Intensified research on tuberculosis in the Western Pacific Region: a bibliometric analysis, 2000-2019

Deciphering drug discovery and microbial pathogenesis research in tuberculosis during the two decades of postgenomic era using entity mining approach

We examined literature on Mycobacterium tuberculosis (Mtb) subsequent to its genome release, spanning years 1999-2020. We employed scientometric mapping, entity mining, visualization techniques, and PubMed and PubTator databases. Most popular keywords, most active research groups, and growth in quantity of publications were determined. By gathering annotations from the PubTator, we determined direction of research in the areas of drug hypersensitivity, drug resistance (AMR), and drug-related side effects. Additionally, we examined the patterns in research on Mtb metabolism and various forms of tuberculosis, including skin, brain, pulmonary, extrapulmonary, and latent tuberculosis. We discovered that 2011 had the highest annual growth rate of publications, at 19.94%. The USA leads the world in publications with 18,038, followed by China with 14,441, and India with 12,158 publications. Studies on isoniazid and rifampicin resistance showed an enormous increase. Non-tuberculous mycobacteria also been the subject of more research in effort to better understand Mtb physiology and as model organisms. Researchers also looked at co-infections like leprosy, hepatitis, plasmodium, HIV, and other opportunistic infections. Host perspectives like immune response, hypoxia, and reactive oxygen species, as well as comorbidities like arthritis, cancer, diabetes, and kidney disease etc. were also looked at. Symptomatic aspects like fever, coughing, and weight loss were also investigated. Vitamin D has gained popularity as a supplement during illness recovery, however, the interest of researchers declined off late. We delineated dominant researchers, journals, institutions, and leading nations globally, which is crucial for aligning ongoing and evolving landscape of TB research efforts. Recognising the dominant patterns offers important information about the areas of focus for current research, allowing biomedical scientists, clinicians, and organizations to strategically coordinate their efforts with the changing priorities in the field of tuberculosis research.

Clinical pharmacy services for tuberculosis management: a systematic review

Objective: This study aims to systematically review the content and potential effects of clinical pharmacy services in tuberculosis (TB) care management. Methods: Searches were performed in PubMed, Embase, Cochrane, Scopus, and Web of Science databases following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Study characteristics and outcomes were extracted, and clinical pharmacy service components were characterized using the Descriptive Elements of Pharmacist Intervention Characterization Tool. Results: Twenty articles were included for full-text assessment, of which 10 fulfilled inclusion criteria, comprising 1,168 patients (N = 39 to 258 per study). These articles included five prospective cohort studies, two case-control studies, two quasi-experimental studies, and one cross-sectional study. Intervention foci within clinical pharmacy services were medication adherence (50%), medication safety (40%), education to patients/caregivers regarding needs/beliefs (30%), optimizing medication/therapy effectiveness (30%), emphasizing HRQoL (10%), and drug selections (10%). The three most frequently applied interventions were drug information/patient counseling (80%), adverse drug reaction monitoring (50%), and drug use evaluation (20%). Based on the World Health Organization (WHO) outcome classification, treatment success ranged from 72% to 93%, with higher cure outcomes (53%-86%) than treatment completion (7%-19%). Other outcomes, including isoniazid metabolites, medication counts, sputum conversion, adherence/compliance, knowledge, and quality of life, were better in the intervention group than those in comparator groups, and/or they improved over time. Risk of bias analysis indicated that the included studies were not comparable to a randomized clinical trial. Conclusion: Clinical pharmacy services as single or composite interventions potentially improve TB outcomes, but its evidence is still inconsistent and limited due to the lack of randomized controlled studies using the WHO outcome classification. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199028, identifier CRD42020199028.

Financing for tuberculosis prevention, diagnosis and treatment services in the Western Pacific Region in 2005-2020

Objective

This paper provides an overview of financing for tuberculosis (TB) prevention, diagnostic and treatment services in the World Health Organization (WHO) Western Pacific Region during 2005-2020.

Methods

This analysis uses the WHO global TB finance database to describe TB funding during 2005-2020 in 18 low- and middle-income countries (LMICs) in the Western Pacific Region, with additional country-level data and analysis for seven priority countries: Cambodia, China, the Lao People's Democratic Republic, Mongolia, Papua New Guinea, the Philippines and Viet Nam.

Results

Funding for the provision of TB prevention, diagnostic and treatment services in the 18 LMICs tripled fromUS$ 358 million in 2005 to US$ 1061 million in 2020, driven largely by increases in domestic funding, which rose from US$ 325 million to US$ 939 million over the same period. In the seven priority countries, TB investments also tripled, from US$ 340 million in 2005 to US$ 1020 million in 2020. China alone accounted for much of this growth, increasing its financing for TB programmes and services fivefold, from US$ 160 million to US$ 784 million. The latest country forecasts estimate that US$ 3.8 billion will be required to fight TB in the seven priority countries by 2025, which means that unless additional funding is mobilized, the funding gap will increase from US$ 326 million in 2020 to US$ 830 million by 2025.

Discussion

Increases in domestic funding over the past 15 years reflect a firm political commitment to ending TB. However, current funding levels do not meet the required needs to finance the national TB strategic plans in the priority countries. An urgent step-up of public financing efforts is required to reduce the burden of TB in the Western Pacific Region.

A bibliometric analysis of global research performance on tuberculosis (2011-2020): Time for a global approach to support high-burden countries

BACKGROUND:

Tuberculosis (TB) is a persistent public health issue requiring consistent global effort for its eradication and control. Research on the subject plays a vital role in combatting the disease, giving future directions, and meeting the sustainable development goals (SDGs). This study aimed to evaluate the global TB research trends and performance from 2011 to 2020.

MATERIALS AND METHODS:

All the data for TB-related research publications from 2011 to 2020 were extracted from the Web of Science database and a comprehensive analysis was performed on the R-bibliometrix package.

RESULTS:

An increasing number of publications with an annual growth rate of 6.32% and a plateau in production from 2015 to 2018 was observed. Of 145 countries, the United States of America (USA), China, India, the United Kingdom, and South Africa led and made up half of the global contribution. Out of 91,862 authors, Zhang Y was the most productive with 205 articles and Barry CE had the highest H-index of 45. Only seven of the top 20 authors were from high-burden countries. The University of Cape Town was the leading institutional affiliation, followed by Stellenbosch University and the London School of Hygiene and Tropical Medicine. The most frequent international collaboration was between the USA and South Africa, occurring on 1203 instances. Only five of the top 30 high-burden countries were present in the top 30 collaborations. PLOS ONE, disseminating 2271 articles, was the most productive out of 3500 sources.

CONCLUSION:

The past decade has seen a steady increase in global TB research. Prominent authors, affiliations, and countries showed collaborative trends, but publications were found to be mostly from developed, low-burden countries except China, India, and South Africa. To meet the goals set by the SDGs and the WHO End TB Strategy, high-burden countries need to explore feasible opportunities and global support to enhance their expected TB-related research contributions.