths, damages and prison breaks. The aim of this study is to shed some light, through analysis of the infection and relevant disease parameters, on the period spanning from the second to the fourth wave of the outbreak in Italy's prisons. METHODS Reproductive number (Rt) and Hospitalisation were calculated through a Eulerian approach applied to differential equations derived from compartmental models. Comparison between trends was performed through paired t-test and linear regression analyses. RESULTS The infection trends (prevalence and Rt) show a high correlation between the prison population and the external community. Both the indices appear to be lagging 1 week in prison. The prisoners' Rt values are not statistically different from those of the general population. The hospitalisation trend of inmates strongly correlates with the external population's, with a delay of 2 weeks. The magnitude of hospitalisations in prison is less than in the external community for the period analysed. CONCLUSIONS The comparison with the external community revealed that in prison the infection prevalence was greater, although Rt values showed no significant difference, and the hospitalisation rate was lower. These results suggest that the consistent monitoring of inmates results in a higher infection prevalence while a wide vaccination campaign leads to a lower hospitalisation rate. All three indices demonstrate a lag of 1 or 2 weeks in prison. This delay could represent a useful time-window to strengthen planned countermeasures.
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Affiliation(s)
- Cristiano Franchi
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy
| | - Riccardo Rossi
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy
| | - Andrea Malizia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata Faculty of Medicine and Surgery, Roma, Italy
| | - Pasqualino Gaudio
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy
| | - Daniele Di Giovanni
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy.,UniCamillus, Rome, Italy
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Matucci T, Riccardi N, Occhineri S, Pontarelli A, Tiseo G, Falcone M, Puci M, Saderi L, Sotgiu G. Treatment of latent tuberculosis infection in incarcerated people: a systematic review. Clin Microbiol Infect 2023:S1198-743X(23)00086-1. [PMID: 36868354 DOI: 10.1016/j.cmi.2023.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND The estimated number of people deprived of liberty is increasing, with 11.55 million incarcerated globally in 2021. Transmission of Mycobacterium tuberculosis (MTB) strains is facilitated in over-crowded, poorly ventilated settings such as jails and penitentiaries. Moreover, inmates may show individual risk factors for the development of tuberculosis (TB) disease. Treatment regimens for latent tuberculosis infection (LTBI) may require up to 9 months of drug exposure and are characterized by adverse events (AEs) and low completion rates. OBJECTIVES to describe current scientific evidence on feasibility, acceptability and completion rate of LTBI treatment in prison/correctional institutes. DATA SOURCES Articles were retrieved from MEDLINE/PubMed, no time restriction was applied. STUDY ELIGIBILITY CRITERIA Human retrospective and prospective studies published on LTBI treatment in incarcerated populations were included. ASSESSMENT OF RISK OF BIAS Bias assessment plots and Egger weighted regression test were used to determine the risk of bias. METHODS OF DATA SYNTHESIS Absolute and relative frequencies were assessed for qualitative data. Pooled proportion of included study groups and 95% confidence interval estimates, weighted for sample sizes, were illustrated in forest plots. I2 indicator association were used for true variability and overall variation. Fixed and random-effects models were chosen depending on the estimated between-study heterogeneity. RESULTS Of11 selected studies only 1 was conducted in a high TB incidence country. Overall, completion rates ranged from 26% to 100% across the included studies. Reason for discontinuation of treatment were transfer to other facilities, release, or loss to follow-up (LTFU) (range 0-74%), incidence of AEs (range 0-18%), and refusal or withdrawal from treatment (range 0-16%). CONCLUSIONS Implementation of short-course regimens in prisons should be considered given the low incidence of AEs observed; however, inmates consistently refused to complete LTBI treatment, thus underlining the need for improvement in retention in care.
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Affiliation(s)
- Tommaso Matucci
- StopTB Italia, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Niccolò Riccardi
- StopTB Italia, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
| | - Sara Occhineri
- StopTB Italia, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Agostina Pontarelli
- StopTB Italia, Milan, Italy; Unit of Respiratory Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Mariangela Puci
- University of Sassari, Department of Medicine, Surgery and Pharmacy, Italy
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- StopTB Italia, Milan, Italy; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality. Healthcare (Basel) 2022; 10:healthcare10071290. [PMID: 35885817 PMCID: PMC9324339 DOI: 10.3390/healthcare10071290] [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: 06/15/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Respecting the consent and confidentiality of a patient is an underlying element in establishing the patient’s trust in the physician and, implicitly, obtaining the patient’s compliance. In particular, cases of inmate patients require increased attention in order to fulfill this goal against a background of institutional interferences, which, in certain situations, may endanger the autonomy of the physician and their respect for the inmate’s dignity. The purpose of this article is to depict the characteristics of consent and confidentiality in a prison environment, in special cases, such as hunger strikes, violent acts, HIV testing, COVID-19 measures, and drug use, bringing into focus the physician and the inmate in the context of the particular situation where the target is disciplining someone in order for them to conform to social and juridical norms. Respecting the dignity of the inmate patient requires an adequate approach of informed consent and confidentiality, depending on each case, considering the potential unspoken aspects of the inmate’s account, which can be key elements in obtaining their compliance and avoiding malpractice claims.
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