High Incidence Of Tuberculosis Research Articles

MAPPING DISTRIBUTION OF RISK FACTORS OF THE EVENT OF PULMONARY TUBERCULOSIS (pulmonary TB) USING GEOGRAPHIC INFORMATION SYSTEM (GIS)

According to WHO data in 2018, the largest proportion of pulmonary TB cases was in the Asian region at 45%, Indonesia was the 2nd highest for pulmonary TB cases in the world after India. Based on data from the Kuningan District Health Office in 2021, the prevalence of pulmonary TB cases was 0.92% with a total of 1,389 cases. The purpose of this study was to describe the distribution of risk factors for the incidence of pulmonary tuberculosis (Pulmonary TB) using a Geographic Information System (GIS) in Kuningan District 2022. This study uses a descriptive type of research with a quantitative approach. The population and sample in this study were 32 sub-districts in Kuningan Regency with a total of 1,389 cases. The sample in this study is total sampling. Data analysis in this study includes univariate analysis using SPSS application and spatial distribution using ArcGIS application. The distribution of the incidence of pulmonary tuberculosis (pulmonary TB) in Kuningan Regency showed that most of them were classified as low, namely 30 sub-districts (93.8%). The distribution of high incidence of Pulmonary Tuberculosis (Pulmonary TB) is found in sub-districts with high population density, PHBS coverage that has not reached the target, and coverage of healthy homes that have not reached the target, namely Kuningan District with a total of 367 cases. The distribution of the incidence of pulmonary tuberculosis (TB) is high in sub-districts with high population density, PHBS coverage that has not reached the target, and healthy housing coverage that has not reached the target. There is a need for more intensive program monitoring efforts by the Kuningan egency Health Office so that it can reduce the prevalence of Pulmonary Tuberculosis (Pulmonary TB) incidence in Kuningan Regency.

Association Between Vitamin D Levels With Mdr-Tb Patients With Household Contacts And Healthy People As Comparison

Abstract
 Background: The high incidence of pulmonary tuberculosis (TB) progressing into multidrugresistant TB (MDR-TB) has become a serious concern and caused a high mortality rate. The incidence of MDR-TB was 3.3% of new cases and 20% of cases of recurrent treatment. Low levels of vitamin D is a predisposing factor of MDR-TB, and family members in contact with the patient also show risk of infection. Currently, there is no study that compares vitamin D levels between MDR-TB patients and their household contact.
 Method: This is a case control study, with the number of samples of each group (MDR-TB patients, household contact, healthy controls) 40 subjects, respectively. Each member of each group were checked for vitamin D levels using enzyme-linked immunosorbent assay (ELISA) technique.
 Result: Mean levels of vitamin D in MDR-TB patients are 32.21, contact families 31.7 and healthy controls 26.86. There is a significant relationship between vitamin D levels and MDR-TB incidence (p=0.006).
 Conclusion : There was no significant association between vitamin D deficiency level with MDRTB. Vitamin D insufficiency was a protective factor for MDR-TB than in healthy control.

TUBERCULOUS PLEURAL EFFUSION MASQUERADING AS DRUG-INDUCED LUPUS

TUBERCULOUS PLEURAL EFFUSION MASQUERADING AS DRUG-INDUCED LUPUS

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis

A high incidence of tuberculosis (TB), especially in endemic countries, makes this infectious disease a concern. Abdominal TB contributes to 10% of extrapulmonary TB. Due to nonspecific clinical, radiological, and endoscopic findings, diagnosing abdominal TB continues to be a challenge. Hence, a precise diagnosis is needed. The diagnosis of gastrointestinal disease using endoscopic ultrasound (EUS) is often performed due to its high resolution and ability to provide a real-time visual representation of the gastrointestinal tract and extramural structures. EUS-guided fine-needle aspiration (FNA) and fine-needle biopsy (FNB) have helped diagnose TB as they offer an adequate specimen for cytology or histopathological examination. This method is considered safer, more effective, and more efficient. The capacity of EUS to diagnose abdominal TB based on the affected organs was examined via a literature search. We reviewed the role of EUS in diagnosing esophageal, gastric, pancreatic, peripancreatic, hepatosplenic, peritoneal, and intestinal TB. Generally, EUS aids in diagnosing abdominal TB. In some organs, it is superior to other diagnostic modalities. However, further examinations, such as cytology or histopathology and microbial, are still needed. We also studied the roles of EUS-FNA and EUS-FNB. EUS-FNA has shown a high diagnostic yield in esophageal (94.3-100%), pancreatic and peripancreatic (76.2%), and intestinal TB (84.1%). As minimally invasive methods, EUS-FNA and EUS-FNB can successfully provide sufficient samples. EUS is a functional diagnostic modality for abdominal TB. EUS-FNA and EUS-FNB provide sufficient samples safely and efficiently for further cytology, histopathology, and microbial examinations.

Mycobacterium tuberculosis Genotypes and Drug Susceptibility Test Results from Timor-Leste: A Pilot Study.

Tuberculosis (TB) is prevalent and a major public health problem in Timor-Leste. The government of Timor-Leste is prioritising the surveillance of TB and drug-susceptibility testing (DST) to understand the burden of TB and TB drug resistance in the country. Moreover, little is known about the origin of Mycobacterium tuberculosis (MTB) in Timor-Leste. This study reports MTB DST and sequencing for Timor-Leste. A pilot study was carried out in which a convenience sample of TB isolates from mucopurulent sputum collected from presumptive TB patients in the capital Dili between July and December 2016 was tested for phenotypic and genotypic evidence of drug resistance. Standard MTB culture was performed at the Timor-Leste National Health Laboratory (NHL). The MTB isolates were sent to the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Australia for DST and sequencing. Overall, 36 MTB isolates were detected at the NHL; 20 isolates were recovered during sub-culturing at VIDRL. All 20 isolates were susceptible to rifampicin, isoniazid, pyrazinamide, and ethambutol, with no genotypic markers of resistance identified. On sequencing, lineage 4 was the most common. The results of this study provide a small snapshot of MTB diversity and resistance in an under-sampled region with very high TB incidence. Future investment in whole-genome sequencing capacity in Timor-Leste will make it possible to undertake further, more representative analyses that may be used to evaluate transmission dynamics and epidemiology of genotypic markers of resistance.

MAPPING OF CHILDREN'S TUBERCULOSIS INCIDENCE BY COVERAGE OF BCG IMMUNIZATION, MALNUTRITION, AND HOME ENVIRONMENT

Background: Based on the Global Tuberculosis (TB) Report, Indonesia is one of the countries with a triple burden of TB, and TB disease can attack all age groups, including children. East Java Province in 2019 was ranked third in the highest number of pediatric TB cases in Indonesia. Purpose: This study aims to describe the distribution trend of tuberculosis cases in children in East Java Province in 2017-2018 based on BCG immunization coverage, cases of malnutrition, amount of healthy houses, and households with PHBS. Methods: The research design was a descriptive study with a correlation study design. The populations were all districts/cities in East Java Province, with as many as 38 districts. The data analysis technique to describe the trend distribution of tuberculosis in children was the health mapper software on a computer developed by World Health Organization (WHO). Results: The distribution of the incidence of tuberculosis in children in East Java from 2017 to 2018 tends to increase. The city of Surabaya became the area with the highest incidence of tuberculosis in children from 2017 to 2018. Based on a spatial map, most districts or cities with BCG immunization coverage, cases of malnutrition, several healthy homes, and high PHBS households experience tuberculosis incidence in children is high. Conclusion: Based on the map, spatially, districts or cities with high cases of tuberculosis in children mainly occur in areas with cases of malnutrition, the number of healthy home environments, and high coverage of BCG immunization as well.

Analysis of the effect of temperature on tuberculosis incidence by distributed lag non-linear model in Kashgar city, China.

The aim of this study was to explore the effect of temperature on tuberculosis (TB) incidence using the distributed lag non-linear model (DLNM) from 2017 to 2021 in Kashgar city, the region with higher TB incidence than national levels, and assist public health prevention and control measures. From January 2017 to December 2021, a total of 8730 cases of TB were reported, with the higher incidence of male than that of female. When temperature was below 1 °C, it was significantly correlated with TB incidence compared to the median observed temperature (15 °C) at lag 7, 14, and 21, and lower temperatures showed larger RR (relative risk) values. High temperature produced a protective effect on TB transmission, and higher temperature from 16 to 31 °C has lower RR. In discussion stratified by gender, the maximum RRs were achieved for both male group and female group at − 15 °C with lag 21, reporting 4.28 and 2.02, respectively. At high temperature (higher than 20 °C), the RR value of developing TB for female group was significantly larger than 1. In discussion stratified by age, the maximum RRs were achieved for all age groups (≤ 35, 36–64, ≥ 65) at − 15 °C with lag 21, reporting 3.20, 2.07, and 3.45, respectively. When the temperature was higher than 20 °C, the RR of the 36–64-year-old group and the ≥ 65-year-old group was significantly larger than 1 at lag 21, while significantly smaller than 1 for cumulative RR at lag 21, reporting 0.11, 95% confidence interval (CI) (0.01, 0.83) and 0.06, 95% CI (0.01, 0.44), respectively. In conclusion, low temperature, especially in extreme level, acts as a high-risk factor inducing TB transmission in Kashgar city. Males exhibit a significantly higher RR of developing TB at low temperature than female, as well as the elderly group in contrast to the young or middle-aged groups. High temperature has a protective effect on TB transmission in the total population, but female and middle-aged and elderly groups are also required to be alert to the delayed RR induced by it.

Epidemiology of infection by pulmonary non-tuberculous mycobacteria in French Guiana 2008-2018.

Unlike diseases caused by Mycobacterium tuberculosis, M. leprae and M. ulcerans, the epidemiology of pulmonary non-tuberculous mycobacteria (PNTM) has not received due attention in French Guiana. The main objective of the current study was to define the incidence of these PNTM infections: NTM pulmonary diseases (NTM-PD) and casual PNTM isolation (responsible of latent infection or simple colonization). The secondary objectives were to determine species diversity and geographic distribution of these atypical mycobacteria. A retrospective observational study (2008-2018) of French Guiana patients with at least one PNTM positive respiratory sample in culture was conducted. Patients were then classified into two groups: casual PNTM isolation or pulmonary disease (NTM-PD), according to clinical, radiological and microbiological criteria defined by the American Thoracic Society / Infectious Disease Society of America (ATS / IDSA) in 2007. 178 patients were included, out of which 147 had casual PNTM isolation and 31 had NTM-PD. Estimated annual incidence rate of respiratory isolates was 6.17 / 100,000 inhabitants per year while that of NTM-PD was 1.07 / 100,000 inhabitants per year. Among the 178 patients, M. avium complex (MAC) was the most frequently isolated pathogen (38%), followed by M. fortuitum then M. abscessus (19% and 6% of cases respectively), the latter two mycobacteria being mainly found in the coastal center region. Concerning NTM-PD, two species were mainly involved: MAC (81%) and M. abscessus (16%). This is the first study on the epidemiology of PNTM infections in French Guiana. PNTM's incidence looks similar to other contries and metropolitan France and NTM-PD is mostly due to MAC and M.abscessus. Although French Guiana is the French territory with the highest tuberculosis incidence, NTM should not be overlooked.

Development and validation of a prediction algorithm to identify birth in countries with high tuberculosis incidence in two large California health systems.

ObjectiveThough targeted testing for latent tuberculosis infection (“LTBI”) for persons born in countries with high tuberculosis incidence (“HTBIC”) is recommended in health care settings, this information is not routinely recorded in the electronic health record (“EHR”). We develop and validate a prediction model for birth in a HTBIC using EHR data.Materials and methodsIn a cohort of patients within Kaiser Permanente Southern California (“KPSC”) and Kaiser Permanent Northern California (“KPNC”) between January 1, 2008 and December 31, 2019, KPSC was used as the development dataset and KPNC was used for external validation using logistic regression. Model performance was evaluated using area under the receiver operator curve (“AUCROC”) and area under the precision and recall curve (“AUPRC”). We explored various cut-points to improve screening for LTBI.ResultsKPSC had 73% and KPNC had 54% of patients missing country-of-birth information in the EHR, leaving 2,036,400 and 2,880,570 patients with EHR-documented country-of-birth at KPSC and KPNC, respectively. The final model had an AUCROC of 0.85 and 0.87 on internal and external validation datasets, respectively. It had an AUPRC of 0.69 and 0.64 (compared to a baseline HTBIC-birth prevalence of 0.24 at KPSC and 0.19 at KPNC) on internal and external validation datasets, respectively. The cut-points explored resulted in a number needed to screen from 7.1–8.5 persons/positive LTBI diagnosis, compared to 4.2 and 16.8 persons/positive LTBI diagnosis from EHR-documented birth in a HTBIC and current screening criteria, respectively.DiscussionUsing logistic regression with EHR data, we developed a simple yet useful model to predict birth in a HTBIC which decreased the number needed to screen compared to current LTBI screening criteria.ConclusionOur model improves the ability to screen for LTBI in health care settings based on birth in a HTBIC.

Linking nationwide health and social registry data to informthe policy for Tuberculosis contact tracing in Brazil.

ObjectivesMitigating the socioeconomic determinants of Tuberculosis (TB) and systematic screening of contacts and high-risk groups are targets of The World Health Organization (WHO) End TB Strategy by 2035. Our aim was to link socioeconomic information to TB datasets to inform policy makers in Brazil and contribute to addressing current challenges.
 ApproachFollowing a signed technical cooperation agreement with the Ministry of Health (MoH), we linked nationwide data on 1.405.682 registries of TB diagnosed between 2004 and 2019 in Brazil to 131.697.800 demographic and socioeconomic registries from the 100 Million Brazilian Cohort (2001-2018) previously linked to nationwide mortality data. We established close links with TB managers to understand the database, clean and deduplicate registries and to analyse the data. We took advantage of the data structure, to set up a cohort of household contacts of TB patients and produce estimates of TB incidence by subgroups of demographic and socioeconomic characteristics.
 ResultsThe interaction of the MoH was effective and facilitated by a robust TB Programme in the country. 567.999 (40,41%) TB cases were linked to the 100 Million Brazilian Cohort with high specificity (93.6%) and sensitivity (94.6%). Using family identifiers, we established the first TB case within a family unit (i.e., primary case) and followed their household contacts up to 15 years. We found the TB incidence among household contacts to be 427.8/100.000 person-years (95%CI 419.1-436.8). In the first year following the identification of the primary case, there was higher cumulative incidence among household contacts under 5 years of age, which was followed by a plateau of cases in this age group. Cummulative incidence in the other age groups presented a constant increase over time.
 ConclusionThe close collaboration with the MoH, the development of an effective linkage algorithm and the availability of large socioeconomic data allowed for a unique analysis of the high incidence of TB among household contacts. Findings reinforce need for constant dialogue among stakeholders to strengthen case detection by primary health care.

Case Report: Acute isoniazid intoxication after intentional ingestion

Isoniazid is an anti-tuberculosis medication that is extensively used for treatment and prevention of tuberculosis. Acute isoniazid poisoning is characterized by a clinical triad of recurrent seizures, raised anion gap metabolic acidosis and coma. The seizures are unresponsive to standard anticonvulsant drugs, instead requiring pyridoxine administered in a dose equal to the amount of isoniazid consumed. Due to the high incidence of tuberculosis in low-income countries like Nepal, isoniazid intoxication should be considered in any patient who present with such unresponsive seizures and coma. We report a case of a 31 years old woman from Nepal, who intentionally ingested 12 grams of isoniazid and presented with generalized tonic-clonic seizures. She was successfully managed with 10 grams of pyridoxine along with other supportive management, including sodium bicarbonate for metabolic acidosis and mechanical ventilation. Doctors working in low-income countries, like Nepal, where tuberculosis is endemic, should be well acquainted with presentations and management of isoniazid intoxication.

Factors affecting tuberculosis cadres’ motivation in the detection of tuberculosis cases in Kediri City, Indonesia

Background and purpose: Tuberculosis (TB) is an infectiousdisease caused by Mycobacterium tuberculosis (MTB). The high incidence of TB acquires the active role of TB cadres in TB case finding. Motivation is an important factor that support the performance of TB cadres. This study aims to explore factors that affect the motivation of TB cadres case detection rate of TB. Methods: This was an observational analytic study with crosssectional study design, conducted in Kediri City. A total samplingtechnique was applied with a total of 59 TB cadres in the workingarea of Sukorame Public Health Center, in Kediri City. TB cadres filled in a questionnaire containing questions about sociodemographic, attitudes, knowledge, and motivation with a total of 39 questions. Data were analyzed with univariate descriptive statistics, bivariate test by Fisher and Chi Square tests and followed by multivariate analysis using logistic regression. Results: Of the 59 cadres, 37 (67.2%) have a good motivation onTB case findings. The results of multivariate analysis showed that there were four independent variables which have a significant association with the motivation of TB cadres, including age, education, jobs and incentive. Cadres who are 41-60 years have better motivation compared to 25-40 years (OR=31.49; 95%CI:2.373-417.907; p=0.009), cadres who have higher education (university/college) have better motivation (OR=36.957; 95%CI:2.389-571.805; p=0.010). While those who not getting incentives (OR=0.100; 95%CI: 0.013-0.758; p=0.026) and having a job (OR=0.120; 95%CI: 0.021-0.670; p=0.016) were less likely to have a good motivation. Conclusion: Motivation of TB cadres in Kediri City is influenced by intrinsic factors (age, education and employment) and extrinsic factor (incentive). Providing appropriate incentive will significantly boost cadre motivation and relevant stakeholders should consider making this strategy sustainable.

Use of Whole-Genome Sequencing to Explore Mycobacterium tuberculosis Complex Circulating in a Hotspot Department in France.

The Seine-Saint-Denis is the French metropolitan department with the highest incidence of tuberculosis (TB). Our aim was to explore epidemiological and phylogenetic characteristics of TB strains in this hotspot department. We performed WGS on 227 strains of Mycobacterium tuberculosis complex isolated from patients at the Avicenne Hospital from 2016 to 2021 and randomly selected to represent the clinical diversity of French TB localization. Clinical and demographic data were recorded for each TB patient. The mean age of patients was 36 years old. They came from Africa (44%), Asia (27%), Europe (26%) and America (3%). Strains isolated from extrapulmonary samples were associated with Asian patients, whereas strains isolated from pulmonary samples were associated with European patients. We observed a high level of lineage diversity in line with the known worldwide diversity. Interestingly, lineage 3 was associated with lymph node TB. Additionally, the sensitivity of WGS for predicting resistance was 100% for rifampicin, isoniazid and ethambutol and 66.7% for pyrazinamide. The global concordance with drug-susceptibility testing using the phenotypic approach was 97%. In microbiology laboratories, WGS turns out to be an essential tool for better understanding local TB epidemiology, with direct access to circulating lineage identification and to drug susceptibilities to first- and second-line anti-TB drugs.

Investigation of 3-year inpatient TB cases in Zunyi, China: Increased TB burden but improved bacteriological diagnosis.

BackgroundAs one of the top three high tuberculosis (TB) burden countries, China is a country where the overall TB incidence continues to decline. However, due to its large population and area, the increased TB burden exists in regional areas.MethodsThis retrospective study analyzed local inpatient pulmonary TB cases in the Affiliated Hospital of Zunyi Medical University (AHZMU) from January 2016 to December 2018 in a high TB incidence and economically-less-developed area of China. Four methods, acid-fast bacilli stain, culture, Xpert and LAMP, were used to detect Mycobacterium tuberculosis (M.tb), while proportional method and Xpert were used to identify rifampicin-resistant TB (RR-TB). Case number, treatment history, M.tb confirmed TB and rifampicin resistant proportion were analyzed to investigate the local TB epidemic.ResultsTotal 3,910 local inpatient cases with pulmonary TB were admitted to AHZMU during this study period. The annual numbers of total TB cases increased 26.4% (from 1,173 to 1,483), while new cases increased 29.6% (from 936 to 1,213) and RR-TB cases increased 2.7 times (from 31 to 84). Meanwhile, the percentage of previously treated cases declined from 20.2 to 18.2% and the M.tb confirmed TB proportion increased from 34.7 to 49.7%.ConclusionThe elevated M.tb confirmed TB proportion and the declined percentage of previously treated cases indicated the improved TB diagnosis and treatment of AHZMU. However, the increasing number of total TB cases, new and RR-TB cases showed an upward trend and increased TB burden in a relatively underdeveloped area of China.

Incidence and risk factors for tuberculosis among people living with HIV in Bangui: A cohort study

ObjectivesThe objectives of this study were to determine the incidence and risk factors of tuberculosis (TB) among people living with HIV (PLHIV). MethodsA cohort study was carried out in an HIV infection management centre in Bangui. PLHIV aged 18 or older, with no history of TB, enrolled between January 1, 2017 and December 31, 2018 were included in the study. The chi-square test was used only to compare the proportions at the 5% significance level. To determine the risk factors, we used the Cox regression adjusted hazard ratio, using Epi Info 7 software. ResultsA total of 677 patients including 618 (91.28%) on antiretroviral therapy were included in the study. The median age was 34 with extremes ranging from 18 to 57. Of the patients followed, 104 developed TB. The overall incidence of TB was 15.37 (104/677) cases per 100 PLHIV-years. This incidence was 13.10 (81/618) cases per 100 in patients on ART-years and 38.99 (23/59) cases per 100 patients on pre-ART-years. In pre-ART patients the incidence of TB was therefore almost 3 times higher than that of PLHIV on ART (p = 0.03). WHO clinical stages III and IV (p = 0.02), absence of ART (p = 0.03), poor adherence (p = 0.004) and low functional capacity (p = 0.04) were the risk factors associated with the occurrence of TB among PLHIV in Bangui. ConclusionsThe high incidence of TB in our context is essentially linked to delay in diagnosis and the quality of care. Early initiation of antiretroviral therapy, systematic screening for TB in PLHIV upon entry into the active queue and better monitoring of patients on ART are strongly recommended.

A case of acute-onset paraplegia due to spinal tuberculosis in term pregnancy

Acute paraplegia in pregnancy is uncommon but can result from pathology including Guillain-Barre syndrome, acute transverse myelitis, and spinal tuberculosis, also known as Pott's disease of the spine. India has a high incidence of tuberculosis (2.8 million cases annually) therefore spinal tuberculosis is a particularly important disease to consider during pregnancy. Management of spinal tuberculosis in pregnancy poses a challenge especially at term gestation as immobilization of the spine and maintaining supination is difficult, particularly at delivery.

Applying logistic LASSO regression for the diagnosis of atypical Crohn's disease

In countries with a high incidence of tuberculosis, the typical clinical features of Crohn's disease (CD) may be covered up after tuberculosis infection, and the identification of atypical Crohn's disease and intestinal tuberculosis (ITB) is still a dilemma for clinicians. Least absolute shrinkage and selection operator (LASSO) regression has been applied to select variables in disease diagnosis. However, its value in discriminating ITB and atypical Crohn's disease remains unknown. A total of 400 patients were enrolled from January 2014 to January 2019 in second Xiangya hospital Central South University.Among them, 57 indicators including clinical manifestations, laboratory results, endoscopic findings, computed tomography enterography features were collected for further analysis. R software version 3.6.1 (glmnet package) was used to perform the LASSO logistic regression analysis. SPSS 20.0 was used to perform Pearson chi-square test and binary logistic regression analysis. In the variable selection step, LASSO regression and Pearson chi-square test were applied to select the most valuable variables as candidates for further logistic regression analysis. Secondly, variables identified from step 1 were applied to construct binary logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed on these models to assess the ability and the optimal cutoff value for diagnosis. The area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy rate, together with their 95% confidence and intervals (CIs) were calculated. MedCalc software (Version 16.8) was applied to analyze the ROC curves of models. 332 patients were eventually enrolled to build a binary logistic regression model to discriminate CD (including comprehensive CD and tuberculosis infected CD) and ITB. However, we did not get a satisfactory diagnostic value via applying the binary logistic regression model of comprehensive CD and ITB to predict tuberculosis infected CD and ITB (accuracy rate:79.2%VS 65.1%). Therefore, we further established a binary logistic regression model to discriminate atypical CD from ITB, based on Pearsonchi-square test (model1) and LASSO regression (model 2). Model 1 showed 89.9% specificity, 65.9% sensitivity, 88.5% PPV, 68.9% NPV, 76.9% diagnostic accuracy, and an AUC value of 0.811, and model 2 showed 80.6% specificity, 84.4% sensitivity, 82.3% PPV, 82.9% NPV, 82.6% diagnostic accuracy, and an AUC value of 0.887. The comparison of AUCs between model1 and model2 was statistically different (P < 0.05). Tuberculosis infection increases the difficulty of discriminating CD from ITB. LASSO regression showed a more efficient ability than Pearson chi-square test based logistic regression on differential diagnosing atypical CD and ITB.

The incidence of tuberculosis and HIV-infection among adult population in Russia

Introduction. Assessment of dynamics of the overall incidence of both tuberculosis and HIV-infection, without a detailed analysis of its distribution by age, is insufficient to understand the current trends and their forecast from the standpoint of achieving WHO and UNAIDS targets in relation to the elimination of tuberculosis (2035) and HIV-infection (2030). The purpose of the study: to study the age characteristics of the incidence of tuberculosis and HIV-infection in the adult population of Russia in dynamics for 2010-2019. Material and methods: retrospective analysis of the incidence of tuberculosis and HIV-infection, and its age structure for 2010-2019. Results: In Russia, in 2010-2019, the incidence of tuberculosis in the adult population (≥ 18 years) has been steadily decreasing. However, analysis of its distribution by age showed that among young groups (25-44 years) its level was higher and reached the maximum value of 84.6 per 100000 of population in the group of 35-44 years. In recent years, an increase in the incidence of HIV-infection was observed in Russia, and its highest values were recorded among patients from young age groups (25-44 years). Limitations of the study. The analysis of the incidence of tuberculosis and HIV infection in the adult population of Russia was carried out both in general for the entire population and in individual age groups for the period from 2010 to 2019, which seemed sufficient to effectively achieve this goal. Discussion: Retention of high incidence of tuberculosis and an increase in the incidence of HIV-infection among patients aged 25-44 is largely due to widespread prevalence of tuberculosis among patients with HIV-infection. Today in Russia every fourth patient with tuberculosis, both newly diagnosed and among the contingents with TB, is a patient with HIV-infection with manifestations of tuberculosis. Conclusion: In Russia over the past 10 years, an increase in the number of newly diagnosed HIV-infected patients with TB manifestations, which are included in the structure of both the incidence of HIV infection and TB, has led to an increase in the incidence of HIV infection and a slowdown in the rate of decline in the incidence of TB among young age groups.

Tuberculosis endemicity and BCG vaccination: Protection against COVID-19.

The coronavirus disease 2019 (COVID-19) has affected different countries in a differential manner. The host susceptibility and host factors are important parameters for this variability. This study aimed to assess the effect of tuberculosis (TB) endemicity and Bacille Calmette-Guerin (BCG) coverage on COVID-19. Available data regarding TB incidence, BCG coverage (as per the World Health Organization), and COVID-19 incidence of 168 countries as of 19th September 2021. Countries were divided into four cohorts based upon annual TB incidence and BCG coverage and COVID-19 incidence and case fatality rates were compared using the Kruskal-Wallis test. Countries with low TB incidence and low BCG coverage had the highest COVID-19 incidence per lac population. However, no significant difference was seen in COVID-19 cases fatality rate. Higher TB incidence and BCG coverage were associated with lesser incidence of COVID-19. This result paves the way for research into pathogenesis and host immune response in COVID-19.

The cascade of care in tuberculosis infection screening and management in newly arrived refugees in Aarhus, Denmark

BackgroundScreening for tuberculosis (TB) disease and infection is often a part of health screening programs offered to refugees, but the yield of screening varies and losses along the steps from screening to treatment completion was reported. MethodsA retrospective cohort study was performed investigating a newly arrived refugee population offered a systematic refugee health assessment in Aarhus, Denmark. Data was collected on screening, referral, diagnosis and treatment for TB disease and infection. ResultsAmong both adults and children IGRA positivity was associated with origin in a high TB incidence country and increasing age. The number needed to screen (NNS) to find one case of TB infection was 7 among adult refugees and 19 among children, while NNS for TB disease was 266 and 164 respectively. The proportion of the eligible population with a valid result was 78.1% for adults and 71.3% for children, while 43.1% and 50% of adults and children with presumed TB infection completed preventive treatment. DiscussionScreening for TB disease and infection among refugees in Aarhus had a high yield in terms of diagnosis, however significant losses were seen during screening, follow-up and preventive treatment completion.