Comprehension of Calcitriol Levels in Pregnant Women With Latent Tuberculosis and Immune Function in their Newborns

Background

Pregnant women with latent tuberculosis infection (LTBI) may develop active tuberculosis infection and could infect their neonates, which could impair the child's immune system due to infection-mediated immunological responses. In order to develop a preventative TB program in this study, we desired to understand the impact of calcitriol in LTBI pregnant women and immunological responses in neonates.

Patients and Methods

In three hospitals in Medan, North Sumatra, we implemented a case-control design with 84 pregnant women in their third trimester and their newborns. We determined the levels of calcitriol, cathelicidin, and interferon gamma (IFN-γ) in women between December 2021 and July 2022. These measurements were then compared to the newborns' levels of calcitriol, cathelicidin, IFN-γ, and Toll-Like Receptor (TLR) 2. Analyses were performed using the Chi-squared and Fisher's tests, while Spearman correlations were employed to assess for correlations.

Results

42 pregnant women with LTBI (interferon gamma release assay (IGRA) positive) and 42 pregnant women without LTBI (IGRA negative) participated in the study. The findings demonstrated that pregnant women with LTBI were at increased risk for calcitriol deficiency (Odds Ratio (OR) = 3.667, p = 0.006), which had an impact on the calcitriol levels of their unborn children (p = 0.038). TLR2 levels and calcitriol levels were substantially associated with LTBI pregnant women and their healthy neonates (p = 0.048; p = 0.005). Cathelicidin levels in the newborns of non-LTBI pregnant women were influenced by their higher calcitriol levels (p = 0.043). Pregnant women with LTBI had higher levels of cathelicidin and IFN-γ than those without it (p = 0.03; p = 0.001).

Conclusion

Pregnant LTBI women's calcitriol levels had an impact on the calcitriol levels of their newborns. Mother's immunological responses and babies' calcitriol levels affected the levels of cathelicidin, IFN-γ, and TLR2 in newborns.

Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact

Background Children in household contact of adults with smear-positive tuberculosis (TB) are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB.Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients.Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests.Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%)] or the control group [TB score <6; 84 subjects (58.0%)]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively.Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.

Hematological scoring system as an early diagnostic tool for neonatal sepsis

Background Sepsis was the leading cause of death in babies by30%-50% in developing countries. Early diagnosis of neonatalsepsis is still a difficult problem because of clinical features are notspecific. Blood culture is the gold standard, but it takes several daysand is expensive. The hematological scoring system (HSS) consistsof hematologic parameters (leucocyte count, polymorphonuclear(PMN) cells, degenerative changes, and platelet count) for earlydiagnosis of neonatal sepsis.Objective To measure HSS as an early diagnostic tool for neonatalsepsis.Methods A cross sectional study was conducted in March toJune 2013. Samples were collected by consecutive sampling.Fourty neonates suspected sepsis in neonatology unit H. AdamMalik Hospital, Medan, North Sumatera, underwent routineblood count, blood culture, and peripheral blood smear. Eachhematologic parameters were analysed using the HSS of Rodwellet al. The hematologic parameters were total leucocyte count, totalPMN cells, total PMN immature, I:T PMN ratio, I:M PMN ratio,degenerative changes, and platelet count. The total value revealedHSS score. Diagnostic study parameters were calculated.Results Ten of fourty neonates had sepsis based on blood culture􀁕􀁈􀁖􀁘􀁏􀁗􀁖􀀑􀀃􀀷􀁋􀁈􀀃􀀫􀀶􀀶􀀃􀁖􀁆􀁒􀁕􀁈􀀃􀂕􀀗􀀃􀁋􀁄􀁇􀀃􀁖􀁈􀁑􀁖􀁌􀁗􀁌􀁙􀁌􀁗􀁜􀀃􀀛􀀓􀀈􀀏􀀃􀁖􀁓􀁈􀁆􀁌􀁉􀁌􀁆􀁌􀁗􀁜􀀃􀀜􀀓􀀈􀀏􀀃with positive predictive value (PPV) 73%, negative predictivevalue (NPV) 93%, ROC curve showed cut off point 0.902 (95%CI 0.803 to 1.0).Conclusion 􀀶􀁆􀁒􀁕􀁈􀀃􀀫􀀶􀀶􀀃􀂕􀀗􀀃􀁆􀁒􀁘􀁏􀁇􀀃􀁅􀁈􀀃􀁘􀁖􀁈􀁇􀀃􀁄􀁖􀀃􀁄􀁑􀀃􀁈􀁄􀁕􀁏􀁜􀀃􀁇􀁌􀁄􀁊􀁑􀁒􀁖􀁗􀁌􀁆􀀃tool for neonatal sepsis.