Detection Of Tuberculosis Research Articles

Development and modification Sobel edge detection in tuberculosis X-ray images

Tuberculosis (TB), a major global health threat caused by mycobacterium tuberculosis, claims lives across all age groups, underscoring the urgent need for accurate diagnostic methods. Traditional TB diagnosis using X-ray images faces challenges in detection accuracy, highlighting a critical problem in medical imaging. Addressing this, our study investigates the use of image processing techniques-specifically, a dataset of 112 TB X-ray images-employing pre-processing, segmentation, edge detection, and feature extraction methods. Central to our method is the adoption of a modified Sobel edge detection technique, named modification and extended magnitude gradient (MEMG), designed to enhance TB identification from X-ray images. The effectiveness of MEMG is rigorously evaluated against the gray-level co-occurrence matrix (GLCM) parameters, contrast, and correlation, where it demonstrably surpasses the standard Sobel detection, amplifying the contrast value by over 50% and achieving a correlation value nearing 1. Consequently, the MEMG method significantly improves the clarity and detail of TB-related anomalies in X-ray images, facilitating more precise TB detection. This study concludes that leveraging the MEMG technique in TB diagnosis presents a substantial advancement over conventional methods, promising a more reliable tool for combating this global health menace.

Comparison of Deep Learning Methods for Detecting Tuberculosis Through Chest X-Rays

Chronic diseases are the leading cause of death worldwide, accounting for 73% of deaths in 2020. Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis, is one of these diseases and has a significant impact on countries with a high TB burden due to a lack of radiologists and medical equipment. Early diagnosis of TB is crucial but challenging because of its similarity to lung cancer and the shortage of radiologists. A semi-automatic TB detection system is needed to support medical diagnosis and improve public health services. Deep learning technology, such as Convolutional Neural Networks (CNN), offers an effective solution for disease diagnosis with high accuracy. This study compares deep learning methods using an 8-layer CNN and VGG-19, both enhanced with Histogram Equalization (HE) for improved image quality. The study utilizes chest X-ray images of normal lungs and TB-affected lungs from Kaggle. Model performance is evaluated using accuracy, precision, recall, and F1-score metrics. Results indicate that the VGG-19 model outperforms the 8-layer CNN across all evaluation metrics, achieving an accuracy of 72.00% compared to 65.00% for the 8-layer CNN. VGG-19 also demonstrates better precision, recall, and F1-score, making it a more suitable choice for TB detection with enhanced image quality.

Viewpoint of multi-omics potential in tuberculosis research: identifying biomarkers for biomanufacturing of efficient control tools

Tuberculosis (TB), caused by Mycobacterium tuberculosis complex (MTBC), remains a global health burden, claiming millions of lives annually. Despite the availability of a vaccine (the Bacillus Calmette-Guérin; BCG), diagnostics (smear microscopy and DNA-based diagnostics) and drugs for treatment, challenges like drug resistance, lower diagnostic sensitivity such as microscopy, instrumentation and high-level operational expertise requirement and poor vaccine efficacy pose a greater hinderance to TB monitoring and control. The inability of the BCG vaccine to protect against TB other than disseminated disease in neonates call for innovative approaches to provide improved interventions. This review highlights the potential of multi-omics as a powerful emerging tool offering a holistic insight into the intricate interplay between pathogens and the host immune response. It discusses the potential of multi-omics for discovering biomarkers as targets for rational drug design, production of more effective vaccines and as stable targets for production of universally applicable rapid diagnostics for early and accurate TB detection as well as monitoring treatment.

Prevention of Tuberculosis Transmission Through Mycobacterium Tuberculosis Detection in the Air

Prevention of Tuberculosis Transmission Through Mycobacterium Tuberculosis Detection in the Air

FDG-PET-CT as an early detection method for tuberculosis: a systematic review and meta-analysis

Tuberculosis (TB) causes major public health problems worldwide. Fighting TB requires sustained efforts in health prevention, diagnosis and treatment. Previous literature has shown that conventional diagnostic methods like X-ray and sputum microscopy often miss early or extrapulmonary TB due to their limited sensitivity. Blood tests, while useful, lack the anatomical detail needed for precise localization of TB lesions. A possible step forward in the fight against TB could be the use of Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) and Computed Tomography (CT). This meta-analysis discusses the current literature, including the methods, results and implications of using FDG-PET-CT in the early diagnosis of TB. Analysis of the studies showed that the sensitivity of FDG-PET-CT as a potential method for early detection of TB was 82.6%.

An update on the detection of tuberculosis through molecular testing

An update on the detection of tuberculosis through molecular testing

Evaluation of GeneNAT Real-Time Polymerase Chain Reaction Analyzer and Pre-loaded Chip-Based Mycobacterium tuberculosis and Multidrug-Resistant Tuberculosis Detection in the Diagnosis of Pulmonary Tuberculosis.

Tuberculosis (TB) is still the second causative agent of death worldwide after COVID-19. It is caused by Mycobacterium tuberculosis (MTB) infection. The aim of the current study was to compare the performance of GeneNAT real-time polymerase chain reaction analyzer and pre-loaded chip-based MTB screening and multidrug-resistant tuberculosis (MDR-TB) detection kit (Smart SureTM MTB & MDR-TB, Genetix Biotech Asia Pvt. Ltd., New Delhi, India) against the established WHO-approved GeneXpert Ultra (MTB/rifampicin (RIF)), line probe assay (LPA), and mycobacteriagrowthindicatortube(MGIT) culture at point of care (POC) level. A total of 450 pulmonary TB (PTB) suspect patients were enrolled from October 2023 to March 2024 at the Intermediate Reference Laboratory, Department of Medicine, All India Instituteof Medical Sciences, New Delhi, India. GeneXpert and GeneNAT tests were done directly from sputum specimens. However, processed sputum specimens were used for both LPA (GenoType MTBDRplus) and liquid culture and drug susceptibility testing (MGIT culture and drug susceptibility testing (DST)). On comparing with GeneXpert, for the detection of MTB and rifampicin (RIF), Smart SureTM showed a sensitivity of 98.18% and 97.5% with a specificity of 100% and 98.92%, respectively. While comparing mutations in therpoB gene with LPA, the Smart SureTM MDR-TB kit exhibited sensitivity and specificity of 96.77% and 99.12%, respectively. For katG and inhA genes, sensitivity and specificity were 97.6% & 85.71% and 98.66% & 98.01%, respectively, for both genes. Smart SureTM MDR-TB showed comparable results with MGIT-DST with sensitivity and specificity of 96.88% & 96.15% and 98.99%& 99.02%, respectively, for both RIF and isoniazid (INH) drugs. The GeneNAT system test may provide the status of RIF and INH resistance in PTB cases in a short time with the use of minimal specimens. It required very little infrastructurewith less skilled laboratory staffin comparison with other WHO-approved diagnostics used in resource-limited countries with TB and drug-resistant TB burdens.

Bronchial lavage tNGS in the diagnosis of pulmonary tuberculosis.

Tuberculosis (TB), primarily caused by Mycobacterium tuberculosis, remains a significant global health concern. Targeted Next-Generation Sequencing (tNGS) has emerged as a rapid and comprehensive diagnostic tool for tuberculosis, offering advantages over traditional methods and serving as an effective alternative for drug susceptibility testing and the detection of drug-resistant tuberculosis. This study aimed to retrospectively analyze the clinical characteristics of pulmonary tuberculosis patients. After explore the application value of targeted next-generation sequencing technology in this patient population, providing valuable insights for clinical diagnosis and treatment. In this retrospective study, we analyzed data from 65 patients with laboratory-confirmed tuberculosis admitted to Tianjin Baodi Hospital from November 14, 2020, to February 1, 2023. Patients underwent bronchoalveolar lavage fluid (BALF) testing, including acid-fast staining, culture, and tNGS. Biopsies and histopathological examinations were performed on some patients, along with comprehensive radiological assessments for all. Among the 65 pulmonary tuberculosis patients, targeted next-generation sequencing detected pathogens in bronchoalveolar lavage fluid with a positivity rate of 93.8%, significantly higher than traditional methods such as acid-fast staining, culture, and pathology. Compared to bronchoalveolar lavage fluid smear, targeted next-generation sequencing demonstrated significantly higher diagnostic sensitivity (98.46% vs. 26.15%) and accuracy (98.46% vs. 26.15%). Targeted next-generation sequencing, with its high sensitivity and specificity compared to traditional methods, provides unique advantages in detecting pathogens among these patients, highlighting its importance in disease management.

Computer-aided detection of tuberculosis from chest radiographs in a tuberculosis prevalence survey in South Africa: external validation and modelled impacts of commercially available artificial intelligence software

Computer-aided detection (CAD) can help identify people with active tuberculosis left undetected. However, few studies have compared the performance of commercially available CAD products for screening in high tuberculosis and high HIV settings, and there is poor understanding of threshold selection across products in different populations. We aimed to compare CAD products' performance, with further analyses on subgroup performance and threshold selection. We evaluated 12 CAD products on a case-control sample of participants from a South African tuberculosis prevalence survey. Only those with microbiological test results were eligible. The primary outcome was comparing products' accuracy using the area under the receiver operating characteristic curve (AUC) against microbiological evidence. Threshold analyses were performed based on pre-defined criteria and across all thresholds. We conducted subgroup analyses including age, gender, HIV status, previous tuberculosis history, symptoms presence, and current smoking status. Of the 774 people included, 516 were bacteriologically negative and 258 were bacteriologically positive. Diverse accuracy was noted: Lunit and Nexus had AUCs near 0·9, followed by qXR, JF CXR-2, InferRead, Xvision, and ChestEye (AUCs 0·8-0·9). XrayAME, RADIFY, and TiSepX-TB had AUC under 0·8. Thresholds varied notably across these products and different versions of the same products. Certain products (Lunit, Nexus, JF CXR-2, and qXR) maintained high sensitivity (>90%) across a wide threshold range while reducing the number of individuals requiring confirmatory diagnostic testing. All products generally performed worst in older individuals, people with previous tuberculosis, and people with HIV. Variations in thresholds, sensitivity, and specificity existed across groups and settings. Several previously unevaluated products performed similarly to those evaluated by WHO. Thresholds differed across products and demographic subgroups. The rapid emergence of products and versions necessitates a global strategy to validate new versions and software to support CAD product and threshold selections. Government of Canada.

Exosomal Small RNA Sequencing Profiles in Plasma from Subjects with Latent Mycobacterium tuberculosis Infection.

Despite huge efforts, tuberculosis (TB) is still a major public health threat worldwide, with approximately 23% of the human population harboring a latent TB infection (LTBI). LTBI can reactivate and progress to active and transmissible TB disease, contributing to its spread within the population. The challenges in diagnosing and treating LTBI patients have been major factors contributing to this phenomenon. Exosomes offer a novel avenue for investigating the process of TB infection. In this study, we conducted small RNA sequencing to investigate the small RNA profiles of plasma exosomes derived from individuals with LTBI and healthy controls. Our findings revealed distinct miRNA profiles in the exosomes between the two groups. We identified 12 differentially expressed miRNAs through this analysis, which were further validated via qRT-PCR using the same exosomes. Notably, six miRNAs (hsa-miR-7850-5p, hsa-miR-1306-5p, hsa-miR-363-5p, hsa-miR-374a-5p, hsa-miR-4654, has-miR-6529-5p, and hsa-miR-140-5p) exhibited specifically elevated expression in individuals with LTBI. Gene ontology and KEGG pathway analyses revealed that the targets of these miRNAs were enriched in functions associated with ferroptosis and fatty acid metabolism, underscoring the critical role of these miRNAs in regulating the intracellular survival of Mycobacterium tuberculosis (Mtb). Furthermore, our results indicated that the overexpression of miR-7850-5p downregulated the expression of the SLC11A1 protein in both Mtb-infected and Mtb-uninfected THP1 cells. Additionally, we observed that miR-7850-5p promoted the intracellular survival of Mtb by suppressing the expression of the SLC11A1 protein. Overall, our findings provide valuable insights into the role of miRNAs and repetitive region-derived small RNAs in exosomes during the infectious process of Mtb and contribute to the identification of potential molecular targets for the detection and diagnosis of latent tuberculosis.

The Influence of the COVID‑19 Pandemic on the Detection, Diagnosis and Treatment in the Republic of North Ossetia — Alania

Introduction. Prioritization of measures to contain the COVID-19 pandemic has led to a decrease in the coverage and intensity of TB control activities.The aim of study to assess the indicators of detection, diagnosis and treatment of tuberculosis during the COVID-19 pandemic in the Republic of North Ossetia-Alania and compare them with those at the all-Russian level.Materials and methods. A preliminary collection of statistical information in Russian and several foreign sources closest to the topic was carried out on the PubMed, ResearchGate, ScienceDirect, CyberLeninka and eLibrary platforms. An analysis of the epidemiology of tuberculosis in North Ossetia for 2020–2021 was performed. according to annual reporting forms and reports from epidemiological monitoring systems for tuberculosis.Results. The detection rate of tuberculosis has decreased during the pandemic. The indicator in North Ossetia was higher than the national level. Clinical and diagnostic indicators for tuberculosis in the republic in 2020 were lower compared to those for 2021 for the study of sputum, decay phase, and bacterial excretion. The proportion of successful tuberculosis chemotherapy in the republic was higher than in a number of regions of the Russia.Discussion. There was a decrease in registered and, obviously, accumulation of latent cases of tuberculosis during the COVID 19 2020 pandemic due to a drop in preventive coverage of the population in the Russia. A worsening of the clinical structure of tuberculosis in 2021 in Republic of North Ossetia and an increase in the proportion of patients with destruction of lung tissue and the fibrous-cavernous type of disease in the Russia are revealed, possibly due to untimely detection of tuberculosis.Conclusion. Low activity of primary health care organizations regarding tuberculosis was revealed. Restrictions to prevent the spread of the SARS-CoV-2 pathogen contributed to a decrease in the coverage and intensity of anti-tuberculosis measures. The COVID-19 pandemic clearly affected the rates of primary diagnosis of tuberculosis in 2020, and in 2021 a significant increase was noted.

1D Topological Photonic Crystal based Nanosensor for Tuberculosis Detection.

In this study, we present a nanosized biosensor based on the photobiological properties of one-dimensional (1D) topological photonic crystals (PCs). A topological structure had been designed by combining two photonic crystal structures (PC 1 and PC 2) comprised of functional material layers, Si and SiO2. These two, PC 1 and PC 2, differ in terms of the thickness and arrangement of these dielectric materials. We carried out a comparison between two distinct topological photonic crystals: one using random photonic crystals, and the other featuring a mirror heterostructure. Tuberculosis may be diagnosed by inserting a sensor layer into 1D topological photonic crystals. The sensing process is based on the refractive indexes of the analytes in the sensor layer. When the 1D-topological heterostructure-based PC and its mirror-image structures are stacked together, the sensor becomes more efficient for analyte detection than the conventional PCs. The random-based topological photonic crystal outperformed the heterostructure-based topological photonic crystal in analyte sensing. Photonic media witness notable blue shifts due to the analytes' variations in refractive index. The numerical results of the sensor are computed using the transfer matrix approach. Effective results are achieved by optimizing the thicknesses of the sensor layer and dielectric layers; number of periods and incident angle. In normal incident light, the developed sensor shows a high sensitivity of 1500 nm/RIU with a very low limit of detection in the order of 2.24E-06 RIU and a high-quality factor of 30659.54.

Comparative performance analysis of mussel-inspired polydopamine, polynorepinephrine, and poly-α-methyl norepinephrine in electrochemical biosensors.

Polydopamine (PDA) has garnered significant interest for applications in biosensors, drug delivery, and tissue engineering. However, similar polycatecholamines like polynorepinephrine (PNE) with additional hydroxyl groups and poly-α-methylnorepinephrine (PAMN) with additional hydroxyl and methyl groups remain unexplored in the biosensing domain. This research introduces three innovative biosensing platforms composed of ternary nanocomposite based on reduced graphene oxide (RGO), gold nanoparticles(Au NPs), and three sister polycatecholamine compounds (PDA, PNE, and PAMN). The study compares and evaluates the performance of the three biosensing systems for the ultrasensitive detection of Mycobacterium tuberculosis (MTB). The formation of the nanocomposites was meticulously examined through UV-Visible, Raman, XRD, and FT-IR studies with FE-SEM and HR-TEM analysis. Cyclic voltammetry and differential pulse voltammetry measurements were also performed to determine the electrochemical characteristics of the modified electrodes. Electrochemical biosensing experiments reveal that the RGO-PDA-Au, RGO-PNE-Au, and RGO-PAMN-Au-based biosensors detected target DNA up to a broad detection range of 0.1 × 10-8 to 0.1 × 10-18M, with a low detection limit (LOD) of 0.1 × 10-18, 0.1 × 10-16, and 0.1 × 10-17M, respectively. The bioelectrodes were proved to be highly selective with excellent sensitivities of 3.62 × 10-4mAM-1 (PDA), 7.08 × 10-4mAM-1 (PNE), and 6.03 × 10-4mAM-1 (PAMN). This study pioneers the exploration of two novel mussel-inspired polycatecholamines in biosensors, opening avenues for functional nanocoatings that could drive further advancements in this field.

A label-free immunosensor based on E-SMS optical fiber structure for rapid Ag85B detection of tuberculosis

Tuberculosis, caused by Mycobacterium tuberculosis bacillus, is one of the most prevalent, widespread, infectious, and deadliest diseases in the world. In this work, a compact and sensitive biosensor based on an etched single-mode–multimode–single-mode (E-SMS) optical fiber structure was developed for the rapid detection of Mycobacterium tuberculosis Ag85B protein in phosphate buffered saline solution. This biosensor, based on the multimode interference produced into an E-SMS structure, was fabricated by chemical etching of the cladding region of the multimode fiber, followed by the immobilization of the anti-Ag85B antibody on the surface of the etched region. The functionalized E-SMS biosensor provided high selectivity in the detection of Ag85B protein, with the ability to detect biological interactions in a range of 1.31 µg/mL to 4.36 µg/mL, with a sensitivity of 2.3 nm/(µg/mL); also, signal was even obtained at concentrations as low as 80 ng/mL. This sensitive label-free biosensing technology could contribute significantly improve Mycobacterium tuberculosis detection, management in clinical diagnosis, and medical treatment of infected patients.

Multi-centric evaluation of Truenat MTB and MTB-RIF Dx assays for diagnosis of extrapulmonary tuberculosis

Extra-pulmonary TB (EPTB) is difficult to diagnose due to paucibacillary nature of disease. Current study evaluated accuracy of Truenat MTB and MTB-Rif Dx (TN), for detection of Mycobacterium tuberculosis and resistance to rifampicin. Samples were collected from 2103 treatment naive adults with presumptive EPTB, and tested by smear microscopy, liquid culture (LC) (MGIT-960) and GeneXpert MTB/RIF (GX) (Microbiological Reference Standards, MRS). TN results were compared to MRS and Composite Reference Standards (CRS, Microbiology, histopathology, radiology, clinical features prompting decision to treat, response to treatment). CRS grouped patients into 551 confirmed, 1096 unconfirmed, and 409 as unlikely TB. TN sensitivity and specificity was 73.7% and 90.4% against GX. Against LC, Overall sensitivity of GX was 67.6%, while that of TN was 62.3%. Highest sensitivity by TN was observed in pus samples (89%) and highest specificity (92%) in CSF samples, similar to GX. TN sensitivity was better in fluid and biopsy samples and slightly inferior for lymph node aspirates compared to GX. TN sensitivity for RIF resistance detection was slightly superior to GX. TN and GX results were further compared to Clinical Reference Standards. TN detected 170 TB patients initiated on treatment missed by GX, while GX detected 113 such patients missed by TN. Of 124 samples with RIF resistance discordance between GX and TN, GX reported 103/124 as sensitive, 3/124 as indeterminate and 18 as resistant (13/18 samples had low/very low DNA load) while TN reported RIF resistance indeterminate in 103/111 low/very low DNA load samples. Due to paucibacillary nature of EPTB samples, culture yield was poor and phenotypic drug susceptibility testing failed to resolve the discordance. The study establishes TN at par with GX and can be utilized for quick and accurate diagnosis of EPTB.

Problems of Detecting Tuberculosis by Sputum Microscopy in General Medical Services in the Republic of Karelia

The objective: to determine the effectiveness of detection of patients with pulmonary tuberculosis and prevention of its spread by sputum microscopy in clinical diagnostic laboratories of general medical services of the Republic of Karelia.Results. A reduction in the number of sputum microscopy tests in clinical laboratories of GMS and decrease in the positivity rate to 0.66% was revealed. Among new tuberculosis patients with rifampicin resistance, 51% had abundant bacterial excretion (AFB 2+ and 3+); according to sputum microscopy, tuberculous mycobacteria susceptible to rifampicin were isolated in 38%. In the Republic of Karelia, 31.7% of tuberculosis patients were detected in in-patient units of GMS: 60% of them had cavities, and 28.8% had abundant bacterial excretion (AFB 2+ and 3+). The poor quality of sputum microscopy is the cause of late detection of tuberculosis in the Republic of Karelia and promotes the spread of MDR tuberculosis strains among the population, including nosocomial infection.

Exploring the Role of the Private Sector in Tuberculosis Detection and Management in Lima, Peru: A Mixed-Methods Patient Pathway Analysis.

In Latin America, little is known about the involvement of private health-care providers in tuberculosis (TB) detection and management. We sought to gain a better understanding of current and potential roles of the private sector in delivering TB services in Peru. We conducted a mixed-methods study in North Lima, Peru. The quantitative component comprised a patient pathway analysis assessing the alignment of TB services with patient care-seeking behavior. The qualitative component comprised in-depth interviews with 18 private health-care providers and 5 key informants. We estimated that 77% of patients sought care initially at a facility with TB diagnostic capacity and 59% at a facility with TB treatment capacity. Among private facilities, 43% offered smear microscopy, 13% offered radiography, and none provided TB treatment. Among public-sector facilities, 100% offered smear microscopy, 26% offered radiography, and 99% provided TB treatment. Private providers believed they offered shorter wait times and a faster diagnosis, but they struggled with a lack of referral systems and communication with the public sector. Nonrecognition of private-sector tests by the public sector led to duplicate testing of referred patients. Although expressing willingness to collaborate with public-sector programs for diagnosis and referral, private providers had limited interest in treating TB. This study highlights the role of private providers in Peru as an entry point for TB care. Public-private collaboration is necessary to harness the potential of the private sector as an ally for early diagnosis.

Drug resistance profiles of Mycobacterium tuberculosis clinical isolates by genotype MTBDRplus line probe assay in Zambia: findings and implications.

The emergence of drug resistance is a threat to global tuberculosis (TB) elimination goals. This study investigated the drug resistance profiles of Mycobacterium tuberculosis (M. tuberculosis) using the Genotype MTBDRplus Line Probe Assay at the National Tuberculosis Reference Laboratory (NTRL) in Zambia. A cross-sectional study was conducted between January 2019 and December 2020. GenoType MTBDRplus line probe assay records for patients at the NTRL were reviewed to investigate drug susceptibility profiles of M. tuberculosis isolates to rifampicin and isoniazid. Data analysis was done using Stata version 16.1. Of the 241 patient records reviewed, 77% were for females. Overall, 44% of patients were newly diagnosed with TB, 29% had TB relapse, 10% treatment after failure and 8.3% treatment after loss to follow-up. This study found that 65% of M. tuberculosis isolates were susceptible to rifampicin and isoniazid. Consequently, 35% of the isolates were resistant to rifampicin and/or isoniazid and 21.2% were multidrug-resistant (MDR). Treatment after failure [relative risk ratios (RRR) = 6.1, 95% CI: 1.691-22.011] and treatment after loss to follow-up (RRR = 7.115, 95% CI: 1.995-25.378) were significantly associated with MDR-TB. Unknown HIV status was significantly associated with isoniazid mono-resistance (RRR = 5.449, 95% CI: 1.054-28.184). This study found that 65% of M. tuberculosis isolates were susceptible to rifampicin and isoniazid while 35% were resistant. Consequently, a high prevalence of MDR-TB is of public health concern. There is a need to heighten laboratory surveillance and early detection of drug-resistant TB to prevent the associated morbidity and mortality.

Examining Diagnostic Efficacy: GeneXpert Versus Traditional Staining Techniques With Culture in the Diagnosis of Tuberculosis.

Introduction The tuberculosis (TB) diagnosis involves various methods, such as microscopic examination, culture-based methods, molecular techniques, chest X-rays, serological tests, and interferon-gamma release assays. These methods help identify and confirm TB and its resistance to rifampicin, balancing speed and accuracy for prompt treatment initiation and effective disease management. Aims and objectives To assess the diagnostic accuracy of GeneXpert, Ziehl-Neelsen staining, and fluorescence staining compared to culture media in TB-suspected patients. Materials and methods We analysed 416 patient samples for TB over one year using GeneXpert, Ziehl-Neelsen staining, fluorescence staining, andLöwenstein-Jensen (LJ) medium. Only samples with a suspicion of TB were included in the study. The samples received without clinical history and requests for all four tests were excluded. Results A total of 416 patient samples were categorised into pulmonary and extrapulmonary samples. GeneXpert detected 62 positive cases for TB, out of which 53 were rifampicin-sensitive, seven were rifampicin-indeterminate, and two were rifampicin-resistant. The indeterminate samples were further evaluated using the line probe assay (LPA), of which six were rifampicin-sensitive, and one was rifampicin-resistant. Fluorescent staining detected 44 cases, Ziehl-Neelsen staining detected 40 cases, and LJ culture medium detected 65 cases. Conclusion GeneXpert is superior to staining methods for detecting TB. GeneXpert, combined with microscopyand culture, can enhance TB and multi-drug resistant tuberculosis (MDR-TB) detection and aid in early treatment initiation.

An overview of next generation sequencing strategies and genomics tools used for tuberculosis research.

Tuberculosis (TB) is a grave public health concern and is considered the foremost contributor to human mortality resulting from infectious disease. Due to the stringent clonality and extremely restricted genomic diversity, conventional methods prove inefficient for in-depth exploration of minor genomic variations and the evolutionary dynamics operating in Mycobacterium tuberculosis (M.tb) populations. Until now, the majority of reviews have primarily focused on delineating the application of whole-genome sequencing (WGS) in predicting antibiotic resistant genes, surveillance of drug resistance strains, and M.tb lineage classifications. Despite the growing use of next generation sequencing (NGS) and WGS analysis in TB research, there are limited studies that provide a comprehensive summary of there role in studying macroevolution, minor genetic variations, assessing mixed TB infections, and tracking transmission networks at an individual level. This highlights the need for systematic effort to fully explore the potential of WGS and its associated tools in advancing our understanding of TB epidemiology and disease transmission. We delve into the recent bioinformatics pipelines and NGS strategies that leverage various genetic features and simultaneous exploration of host-pathogen protein expression profile to decipher the genetic heterogeneity and host-pathogen interaction dynamics of the M.tb infections. This review highlights the potential benefits and limitations of NGS and bioinformatics tools and discusses their role in TB detection and epidemiology. Overall, this review could be a valuable resource for researchers and clinicians interested in NGS-based approaches in TB research.