Cases Of Pulmonary Tuberculosis Research Articles

Comparison study of genexpert MTB / RIF assay versus sputum smear microscopy results in presumptive tuberculosis cases in district Ghotki, Sindh.

Objective: To evaluate the performance of GeneXpert MTB/RIF assay by comparing its results with sputum smear microscopy. Study Design: Comparative Cross-Sectional Study. Setting: Department of Outpatient (OPD), Taluka and District Head Quarter Hospitals of District Ghotki Sindh. Period: October 2022 to 2023. Methods: In this study 350 Participants were included and all sputum specimens were tested for both above mentioned diagnostic tools that are sputum smear microscopy and GeneXpert MTB/RIF assay during the period October 2022 to April 2023. All details regarding the study such as Demographic details, sputum smear microscopy results, and GeneXpert MTB/RIF assay test results of patients were collected. A case of pulmonary tuberculosis (PTB) was considered to be a patient having mycobacterium tuberculosis detected in sputum by GeneXpert MTB/RIF assay. Results: In this study, 61 cases (17.4%) out of 350 participants, were detected in GeneXpert MTB/ RIF assay and 35 cases (10%) out of 350 participants were positive in sputum smear microscopy. Male ratio is slightly higher than female among GeneXpert positive cases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy sputum smear microscopy were 57%, 100%, 100%, 91.7%, and 92.5%, respectively, when GeneXpert test is taken as reference test. Conclusion: Sputum smear microscopy is as specific as GeneXpert but less sensitive test for the diagnosis of pulmonary tuberculosis than GeneXpert MTB/RIF assay.

Prevalence trends, population characteristics and treatment outcomes of tuberculosis combined with diabetes in Southwest China: a register-based retrospective study.

The global situation regarding the prevention and control of pulmonary tuberculosis (PTB) remains challenging. With the ongoing aging population and the increasing prevalence of chronic diseases, the epidemic of comorbid pulmonary tuberculosis and diabetes mellitus (PTB-DM) presents challenges to PTB control. We conducted this study given that current research on PTB-DM has primarily focused on clinical medicine and immunology, with limited reports on the true prevalence of population-wide PTB-DM in specific regions, as well as the heightened risk of PTB-DM co-prevalence due to aging and the high prevalence of DM in Chongqing, Southwest China. This retrospective study used PTB case data from the PTB Information Management System within the China Information System for Disease Control and Prevention (CISDP). The medical records of 112,592 PTB patients registered in Chongqing from 2016 to 2022 were extracted. After excluding patients with incomplete records, those not residing in Chongqing, and individuals still undergoing treatment, a total of 108,003 PTB patients were included in the study. The trend in PTB-DM incidence was analyzed using the Joinpoint regression model, and population and clinical characteristics of patients were described using frequencies (n) and percentages. Chi-squared test and Fisher's exact tests was used to compare groups, and multivariable logistic regression model with stepwise backward elimination based on the Wald test was used to examine risk factors for adverse treatment outcomes. From 2016 to 2022, the incidence rate of PTB in southwest China showed a decreasing trend (AAPC = -10.22, 95% CI: -11.49% ~ -8.94%), while the incidence rate of PTB-DM increased rapidly (AAPC = 14.25, 95% CI: 11.35% ~17.23%). The proportion of PTB-DM among PTB cases increased from 2.96 to 12.28%. PTB-DM patients were characterized by a higher proportion of males and older adult individuals, the age range of the patients was 11 ~ 100 years, with a mean age of 58.21 ± 12.02 years, with multiple positive aetiological results, and lower rates of proactive medical consultation. Among PTB-DM patients, successful outcomes accounted for 80.85%, while unsuccessful outcomes accounted for 19.15%. Although the number of PTB-DM patients with successful treatment outcomes increased overall (AAPC = 12.22, 95% CI: 10.30% ~14.16%), the failure rate showed a gradual upward trend (AAPC = 14.18, 95% CI: 6.53% ~ 27.67%). Older age, retreatment, referral, and multiple positive aetiological results were risk factors for adverse treatment outcomes among PTB-DM patients. The study presents the true prevalence of PTB-DM comorbidity in the general population of Southwest China, revealing a significant upward trend in its prevalence and a higher risk of adverse outcomes among PTB-DM patients. Future efforts should focus on the prevention and control of PTB-DM comorbidity, with early screening and standardized treatment for high-risk groups such as the older adult, as well as implementing comprehensive and effective treatment and management measures for patients.

Analysis and prediction of infectious diseases based on spatial visualization and machine learning.

Infectious diseases are a global public health problem that poses a threat to human society. Since the 1970s, constantly mutated new infectious viruses have been quietly attacking humanity, and at least one new type of infectious disease is discovered every year. Therefore, early warning of infectious diseases will greatly reduce the socio-economic harm of infectious diseases. This study is based on the data of COVID-19 epidemic in China (except Macau and Taiwan Province) from 2020 to 2022. Firstly, we used ArcGIS software to analyze the spatial agglomeration pattern of the number of patients in various regions of China through global spatial autocorrelation analysis, local spatial autocorrelation analysis, center of gravity trajectory migration algorithm and other statistical tools; In addition, the areas with serious COVID-19 epidemic and requiring special attention were screened out. Then, autoregressive integrated moving average model (ARIMA), extreme learning machine (ELM), support vector regression (SVR), wavelet neural network (Wavelet), recurrent neural network (RNN) and long short-term memory (LSTM) were used to predict COVID-19 epidemic data in Guangdong Province, China; And the prediction performance of each model was compared through prediction accuracy indicators. Finally, a multi algorithm fusion learning model based on stacking technology is proposed to address the problem of poor generalization ability of single algorithm models in prediction; Furthermore, radial basis function network (RBF) was used as a two-level meta learner to fuse the above models, and particle swarm optimization (PSO) was used to optimize RBF parameters to reduce generalization error. The experimental results show that the performance of the integrated model is better than that of the single model in the COVID-19 dataset. In order to better apply the stacking model to the prediction of new infectious diseases, we applied the prediction model based on the COVID-19 dataset to the prediction of the number of AIDS and pulmonary tuberculosis (PTB) cases, and verified the wide applicability of our model in the prediction of infectious diseases.

Ecological Studies of Climate Factors and Pulmonary Tuberculosis Cases in Padang City 2020-2023

Introduction: Tuberculosis (TB) is actually a disease that can be prevented and cured. In 2022, TB became the second leading cause of death in the world after Coronavirus (COVID-19), and caused twice as many deaths as HIV/AIDS. Several studies have stated that climate factors such as exposure to high temperatures, dry environments and exposure to ultraviolet light can influence the growth of Mycobacterium tuberculosis. Objective: This research aims to determine the distribution and correlation of climate factors with the number of pulmonary TB cases in Padang City in 2020-2023. Method: This research is an ecological study with the study population of Padang City. In this study the dependent variable is pulmonary TB cases and the independent variables are temperature, precipitation, and humidity. Pearson correlation is used to determine whether or not there is a relationship, the strength of the relationship, and the direction of the relationship between two normally distributed numerical variables. This research also describes descriptively the distribution of pulmonary TB cases in Padang City based on sub-districts using spatial analysis. Result: There is significant relationship in 2022 between temperature (p=0.010) and precipitation (p=0.019) with pulmonary TB cases in Padang City. However, there are no variables of climates related to pulmonary TB when analyzed cumulatively from 2020-2023. Based on the results of spatial analysis, it can be seen that Koto Tangah sub-district is consistently in the high category of pulmonary TB cases in 2020-2023. Conclusion: The research results found that temperature and precipitation in 2022 were significantly related with the incidence of pulmonary TB, while the humidity variable had no significant relationship with the incidence of pulmonary TB cases in Padang City. It is recommended to make climate factors such as one of the considerations in making policies related to the prevention of pulmonary TB.

Case of delayed diagnosis of combined urogenita and pulmonary tuberculosis in a patient with abnormal uterine bleeding

According to the World Health Organization tuberculosis remains a global health issue for both adult and pediatric populations worldwide. Among women the peak incidence occurs during the active reproductive age, with pregnant women being 1.5–2 times more likely to be affected and experience more severe symptoms than non-pregnant women. In the Altai Region, the epidemiological situation of tuberculosis is characterized by instability, with the incidence rate among women reaching30.5 per 100 000 of the corresponding population in 2022. Delayed diagnosis and treatment can lead to serious complications, including fatal outcomes for both mother and fetus. This article describes a clinical observation of a case of urogenital and pulmonary tuberculosis diagnosed three months after premature abdominal delivery. The course of pregnancy was complicated by acute pleuritis at 13–14 weeks, however, negative results of bacteriological culture of pleural fluid led to the absence of specific tuberculosis treatment and the development of chronic subcompensated placental dysfunction. Three months after delivery, a 34-year-old patient was admitted to the gynecological department of the emergency hospital with abnormal uterine bleeding. The diagnosis was confirmed by histopathology of an endometrial sample revealing tuberculous granulomas without caseous necrosis with epithelioid giant cells of Pirogov – Langhans. Subsequently, generalized tuberculosis was diagnosed in the preterm infant. The negative impact of undiagnosed combined urogenital and pulmonary tuberculosis on the course and outcome of pregnancy is demonstrated, including the development of anemia, placental dysfunction, preterm delivery, puerperal complications, and adverse perinatal outcomes.

Analysis of the epidemic characteristics of reported pulmonary tuberculosis incidence in Kashgar Prefecture, Xinjiang Uygur Autonomous Region from 2015 to 2022 and establishment of SARIMA prediction

Objective: To analyze the epidemic characteristics of reported tuberculosis incidence in Kashgar from 2015 to 2022, and use the seasonal autoregressive integrated moving average (SARIMA) model to predict the incidence, providing references for the local control of pulmonary tuberculosis. Methods: The reported incidence data of tuberculosis in the Kashgar area of Xinjiang from January 2015 to August 2023 were collected through the"Infectious Disease Monitoring System", a subsystem of the "Chinese Disease Prevention and Control Information System". The epidemic characteristics of reported incidence in this area from 2015 to 2022 were analyzed. Two SARIMA models of monthly reported incidence number and rate were established. The prediction performance of the two models was evaluated using the reported incidence data of tuberculosis from January 2023 to August 2023. The χ2 test was used to analyze population characteristics, and the Cochran-Armitage trend test was used to analyze annual incidence. Results: From 2015 to 2022, 133 972 cases of pulmonary tuberculosis were reported in Kashgar, with a yearly reported incidence rate of 383.64/100 000, showing a rising trend (TCA=77.03, P<0.001) and then a declining trend (TCA=176.16, P<0.001). The proportion of pathogenic positive pulmonary tuberculosis had increased yearly (TCA=132.66, P<0.001). The reported onset time was concentrated from January to June each year, with a peak in April. Yengisar County, Zepu County and Yopurga County had the highest reported incidence rate in Kashgar. The sex ratio of men to women was 1.03∶1, and the reported incidence rate of men was higher than that of women (χ2=27.04, P<0.001). The reported incidence rate of the group aged 60 years and older was the highest. The patient's occupation was mainly farmers (84.99%). The average relative errors of the SARIMA (1, 1, 2) (0, 1, 1)12 model and SARIMA (0, 1, 1)(0, 1, 1)12 model in predicting the reported monthly incidence number and rate were 11.67% and -9.81%, respectively. Both models had good prediction accuracy (MAPE=33.55%, MAPE=38.22%). Conclusion: The average reported incidence rate of pulmonary tuberculosis in the Kashgar area shows a rising trend first and then a declining trend. The patients are mainly men and farmers, and attention should be paid to the prevention and control of tuberculosis among the elderly in winter and spring. The SARIMA (1, 1, 2) (0, 1, 1)12 model and SARIMA (0, 1, 1)(0, 1, 1)12 model can fit the trend of reported tuberculosis incidence in the Kashgar area well and have good predictive performance.

ANALYSIS OF QUALITY OF LIFE AND COMPLIANCE LEVEL OF PULMONARY TB PATIENTS AND BODY MASS INDEX IN POST-TRANSFERENCE TREATMENT ANTI TUBERCULOSIS IN HOSPITAL dr. M HAULUSSY AMBON

Tuberculosis is the most common multi-systemic infection, with various types of manifestation and clinical description, lung is the most common location for developing tuberculosis disease (WHO, 2018). As many as 58% of cases of pulmonary TB occur in 3 (three) countries such as Southeast Asia. Based on profile Service Health Maluku Province, in 2021 number of invention Pulmonary TB cases Service Health (Health Office) of Maluku Province to end in 2019 it reached 6,379 people or by 0.35 percent of total population in the province the largest as 1.8 million people.This research uses a quantitative observational design with a cross sectional approach. With sample use systematic type Purposive sampling of 83 respondents. Data analysis using linear regression. Results test statistics show the most influential variable to level pulmonary tuberculosis treatment is a level indicator compliance with level significance sig 0.000. Based on the results of the Multiple Linear Regression analysis, it shows that with a p-value of 0.00 0 &lt; 0.05, H 1 is accepted, so it is concluded that there is a simultaneous influence quality of life as well as the level of compliance of TB lung sufferers And body mass index on post treatment tb lung at DR M Haulussy Ambon Regional Hospital.

Rapid diagnosis of latent and active pulmonary tuberculosis by autofluorescence spectroscopy of blood plasma combined with Artificial Neural Network algorithm

The existing clinical diagnostic methods of pulmonary tuberculosis (TB) usually have some of the following limitations, such as time-consuming, invasive, radioactive, insufficiently sensitive and accurate. This study demonstrates the possibility of using blood plasma autofluorescence spectroscopy and Artificial Neural Network (ANN) algorithm for the rapid and accurate diagnosis of latent and active pulmonary TB from healthy subjects. The fluorescence spectra of blood plasma from 18 healthy volunteers, 12 individuals with latent TB infections and 80 active TB patients are measured and analyzed. By optimizing the ANN structure and activation functions, the ANN three-classification model achieves average classification accuracy of 96.3%, and the accuracy of healthy persons, latent TB infections and active TB patients are 100%, 83.3% and 97.5%, respectively, which is much better than the results of traditional Principal component analysis (PCA) and Linear discriminant analysis (LDA) method. To the best of our knowledge, this is the first research work of differentiating latent, active pulmonary TB cases from healthy samples with autofluorescence spectroscopy. As a rapid, accurate, safe, label-free, non-invasive and cost-effective technique, it can be developed as a promising diagnostic tool for the screening of pulmonary TB disease in the early stage.

Tuberculosis pericarditis: a case report

Tuberculosis (TB) is still prevalent in the world. In 2020, 1.5 million people died from TB.18 TB accounts for 4% of acute pericarditis. Tuberculous pericarditis (TBP) is due to hypersensitivity to tuberculin protein produced by Mycobacterium tuberculosis and develops in 1-2% of pulmonary TB cases, representing about 1-2% of extrapulmonary tuberculosis. Complications occur in the form of acute pericarditis (4%) and cardiac tamponade (7%), which may require life-saving invasive procedures. Tuberculous pericarditis has an overall mortality rate of 1.43 per 100 person-months over a median follow-up of 11.97 months. Risk factors include diabetes, substance use disorder, HIV-positivity, renal insufficiency, biological or immunosuppressive therapy, and exposure to regions with a high prevalence of tuberculosis. We present a 49-year-old diabetic male with a large complex pericardial effusion occurring three months after a diagnosis of TB pleurisy on antituberculosis drugs, which required pericardiocentesis and pericardial window in the context of cardiac tamponade. Cases of TB pericarditis in developed countries are rarely reported, and there are even fewer in the US. Along with a literature review of the road map for its accurate diagnosis and treatment, this case highlights the relevance of TB in the differential of pericarditis worldwide, even in developed countries.

Prevalence of rifampicin and isoniazid mono-resistance among cases of pulmonary tuberculosis from Western Uttar Pradesh, North India.

Mono-resistance to rifampicin/isoniazid increases poor treatment outcomes and the risk of multi-drug resistance (MDR) in tuberculosis (TB) patients. Limited information exists about mono-resistance status of TB patients in Uttar Pradesh, North India. This study aimed to estimate the burden of rifampicin and isoniazid mono-resistance in Western Uttar Pradesh. 153 sputum samples of suspected pulmonary tuberculosis patients were processed to isolate Mycobacterium tuberculosis using the Lowenstein-Jensen (L-J) culture medium. The isolates were identified using an immuno-chromatographic test and IS6110 PCR. The confirmed Mycobacterium tuberculosis isolates were tested for drug susceptibility testing against rifampicin and isoniazid anti-tuberculosis drugs. The results of the drug susceptibility testing were compared with demographic information and analyzed statistically. Out of 153 sputum samples, 83 (54.24%) samples were positive for growth on L-J medium, including 82 (98.79%) Mycobacterium tuberculosis isolates. Of the 82 Mycobacterium tuberculosis isolates, 16 (19.51%), 7 (8.54%), and 5 (6.10%) isolates were MDR, mono-resistant to rifampicin and isoniazid, respectively. The occurrence of RIF/INH mono-resistant-TB was higher in patients of male gender, age above 45 years, living in rural conditions, history of weight loss, and previous anti-TB treatment, but the effect was not statistically significant. The study reported the status of rifampicin and isoniazid mono-resistance among TB patients and highlighted the need for continuous monitoring and improved intervention for the initial detection of mono-drug-resistant cases. This will improve clinical treatment outcomes and decrease the rate of drug-resistant TB in Uttar Pradesh, North India.

Evaluation of Multiplex loop-mediated isothermal amplification assay for the detection of Mycobacterium tuberculosis complex from clinically suspected cases of pulmonary tuberculosis

Tuberculosis (TB) is the second leading cause of death from a single infectious agent worldwide. Bangladesh ranks 7th among the 30 high TB burdened countries in the world. Accurate detection of Mycobacterium tuberculosis complex (MTBC) is challenging for developing countries as most of the resource poor settings are not suitable to perform molecular techniques.The purpose of the study was to compare the multiplex TB-LAMP assay with MTB/NTM qPCR, culture, Z-N staining, and fluorescence microscopy in order to assess the effectiveness of the LAMP assay for detecting cases of pulmonary tuberculosis.This research work was done from March 2022 to February 2023. Fulfilling the inclusion criteria 130 sputum samples were collected. TB-LAMP assay, qPCR, culture in L-J media, Z-N staining and fluorescence microscopy were performed.Out of 130 samples qPCR detected MTBC in 56.92 % cases and TB-LAMP detected 53.85 %. MTBC was detected by culture 46.15 %, by Fluorescence microscopy 40.77 % and Z-N staining 36.92 %. TB-LAMP detected 16.93 % more cases than Z-N staining and 13.08 % more cases than fluorescence microscopy. The sensitivity, specificity, positive, and negative predictive values of multiplex-LAMP assay were 95 %, 81.4 %, 81.4 % and 95 % respectively considering culture as a gold-standard. MTBC negative culture samples (18.57 %) showed positivity by LAMP assay as well as by qPCR. This study detected 7.69 % non-tuberculous mycobacteria (NTM) by qPCR. All NTM positive samples were negative by TB-LAMP.TB-LAMP is an easy to perform, cost-effective, reliable assay with high sensitivity and specificity. World Health Organization recommended TB-LAMP as a rapid molecular test for rapid detection of tuberculosis and as replacement of microscopy in resource poor settings/hard to reach areas. Bangladesh being a high TB burden country it is essential to implement TB-LAMP to achieve End TB Strategy by 2035.

Multidrug-resistant tuberculosis treatment outcomes and associated factors at Yirgalem General Hospital, Sidama Region, South Ethiopia: a retrospective cohort study

BackgroundThe spread of multidrug-resistant tuberculosis (MDR-TB) poses a significant challenge to TB control efforts. This study evaluated the treatment outcomes and associated factors among patients receiving treatment for MDR-TB in southern Ethiopia.MethodsA retrospective follow-up study covering ten years, from 2014 to 2023, analyzed the records of confirmed cases of pulmonary TB admitted to Yirgalem General Hospital, an MDR-TB treatment initiation center in the Sidama Region. To compare the successful treatment outcomes across the years, a chi-square test of independence was conducted. Bivariate and multivariable logistic regression models were used to identify factors associated with treatment outcomes for MDR-TB.ResultsOut of 276 confirmed MDR-TB cases, 4(1.4%) were diagnosed with resistance to second-line drugs (SLDs). Overall, 138 patients achieved favourable treatment outcomes, resulting in a treatment success rate of 50.0% [95% CI 44.1–55.9%]. Among these 138 patients, 105(76.1%, 95 CI 68.7–83.5%) were cured, while 33(23.9%, 95 CI 16.5–31.3%) completed their treatment. The successful treatment outcomes varied significantly across the years, ranging from 3.6% in 2020 to 90% in 2021. The analysis indicated a statistically significant difference in treatment outcomes when considering data from 2014 to 2023 (χ2 = 44.539, p = 0.001). The proportion of patients with deaths, lost-to-follow-up (LTFU), treatment failures and not evaluated were 7.9% [95% CI 4.8–11.2%], 10.9% [95% CI 7.2–14.6%), 2.2% [95% CI 1.1–3.3%), and 28.9% [95% CI 23.7–34.2%] respectively. Individuals with a positive HIV status had significantly lower odds of a favorable treatment outcome [AOR = 0.628, 95% CI (0.479–0.824), p = 0.018]. Similarly, patients with a BMI of less than 18 are more likely to have unfavorable treatment outcomes compared to those with a BMI of 18 or higher [AOR = 2.353, 95% CI 1.404–3.942, p < 0.001].ConclusionThe study revealed a concerning 1.4% prevalence of additional resistance to SLDs. The 50% rate of unfavorable treatment among MDR-TB cases exceeds the target set by the WHO. A significant number of patients (10.9%) were LTFU, and the 28.9% categorized as ‘not evaluated’ is also concerning. Enhanced strategic interventions are needed to reduce such cases, and factors associated with poor treatment outcomes should receive greater attention. Future prospective studies can further explore the factors influencing improved treatment success.

Study of Co-relation between Clinical and Diagnostic Profile of Pediatric Tuberculosis in a Tertiary Care Hospital

Objective: Study of Co-relation between Clinical and Diagnostic profile of Pediatric Tuberculosis in a tertiary care hospital. Methods: This hospital-based observational study was conducted at the Department of Pediatrics, Muzaffarnagar Medical College and Hospital, covering a population of children aged &lt;18 years diagnosed with TB. Data collection spanned 18 months, with a sample size of 100 children. Results: The study identified a predominant TB incidence in children aged 11-17 years (73%) with more females affected (66%) than males. Common symptoms included fever, cough, weight loss, and loss of appetite. Diagnostic findings showed a high use of Chest X-rays and Molecular tests. PTB was the most common form, accounting for 47 cases, EPTB accounting for 48 cases and Disseminated form was seen in 5 cases. Conclusions: Chest X-ray, Tuberculin Skin Test, Molecular Tests, and Blood Tests were universally performed on all patients. Microbiological confirmation is more common in pulmonary tuberculosis cases, while radiology, FNAC/Biopsy, and body fluid analysis are more utilized for extrapulmonary/disseminated cases. Diagnosing tuberculosis (TB) in children is often challenging due to several factors, including the difficulty in obtaining specimens and the typical paucibacillary nature.

Detection of Rifampicin Resistance rpoB Gene Using GeneXpert MTB/RIF Assay in Pulmonary Tuberculosis Cases at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.

Tuberculosis (TB) is a preventable and treatable disease leading to the second death globally. The evolution of drug resistance in Mycobacterium tuberculosis (MTB), particularly rifampicin resistance (RR), has hampered TB control efforts. Thus, this study aimed to provide information regarding the magnitude of MTB and rifampicin resistance among patients tested using the GeneXpert method. A retrospective analysis was carried out at DTCSH. The study included TB registration logbook data from all patients who visited the hospital and were tested for MTB with the Xpert MTB/RIF assay from 2017 to 2024. The laboratory-based data were entered, cleaned, and analyzed using SPSS version 26 software. Multilogistic regression analysis was employed, and a p value ≤ 0.05 was considered statistically significant. A total of 12,981 patient results were included, of which 8.9% (1160/12,981) were MTB-positive and 7.1% (82/1160) were RR. Individuals aged 15-29 years (AOR = 2.13; 95% CI = 1.55-2.93, p < 0.001), living in rural areas (AOR = 1.23; 95% CI = 1.08-1.41, p = 0.003), and HIV+ (AOR = 1.79; 95% CI = 1.48-2.33, p < 0.001) had a higher risk of developing tuberculosis. While RR was identified in 63.4% (52/82) of new, 24.4% (20/82) of re-treated, and 12.2% (10/82) of failed presumptive TB patients. In this study, MTB and RR trends were high. Productive age groups, rural populations, and HIV patients were at risk. To lessen the burden of this contagious and fatal disease, it is recommended to increase early diagnosis of drug-resistant TB and enhance infection control.

A Study of Respiratory Hygiene Among Patients With Respiratory Manifestations in a Selected Primary Healthcare Setting in India.

Tuberculosis is the second leading infectious killer disease, mainly transmitted through undiagnosed presumptive and inadequately treated pulmonary tuberculosis (PTB) cases in the community. This study was conducted to assess the knowledge, attitude, and practices (KAP) related to respiratory hygiene and sputum disposal methods and to estimate the proportion of presumptive PTB cases among patients with clinical features of respiratory manifestations. A hospital-based cross-sectional study was conducted among 80 adult patients with respiratory manifestations at an urban health centre in Goa using a validated, pre-tested, semi-structured questionnaire by interview method. Among 80 study participants, 10 (12.5%) presumptive PTB cases were found. The knowledge regarding the exact cause and transmission of tuberculosis was 55% (44) and 72.4% (58), respectively. Around 32.5% (26) of participants were not following cough etiquette and they studied only up to middle school. Regarding the attitude towards ideal sputum disposal methods, more than three-fourths (81.3%, 65) of the responses were towards unsafe sputum disposal methods. There is a need for health education regarding proper respiratory hygiene and sputum disposal methods, especially among patients with low educational and socio-economic groups.

Cost-effective analysis of active case finding (ACF) strategy to detect pulmonary tuberculosis (PTB) in selected public health care facilities of the northern state, India

BackgroundIn addition to passive case finding (PCF), active case finding (ACF) strategy under National Tuberculosis Elimination Program is a vital secondary prevention intervention under National Strategic Plan (NSP). The present study was conducted to assess ACF's cost-effectiveness compared to PCF in selected public health facilities for the detection of presumptive TB cases under NTEP. Material and methodsA cross-sectional study was carried out in randomly selected seven public health facilities of a health block of one district of Himachal Pradesh. Bottom-up costing method was used with bootstrapping of results to assess incremental cost-effectiveness ratio (CEAC) and cost-effectiveness acceptability curve (CEAC). ResultsMean cost for ACF and PCF with US$ 3325.8 and 3006.0 respectively to detect all presumptive PTB cases; and US$ 4121.2 and to US$ 3709.0 to confirm all PTB cases. Below WTP threshold (per capita income US$ 2735), WTP 80.3% of simulated ICER values were cost-effective. CEAC showed that saturation was achieved around US$ 300 indicating a likely WTP threshold at which 79.5% of simulated values were cost-effective. For both strategies, One way sensitivity analysis showed the cost is influenced mostly by human resources. ConclusionCurrent study used bottom-up costing method in public health care facilities observed ACF as a cost-effective strategy in reaching out for presumptive PTB. The major cost driver in both strategies is human resource for training, travelling, and administration.

Anal tuberculosis presented as chronic perianal abscess in an immunocompetent adult: A rare case report

ABSTRACT There are reported 7.5 million cases of extra pulmonary tuberculosis (TB) (EPTB) worldwide and 19% in the South-East Asia region. Anal TB represents an exceedingly uncommon extra pulmonary manifestation of TB), occurring in fewer than 1% of individuals who acquire TB. The occurrence of perianal illness is extremely rare, accounting for 1% of the gastrointestinal (GI) tract, while GI TB makes up less than 1% of all TB cases. The most prevalent manifestation is the development of a fistula in the anus, while the presentation as a perianal abscess is uncommon. We present a case of isolated perianal TB with no associated GI or pulmonary dissemination in the immunocompetent.

Epidemiological Characteristics and Spatiotemporal Clustering of Pulmonary Tuberculosis Among Students in Southwest China From 2016 to 2022: Analysis of Population-Based Surveillance Data.

Pulmonary tuberculosis (PTB), as a respiratory infectious disease, poses significant risks of covert transmission and dissemination. The high aggregation and close contact among students in Chinese schools exacerbate the transmission risk of PTB outbreaks. This study investigated the epidemiological characteristics, geographic distribution, and spatiotemporal evolution of student PTB in Chongqing, Southwest China, aiming to delineate the incidence risks and clustering patterns of PTB among students. PTB case data from students monitored and reported in the Tuberculosis Information Management System within the China Information System for Disease Control and Prevention were used for this study. Descriptive analyses were conducted to characterize the epidemiological features of student PTB. Spatial trend surface analysis, global and local spatial autocorrelation analyses, and disease rate mapping were performed using ArcGIS 10.3. SaTScan 9.6 software was used to identify spatiotemporal clusters of PTB cases. From 2016 to 2022, a total of 9920 student TB cases were reported in Chongqing, Southwest China, with an average incidence rate of 24.89/100,000. The incidence of student TB showed an initial increase followed by a decline, yet it remained relatively high. High school students (age: 13-18 years; 6649/9920, 67.03%) and college students (age: ≥19 years; 2921/9920, 29.45%) accounted for the majority of student PTB cases. Patient identification primarily relied on passive detection, with a high proportion of delayed diagnosis and positive etiological results. COVID-19 prevention measures have had some impact on reducing incidence levels, but the primary factor appears to be the implementation of screening measures, which facilitated earlier case detection. Global spatial autocorrelation analysis indicated Moran I values of >0 for all years except 2018, ranging from 0.1908 to 0.4645 (all P values were <.05), suggesting strong positive spatial clustering of student PTB cases across Chongqing. Local spatial autocorrelation identified 7 high-high clusters, 13 low-low clusters, 5 high-low clusters, and 4 low-high clusters. High-high clusters were predominantly located in the southeast and northeast parts of Chongqing, consistent with spatial trend surface analysis and spatiotemporal clustering results. Spatiotemporal scan analysis revealed 4 statistically significant spatiotemporal clusters, with the most likely cluster in the southeast (relative risk [RR]=2.87, log likelihood ratio [LLR]=574.29, P<.001) and a secondary cluster in the northeast (RR=1.99, LLR=234.67, P<.001), indicating higher reported student TB cases and elevated risks of epidemic spread within these regions. Future efforts should comprehensively enhance prevention and control measures in high-risk areas of PTB in Chongqing to mitigate the incidence risk among students. Additionally, implementing proactive screening strategies and enhancing screening measures are crucial for early identification of student patients to prevent PTB outbreaks in schools.

Characteristics of smear-positive pulmonary tuberculosis with normal chest radiographic findings during a tuberculosis outbreak in northeast Malaysia: A cross-sectional study.

Tuberculosis (TB) remains a highly prevalent disease in Malaysia. Early identification using cost-effective methods such as chest radiography can reduce the health burden of a TB epidemic. However, normal chest radiographic findings are common. This study aimed to evaluate the characteristics of smear-positive pulmonary TB with normal chest radiographic findings during an outbreak. A cross-sectional study was conducted by reviewing the medical records of 56 pulmonary TB cases registered at Kodiang Health Clinic from April to October 2022. Smear-negative and extrapulmonary TB cases were excluded. Relevant information was extracted from the medical records and recorded in a case report form for data management and analysis. Approximately 60.7% of the cases had symptoms lasting >2 weeks, and 89.3% showed abnormal findings upon clinical examination. Additionally, 73.2% had sputum acid-fast bacilli counts of ≥1+, and the sputum Mycobacterium tuberculosis culture and sensitivity test findings were positive in 82.1% of the cases. The proportion of smear-positive pulmonary TB with normal chest radiographic findings was 42.9%. The factors associated with smear-positive pulmonary TB with normal chest radiographic findings included being under 18 years old (P=0.021), being a student (P=0.010), being single (P=0.012) and being asymptomatic (P=0.04). Normal chest radiographic findings may lead to a misdiagnosis of smear-positive pulmonary TB, especially during an outbreak. Therefore, active case detection among close contacts with risk factors for normal radiographic findings should consider additional supportive tests.

Laboratory-based surveillance of non-tuberculous mycobacterial pulmonary disease in Japan

BackgroundIntractable pulmonary diseases with non-tuberculous mycobacteria (NTM-PDs) and antimicrobial resistance have become increasingly concerning worldwide. Nevertheless, a surveillance system for NTM has not been established in most countries, thus requiring repeated, intermittent, and time-consuming cross-sectional nationwide surveys.MethodsTo establish a nationwide surveillance system for NTM-associated diseases, we aimed to develop a prototype computer system primarily designed to continuously estimate NTM-PD incidence using a bacteriological case-defining algorithm through an automatic process of integrating bacteriological data collected from microbiology laboratories across Japan. To validate the accuracy of our study results, we compared the distribution of pulmonary TB cases between our laboratory data and the national surveillance data, which is representative of the Japanese population.ResultsOur estimates implied a 17.7% increase in NTM-PD incidence from 15.8 [14.9–16.8] in 2013 to 19.2 [18.2–20.4] in 2017, per 100 000 population. Moreover, 93.0% of the identified NTM-PD cases were dominated by theMycobacterium avium-intracellularecomplex, and the proportion ofM. abscessusspecies exceeded that ofM. kansasiifor the first time in Japan. We also revealed significant age and sex differences in NTM-PDs. Notably, we found similar characteristics between our laboratory data and national surveillance data covering almost the entire Japanese population.ConclusionThese findings, despite being laboratory-based, are extrapolatable to the general population in Japan and provide evidence that supports our system as a viable alternative to the nationwide NTM surveillance system.