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Baya B, Diarra B, Dabitao DK, Somboro A, Traore FG, Goita D, Coulibaly G, Sanogo M, Wague M, Kone B, Kone D, Ouattara K, Soumare D, Kanoute T, Toloba Y, Maiga AI, Maiga M, Diallo S, Murphy RL, Doumbia S. High Schistosoma mansoni Co-Infection in Tuberculosis Patients with or without Human Immunodeficiency Virus: A Prospective Cohort Study. RESEARCH SQUARE 2024:rs.3.rs-4796634. [PMID: 39281870 PMCID: PMC11398560 DOI: 10.21203/rs.3.rs-4796634/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: 09/18/2024]
Abstract
Background People with Latent tuberculosis infection (LTBI) remain the reservoir of tuberculosis. One-third to 1/4 of the world's population is infected. Its reactivation is due to factors that disrupt the host's immune response. Recent findings showed that Schistosoma mansoni coinfection leads to a Th2/Th1 profile which results in an immune modulation that favors the escape of the Mycobacteria. Schistosoma mansoni may contribute to TB incidence in endemic regions. We aimed to investigate the co-infection rate and patient outcomes. Methods A prospective cohort study was conducted between 2020-2022 at University Clinical Research Center (UCRC), including culture-confirmed active pulmonary TB patients and tested for Schistosoma mansoni in stools using Kato-Katz Technique. After descriptive analysis a logistic regression was performed to determine risk factors associated with TB and Schistosoma mansoni co-infection. Results Data of 174 tuberculosis-confirmed patients, Kato-Katz tested were analyzed. Males represented 62.6%, mean age was 34.9 ± 13.8 years, 29.9% were smokers, alcohol consumption 13.8%, TB contact history 26.4%, HIV coinfection 11.5%, diabetes 6.3%, undernourished 55.7%. Schistosoma mansoni prevalence was 28.7%. The co-infection was associated with less lung cavitation [aOR = 0.24 [95% CI (0.06-0.85), p = 0.028], unfavorable treatment result [aOR = 2.95 (1.23-7.08), p = 0.015] and death [aOR = 3.43 (1.12-10.58), p = 0.032]. Conclusions Despite Kato-Katz's low sensitivity, Schistosoma mansoni coinfection was found in one-third of the TB patients; 2.5-fold higher than that of HIV. The coinfection was associated with poor treatment results and death.
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Affiliation(s)
- Bocar Baya
- University Clinical Research Center (UCRC)
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Morán-Mariños C, Visconti-Lopez FJ, Espiche C, Llanos-Tejada F, Villanueva-Villegas R, Casanova-Mendoza R, Bernal-Turpo C. Research priorities and trends in pulmonary tuberculosis in Latin America: A bibliometric analysis. Heliyon 2024; 10:e34828. [PMID: 39144936 PMCID: PMC11320310 DOI: 10.1016/j.heliyon.2024.e34828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 08/16/2024] Open
Abstract
Tuberculosis (TB) poses a significant global public health challenge, particularly in developing countries. Over the years, scientific research has played a pivotal role in addressing this disease. In this study, we aimed to analyze and outline the trends in scientific output on TB and identify research priorities in Latin America (LA) from 1990 to 2021. Scientific production was analyzed, and the number of publications, financing sources, and journal characteristics were evaluated. Collaboration networks and keywords were visualized using mapping analysis with VOSviewer software. Research themes were prioritized by country based on co-occurrence frequency. In total, 4399 documents were identified, a significant trend was evident in the number of publications per year (R2 = 0.981), and research substantially contributed to the reduction of TB-related mortality (R2 = -0.876). Most publications were original articles (83.8 %). The International Journal of Tuberculosis and Lung Disease had the highest publication and citation rates per document. International collaboration was predominantly with the United States, France, and Canada. Brazil, Argentina, and Mexico had the highest number of publications and external collaborations. In LA, interest in researching studies related to treatment and diagnosis (32.5 %) was notably high, followed by epidemiology and screening (26.9 %). Among the 20 countries in LA, research priorities varied, with the highest emphasis on HIV/AIDS (14/20), epidemiology (9/20), anti-TB agents (6/20), and mortality (5/20). TB resistance was only considered a research priority in Brazil, Peru, and Haiti. Therefore, LA experienced significant growth in its scientific output, playing a crucial role in TB control. Strategic adaptation to the region's specific challenges was observed, particularly in HIV/AIDS coinfection, epidemiological studies, and drug resistance. This progress was achieved by outstanding international scientific collaboration. This holistic approach emphasizes the importance of research in the fight against TB in LA.
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Affiliation(s)
- Cristian Morán-Mariños
- Unidad de Investigación en Bibliometría, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Unidad Especializada en Tuberculosis, Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru
| | | | - Carlos Espiche
- Facultad de Ciencias de La Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Felix Llanos-Tejada
- Unidad Especializada en Tuberculosis, Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru
- Instituto de Investigaciones en Ciencias Biomédicas - INICIB, Facultad de Medicina. Universidad Ricardo Palma, Lima, Peru
| | - Renzo Villanueva-Villegas
- Unidad Especializada en Tuberculosis, Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru
| | - Renato Casanova-Mendoza
- Unidad Especializada en Tuberculosis, Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru
| | - Capriny Bernal-Turpo
- Unidad Especializada en Tuberculosis, Servicio de Neumología, Hospital Nacional Dos de Mayo, Lima, Peru
- Clínica Internacional, Lima, Peru
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Cai X, Xu X, He G, Jiang X, Wu L. Drug resistance in drug-resistant tuberculosis patients with and without diabetes mellitus: a comparative analysis. BMC Infect Dis 2024; 24:807. [PMID: 39123148 PMCID: PMC11316371 DOI: 10.1186/s12879-024-09712-3] [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: 03/28/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND This dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a global public health concern. This study aims to compare drug resistance in drug-resistant tuberculosis (DR-TB) patients with and without DM and analyse the risk factors of multidrug-resistant tuberculosis (MDR-TB). METHODS A total of 893 DR-TB patients were admitted to Wenzhou Central Hospital between January 2018 and December 2022. After excluding 178 cases with incomplete clinical and laboratory data, 715 patients were included in the study. These patients were then categorized into two groups based on the presence of type 2 DM: the DM group (160 cases) and the non-DM group (555 cases). Demographic information, baseline clinical characteristics, laboratory and imaging test results, clinical diagnoses, and other relevant data were collected for analysis. Statistical analysis was conducted on demographic information, clinical parameters, drug resistance spectrum, and risk factors for multidrug resistance. RESULTS In both the DM and non-DM groups, the order of resistance to first-line anti-tuberculosis drugs is isoniazid, streptomycin, rifampicin, and ethambutol. There is no significant difference in the proportion of mono-resistant tuberculosis, polydrug-resistant tuberculosis, and multidrug-resistant tuberculosis between the two groups (P > 0.05). The prevalence of MDR-TB in both groups shows a downward trend between 2018 and 2022, but the trend is not statistically significant (P > 0.05). Among patients without DM, residence in rural areas, retreatment of tuberculosis, pulmonary cavity, and uric acid ≥ 346 µmol/L are identified as independent risk factors for MDR-TB. Among patients with DM, residence in rural areas, retreatment of tuberculosis, pulmonary cavity, and HbA1c ≥ 9.8% were identified as independent risk factors for MDR-TB. CONCLUSION Isoniazid is the most resistant drug among DR-TB patients with and without DM. There is no statistically significant difference in drug resistance patterns between the two groups. Some progress has been made in the prevention and control of DR-TB in this area, but the effect is not very significant. There are differences in the risk factors of MDR-TB between patients with and without DM.
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Affiliation(s)
- Xiaoxiao Cai
- Department of Clinical Laboratory Medicine, Wenzhou People's Hospital, Wenzhou, 325000, China
| | - Xueqin Xu
- Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, The Ding Li Clinical College of Wenzhou Medical University, Wenzhou, 325000, China
| | - Guiqing He
- Key Laboratory of Diagnosis and Treatment of New and Recurrent Infectious Diseases of Wenzhou, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, No. 252 Baili east road, Lucheng district, Wenzhou, 325000, China
- Department of Infectious Diseases, The Ding Li Clinical College of Wenzhou Medical University, Wenzhou Central Hospital, Wenzhou, 325000, China
| | - Xiangao Jiang
- Key Laboratory of Diagnosis and Treatment of New and Recurrent Infectious Diseases of Wenzhou, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, No. 252 Baili east road, Lucheng district, Wenzhou, 325000, China.
- Department of Infectious Diseases, The Ding Li Clinical College of Wenzhou Medical University, Wenzhou Central Hospital, Wenzhou, 325000, China.
| | - Lianpeng Wu
- Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, The Ding Li Clinical College of Wenzhou Medical University, Wenzhou, 325000, China.
- Key Laboratory of Diagnosis and Treatment of New and Recurrent Infectious Diseases of Wenzhou, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, No. 252 Baili east road, Lucheng district, Wenzhou, 325000, China.
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Yoopetch P, Wu O, Jittikoon J, Thavorncharoensap M, Youngkong S, Praditsitthikorn N, Mahasirimongkol S, Anothaisintawee T, Udomsinprasert W, Chaikledkaew U. Economic evaluation of diagnosis and treatment for latent tuberculosis infection among contacts of pulmonary tuberculosis patients in Thailand. Sci Rep 2024; 14:17693. [PMID: 39085338 PMCID: PMC11291668 DOI: 10.1038/s41598-024-68452-1] [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: 02/21/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
Currently, interferon-gamma release assay (IGRA) is costly and not included as latent tuberculosis infection (LTBI) screening test strategy in Thailand's Universal Coverage Scheme (UCS) benefit package. The objective of this study was to assess the cost-utility of LTBI screening strategies among tuberculosis (TB) contacts in Thailand. A hybrid decision tree and Markov model was developed to compare the lifetime costs and health outcomes of tuberculin skin test (TST) and IGRA, in comparison to no screening, based on a societal perspective. Health outcomes were the total number of TB cases averted and quality-adjusted life years (QALYs), with results presented as an incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to explore uncertainties in all parameters. The ICER of TST compared with no screening was 27,645 baht per QALY gained, while that of IGRA compared to TST was 851,030 baht per QALY gained. In a cohort of 1000 TB contacts, both TST and IGRA strategies could avert 282 and 283 TB cases, respectively. At the Thai societal willingness-to-pay threshold of 160,000 baht per QALY gained, TST was deemed cost-effective, whereas IGRA would not be cost-effective, unless the cost of IGRA was reduced to 1,434 baht per test.
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Affiliation(s)
- Panida Yoopetch
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
| | - Olivia Wu
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Jiraphun Jittikoon
- Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Montarat Thavorncharoensap
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Social Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Sitaporn Youngkong
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Social Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | | | - Surakameth Mahasirimongkol
- Information and Communication Technology Center, Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - Thunyarat Anothaisintawee
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Usa Chaikledkaew
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand.
- Social Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
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John S, Abdulkarim S, Katlholo T, Smyth C, Basason H, Rahman MT, Creswell J. Using a Knowledge and Awareness Survey to Engage and Inform a Community-Based Tuberculosis Intervention among Nomads in Adamawa State, Nigeria. Trop Med Infect Dis 2024; 9:167. [PMID: 39195605 PMCID: PMC11359801 DOI: 10.3390/tropicalmed9080167] [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: 03/31/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Nomadic populations are frequently isolated and vulnerable to diseases including tuberculosis (TB) and human immunodeficiency virus (HIV) due to limited access to health-related information and services, poverty, and social exclusion. We designed and implemented community-driven and -based outreach for TB and HIV based on the results of a TB knowledge, attitude, and practices (KAP) survey in Adamawa, Nigeria. METHODS We conducted a cross-sectional study on KAP among nomads using an adapted WHO survey. A TB and HIV community-level active case-finding intervention among nomadic populations was planned and delivered based on the KAP survey results. RESULTS Among 81 respondents, 26 (32.1%) knew what caused TB. More than 60% reported no health facilities in their community. Radio and healthcare workers were primary sources of information on health. Using community input, we developed and broadcasted radio jingles to sensitize people to TB services. Outreach initiatives led to the verbal screening of 61,891 individuals and 306 were diagnosed with TB. Additionally, 4489 people underwent HIV testing, and 69 were HIV-positive, all of whom were linked to treatment. CONCLUSIONS The results of KAP surveys can inform the design of evidence-based TB and HIV community-driven and -based case-finding interventions in rural Nigeria among nomadic populations.
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Affiliation(s)
- Stephen John
- Janna Health Foundation, Yola 640231, Nigeria; (S.J.); (H.B.)
| | - Suraj Abdulkarim
- SUFABEL Community Development Initiative, Gombe 760253, Nigeria;
| | - Thandi Katlholo
- Country and Community Support for Impact Team, Stop TB Partnership, 1218 Geneva, Switzerland; (T.K.); (C.S.)
| | - Caoimhe Smyth
- Country and Community Support for Impact Team, Stop TB Partnership, 1218 Geneva, Switzerland; (T.K.); (C.S.)
| | - Hunpiya Basason
- Janna Health Foundation, Yola 640231, Nigeria; (S.J.); (H.B.)
| | - Md. Toufiq Rahman
- Innovations & Grants Team, Stop TB Partnership, 1218 Geneva, Switzerland;
| | - Jacob Creswell
- Innovations & Grants Team, Stop TB Partnership, 1218 Geneva, Switzerland;
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Ayenew B, Belay DM, Gashaw Y, Gimja W, Gardie Y. WHO's end of TB targets: unachievable by 2035 without addressing under nutrition, forced displacement, and homelessness: trend analysis from 2015 to 2022. BMC Public Health 2024; 24:961. [PMID: 38575958 PMCID: PMC10996214 DOI: 10.1186/s12889-024-18400-5] [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: 12/14/2023] [Accepted: 03/20/2024] [Indexed: 04/06/2024] Open
Abstract
Tuberculosis (TB) remains a significant global health challenge, despite the World Health Organization (WHO) actively working towards its eradication through various initiatives and programs. Undernutrition, forced displacement, and homelessness worsen TB's burden and challenge control efforts; however, there is still no adequate research that shows the trend of these underlying factors to attain the WHO's ambitious TB targets. So, this study aims to analyze the trend analysis of these underlying factors worldwide from 2015 to 2022 and their impact on the feasibility and implications of reaching the End TB targets by 2035. We utilized international databases, including UNHCR, FAO, and WHO reports, as secondary data sources. Data were extracted chronologically from 2015 to 2022 to illustrate trends in undernutrition, forced displacement, and homelessness on a global level.This trend analysis reveals that undernutrition, forced displacement, and homelessness have worsened over time. Undernutrition rose from 8.4 to 9.8% globally between 2015 and 2021, affecting 22.7 million additional individuals each year. In 2022, undernutrition affected 735 million people globally. Africa (21.9%) and Asia (10.6%) had the highest rates, while Western Europe and North America had lower rates than the global average: 3.4% and 2.5%, respectively.Similarly, the global rate of forced displacement increased from 65.1 million people in 2015 to 108.4 million in 2022, a 21% increase from 2021. This means that an extra 19 million people were displaced in 2021. Globally, homelessness, affecting 1.6 billion people, has worsened over time. Despite being a highly vulnerable group to TB, homeless individuals are often neglected in TB control efforts. Our findings underscore the critical importance of addressing undernutrition, forced displacement, and homelessness in achieving the World Health Organization's ambitious End TB targets by 2035, as highlighted through trend analysis from 2015 to 2022. Implementing policies focusing on nutrition, stable housing, and the challenges faced by displaced populations is imperative for progress toward a TB-free world.
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Affiliation(s)
- Birhanu Ayenew
- Department of Adult Health Nursing, College of Health Science, Assosa University, Assosa, Ethiopia.
| | - Dawit Misganaw Belay
- Department of Midwifery, College of Health Sciences, Assosa University, Assosa, Ethiopia
| | - Yegoraw Gashaw
- Department of Pediatric and Child Health Nursing, College of Health Science, Assosa University, Assosa, Ethiopia
| | - Wondimu Gimja
- Department of Adult Health Nursing, College of Health Science, Assosa University, Assosa, Ethiopia
| | - Yimenu Gardie
- Department of Pediatric and Child Health Nursing, College of Health Science, Assosa University, Assosa, Ethiopia
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Polidoro M, de Oliveira DC. Prevalence and Spatial Autocorrelation of Tuberculosis in Indigenous People in Brazil, 2002-2022. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01924-2. [PMID: 38300427 DOI: 10.1007/s40615-024-01924-2] [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: 11/14/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/02/2024]
Abstract
Tuberculosis (TB) among indigenous populations in Brazil poses a multifaceted public health challenge influenced by geographical, social, institutional, economic, and cultural factors. This study scrutinized the prevalence and spatial distribution of TB among Brazilian indigenous communities from 2002 to 2022. Employing a cross-sectional and descriptive approach, we analyzed data from the Notifiable Diseases Information System (SINAN) and conducted spatial autocorrelation tests to identify clusters and outliers. The findings uncovered substantial disparities in TB prevalence between the North and Central-West regions, in contrast to the South and Southeast, mirroring social, economic, and cultural inequalities in Brazil. It is concluded that public health strategies should not only consider the epidemiological aspects of TB but also encompass social and environmental determinants, notably the impact of climate change. Holistic and context-sensitive approaches are imperative for addressing TB within indigenous communities, underscoring the need for adaptive and culturally sensitive interventions in the public health landscape.
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Affiliation(s)
- Maurício Polidoro
- Federal Institute of Rio Grande do Sul, Coronel Vicente St., Historic Center, Porto Alegre, Rio Grande do Sul, 90030-041, Brazil.
| | - Daniel Canavese de Oliveira
- Federal University of Rio Grande do Sul, São Manoel St., Rio Branco, Porto Alegre, Rio Grande do Sul, 90620-110, Brazil.
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Muniyandi M, Nagarajan K, Mathiyazhagan K, Giridharan P, Thiruvengadam K, Krishnan R. The Predicted Potential Impact of COVID-19 Pandemic on Tuberculosis Epidemic in Tamil Nadu, South India. Trop Med Infect Dis 2024; 9:12. [PMID: 38251209 PMCID: PMC10821053 DOI: 10.3390/tropicalmed9010012] [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: 11/09/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE To estimate the prevalence and incidence of TB before and during the COVID-19 pandemic in Tamil Nadu, south India. METHODS In the present study, the effect of COVID-19 epidemiology on the TB epidemic was assessed by the SEIR (Susceptible-Exposed-Infected-Recovered), a compartmental epidemiological model. The model input parameters on compartments of TB and incidence of COVID-19 were collected from the published literature. Based on the data collected, point prevalence and incidence of TB per 100,000 population is calculated with and without COVID-19. A prediction was conducted up to 2025, trend analysis was performed, and a trend chi-square test and chi-square test of independence were used to test the difference between the prevalence with and without COVID-19. R software 2000 (R 4.0.0) was used for analysis. RESULTS The TB prevalence without and with COVID-19 decreases from 289 in 2020 to 271 in 2025 and from 289 in 2020 to 269 in 2025, respectively. Similarly, the incidence of TB was decreasing from 144 in 2020 to 135 in 2025 without COVID-19 and 143 in 2020 to 134 in 2025 with COVID-19. Though the TB burden is decreasing over the years, the trend was not statistically significant (p > 0.05). With respect to the district level, the prevalence and incidence of TB with and without COVID-19 is also found to be decreasing over the years. It was also found that the difference in the prevalence and incidence of TB with and without COVID-19 was not statically significant. CONCLUSION The results of our study shows that there was an annual decline of around 2% from 2020 to 2025 in the trend of the prevalence and incidence of TB with and without COVID-19. Overall, there is a reduction, but it was not significant, and there is no significant effect of COVID-19 on TB in Tamil Nadu.
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Alwahsh W, Sahudin S, Alkhatib H, Bostanudin MF, Alwahsh M. Chitosan-Based Nanocarriers for Pulmonary and Intranasal Drug Delivery Systems: A Comprehensive Overview of their Applications. Curr Drug Targets 2024; 25:492-511. [PMID: 38676513 DOI: 10.2174/0113894501301747240417103321] [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: 01/24/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 04/29/2024]
Abstract
The optimization of respiratory health is important, and one avenue for achieving this is through the application of both Pulmonary Drug Delivery System (PDDS) and Intranasal Delivery (IND). PDDS offers immediate delivery of medication to the respiratory system, providing advantages, such as sustained regional drug concentration, tunable drug release, extended duration of action, and enhanced patient compliance. IND, renowned for its non-invasive nature and swift onset of action, presents a promising path for advancement. Modern PDDS and IND utilize various polymers, among which chitosan (CS) stands out. CS is a biocompatible and biodegradable polysaccharide with unique physicochemical properties, making it well-suited for medical and pharmaceutical applications. The multiple positively charged amino groups present in CS facilitate its interaction with negatively charged mucous membranes, allowing CS to adsorb easily onto the mucosal surface. In addition, CS-based nanocarriers have been an important topic of research. Polymeric Nanoparticles (NPs), liposomes, dendrimers, microspheres, nanoemulsions, Solid Lipid Nanoparticles (SLNs), carbon nanotubes, and modified effective targeting systems compete as important ways of increasing pulmonary drug delivery with chitosan. This review covers the latest findings on CS-based nanocarriers and their applications.
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Affiliation(s)
- Wasan Alwahsh
- Department of Pharmaceutics, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300, Selangor, Malaysia
| | - Shariza Sahudin
- Department of Pharmaceutics, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300, Selangor, Malaysia
- Atta-Ur-Rahman Institute of Natural Products Discovery, Universiti Teknologi MARA, Puncak Alam Campus, 42300, Selangor, Malaysia
| | - Hatim Alkhatib
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, 11942, Jordan
| | | | - Mohammad Alwahsh
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
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Garg A, Agrawal R, Chopra H, Singh T, Chaudhary R, Tankara A. A Glance on Nanovaccine: A Potential Approach for Disease Prevention. Curr Pharm Biotechnol 2024; 25:1406-1418. [PMID: 37861010 DOI: 10.2174/0113892010254221231006100659] [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: 03/29/2023] [Revised: 08/03/2023] [Accepted: 08/18/2023] [Indexed: 10/21/2023]
Abstract
There are several vaccines available for preventing various bacterial and viral infections, but still, there are many challenges that require the development of noninvasive, more efficient, and active vaccines. The advancement in biotechnological tools has provided safer antigens, such as nucleic acids, proteins etc., but due to their lower immunogenic property, adjuvants of stronger immune response are required. Nanovaccines are effective vaccines when compared with conventional vaccines as they can induce both Humoral and cell-mediated immune responses and also provide longer immunogenic memory. The nanocarriers used in vaccines act as adjuvant. They provide site-specific delivery of antigens and can be used in conjugation with immunostimulatory molecules for enhancing adjuvant therapy. The nanovaccines avoid degrading cell pathways and provide effective absorption into blood vessels. The higher potential of nanovaccines to treat various diseases, such as acquired immuno deficiency syndrome, cancer, tuberculosis, malaria and many others, along with their immunological mechanisms and different types, have been discussed in the review.
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Affiliation(s)
- Akash Garg
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura-Delhi Road, P.O Chhatikara, Mathura, 281001, Uttar Pradesh, India
| | - Rutvi Agrawal
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura-Delhi Road, P.O Chhatikara, Mathura, 281001, Uttar Pradesh, India
| | - Himansu Chopra
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura-Delhi Road, P.O Chhatikara, Mathura, 281001, Uttar Pradesh, India
| | - Talever Singh
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura-Delhi Road, P.O Chhatikara, Mathura, 281001, Uttar Pradesh, India
| | - Ramkumar Chaudhary
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura-Delhi Road, P.O Chhatikara, Mathura, 281001, Uttar Pradesh, India
| | - Abhishek Tankara
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura-Delhi Road, P.O Chhatikara, Mathura, 281001, Uttar Pradesh, India
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Tripathi R, Singh N, Agrawal R, Chandra A, Bera R, Asodariya MR. An Analysis of Xpert Test for Diagnosing Maxillofacial Tuberculosis. J Maxillofac Oral Surg 2023; 22:533-537. [PMID: 37534343 PMCID: PMC10390446 DOI: 10.1007/s12663-021-01645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background Maxillofacial tuberculosis is a diagnostic challenge for surgeons. The aim of this study was to present a detailed analysis of Xpert test in diagnosing maxillofacial tuberculosis and to analyse the accuracy of Xpert test results for various tissues of maxillofacial region. Materials and Methods In this cross-sectional study, patients were selected randomly from outpatient department. The patients who had clinical picture and differential diagnosis highly suggestive of maxillofacial tuberculosis were included. Patients were divided into three different groups depending upon the site of involvement. The samples collected from the patients were further subdivided depending upon the type of specimen. Patients were screened first by routine tests, and the negative cases were followed by Xpert test for tuberculosis. Results A total of 54 patients were enrolled in the study, 13 patients were found to be positive for maxillofacial tuberculosis on routine screening tests for tuberculosis, and 41 tested negative on routine test and were evaluated further through Xpert test. Specimens from bone (n12), soft tissue and skin biopsy (n15) and aspirates from lymph nodes (n14) were obtained and tested. Twenty-one samples were found to be positive, and 20 were negative upon Xpert testing. There was a statistically significant difference seen between the test groups (p < 0.01) with higher frequency of negative results in routine test. The p value for various specimens containing pus, biopsies and aspirates was 0.045, 0.023 and 0.067, respectively. Conclusion Xpert test is more accurate when compared to routine test for diagnosing maxillofacial tuberculosis. Although accuracy of Xpert test is better for pus and biopsy samples in the specimens from bone and soft tissue, it gives poor accuracy for aspirated cells. The aspirates from lymph nodes were more susceptible for false negative test.
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Affiliation(s)
| | - Nidhi Singh
- Faculty of Dental Sciences, IMS BHU, Varanasi, India
| | - Rahul Agrawal
- Faculty of Dental Sciences, IMS BHU, Varanasi, India
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Seloma NM, Makgatho ME, Maimela E. Knowledge, attitude and preventative practice of tuberculosis in rural communities of Dikgale, Mamabolo and Mothiba health and demographic surveillance system in Limpopo province, South Africa. BMC Public Health 2023; 23:1687. [PMID: 37658300 PMCID: PMC10472723 DOI: 10.1186/s12889-023-15845-y] [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: 09/07/2022] [Accepted: 05/08/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Tuberculosis continues to be a serious public health issue. To reduce the transmission of the disease, it is imperative to address the major obstacle of inadequate understanding regarding the causes, risk factors, treatments, and prevention of pulmonary TB. The study assessed knowledge, attitude, and preventative practices of tuberculosis among community members in Dikgale, Mamabolo and Mothiba (DIMAMO) Health Demographic Surveillance system, Limpopo Province South Africa. METHODS A cross-sectional clinic-based survey involving 360 participants was conducted at clinics at Dikgale, Mamabolo and Mothiba (DIMAMO) Health and Demographic Surveillance System. A standardised questionnaire on socio-demographic, knowledge, attitude and preventative practices towards tuberculosis based on (WHO) KAP-TB template guidelines was used to collect data. Descriptive statistics on Statistical Package for Social Sciences (SPSS) version 27.0 was used to analyse data. RESULTS The results of the cross-sectional survey on KAP-TB illustrated that the participants have good knowledge, attitude, and perception of TB. Majority of the participants (n = 270, 75%) had good general knowledge, while (n = 90, 25%) had poor knowledge about TB. However, the study reports (n = 57, 15.6%) having knowledge of causative agents of TB. Participants showed a favourable attitude toward people who are infected with TB. 87% showed a favourable attitude while only 12.46% showed an unfavourable attitude towards TB. Participants showed a good practice of (71.7%) while (28.3%) of participants had poor practice towards TB. CONCLUSION Health education interventions programme on TB needs to be intensified among the community members to improve TB awareness and reduce transmission. Focused educational interventions on TB aetiology and mode of transmission are required to increase TB preventative practices and improve health-seeking behaviour among community members.
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Affiliation(s)
- Ngwanamohuba Mologadi Seloma
- Department of Pathology and Medical Sciences, Faculty of Health Sciences, University of Limpopo, Sovenga, South Africa.
| | - Marema Ephraim Makgatho
- Department of Pathology and Medical Sciences, Faculty of Health Sciences, University of Limpopo, Sovenga, South Africa
| | - Eric Maimela
- Department of Public Health and Health Promotion, Faculty of Health Sciences, University of Limpopo, Sovenga, South Africa
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Rath N, Nikam C, Seidel S, Sinha A, Arora VK. Yes, we have the power to end TB! Indian J Tuberc 2023; 70:269-272. [PMID: 37562899 DOI: 10.1016/j.ijtb.2023.06.017] [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: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 08/12/2023]
Abstract
Robust efforts are essential to sustain and increase the advancements made in battling TB, as well as to tackle persistent issues that have caused the fight against the disease to be uneven. The End TB Strategy proposes that new technologies are to be developed by 2025 to encourage a quick growth in TB occurrence diminishment. This calls for a cross-sectoral focus on creating and distributing suitable medical and programmatic modernizations in a fair manner. However, many difficulties and differences still exist in the realms of research and development regarding vaccines, drugs, technical advances, and services related to TB. Therefore, priority needs to be given to overcoming these difficulties and discrepancies for a better future. On World TB Day 2023, SEAR Union, TB Alliance, the National Institute of Advanced Studies (NIAS) and Open Source Pharma Foundation (OSPF) gathered to discuss an important topic under the heading: "YES, WE HAVE THE POWER TO END TB!" With a commitment to putting the patient first and increasing their collective efforts, the organizations recognized that it is possible to make this goal a reality. The organizations involved in the discussion have declared their commitment to engaging in collaborative efforts to end TB globally. They advocate for strengthening access to TB services, controlling and preventing TB, improving surveillance and drug resistance management, and investing in research and development. Furthermore, they recognize the importance of reducing stigma and integrating patient voices in this endeavour. This Round Table serves as a framework to build on and ensure that the goal of ending TB is achievable.
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Affiliation(s)
- Nibedita Rath
- Union Lung Health, South East Asia Region, New Delhi, India; Open Source Pharma Foundation, National Institute of Advanced Studies, Faculty Block, Indian Institute of Science Campus, Bangalore, 560012, India
| | - Chaitali Nikam
- Union Lung Health, South East Asia Region, New Delhi, India; Thyrocare Technologies Limited, Navi Mumbai, 400703, India
| | | | - Anindya Sinha
- National Institute of Advanced Studies, Indian Institute of Science Campus, Bangalore, 560012, India; Institute of Public Health Bengaluru, 3009, II-A Main, 17th Cross, Krishna Rajendra Road, Banashankari Stage II, Bangalore, 560070, India
| | - Vijay Kumar Arora
- Union Lung Health, South East Asia Region, New Delhi, India; The Tuberculosis Association of India, New Delhi, 110001, India.
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Sun Y, Zhang Y, Ma N, Cai S. Rhus chinensis Mill. fruits alleviate liver injury induced by isoniazid and rifampicin through regulating oxidative stress, apoptosis, and bile acid transport. JOURNAL OF ETHNOPHARMACOLOGY 2023; 310:116387. [PMID: 36948265 DOI: 10.1016/j.jep.2023.116387] [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: 06/07/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Rhus chinensis Mill. is a species of the genus Rhus belonging to the family Anacardiaceae. Its fruits used to treat/prevent liver related diseases (e.g., jaundice and hepatitis) in folk medicine. Otherwise, the effects and underlying mechanisms of the fruits on the prevention of isoniazid and rifampicin-caused liver injury have not been investigated. AIM OF THE STUDY To study the preventive effects and mechanisms of the Rhus chinensis Mill. fruits on isoniazid and rifampicin-caused liver injury. MATERIALS AND METHODS This experiment was based on rifampicin (75 mg/kg/day) and isoniazid (75 mg/kg/day)-induced liver damage model to explain the pharmacological effects of Rhus chinensis Mill. fruits. The prevention of the extract from Rhus chinensis Mill. fruits on isoniazid and rifampicin-caused liver injury were evaluated using biochemical parameters, histopathological analysis, and immunofluorescence technique. Apart from that, the potential molecular mechanisms were elucidated by analyzing the expression of such crucial proteins participated in oxidative stress, apoptosis, and bile acid transport. RESULTS The extract from Rhus chinensis Mill. fruits significantly reduced the levels of ALT, AST, TBIL, ALP and MDA. Besides, the extract, especially 800 mg/kg b.w., was remarkably decreased the content of TNF-α,IL-6 and IL-1β, restored the levels of GSH and SOD. The results of Western blot also presented that the extract could activate the Nrf2 protein pathway and inhibit the expression of CYP2E1 to reduce oxidative stress. Meanwhile, the extract significantly up-regulated the expressions of BSEP and Mrp2 to regulate the transport of bile acid, and alleviated the cellular apoptosis via adjusting the expression of Bax and Bcl-2 proteins. CONCLUSIONS Rhus chinensis Mill. fruits can prevent the liver injury induced by isoniazid and rifampicin in mice through adjusting the expressions of multiple proteins in oxidative stress, apoptosis, and bile acid transport pathways. This paper may provide scientific basis for the fruits as a Chinese medicine to prevent/cure liver injury.
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Affiliation(s)
- Yilin Sun
- Faculty of Food Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan Province, 650500, People's Republic of China.
| | - Yuanyue Zhang
- Faculty of Food Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan Province, 650500, People's Republic of China.
| | - Nan Ma
- Faculty of Food Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan Province, 650500, People's Republic of China.
| | - Shengbao Cai
- Faculty of Food Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan Province, 650500, People's Republic of China.
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Debash H, Nega J, Bisetegn H, Tesfaw G, Feleke DG, Ebrahim H, Gedefie A, Tilahun M, Mohammed O, Alemayehu E, Belete MA, Seid A, Shibabaw A. Tuberculosis Treatment Outcomes and Its Predictors among Tuberculosis Patients Registered at Tefera Hailu Memorial General Hospital, Sekota Town, Northeast Ethiopia: A Seven-Year Retrospective Study. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:4212312. [PMID: 36923155 PMCID: PMC10010884 DOI: 10.1155/2023/4212312] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Background Despite the availability of effective medications, tuberculosis (TB) continues to be a serious global public health problem, primarily affecting low and middle-income nations. Measuring and reporting TB treatment outcomes and identifying associated factors are fundamental parts of TB treatment. The goal of this study was to look at the outcomes of TB treatment and the factors that influence them in Sekota, Northeast Ethiopia. Materials and Methods A facility-based retrospective study was conducted in Tefera Hailu Memorial General Hospital, Sekota town, Northeast Ethiopia. All TB patients who registered in the TB log book and had known treatment outcomes at the treatment center between January 1, 2015, and December 30, 2021, were included in this study. The data was gathered utilizing a pretested structured data extraction format that comprised demographic, clinical, and treatment outcome characteristics. Data were entered, cleaned, and analyzed using SPSS version 25. Descriptive statistics and logistic regression analysis were employed. A p value of less than 0.05 was considered statistically significant. Results A total of 552 registered TB patients' data were reviewed. Of these, 49.6% were male, 94.4% were new cases, 64.9% were presented with pulmonary TB, and 18.3% were HIV positive. Regarding the treatment outcome, 11.6% were cured, 82.2% completed their treatment, 1.1% had failed treatment, 1.3% were lost to follow-up, and the remaining 3.8% died during the follow-up. The overall treatment success rate among TB patients was 93.8%. The maximum number of successful treatment outcomes was 94.9% in 2021, while the lowest was 86.7% in 2020. The pattern of successful treatment results changes with the number of years of treatment. In the current study, being a new TB patient (AOR = 1.75, 95% CI: 1.31-7.32) and being an HIV-negative patient (AOR = 2.64, 95% CI: 1.20-5.8) were factors independently associated with a successful treatment outcome. Conclusion The rate of successful TB treatment outcomes in the current study was satisfactory. This achievement should be maintained and enhanced further by developing effective monitoring systems and educating patients about medication adherence.
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Affiliation(s)
- Habtu Debash
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Jemberu Nega
- Department of Medical Laboratory Science, Tefera Hailu Memorial General Hospital, Sekota, Ethiopia
| | - Habtye Bisetegn
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Gebru Tesfaw
- Department of Internal Medicine, School of Medicine, Wollo University, Dessie, Ethiopia
| | - Daniel Getacher Feleke
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hussen Ebrahim
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mihret Tilahun
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ousman Mohammed
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Ashagrie Belete
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abdurahaman Seid
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Agumas Shibabaw
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Baya B, Kone B, Somboro A, Kodio O, Somboro AM, Diarra B, Traore FG, Kone D, Traore MA, Kone M, Togo AG, Sarro YS, Maiga A, Maiga M, Toloba Y, Diallo S, Murphy RL, Doumbia S. Prevalence and Clinical Relevance of Schistosoma mansoni Co-Infection with Mycobacterium tuberculosis: A Systematic Literature Review. OPEN JOURNAL OF EPIDEMIOLOGY 2023; 13:97-111. [PMID: 36910425 PMCID: PMC9997105 DOI: 10.4236/ojepi.2023.131008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Tuberculosis disease stands for the second leading cause of death worldwide after COVID-19, most active tuberculosis cases result from the reactivation of latent TB infection through impairment of immune response. Several factors are known to sustain that process. Schistosoma mansoni, a parasite of the helminth genus that possesses switching power from an immune profile type Th1 to Th2 that favors reactivation of latent TB bacteria. The aim of the study was to assess the prevalence of the co-infection between the two endemic infections. Systematic literature was contacted at the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. Original articles were included, and full texts were reviewed to assess the prevalence and better understand the immunological changes that occur during the co-infection. In total, 3530 original articles were retrieved through database search, 53 were included in the qualitative analysis, and data from 10 were included in the meta-analysis. Prevalence of the co-infection ranged from 4% to 34% in the literature. Most of the articles reported that immunity against infection with helminth parasite and more specifically Schistosoma mansoni infection enhances latent TB reactivation through Th1/Th2. In sum, the impact of Schistosoma mansoni co-infection with Mycobacterium tuberculosis is under-investigated. Understanding the role of this endemic tropical parasite as a contributing factor to TB epidemiology and burden could help integrate its elimination as one of the strategies to achieve the END-TB objectives by the year 2035.
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Affiliation(s)
- Bocar Baya
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,Service of Pneumopthisiology of the University Teaching Hospital of Point G, Bamako, Mali
| | - Bourahima Kone
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Amadou Somboro
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Ousmane Kodio
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Anou Moise Somboro
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bassirou Diarra
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Fah Gaoussou Traore
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Drissa Kone
- Clinical Laboratory of the University Teaching Hospital of Point G, Bamako, Mali
| | - Mama Adama Traore
- Clinical Laboratory of the University Teaching Hospital of Point G, Bamako, Mali
| | - Mahamadou Kone
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Antieme Georges Togo
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Yeya Sadio Sarro
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Almoustapha Maiga
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Mamoudou Maiga
- Clinical Laboratory of the University Teaching Hospital of Point G, Bamako, Mali.,Havey Institute for Global Health (Havey IGH), Northwestern University (NU), Chicago, USA
| | - Yacouba Toloba
- Service of Pneumopthisiology of the University Teaching Hospital of Point G, Bamako, Mali
| | - Souleymane Diallo
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Robert L Murphy
- Havey Institute for Global Health (Havey IGH), Northwestern University (NU), Chicago, USA
| | - Seydou Doumbia
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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Takhar R, Saran R, Saran S, Maan L, Bainara M, Purohit G. Radiographic manifestations of tuberculosis in HIV-co-infected patients and correlation of the findings with CD4 counts. SAUDI JOURNAL FOR HEALTH SCIENCES 2023. [DOI: 10.4103/sjhs.sjhs_76_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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18
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Bakare AA, Moses VY, Beckely CT, Oluyemi TI, Ogunfeitimi GO, Adelaja AA, Ayorinde GT, Gbadebo AM, Fagbenro OS, Ogunsuyi OI, Ogunsuyi OM, Ige OM. The first-line antituberculosis drugs, and their fixed-dose combination induced abnormal sperm morphology and histological lesions in the testicular cells of male mice. Front Cell Dev Biol 2022; 10:1023413. [PMID: 36582470 PMCID: PMC9793334 DOI: 10.3389/fcell.2022.1023413] [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: 08/19/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Rifampicin (RIF), Isoniazid (INH), Ethambutol (EMB), Pyrazinamide (PZA), and/or their fixed-dose combination (FDC) are extensively prescribed in the cure of Tuberculosis (TB) globally. In spite of the beneficial effect, these drugs are capable of inducing cellular toxicity. Existing information on the genotoxic effects of the first-line anti-TB drugs is limited and contentious. Herein, we evaluated the reproductive genotoxicity of RIF, INH, EMB, PZA, and their FDC utilizing the mouse sperm morphology assay. Histological examination of the testes of exposed mice was also performed. Male Swiss albino mice (11-13 weeks old) were intraperitoneally exposed for 5 consecutive days to each of the anti-TB drugs at four different doses of 6.25, 12.5, 25, and 50 mg/kg bw of PZA; 2.5, 5.0, 10, and 20 mg/kg bw of RIF; 1.25, 2.5, 5.0 and 10 mg/kg bw of INH; 3.75, 7.5, 15 and 30 mg/kg bw of EMB; and 7, 14, 28 and 56 mg/kg bw of FDC corresponding respectively to ×0.25, ×0.5, ×1 and ×2.0 of the standard daily dose. In comparison with the negative control (normal saline), there was no significant difference in the testicular weight and organo-somatic index of exposed mice. There was an increase (p > 0.05) in the frequency of abnormal spermatozoa at most of the tested doses of each drug and a dose-dependent decrease with the FDC. Each of the anti-TB drugs except the FDC induced pathological lesions in the testes. These findings suggest that the individual first-line anti-TB drug unlike the FDC has the potential to provoke testicular anomalies in male mice.
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Affiliation(s)
- Adekunle A. Bakare
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria,*Correspondence: Adekunle A. Bakare, ,
| | - Victoria Y. Moses
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Charles T. Beckely
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Toluwani I. Oluyemi
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Gift O. Ogunfeitimi
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Aduragbemi A. Adelaja
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Glory T. Ayorinde
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | | | - Olukunle S. Fagbenro
- Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Olusegun I. Ogunsuyi
- Department of Biological Sciences, College of Basic and Applied Sciences, Mountain Top University, Ibafo, Ogun State, Nigeria
| | - Opeoluwa M. Ogunsuyi
- Department of Cell Biology and Genetics, University of Lagos, Akoka, Lagos State, Nigeria
| | - Olusoji Mayowa Ige
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Assessment of Knowledge, Attitudes, and Practices (KAP): Public Health and Economic Burden of Tuberculosis in Jarso District of West Wollega Zone, Oromia, Western Ethiopia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3314725. [DOI: 10.1155/2022/3314725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/02/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
Tuberculosis is a communicable mycobacterial disease of humans and animals caused by members of Mycobacterium tuberculosis complex, highly impacting the public health and economy of the country in endemic areas. Retrospective and cross-sectional study was conducted between March and August 2021. For knowledge, attitude, and practices study, five villages were randomly selected using simple random sampling. To quantify the public health burden, one-year data were collected from Jarso Health Center, and unregistered patients were identified using snowball method, and the estimation was based on disability-adjusted life years. Younger age groups (18-40 years) had shown 105.8 times more odds of knowledge towards tuberculosis than the older (>60 years). Moreover, tertiary levels of education had 9395.1 times more odds of knowledge towards tuberculosis compared to illiterates. The estimated economic burden was 7,731.25US$. Of the 51 tuberculosis patients, two died from the disease, resulting in 45.03 disability-adjusted life years. Communities of the study district were heard about tuberculosis, however, unaware of the cause and sources of the infection. Therefore, further strategic and continuous community-based health education and awareness should be given for effective control and prevention of tuberculosis in the study area.
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Shah PT, Tufail M, Wu C, Xing L. THP-1 cell line model for tuberculosis: A platform for in vitro macrophage manipulation. Tuberculosis (Edinb) 2022; 136:102243. [PMID: 35963145 DOI: 10.1016/j.tube.2022.102243] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/20/2022] [Accepted: 07/31/2022] [Indexed: 11/18/2022]
Abstract
Macrophages are large mononuclear phagocytic cells that play a vital role in the immune response. They are present in all body tissues with extremely heterogeneous and plastic phenotypes that adapt to the organs and tissues in which they live and respond in the first-line against invading microorganisms. Tuberculosis (TB) is caused by the pathogenic bacteria Mycobacterium tuberculosis (Mtb), which is among the top 10 global infectious agents and the leading cause of mortality, ranking above human immunodeficiency virus (HIV), as a single infectious agent. Macrophages, upon Mtb infection, not only phagocytose the bacteria and present the antigens to T-cells, but also react rapidly by developing antimycobacterial immune response depending highly on the production of cytokines. However, Mtb is also capable of intracellular survival in instances of sub-optimal activation of macrophages. Hence, several systems have been established to evaluate the Mtb-macrophage interaction, where the THP-1 monocytes have been developed as an attractive model for in vitro polarized monocyte-derived macrophages. This model is extensively used for Mtb as well as other intracellular bacterial studies. Herein, we have summarized the updated implications of the THP-1 model for TB-related studies and discussed the pros and cons compared to other cell models of TB.
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Affiliation(s)
- Pir Tariq Shah
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, Shanxi province, China
| | - Muhammad Tufail
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, Shanxi province, China
| | - Changxin Wu
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, Shanxi province, China; The Key Laboratory of Medical Molecular Cell Biology of Shanxi Province, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, China; Shanxi Provincial Key Laboratory for Prevention and Treatment of Major Infectious Diseases, 92 Wucheng Road, Taiyuan, 030006, China
| | - Li Xing
- Institutes of Biomedical Sciences, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, Shanxi province, China; The Key Laboratory of Medical Molecular Cell Biology of Shanxi Province, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, China; Shanxi Provincial Key Laboratory for Prevention and Treatment of Major Infectious Diseases, 92 Wucheng Road, Taiyuan, 030006, China.
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Fan J, An J, Shu W, Tang K, Shang Y, Xue Y, Qin S, Pang Y. Impact of Xpert MTB/RIF on Outcomes of Adults Hospitalized With Spinal Tuberculosis: Findings From a Comparative Cohort in Beijing, China. Front Public Health 2022; 10:901504. [PMID: 35784201 PMCID: PMC9247639 DOI: 10.3389/fpubh.2022.901504] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSpinal tuberculosis (TB) is one of the most common forms of extrapulmonary tuberculosis, causing increased morbidity and lifelong disabilities. Here, we conducted a retrospective study to determine the impact on patient outcomes of the Xpert MTB/RIF test vs. phenotypical drug susceptibility testing for spinal TB.MethodsIn-patients with spinal TB were enrolled in 2013 and 2017 at Beijing Chest Hospital. Data were collected from an electronic patient record system that documented demographic and clinical characteristics. All the patients were routinely followed-up at 1, 3, 6, 9, and 12 months after surgery during outpatient treatment.ResultsA total of 361 patients affected by spinal TB were enrolled in our analysis, including 178 patients in 2013 and 183 patients in 2017. In 2013, the cumulative postoperative recurrence rate of patients with spinal TB was 23% (41/178), which was significantly higher than that in 2017 (8.2%, 15/183, P < 0.001). Additionally, the patients with spinal TB diagnosed in 2013 relapsed significantly sooner than those in 2017 (P < 0.001). In the multivariate analysis, rifampicin (RIF) resistance was associated with the recurrence of spinal TB. The turnaround time of Xpert ranged from 1 to 3 days, with a median of 1 day (IQR: 1–2). For the phenotypic drug susceptibility test (pDST)-based algorithm, the median turnaround time was 67 days, considerably longer than that of the Xpert-based algorithm (P < 0.001).ConclusionThe RIF resistance is an independent risk factor for postoperative recurrence in patients with spinal TB. Early detection of RIF resistance due to the application of Xpert is an effective strategy to reduce spinal TB recurrence.
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Affiliation(s)
- Jun Fan
- Orthopaedics Department, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Jun An
- Medical Records Department, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Wei Shu
- Clinical Center on TB Control, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Kai Tang
- Orthopaedics Department, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Yuanyuan Shang
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Yi Xue
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Shibing Qin
- Orthopaedics Department, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
| | - Yu Pang
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, China
- *Correspondence: Yu Pang
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22
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Gairola A, Benjamin A, Weatherston JD, Cirillo JD, Wu HJ. Recent Developments in Drug Delivery for Treatment of Tuberculosis by Targeting Macrophages. ADVANCED THERAPEUTICS 2022; 5:2100193. [PMID: 36203881 PMCID: PMC9531895 DOI: 10.1002/adtp.202100193] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Indexed: 11/10/2022]
Abstract
Tuberculosis (TB) is among the greatest public health and safety concerns in the 21st century, Mycobacterium tuberculosis, which causes TB, infects alveolar macrophages and uses these cells as one of its primary sites of replication. The current TB treatment regimen, which consist of chemotherapy involving a combination of 3-4 antimicrobials for a duration of 6-12 months, is marked with significant side effects, toxicity, and poor compliance. Targeted drug delivery offers a strategy that could overcome many of the problems of current TB treatment by specifically targeting infected macrophages. Recent advances in nanotechnology and material science have opened an avenue to explore drug carriers that actively and passively target macrophages. This approach can increase the drug penetration into macrophages by using ligands on the nanocarrier that interact with specific receptors for macrophages. This review encompasses the recent development of drug carriers specifically targeting macrophages actively and passively. Future directions and challenges associated with development of effective TB treatment is also discussed.
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Affiliation(s)
- Anirudh Gairola
- Department of Chemical Engineering, Texas A&M University, College Station, Texas, USA
| | - Aaron Benjamin
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, Texas, USA
| | - Joshua D Weatherston
- Department of Chemical Engineering, Texas A&M University, College Station, Texas, USA
| | - Jeffrey D Cirillo
- Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, Texas, USA
| | - Hung-Jen Wu
- Department of Chemical Engineering, Texas A&M University, College Station, Texas, USA
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Pi J, Zhang Z, Yang E, Chen L, Zeng L, Chen Y, Wang R, Huang D, Fan S, Lin W, Shen H, Xu JF, Zeng G, Shen L. Nanocages engineered from Bacillus Calmette-Guerin facilitate protective Vγ2Vδ2 T cell immunity against Mycobacterium tuberculosis infection. J Nanobiotechnology 2022; 20:36. [PMID: 35033108 PMCID: PMC8760571 DOI: 10.1186/s12951-021-01234-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/29/2021] [Indexed: 12/12/2022] Open
Abstract
Tuberculosis (TB), induced by Mycobacterium tuberculosis (Mtb) infection, remains a top killer among infectious diseases. While Bacillus Calmette-Guerin (BCG) is the sole TB vaccine, the clumped-clustered features of BCG in intradermal immunization appear to limit both the BCG protection efficacy and the BCG vaccination safety. We hypothesize that engineering of clumped-clustered BCG into nanoscale particles would improve safety and also facilitate the antigen-presenting-cell (APC)’s uptake and the following processing/presentation for better anti-TB protective immunity. Here, we engineered BCG protoplasts into nanoscale membraned BCG particles, termed as “BCG-Nanocage” to enhance the anti-TB vaccination efficiency and safety. BCG-Nanocage could readily be ingested/taken by APC macrophages selectively; BCG-Nanocage-ingested macrophages exhibited better viability and developed similar antimicrobial responses with BCG-infected macrophages. BCG-Nanocage, like live BCG bacilli, exhibited the robust capability to activate and expand innate-like T effector cell populations of Vγ2+ T, CD4+ T and CD8+ T cells of rhesus macaques in the ex vivo PBMC culture. BCG-Nanocage immunization of rhesus macaques elicited similar or stronger memory-like immune responses of Vγ2Vδ2 T cells, as well as Vγ2Vδ2 T and CD4+/CD8+ T effectors compared to live BCG vaccination. BCG-Nanocage- immunized macaques developed rapidly-sustained pulmonary responses of Vγ2Vδ2 T cells upon Mtb challenge. Furthermore, BCG- and BCG-Nanocage- immunized macaques, but not saline controls, exhibited undetectable Mtb infection loads or TB lesions in the Mtb-challenged lung lobe and hilar lymph node at endpoint after challenge. Thus, the current study well justifies a large pre-clinical investigation to assess BCG-Nanocage for safe and efficacious anti-TB vaccination, which is expected to further develop novel vaccines or adjuvants. ![]()
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Affiliation(s)
- Jiang Pi
- Department of Clinical Immunology, Institute of Laboratory Medicine, School of Medical Technology, The First Dongguan Affiliated Hospital, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China. .,Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, 60612, USA.
| | - Zhiyi Zhang
- Department of Microbiology, Zhongshan School of Medicine, Key Laboratory for Tropical Diseases Control of the Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Enzhuo Yang
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, 60612, USA.,Clinic and Research Center of Tuberculosis, Shanghai Key Lab of Tuberculosis, Shanghai Pulmonary Hospital, Institute for Advanced Study, Tongji University School of Medicine, Shanghai, China
| | - Lingming Chen
- Department of Microbiology, Zhongshan School of Medicine, Key Laboratory for Tropical Diseases Control of the Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Lingchan Zeng
- Clinical Research Center, Department of Medical Records Management, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Yiwei Chen
- Department of Microbiology, Zhongshan School of Medicine, Key Laboratory for Tropical Diseases Control of the Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Richard Wang
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Dan Huang
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Shuhao Fan
- Department of Clinical Immunology, Institute of Laboratory Medicine, School of Medical Technology, The First Dongguan Affiliated Hospital, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China
| | - Wensen Lin
- Department of Clinical Immunology, Institute of Laboratory Medicine, School of Medical Technology, The First Dongguan Affiliated Hospital, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China
| | - Hongbo Shen
- Clinic and Research Center of Tuberculosis, Shanghai Key Lab of Tuberculosis, Shanghai Pulmonary Hospital, Institute for Advanced Study, Tongji University School of Medicine, Shanghai, China
| | - Jun-Fa Xu
- Department of Clinical Immunology, Institute of Laboratory Medicine, School of Medical Technology, The First Dongguan Affiliated Hospital, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, 523808, China.
| | - Gucheng Zeng
- Department of Microbiology, Zhongshan School of Medicine, Key Laboratory for Tropical Diseases Control of the Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
| | - Ling Shen
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, 60612, USA.
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Haque M, Mohd Izham M, A Rahman N. Knowledge, attitude and practices related to tuberculosis among students in a public university in East Coast Malaysia. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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25
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Haque M, Chowdhury K. Childhood tuberculosis - An emerging health challenge for Bangladesh. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_171_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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González-Duran JA, Plaza RV, Luna L, Arbeláez MP, Deviaene M, Keynan Y, Rueda ZV, Marin D. Delayed HIV treatment, barriers in access to care and mortality in tuberculosis/HIV co-infected patients in Cali, Colombia. Colomb Med (Cali) 2021; 52:e2024875. [PMID: 35571589 PMCID: PMC9067911 DOI: 10.25100/cm.v52i3.4875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/29/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine factors associated with mortality in tuberculosis/HIV co-infected patients in Cali, Colombia. METHODS This retrospective cohort design included tuberculosis/HIV co-infected persons. Kaplan-Meier and Cox regression were used to estimate survival and risk factors associated with mortality. RESULTS Of the 279 tuberculosis/HIV co-infected participants, 27.2% died during the study. Participants mainly were adults and males. CD4 count information was available for 41.6% (the median count was 83 cells/mm3), and half were subject to tuberculosis susceptibility testing. The median time between HIV diagnosis and antiretroviral therapy initiation was 372 days. HIV was identified prior to tuberculosis in 53% and concurrent HIV-tuberculosis were diagnosed in 37% of patients. 44.8% had tuberculosis treatment success. Body mass index above 18 kg/m2, initiation of tuberculosis treatment within two weeks, having any health insurance coverage and CD4 count information conferred a survival advantage. CONCLUSIONS Delays in treatment initiation and factors associated with limited health care access or utilization were associated with mortality. As HIV and tuberculosis are both reportable conditions in Colombia, strategies should be focused on optimizing treatment outcomes within both tuberculosis and HIV programs, particularly improving early HIV diagnosis, early antiretroviral therapy treatment initiation, and adherence to tuberculosis treatment.
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Affiliation(s)
| | - Regina V Plaza
- Universidad del Cauca, Facultad de Ciencias de la Salud, Popayán, Colombia
| | - Lucy Luna
- Secretaría de Salud de Cali, Programa de tuberculosis, Cali, Colombia
| | | | - Meagan Deviaene
- University of Manitoba, Department of Medical Microbiology and Infectious Diseases, Winnipeg, Manitoba, Canada
| | - Yoav Keynan
- University of Manitoba, Department of Medical Microbiology and Infectious Diseases, Winnipeg, Manitoba, Canada
| | - Zulma Vanessa Rueda
- University of Manitoba, Department of Medical Microbiology and Infectious Diseases, Winnipeg, Manitoba, Canada
| | - Diana Marin
- Universidad Pontificia Bolivariana, School of Medicine, Medellín, Colombia
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Ejaz T, Malik MI, Ahmed J, Azam R, Jamal Y, Saadia S. Clinico-radiological and bronchoscopic predictors of microbiological yield in sputum negative tuberculosis in Pakistan. Monaldi Arch Chest Dis 2021; 92. [PMID: 34873901 DOI: 10.4081/monaldi.2021.1976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/05/2021] [Indexed: 11/23/2022] Open
Abstract
To determine association of clinico-radiological factors and radiological activity with diagnostic yield in sputum-smear negative tuberculosis (TB). Prospective observational study in Military Hospital Rawalpindi from July to December 2018. Adult patients having no contraindications to bronchoscopy were included. HIV positive patients and those on anti-tuberculosis therapy for more than one week were excluded. High-Resolution Computed tomography (HRCT) findings were classified based on active and inactive tuberculosis features. Washings were sent for Acid-Fast Bacillus (AFB) smear, GeneXpert assay and cultures. Out of 215 patients, 42.3% (91) were diagnosed with microbiological or histological evidence of TB. On univariate analysis, cavitation (p-value <0.001), soft-tissue nodules (p-value 0.04), and endobronchial mucosal changes (p-value 0.02) were associated with culture positivity. Presence of cavitation (OR= 4.10; CI= 2.18,7.73; p-value<0.001) was the only independent predictor of microbiological yield. Diagnostic yield was 70%, 50%, 12.5% and 8.6% in patients with definitely active, probably active, indeterminate and inactive tuberculosis HRCT features respectively. Sensitivity, specificity, positive predictive value and negative predictive value of HRCT active TB were 95.38% (95% CI 87.10 -99.04), 48.00 % (95% CI 39.78 -56.30), 44.29% (95% CI 40.31 -48.33), 96.00 % (95%CI 88.70 -98.66) respectively. There was no significant association between age groups, smoking status and gender with diagnosis of tuberculosis in our study. Radiological activity and certain visualized bronchoscopic changes were associated with good diagnostic performance and can be used as predictive factors in diagnosis of active smear negative tuberculosis.
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Affiliation(s)
- Taymmia Ejaz
- Department of Medicine, Aga Khan University Hospital, Karachi.
| | - Mahmood Iqbal Malik
- Department of Pulmonology, Pak Emirates Military Hospital, National University of Medical Sciences, Rawalpindi.
| | - Jamal Ahmed
- Department of Pulmonology, Pak Emirates Military Hospital, National University of Medical Sciences, Rawalpindi.
| | - Rizwan Azam
- Department of Pulmonology, Pak Emirates Military Hospital, National University of Medical Sciences, Rawalpindi.
| | - Yousaf Jamal
- Department of Pulmonology, Pak Emirates Military Hospital, National University of Medical Sciences, Rawalpindi.
| | - Sheema Saadia
- Department of Medicine, Aga Khan University Hospital, Karachi.
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Dharmadji HP, Suwarsa O, Sutedja E, Pangastuti M, Gunawan H, Makarti K. Erythema Induratum of Bazin Accompanied by Atrophy of the Subcutaneous Fat. Int Med Case Rep J 2021; 14:777-781. [PMID: 34815719 PMCID: PMC8604635 DOI: 10.2147/imcrj.s336088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022] Open
Abstract
Erythema induratum of Bazin (EIB) is a predominantly lobular panniculitis with or without vasculitis due to Mycobacterium tuberculosis (MTB) infection. Atrophic scars may remain after EIB was healed. Rare cases of EIB showing sharp skin depression may mimic deep morphea and lupus profundus. A rare case of EIB was reported in a 35-year-old female with slightly tender erythematous-violaceous nodules and hyperpigmented depressed scars on both lower legs, resulting in asymmetrical lower leg shape. Histopathological examination showed lobular panniculitis without vasculitis and granulomatous inflammation consisted of caseous necrosis, epithelioid cells, and multinucleated giant cells. Polymerase chain reaction (PCR) from skin biopsy revealed deoxyribonucleic acid (DNA) of MTB. Tuberculin skin test (TST) was positive with a 20-mm induration, and nuclear 99mTc-ethambutol scintigraphy was positive for tuberculosis infection in one-third distal portion of the left lower leg. Clinical improvements were shown after 6 months of antituberculosis therapy. EIB must be considered in patient with erythematous-violaceous nodules on lower leg, especially in endemic areas of tuberculosis infection since diagnosis can be difficult and occasionally, deceptive.
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Affiliation(s)
- Hartati Purbo Dharmadji
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Oki Suwarsa
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Endang Sutedja
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Miranti Pangastuti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Hendra Gunawan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Kristina Makarti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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Baatjies L, Loxton AG, Williams MJ. Host and Bacterial Iron Homeostasis, an Underexplored Area in Tuberculosis Biomarker Research. Front Immunol 2021; 12:742059. [PMID: 34777355 PMCID: PMC8586213 DOI: 10.3389/fimmu.2021.742059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/14/2021] [Indexed: 01/10/2023] Open
Abstract
Mycobacterium tuberculosis (Mtb) "a human adapted pathogen" has found multiple ways to manipulate the host immune response during infection. The human immune response to Mtb infection is a highly complex cascade of reactions, with macrophages as preferred intracellular location. Interaction with the host through infection gives rise to expression of specific gene products for survival and multiplication within the host. The signals that the pathogens encounter during infection cause them to selectively express genes in response to signals. One strategy to identify Mtb antigens with diagnostic potential is to identify genes that are specifically induced during infection or in specific disease stages. The shortcomings of current immunodiagnostics include the failure to detect progression from latent infection to active tuberculosis disease, and the inability to monitor treatment efficacy. This highlights the need for new tuberculosis biomarkers. These biomarkers should be highly sensitive and specific diagnosing TB infection, specifically distinguishing between latent infection and active disease. The regulation of iron levels by the host plays a crucial role in the susceptibility and outcome of Mtb infection. Of interest are the siderophore biosynthetic genes, encoded by the mbt-1 and mbt-2 loci and the SUF (mobilization of sulphur) operon (sufR-sufB-sufD-sufC-csd-nifU-sufT), which encodes the primary iron-sulphur cluster biogenesis system. These genes are induced during iron limitation and intracellular growth of Mtb, pointing to their importance during infection.
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Affiliation(s)
- Lucinda Baatjies
- Department of Science and Innovation (DSI)-National Research Foundation (NRF) Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Andre G. Loxton
- Department of Science and Innovation (DSI)-National Research Foundation (NRF) Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Monique J. Williams
- Department of Science and Innovation (DSI)-National Research Foundation (NRF) Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
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Variation of tuberculosis prevalence across diagnostic approaches and geographical areas of Indonesia. PLoS One 2021; 16:e0258809. [PMID: 34653233 PMCID: PMC8519455 DOI: 10.1371/journal.pone.0258809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 10/05/2021] [Indexed: 12/01/2022] Open
Abstract
Background Tuberculosis (TB) has contributed to a significant disease burden and economic loss worldwide. Given no gold standard for diagnosis, early identification of TB infection has been challenging. This study aimed to comparatively investigate the prevalence of TB across diagnostic approaches (sputum AFB, sputum culture, sputum genetic test, and chest x-ray) and geographical areas of Indonesia. Methods Participant demographic variables and TB screening test results were obtained from the Tuberculosis Unit, Health Research and Development Agency, Ministry of Health (HRDA-MoH). The prevalence of pulmonary TB in populations aged 15 years and over was calculated using TB cases as a numerator and populations aged 15 years and over as a denominator. Variations across geographical areas and diagnostic approaches were expressed as prevalence and 95% confidence interval (CI). Results A total of 67,944 records were reviewed. Based on bacteriological evidence, the prevalence of TB per 100,000 in Indonesia was 759 (95% CI: 589.7–960.8) with variations across areas: 913 (95% CI 696.7–1,176.7; Sumatra), 593 (95% CI 447.2–770.6; Java-Bali), and 842 (95% CI 634.7–1,091.8; other islands). Also, the prevalence of TB varied across diagnostic approaches: 256.5 (sputum AFB), 545 (sputum culture), 752.2 (chest x-ray), and 894.9 (sputum genetic test). Based on sputum AFB, the TB prevalence varied from 216.6 (95% CI 146.5–286.8; Java-Bali), 259.9 (95% CI 184.2–335.6; other islands) to 307.4 (95% CI 208.3–406.5; Sumatra). Based on sputum culture, the TB prevalence ranged from 487.9 (95% CI 433.6–548.6; Java-Bali), 635.9 (95% CI 564.9–715.1; Sumatra), to 2,129.8 (95% CI 1,664.0–2,735.6; other islands). Based on chest x-ray, the TB prevalence varied from 152.1 (95% CI 147.9–156.3; Java-Bali), 159.2 (95% CI 154.1–164.3; Sumatra), to 864 (95% CI 809–921.4; other islands). Based on sputum genetic test, the TB prevalence ranged from 838.7 (95% CI 748.4–900.8; Java-Bali), 875 (95% CI 775.4–934.2; Sumatra), to 941.2 (95% CI 663.6–992.3; other islands). Conclusions The variation of TB prevalence across geographical regions could be confounded by the diagnostic approaches. Trial registration This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No. 684/63).
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Goscé L, Abou Jaoude GJ, Kedziora DJ, Benedikt C, Hussain A, Jarvis S, Skrahina A, Klimuk D, Hurevich H, Zhao F, Fraser-Hurt N, Cheikh N, Gorgens M, Wilson DJ, Abeysuriya R, Martin-Hughes R, Kelly SL, Roberts A, Stuart RM, Palmer T, Panovska-Griffiths J, Kerr CC, Wilson DP, Haghparast-Bidgoli H, Skordis J, Abubakar I. Optima TB: A tool to help optimally allocate tuberculosis spending. PLoS Comput Biol 2021; 17:e1009255. [PMID: 34570767 PMCID: PMC8496838 DOI: 10.1371/journal.pcbi.1009255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 10/07/2021] [Accepted: 07/07/2021] [Indexed: 12/02/2022] Open
Abstract
Approximately 85% of tuberculosis (TB) related deaths occur in low- and middle-income countries where health resources are scarce. Effective priority setting is required to maximise the impact of limited budgets. The Optima TB tool has been developed to support analytical capacity and inform evidence-based priority setting processes for TB health benefits package design. This paper outlines the Optima TB framework and how it was applied in Belarus, an upper-middle income country in Eastern Europe with a relatively high burden of TB. Optima TB is a population-based disease transmission model, with programmatic cost functions and an optimisation algorithm. Modelled populations include age-differentiated general populations and higher-risk populations such as people living with HIV. Populations and prospective interventions are defined in consultation with local stakeholders. In partnership with the latter, demographic, epidemiological, programmatic, as well as cost and spending data for these populations and interventions are then collated. An optimisation analysis of TB spending was conducted in Belarus, using program objectives and constraints defined in collaboration with local stakeholders, which included experts, decision makers, funders and organisations involved in service delivery, support and technical assistance. These analyses show that it is possible to improve health impact by redistributing current TB spending in Belarus. Specifically, shifting funding from inpatient- to outpatient-focused care models, and from mass screening to active case finding strategies, could reduce TB prevalence and mortality by up to 45% and 50%, respectively, by 2035. In addition, an optimised allocation of TB spending could lead to a reduction in drug-resistant TB infections by 40% over this period. This would support progress towards national TB targets without additional financial resources. The case study in Belarus demonstrates how reallocations of spending across existing and new interventions could have a substantial impact on TB outcomes. This highlights the potential for Optima TB and similar modelling tools to support evidence-based priority setting. Tuberculosis (TB) remains a leading global cause of death and morbidity, and 85% of deaths occur in countries where resources for TB care and control are limited. Many countries cannot finance all TB interventions or technologies, which means difficult decisions on what to prioritise and publically finance. Modelling tools can help decision-makers set priorities based on evidence, in a systematic and transparent way. This study presents Optima TB, a tool that estimates which allocations of spending across interventions will most likely maximise specified objectives—such as minimising TB deaths, prevalence and incidence. In partnership with local decision-makers and stakeholders, Optima TB was applied in Belarus. Recommendations from the model findings include focussing investment on outpatient rather than inpatient care and actively finding people with TB (e.g. through contact tracing) rather than mass testing of the population. The recommended reallocations of spending could reduce TB prevalence and deaths by up to 45% and 50%, respectively, by 2035 for the same amount of spending. Key stakeholders were engaged throughout the analysis and findings and uncertainty around the results were clearly communicated with decision-makers. The timeliness of the results helped inform national dialogue on TB care reform, among other key policy discussions.
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Affiliation(s)
- Lara Goscé
- University College London, London, United Kingdom
- * E-mail:
| | | | | | - Clemens Benedikt
- World Bank, Washington, District of Columbia, United States of America
| | | | | | - Alena Skrahina
- The Republican Scientific and Practice Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Dzmitry Klimuk
- The Republican Scientific and Practice Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Henadz Hurevich
- The Republican Scientific and Practice Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Feng Zhao
- World Bank, Washington, District of Columbia, United States of America
| | | | - Nejma Cheikh
- World Bank, Washington, District of Columbia, United States of America
| | - Marelize Gorgens
- World Bank, Washington, District of Columbia, United States of America
| | - David J. Wilson
- World Bank, Washington, District of Columbia, United States of America
| | | | | | | | | | - Robyn M. Stuart
- Burnet Institute, Melbourne, Australia
- University of Copenhagen, Copenhagen, Denmark
| | - Tom Palmer
- University College London, London, United Kingdom
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Velleca M, Malekinejad M, Miller C, Abascal Miguel L, Reeves H, Hopewell P, Fair E. The yield of tuberculosis contact investigation in low- and middle-income settings: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:1011. [PMID: 34579667 PMCID: PMC8474777 DOI: 10.1186/s12879-021-06609-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/17/2021] [Indexed: 02/08/2023] Open
Abstract
Background Contact investigation, the systematic evaluation of individuals in close contact with an infectious tuberculosis (TB) patient, is a key active case-finding strategy for global TB control. Better estimates of the yield of contact investigation can guide strategies to reduce the number of underreported and underdiagnosed TB cases, approximately three million cases per year globally. A systematic review (Prospero ID # CRD42019133380) and meta-analysis was conducted to update and enhance the estimates of the yield of TB contact investigation in low- and middle-income countries (LMIC). Pubmed, Web of Science, Embase and the WHO Global Index Medicus were searched for peer-reviewed studies (published between January 2006–April 2019); studies reporting the number of active TB or latent tuberculosis infection (LTBI) found through contact investigation were included. Pooled data were meta-analyzed using a random effects model and risk of bias was assessed. Results Of 1,644 unique citations obtained from database searches, 110 studies met eligibility criteria for descriptive data synthesis and 95 for meta-analysis. The pooled yields of contact investigation activities for different outcomes were: secondary cases of all active TB (defined as those bacteriologically confirmed or clinically diagnosed) 2.87% (2.61–3.14, I2 97.79%), bacteriologically confirmed active TB 2.04% (1.77–2.31, I2 98.06%), and LTBI 43.83% (38.11–49.55, I2 99.36%). Yields are interpreted as the percent of contacts screened who are diagnosed with active TB as a result of TB contact investigation activities. Pooled estimates were substantially heterogenous (I2 ≥ 75%). Conclusions This study provides methodologically rigorous and up-to-date estimates for the yield of TB contact investigation activities in low- and middle-income countries (LMIC). While the data are heterogenous, these findings can inform strategic and programmatic planning for scale up of TB contact investigation activities.
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Affiliation(s)
- Mariana Velleca
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Mohsen Malekinejad
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Cecily Miller
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA.,Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland
| | - Lucia Abascal Miguel
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Hailey Reeves
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Philip Hopewell
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Elizabeth Fair
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, CA, USA. .,Institute for Global Health Sciences, University of California, San Francisco, CA, USA.
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Incidence and risk factors of postoperative complications in patients with tuberculosis-destroyed lung. BMC Pulm Med 2021; 21:273. [PMID: 34419012 PMCID: PMC8380317 DOI: 10.1186/s12890-021-01641-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to determine risk factors of postoperative complications in tuberculosis-destroyed lung (TDL) patients. Methods We retrospectively analyzed the data from all consecutive TDL patients undergoing surgical treatment at the Beijing Chest Hospital from January 2001 to September 2019. Results Of 113 TDL cases experiencing surgery, 33 (29.2%) experienced postoperative complications. The patients with low BMI were more likely to have postoperative complications compared to those with normal BMI, whereas a significant lower rate of postoperative complications was noted in patients with BMI ≥ 25 kg/m2. In addition, significant increased risk was observed in patients with smoking history. We found that the patients with underlying infection, including aspergillus and nontuberculous mycobacteria (NTM), had significantly higher odds of having postoperative complications compared with those without underlying infection. The anaemia was another important independent factor associated with postoperative complication. Patients with blood transfusion above 1000 mL had a strongly increased frequency of postoperative complications than patients with blood transfusion below 1000 mL. Conclusion In conclusion, our data demonstrate that approximate one third of TDL patients experience postoperative complications in our cohort. Patients with low BMI, anaemia, tobacco smoking, and coinfected aspergillus or NTM are at markedly higher risk to experience postoperative complications after pneumonectomy.
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Soe PT, Hanthamrongwit J, Saelee C, Kyaw SP, Khaenam P, Warit S, Satproedprai N, Mahasirimongkol S, Yanai H, Chootong P, Leepiyasakulchai C. Circulating IgA/IgG memory B cells against Mycobacterium tuberculosis dormancy-associated antigens Rv2659c and Rv3128c in active and latent tuberculosis. Int J Infect Dis 2021; 110:75-82. [PMID: 34284090 DOI: 10.1016/j.ijid.2021.07.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To elucidate the antigenic potential of dormancy-associated antigens Rv2659c and Rv3128c of Mycobacterium tuberculosis by examining the persistence of specific IgG and IgA memory B cells (MBCs) among patients with active tuberculosis (TB), household contacts with latent tuberculosis (LTBI), and an endemic healthy control group. METHODS Fresh peripheral blood mononuclear cells from the three study groups were used to enumerate the numbers of IgG and IgA MBCs specific to recombinant protein Rv2659c and Rv3128c by ELISpot assay. The composition of MBC subsets IgA+ and IgG + was analyzed by flow cytometry. RESULTS The number of IgA MBCs specific to antigen Rv2659c was significantly higher in the LTBI group than the TB group. In contrast, no significant difference was found in IgA or IgG MBCs against antigen Rv3128c. The number of IgA+ MBCs was significantly higher than that of IgG+ MBCs in the classical MBC subset of the LTBI group. CONCLUSION The results indicated that the dormancy-associated antigen Rv2659c induced an IgA MBCs response in individuals with latent TB, and IgA+ classical MBCs formed a major portion of the MBCs subset. This new knowledge will be beneficial for the development of novel TB vaccines and their control of latent TB.
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Affiliation(s)
- Phyu Thwe Soe
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand; Department of Medical Laboratory Technology, University of Medical Technology, Mandalay, Myanmar
| | - Jariya Hanthamrongwit
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Chutiphon Saelee
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Soe Paing Kyaw
- Clinical Pathology Laboratory, (1000) Bedded General Hospital, Nay Pyi Taw, Myanmar
| | - Prasong Khaenam
- Center of Standardization and Product Validation, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Saradee Warit
- Industrial Tuberculosis Team, IMMBRG, National Center for Genetic Engineering and Biotechnology (BIOTEC), NSTDA, Pathum Thani, Thailand
| | - Nusara Satproedprai
- Genomic Medicine and Innovation Support Division, Department of Medical Sciences, Ministry of Public Health, Thailand
| | - Surakameth Mahasirimongkol
- Genomic Medicine and Innovation Support Division, Department of Medical Sciences, Ministry of Public Health, Thailand
| | - Hideki Yanai
- Department of Clinical Laboratory, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Patchanee Chootong
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Chaniya Leepiyasakulchai
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.
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Shahi F, Khosravi AD, Tabandeh MR, Salmanzadeh S. Investigation of the Rv3065, Rv2942, Rv1258c, Rv1410c, and Rv2459 efflux pump genes expression among multidrug-resistant Mycobacterium tuberculosis clinical isolates. Heliyon 2021; 7:e07566. [PMID: 34337183 PMCID: PMC8318855 DOI: 10.1016/j.heliyon.2021.e07566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/23/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background Different resistance mechanisms for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) have been reported. Although mutations in target genes are the main cause of drug resistance, efflux pumps (Eps) also play an important role in this process. Here, we investigated the overexpression of five putative EP genes plus gene mutations in MDR-TB clinical isolates. Methods A total of 27 M. tuberculosis (Mtb) clinical isolates including, 22 MDR and 5 sensitive isolates were analyzed. Minimum inhibitory concentrations (MIC) were determined in the absence and presence of efflux inhibitor. The expression level of 5 EP genes (Rv3065, Rv2942, Rv1258c, Rv1410c, Rv2459) was investigated by quantitative real time PCR (RT-qPCR). DNA sequencing of rpoB, katG, and inhA promoter was done. Results Among the 22 MDR-TB isolates, 13 (59.1%) showed significant overexpression (>4-fold) for at least one EP gene. The expression levels of 5 genes were significantly higher (P < 0.05) in MDR-TB isolates than sensitive isolates. The Rv3065 (22.7%), and Rv1410c (18.2%) were found to be the most commonly overexpressed EPs. The observed MICs were as follows: RIF (2 to >128 μg/ml) and INH (2-32 μg/ml). After efflux pump inhibitor exposure, 10/22 (45.45%) isolates showed a decrease in MIC of INH, and 17/22 (77.27%) isolates showed a decrease in MIC of RIF. Of the isolates that overexpressed, 4 isolates lacked mutation in inhA, rpoB, and katG genes and 10 ones lacked mutation in inhA and katG. Conclusion The results showed that overexpression of EP genes in Mtb isolates, besides target gene mutations can contribute to the development of MDR phenotype.
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Affiliation(s)
- Fatemeh Shahi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Azar Dokht Khosravi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Iranian Study Group on Microbial Drug Resistance, Iran
| | - Mohammad Reza Tabandeh
- Department of Basic Sciences, Division of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Shokrollah Salmanzadeh
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Tropical Medicine Ward, Razi Teaching Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Gray BJ, Perrett SE, Gudgeon B, Shankar AG. Investigating the prevalence of latent Tuberculosis infection in a UK remand prison. J Public Health (Oxf) 2021; 42:e12-e17. [PMID: 30608602 DOI: 10.1093/pubmed/fdy219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/11/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a major global public health issue and in low-incidence countries guidance identifies the need to screen for and treat latent tuberculosis infection (LTBI) with the prison environment recommended as a setting to perform LTBI screening. This study describes the findings of a LTBI screening programme which took place on entry to a remand prison in the UK. METHODS Testing for LTBI was undertaken alongside screening for blood borne viruses in 567 men. During the screening process, information was collected on demographic variables and also specific risk factors based on World Health Organization recommendations. LTBI analysis was performed using Interferon-Gamma Release Assay (IGRA) technique. RESULTS In total, 40 men returned an IGRA positive result (7.1%). However, irrespective of IGRA/LTBI status there was a substantial burden of risk factors present including previous prison stay, history of substance misuse and no BCG vaccination. Non-White ethnicity, a history of substance misuse and age over 34 years were the most significant factors in identifying individuals who would require treatment for LTBI (Positive IGRA result). CONCLUSIONS The study further demonstrates that the prevalence of LTBI remains increased within the prison environment and is a setting that still requires effective LTBI management.
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Affiliation(s)
- Benjamin J Gray
- Policy, Research and International Development, Public Health Wales NHS Trust, Cardiff, UK
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Alnour TMS, Abuduhier F, Khatatneh M, Albalawi F, Alfifi K, Silvala B. Multiplex PCR is a Rapid, Simple and Cheap Method for Direct Diagnosis of M. tuberculosis from Sputum Samples. Infect Disord Drug Targets 2021; 20:495-500. [PMID: 30864512 DOI: 10.2174/1871526519666190311165257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Rapid diagnosis of M. tuberculosis directly from sputum samples is a challenging process. This study aimed to design and evaluate a multiplex-PCR method for direct diagnosis of M. tuberculosis from sputum specimens. MATERIALS AND METHODS 46 suspected tuberculosis patients and 25 apparently healthy individuals were enrolled in the study. Sputa were collected from the study population and processed by cold ZN stain. DNA was extracted from each sample and processed by Multiplex PCR and Genotype Mycobacteria CM. RESULTS Out of the 46 Tuberculosis suspected patients, 22 (47.8%) revealed positive Acid fast ba- cilli (AFB), while 19 (41.3%) showed positive by both multiplex PCR and Genotype Mycobacte- ria CM. The overall sensitivity of multiplex PCR and smear microscopy were 100% while the specificity were 100, and 86.3%, respectively. CONCLUSION Multiplex PCR method using two different sets of primers in combination with other diagnostic tools such as X-Rays and smear Microscopy are cheap, rapid and reliable methods for the diagnosis of M. tuberculosis from clinical samples and are able to identify most of the smear positive cases with valuable accuracy.
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Affiliation(s)
- Tarig M S Alnour
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, University of Tabuk, Tabuk, Saudi Arabia
| | - Faisel Abuduhier
- Deanship of Academic Affairs, University of Tabuk, Tabuk, Saudi Arabia
| | - Mohammed Khatatneh
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, University of Tabuk, Tabuk, Saudi Arabia
| | | | | | - Bernard Silvala
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, University of Tabuk, Tabuk, Saudi Arabia
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Muniyandi M, Thomas BE, Karikalan N, Kannan T, Rajendran K, Dolla CK, Saravanan B, Tholkappian AS, Tripathy SP, Swaminathan S. Catastrophic costs due to tuberculosis in South India: comparison between active and passive case finding. Trans R Soc Trop Med Hyg 2021; 114:185-192. [PMID: 31820812 DOI: 10.1093/trstmh/trz127] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 11/01/2019] [Accepted: 12/08/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To measure and compare economic burden at the household level for tuberculosis (TB) patients who were detected through active case finding (ACF) and passive case finding (PCF) in rural areas. METHODS This study was conducted in the Thiruvallur district from October 2016 to March 2018. TB patients diagnosed through ACF were included in this study. For the comparison, patients diagnosed through ACF were recruited in the ratio of 1:2 from the same study area during the same period. Costs between the groups were compared and a multiple regression model was used to identify factors associated with catastrophic costs due to TB. RESULTS Of the 336 individuals, 110 were diagnosed through ACF and 226 through PCF. A total of 29% of patients diagnosed through PCF and 9% of patients diagnosed through ACF experienced catastrophic costs due to TB. The multiple logistic model shows that catastrophic costs due to TB had a significant association with higher income status (adjusted odds ratio [aOR] 4.91 [confidence interval {CI} 2.39 to 10.08]; p<0.001), alcohol use (aOR 2.78 [CI 1.33 to 5.81]; p=0.007), private as a first point of care (aOR 3.91 [CI 2.01 to 7.60]; p<0.001) and PCF (aOR 3.68 [CI 1.62 to 8.33]; p=0.002). CONCLUSIONS Findings highlight that ACF significantly averted catastrophic costs due to TB among patients. ACF as a strategy could ensure financial protection of TB patients and limit their risk of poverty.
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Affiliation(s)
- Malaisamy Muniyandi
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Beena Elizabeth Thomas
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Nagarajan Karikalan
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Thiruvengadam Kannan
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Krishnan Rajendran
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Chandra Kumar Dolla
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Balakrishnan Saravanan
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Ayyakannu Sivaprakasham Tholkappian
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Srikanth Prasad Tripathy
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
| | - Soumya Swaminathan
- Department of Health Economics, Indian Council of Medical Research, National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chennai 600031, India
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Homann AR, Niebling L, Zehnle S, Beutler M, Delamotte L, Rothmund MC, Czurratis D, Beller KD, Zengerle R, Hoffmann H, Paust N. A microfluidic cartridge for fast and accurate diagnosis of Mycobacterium tuberculosis infections on standard laboratory equipment. LAB ON A CHIP 2021; 21:1540-1548. [PMID: 33625429 DOI: 10.1039/d1lc00035g] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We present a novel centrifugal microfluidic approach for fast and accurate tuberculosis (TB) diagnosis based on the use of standard laboratory equipment. The herein presented workflow can directly be integrated into laboratories with standard equipment and automates complex sample preparation. The system consists of a microfluidic cartridge, a laboratory centrifuge and a standard PCR cycler. The cartridge includes all required reagents and automates collection of bacteria on filter membranes, bacterial lysis, nucleic acid extraction and aliquoting of the DNA extract for PCR analysis. We show that storage of the reagents in aluminium-coated pouches is stable during accelerated storage and transport tests. When the limit of detection was assessed, we found that the cartridge-automated workflow consistently detected 10 CFU ml-1 of mycobacteria in spiked sputum samples. First tests with clinical samples showed a 100% specificity for non-TB specimens. In addition, Mycobacterium tuberculosis (MTB) was re-found in pre-characterized smear microscopy and culture positive sputum samples suggesting a high diagnostic sensitvity. In summary, the novel cartridge-automated workflow enables a flexible and sensitive TB diagnosis without the need to invest in specialized instrumentation.
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Affiliation(s)
- Ana R Homann
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
| | - Laura Niebling
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
| | - Steffen Zehnle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
| | - Markus Beutler
- IML red, WHO Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, 82131 Gauting, Germany
| | - Lubov Delamotte
- IML red, WHO Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, 82131 Gauting, Germany
| | | | | | | | - Roland Zengerle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany. and Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Harald Hoffmann
- SYNLAB Gauting SYNLAB Human Genetics Munich, Robert-Koch-Allee 2, 82131 Gauting, Germany
| | - Nils Paust
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany. and Laboratory for MEMS Applications, IMTEK - Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
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Igwaran A, Edoamodu CE. Bibliometric Analysis on Tuberculosis and Tuberculosis-Related Research Trends in Africa: A Decade-Long Study. Antibiotics (Basel) 2021; 10:antibiotics10040423. [PMID: 33921235 PMCID: PMC8069363 DOI: 10.3390/antibiotics10040423] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/02/2022] Open
Abstract
Tuberculosis is one of the oldest known diseases and the leading communicable cause of deaths worldwide. Although several studies have been carried out on tuberculosis, no research has examined the publication trends in this area. Hence, this study aimed to fill the gap by conducting a bibliometric study in publications trends on tuberculosis and tuberculosis-related studies in Africa from 2010–2019 and explore the hotspots. Information in published documents on tuberculosis and its related studies from 2010 to 2019 were retrieved from the Web of Science (WoS) database. The bibliometric tool biblioshiny and Microsoft Excel 2016 were used to analyse the top leading journals, top cited documents, authors’ country production, country collaboration networks, most relevant authors, authors’ impacts, most relevant authors by corresponding author, most cited countries, university collaborations, most relevant affiliations, conceptual structural maps, title word co-occurrence networks, collaboration and significance of individual sources, university, country and keyword relations. A total of 3945 published documents were retrieved. The analyses showed that European Respiratory Journal was the leading journal in publications on tuberculosis studies with a total of 452 published articles, the WHO 2012 report was the most cited document with 2485 total citations while South Africa was the most productive country in tuberculosis publications as well as the leading country with the highest co-authorship collaboration. Analysis of top relevant authors revealed that Anonymous (133) and Dheda (44) were the two topmost relevant authors of tuberculosis publications, South Africa was the most relevant country by corresponding authors and the topmost cited country for tuberculosis publications. Furthermore, analysis of the university collaborations network showed that the University of Cape Town was the topmost university in Africa with the highest collaboration network, tuberculosis as a word had the highest co-occurrence network while the Three Field Plot diagram revealed the relations between universities, keywords and countries. This study provides a quantitative and qualitative analyses of the leading journals, most cited published articles, title word occurrences, and most relevant authors in published documents on tuberculosis and tuberculosis related studies from 2010–2019.
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Adomako BY, Peprah NY, Malm K, Sackey S, Ameme D, Nyarko KM, Kenu E. Tuberculosis surveillance system evaluation: case of Ga West municipality, Ghana, 2011 to 2016. Ghana Med J 2021; 54:3-10. [PMID: 33536662 PMCID: PMC7837341 DOI: 10.4314/gmj.v54i2s.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Evaluate the Tuberculosis (TB) surveillance system in the Ga West Municipality to determine if it is achieving its objectives, and to assess its attributes and usefulness. Design Descriptive analysis of primary and secondary data Data source Stakeholder interviews and record reviews on the objectives and operation of the surveillance system at all levels of the system. Intervention We evaluated the system's operation from 2011–2015 using the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems and the World Health Organisation (WHO) TB surveillance checklist for assessing the performance of national surveillance systems. Results The TB surveillance system in the municipality was functional and operated at all levels for timely detection of cases, accurate diagnosis, and case management. The system improved management of TB/HIV co-infections. The average time taken to confirm a suspected TB case was one day. The registration of a confirmed case and subsequent treatment happen immediately after confirmation. The municipality detected 109 of 727 TB cases in 2015 (case detection rate=15%). The positive predictive value (PPV) was 6.4%. There was one diagnostic centre in the municipality. Private facilities involvement in TB surveillance activities was low (1/15). Conclusion The Tuberculosis surveillance system in the Ga West Municipality is well structured but partially meeting its objectives. The system is timely, stable and acceptable by most stakeholders and useful at all levels. It has no major data quality issues. Private health facilities in the municipality should be well incorporated into TB surveillance. Funding This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana through the support of the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN° 57212014/mcrt) to B-YA
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Affiliation(s)
- Boakye-Yiadom Adomako
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana.,National Malaria Control Programme, Ghana Health Service, Accra
| | - Nana Y Peprah
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana.,National Malaria Control Programme, Ghana Health Service, Accra
| | - Kezia Malm
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana.,National Malaria Control Programme, Ghana Health Service, Accra
| | - Samuel Sackey
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana
| | - Donne Ameme
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana
| | - Kofi M Nyarko
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana
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Hakim JMC, Yang Z. Predicted Structural Variability of Mycobacterium tuberculosis PPE18 Protein With Immunological Implications Among Clinical Strains. Front Microbiol 2021; 11:595312. [PMID: 33488541 PMCID: PMC7819968 DOI: 10.3389/fmicb.2020.595312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
Recent advancements in vaccinology have led to the development of the M72/AS01E subunit vaccine, of which the major component is the Mycobacterium tuberculosis (MTB) PPE18 protein. Previous studies have demonstrated the genetic variability of the gene encoding PPE18 protein and the resulting peptide changes in diverse clinical strains of MTB; however, none have modeled the structural changes resulting from these peptide changes and their immunological implications. In this study, we investigated the structural predictions of 29 variant PPE18 proteins previously reported. We found evidence that PPE18 is at least a two-domain protein, with a highly conserved first domain and a largely variable second domain that has different coevolutionary clusters. Further, we investigated putative epitope sites in the clinical variants of PPE18 using prediction software. We found a negative relationship between T-cell epitope number and residue variability, while B-cell epitope likelihood was positively correlated with residue variability. Moreover, we found far more residues in the second domain predicted to be B-cell epitopes compared with the first domain. These results suggest an important functional role of the first domain and a role in immune evasion for the second, which extends our knowledge base of the basic biology of the PPE18 protein and indicates the need for further study into non-traditional immunological responses to TB.
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Affiliation(s)
- Jill M C Hakim
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Zhenhua Yang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
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Yuan X, Wan L, Hu J, Zhang W. A Case Report of Complete Dislocation of Atlantoaxial Joint due to a Traumatic and Pathological Axial Lesion. Int J Spine Surg 2021; 14:S5-S9. [PMID: 33900937 DOI: 10.14444/7157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Atlantoaxial dislocation usually results in sudden death. The patient had never found any axial lesion before, and the atlantoaxial joint dislocation was caused by rotation of the neck due to discomfort of the neck. The patient was given surgical treatment after the rescue of respiratory and cardiac arrest during transportation, which was extremely rare and rarely reported. METHODS A 62-year-old male patient presented with limited cervical mobility after a violent rotation of the neck due to neck discomfort. X-ray and computed tomography (CT) scan suggested atlantoaxial dislocation. Sudden respiratory and cardiac arrest during transportation was immediately followed by continuous cranial traction and successful occipital and neck fusion operation. RESULTS After the successful rescue of endotracheal intubation, the patient was given continuous cranial traction. After the completion of CT scan, the patient was given occipital neck fusion, and 6 days after the surgery, the patient wore the skull-neck-thorax brace and walked freely. CONCLUSION Continuous cranial traction and posterior occipitocervical fusion are effective methods for treating axial pathological fracture with atlantoaxial dislocation. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Xinwei Yuan
- Department of Orthopedics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, P.R. China
| | - Lun Wan
- Department of Orthopedics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, P.R. China
| | - Jiang Hu
- Department of Orthopedics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, P.R. China
| | - Wei Zhang
- Department of Orthopedics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, P.R. China
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Lule SA, Gupta RK, Krutikov M, Jackson C, Southern J, Abubakar I. The relationship between social risk factors and latent tuberculosis infection among individuals residing in England: a cross-sectional study. BMJ Glob Health 2020; 5:bmjgh-2020-003550. [PMID: 33293291 PMCID: PMC7722758 DOI: 10.1136/bmjgh-2020-003550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/03/2020] [Accepted: 11/17/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate the relationship between social risk factors and latent tuberculosis infection (LTBI) among individuals who are eligible for LTBI screening in the United Kingdom (UK). METHODS This cross-sectional study used data collected in the UK Prognostic Evaluation of Diagnostic Interferon-Gamma Release Assays (IGRAs) Consortium Study which enrolled 9176 recent tuberculosis (TB) contacts and migrants at National Health Service (NHS) facilities and community settings in the UK. The study outcome was LTBI (positive IGRA test (QuantiFERON-TB Gold In-Tube or T-SPOT.TB)). The main exposures were history of smoking, history of substance misuse, homelessness, prison stay and socioeconomic deprivation. RESULTS 4914 (56.2%) individuals resided in the most deprived areas and 2536 (27.6%) had LTBI. In the multivariable analysis (adjusting for age, gender, place of birth, ethnicity, HIV status, BCG vaccination and recent TB contact) living in the least deprived areas compared with living in the most deprived areas was associated with reduced odds of LTBI (odds ratio (OR)=0.68, 95% CI: 0.51 to 0.90) while ever been homeless (OR=1.50, 95% CI: 1.02 to 2.21) was associated with increased odds of LTBI. Smoking, homelessness and substance misuse were not associated with LTBI. CONCLUSION Social deprivation could be an important risk factor for LTBI, highlighting the social inequality in the burden of TB infection in the UK. Migrants and TB contacts who were socially deprived or homeless were at a significantly higher risk for LTBI, thus tailored intense public health interventions to these groups may help to reduce the risk of future TB disease. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT01162265).
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Affiliation(s)
- Swaib A Lule
- Institute for Global Health, University College London, London, UK
| | - Rishi K Gupta
- Institute for Global Health, University College London, London, UK
| | - Maria Krutikov
- Institute for Global Health, University College London, London, UK
| | | | - Jo Southern
- Tuberculosis (TB) Unit, National Infection Service, Public Health England, London, UK
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
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Alateah SM, Othman MW, Ahmed M, Al Amro MS, Al Sherbini N, Ajlan HH. A retrospective study of tuberculosis prevalence amongst patients attending a tertiary hospital in Riyadh, Saudi Arabia. J Clin Tuberc Other Mycobact Dis 2020; 21:100185. [PMID: 33024839 PMCID: PMC7527716 DOI: 10.1016/j.jctube.2020.100185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Tuberculosis (TB) is a public health challenge that affects all genders and age groups and is a single leading infectious disease killer globally. We retrospectively investigated the prevalence of TB and anti-TB drug resistance among patients treated at the Prince Sultan Military Medical City (PSMMC) between the years 2000 and 2017. Patient demographic variables and drug susceptibility test results were obtained from TB notification records located in the TB laboratory at PSMMC. A total of 58,141 records were reviewed of which 1123 (2%) specimens were positive for Mycobacterium tuberculosis. Of the positive, 621 (55%) were from pulmonary specimens. Males over the age of 15 years accounted for 60% of the positive specimens. Drug resistance to at least one drug was detected in 90 (8%) of which 60 (5.3%), 24 (2%) 6 (0.5%) patients were mono-drug-resistant, poly-drug resistant and multidrug resistant (MDR-TB) respectively. Resistance to isoniazid and streptomycin were the most frequently found among first-line tuberculosis drugs, accounting for 4.5% and 3.8% of drug resistance cases respectively. Our findings show low prevalence of tuberculosis and multidrug resistant TB among patients treated at PSMMC over a 17-year period. Nationwide assessment is needed to get a clear picture of the TB burden across Saudi Arabia and inform national policies for eradication of TB.
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Affiliation(s)
- Souad M Alateah
- Prince Sultan Military Medical City, Central Military Laboratory & Blood Bank, Microbiology Laboratory, Saudi Arabia
| | - Maha W Othman
- Prince Sultan Military Medical City, Central Military Laboratory & Blood Bank, Microbiology Laboratory, Saudi Arabia
| | - Medina Ahmed
- Prince Sultan Military Medical City, Central Military Laboratory & Blood Bank, Microbiology Laboratory, Saudi Arabia
| | - Mohammed S Al Amro
- Prince Sultan Military Medical City, Central Military Laboratory & Blood Bank, Saudi Arabia
| | - Nisreen Al Sherbini
- Prince Sultan Military Medical City, Infectious Diseases Department, Saudi Arabia
| | - Hisham H Ajlan
- Prince Sultan Military Medical City, Central Military Laboratory & Blood Bank, Microbiology Laboratory, Saudi Arabia
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Jayaraman M, Ramadas K. An integrated computational investigation to unveil the structural impacts of mutation on the InhA structural gene of Mycobacterium tuberculosis. J Mol Graph Model 2020; 101:107768. [DOI: 10.1016/j.jmgm.2020.107768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
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KB S, Kumari A, Shetty D, Fernandes E, DV C, Jays J, Murahari M. Structure based pharmacophore modelling approach for the design of azaindole derivatives as DprE1 inhibitors for tuberculosis. J Mol Graph Model 2020; 101:107718. [DOI: 10.1016/j.jmgm.2020.107718] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/05/2020] [Accepted: 08/07/2020] [Indexed: 11/16/2022]
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Yang M, Qiu Y, Jin Y, Liu W, Wang Q, Yi H, Tang S. NR1I2 genetic polymorphisms and the risk of anti-tuberculosis drug-induced hepatotoxicity: A systematic review and meta-analysis. Pharmacol Res Perspect 2020; 8:e00696. [PMID: 33300686 PMCID: PMC7726956 DOI: 10.1002/prp2.696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 01/12/2023] Open
Abstract
Anti-tuberculosis drug-induced hepatotoxicity (ATDH) is a serious adverse drug reaction. Conflicting results have been obtained regarding the associations of nuclear receptor subfamily 1 group I member 2 (NR1I2) gene polymorphisms on susceptibility to ATDH. Therefore, we aimed to evaluate the associations using a systematic review/meta-analysis approach. PubMed, Medline, Cochrane Library, Web of Science and SinoMed databases were searched for all eligible studies from inception to June 10, 2020. Pooled adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were employed to evaluate the strength of the association between the NR1I2 polymorphisms and the risk of ATDH. Subgroup analysis was performed by region of origin, and meta-regression were performed to detect potential sources of heterogeneity. A total of five case-control studies involving 572 cases and 1867 controls were identified. Fourteen SNPs in the NR1I2 gene have been reported, and the most heavily studied SNPs were rs3814055 and rs7643645. The pooled estimates did not exhibit any significant associations between SNPs rs3814055 and rs7643645 and the risk of ATDH (rs3814055: dominant model, OR = 1.00, 95% CI: 0.82-1.22, P = 1.00; recessive model, OR = 1.17, 95% CI: 0.76-1.78, P = .48; rs7643645: dominant model, OR = 1.04, 95% CI: 0.64-1.68, P = .89; recessive model, OR = 0.98, 95% CI: 0.65-1.49, P = .93). Subgroup analysis obtained similar negative results in Chinese patients, and the diagnostic criteria of ATDH may be the source of heterogeneity. Based on the meta-analysis described in this report, we did not observe any association between NR1I2 gene polymorphisms and ATDH susceptibility. However, this conclusion should be interpreted with caution due to the low number of studies and the relatively small sample size.
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Affiliation(s)
- Miaomiao Yang
- Department of Epidemiology and BiostatisticsSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Yunliang Qiu
- Department of Criminal Science and TechnologyNanjing Forest Police CollegeNanjingChina
| | - Yanyu Jin
- School of PediatricsNanjing Medical UniversityNanjingChina
| | - Wenpei Liu
- Department of Epidemiology and BiostatisticsSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Qingliang Wang
- Department of Medical AffairsQilu Hospital of Shandong UniversityJinanChina
| | - Honggang Yi
- Department of Epidemiology and BiostatisticsSchool of Public HealthNanjing Medical UniversityNanjingChina
| | - Shaowen Tang
- Department of Epidemiology and BiostatisticsSchool of Public HealthNanjing Medical UniversityNanjingChina
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Ngilirabanga JB, Aucamp M, Pires Rosa P, Samsodien H. Mechanochemical Synthesis and Physicochemical Characterization of Isoniazid and Pyrazinamide Co-crystals With Glutaric Acid. Front Chem 2020; 8:595908. [PMID: 33282840 PMCID: PMC7706006 DOI: 10.3389/fchem.2020.595908] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/12/2020] [Indexed: 11/15/2022] Open
Abstract
The present work reports two novel pharmaceutical co-crystals; 2:1 isoniazid-glutaric acid (INHGA) and 2:1 pyrazinamide-glutaric acid (PGA). Isoniazid and pyrazinamide are key first-line drugs used for the treatment of tuberculosis. The co-crystals were produced via solid-state and solvent assisted grinding methods. Thermal characteristics of the samples were obtained using the differential scanning calorimetry, hot stage microscopy, and thermogravimetric analyses. The morphology of the powder samples by scanning electron microscopy, structural analysis by Fourier transform infrared spectroscopy and powder X-rays diffraction ensured co-crystal formation. Thermal analyses confirmed the co-crystals with new melting transitions ranging between their respective starting materials. Unique morphologies of the co-crystal particles were clear in SEM micrographs. The formation of intermolecular interactions with the co-crystal former was confirmed by the FT-IR spectral band shifting and was supported by distinct PXRD patterns of co-crystals thereby authenticating the successful co-crystal formation. In vitro solubility evaluation of the synthesized co-crystals by HPLC suggested a remarkable increase in solubility of both INH and PZA in their respective co-crystals.
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Affiliation(s)
| | - Marique Aucamp
- School of Pharmacy, University of the Western Cape, Cape Town, South Africa
| | - Paulo Pires Rosa
- Faculty of Pharmaceutical Sciences, State University of Campinas, Saö Paulo, Brazil
| | - Halima Samsodien
- School of Pharmacy, University of the Western Cape, Cape Town, South Africa
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Cavalin RF, Pellini ACG, Lemos RRGD, Sato APS. TB-HIV co-infection: spatial and temporal distribution in the largest Brazilian metropolis. Rev Saude Publica 2020; 54:e112. [PMID: 33146301 PMCID: PMC7593020 DOI: 10.11606/s1518-8787.2020054002108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 05/03/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To describe the spatial and temporal distribution of TB-HIV co-infection, as well as the profile of the characteristics of the co-infected population in the municipality of São Paulo. METHODS This is an ecological and time series study with data from the Tuberculosis Patient Control System (TBWeb), including all new cases of tuberculosis co-infected individuals with HIV living in the municipality from 2007 to 2015. Time trends of the disease were analyzed using Prais-Winsten regression. The cases were geocoded by the address of residence for the elaboration of maps with the incidence rates smoothed by the local empirical Bayesian method. The global and local Moran indexes evaluated spatial autocorrelation. Individuals' profiles were described and the characteristics of the cases with and without fixed residence were compared by Pearson's chi-square or Fisher's exact tests. RESULTS We analyzed 6,092 new cases of TB-HIV co-infection (5,609 with fixed residence and 483 without fixed residence). The proportion of TB-HIV co-infection ranged from 10.5% to 13.7%, with a drop of 3.0% per year (95%CI -3.4 - -2.6) and was higher in individuals without fixed residence. Incidence rates decreased by 3.6% per year (95%CI -4.4% - -2.7%), declining from 7.0 to 5.3 per 100,000 inhabitants/year. Co-infection showed positive and significant spatial autocorrelation, with heterogeneous spatial pattern and a high-risk cluster in the central region of the municipality. Cure was achieved in 55.5% of cases with fixed residence and in 32.7% of those without a fixed residence. CONCLUSIONS The data indicate an important advance in the control of TB-HIV co-infection in the period analyzed. However, we identified areas and populations that were unequally affected by the disease and that should be prioritized in the improvement of actions to prevent and control co-infection.
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Affiliation(s)
- Roberta Figueiredo Cavalin
- Universidade de São Paulo . Faculdade de Saúde Pública . Programa de Pós-Graduação em Saúde Pública . São Paulo , SP , Brasil
| | | | - Regina Rocha Gomes de Lemos
- Secretaria Municipal da Saúde . Coordenação de Vigilância em Saúde de São Paulo . Programa Municipal de Controle da Tuberculose . São Paulo , SP , Brasil
| | - Ana Paula Sayuri Sato
- Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Epidemiologia . São Paulo , SP , Brasil
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