Early Diagnosis Of Tuberculosis Research Articles

Evaluation of a real-time PCR assay performance to detect Mycobacterium tuberculosis, rifampicin, and isoniazid resistance in sputum specimens: a multicenter study in two major cities of Indonesia.

Tuberculosis (TB) is one of the major global health issues due to its high mortality rate, especially in low- and middle-income countries. One of the key success points of the TB eradication program is early TB diagnosis, which requires rapid and accurate diagnostic testing. This study aimed to evaluate the performance of a newly developed RT-PCR kit (Indigen MTB/DR-TB RT-PCR) in a routine TB clinical setting. A multi-fluorescence RT-PCR assay was designed and developed to detect regions within IS6110, rpoB, katG, and inhA of the Mycobacterium tuberculosis (MTB) genes. Sputum specimens were obtained from suspected TB patients who visited TB healthcare facilities in two major cities of Indonesia from September 2022 to May 2023. Specimens were assessed using Indigen MTB/DR-TB RT-PCR, acid-fast bacillus (AFB) smear microscopy, MTB culture, and drug susceptibility testing (DST) methods. Fisher's exact test (χ2) was used to analyze the Indigen performance relative to culture methods. The performance of Indigen MTB/DR-TB RT-PCR to detect MTB was assessed using 610 sputum specimens obtained from suspected patients. The overall sensitivity and specificity were 94.12% (95% CI: 90.86-96.48%) and 98.32% (95% CI: 96.20-99.46%), respectively. When the analysis was performed on AFB smear-negative TB subjects (386 subjects), a lower sensitivity level was found at 78.57% (95% CI: 68.26-86.78%), while the specificity level remained similar at 98.34% (95% CI: 96.18-99.46%). The overall performance of Indigen MTB/DR-TB RT-PCR to detect MTB showed substantial agreement with the MTB culture method (kappa value 0.93). In comparison to DST, the sensitivity and specificity levels of Indigen to detect RIF resistance or INH resistance were 78.2% (95% CI: 61.8-90.2%) and 82.8% (95% CI: 64.2-94.2%), respectively, while the specificity level for both groups was at 100% (95% CI, 87.7-100%). Indigen MTB/DR-TB RT-PCR demonstrated reliable performance for TB molecular diagnostic testing and can be implemented in routine TB diagnostic settings.

Retrospective evaluation of the results of immunodiagnostics for tuberculosis in children

Introduction. For early immunodiagnostics of tuberculosis (TB) in Russia, the Mantoux test (MT) has been used for decades; since 2013, the recombinant tuberculosis antigen (RTA) test has seen widespread use.
 The objective of this retrospective analytic observational cohort study was to evaluate the results of immunodiagnostics for TB in children with newly diagnosed active TB.
 Materials and methods. We studied data from Russian TB institutions on the results of MT and RTA assay in children with active and inactive TB first detected in 2013–2018, as well as children with active TB first detected in Moscow in 2017–2022.
 Results and discussion. In 2013–2018, out of 12,902 examined children with active TB, 11,673 (90.5%) had positive results of both skin tests and 198 (1.5%) had negative results. A negative RTA assay result with positive MT was found in 861 (6.7%) patients, and a positive RTA assay result with negative MT in 170 (1.3%). The sensitivity of the RTA assay in detecting active TB was 91.3%, while the sensitivity of MT was 97.2% (p 0.01). Similar data were obtained in the same regions in 14,127 children with inactive TB: the sensitivity of MT was higher than that of the RTA assay — 97.2% versus 95.2% (p 0.01). In Moscow, due to the small number of observations in 2022, it was not possible to show statistical reliability of the difference between the sensitivity of MT and RTA assay in detecting active TB in 2017–2022 (95.8% and 92.1% respectively; p 0.5). For the results obtained in 2017–2021, the difference was significant (p 0.05).
 Conclusion. The sensitivity of MT is higher than that of the RTA assay in screening children for TB. It is recommended to use the more sensitive MT test for screening children; screening with the RTA assay will increase the number of undetected and undiagnosed cases of active TB in children. Currently, MT cannot be excluded from the algorithm of early TB diagnosis in children.

Diagnosis of multiple tuberculous muscle abscesses in a patient with systemic lupus erythematosus by metagenomic next-generation sequencing- a case report and literature review

BackgroundEarly diagnosis of muscular tuberculosis (TB) without coexistent active skeletal involvement is often challenging because the disease is very rare and its clinical manifestation is nonspecific and misleading. To raise the awareness and emphasize early diagnosis of muscular TB, we present a case of multiple tuberculous muscle abscesses in a systemic lupus erythematosus (SLE) female, but without pulmonary tuberculosis (PTB), in order to increase awareness of and stress the need of early detection of muscular TB.Case presentationA 44-year-old woman with a 6-year history of SLE who had been treated with methylprednisolone for a long time complained of erythema on her trunk and extremities for five months, along with edema and myalgia for two months, and fever for one month. The patient was first misdiagnosed as SLE overlap dermatomyositis. However, an ultrasound-guided drainage of muscle abscesses revealed positive acid-fast staining combined with positive deoxyribonucleic acid fragment of Mycobacterium tuberculosis using metagenomic next-generation sequencing (mNGS). The patient was cured and released following standard anti-tuberculosis medication, local puncture drainage, and an intravitreal injection of streptomycin. Literature search found only 19 cases of tuberculous muscle abscesses occurring in the extremities reported from 1999 to 2023.ConclusionsExtrapulmonary TB with predominantly muscle involvement is rare and with no specific clinical presentation. Muscular tuberculosis may be disdiagnosed for dermatomyositis due to the high muscle enzyme levels, delaying diagnosis and treatment. mNGS technology is helpful in the early and rapid diagnosis of muscular TB. On the basis of traditional anti-tuberculosis treatment, an ultrasound-guided percutaneous puncture drainage and intracavitary injection of streptomycin for the treatment of tuberculous muscle abscess is easy to operate, safe and effective, which is worthy of clinical popularization and application.

Pancreatic Tuberculosis With Duodenal Fistula Presenting as Life-Threatening Gastrointestinal Bleeding

ABSTRACT Pancreatic tuberculosis (TB) warrants heightened suspicion in individuals with pancreatic lesions and risk factors such as HIV, organ transplantation, or pertinent immigration history. We present a 38-year-old man who presented with hemodynamically unstable gastrointestinal bleeding. He was found to have pancreatic TB complicated by a duodenal ulcer with fistula. Following 1 month of antitubercular therapy, he experienced complete resolution of symptoms, healing of the duodenal ulcer, closure of the fistulous tract, and a decrease in the size of the pancreatic lesion as observed on imaging. Our case highlights the importance of early diagnosis and treatment of pancreatic TB.

Burden of Tuberculosis in End Stage Renal Disease Patients Undergoing Maintenance Hemodialysis: A Multicenter Study and Experience from Ethiopian Dialysis Setting.

Patients with end stage renal disease (ESRD) are at a higher risk of developing tuberculosis (TB) due to the immunosuppressed state along with concomitant comorbidities and socioeconomic and demographic factors. Data on the prevalence of tuberculosis in ESRD are scarce despite the high burden of the disease in developing nations. A multicenter, cross-sectional study was conducted at eight dialysis centers in Addis Ababa on the prevalence of TB among CKD patients on maintenance hemodialysis from August 2022 to October 2022 G.C. The study enrolled 263 participants selected by systematic random sampling. Data were collected by reviewing the patient's electronic medical records. The Collected data were analyzed using SPSS version 26.0. Our study found a 27% prevalence of TB in patients with ESRD receiving maintenance hemodialysis (MHD). Pulmonary tuberculosis was the most prevalent form, and lymphadenitis was the most common extra-pulmonary tuberculosis (EPTB). Only 5.6% of the study participants had microbiologic evidence of TB. Chemistry and cytological studies from pleural fluid and imaging evidences were commonly used diagnostic modalities. The presence of HIV infection, longer duration of dialysis (>1 year), and contact history with a known TB patient were all significantly associated with higher prevalence of TB among the study participants. Although there is a strong association between TB and CKD, there are no local data from Ethiopia. Our study identified a higher prevalence of TB among CKD patients on MHD. Thus, maintaining a high index of suspicion and early diagnosis and treatment of TB among ESRD patients on MHD and use of TB preventive therapy (TPT) is important in decreasing morbidity and mortality.

Role of Culture Free Rapid ImmunoAssay (ELISA) and Genexpert (MTB/RIF) Technology in the Diagnosis of Tuberculosis

Introduction: Prolonged laboratory processes are major hurdles in the early diagnosis of tuberculosis. Prompt management of this disease is utmost necessary to control its spread. For this purpose, use of rapid and reliable laboratory testing methods for the diagnosis of Mycobacterium tuberculosis are crucial alongwith timely infection management and preventing its transmission to the close contact population. Aims and Objective: The aim of this study was to establish a diagnostic-connection between culture free cost effective rapid immuno-assay (IgG and IgM) and GeneXpert (MTB/RIF) technology for the detection of Mycobacterium tuberculosis within the shortest possible turnaround time. Place and Duration of Study: This cross-sectional study was carried out at Institute of Microbiology and Molecular Genetic, University of the Punjab, Pakistan in collaboration with the Department of Pulmonology and TB Outpatient Department (OPD) at Jinnah Hospital, Lahore over the time of one year (2019-2020). Material and Methods: To achieve the aim, a total of 180 (pulmonary and extra-pulmonary) samples along with blood samples were collected from clinical suspects of Tuberculosis. All collected samples were subjected to AFB microscopy, GeneXpert (MTB/RIF) assay and Enzyme-linked Immunosorbent Assay (ELISA) for IgG and IgM. The diagnostic sensitivity and specificity of both methods were determined by using the solid culture as the gold standard.Study data collected through questionnaire was entered and analyzed using Statistical Package for Social Sciences (SPSS version 20).p value of ? 0.05 was considered significant. Results: The overall sensitivity and specificity of GeneXpert (MTB/RIF) assay were 98.2 % and 82.4% respectively, whereas, for IgG (ELISA) antibodies, it was 50.0% and 76.4% and for IgM (ELISA) antibodies 50.4% and 97.1% respectively. Conclusion: It was concluded that with fully automated GeneXpert (MTB/RIF) technology, maximum sensitivity and specificity can be achieved for diagnosis of tuberculosis within 2 hours.

Evaluation of the Tuberculosis Surveillance System in the Southern Region of Iran

Aim The aim of this study was the evaluation of Tuberculosis (TB) surveillance system in Southern Iran. Background TB is one of the most important infectious diseases that has been common since ancient times. Methods This is a cross-sectional descriptive-analytical study that was conducted by the census method using the TB Surveillance System on 77 patients with tuberculosis in the southern region of Kerman province in Iran. The study was conducted over one year, from April 2020 to March 2021. Statistical tests were used by SPSS version 20 to analyze the data. Results 90.62% of the patients were cured and the rest experienced treatment failure and absenteeism. The average and standard deviation of the interval between the onset of the first symptom and the diagnosis and discovery of the disease were 88 and 93 days, respectively. Regarding the treatment duration, 95.5% of the cases followed the prescribed duration while the remaining cases did not. Among the affected patients, 34.8% had a history of hospitalization, while the rest had no such history. The average hospitalization duration was 12.92 days, with a standard deviation of 9.94 days. The longest hospital stay was 60 days, while the shortest was 2 days. Conclusion We need to have a suitable program for early diagnosis of TB, compliance with the length of treatment, and training of private and public centers to strengthen the care system. Additionally, we should strengthen the process of the directly observed treatment, short-course (DOTS) program to control TB.

Latent and active tuberculosis development in patients with rheumatoid arthritis receiving biologic disease-modifying antirheumatic drugs: A single-center prospective study.

Biologics have revolutionized the treatment of rheumatoid arthritis (RA) in recent years. However, data from clinical trials and actual clinical practice have shown that biologics currently in use may constitute a risk factor for reactivation of tuberculosis (TB) in patients with latent TB infection. Therefore, screening for latent and active TB infection is mandatory before initiating biologic therapy in patients with RA. This prospective study aimed to analyze the clinical characteristics of patients with RA receiving biologic disease-modifying antirheumatic drugs at Bach Mai Hospital, Vietnam, between 2017 and 2022, and to identify factors affecting the occurrence of active and latent TB infection among these patients. Over a 12-month follow-up period, latent TB infection was confirmed in 20% of the total 180 included patients, while 3 (1.7%) patients developed active TB (one case of pulmonary, pleural, and gluteal TB each). History of TB risk factor exposure and lack of education were significantly associated with the occurrence of active and latent TB infection, with odds ratios (95% confidence intervals [CIs]) of 1.98 (1.78; 2.2) and 1.45 (1.31; 1.6), respectively. Follow-up duration and number of X-ray, computed tomography, bronchoscopy, and sputum acid-fast bacteria examinations were identified as factors that can aid in the early diagnosis of latent TB, with odds ratios (95% CIs) of 1.00 (1; 1.01), 1.02 (1; 1.05), 1.12 (1.11; 1.2), 1.11 (1.09; 1.2), and 1.13 (1.09; 1.17), respectively. Our study showed that, in countries with high TB burden like Vietnam, latent TB infection has high prevalence among patients with RA. We also provide useful information for the screening, monitoring, and treatment of latent and active TB infection in patients with RA.

Mycobacterium tuberculosis: immune response, biomarkers, and therapeutic intervention.

Although tuberculosis (TB) is an infectious disease, the progression of the disease following Mycobacterium tuberculosis (MTB) infection is closely associated with the host's immune response. In this review, a comprehensive analysis of TB prevention, diagnosis, and treatment was conducted from an immunological perspective. First, we delved into the host's immune response mechanisms against MTB infection as well as the immune evasion mechanisms of the bacteria. Addressing the challenges currently faced in TB diagnosis and treatment, we also emphasized the importance of protein, genetic, and immunological biomarkers, aiming to provide new insights for early and personalized diagnosis and treatment of TB. Building upon this foundation, we further discussed intervention strategies involving chemical and immunological treatments for the increasingly critical issue of drug-resistant TB and other forms of TB. Finally, we summarized TB prevention, diagnosis, and treatment challenges and put forward future perspectives. Overall, these findings provide valuable insights into the immunological aspects of TB and offer new directions toward achieving the WHO's goal of eradicating TB by 2035.

Early diagnosis and meta-agnostic model visualization of tuberculosis based on radiography images

Despite being treatable and preventable, tuberculosis (TB) affected one-fourth of the world population in 2019, and it took the lives of 1.4 million people in 2019. It affected 1.2 million children around the world in the same year. As it is an infectious bacterial disease, the early diagnosis of TB prevents further transmission and increases the survival rate of the affected person. One of the standard diagnosis methods is the sputum culture test. Diagnosing and rapid sputum test results usually take one to eight weeks in 24 h. Using posterior-anterior chest radiographs (CXR) facilitates a rapid and more cost-effective early diagnosis of tuberculosis. Due to intraclass variations and interclass similarities in the images, TB prognosis from CXR is difficult. We proposed an early TB diagnosis system (tbXpert) based on deep learning methods. Deep Fused Linear Triangulation (FLT) is considered for CXR images to reconcile intraclass variation and interclass similarities. To improve the robustness of the prognosis approach, deep information must be obtained from the minimal radiation and uneven quality CXR images. The advanced FLT method accurately visualizes the infected region in the CXR without segmentation. Deep fused images are trained by the Deep learning network (DLN) with residual connections. The largest standard database, comprised of 3500 TB CXR images and 3500 normal CXR images, is utilized for training and validating the recommended model. Specificity, sensitivity, Accuracy, and AUC are estimated to determine the performance of the proposed systems. The proposed system demonstrates a maximum testing accuracy of 99.2%, a sensitivity of 98.9%, a specificity of 99.6%, a precision of 99.6%, and an AUC of 99.4%, all of which are pretty high when compared to current state-of-the-art deep learning approaches for the prognosis of tuberculosis. To lessen the radiologist’s time, effort, and reliance on the level of competence of the specialist, the suggested system named tbXpert can be deployed as a computer-aided diagnosis technique for tuberculosis.

Bode Phase Angle Signaling of a TB Disease Biomarker.

Tuberculosis (TB) is a worldwide burden whose total control and eradication remains a challenge due to factors including false positive/negative diagnoses associated with the poor sensitivity of the current diagnostics in immune-compromised and post-vaccinated individuals. As these factors complicate both diagnosis and treatment, the early diagnosis of TB is of pivotal importance towards reaching the universal vision of a TB-free world. Here, an aptasensor for signaling an interferon gamma (IFN-γ) TB biomarker at low levels is reported. The aptasensor was assembled through gold-thiol interactions between poly(3,4-propylenedioxythiophene), gold nanoparticles, and a thiol-modified DNA aptamer specific to IFN-γ. The aptasensor sensitively detected IFN-γ in spiked pleural fluid samples with a detection limit of 0.09 pg/mL within a linear range from 0.2 pg/mL to 1.2 pg/mL. The good performance of the reported aptasensor indicates that it holds the potential for application in the early diagnosis of, in addition to TB, various diseases associated with IFN-γ release in clinical samples.

Long non-coding RNA expression in PBMCs of patients with active pulmonary tuberculosis.

Mycobacterium tuberculosis (Mtb) infection is the primary cause of the chronic infectious illness tuberculosis (TB). Long non-coding RNAs (lncRNAs) are functional RNA molecules that cannot be translated into proteins and play a crucial role in regulating the immune system's innate and adaptive responses. It has been demonstrated that the dysregulation of lncRNA expression is associated with various human diseases. However, the mechanism underlying the involvement of so many lncRNAs in the immune response to TB infection remains unclear. The objective of our current study was to identify a number of significantly differentially expressed lncRNAs in peripheral blood mononuclear cells (PBMCs) from TB patients and to select the most indicative lncRNAs as potential biomarkers for active pulmonary tuberculosis. Microarray analysis was performed to determine the lncRNA and mRNA expression profiles in TB patients using a case-control model. The differentially expressed lncRNAs were subjected to gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis to investigate potential roles and pathways associated with the pathogenesis of TB infection, and to screen lncRNAs specifically linked to TB infection. Using real-time fluorescence quantitative PCR (QRT-PCR), specific lncRNAs were identified in TB patients and latent infections. Our findings revealed that various signaling pathways were differentially expressed in TB-infected individuals, suggesting a potential role for lncRNAs in the immunological responses driven by TB infection. This study provides crucial guidelines for future functional research. Upregulated lncRNAs were mainly enriched in Neutrophil extracellular trap formation and Chemokine signaling pathways, while downregulated lncRNAs were enriched in Neuroactive ligand-receptor interaction and Cushing syndrome in TB PBMCs. Furthermore, we found that lnc-XPNPEP1-5, lnc-CASKIN2-2, lnc-HSPA13-6, lnc-CLIC5-1, and LINC02502 were significantly downregulated in TB-infected patients, while LINC00528, lnc-SLC45A4-3, and LINC00926 were significantly upregulated in TB patients and latent infections. These eight lncRNAs, identified as novel biological marker candidates for diagnosing TB infection, were validated by real-time fluorescence quantitative PCR (QRT-PCR). The abnormally expressed lncRNAs identified in this research may provide crucial information for understanding the pathophysiological characteristics of TB patients and the dysfunction of PBMCs. Our findings reveal potential targets for early TB diagnosis and therapy, as well as offer new insights into the mechanisms underlying TB infection.

Active close contact investigation of tuberculosis through computer-aided detection and stool Xpert MTB/RIF among people living in Oromia Region, Ethiopia (CADOOL Study): protocol for a prospective, cross-sectional study

IntroductionPulmonary tuberculosis (TB) is an infectious disease with high incidence in low-income countries (LICs); it remains one of the infectious diseases with the highest mortality in the world, especially in...

Perinatal tuberculosis-An approach to an under-recognized diagnosis.

Tuberculosis (TB) in young infants (<3 months of age), often referred to as perinatal TB, is underdiagnosed, leading to severe morbidity and high mortality. Perinatal TB includes both congenital and postnatal transmission of Mycobacterium tuberculosis. We aimed to increase an awareness of TB in neonates and young infants and to provide guidance on the assessment and management when in contact with mothers with TB during or soon after pregnancy. Approximately 217,000 pregnant women develop TB annually; if they are not diagnosed and treated during pregnancy, their infants are at high risk of adverse birth outcomes and TB disease. Although safe and effective antituberculosis treatment regimens are available during pregnancy, the diagnosis of TB is challenging. Infants born to mothers newly diagnosed with TB, not receiving any effective treatment or with cultures not yet negative, should be assessed for TB disease or M. tuberculosis infection. TB preventive therapy should be instituted if the infant is clinically well but exposed to TB, while prompt initiation of TB treatment is essential if TB disease is presumed. HIV status of mother and infant should be considered as this will affect the management. Further research is needed for the diagnosis and prevention of TB during pregnancy, an early diagnosis of TB in infants, and antituberculosis drug pharmacokinetics in young infants.

Prevalence of subclinical pulmonary tuberculosis and its association with HIV in household contacts of index tuberculosis patients in two South African provinces: a secondary, cross-sectional analysis of a cluster-randomised trial

BackgroundPeople with subclinical tuberculosis (TB) have microbiological evidence of disease caused by Mycobacterium tuberculosis, but either do not have or do not report TB symptoms. The relationship between human immunodeficiency virus (HIV) and subclinical TB is not yet well understood. We estimated the prevalence of subclinical pulmonary TB in household contacts of index TB patients in two South African provinces, and how this differed by HIV status.MethodsThis was a cross-sectional, secondary analysis of baseline data from the intervention arm of a household cluster randomised trial. Prevalence of subclinical TB was measured as the number of household contacts aged ≥ 5 years who had positive sputum TB microscopy, culture or nucleic acid amplification test (Xpert MTB/Rif or Xpert Ultra) results on a single sputum specimen and who did not report current cough, fever, weight loss or night sweats on direct questioning. Regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between HIV status and subclinical TB; adjusting for province, sex and age in household contacts; and HIV status in index patients.ResultsAmongst household contacts, microbiologically confirmed prevalent subclinical TB was over twice as common as symptomatic TB disease (48/2077, 2.3%, 95% CI 1.7–3.1% compared to 20/2077, 1.0%, 95% CI 0.6–1.5%). Subclinical TB prevalence was higher in people living with HIV (15/377, 4.0%, 95% CI 2.2–6.5%) compared to those who were HIV-negative (33/1696, 1.9%, 95% CI 1.3–2.7%; p = 0.018). In regression analysis, living with HIV (377/2077, 18.2%) was associated with a two-fold increase in prevalent subclinical TB with 95% confidence intervals consistent with no association through to a four-fold increase (adjusted OR 2.00, 95% CI 0.99–4.01, p = 0.052). Living with HIV was associated with a five-fold increase in prevalent symptomatic TB (adjusted OR 5.05, 95% CI 2.22–11.59, p < 0.001).ConclusionsMost (70.6%) pulmonary TB diagnosed in household contacts in this setting was subclinical. Living with HIV was likely associated with prevalent subclinical TB and was associated with prevalent symptomatic TB. Universal sputum testing with sensitive assays improves early TB diagnosis in subclinical household contacts.

Diagnostic delay, treatment duration and outcomes since the implementation of integrated model of tuberculosis control and their associated factors in a county in East China

ObjectiveThis study assesses the diagnostic delay, treatment duration and treatment outcomes of tuberculosis (TB) patients since the implementation of the integrated model of TB control in a county in eastern China. It further identifies factors associated with diagnostic delay and treatment duration in the integrated model.MethodsWe collected data through the Chinese Tuberculosis Information Management System (TBIMS) for Cangnan County in Zhejiang Province. Chi-square and Mann-Whitney tests were adopted to identify factors associated with duration of treatment and treatment delay for TB patients within the integrated model. Multiple regression analysis was subsequently performed to confirm the identified factors.ResultsIn the integrated model from 2012 to 2018, the median health system delay was maintained at 1 day, and the median patient delay decreased from 14 to 9 days and the median total delay decreased from 15 to 11 days. In addition, the proportion of patients who experienced patient delay > 14 days and total delay > 28 days decreased from 49% to 35% and from 32% to 29% respectively. However, the proportion of patients who had health system delay > 14 days increased from 0.2% to 13% from 2012 to 2018. The median treatment duration increased from 199 to 366 days and the number of TB patients lost to follow-up showed an overall upward trend from 2012 to 2018. The multivariable regression analysis indicated that migrant TB patients and TB patients initially diagnosed in hospitals at the prefectural level and above tended to experience total delay > 28 days (p < 0.001). Linear regression analysis confirmed that new TB patients>60 years tended to have longer treatment duration (p < 0.05).ConclusionsWhile our study may suggest the potential of the integrated model in early detection and diagnosis of TB, it also suggests the importance of strengthening supervision and management of designated hospitals to optimize the treatment duration and improve retention of patients in TB care. Enhancing health education for TB patients, especially amongst migrant patients, and training in TB identification and referral for non-TB doctors are also key for early TB detection and diagnosis in the integrated model.

A study on association of obstructive airway disease in previously treated pulmonary tuberculosis patients

Pulmonary tuberculosis (TB) and obstructive airway disease are of growing concern in a developing country akin to India. A considerable number of TB patients develop post-tubercular respiratory disease. There are few Indian studies assessing the relationship between antecedents of PTB and COPD. PTB has a considerable impact on quality of life. To evaluate the prevalence of obstructive airway disease in previously treated pulmonary tuberculosis patients and to evaluate the impact of post TB obstructive airway disease on QOL using SGRQ-C. A prospective, observational cross-sectional study was conducted in a tertiary care health centre over six months, enrolling 116 study subjects who met the inclusion criteria included after acquiring Informed consent. Study subjects had been categorized primarily based on prior history of PTB. Therefore, this study involved two groups of study subjects, PTB associated COPD and COPD. Subjects were assessed for PFT through the aid of MIR Spirobank smart App and QOL using SGRQ-C scale. Of 116 patients, 19(22.6%) women and 65(77.4%) men and 5(15.6%) women and 27(84.4%) men were diagnosed as PTB associated COPD and COPD respectively. Dyspnea and cough with sputum were the most common symptoms presented by 76(94.04%) and 62(71.42%) patients respectively. The effect of airflow limitation (FEV1) was slightly increased in PTB associated COPD patients (25.65%) compared to COPD patients (26.4%) and study endpoint showed noteworthy decrease in QOL of PTB associated COPD(72%) patients compared to COPD(66.4%). PTB-associated COPD constitutes a significant proportion of COPD within clinical setting. It is an independent risk factor for OAD in extensive TB burden countries. The results indicated that early diagnosis, appropriate management and control of TB are as critical as smoking cessation for reducing OAD. Early identification of Post tubercular COPD and early initiation of treatment in these patients improve the QOL and reduces morbidity and mortality.

From simple to complex: Protein-based biomarker discovery in tuberculosis.

Tuberculosis (TB) is a deadly infectious disease that affects millions of people globally. TB proteomics signature discovery has been a rapidly growing area of research that aims to identify protein biomarkers for the early detection, diagnosis, and treatment monitoring of TB. In this review, we have highlighted recent advances in this field and how it is moving from the study of single proteins to high-throughput profiling and from only using proteomics to include additional types of data in multi-omics studies. We have further covered the different sample types and experimental technologies used in TB proteomics signature discovery, focusing on studies of HIV-negative adults. The published signatures were defined as either coming from hypothesis-based protein targeting or from unbiased discovery approaches. The methodological approaches influenced the type of proteins identified and were associated with the circulating protein abundance. However, both approaches largely identified proteins involved in similar biological pathways, including acute-phase responses and T-helper type 1 and type 17 responses. By analysing the frequency of proteins in the different signatures, we could also highlight potential robust biomarker candidates. Finally, we discuss the potential value of integration of multi-omics data and the importance of control cohorts and signature validation.

A Enhanced Approach for Identification of Tuberculosis for Chest X-Ray Image using Machine Learning

Lungs are the primary organs affected by the infectious illness tuberculosis (TB). Mycobacterium tuberculosis, often known as Mtb, is the bacterium that causes tuberculosis. When a person speaks, spits, coughs, or breathes in, active tuberculosis can quickly spread through the air. Early TB diagnosis takes some time. Early detection of the bacilli allows for straightforward therapy. Chest X-ray images, sputum images, computer-assisted identification, feature selection, neural networks, and active contour technologies are used to diagnose human tuberculosis. Even when several approaches are used in conjunction, a more accurate early TB diagnosis can still be made. Worldwide, this leads to a large number of fatalities. An efficient technology known as the Deep Learning approach is used to diagnose tuberculosis microorganisms. Because this technology outperforms the present methods for early TB diagnosis, Despite the fact that death cannot be prevented, it is possible to lessen its effects.

Toward the early diagnosis of tuberculosis: A gold particle-decorated graphene-modified paper-based electrochemical biosensor for Hsp16.3 detection

Tuberculosis (TB) currently remains a major life-threatening disease as it can be fatal if not treated properly or in a timely manner. Herein, we first describe a disposable and cost-effective paper-based electrochemical biosensor based on a gold particle-decorated carboxyl graphene (AuPs/GCOOH)-modified electrode for detecting heat shock protein (Hsp16.3), which is a specific biomarker indicating the onset of TB infection. The device pattern was first engineered to facilitate detection procedures and printed on low-cost filter paper to create hydrophobic and hydrophilic regions using a wax printing technique. Immunoassays proceeded in a half-sandwich format because it is a reagent-less approach and requires no labeling step. The fabrication of the immunosensor began with GCOOH drop casting, the electrochemical deposition of AuPs, and the establishment of a biorecognition layer against Hsp16.3 utilizing 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC)/N-hydroxysuccinimide (NHS)-sulfo standard chemistry. The appearance of Hsp16.3 resulted in a substantial decrease in the electrochemical signal response of the redox probe employed [Fe (CN)6]3−/4− due to the created immunocomplexes that possess insulation properties. GCOOH enables direct antibody immobilization, and AuPs enhance the electrochemical properties of the sensor. This proposed immunosensor, while requiring only a miniscule sample volume (5 μL), achieved superior performance in terms of the limit of detection, measuring at 0.01 ng/mL. Our platform was confirmed to be highly specific to Hsp16.3 and can rapidly detect TB-infected sera without necessitating any pre-enrichment (20 min), making it an alternative and particularly suitable for the early diagnosis of TB in resource-scarce countries.