Tuberculosis Detection Rate Research Articles

The Imperative Role of Xpert® Mycobacterium Tuberculosis Complex/Resistance to Rifampin (MTB/RIF) in Rapid Diagnosis of Pulmonary and Extrapulmonary Tuberculosis.

Background The Xpert® mycobacterium tuberculosis complex/resistance to rifampin (MTB/RIF) test is widely recognized for its ability to provide rapid and accurate results for diagnosing tuberculosis (TB) in both pulmonary and extrapulmonary samples. Its utility is especially critical in smear-negative and paucibacillary cases where traditional diagnostic methods often fail. This study aimed to evaluate the role of Xpert® MTB/RIF in diagnosing TB in various pulmonary and extrapulmonary samples and TB in smear-negative pulmonary samples. Methods This retrospective study analyzed records from 2017 to 2021, focusing on presumptive TB patients who underwent Xpert® MTB/RIF testing at a tertiary care hospital. Data from 1174 samples (671 pulmonary and 503 extrapulmonary) were included. The Xpert® MTB/RIF reports were assessed for Mycobacterium tuberculosis (MTB) detection rates across different sample types. Results Of the pulmonary samples, MTB detection was highest insputum samples, 122 (48.41%), followed bybronchial washing samples, 49 (16.33%). In smear-negative pulmonary cases, Xpert® MTB/RIF detected MTB in 72 (16.55%) samples, demonstrating its utility in paucibacillary cases. The test also proved valuable in diagnosing extrapulmonary TB, where symptoms are often atypical. Conclusion Xpert® MTB/RIF is a reliable tool for the rapid and accurate diagnosis of pulmonary and extrapulmonary TB, including smear-negative and paucibacillary cases. Its application can significantly enhance the timely diagnosis and treatment of TB, especially in resource-limited settings.

Five-year tuberculosis trends analysis in eight districts of Mwanza region, Tanzania; (2017-2021).

In Tanzania like other developing countries, TB detection is hindered by totally missed, late notification, and delayed diagnosis of active cases. Apart from having TB control strategies and interventions to detect patients and put them on treatment to cut down the chain of transmission, TB remains a health concern. Limited data exist on the burden and trends of tuberculosis in Mwanza, which includes fishing communities and living conditions that are associated with high TB transmission like overcrowding. This study aimed to determine tuberculosis trends in the Mwanza region of Tanzania for five years, from 2017 to 2021. We extracted routine TB diagnostic data from 2017 to 2021 from eight districts of the Mwanza region of Tanzania from the electronic TB database. Data were captured in Microsoft Office Excel 2007 with district TB and leprosy coordinators and then imported into STATA 13 (Stata Corp LLC, College Station, TX, USA) for analysis. We estimated the TB case detection rate per 100,000 population. A total of 6,414 laboratory-confirmed tuberculosis cases were detected in eight districts of the Mwanza region in Tanzania from 2017 to 2021. The average tuberculosis detection rate in five years was 34.7 per 100,000 population. Overall, the TB detection rate was two times higher in people without HIV (30.5) compared to those infected with HIV; 13.4 per 100,000 population. Of the 15 rifampicin-resistant TB cases detected in the year 2018, 66.7% (10/15) were HIV-negative compared to 33.3% (5/15) infected with HIV. The TB case detection rate decreased in Mwanza region from 43.9 in 2017 to 21.4 per 100,000 population in 2021. Other parameters were missing in the database, which indicates remarkable gaps in the established database to monitor TB management in the region. The program may consider investigating and improving the documentation of information necessary to attain its goals.

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.

Diagnostic Value of Metagenomic next-generation sequencing and X-pert in Bronchoalveolar lavage fluid for pneumonia in HIV-infected and HIV-uninfected patients

The pathogens causing unexplained pneumonia in both HIV-infected or HIV-unfected patients are likely to be complex. This retrospective study aimed to characterize the etiology of pneumonia in HIV-infected and HIV-uninfected patients using bronchoalveolar lavage fluid (BALF) analysis with metagenomic next-generation sequencing (mNGS) and X-pert MTB/RIF. Between January 2022 and May2024, 141 HIV-infected and 104 HIV-uninfected patients admitted to Nanjing Second Hospital with pneumonia were included. BALF samples were collected and analyzed using mNGS to detect bacteria, fungi, viruses, tuberculosis (TB) and non-tuberculous mycobacteria (NTM), and X-pert for TB detection. Clinical data including CD4 T-cell counts, comorbidities, and ART status were collected and analyzed. HIV-uninfected patients were found to be older and exhibited a higher prevalence of comorbidities compared to HIV-infected patients. Despite higher median CD4 T-cell counts in HIV-uninfected individuals (412cells/μL vs. 31cells/μL in HIV-infected), TB detection rates using X-pert and mNGS were lower than anticipated, particularly in HIV-infected patients. Mixed-pathogen infections were significantly more prevalent in HIV-infected patients, especially those with lower CD4 T-cell counts. ART use showed variable impacts on pathogen diversity, with longer treatment durations associated with reduced infection complexity but persistent immunodeficiency in some cases.In patients with pneumonia, whether HIV-infected or HIV-uninfected, pathogens often exhibit complexity, underscoring the critical role of timely mNGS and X-pert analysis of BALF for early pathogen detection.

Identification of pathological characteristics in pulmonary tuberculosis using polarization-sensitive optical coherence tomography

The low detection rate of Mycobacterium tuberculosis in clinical practice leads to a high rate of missed diagnosis for pulmonary tuberculosis (PTB). As a noninvasive, high-resolution, real-time imaging technology, polarization-sensitive optical coherence tomography (PS-OCT) may be feasible for the rapid identification of pathological feature. This study aimed to explore the feasibility of using PS-OCT to identify pathological features of PTB. In the experiments, PTB samples containing some surrounding lung tissues were imaged using PS-OCT. It is demonstrated that PS-OCT images showed good consistency with the corresponding pathological images and were able to identify PTB-related characteristic pathological regions. We think PS-OCT can serve as an effective supplement for the diagnosis of PTB, enabling rapid and accurate diagnosis, and aiding in the understanding of the pathological characteristics and pathophysiological processes of PTB.

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.

Estimating the budget impact of a Tuberculosis strategic purchasing pilot study in Medan, Indonesia (2018–2019)

BackgroundIndonesia has the world’s second-highest tuberculosis (TB) burden, with 969,000 annual TB infections. In 2017, Indonesia faced significant challenges in TB care, with 18% of cases missed, 29% of diagnosed cases unreported, and 55.4% of positive results not notified. The government is exploring a new approach called “strategic purchasing” to improve TB detection and treatment rates and offer cost-effective service delivery.ObjectivesWe aimed to analyze the financial impact of implementing a TB purchasing pilot in the city of Medan and assess the project’s affordability and value for money.MethodsWe developed a budget impact model to estimate the cost-effectiveness of using strategic purchasing to improve TB reporting and treatment success rates. We used using data from Medan’s budget impact model and the Ministry of Health’s guidelines to predict the total cost and the cost per patient.ResultsThe model showed that strategic purchasing would improve TB reporting by 63% and successful treatments by 64%. While this would lead to a rise in total spending on TB care by 60%, the cost per patient would decrease by 3%. This is because more care would be provided in primary healthcare settings, which are more cost-effective than hospitals.ConclusionsWhile strategic purchasing may increase overall spending, it could improve TB care in Indonesia by identifying more cases, treating them more effectively, and reducing the cost per patient. This could potentially lead to long-term cost savings and improved health outcomes.

War related disruption of clinical tuberculosis services in Tigray, Ethiopia during the recent regional conflict: a mixed sequential method study

BackgroundMore than 70% of the health facilities in Tigray, northern Ethiopia, have been totally or partially destroyed by the recent war in the region. Diagnosis and management of tuberculosis were among many health services that suffered. In this study we assess the status of tuberculosis care in health facilities of Tigray during the recent war and compare it with the immediate pre-war state.MethodsUsing sequential mixed method, we analyzed and compared the availability of diagnostic services in 69 health facilities and the utilization of tuberculosis care in 50 of them immediately before the war (September-October 2020) and during the war (November-July 2021). TB focal persons in each selected health facility were interviewed to evaluate the status of diagnostic services. Patient service utilization was assessed using health facility registrations. We also compared the average monthly case detection rate of multidrug resistant tuberculosis in the region before and during the war. We computed summary statistics and performed comparisons using t-tests. Finally, existing challenges related to tuberculosis care in the region were explored via in-depth interviews. Two investigators openly coded and analyzed the qualitative data independently via thematic analysis.ResultsAmong the 69 health facilities randomly selected, the registers of 19 facilities were destroyed by the war; data from the remaining 50 facilities were included in the TB service utilization analysis. In the first month of the war (November 2021) the number of tuberculosis patients visiting health facilities fell 34%. Subsequently the visitation rate improved steadily, but not to pre-war rates. This reduction was significant in northwest, central and eastern zones. Tuberculosis care in rural areas was hit hardest. Prior to the war 60% of tuberculosis patients were served in rural clinics; this number dropped to an average of 17% during the war. Health facilities were systematically looted. Of the 69 institutions assessed, over 69% of the microscopes in health centers, 87.5% of the microscopes in primary hospitals, and 68% of the microscopes in general hospitals were stolen or damaged. Two GeneXpert nucleic acid amplification machines were also taken from general hospitals. Regarding drug resistant TB, the average number of multidrug resistant tuberculosis (MDR TB) cases detected per month was reduced by 41% during the war with p-value < 0.001. In-depth interviews with eight health care workers indicated that the main factors affecting tuberculosis care in the area were lack of security, health facility destruction, theft of essential equipment, and drug supply disruption.Conclusion and recommendationMany tuberculosis patients failed to visit health facilities during the war. There was substantial physical damage to health care facilities and systematic looting of diagnostic equipment. Restoring basic public services and revitalizing clinical care for tuberculosis need urgent consideration.

Sociocultural understanding of Tuberculosis and implications for care-seeking among adults in the province of Zambezia, Mozambique: Qualitative research.

Mozambique has a high burden of Tuberculosis (TB) with an incidence of 368 per 100,000 population in 2020, coupled with a low all-form TB detection rate. The COVID-19 pandemic has exacerbated delays in timely diagnosis and treatment of new TB cases. Promoting active TB case finding is a national priority in Mozambique. We conducted qualitative research to explore factors influencing TB testing in Zambezia province in Mozambique. One-to-one, semi-structured, audio-recorded telephone interviews were conducted to explore TB-related knowledge, and barriers and facilitators to TB testing. A sample of two TB Program staff, two community providers of TB services, and 19 community members (10 women and 9 men) was recruited, with support from provincial government TB staff, from four districts in Zambezia with a high TB burden. Interviews were transcribed verbatim, and thematic analysis was conducted. The Mozambican National Bioethics Committee for Health approved the study protocol. Our study highlights that knowledge about TB symptoms and its causes is low, which could delay timely TB testing. Sociocultural beliefs often implicate certain types of sexual activity and women as causes of TB symptoms; for example, having sex with a widow who has not been traditionally purified, or with a woman who has had an abortion. Therefore, people usually tend to first seek care from traditional healers instead of going to a health facility. Additionally, stigma associated with HIV and TB also delays care seeking. Gender-related disparities in TB care seeking were also evident. This study provides valuable insights into how healthcare seeking for TB is influenced by sociocultural understanding of symptoms and gender dynamics. Therefore, interventions to promote timely and appropriate care seeking for TB should be contextually tailored, culturally appropriate, and gender sensitive.

Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups - The Romanian Experience.

Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions.

ЯК ВПЛИНЕ ВІЙНА В УКРАЇНІ НА ЕПІДЕМІЧНУ СИТУАЦІЮ З ТУБЕРКУЛЬОЗОМ: МІРКУВАННЯ ФАХІВЦІВ

To determine the leading trends regarding the impact of the war in Ukraine on the situation with tuberculosis (TB) in real time, professional sources of information were analyzed. Publications regarding the impact of the war in Ukraine on the epidemic situation with TB are mainly of an overview nature. An increase in morbidity, mortality and worsening of other epidemiological indicators are predicted. Possible spread of multidrug-resistant tuberculosis (MDR-TB) and TB/HIV confections is of special concern, as even before the war Ukraine ranked second in Europe for the burden of HIV infection, fourth for the spread of TB and fifth in the world for MDRTB. The impact of war on the health of the population and the medical care system is determined by many factors, including damage to the country's infrastructure, overcrowding, deterioration of sanitary conditions, forced displacement of the population, insufficient availability of medical care, lack of adequate supply of water and food, mental overload, financial difficulties etc. The war affects patient care and the effectiveness of the health care system, which means poor TB detection rates, coverage of preventive examinations, and limited access to health care in general. This problem requires an immediate and comprehensive research and develop a set of measures to restore the full provision of medical care for this disease. Establishing the determinants of TB risk caused by the war will allow offering practical health care measures that should reduce the negative impact of the war on the epidemic situation with TB in Ukraine. Key words: tuberculosis, epidemic situation, war.

Impact of the use of GeneXpert on TB diagnosis and anti-TB treatment outcome at health facilities in Addis Ababa, Ethiopia in the post-millennium development years.

GeneXpert is an effective and rapid molecular system used for tuberculosis (TB) diagnosis. It is expected to improve the detection rate and treatment outcomes needed to meet the sustainable development goals (SDG) and End TB strategy targets set for 2030. This study aimed to evaluate the impact of GeneXpert on diagnosis and anti-TB treatment outcomes in the post-millennium development goals (MDGs) in the capital city of Ethiopia. Hence, the global priority indicator based on the End TB Strategy for TB treatment success rate was met early in 2018 in Addis Ababa, Ethiopia, which was anticipated to be met by 2025. A retrospective health facilities-based study was conducted in Addis Ababa, Ethiopia. Records of all TB cases diagnosed and treated in selected health facilities from January 1st, 2015 to December 31st, 2018 were reviewed and included in the study. Data analysis of descriptive and inferential statistics was conducted using SPSS version 20. The reviewed records have shown that a total of 45,158 presumptive pulmonary TB (PTB) cases had accessed TB diagnosis services. Of which, 28.9% (13072/45158) were tested by AFB microscopy and 71.1% (32086/45158) were tested by GeneXpert. During the study period, the coverage of Xpert MTB/RIF testing increased to 94.9% in 2018 compared to 1.6% in 2015. The number of presumptive PTB cases tested with the GeneXpert system showed a significant increase compared to smear microscopy. The odds of positivity were detected in males compared to females. The odds of detecting TB cases were much higher among study participants aged 15-44 years compared to younger than 15 years. Treatment success rate showed a relative improvement each year between 2015 and 2018 with a mean of 92.6%. Reduced odds of treatment successes were observed in age categories older than 35 years, and in TB/HIV co-infected patients. Increased odds of treatment successes were reported in the years between 2016 and 2018 compared to 2015. Scaling up the Xpert MTB/RIF assay as a point-of-care test for presumptive TB cases in resource-limited settings would have a significant impact to meet the SDG and End TB strategy both in TB detection and treatment success rates.

Теоретическое обоснование организации выявления случаев туберкулёза и ВИЧ-инфекции в изоляторах временного содержания территорий с низкой плотностью населения.

Detection of cases of tuberculosis in temporary detention facilities (TDF) and police reception centers (PR) makes it possible to identify TB patients among socially vulnerable segments of the population with high efficiency; a similar result is expected for HIV infection. This is especially true for low-density entities where the population is exposed to specific risk factors. However, at present there are no calculations showing the potential effectiveness of implementing the method in them. T h e p u r p o s e o f t h e s t u d y : to develop theoretical prerequisites for the introduction of a survey of detainees, suspects and accused in order to detect tuberculosis and HIV infection in PR and TDF. M a t e r i a l s a n d m e t h o d s . We used information from official statistical observation to analyze the detection rate of tuberculosis and HIV in pre-trial detention centers. Information about the number of offenders according to the Ministry of Internal Affairs, and estimates of the detection of tuberculosis patients according to statistical materials. 95% confidence limits (95% CI) were used as limits for the 95% uncertainty interval. R e s u l t s . From 2018 to 2022 2,512 newly arrested people passed through the pre-trial detention center in Petropavlovsk-Kamchatsky, among whom 94 people living with HIV were identified for the first time (detection rate is 37,4 per 1,000 examined; for comparison, in public health care – 2,1 per 1,000 examined) and 54 patients tuberculosis (detection rate is 21,5 per 1000 examined; for comparison, in public health care – 0,29 per 1000 examined). During this time, the police detained 16,282 people who, one way or another, went through the PR and IVS. Their examination would make it possible to additionally identify from 80 to 108 PLHIV and from 34 to 71 TB patients annually. C o n c l u s i o n . Screening for the detection of tuberculosis and HIV infection in TDFs and PRs is a potentially extremely effective tool that can lead to a significant improvement in the detection of patients with socially significant infectious diseases with the potential to interrupt the infection chain among socially vulnerable part of the population.

Transmission pattern and the role of DOTS clinic in the control strategies of Tuberculosis in Kano, Nigeria

Tuberculosis (TB) is a major public health concern not only in developing nations but globally and the World Health Organization (WHO) estimated 10.4 million incident cases of TB and 1.67 million TB deaths in 2017. The study was conducted in Infectious Disease Hospital (IDH), Kano, a reference health facility for infectious disease of public health importance. The aim of the study was to determine the transmission pattern of Mycobacterium tuberculosis complex (MTBC) strains and the role played by Directly Observed Therapy Short course (DOTS) clinic in the control of TB. Of the 945 case-patients enrolled, 625 (66.1%) were males and 320 (33.9%) were females. The mean age of patients in years was 32.8 ± 13.8 SD and the median age was 30 years (range 3-95 years). Incidence of TB among presumptive cases was 15.0%. There was a fairly consistent increase in TB prevalence from 2015 (11.0%), 2016 (11.5%), 2017 (10.0%) and 2018 (36%). Pulmonary TB was diagnosed in 884 (93.5%) while Extra-Pulmonary TB accounted for 6.5%. New cases of TB within the study period were 819 (86.7%) and while 126 (13.3%) were relapse TB cases. Treatment outcome that included patients described as cured or have completed treatment successfully (smear negative) were recorded in 811 (85.8%) cases. DOTS clinic has improved TB detection rate through the years and consequently played a big supervisory role in TB treatment and control strategy in the state.

Burden of pulmonary tuberculosis and challenges related to tuberculosis detection in Ethiopia.

Early and rapid diagnosis of Mycobacterium tuberculosis in clinical specimen is important for the treatment of patients and control of disease transmission to the community. The disease is largely preventable and curable, but without rapid, and correct diagnostic tools for tuberculosis (TB) infection and drug resistance, it is unlikely that we can meet the national TB elimination program in Ethiopia by 2035. Moreover, drug resistant TB is becoming more common and is a great challenge for the successful control and eradication of TB. The need for rapid, accurate and affordable methods for TB management should be considered by policy makers to improve TB detection rate and reduction of TB related deaths in line with the stop TB strategy by 2030 in Ethiopia.

Evaluation of prognostic inflammatory and systemic inflammatory response indices in auxiliary diagnosis of bacteria-negative pulmonary tuberculosis: A diagnostic accuracy study.

Although molecular biology has made great progress in recent years, the detection rate of mycobacterium tuberculosis (MTB) is still not ideal. This study aimed to evaluate the role of prognostic inflammatory index (PII) and systemic inflammatory response index (SIRI) in the auxiliary diagnosis of bacteria-negative pulmonary tuberculosis (TB). Sixty patients diagnosed with bacteria-negative pulmonary TB at the Affiliated Hospital of Qinghai University between October 2019 and September 2022 were randomly selected as the case group, and seventy patients with nontuberculous pulmonary infection in the same department of the same hospital during the same period were randomly selected as the control group. Baseline data and values of erythrocyte sedimentation rate (ESR), lymphocyte count (LY), neutrophil count (NE), monocyte count (MO), albumin (ALB), prealbumin (PA), C-reactive protein (CRP), fibrinogen (FIB), neutrophil-to-lymphocyte ratio (NLR), PII, and SIRI were compared between the 2 groups. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of PII and SIRI in the diagnosis of bacteria-negative pulmonary TB. No significant differences were found between the 2 groups in terms of sex and age (P > .05); however significant differences were observed in relation to body mass index (BMI), ESR, LY, NE, MO, ALB, PA, CRP, FIB, NLR, PII, and SIRI (P < .05). ROC curve analysis showed that area under curve (AUC) value {0.84 [95% CI (0.77, 0.90)]} and specificity {82.86% [95% CI (72.0, 90.8)]} of PII were the highest, while the sensitivity {86.67 [95% CI (75.4, 94.1)]} of NLR + PII was the highest. Pairwise comparison of the 7 indicators of ROC curve was performed, and only the diagnostic efficiency of NLR and NLR + PII was statistically significant (Z = 2.36, P = .02 < .05). NLR, PII, SIRI, pairwise combinations, and NLR + PII + SIRI showed auxiliary diagnostic values for bacteria-negative pulmonary TB, among which PII had the highest diagnostic value and specificity, while NLR + PII had the highest sensitivity.

Gambaran Karakteristik dan Praktik Petugas Puskesmas Dalam Penemuan Kasus Tuberkulosis Paru di Kabupaten Magelang

Case Detection Rate of pulmonary Tuberculosis in Magelang District still low. The purpose of this research is to gain characteristics and practices of Public Health Center on case finding of pulmonary tuberculosis in Magelang District in terms of aspects of age, gender, level of education, level of knowledge, length of employment, perception of workload, training history, contact tracing, counseling, networking and practical cases of laboratory officer. This research is a descriptive study. The population is all Pulmonary tuberculosis programs officers in 29 Public Health Center in Magelang District. The total samples are 87 officers, consist of 29 P2TB officers, 29 laboratory officers, 29 medics and paramedics. The sampling technique is purposive sampling. Median of age of P2TB officers is 44 years, mean of medics and paramedics is 39.2 years, and median of laboratory officer is 30 years. Most of respondents are female and background in college-level education. Mean of the length of working for P2TB officer is 9.7 years, median for laboratory officer is 4 years, and median for medical officer and paramedics are 4 years. 79.3% of P2TB officers and 93.1% of medical officers and paramedical had a training history of &lt; 2 training. The level of knowledge of P2TB officer 51.7% in poor category. Contact tracing of P2TB officer 41.4% in poor category. Counseling of P2TB officers 41.4% in poor category. The entire laboratory officer practice fixation and staining in both categories. Networking cases of medical and paramedical staff 51.7% in poor category. Perception workload of medical and paramedical officer 51.7% in weight category. Suggestions for Magelang District health department is that the department should expand networking case by cooperating with private practice doctors and give a priority for officers who have been trained yet to be included in the training on Tuberculosis.

Tuberculosis literacy and stigma: female activists in five areas with the lowest treatment success rate in Semarang, Indonesia

Background: The Case Detection Rate of Tuberculosis (TB) in Semarang city increased from 2014 to 2018, while the Treatment Success Rate declined. Low literacy can trigger stigma in society, especially among women, resulting in low awareness of suspect TB for treatment. Objectives: The aims are to analyze the correlation between TB literacy and stigma expressed among female health and social activists. Methods: Cross-sectional research was conducted in five public health centers with the lowest Treatment Success Rate (TSR). A valid and reliable self-administered online questionnaire collected data that involved 391 respondents predominantly in the urban areas. Rank Spearman test was used to analyze the data with a confidence interval of 95%. Results: The respondents were mostly elderly (&gt;45 years; 61.6%), health activists with high school graduation, didn't have a family with a health background and did not work. Most of them showed low TB literacy (Me:60; SD±6.62) and high stigma (Me: 76; SD±10.36). They were also difficult to access, understand, assess, and apply information about TB. Age (p.0.03; r.-0.110), being health activist (p.0.081; r.-0.088), and TB literacy (p.0.001; r.0.165) correlated significantly with stigma. Conclusions: Public Health Center's officers require inserting literacy education materials related to stigma to form a comfortable support system for persons with TB.

Эпидемическая ситуация по туберкулезу в Республике Мордовия

The article considers the epidemic situation of tuberculosis in the Republic of Mordovia for the period 2017-2021. The aim of the study is to analyze the epidemic situation of tuberculosis in the Republic of Mordovia. In this work, statistical data of Mordovia Statistics (territorial body of the Federal State Statistics Service for the Republic) are used. The incidence rate of active tuberculosis among the permanent resident population in the reporting year increased by 4.3% and amounted to 16.8 per 100 thousand population, 131 cases of newly detected active tuberculosis were registered. The total mortality from tuberculosis in 2021 increased by 12.5% and amounted to 1.8 per 100 thousand population or 14 cases. The detection rate of active tuberculosis by the population in 2021 increased and amounted to 42%. Preventive checks for tuberculosis in 2021 involved 610143 persons or 79.5% of the total population of the Republic. In the course of a retrospective analysis of the epidemiological situation in the Republic of Mordovia for the periods 2017-2021, positive changes were identified due to the quality of anti-epidemic measures and the level of etiological verification of pulmonary tuberculosis. At the same time, negative trends have also been identified, due to the pathomorphosis of tuberculosis of the respiratory organs at the present stage of the epidemic process, which require further studies to provide solutions.

Role of line probe assay in detection of Mycobacterium tuberculosis in children with pulmonary tuberculosis

India is the highest TB burden country in the world with almost 27 lakh cases reported in 2019. Pediatric tuberculosis in India accounts for almost 31% of global TB burden. Despite such high mortality and morbidity in children, diagnosis of pulmonary TB in children still remains very challenging. This cross-sectional study was conducted in a tertiary care hospital in Delhi, India. Children between 1 and 12 months with clinical suspicion of pulmonary tuberculosis who had not previously taken ATT were included. Early morning gastric aspirate samples were collected after overnight fasting, on two days. Both days sputum sample were subjected to sputum smear microscopy and one of the two samples was subjected to line probe assay (LPA), cartridge based nucleic acid amplification (CBNAAT) and mycobacterium growth in tube (MGIT-960). 84 children with pulmonary tuberculosis were enrolled. The most common presenting complaint was fever seen in 83 patients (98.8%). Only 17 (20.24%) were sputum smear positive by Ziehl- Neelsen (ZN) staining. LPA was positive in 47 (55.95%) samples and among these positive samples both INH and RIF resistance was detected in 2 (4.26%) samples. CBNAAT was positive in 53 patients (63%). Growth in liquid culture media (MGIT 960) was observed in 44 (52.38%) samples. Among 17 smear positive samples, LPA was detected in 14 (82.35%) samples and among 67 smear negative sample LPA was detected in 33 (49.25%) samples. LPA had 63.46% sensitivity, 100% specificity in detecting mycobacterium tuberculosis. WHO's recommendation for using LPAs has been limited to culture isolates or smear-positive sputum specimens. New data has since been generated on the use of LPAs as newer versions of LPA have been developed over past few years. Previous studies conducted using LPA version 1.0 reported much lower detection rate of mycobacterium tuberculosis in smear negative specimens. With the availability of newer versions such as Hain GenoTypeMTBDRplusversion 2 and Nipro NTM+MDRTB detection kit 2, the diagnostic utility of LPA may be enhanced.