Awareness Of Tuberculosis Research Articles

Study on Prevalence of Adverse Drug Reactions and Drug-Drug Interactions and Co-Morbid Conditions of Patients Suffering from Tuberculosis

Background: Tuberculosis is the oldest common infectious disease affecting not only lungs but several organs in a human body. Its caused by the bacteria Mycobacterium tuberculosis. Tuberculosis exposure is through lungs. This disease has co-morbid conditions. The basic treatment according to WHO is with Isoniazid, Rifampicin, Pyrazinamide, Ethambutol, but these drugs may lead to adverse drug reactions and drug interactions. Objective: To determine the adverse effects and drug-drug interactions post administration of anti-tubercular drugs and to determine the influence of drugs on their co-morbid conditions of patients suffering from tuberculosis in Aster Prime Hospital. Methods: The patient’s prescriptions of total 110 were collected from the outpatient and in-patient Pulmonology department. These were noted in the data collection form and the comparative study was done by evaluating the number of male and female affected with Tuberculosis, common drug-drug interaction with respective drug, adverse drug reaction followed by the common co-morbid condition occurring with TB and the effect of drugs on co-morbidities Results: The prevalence of tuberculosis in 110 patients was found to be more in females by 12% than males. The co-morbid conditions found with tuberculosis were Hypertension, diabetes, pleural effusion, hepatitis, cavitary disease and respiratory failure. The least common comorbidities were chronic obstructive pulmonary disease (COPD), gastritis, and stroke and chronic kidney disease (CKD) and ulcerative colitis. The total adverse effect found in the 62 patients (56.36%) and the patients with no adverse drug reactions were 48 (43.63%) The percentage of total drug-drug interactions found in the patients were 44% (n=48) and the percentage of patients with no interactions were 56% (n=62). Conclusion: Health care workers play an important role and considered as a vital group for tuberculosis awareness activities to increase competence in TB management and compliance with national guidelines. Interventions address a combination of varying influences on behaviour, focusing on specific gaps identified to improve their impact.

Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study.

Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.

Clinical and pharmacological approaches to the optimisation of therapy in a coughing patient

Cough is considered as an unconditional reflex adaptive defense response to irritating agents such as aeropollutants, foreign bodies, sputum, and is supposed to ensure adequate airway patency for normal gas exchange. Unfortunately, this mechanism is often transformed from a protective to a pathological one, lacking an adaptive function, causing suffering to the patient and exacerbating his poor condition. The line between physiological and pathological cough is often blurred and is perceived differently by both patients and physicians. In most cases, cough, including persistent cough, is treated with neglect by the general population - as an everyday occurrence with no major problems, and with a lack of awareness of tuberculosis, cancer and a number of other serious diseases. There are a large number of medicines on the market that are positioned as effective cough medicines. However, the wide variety of ways to treat this pathology demonstrates that there is no ideal cough medicine that combines universality, high efficacy and safety. Many drugs can cause serious side-effects, imposing severe restrictions on their use. Another difficulty is that the triggers and pathways of the cough reflex are extremely varied. Identifying the causes of persistent cough requires a thorough medical history, often with a multidisciplinary approach: extended examination, doctors such as otorhinolaryngologist, cardiologist, gastroenterologist, pulmonologist, oncologist, phthisiatrician, clinical pharmacologist (druginduced cough, drug-drug interactions). This article focuses on the differential diagnosis of cough and the selection of cough medicines based on their proven efficacy and safety. This information becomes particularly relevant during the seasonal increase in the incidence of acute respiratory infections.

Tuberculosis treatment outcomes in a rural area of Senegal: a decade of experience from 2010 to 2019 by StopTB Italia.

Background: Tuberculosis (TB) unevenly affects individuals across the globe, especially in rural areas of low-income countries. Aim of the study was to assess the impact of social protection to increase TB awareness on treatment outcomes among TB patients in a rural area of Senegal. Materials & methods: The study, conducted in Fimela district (Senegal) from 1 January 2010to 31 December2019 and the intervention started from 31 January2013, includes activities to increase awareness, active case finding, active follow-upand social protection. Results: Overall, 435 subjects - mainly male and young-were included in the analysis. Among TB cases, 94% had pulmonary involvement, 87% had no previous TB history, and 6% resulted positiveHIV. Improved outcome was observed once intervention began (from 71to 91%, p<0.001); whereas mortality decreased (from 15 to 5%; p<0.001), especially for those HIV co-infected for whom TB mortality rate dropped from 70 to 29%. Conclusion: After beginning the cooperation program, TB treatment success increased as a result of the decline of mortality, especially in people living with HIV.

Tuberculosis Outbreak Associated With Delayed Diagnosis and Long Infectious Periods in Rural Arkansas, 2010-2018.

During 2010-2018, the Arkansas Department of Health reported 21 genotype-matched cases of tuberculosis (TB) among residents of a rural county in Arkansas with a low incidence of TB and in nearby counties. The Arkansas Department of Health and the Centers for Disease Control and Prevention investigated to determine the extent of TB transmission and provide recommendations for TB control. We reviewed medical and public health records, interviewed patients, and reviewed patients' social media posts to describe patient characteristics, identify epidemiologic links, and establish likely chains of transmission. We identified 21 cases; 11 reported during 2010-2013 and 10 during 2016-2018. All case patients were US-born non-Hispanic Black people. Eighteen case patients had the outbreak genotype, and 3 clinically diagnosed (non-culture-confirmed) case patients had epidemiologic links to patients with the outbreak genotype. Social media reviews revealed epidemiologic links among 10 case patients not previously disclosed during interviews. Eight case patients (38%) had ≥1 health care visit during their infectious period, and 7 patients had estimated infectious periods of >12 months. Delayed diagnoses and prolonged infectiousness led to TB transmission in this rural community. TB education and awareness is critical to reducing transmission, morbidity, and mortality, especially in areas where health care providers have limited TB experience. Use of social media can help elucidate people at risk, especially when traditional TB investigation techniques are insufficient.

Rifampicin Mono-Resistant Tuberculosis-A Review of an Uncommon But Growing Challenge for Global Tuberculosis Control.

Tuberculosis (TB) remains the leading cause of death by an infectious pathogen worldwide, and drug-resistant TB is a critical and rising obstacle to global control efforts. Most scientific studies and global TB efforts have focused on multidrug-resistant TB (MDR-TB), meaning isolates resistant to both isoniazid (INH) and rifampicin (RIF). Newer diagnostic tests are resulting in an increasing awareness of RIF-resistant TB in addition to MDR disease. To date, RIF resistance has been assumed to be synonymous with MDR-TB, but this approach may expose TB patients with RIF mono-resistance disease to unnecessarily long and toxic treatment regimens. We review what is currently known about RIF mono-resistant TB, its history and epidemiology, mechanisms of RIF resistance, available diagnostic techniques, treatment outcomes reported globally, and future directions for combatting this disease.

An analysis of public awareness of core information on tuberculosis in Guizhou Province

Tuberculosis (TB) is a global public health problem and China is one of the 22 countries with a high TB burden. The characteristics of the epidemic of TB in China include a high rate of infection, high prevalence, serious drug resistance, and low rate of decline and the TB epidemic in Guizhou Province is more serious than in other parts of the country. We conducted a survey during September and October 2019 to investigate public awareness of core TB information. A multi-stage, stratified random sampling method was used to survey individuals at 18 investigation sites on their awareness of core information related to TB. SPSS22.0 software was used to analyze data and P<0.05 was considered statistically different. Of the 10,563 questionnaires collected, the total awareness rate of TB, the awareness rates of transmission, symptoms, treatment (doctor visit way), preferential policies, and prognosis of TB were 62.5% (95% CI: 0.6169-0.6329), 62.8% (95% CI: 0.6190-0.6374), 75.2% (95% CI: 0.7434-0.7599), 66.4% (95% CI: 0.6553-0.6733), 39.1% (95% CI: 0.3819-0.4005), 61.2% (95% CI: 0.6029-0.6215) respectively. The personal awareness qualified rate was 45.0% (95% CI: 0.4404-0.4594) and multivariate logistic regression analysis showed that education was the main factor associated with awareness of TB. Public awareness of the core information about TB is low in Guizhou Province. Intensive education about TB should be carried out.

Tuberculosis Knowledge and Delayed Health Care Seeking Among New Diagnosed Tuberculosis Patients in Primary Health Facilities in an Urban District, South Africa.

Patients’ delay in seeking health care is a major problem in the control of tuberculosis (TB) and increases the risk of TB transmission. This study determined health-seeking practices and delays that occurred from the onset of TB symptoms until diagnosis and assessed the patients’ TB-related knowledge. This was a cross-sectional study involving 391 new TB patients recruited from health facilities at an urban sub-district in South Africa from December 2016 to March 2017. Descriptive statistics and logistic regression analyses were performed using Stata 14. Over half (56.3%) of the patients delayed seeking health care for more than 30 days after the onset of their symptoms, 32% sought treatment from informal providers, and 13.3% self-medicated. Lack of suspicion of a TB diagnosis, which was prevalent in 45% of respondents, was statistically associated with delay in seeking healthcare (AOR = 0.53, CI: 0.32-1.87). Overall TB knowledge was high, correct knowledge about TB transmission was 92.6%. TB knowledge was significantly associated with educational status (AOR = 3.96, CI: 1.69-9.28) and seeking treatment from informal sectors (AOR = 0.17, CI: 0.03-0.95). High overall TB knowledge was not statistically associated with seeking health care for TB diagnosis and treatment. We found a substantial delay between the onset of TB symptoms and seeking healthcare from a public health facility providing TB screening services. Promoting early screening and diagnosis through increasing awareness of TB is key in the elimination of TB in communities with a high TB burden

Tuberculosis, a preventable pandemic through sensitization programme

The focus of India's tuberculosis control measure has shifted to improving education, understanding symptoms, eliminating transmission, and trying to influence healthcare seeking behavior among both tuberculosis patients and the general public. Tuberculosis is the leading cause of death from an infectious disease worldwide, and drug-resistant strains pose a significant threat to global health security. Sensitization programmes regarding Tuberculosis Disease, Early Detection, Vaccination, Screening, Treatment Compliance, Cough Etiquette & Disposal of Sputum, National Health Programmes, Nutrition, Home & Environment Control can create patient awareness of tuberculosis can promote infection prevention and treatment adherence. Tuberculosis can be reduced by using measures like protecting one's mouth while coughing or sneezing and safely dispose of sputum. Besides that, appropriate sputum disposal will dramatically reduce disease transmission. In tuberculosis patients, knowledge and understanding of touch sensitivity to droplet infection is understood to influence their behavior and assess the frequency and level of transmission in their contacts. Early diagnosis of pulmonary tuberculosis patients and treatment with a complete course of anti-tuberculosis medications are important for TB management. As a result, any reported TB symptomatics with a cough lasting more than two weeks should be referred for TB assessment. Following that, proper treatment necessitates adherence to World Health Organization-recommended treatment guidelines as well as other relevant TB care requirements such as the International Standards for TB Care (ISTC) and the Standards for TB Care in India. Tuberculosis (TB) is still prevalent in many parts of the world, including India, and needs monitoring, clinical assessment, examination, touch tracking, proof of diagnosis, and treatment regimens that are either monitored or unsupervised for successful eradication.

Extrapulmonary tuberculosis among migrants in Europe, 1995 to 2017

ObjectivesThe proportion of tuberculosis (TB) cases occurring in migrants in Europe is increasing. Extrapulmonary TB poses challenges in diagnosis and treatment and causes serious morbidity and mortality, yet its extent in migrant populations is unclear. We assessed patterns of extrapulmonary TB in migrants across the European Union (EU)/European Free Trade Association (EFTA). We investigated the proportion of extrapulmonary TB cases among migrants versus non-migrants, and variations by specific site of disease, reporting European region, and migrant region of origin. MethodsWe carried out a cross-sectional secondary database analysis, utilizing 23 years of data collected between 1995 and 2017 from the European Surveillance System of the European Centre for Disease Prevention and Control for 32 EU/EFTA countries. ResultsIn total, 1 270 896 TB cases were included, comprising 326 987 migrants (25.7%) and 943 909 non-migrants (74.3%). Of TB cases among migrants, 45.2% (n = 147 814) were extrapulmonary compared to 21.7% (n = 204 613) among non-migrants (p < 0.001). Lymphatic, bone/joint and peritoneal/digestive TB were more common among migrant than non-migrant extrapulmonary cases. A lower proportion of extrapulmonary TB was seen in Eastern Europe (17.4%, n = 98 656 of 566 170) and Southern Europe (29.6%, n = 62 481 of 210 828) compared with Western (35.7%, n = 89 498 of 250 517) and Northern Europe (41.8%, n = 101 792 of 243 381). Migrants from South-East Asia and Sub-Saharan Africa were at highest risk of extrapulmonary disease, with 62.0% (n = 55 401 of 89 353) and 54.5% (n = 38 327 of 70 378) of cases, respectively, being extrapulmonary. ConclusionsAmong TB cases in the EU/EFTA, extrapulmonary disease is significantly more common in migrants than in non-migrants. There is a need to improve clinical awareness of extrapulmonary TB and to integrate its detection into screening programmes.

Perception about BCG vaccination and tuberculosis among urban mothers

Aim: To identify perception about BCG vaccination and Tuberculosis awareness among urban mothers. Methodology: A cross sectional study was carried out among mothers residing in urban areas through health camps to know awareness about schedule of BCG vaccination, purpose of giving it and also find out awareness about Tuberculosis disease. Data was collected from August 2016 to January 2017 using a standard semi-structured questionnaire. Chi-square test was utilized to find the factors which are associated with students’ knowledge about TB Results: Among 241 study participants, main source of vaccine information was health department [n=127, 52.7%] were aware of side effects of BCG vaccination [n=219, 90.9%] .All the participants had heard about Tuberculosis disease [n=241, 100%], majority knew that it was a contagious [n=236, 97.9%] and mode of transmission [n= 199, 82.6%]. Conclusion: Health workers continue to be main source of information for BCG vaccination and Tuberculosis. Awareness has to be improved regarding transmission of TB and prevention of TB meningitis through BCG vaccination. Keywords: BCG, TB, Perception, Mothers, Vaccination.

An exploration of health workers risks of contracting tuberculosis in the workplace: a qualitative study

BackgroundTo explore the perceptions of health workers on the risks of contracting tuberculosis at Namwala District Hospital. Tuberculosis literature indicates that health workers are at risk of contracting tuberculosis while conducting their daily duties in the workplace. This is mainly attributed to low tuberculosis awareness. It is with this empirical evidence that this study was conducted to further explore health workers risky behavior, attitude and practices that expose them to tuberculosis infection when on duty and eventually generate effective health promotion and public health interventions.MethodsSemi-structured interviews lasting between 35 to 45 min were conducted to all the participants. A purposive sampling technique was used to recruit ten participants for this study. All the ten interviews were audio recorded in order to enhance consistency during data analysis process. Interview materials were transcribed verbatim, coded and themes generated to form thematic networks. Data analysis was conducted using thematic analysis strategy.ResultsFour themes were identified; 1. Health workers personal safety: participants reported wearing uniforms and gloves but they were not putting-on face masks hence, exposing themselves to tuberculosis infection. 2. Tuberculosis infection prevention practices: hand washing was described by many participants as a universal method of protecting health staff from the risks of contracting tuberculosis at the hospital however, few health workers frequently washed their hands after attending to tuberculosis patients. 3. Health workers working environment: the working environment at the hospital was not conducive for both health workers and patients due to poor ventilation, unhygienic conditions, overcrowding and the lack of an isolation ward. 4. Health promotion: awareness on tuberculosis was reported to be low with no refresher training being conducted for health workers at the hospital.ConclusionThe risks of contracting tuberculosis by health workers at Namwala District Hospital did exist hence, a need of advocating for tuberculosis awareness for health workers through appropriate health promotion interventions. Health policy should focus on continuous health promotion activities on prevention and control of tuberculosis in health facilities and communities.

Opportunities from a new disease for an old threat: Extending COVID-19 efforts to address tuberculosis in South Africa.

The COVID-19 pandemic and phased nationwide lockdown have impacted negatively on individuals with tuberculosis (TB) and routine TB services. Through a literature review and the perspective of members of a national TB Think Tank task team, we describe the impact of the pandemic and lockdown on TB patients and services as well as the potential long-term setback to TB control in South Africa (SA). Strategies to mitigate risk and impact are explored, together with opportunities to leverage synergies from both diseases to the benefit of the National TB Programme (NTP). With the emergence of COVID-19, activities to address this new pandemic have been prioritised across all sectors. Within the health system, the health workforce and resources have been redirected away from routine services towards the new disease priority. The social determinants of health have deteriorated during the lockdown, potentially increasing progression to TB disease and impacting negatively on people with TB and their households, resulting in additional barriers to accessing TB care, with early reports of a decline in TB testing rates. Fewer TB diagnoses, less attention to adherence and support during TB treatment, poorer treatment outcomes and consequent increased transmission will increase the TB burden and TB-related mortality. People with TB or a history of TB are likely to be vulnerable to COVID-19. Modifications to current treatment practices are suggested to reduce visits to health facilities and minimise the risks of COVID-19 exposure. The COVID-19 pandemic has the potential to negatively impact on TB control in TB-endemic settings such as SA. However, there are COVID-19-related health systems-strengthening developments that may help the NTP mitigate the impact of the pandemic on TB control. By integrating TB case finding into the advanced screening, testing, tracing and monitoring systems established for COVID-19, TB case finding and linkage to care could increase, with many more TB patients starting treatment. Similarly, integrating knowledge and awareness of TB into the increased healthcare worker and community education on infectious respiratory diseases, behavioural practices around infection prevention and control, and cough etiquette, including destigmatisation of mask use, may contribute to reducing TB transmission. However, these potential gains could be overwhelmed by the impact of increasing poverty and other social determinants of health on the burden of TB.

Knowledge and awareness among college students about the importance of iron blockage in tuberculosis - A survey

Tuberculosis threatens to destroy millions across the globe. There is an urgent need for new methods to prevent and treat the disease. Similar to most microorganisms, mycobacterium tuberculosis - the causative agent of tuberculosis, requires iron for important metabolic pathways. Since iron is not readily accessible in the host, pathogens must compete aggressively to create an infection for this metal, but they must also carefully regulate the acquisition of iron, as excess free iron can be highly toxic. The aim of the study was to create awareness of iron blockage and stop tuberculosis among college students. A descriptive survey was conducted among various college students using questionnaires in google forms. The questionnaire consists of 16 questions were framed based on the knowledge and awareness of iron knowledge to stop tuberculosis and receive a response from 100 participants. In this survey, 67.53% were aware of Mycobacterium tuberculosis cause tuberculosis in the human body and 59.74% were aware that bacteria which causes tuberculosis to need iron to survive but 27.27% were not aware. Majority of participants were aware that iron was capable of restarting replication and refractive to antibodies and trigger the state of persistence bacteria. Nearly 57.14% of participants Mycobacterium tuberculosis has a remarkable ability to persist in the absence of Fe, but 19.48% stated it does not survive. By this current survey, it can be evident that the majority of participants are educated about knowledge of tuberculosis associated with causes, main role and physiological mechanisms involved in it.

Awareness of Tuberculosis and RNTCP among Interns at a Tertiary Care Hospital in Goa

Introduction: India is the highest burdened country with Tuberculosis (TB) bearing over one fourth of the global TB burden. HIV and drug resistance have further complicated the scenario. Thorough knowledge about TB, its diagnosis and treatment as well as about HIV-TB and drug resistance is needed to make RNTCP and TB control a success. Materials & Methods: A cross sectional study was conducted among 90 medical interns who answered a self-administered semi structured questionnaire consisting of 30 questions, answered over 30 minutes, conducted over a 3-month period from July to September 2019. Data was entered in MS Excel and analysed using SPSS 14.0 software. Results were expressed in percentages and proportions. P value <0.05 was considered as statistically significant. Result: The response rate was 100%. Mean age of interns was 23 to 25 years with 56.6% of them being females. 98.8% of the interns correctly identified the chief symptom of TB. 90% of them knew the role of DOTS centre in TB control. However, the overall knowledge regarding HIV-TB and Drug resistant TB was poor. None of them had received prior RNTCP training. Conclusion: Our study has identified several gaps in the knowledge among medical interns in Goa regarding various aspects of TB diagnosis, RNTCP, HIV-TB and Drug resistant TB. RNTCP training and sensitization must be a mandatory part of the interns training to improve the control of TB in India. How to cite this article:Naik MV, Parrikar AAP, Cacodcar JA. Awareness of Tuberculosis and RNTCP among Interns at a Tertiary Care Hospital in Goa. Epidem Int 2020; 5(3): 1-5. DOI: https://doi.org/10.24321/2455.7048.202019

Social media for health promotion: A visual analysis of “TB proof” South Africa's Facebook page

Health promotion is an educational tool that can be used to educate and create awareness of health issues through various media forms. The purpose of this study was to explore the use of social media (TB Proof South Africa's Facebook page) in creating tuberculosis (TB) awareness. A qualitative case study approach was used to collect data from TB Proof South Africa's Facebook page. An in-depth visual analysis of TB Proof South Africa's Facebook page was carried out over a five-month period (from 1 February to June 30, 2017). The analysis of TB Proof South Africa's Facebook page was conducted in order to determine the use of social media for health promotion. Such a comprehensive analysis was aimed at determining if the visuals on this page create awareness on TB as an illness. Common themes were identified including, TB medication, TB patients and healthcare workers raising awareness on TB. The findings have potential implications for health promotion efforts using social media.

Extrapulmonary tuberculosis among migrants in the EU/EFTA: Implications for policy and practice

Abstract Background The proportion of tuberculosis (TB) cases in the European Union/European Free Trade Association (EU/EFTA) that occur in migrants is increasing. Extrapulmonary TB poses challenges in diagnosis and treatment and causes serious morbidity and mortality. To date, there has been no in-depth exploration of extrapulmonary TB in migrants across Europe. Methods We analysed 22 years of data from the European Centre for Disease Prevention and Control's European Surveillance System (TESSy) for 32 EU/EFTA countries between 1995 and 2017. We investigated whether the proportion of TB cases that were extrapulmonary varied between migrants and non-migrants, and whether this varied by a) country/region of origin, b) reporting country/region, and c) site of disease. Results 1,270,896 TB cases were included in the analysis, comprising 326,987 (25.7%) migrants, and 943,909 (74.3%) non-migrants. The proportion of TB that is extrapulmonary is significantly higher in migrants than in non-migrants: 45.2% (n = 147,814) of cases in migrants were extrapulmonary, compared to 21.7% (n = 204,613) in non-migrants (χ2=6.7x104, p &amp;lt; 0.001). A relatively low proportion of extrapulmonary TB was seen in Eastern (17.4%) and Southern (29.6%) Europe compared with Western (35.7%) and Northern (41.8%) Europe, with migrants having a greater proportion of extrapulmonary TB only in Northern/Western Europe. Migrants from South-East Asia and Sub-Saharan Africa were at highest risk of extrapulmonary TB, with over half of all cases being extrapulmonary (62.0% and 54.5% respectively). Conclusions Among TB cases in the EU/EFTA, extrapulmonary disease is significantly more common in migrants than non-migrants, which has clinical and policy implications for patient detection and management. There is a need to improve clinical awareness of extrapulmonary TB, integrate detection of extrapulmonary TB into latent TB infection screening programmes, and harmonise data collection on migrant status in health systems. Key messages Migrants in the EU/EFTA are disproportionately affected by extrapulmonary TB compared to non-migrants. This has clinical and policy implications for diagnosis, screening, and data collection.

Survey of the knowledge, attitude and perceptions on bovine tuberculosis in Mnisi community, Mpumalanga, South Africa.

Tuberculosis (TB) is a global health concern of zoonotic importance, and Mycobacterium bovis and Mycobacterium tuberculosis are the most common causes of TB in animals and humans, respectively. Integral to TB control strategies are the communities affected by this epidemic. Tuberculosis awareness by the community is an effective TB control strategy as education empowers people to make informed choices with regard to mitigating TB risk factors in their daily lives. We conducted a knowledge, attitude and perceptions survey in Mnisi pastoral community in South Africa using a semi-structured questionnaire to evaluate the level of bovine TB (bTB) awareness, and provided informed feedback to the community on the outcome of the study. Although participants were aware of TB, the knowledge of the zoonotic potential of bTB and about susceptible hosts was limited. The study findings showed knowledge gaps regarding common risk factors, including coughing while herding cattle, unsupervised/uninspected communal slaughter and improper disposal of infected meat. In contrast, it was noted that the majority of participants discarded meat with visible lesions and consumed pasteurised milk; thus, the risk of TB transmission via the ingestion route is low. Tuberculosis knowledge gaps were evident in the community, and public health and veterinary authorities need to improve relationships with stakeholders and implement awareness programmes that use a one health approach.

Impact of Targeted Local Interventions on Tuberculosis Awareness and Screening Among Persons Experiencing Homelessness During a Large Tuberculosis Outbreak in Atlanta, Georgia, 2015-2016.

Tuberculosis (TB) outbreaks disproportionately affect persons experiencing homelessness (PEH) in the United States. During 2014-2016, a resurgent TB outbreak occurred among PEH in Atlanta, Georgia. To control the outbreak, citywide policies and educational interventions were implemented in January 2015. Policy changes standardized and enforced TB screening requirements for PEH in homeless shelters. Educational campaigns informed PEH of the outbreak and encouraged TB screening. We evaluated factors associated with, and the effect policy changes and educational interventions had on, TB screening and awareness among PEH in Atlanta. Questions related to TB screening and awareness of the outbreak were added to an annual US Department of Housing and Urban Development survey of PEH in Atlanta in 2015 (n = 296 respondents) and 2016 (n = 1325 respondents). We analyzed the 2016 survey data to determine characteristics associated with outcomes. From 2015 to 2016, reported TB screening increased from 81% to 86%, and awareness of the TB outbreak increased from 68% to 75%. In 2016, sheltered PEH were significantly more likely than unsheltered PEH to report being evaluated for TB in the previous 6 months (prevalence odds ratio [pOR] = 3.18; 95% confidence interval [CI], 2.28-4.47) and to report being aware of the TB outbreak (pOR = 4.00; 95% CI, 2.89-5.55). Implementation of required TB screening and educational interventions may reduce the incidence and severity of TB outbreaks among PEH in other communities. Furthermore, the annual survey of PEH offers an opportunity to collect data to better inform practices and policies.

Tuberculosis among First Nations, Inuit and Métis children and youth in Canada: Beyond medical management.

First Nations, Inuit and Métis people in Canada continue to be disproportionately affected by tuberculosis (TB), a disparity rooted primarily in factors such as poverty, crowded and inadequate housing, food insecurity, and inequitable health care access. Historical TB control practices in Canada have contributed to stigma and discrimination toward those with the disease, as well as fear and mistrust of the health system. These individual and system-level factors result in delays in TB diagnoses, ongoing transmission, poorer outcomes, and lower treatment completion rates. Children are especially vulnerable, as they are more likely to develop disease once infected with TB bacteria and to experience life-threatening conditions such as TB meningitis. Paediatric health professionals can help to increase TB awareness and literacy, reduce stigma and discrimination, and ultimately, improve the quality and uptake of services for treatment and prevention in families and communities at risk. They can also advocate for sustainable, community-driven TB elimination strategies that incorporate First Nations, Inuit and Métis principles of wellness, healing and self-determination.