Tuberculosis Cases Research Articles

UNSEEN TUBERCULOSIS: STUDY AMONG INPATIENTS OF A TERTIARY CARE HOSPITAL OF NORTH KARNATAKA

Objective: Tuberculosis (TB) remains a significant global health challenge, particularly in high-burden countries like India. However, high proportion of people never diagnosed or treated. Delayed diagnosis poses a significant threat to hospital inpatients, health-care workers, and medical trainees. Hence, systematic screening of high-risk groups, including hospital inpatients, has been recommended as a strategy to identify TB. Using signs and symptoms as an independent screening tool remains a global challenge for its relatively low accuracy. However, it could still be of value when it was used in a specific target population like inpatients of hospital. Hence, this study is aimed to determine the proportion of presumptive and active TB cases among inpatients. Methods: A hospital-based cross-sectional study was conducted among inpatients above 18 years of age admitted in non-emergency wards admitted during March to April 2023 at ESIC Hospital in Kalaburagi. A pre-existing TB diagnosis and patients admitted to critical care units were excluded. The convenient sampling method was used to recruit participants. Data were collected through using a pre-designed, semi-structured questionnaire. The patients who presented with one of the four symptoms for screening had undergone investigations such as cartridge-based nucleic acid amplification test, chest X-ray, and sputum microscopy to confirm the diagnosis, and the findings were recorded as proportion. Results: Out of 1363 inpatients, 35 (2.5%) patients had classified as presumptive TB case. Out of 35, 3 (8.57%) were found to be actual TB cases. All patients who had positive results for TB were young patients and belonged to low socioeconomic class. Two of three were rifampicin-sensitive TB cases. Conclusion: Timely screening of the patient’s is of utmost importance to avoid further spread of TB infection among inpatients. The higher prevalence of actual TB cases in younger adults needs further exploration.

Rifampicin-resistant Tuberculosis and Associated Factors Among Pulmonary Tuberculosis Patients in Mahakali Provincial Hospital, Nepal

The study aims at assessing the prevalence of RR-TB and identify associated factors among pulmonary TB patients using GeneXpert MTB/RIF assay data from January to December 2023. Tuberculosis (TB) continues to pose a significant global health threat, with rifampicin-resistant (RR) strains presenting a formidable challenge to disease control efforts. This study based the retrospective cross-sectional study conducted at Mahakali Provincial Hospital in Nepal. Out of 2587 presumptive TB cases, 11.8% were confirmed positive for TB, with males constituting a significantly higher proportion (66.1%) than females (33.9%). Among TB-positive cases, 3% showed resistance to rifampicin, predominantly affecting males (77.8%). Age group analysis revealed higher TB detection rates in the 46-60 years group, while rifampin -resistance tuberculosis (RR-TB) cases were more evenly distributed across age groups without statistical significance. Ethnicity and residential locality did not show significant associations with RR-TB. Multivariate logistic regression highlighted gender as RR-TB and associated factors among pulmonary tuberculosis patients in a Mahakali Provincial Hospital, Nepal. Rifampicin-resistant TB (RR-TB) remains a significant challenge at Mahakali Provincial Hospital, with a 3% prevalence, predominantly affecting males. Gender is a key factor in RR-TB prevalence. To manage and reduce RR-TB effectively, it is necessary to implement targeted interventions for high-risk groups, particularly males, and to enhance diagnostic capabilities.

Analysis and dynamical transmission of tuberculosis model with treatment effect by using fractional operator

ABSTRACT Each year, millions of people die from the airborne infectious illness tuberculosis (TB). Several drug-susceptible (DS) and drug-resistant (DR) forms of the causative agent, Mycobacterium tuberculosis (MTB), are currently common in the majority of affluent and developing nations, particularly in Bangladesh, and completely drug-resistant strains are beginning to arise. The main purpose of this research is to develop and examine a non-integer-order mathematical model for the dynamics of tuberculosis transmission using the fractal fractional operator. By demonstrating characteristics such as the boundedness of solutions, positivity, and reliance of the solution on the original data, the biological well-posedness of the mathematical model formulation was investigated for TB cases from 2002 to 2017 in KPK Pakistan. Ulam-Hyres stability is also used to assess both local and global aspects of TB bacterial infection. Sensitivity analysis of the TB model with therapy was also examined. The advanced numerical technique is used to find the solution of the fractional-order system to check the impact of fractional parameters. Simulation highlights that all classes have converging qualities and retain established positions with time, which shows the actual behavior of bacterial infection with TB.

Diagnostic Value of Targeted Next-generation Sequencing in Pulmonary Mycobacterial Infections.

This study aimed to explore the diagnostic value of novel technique-targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF) in pulmonary mycobacterial infections. This retrospective study was conducted on patients who underwent bronchoscopy and tNGS, smear microscopy, and mycobacterial culture of BALF. Patients with positive Mycobacterium tuberculosis (MTB) culture or GeneXpert results were classified into the tuberculosis case group. Those diagnosed with nontuberculous mycobacteria (NTM)-pulmonary disease (NTM-PD) composed the case group of NTM-PD patients. The control group comprised patients without tuberculosis or NTM-PD. Sensitivity, specificity, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance. For tuberculosis patients with positive mycobacterial culture results, the areas under the ROC curves (AUCs) for tNGS, GeneXpert, and smear microscopy were 0.975 (95% CI: 0.935, 1.000), 0.925 (95% CI: 0.859, 0.991), and 0.675 (95% CI: 0.563, 0.787), respectively. For tuberculosis patients with positive GeneXpert results, the AUCs of tNGS, culture, and smear microscopy were 0.970 (95% CI: 0.931, 1.000), 0.850 (95% CI: 0.770, 0.930), and 0.680 (95% CI: 0.579, 0.781), respectively. For NTM-PD, the AUCs of tNGS, culture, and smear-positive but GeneXpert-negative results were 0.987 (95% CI: 0.967, 1.000), 0.750 (95% CI: 0.622, 0.878), and 0.615 (95% CI: 0.479, 0.752), respectively. The sensitivity and specificity of tNGS in NTM-PD patients were 100% and 97.5%, respectively. tNGS demonstrated superior diagnostic efficacy in mycobacterial infection, indicating its potential for clinical application.

Tuberculosis Elimination Forecast for Moscow Region

The objective: to assess the possibility of tuberculosis elimination in Moscow Region by 2035.Subjects and Methods. For the study, Federal Statistical Surveillance Form No. 8 Information on Active Tuberculosis cases, and Form No. 33 Information on Tuberculosis Patients for 015-2023 were selected, rates were calculated for the average annual population in the region. Changes in tuberculosis incidence in Moscow Region were analyzed.Results. Based on results of the study on possibility to eliminate tuberculosis in Moscow Region by 2035, it has been found that if the current epidemic situation persists, it is only possible to achieve the mortality target. To achieve the target results for other rates, additional measures to prevent tuberculosis among the population are needed.

The rising tide of tuberculosis in Pakistan: Factors, impact, and multi-faceted approaches for prevention and control.

Tuberculosis (TB) remains a major public health concern in Pakistan, which is ranked fifth among high-burden TB nations worldwide. The growing frequency of drug-resistant TB strains, particularly multidrug-resistant TB (MDR-TB), creates new obstacles. Socioeconomic factors, a lack of awareness, and inadequate healthcare infrastructure all contribute to the spread of the disease. This study investigates the mechanisms contributing to the growth in tuberculosis cases in Pakistan, the implications for public health, and multifaceted approaches to prevention and control. A comprehensive literature study was undertaken, including an analysis of peer-reviewed articles, World Health Organization (WHO) data, and government sources, to identify factors driving tuberculosis prevalence, control issues, and disease-fighting tactics.Result: Several factors like Poverty, overcrowding, malnutrition, stigma, and restricted access to healthcare services are all factors contributing to an increase in tuberculosis incidence in Pakistan. The prevalence of MDR-TB, along with a lack of an integrated healthcare response, complicates efforts to contain the disease's spread. Tuberculosis has a profound social, mental, and financial impact on individuals and communities. Public health efforts, such as the National Tuberculosis Control Program (NTP) and international partnerships, have been created to eradicate tuberculosis, although considerable hurdles persist. This study investigates the mechanisms contributing to the growth in tuberculosis cases in Pakistan, the implications for public health, and multifaceted approaches to prevention and control.

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.

Spectrum of Ocular Tuberculosis in Tertiary Care Hospitals of Khyber Pakhtunkhwa Peshawar

Purpose: To describe the spectrum of ocular tuberculosis (TB), highlight the difficulty in diagnosis and treatment of such cases encountered in a tertiary care hospital of Peshawar, Pakistan. Study Design: Descriptive Case series. Place and Duration of Study: Khyber teaching hospital MTI Peshawar from Jan 2021 till July 2022. Methods: Eleven cases with Ocular tuberculosis are described. At presentation, complete history was taken and detailed examination was done including fundus examination and OCT macula. For diagnosis, a combination of Tuberculin skin test (TST) and Quantiferon-Gold was performed. On the basis of results of both tests Anti-TB treatment (ATT) was started and continued for an average of 9 months. Results: This study highlights the diverse ocular manifestations of TB in patients, even without a known history of systemic disease. Among 11 patients, 3 presented with panuveitis, 6 with posterior uveitis, and 2 with serpiginous-like choroidopathy with uveitis. Notably, only 2 had a known history of systemic TB. The patients were treated primarily with Anti-Tuberculosis Therapy (ATT) along with steroids or other adjunct therapies. Most cases showed improved vision and stable disease post-treatment, with visual acuity ranging from 6/24 to 6/6. However, two patients were lost to follow-up, leaving their outcomes unknown. Conclusion: In this case series, we explore different cases of Ocular Tuberculosis (OTB) seen at a busy hospital in Peshawar, Pakistan. There are variety of symptoms with which the patients present. The combined use of TST and Quantiferon-Gold proved an effective and affordable approach for diagnosis and timely initiation of ATT in ocular TB.

Contrast-enhanced ultrasound for rare testicular tuberculosis

Testicular tuberculosis is a rare form of genital tuberculosis. Ultrasound is a crucial tool for evaluating male genital disorders. Contrast-enhanced ultrasonography (CEUS), which provides real-time monitoring of microvascular hemodynamics, provides rich information about microcirculation, helping distinguish testicular tuberculosis from other testicular conditions such as tumors and inflammation. This study reports on a rare case of testicular tuberculosis diagnosed through CEUS. A 31-year-old male patient presented with two months of persistent right scrotal pain and swelling. Conventional scrotal ultrasound showed an enlarged right testicle with heterogeneous echogenicity and abundant color Doppler blood flow signals. CEUS demonstrated rapid contrast agent filling in the right testicle, followed by the appearance of several irregular regions, indicating perfusion deficits in these areas. Histopathological confirmation through ultrasound-guided biopsy revealed granulomatous inflammation with caseous necrosis, which is consistent with the diagnosis of testicular tuberculosis. As a real-time monitoring technique for microvascular hemodynamics, CEUS provides valuable microcirculatory information that enhances diagnostic accuracy and enables the formulation of appropriate treatment plans for testicular tuberculosis versus other testicular pathologies.

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.

The impact of anti-tuberculosis treatment on respiratory tract microbiome in pulmonary tuberculosis

The growing evidence has underscored the significance of interactions between the host and microbiota in respiratory health, presenting a novel perspective on disease management. Yet, comprehension of the respiratory microbiome shifts before and after anti-tuberculosis treatment is limited. This study compares respiratory microbiome profiles in untreated tuberculosis (UTB) and completed TB treatment (CTB) cases with healthy controls, using 16S rRNA sequencing on sputum samples. Significant reduction in sputum microbial alpha diversity was observed in both TB groups when compared to healthy controls (P < 0.05). Beta diversity analysis showed distinct clustering (P < 0.05). Linear discriminant analysis revealed an abundance of potentially pathogenic bacterial genera like Haemophilus, Pseudomonas, and Mycobacterium in the UTB group, while Streptococcus, Rothia, and Neisseria dominated in CTB samples. Healthy sputum microbiomes were enriched with Prevotella, Fusobacterium, Porphyromonadaceae_unclassified,andPeptostreptococcus. Moreover, predicted bacterial functional pathways showed significant differences among the three groups, mainly related to nutrient metabolism.These findings indicated significant microbial dysbiosis in sputum samples recovered from patients with pulmonary TB with an elevated presence of potentially pathogenic bacteria, depletion of beneficial genera, and downregulation of several essential metabolic pathways. Further exploration of respiratory microbiome-based diagnostic biomarkers and their role in targeted treatment strategies in tuberculosis is warranted.

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.

To investigate the impact of revised diagnostic algorithm on presentation of multidrug-resistant tuberculosis cases at a referral centre in India

ABSTRACT Introduction: A shift in policy has occurred with the introduction of molecular diagnostic tools for the upfront diagnosis of all cases of tuberculosis, including drug-resistant tuberculosis. The impact of this shift in policy on severity of disease was studied, and comparisons were drawn between the year 2015 and 2020. Study Type and Design: This was an observational study conducted between 2020 and 2021. Seventy patients of MDR-TB with or without additional drug resistance, hospitalized in the year 2015 and 2020, were studied. Results: The study reveals a substantial reduction in the median time from the onset of symptoms to diagnosis between 2015 and 2020. Specifically, the median duration decreased from 12 weeks in 2015 to 8 weeks in 2020. Moreover, we found that in 2015, all cases under study had a history of tuberculosis in comparison to 2020. Additionally, there was a higher incidence of anemia in 2015 compared to 2020. In the radiological examination, it was observed that in 2015, a higher frequency of cases exhibited cavitations, bronchiectasis, and fibrosis on chest X-rays compared to the findings in 2020. The mean cavity size in 2015 measured 6.73 cm, while in 2020, it averaged 4.06 cm. Additionally, we noticed a higher occurrence of significantly advanced cases in 2015 in contrast to 2020. Conclusion: The implementation of the new policy of upfront DST was noted to decrease the time required for diagnosis and bacterial load as ascertained from degree of sputum smear positivity, radiological lesions, and severity of anemia.

Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities.

Tuberculosis (TB) and cachexia are clinical entities that have a defined relationship, making them often found together. TB can lead to cachexia, while cachexia is a risk factor for TB. This article reviews cachexia in Tuberculosis patients in Southeast Asian and African regions by conducting a comprehensive literature search across electronic databases such as PubMed, Google Scholar, and Research Gate between 2013 and 2024 using keywords including 'Africa', 'cachexia', 'prevalence', 'implications', 'tuberculosis', and 'Southeast Asia. This article utilized only studies that satisfied the inclusion criteria, revealing knowledge gaps and untapped opportunities for cachexia in TB across Southeast Asian and African regions. Many Southeast Asian and Western Pacific patients initially receive a tuberculosis diagnosis. Sub-Saharan African countries are among the 30 high TB burden nations, according to the WHO. Food inadequacy and heightened energy expenditure can impair the immune system, leading to latent TB and subsequently, active infection. Symptoms needing attention: shortness of breath, productive cough, hyponatremia at 131mmol/l, hypoalbuminemia at 2.1g/dl, elevated aspartate transaminase at 75U/l, increased lactate dehydrogenase at 654, and normocytic anemia. Comorbidities, such as kidney disease, cardiovascular disease, and asthma, can influence the nutritional status of individuals with TB. While efforts like screening, contact tracing, and utilizing gene Xpert to detect TB cases were implemented, only a few proved effective. It is essential to conduct further studies, including RCTs, in Southeast Asia and Africa to evaluate and manage cachexia in TB patients.

Clinical profile, laboratory characteristics and prognostic factors in patients with miliary tuberculosis

BackgroundMiliary tuberculosis (TB) is a severe form of pulmonary TB. It is uncommon in immunocompetent patients. In this study, we aimed to investigate features of miliary TB (clinical, biological, and radiological) and to determine factors associated with unfavorable outcomes in a population of patients in the South East Tunisia where TB remains endemic. MethodsThis is a retrospective study including patients diagnosed with miliary TB between 2006 and 2023. Factors independently associated with poor prognosis were determined by multivariate logistic regression analysis. ResultsMiliary tuberculosis (TB) accounted for 1.8% (n = 36) of all TB cases diagnosed during the study period. A notable female predominance was observed, comprising 66.6% of the cohort. The median age of patients was 47.5 ± 11.33 years. The predominant clinical manifestations included cough (88.8%), loss of appetite (77.7%), and fever (58.3%). Radiologically, a typical miliary pattern was present in 83.3% of patients, although only 36.1% had positive sputum samples on direct smear microscopy. Notably, all patients tested negative for HIV serology. Extrapulmonary TB involvement was documented in 55.5% of cases. All patients were treated with first-line anti-TB medications, and the outcome was favorable in 77.7% (n = 28) of patients. However, 16.6% (n = 6) of patients succumbed to the disease. Factors significantly associated with unfavorable outcomes included age ≥ 65 years (odds ratio (OR) = 0.39; p = 0.03), diabetes (OR = 0.13; p = 0.046), presence of fever (OR = 2.89; p = 0.01), and oxygen saturation ≤ 92% at admission (OR = 3.2; p = 0.001). ConclusionOur study identified advanced age, diabetes, fever at baseline, and low oxygen saturation on admission as significant predictors of poor prognosis in patients with miliary tuberculosis. These findings highlight the need for early identification and targeted management of high-risk individuals to improve clinical outcomes.

Analyzing the seasonality of tuberculosis case notifications in the UK, 2000-2018.

Globally, there is seasonal variation in tuberculosis (TB) incidence, yet the biological and behavioural or social factors driving TB seasonality differ across countries. Understanding season-specific risk factors that may be specific to the UK could help shape future decision-making for TB control. We conducted a time-series analysis using data from 152,424 UK TB notifications between 2000 and 2018. Notifications were aggregated by year, month, and socio-demographic covariates, and negative binomial regression models fitted to the aggregate data. For each covariate, we calculated the size of the seasonal effect as the incidence risk ratio (IRR) for the peak versus the trough months within the year and the timing of the peak, whilst accounting for the overall trend. There was strong evidence for seasonality (p < 0.0001) with an IRR of 1.27 (95% CI 1.23-1.30). The peak was estimated to occur at the beginning of May. Significant differences in seasonal amplitude were identified across age groups, ethnicity, site of disease, latitude and, for those born abroad, time since entry to the UK. The smaller amplitude in older adults, and greater amplitude among South Asians and people who recently entered the UK may indicate the role of latent TB reactivation and vitamin D deficiency in driving seasonality.

Implementation Machine Learning of K-Means Clustering Method and Linear Regression for Detecting the Risk of Tuberculosis Spread in Bangka Regency

The number of tuberculosis (TB) sufferers in Bangka Regency tends to increase and is becoming a very serious public health problem. In 2023, there will be around 331,581 residents of Bangka Regency, with around 1,489 of them suffering from TB. The high number of TB cases in Bangka Regency requires comprehensive monitoring. Surveillance can be carried out by grouping TB cases by region. One clustering method is K-Means which groups data based on similar criteria. Researchers also used the Linear Regression method to predict the effect of population density on increasing TB prevalence. This research was conducted to cluster the distribution pattern of TB by region and identify the influence of population density variables on the increase in TB. Based on the results of the K-Means method analysis by looking at the Performance Davies Bouldin-Index (Dbi) test, researchers obtained a pattern of TB distribution which was categorized into: Areas with High Prevalence (Sungailiat), Medium Prevalence (Belinyu and West Mendo) and Low Prevalence (Bakam, Merawang, Pemali, Pudding Besar, and Riau Silip). Meanwhile, the prediction results show that there is a positive influence of 81% of the population density variable on increasing the number of TB spreads and 19% is influenced by other variables. The results of this research can be used as a reference for the Bangka District Health Service to assist decision-making in preventing an increase in TB cases.

IL-17F gene polymorphism in pulmonary tuberculosis

This study was investigated tuberculosis (TB) patients in an Iraqi population to look at the association between TB development and polymorphisms in the interleukin-17F gene. From January 2017 to April 2017, the study's population included 40 controls and 80 patients with tuberculosis. The IL-17F serum level was assayed using the ELISA technique. Genotyping analyses of IL-17F rs763780 gene were analysed using QRT-PCR for polymorphism. Males outnumbered females (58% vs. 42%) in TB cases. Serum levels of the IL-17F old cases (OC) group have decreased significantly (85.2±109.2pg/ml vs. 194.5±160.0pg/ml), than recently diagnosed (RD) group. The distribution of IL-17F rs76380 genotype was found to be in Hardy-Weinberg equilibrium in OC group and control. The result showed that T allele was more frequent (93.75%, 92.5%, 95% vs. 6.25%, 7.5%, 5% respectively), insignificantly (P&gt;0.05) than C allele in all groups. In addition, TT genotype was more frequent (90%) insignificantly (P&gt;0.05), than genotype TC (7.5%, 5%, 10%) and CC (2.5%, 5%, 0%) among groups of the study. There were insignificant associations between the IL-17F rs763780 gene polymorphism and risk of tuberculosis.

Selective mycobacterial capture with ultraviolet-polymerized poly-dimethyldiallyl chloride functionalized surfaces

Tuberculosis (TB) is the top cause of death from a single infectious pathogen after COVID-19. Despite molecular diagnostic advances, two-thirds of the 10 million annual TB cases are still diagnosed using direct smear microscopy which has ~50% sensitivity. To increase the analytical performance of smear microscopy, we developed and characterized a novel polymer (Polydiallyldimethylammonium chloride [PDADMAC]) engraftment on inexpensive polystyrene (PS) specifically functionalized for mycobacterial capture. Engraftment is achieved via UV photopolymerization of DADMAC monomer on plasma-activated PS. The platform was tested on sputum from presumptive TB cases in Kampala, Uganda (n = 50), with an increased overall sensitivity of 81.8% (27/33) vs. fluorescent smear microscopy 57% (19/33) compared to a molecular (Cepheid GeneXpert MTB/RIF) gold standard. Frugal smear diagnostic innovation that is rapid and does not require dedicated instrumentation may offer an important solution to bridge the TB diagnostic gap.Graphical

Resistance pattern and profile of patients with drug-resistant tuberculosis at a tertiary care center

Abstract Background: Studies on resistance pattern and profile of patients with drug resistant tuberculosis (DRTB) are valuable as they provide insights into what are the rates of DRTB locally. Based on these data, treatment may be optimized. They also help in prevention of spread of DRTB elsewhere due to appropriate treatment. Objective: The objective is to study drug resistance pattern and profile of patients with DRTB. Materials and Methods: The present study was record-based study among records of 194 DRTB patients from December 2021 to May 2024. Their age, sex, height, and weight were recorded. From height and weight, body mass index was calculated. Patient status like pulmonary or extra-pulmonary tuberculosis (TB) was noted. Resistance pattern was also observed. Results: The incidence of DRTB was most common in 19–39 years (47.9%). Males were more affected (70.1%). Underweight was most common (78.3%). Pulmonary TB was most common form of TB (93.3%). Multidrug-resistant TB (MDR-TB) was most commonly seen (64.9%). Pre-extensively drug-resistant TB (XDR-TB) was next common (14.9%). XDR-TB was seen in only two cases. Majority (46.9%) were started on shorter oral regimen (Bedaquiline) followed by all oral longer regimen in 34%. All cases of extrapulmonary TB had MDR-TB and no one had XDR-TB or pre-XDR-TB. Conclusion: Thus, we conclude that young adults, males were commonly affected. Underweight is very common in these cases. Pulmonary TB is the leading form of TB in DRTB patients. XDR-TB is not so common form in DRTB cases. Pre-XDR-TB is more common than XDR-TB.