Tuberculosis Cases Research Articles

Foregut tuberculosis: Too close but miles apart

The worldwide burden of tuberculosis (TB) has increased and it can involve virtually any organ of the body. Intestinal TB accounts for about 2% of the cases of TB worldwide. The ileocecal region is the most commonly affected site, and the foregut is rarely involved. The reported incidence is approximately 0.5%. Esophageal TB presents with dysphagia, weight loss, and hematemesis in rare cases. Gastroduodenal TB usually manifests with symptoms such as nausea, vomiting, weight loss, and sometimes with gastric outlet obstruction. Gastroscopy may reveal shallow ulcers in stomach and duodenal deformity when underlying TB is suspected, therefore histopathology plays pivotal role. On computed tomography, duodenal TB typically manifests as duodenal strictures predominantly, accompanied by extrinsic compression, and occasionally as intraluminal mass. But their diagnosis can easily be missed if proper biopsies are not taken and samples are not sent for GeneXpert testing, TB polymerase chain reaction investigation and histopathological analysis. Despite being in close proximity to the lungs, the esophagus and stomach are rare sites of TB. The reasons could be low gastric pH and acidity which does not let mycobacterium grow. But there are various case reports of TB involving the foregut. We have summarized the rare cases of foregut TB in different sections and highlighted the importance of esophagogastroduodenoscopy, histopathology and advanced techniques like endoscopic ultrasound in establishing the diagnosis.

Osteoarticular tuberculosis: imaging findings in pediatric patients.

Osteoarticular tuberculosis (TB) is an uncommon form of extrapulmonary TB that has the potential to damage joints and bones, generating long-term impairment. Mainly, the initial diagnosis of osteoarticular TB relies on clinical findings and imaging. When required, imaging can aim for less invasive tissue or fluid sampling for pathology, microbiology, and molecular biology analysis. Most TB diagnosis tests have variable and frequently poor sensitivities; however, bone biopsy samples have demonstrated a high percentage of culture positivity. Clinical and imaging findings of osteoarticular TB often mimic other processes, such as rheumatoid arthritis or chronic recurrent multifocal osteomyelitis. When the infection affects the growth plates, angular deformities and extremity length discrepancies can arise. Unfortunately, several osteoarticular TB cases are detected late due to the nonspecific nature of clinical symptoms and non-characteristic imaging findings. This article reviews the most common and atypical osteoarticular TB imaging presentations to increase awareness of osteoarticular TB.

Private sector tuberculosis care quality during the COVID-19 pandemic: a repeated cross-sectional standardised patients study of adherence to national TB guidelines in urban Nigeria

Only a third of tuberculosis (TB) cases in Nigeria in 2020 were diagnosed and notified, in part due to low detection and under-reporting from the private health sector. Using a...

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.

INCIDÊNCIA E CARACTERÍSTICAS CLÍNICO-EPIDEMIOLÓGICAS DA TUBERCULOSE EM IMPERATRIZ – MA

INTRODUCTION: Tuberculosis (TB) is an infectious disease transmitted by Mycobacterium tuberculosis, which spreads through the airways when infected individuals cough, sneeze or speak, releasing aerosols containing active bacilli. OBJECTIVE: To analyze the incidence and clinical-epidemiological characteristics of tuberculosis in Imperatriz - Ma, between 2019 and 2023. MATERIALS AND METHODS: Descriptive epidemiological study, with a quantitative approach, carried out from compulsory notifications of new cases of the disease available via DATASUS. The incidence coefficients were calculated for each year of the disease. The epidemiological variables were treated using descriptive statistics. RESULTS: During the period under investigation, 447 new cases of tuberculosis were reported in the city of Imperatriz. The detection rate of new cases was higher in 2022 and lower in 2021. Regarding the epidemiological characteristics, most cases were male, brown race/color, pulmonary clinical form, first positive sputum culture, negative TB/HIV coinfection, DOT not performed, non-smoker, non-alcoholic and with evolution to cure. In addition, the age group of 20 to 29 years, incomplete 5th to 8th grade of PE and 6th month bacilloscopy not performed stood out. FINAL CONSIDERATIONS: It is essential to invest in strategies that expand access and adherence to treatment, promote a more humanized approach in patient monitoring, and develop intersectoral actions to address socioeconomic and educational barriers.

Implementation of ward's agglomerative hierarchical clustering model to detect pulmonary tuberculosis endemic areas in Aceh Utara regency

This study aims to detect pulmonary Tuberculosis (TB) endemic areas in Aceh Utara Regency based on altitude, population density, and the number of TB cases. The Agglomerative Hierarchical Clustering (AHC) algorithm was used to cluster 27 subdistricts, each measured by these three factors. The clustering results divided the subdistricts into three main clusters with distinct characteristics. Cluster 1 consists of subdistricts with low altitude, high population density, and relatively high numbers of TB cases, identifying this area as having the highest risk of TB endemicity. Cluster 2 includes areas with moderate population density and TB case numbers, while Cluster 3 consists of subdistricts at higher altitudes with fewer TB cases. The clustering results were evaluated using three key metrics: Silhouette Score, Davies-Bouldin Index, and Dunn Index, which indicated that the clustering model performed well, although some subdistricts were positioned near the cluster boundaries. This research provides valuable information for health authorities to prioritize interventions and allocate resources to areas most in need of TB management.

Features of the pathogen and efficacy of drug-resistant tuberculosis treatment

According to the World Health Organization (WHO), nearly 10.6 million new cases of tuberculosis were detected in 2022, indicating an increase of 3.5 % from the reported 10.3 million in 2021. After the COVID-19 pandemic, the incidence of tuberculosis increased by 3.9 % from 2020 to 2022. According to the latest regulatory documents, multidrug-resistant pathogen is diagnosed when any bacteriologic or molecular genetic methods reveal drug resistance of M. Tuberculosis complex at least to isoniazid and rifampicin regardless of resistance to other antituberculosis drugs.With a wide range of virulence genes, the tuberculosis pathogen expresses genes in different phases of infection. Some genes are “switched on” in the early phases and are important for overcoming immune defenses and spreading the pathogen in the host, while others are important for survival in the latent phase. These characteristics of Mycobacterium tuberculosis determine the need for correct and adequate selection of therapy. The problem of diagnostics and treatment of drug-resistant tuberculosis remains extremely urgent. Despite the introduction of new tests for rapid determination of drug susceptibility spectrum of Mycobacterium tuberculosis, the problem of timely and adequate prescription of chemotherapy regimen remains. When selecting therapy, the problem of prescribing a combination of antituberculosis drugs with proven efficacy against M. tuberculosis remains. The need to assess the patient’s comorbid status, which affects the effectiveness of treatment and the occurrence of relapses, remains relevant.Despite the introduction of new tests for rapid determination of the drug susceptibility spectrum of Mycobacterium tuberculosis, the problem of timely and adequate prescription of chemotherapy remains relevant. The problem of prescribing a combination of antituberculosis drugs with proven efficacy against M. tuberculosis remains in the selection of therapy. Currently, the introduction of bedaquiline in therapy regimens is important for improving the effectiveness of tuberculosis treatment. In addition, studies are underway to shorten the duration of therapy for MDR-TB and XDR-TB, which is particularly important for maintaining patient adherence to treatment.

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.

Diagnostic accuracy of TB screening tests in a prospective multinational cohort: Chest-X-ray with computer-aided detection, Xpert TB host response, and C-reactive protein.

Accessible, accurate screening tests are necessary to advance tuberculosis (TB) case finding and early detection in high-burden countries. We prospectively screened adults with ≥2 weeks of cough at primary health centers in the Philippines, Vietnam, South Africa, Uganda, and India. Participants received chest-X-ray, Cepheid Xpert TB Host Response (Xpert HR) testing, and point-of-care C-reactive protein (CRP) testing (Boditech). Chest-X-ray images were processed using CAD4TB v7, a computer-aided detection algorithm. We assessed diagnostic accuracy against a microbiologic reference standard (sputum Xpert Ultra, culture). Optimal cut-points were chosen to maximize specificity at 90% sensitivity. Two-test screening algorithms were considered, using 1) sequential negative serial screening (positive defined as positive on either test) and 2) sequential positive serial screening (positive defined as positive on both tests). Between July 2021 and August 2022, 1,392 participants with presumptive TB had valid index tests and reference standard results, and 303 (22%) had confirmed TB. In head-to-head comparisons, CAD4TB v7 showed the highest specificity at 90% sensitivity (70.3% vs. 65.1% for Xpert HR, difference 95% CI 1.6 to 8.9; 49.7% for CRP, difference 95% CI 17.0 to 24.3). Three two-test screening algorithms met WHO target product profile (TPP) minimum accuracy thresholds and had higher accuracy than any test alone. At 90% sensitivity, the specificity was 79.6% for Xpert HR-CAD4TB [sequential negative], 75.9% for CRP-CAD4TB [sequential negative], and 73.7% for Xpert HR-CAD4TB [sequential positive]. CAD4TB achieves TPP targets and outperforms Xpert HR and CRP. Combining screening tests further increased accuracy. NCT04923958.

Operative Procedures and Postoperative Complications in Patients with Gastric Outlet Obstruction

Background: Gastric outlet obstruction denotes complete or partial obstruction of the distal stomach, pylorus, or proximal duodenum. This can happen as a result of an obstructing lesion, external compression, or obstruction caused by acute edema, chronic scarring and fibrosis, or a combination of the two. The most common causes of gastric outlet obstruction are gastric cancer and pyloric stenosis secondary to peptic ulceration. We have very limited research-based information regarding postoperative complications in patients with gastric outlet obstruction. Aim of the study: This study was carried out to determine the operative procedures and postoperative complications in patients with gastric outlet obstruction. Methods: Between September 2012 to February 2013, this prospective observational study was carried out in the surgery department of Rangpur Medical College Hospital, Rangpur, Bangladesh. A total of 50 patients presenting with the features of gastric outlet obstruction were included in this study. A convenient purposive sampling technic was used in sample selection. In 27 patients, surgery was performed. Registration schedules, editing computerization, preparing dummy tables, and analyzing and matching data were all part of the data processing work. Results: In the cases of benign gastric outlet obstruction, bilateral truncal vagotomy and retro colic isoperistaltic gastrojejunostomy were preferred. Distal partial gastrectomy with lymph node dissection was done in resectable antral growth of the stomach. Palliative gastrojejunostomy was done in advanced gastric and pancreatic malignancy. Gastrojejunostomy with biopsy from the duodenum and lymph node was taken from one pre-operatively diagnosed case of duodenal tuberculosis, which was made by endoscopic biopsy. Complication occurred mostly in the malignant cases; 7 (43.75%) patients developed wound infection, of which 5 (31.25%) patients developed wound dehiscence. There was a duodenal stump-blow out in ...

Breast Tuberculosis: A Case Report

Mammary tuberculosis is a rare condition. Early diagnosis is often difficult. Mammary tuberculosis simulates other much more common breast diseases, in particular cancer in older women, and can only be diagnosed definitively by histopathological examination in the presence of epithelio-giganto-cellular granulomas with caseous necrosis. We report a case of mammary tuberculosis in a 42-year-old woman to raise the problem of diagnosis.

Impact of active case finding for tuberculosis with mass chest X-ray screening in Glasgow, Scotland, 1950-1963: An epidemiological analysis of historical data.

Community active case finding (ACF) for tuberculosis was widely implemented in Europe and North America between 1940 and 1970, when incidence was comparable to many present-day high-burden countries. Using an interrupted time series analysis, we analysed the effect of the 1957 Glasgow mass chest X-ray campaign to inform contemporary approaches to screening. Case notifications for 1950 to 1963 were extracted from public health records and linked to demographic data. We fitted Bayesian multilevel regression models to estimate annual relative case notification rates (CNRs) during and after a mass screening intervention implemented over 5 weeks in 1957 compared to the counterfactual scenario where the intervention had not occurred. We additionally estimated case detection ratios and incidence. From 11 March 1957 to 12 April 1957, 714,915 people (622,349 of 819,301 [76.0%] resident adults ≥15 years) were screened with miniature chest X-ray; 2,369 (0.4%) were diagnosed with tuberculosis. Pre-intervention (1950 to 1956), pulmonary CNRs were declining at 2.3% per year from a CNR of 222/100,000 in 1950. With the intervention in 1957, there was a doubling in the pulmonary CNR (RR: 1.95, 95% uncertainty interval [UI] [1.81, 2.11]) and 35% decline in the year after (RR: 0.65, 95% UI [0.59, 0.71]). Post-intervention (1958 to 1963) annual rates of decline (5.4% per year) were greater (RR: 0.77, 95% UI [0.69, 0.85]), and there were an estimated 4,599 (95% UI [3,641, 5,683]) pulmonary case notifications averted due to the intervention. Effects were consistent across all city wards and notifications declined in young children (0 to 5 years) with the intervention. Limitations include the lack of data in historical reports on microbiological testing for tuberculosis, and uncertainty in contributory effects of other contemporaneous interventions including slum clearances, introduction of BCG vaccination programmes, and the ending of postwar food rationing. A single, rapid round of mass screening with chest X-ray (probably the largest ever conducted) likely resulted in a major and sustained reduction in tuberculosis case notifications. Synthesis of evidence from other historical tuberculosis screening programmes is needed to confirm findings from Glasgow and to provide insights into ongoing efforts to successfully implement ACF interventions in today's high tuberculosis burden countries and with new screening tools and technologies.

Tuberculous parotitis: A case series diagnosed on fine needle aspiration

IntroductionTuberculosis (TB) remains a global health concern with diverse clinical manifestations. Parotid tuberculosis, although rare, presents diagnostic challenges due to its atypical presentation. Cytological examination is pivotal in diagnosing parotid lesions. Case presentationWe present three cases of parotid tuberculosis diagnosed through cytology. A 31-year-old male presented with a painless left parotid swelling. FNAC revealed granulomatous inflammation with AFB positivity. The second case, a 14-year-old female had an enlarging mass in the left parotid. FNAC showed granulomas, confirmed by GeneXpert MTB/RIF assay. The third case, a 39-year-old female presented with a painless swelling in the left parotid. FNAC demonstrated granulomatous inflammation, confirmed by mycobacterial culture. ConclusionCytological examination plays a crucial role in diagnosing parotid tuberculosis. These cases underscore the importance of considering TB in parotid masses. Collaboration among clinicians, radiologists, and cytopathologists is essential for accurate diagnosis and prompt management. Further research is needed to optimize diagnostic algorithms for parotid tuberculosis.

Microbiological Aspects and Clinical Impact of Lower Lung Field Tuberculosis: an Observational Cohort Study in Peru.

Approximately 40% of tuberculosis (TB) cases remain undiagnosed globally. Lower lung field tuberculosis (LLF TB) presents atypically and is often misidentified as other lung diseases, leading to diagnostic delays in resource-limited settings. It may contribute to increased TB transmission and mortality. We aimed to identify microbiological determinants of LLF TB and evaluate treatment responses to optimize care. We conducted an observational cohort study in Lima, Peru, enrolling adults with microbiologically confirmed pulmonary TB (PTB) diagnosed by GeneXpert MTB/RIF assay or sputum culture. Mycobacterium tuberculosis (MTB) lineage was determined using whole-genome sequencing (WGS). Due to the delayed chest radiograph (CXR) changes in LLF TB compared to non-LLF TB, we measured changes in the St. George's Respiratory Questionnaire (SGRQ) score at two-month treatment mark and evaluated World Health Organization (WHO)-specified final treatment outcomes. We used logistic regression to evaluate the associations between LLF TB and microbiological determinants and treatment outcomes. We used linear regression to assess whether the change in SGRQ scores over the first 2 months of treatment varied by LLF TB status. Among 1,316 PTB patients, 84 (6%) had LLF TB. Compared to non-LLF TB patients, LLF TB patients were more likely to be smear-negative (adjusted odds ratio [aOR] [95% CI]=2.04 [1.28-3.23], p=0.002) and to be infected with Lineage 2 (aOR [95% CI]= 1.95 (95% CI: 1.07 to 3.41; p=0.024). People with LLF TB had less improvement in SGRQ scores after two months of treatment (adjusted score difference [95% CI] = -6.29 [-10.99 to -1.59], p = 0.009), while they experienced better final outcomes compared to non-LLF TB patients, though this difference did not reach statistical significance (adjusted odds ratio [aOR] = 0.43 [95% CI: 0.13 to 1.05], p = 0.103). Patients with LLF TB are more likely than those with upper lung lesions to be sputum-negative on conventional tests, to be infected with Lineage 2, and to show less clinical improvement after treatment.

A comprehensive study on tuberculosis prediction models: Integrating machine learning into epidemiological analysis.

Tuberculosis (TB), the second leading infectious killer globally, claimed the lives of 1.3 million individuals in 2022, after COVID-19, surpassing the toll of HIV and AIDS. With an estimated 10.6 million new TB cases worldwide in 2022, the gravity of the disease persists, necessitating urgent attention. Tuberculosis remains a critical public health crisis, and efforts to combat this infectious disease demand intensified global commitment and resources. This study utilizes predictive modeling techniques to forecast the incidence of Tuberculosis (TB), employing a range of machine learning models. Additionally, the research incorporates impactful visualizations for comprehensive data exploration,analysis and comparison. Various machine learning models are developed to anticipate TB incidence, with the optimal performing model to customize a user-defined function. This research provides valuable insights into the potential determinants influencing TB incidence, contributing to the identification of strategies for preventing the spread of Tuberculosis.

Performance of stool-based molecular tests and processing methods for paediatric tuberculosis diagnosis: a systematic review and meta-analysis

There has been a global pursuit to improve the diagnosis of tuberculosis in young children by applying diagnostic methods on accessible biospecimens such as stool. We aimed to conduct a systematic review on the accuracy of stool-based molecular tests for tuberculosis diagnosis in children and to assess the impact of the available pre-processing methods and other design characteristics. In this systematic review and meta-analysis, we evaluated studies in children younger than 16years with presumptive tuberculosis that were published in English, Spanish, French, and Portuguese from Jan 1, 2000, to May3, 2024, in MEDLINE, Embase, and Embase Classic, comparing the molecular detection of Mycobacterium tuberculosis DNA in stool with microbiological tests on other samples or a clinical diagnosis. We did not exclude studies based on geographical location, sample size, or study design if they were reporting primary data. Two independent reviewers (LC-C and SM) screened titles, abstracts, and full-text articles for eligibility and extracted data on study characteristics, study population, and diagnostic performance. If information relevant to the main analysis was not reported in the article, the corresponding authors were contacted. Point estimates and 95% CIs were calculated for sensitivity and specificity for each study and for the different molecular tests (Xpert MTB/RIF, Xpert Ultra MTB/RIF [Cepheid, Sunnyvale, CA, USA], and other tests) versus a reference standard (culture only, any bacteriological confirmation, and tuberculosis case definition). Sensitivity and specificity were stratified by the stool processing method. We also quantified the additionality of stool Xpert Ultra tests for tuberculosis bacteriological confirmation. The protocol was registered with PROSPERO, CRD42022341514. A total of 4521records were identified through the database search, one record was identified from an article bibliography, and 67studies were retained for full-text reading. 39studies were included in the qualitative synthesis, 35of which were included in the meta-analyses. When using any bacteriological confirmation from a respiratory sample as the reference standard, stool Xpert sensitivity was 0·60 (95% CI 0·48-0·71), stool Xpert Ultra sensitivity was 0·73 (0·63-0·81), and sensitivity was 0·44 (0·29-0·60) for other in-house molecular methods combined. When using tuberculosis case definition as the reference standard, stool Xpert sensitivity was 0·23 (0·11-0·41), stool Xpert Ultra sensitivity was 0·38 (0·22-0·56), and sensitivity was 0·17 (0·09-0·23) for other in-house molecular methods. The addition of stool Xpert Ultra increased bacteriological confirmation of tuberculosis by 38·6% overall. Further, the utilisation of centrifuge-free simplified methods improved the sensitivity of stool Xpert Ultra when using any bacteriological confirmation as a reference standard (0·77 [0·66-0·85] for centrifuge-free methods vs 0·61[0·41-0·78] for non-centrifuge-free methods). This systematic review and meta-analysis supports the use of Xpert Ultra in stool samples as a diagnostic tool for paediatric tuberculosis diagnosis. Stool-based Xpert Ultra can contribute to increase the bacteriological confirmation in this population, even when respiratory specimens are also tested. The EDCTP2 programme supported by the EU via Stool4TB Project and the European Society of Pediatric Infectious Diseases.

Factors Related To The Performance Of Health Workers In Finding New Cases Of TB Through Contact Investigation At Hutabaginda Community Health Center, North Tapanuli Regency

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Until now, tuberculosis is still a world health problem. It is estimated that about one third of the world's population has been infected by the bacteria. Every second there is one person infected and in the next decade no less than 300 million people will be infected by pulmonary tuberculosis. Objectives: to analyze factors related to the performance of health workers in finding new TB cases through contact investigations at the Hutabaginda Community Health Center, North Tapanuli Regency. Research method: This type of research is quantitative research in the nature of an analytical survey with a cross sectional design. The population in this study were all health workers involved in finding new TB cases through contact investigations at the Hutabaginda Community Health Center, North Tapanuli Regency, totaling 63 people. Results: The results of this research are that there is a relationship between the factors ability, clarity, help, incentive, evaluation, validity and environment with the performance of health workers in finding new TB cases through contact investigations at the Hutabaginda Community Health Center, North Tapanuli Regency Conclusion: With the performance of health workers in the discovery of new TB cases through contact investigation at the Hutabaginda Health Center, North Tapanuli Regency.

Identifying Predictors of Unfavorable Treatment Outcomes in Tuberculosis Patients

Objectives: In South Korea, there has been a continuous decrease in the incidence of tuberculosis (TB) attributable to a national TB elimination program; however, TB still poses a significant socioeconomic burden. This study aimed to analyze factors associated with successful TB treatment and to identify refractory patient groups with unfavorable outcomes. Methods: We analyzed anonymized data on 89,150 patients with TB provided by the Korea Disease Control and Prevention Agency. Specifically, we collected independent variables, which were categorized as individual, regional, and medical facility factors. Individual factors included age, sex, nationality, TB type, drug-resistant status, category of TB, housing type, underlying disease status, number of referrals, and smoking status. Regional factors referred to the region where the TB case was reported. Medical facility factors included the first visit to a medical facility, categorized by hospital type and the distinction between private–public mix (PPM) and non-PPM depending on the presence or absence of dedicated TB nurses. These factors were analyzed in relation to treatment success to identify refractory patient groups with unfavorable outcomes. Results: Multivariable logistic regression analysis revealed the following significant factors associated with successful TB treatment: sex, nationality, status of drug-resistant TB, category of TB, number of referrals, region of TB registry, underlying diseases, and smoking status. Specifically, compared with their relevant counterparts, male patients had a lower rate of successful treatment (adjusted odds ratio [aOR]: 0.66, reference [Ref.]: women); Korean nationals had a higher rate of treatment success (aOR: 7.20, Ref. foreign residents in Korea); resistant TB was associated with a lower rate of treatment success (aOR: 0.35, Ref.: non-resistant TB status); newly treated patients had a higher rate of treatment success (aOR: 1.75, Ref.: retreatment patient); switching hospitals once (aOR: 1.78), never (aOR: 1.41), or twice (aOR: 1.37) was associated with increased treatment success (Ref.: three or more times); having zero (aOR: 1.45), one (aOR: 1.31), or two (aOR: 1.24) underlying diseases was associated with a higher rate of treatment success (Ref. three or more underlying diseases); and past smokers (aOR: 1.40) and non-smokers (aOR: 1.35) had a higher rate of treatment success (Ref.: current smokers). Conclusions: Our study identified several factors contributing to unfavorable treatment outcomes in tuberculosis patients, including male patients, foreign residents in Korea, drug-resistant TB, retreatment patients, frequent hospital switching, multiple underlying diseases, and current smoking status. These research findings could inform the development of efficient management strategies and policies for improving the treatment success rate among patients with TB.

Evaluation of short-course for private doctors in managing children tuberculosis as part of a public-private mix in Surabaya, Indonesia

This study aimed to improve the private doctor’s role in discovering and managing cases of childhood tuberculosis (TB) according to the Directly Observed Treatment Short-course program. This quasi-experimental study with a pre-post design described 75 private doctors (intervention group) who assisted over two months in finding suspected TB children and 75 private doctors (control group). This study used descriptive quantitative data analysis. Sixty-three of the 75 doctors (84%) attended a course to assist suspected tuberculosis children with a moderate level of knowledge (60.0%). Most suspected tuberculosis children had close contact with adult tuberculosis patients (48.1%). The findings indicated that the intervention group, consisting of skilled private doctors, identified a greater number of children believed to have tuberculosis compared to the control group. There has been an increase in the identification of suspected tuberculosis children by private doctors who were through courses and the provision of routine assistance.

Correlation between notifiable infectious diseases and transportation passenger traffic from 2013 to 2019 in mainland China

PurposePopulation mobility significantly contributes to the spread and prevalence of infectious diseases, posing a serious threat to public health safety and sustainable development across the globe. Understanding the impact of population mobility on the prevention and control of infectious diseases holds profound significance.MethodsIn this study, we collected the data on the incidence of notifiable infectious diseases in mainland China from 2013 to 2019, and analyzed the characteristics of notifiable infectious diseases, as well as their correlation with transportation passenger traffic.ResultsAmong 29 common notifiable infectious diseases, the incidence rate of intestinal diseases per 100,000 people was the highest (256.35 cases), while the mortality rate was the lowest (0.017 cases). The mortality rate per 100,000 people due to sexually transmitted and bloodborne diseases was the highest (1.154 cases). A significant linear correlation was noted between commercial passenger traffic and the number of cases of tuberculosis (r = 0.83, P = 0.022), hepatitis A (r = 0.87, P = 0.012), bacillary and amebic dysentery (r = 0.90, P = 0.006), typhoid/paratyphoid (r = 0.94, P = 0.002), leptospirosis (r = 0.90, P = 0.005), AIDS(r=-0.90, P = 0.006), gonorrhea (r=-0.79, P = 0.035) and scarlet fever (r=-0.85, P = 0.016). A significant linear correlation was noted between public transportation passenger traffic and the number of cases of measles (r = 0.94, P = 0.002), hepatitis A (r = 0.96, P = 0.001), parasitic and vector-borne diseases (r = 0.96, P = 0.001), brucellosis (r = 0.95, P = 0.001), leptospirosis (r = 0.88, P = 0.008), other infectious diarrhea (r = 0.86, P = 0.013) and gonorrhea (r = 0.84, P = 0.018).ConclusionThe results of this study indicated that transportation passenger traffic significantly affected the incidence of infectious diseases, and reasonable management of passenger traffic was a potentially important means of prevention and control of infectious diseases.