High Prevalence Of Tuberculosis Infection Research Articles

Prevalence and Predictors of Tuberculosis Infection in Children and Adolescents in Rural Uganda: A Cross-sectional Study.

Much of the latent tuberculosis (TB) reservoir is established in childhood and adolescence. Yet, age-specific data on prevalence and predictors of infection in this population are sparse and needed to guide prevention and case finding. From December 2021 to June 2023, we measured TB infection in children 1-17 years in 25 villages in rural Southwestern Uganda. We defined TB infection as a positive QuantiFERON Gold Plus Test (QFT). We estimated overall and age-stratified population-level prevalence and adjusted risk ratios (aRR) of TB infection for individual, household, and community-based predictors, accounting for age, TB contact, and clustering by household. Estimated TB infection prevalence was 9.6% [95% confidence interval (CI): 8.7-10.5%] among the 5789 participants, and prevalence varied slightly with age. Household-level risk factors included crowding (aRR: 1.25, 95% CI: 1.03-1.53), indoor cooking (aRR: 1.62, 95% CI: 1.14-2.30), living with ≥2 persons who drink alcohol (aRR: 1.47, 95% CI: 1.04-2.07). The predominant community-based risk factor was child mobility (aRR: 1.67, 95% CI: 1.24-2.26). In age-stratified analyses, household predictors were important in early childhood but not adolescence, where mobility was predominant (aRR: 1.66, 95% CI: 1.13-2.44). We detected a high prevalence of TB infection in children and adolescents in rural Uganda. On a population level, TB risk factors change throughout the early life course, with child mobility a key risk factor in adolescence. Age-specific TB case finding and prevention strategies that address both household and extra-household risk factors are needed to address TB transmission.

Prevalence of tuberculosis infection among contacts of drug-resistant tuberculosis patients: A systematic review and meta-analysis

Contact investigations with drug-susceptible tuberculosis (DS-TB) patients have demonstrated a high prevalence of tuberculosis infection (TBI). However, the prevalence of TBI among individuals in close contact with drug-resistant tuberculosis (DR-TB) patients is poorly understood. This systematic review and meta-analysis aimed to determine the prevalence of TBI among household and non-household contacts of DR-TB patients. We searched five databases (Medline, Embase, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) from inception to 2 June 2023. All studies that reported the prevalence of TBI among DR-TB contacts were included in the study. A random-effects meta-analysis was conducted to estimate the pooled prevalence of TBI with a 95% confidence interval (CI). Sub-group analyses were conducted using study characteristics as covariates. Thirty studies involving 7659 study participants from 19 countries were included. The pooled prevalence of TBI among DR-TB contacts was 36.52% (95% CI: 30.27-42.77). The sub-group analysis showed considerable heterogeneity in the estimates, with the highest prevalence reported in Southeast Asia (80.74%; 95% CI: 74.09-87.39), household contacts (38.60%; 95% CI: 30.07-47.14), lower-middle-income countries (LMICs) (54.72; 95% CI: 35.90, 73.55), children (43.27%; 95% CI: 25.50, 61.04), and studies conducted between 2004 and 2012 (45.10; 95% CI: 32.44, 57.76). The prevalence of TBI among DR-TB contacts was high, with substantial regional variations. Further research is needed to determine the drug susceptibility status of TBI in DR-TB contacts. The protocol is registered in PROSPERO (CRD42023390339).

Prevalence of tuberculosis infection among patients with Takayasu arteritis: a meta-analysis of observational studies

To clarify the risk of tuberculosis (TB) infection in patients with Takayasu arteritis (TAK). In this study, we conducted a comprehensive search across multiple databases, including PubMed, Web of Science, Embase, Cochrane, and Medline, from the inception of the Literature Library to May 16, 2023. Using a specific set of keywords, including “Takayasu Arteritis”, “Tuberculosis”, and “Mycobacterium tuberculosis”, the main objective of this search was to identify all relevant observational studies, including case-control studies, cohort studies, and cross-sectional studies, that report the prevalence of TB in individuals diagnosed with TAK. Two independent evaluators rigorously screened the studies, extracted data, and assessed the study quality using the Joanna Briggs Institute (JBI) critical appraisal tools. Statistical analyses were conducted using R software version 4.3.0, which allowed for the synthesis of prevalence and subgroup analyses. Subgroup analyses were stratified based on quality scores, World Health Organization regional categorizations, and TB categories. Assessment of publication bias was performed using a funnel plot. The study included a total of 30 studies with 5548 participants. The findings showed that individuals with TAK exhibited an average prevalence of TB infection at 31.27% (95% CI 20.48–43.11%). Significantly, the prevalence of TB infection demonstrated notable regional disparities, ranging from 16.93% (95% CI 7.71–28.76%) in the Western Pacific Region to 63.58% (95% CI 35.70–87.66%) in the African Region. Moreover, the study revealed that patients with TAK displayed a high prevalence of latent TB infection (LTBI) at 50.01% (95% CI 31.25–68.77%) and active TB at 14.40% (95% CI 9.03–20.68%). The high heterogeneity observed in the data highlights significant variability in TB infection rates among the populations studied, with the African Region exhibiting the highest rates. The study concludes that there is a high prevalence of TB infection in the TAK population, with regional variations. Consideration should be given to implementing rigorous TB screening measures and preventive interventions specifically tailored for the TAK population.

2511. Screening for Hepatitis B Virus (HBV) and Tuberculosis (TB) Infection among Non-U.S.-Born Adults from High HBV and TB Burden Countries

Abstract Background Hepatitis B virus (HBV) infection and tuberculosis (TB) infection both disproportionately affect non-U.S.–born persons from countries with hepatitis B surface antigen (HBsAg) seroprevalence ≥2% or TB incidence rates ≥20/100,000 population. Early identification and treatment of chronic HBV and TB infection are critical to reduce morbidity and mortality, but little is known about HBV and TB screening among non-U.S.–born persons in the United States. Methods In a cross-sectional study using electronic health record data, we assessed HBV and TB infection screening practices among Kaiser Permanente Northern California eligible members aged ≥18 years born in countries with intermediate to high burdens of both HBV and TB infection. HBV screening was defined as testing for HBV surface antigen and HBV core antibody. TB infection screening was defined as testing with interferon gamma release assay or tuberculin skin test. We calculated the proportion of individuals from intermediate and high HBV-TB burden countries who had HBV or TB infection screening and the proportion of patients positive for HBV or TB infection. Results Of 498,339 non-U.S.–born adults, 275,708 (55.3%) were born in intermediate or high HBV-TB burden countries. Most patients were aged ≥50 years (65.3%) and 23.5% had diabetes. Among persons born in intermediate or high HBV-TB burden countries, 67.1% were screened for HBV infection, 29.4% were screened for TB infection, and only 23.7% were screened for both HBV and TB infection. Among all persons born in intermediate or high HBV-TB burden countries (both screened and unscreened), 3.7% had HBV infection and 10.1% had TB infection. Among 231,431 persons born in intermediate or high HBV-TB burden countries without current or prior HBV infection, 72.9% had received at least one HBV vaccine dose. Conclusion Among non-U.S.–born adults from intermediate or high HBV-TB burden countries, we found low screening proportions, intermediate prevalence of chronic HBV infection and high prevalence of TB infection. Given the large population of persons from intermediate or high HBV-TB burden countries in Kaiser Permanente Northern California, screening for both infections at the same time could improve early diagnosis and treatment for both conditions. Disclosures Jacek Skarbinski, MD, Genentech: Grant/Research Support|Gilead Sciences: Grant/Research Support Robert J. Wong, MD, MS, Gilead Sciences: Grant/Research Support

Burden and associated phenotypic characteristics of tuberculosis infection in adult Africans with diabetes: a systematic review

Diabetes mellitus (DM) increases the risk of developing tuberculosis infection (TBI). However, the evidence on the burden and phenotypic characteristics of TBI in African patients with DM is limited. This study aimed to determine the prevalence and characterisation of TBI in native African patients living with DM. We searched PubMed, EMBASE, and African Journals Online for original studies reporting information on the prevalence and characteristics of TBI in adult Africans with DM. A forest plot was used to describe the pooled prevalence estimate of TBI and the corresponding 95% confidence intervals (CI). Six studies conducted in four African countries involving 721 participants with DM were included in this systematic review. The pooled prevalence estimate of TBI was 40% (95% CI 20–60%, I2 = 98.52%, p < 0.001). Age ≥ 40 years and glycated haemoglobin levels independently predicted TBI positivity in patients with DM in three studies. Africans with DM have a high prevalence of TBI, especially those who are older or with poorly controlled diabetes. This justifies the need for studies to explore how to screen and manage TBI to avert the progression to active TB disease.

Evaluation of the specificity of an intradermal test with recombinant tuberculosis allergen in Bacillus Calmette-Guérin-vaccinated healthy volunteers.

The tuberculin skin test has significant limitations for use in individuals vaccinated with BCG. The presence in the genome of Mycobacterium tuberculosis of the RDI region, which is absent in the genome of Mycobacterium bovis BCG and most non-tuberculous mycobacteria, made it possible to develop new skin tests, which include a skin test with a recombinant tuberculosis allergen [RTA (Diaskintest®, JSC Generium, Russia)]. Diaskintest has shown high diagnostic performance in clinical trials and in conditions of high prevalence of tuberculosis infection. In 2021, the Russia was excluded from the WHO list of high TB burden countries, which makes relevant an assessment of the specificity of the RTA test under conditions of low epidemiologic risk for tuberculosis to confirm the high specificity of the test. To assess the specificity of Diaskintest in the regions of the Russian Federation with low epidemiologic risk for tuberculosis. A multicenter, open-label, prospective study was conducted, which included 150 healthy volunteers aged 18-30 years old, vaccinated with BCG, who were not at risk of tuberculosis, from regions with low epidemiologic risk (Oryol region, Ryazan region, and Arkhangelsk region). During the study, 4 visits were scheduled for each participant: [Visit 0 (screening), Visit 1, Visit 2 (in 72 h) and Visit 3 (in 28 days)]. All participants, who excluded active and latent tuberculosis infection, underwent a test with RTA. To assess the safety of RTA tests, all systemic and local adverse events that occurred during 28 days were recorded. The trial was filed in the NIH clinical trials database ClinicalTrials.gov (NCT05203068). In individuals with a negative T-SPOT.TB test, the specificity of the RTA test was 97% (95% CI: 92-99%) with a cut-off of >0 mm. The study findings confirm data 2009: 100.00 (95% CI: 94-100). When evaluating the safety of the RTA test during 28 days of follow-up, the participants did not report local and systemic adverse reactions that had a causal relationship with the RTA test. Diaskintest is highly specific and safe, therefore it is a valuable tool as a screening test for early detection of tuberculosis.

Fragmentation of Healthcare Services as a Possible Determinant of the Low Completion for the Tuberculosis Cascade of Prevention among Asylum Seekers: Results from a Prospective Study with Historical Comparison.

Background: Effective screening for tuberculosis infection (TBI) among asylum seekers (AS) is crucial for tuberculosis (TB) elimination in low incidence countries. Methods: We assessed the proportion of completion of the screening for TBI among asylum seekers with a centralized delivery method compared to the decentralized model previously adopted in the study area (historical control). In the historical model (January 2017 to May 2018) screening of AS was performed at the arrival offering TBI testing (TST followed by IGRA among those positive), radiological investigation, treatment initiation and hospital referral, if needed, at three sites: migrant health clinic, pneumology clinic and infectious diseases department for active disease (decentralized model). In the study model (June 2018, centralized) all steps of screening were performed at a single site, at a minimum of 6 months after arrival. Multivariable Poisson regression analysis, with robust variance, was used to assess variables associated with the completion of screening for infection. Multivariable logistic regression was used to identify factors associated with the diagnosis of TB infection. Results: The intervention approach was offered to 144 AS with an overall 98.6% proportion of completion (98.7% for those with a positive TST). In the historical screening model, 1192 AS were candidates for screening, which was completed by 74.5% of those who started it (44.7% for those resulted TST positive). Major losses (55%) were detected in the TST/CXR-IGRA sequential step, followed by the execution of TST test (25%). The ratio of screening completion was significantly higher in the intervention period (aIRR 1.78, 95% CI 1.68–1.88) and for AS coming from high incidence TB countries (aIRR 1.14, 95% CI 1.04–1.25). Screening after 6 months from arrival and age were associated with TB infection (2.09, 95% CI 1.36–3.2 and 1.14, 95% CI 1.01–1.29). Conclusions: Screening for TBI can be improved by a centralized approach. Higher prevalence of TBI 6 months after arrival could reflect recent (either during travel or in Italy) acquisition of the infection.

Determining the Impact of Age, Sex and Location in the Spread of Tuberculosis Infection among Patients, in Bayelsa State Nigeria, using Molecular Technique

Introduction: Tuberculosis is a disease condition caused by Mycobacterium tuberculosis. Several predisposing factors such as Age, Sex and overcrowding may have affected the prevalence of tuberculosis in various locations including Bayelsa State and other parts of the world.&#x0D; Aim: The aim of this study is to know if Age, Sex and Location determines tuberculosis rate of infection, using molecular technique to isolate Mycobacterium tuberculosis among tuberculosis patients in Bayelsa State, Nigeria.&#x0D; Methodology: We analyzed a total of 102 sputum samples, which were collected from each of the participants. GeneXpert molecular method was used to identify Mycobacterium tuberculosis and Rifampicin resistant cases. The data and results obtained are statistically analyzed with Statistical Package for Social Science (SPSS) version 21.&#x0D; Result: Out of the 102 sputum samples screened, 91(89.2%) were confirmed to have tuberculosis, Tuberculosis among male and female were 54(52.9%) and 37(36.3%) respectively, while rifampicin resistance among male and female were 3(2.9%) and 5(4.9%) respectively. Tuberculosis infection among male and female were not statistically significant (p = .75). The age intervals are 11-20, 21-31, 31-40, 41-50, 51-60, 61-70 and 71-80. 31-40 years had the highest tuberculosis prevalence of 30(29.4). The various locations were Brass, Ekeremor, Kolokuma/Opokuma, Nembe, Ogbia, Southern Ijaw and Sagbama Local Governmemt Areas. People residing in Yenagoa local Government had more positive case of both rifampicin resistant 5(4.9%) and non-rifampicin resistant tuberculosis infection.&#x0D; Conclusion: Tuberculosis infection is more predominant among male in Bayelsa State than female but rifampicin resistance species are more predominant among females. The age group interval of 40-41 had the highest prevalence of tuberculosis infection while the highest location of tuberculosis infection is Yenagoa.

High Prevalence of Tuberculosis Infection and Disease in Child Household Contacts of Adults With Rifampin-resistant Tuberculosis.

Household contact (HHC) investigation is an important strategy to identify individuals with tuberculosis (TB) exposure, infection and disease, including those who may benefit from tuberculosis preventive therapy (TPT). Data in children exposed to rifampin-resistant TB are limited. In preparation for and to inform the feasibility of an interventional trial, HHC of adults with pulmonary rifampin-resistant TB from high TB-burden countries were evaluated in a cross-sectional study. Using interferon-gamma release assay and study-specific and 2015 international consensus definitions of intrathoracic TB in children, we evaluated the prevalence and predictors of TB infection and disease in child (<15 years) HHCs. Of 303 child HHCs, median age (range) 7 years (0-14), 57% [95% confidence interval (CI): 50%-64%] had a positive interferon-gamma release assay result (TB infected). TB infection was associated with the index case smoking (P = 0.034), being the parent or sleeping in the same room (P = 0.002) and the child HHC being age ≥5 years and having attended school (P = 0.013). Four had study-defined confirmed TB and 9 had probable TB, a prevalence of 4.3% (95% CI: 2.6%-7.1%). Using the international consensus definitions, 4 had confirmed TB and 49 had unconfirmed TB, a prevalence of 17.2% (95% CI: 12.9%-22.4%). Twenty (7%) children had received TPT. The prevalence of TB infection and disease was high in child HHC exposed to rifampin-resistant TB. Few children had routinely received TPT. High-quality evidence is needed to inform strong recommendations for and access to TPT in children exposed to TB resistant to rifampin.

Comparing the Risk of M. Tuberculosis Infection among Men and Women in an African City

Background: Despite the well-known male bias in tuberculosis disease, the underlying reasons remained elusive. We examined whether male predominance in tuberculosis disease is result of higher risk of tuberculosis infection or not. If so, whether it is due to higher likelihood of exposure or higher susceptibility to infection among men. Methods: A household contact study and a prospective cohort study conducted in Kampala, Uganda, from 2013 to 2017 were used to estimate and compare prevalence and annual risk of tuberculosis infection among men and women. In household contact study, index tuberculosis cases and healthy index controls were asked to list their household contacts and extra-household contacts. All contacts were tested with tuberculin skin test to detect tuberculosis infection. In prospective cohort study, individuals with tuberculin skin test (TST) &lt; 5 mm were enrolled and retested with the skin test at one year to detect new infection. Poisson regression with robust standard errors was used to estimate prevalence ratio and relative risk of tuberculous infection between men and women. Results: In household contact study, 123 index tuberculosis cases and 124 index controls listed 382 household contacts of tuberculosis cases, 624 extra-household contacts of tuberculosis cases, and 1044 contacts of controls. Of 1681 enrolled participants in cohort study, 1213 (72%) were retested with TST at one year. There was no sex difference in prevalence of tuberculosis infection among household contacts of tuberculosis cases, but men had a higher prevalence of tuberculosis infection among extra-household contacts of tuberculosis cases (prevalence ratio 1.25, 95% CI 1.06 – 1.48) and contacts of controls (prevalence ratio 1.53, 95% CI 1.30 – 1.81). Similarly, in cohort study, there was no sex difference in annual risk of tuberculosis infection when participant reported knowing tuberculosis cases, but men had a higher annual risk of tuberculosis infection when participants no known contact with tuberculosis (relative risk 1.94, 95% CI: 1.34, 2.80). Conclusion: Men have higher risk of acquiring tuberculous infection than women. Men and women may have the same susceptibility to tuberculosis infection given known exposure to tuberculosis cases. The observed difference in rate of infection may be partially explained by higher rates of exposure to undetected, infectious tuberculosis cases among men.

The Prevalence of Chest Radiography Abnormalities Suggestive of Inactive Tuberculosis and Their Burden of Tuberculosis Infection Among Rural Residents: A Population-Based Screening Study

Background: Individuals with chest radiography indicating inactive tuberculosis (TB) has been suggested to be one of the high risk populations for developing active TB from latent infection. The burden of this specific population and their TB infection status has been rarely studied in China. Method: We conducted a population-based screening study to investigate the prevalence of inactive TB radiographic abnormalities and their current TB infection status among rural residents. Chest radiography examination and Interferon Gamma Release Assay (IGRA) testing were performed for all eligible rural residents with record of anti-TB treatment. While for participants without recorded previous TB, IGRA testing was conducted only for those with radiographic abnormalities indicating inactive TB (i.e. fibrosis, calcification, nodule, and pleural incrassation). Findings: A total of 46,041 rural residents voluntarily participated in the study. Around two thirds (70·39%, 1,583/2,249) of participants with anti-TB treatment records showed hint of inactive TB lesions, while it was 6·87% (3,008/43,792) for those without treatment history. Among participants with inactive TB lesions, IGRA positivity was 54.15% (855/1,579) and 28·77% (862/2,996) for those with and without anti-TB treatment records, respectively. IGRA positivity was found to be varied with respect to the type of inactive abnormalities. Interpretation: Individuals with inactive TB lesions and their remarkably high prevalence of TB infection should be attached more attention for preventing occurrence of active TB in high burden areas like China. Funding: This work was supported by the National Science and Technology Major Project of China [2017ZX10201302-002], the CAMS Innovation Fund for Medical Sciences [2016-I2M-1-013] and [2019-I2M-2-005]. Declaration of Interests: All co-authors declare that we have no conflicts of interest. Ethics Approval Statement: The ethics committees of the Institute of Pathogen Biology and the Chinese Academy of Medical Sciences approved the study protocol with approval number of IPB-2018-1.

Gender differences in pulmonary tuberculosis in Abbassia Chest Hospital

BackgroundThere is growing evidence that tuberculosis (TB) case notifications in men have in many circumstances surpassed those in women. The increase in reported cases among men was often interpreted as the result of barriers to TB diagnosis faced by women in seeking care.AimTo assess Gender differences in patients with pulmonary TB in Abbassia Chest Hospital.Patients and methodsThis study was carried out between 1 January 2017 and 30 April 2017. Patients were divided into two groups based on Gender difference: males and females. All patients were subjected to history taking, clinical examination, radiological and laboratory investigations, and sputum examination (direct smear and Gene Xpert and sputum culture for relapse TB, treatment failure, default, and suspected smear-negative patients). Pleural aspiration was done for cytological, biochemical, and adenosine deaminase level. Therapy was initiated, and patients were followed up for 6 months.ResultsThe study has been carried out on 126 cases of TB, comprising 98 males and 28 females. The highest prevalence of TB infection among men with respect to different occupations was seen to be manual workers (62%), and among women to be housewives (71.4%). The new cases were 73.5% for males and 89.3% for females. The default was 14.3% for males and 3.6% for females. The frequency of relapse was 10.2% in males and 7.1% in females, whereas cases of treatment failure were found only in males. Male patients were much more compatible with anti-TB treatment. Drug complications were more common in women. In terms of treatment outcome, the rate of cure was higher in males and defaulters in females were more common.ConclusionIn our study, the male-to-female ratio of identified patients with TB is higher than the previously reported global figures. Female patients were more likely to be younger, housewives, had longer symptoms duration before diagnosis, were less compatible with anti-TB therapy, and had more drug complications.

Glycemic Control and the Prevalence of Tuberculosis Infection: A Population-based Observational Study.

Several cohort studies demonstrate that diabetics are at increased risk for active tuberculosis, and poor glycemic control may exacerbate this risk. A higher prevalence of tuberculosis infection at baseline among diabetics may partially explain these results; however, no population-based studies have investigated this association. Furthermore, whether glycemic control modifies the relationship between diabetes and tuberculosis infection, as it does with active tuberculosis, is unknown. Diabetics were diagnosed through physician evaluation and using 3 laboratory tests including hemoglobin A1C (HbA1C), fasting plasma glucose (FPG), or 2-hour plasma glucose (PG). Tuberculosis infection was diagnosed through tuberculin skin tests, and glycemic control was assessed linearly and categorically using recommended targets. Among 4215 participants, the prevalence of tuberculosis infection was 4.1%, 5.5%, and 7.6% in nondiabetic, prediabetic, and diabetic participants (Ptrend = .012). In multivariate analysis, diabetes was associated with tuberculosis infection (adjusted odds ratio [AOR], 1.5; 95% confidence interval [CI], 1.0-2.2). Compared to nondiabetics, diabetics who were undiagnosed (AOR, 2.2 and 1.2 in diagnosed diabetics), FPG >130 mg/dL (AOR, 2.6 and 1.3 in diabetics with FPG ≤130 mg/dL), or not on insulin (AOR, 1.7 and 0.8 in diabetics on insulin) had elevated tuberculosis infection rates. In a linear dose-response analysis, increasing values of FPG (AOR, 1.02 per 1-mg/dL; 95% CI, 1.01-1.03), PG (AOR, 1.02 per 1-mg/dL; 95% CI, 1.01-1.04), and HbA1C (AOR, 1.13 per 1%; 95% CI, 1.04-1.22) all predicted tuberculosis infection. Our results suggest glycemic control may modify the relationship between tuberculosis infection and diabetes.

Tuberculosis infection in rural labor migrants in Shenzhen, China: Emerging challenge to tuberculosis control during urbanization

During China’s urbanization process, rural labor migrants have been suggested to be one important bridge population to change urban-rural distribution on tuberculosis (TB) burden. Aiming to estimate the prevalence of TB infection and to track the active disease development in rural labor migrants, a prospective study was conducted in Shenzhen city, southern China. TB infection was detected using interferon-γ release assay (IGRA). Here we mainly report the characteristics of TB infection in the study population based on the baseline survey. A total of 4,422 eligible participants completed baseline survey in July 2013. QuantiFERON (QFT) positivity rates 17.87% (790/4,422) and was found to be consistent with the local TB epidemic of the areas where the participants immigrated from. Age, smoking, residence registered place, and present of BCG scars were found to be independently associated with QFT positivity. Additionally, evidence for interaction between smoking and age was observed (p for likelihood ratio test < 0.001). Our results suggested that the development of TB control strategy including latent TB infection management should pay more attention to the rural flowing population due to their high mobility and higher prevalence of TB infection.

A török hódoltság kori idegen etnikumok összehasonlító embertani vizsgálata

It is well known from historical sources that in the Ottoman Era a large number of Southern Slavs and Vlachs settled down mainly in the southern parts of that-time Hungary. This study tried to answer the questions whether (1) it is possible to differentiate between these immigrant and resident populations based on metrical traits of skulls, and (2) it is possible to determine their origin. The other, larger research objective focused on the lifestyle of the examined populations: the investigation was supposed to determine differences and similarities in the lifestyles and health conditions of the two largest immigrant populations of Bacska (Bacsalmas-Oalmas and Zombor-Repulőter sites). According to the results of distance calculation, almost all remains of the immigrant males from the time of the Turkish occupation in the territory of Hungary tendentiously belonged to one group and strongly differed from the Hungarian findings of the Arpad Age and the Late Middle Ages. The presumed common origin is thus verified with biological methods and on the basis of burial customs and grave goods as well. As for the origins of the examined populations, the foreign parallels clearly point out a connection to the territory of the Balkan, more specifically to the area populated by the Vlachs. The results of the examination of pathological changes have pointed out the dissimilarity of health conditions and lifestyle among the immigrant populations. Moreover, the material from both the Bacsalmas and the Zombor cemeteries belong to the first series to have undergone examination of early-stage/atypical lesions of tuberculosis. On one hand, these results indicate a much higher prevalence of tuberculosis infection in that period, than it is shown by the frequency of classic lesions. On the other hand, they also demonstrate how much manifestations of the disease in individual series can differ.

Prevalence and Etiology of Tuberculosis from Sputum of Patients using Geno-Type Mycobacterium Tuberculosis Complex (MTBC) in Niger State, North Central, Nigeria.

This study aimed at the prevalence of Patients infected with Tuberculosis and their causative Organisms and this was carried out from Six General Hospitals of Niger State,, North Central, Nigeria. Three sputum samples and 2ml of blood were collected from 1920 Patients that have cough of two weeks and above. Their HIV status was determined and Viral antibody detection was carried out using World Health Organization approved kits called Determine, Unigold and Star pack. Their sputum samples were cultured after routine microscopy. Sputum samples were processed using Ziehl -Neelsen (ZN) reagents. The sputa were cultured on Loewenstein-Jensen egg based medium and incubated at 370C for eight weeks. All the Acid-fast bacill (AFB) positive smears and culture positive isolates were tested for genetic identification using Mycobacterium tuberculosis complex (MTBC) (GenoType MTBC (Hain Lifescience)) to confirmed the isolates to species level. The results reviewed that out of the one thousand Nine hundred and twenty (1920) Patients that were screened for HIV and TB, four hundred and sixteen (416) (23.1%) had MTB complex infection: four hundred and thirteen (413) (99.2%) had Mycobacterium tuberculosis ; two (2) (0.4%) had Mycobacterium africanum ; and one (1) (0.2%) had Mycobacterium bovis ; fourty six samples were contaminated while seventy four samples were non tuberculosis mycobacterium (NTM) and were removed from the research, one thousand eight hundred Patients were used for the research. The most affected age group was between elevem to fourty (11-40) years and male had the highest prevalence of tuberculosis infection with two hundred and twelve (212) (50.9%) compared to the female with two hundred and four (204) (49.0%), statistical analysis shows that there was an association between gender and also between the age group with P< 0.05. Five hundred and fifteen (515) (28.6%) patients were screened positive for HIV and one hundred and eighty six (186) (36.1%) Patients had HIV and TB co-infections.

Prevalence of Pulmonary Tuberculosis in Jutpani VDC, Chitwan, Nepal

Tuberculosis (TB) is one of the major public health problems in the developing countries like Nepal. The present study was carried out in Jutpani VDC of Chitwan Nepal from July to December 2012 with the objective to determine the situation of Tuberculosis in Jutpani VDC, Chitwan. During the study period, a total of 600 sputum samples from 200 TB suspected patients were collected and examined in the Laboratory of Jutpani Primary Health Center (PHC). Diagnosis was made after staining the sputum smear by Z-N staining method and examined under light microscope. Out of 200 TB suspected patients, 18(9%) were found to be AFB positive. Among patients diagnosed as having pulmonary Tuberculosis (PTB), males (55.56%) were found to be infected more than females (44.44%) which was found to be statistically insignificant (Χ2cal. = 0.4524, P&lt;0.01). Highest prevalence of TB infection (36.89%) was found to be in the age group of 30-40 years. A questionnaire survey of 57 Pulmonary Tuberculosis (PTB) patients was done to assess their knowledge, attitude and preventive practices for TB. Out of 57 PTB patients interviewed, majority of the patients had positive attitude but the knowledge regarding cause, transmission, prevention of the tuberculosis was not adequate.

FACTORS ASSOCIATED WITH CHANGES IN THE NUMBER OF LATENT TUBERCULOSIS INFECTION NOTIFICATIONS IN JAPAN: NATIONWIDE SURVEY FINDINGS

To investigate factors contributing to the drastic increase and subsequent decrease in latent tuberculosis infection (LTBI) notifications in 2011 (n = 10,046) and 2012 (n = 8,771), respectively, in Japan. We conducted cross-sectional surveys in all 495 health centers in Japan in 2012 and 2013 using a semi-structured questionnaire that contained questions regarding the number of contacts listed for contact investigation, interferon-gamma release assay (IGRA) results, and incident of possible false positive IGRA results. Both the numbers and proportion of patients investigated using IGRA tended to increase from 2009 to 2012. However, the numbers and proportion of IGRA-positive patients, as well as that of those with borderline IGRA results, increased in 2011 and have decreased since 2012. In the 2012 survey, only 34 health centers (8%) reported questionable IGRA results. The removal of the age limit for LTBI treatment in 2010 may have contributed to the increase in the number of LTBI notifications in 2011, as the increase was particularly remarkable in the elderly age group. The increase in the proportion of positive and borderline IGRA results was likely partly due to expanded IGRA coverage that included more medical staff and the older population, which have a relatively high prevalence of tuberculosis infection, as well as a change from second-generation to third-generation QuantiFERON (QFT®) IGRA that offered increased sensitivity. The decrease in the number of outbreak incident cases and infectious patients may have contributed to the decrease in the number of LTBI notifications in 2012. Factors such as the increase in the number of patients undergoing IGRA, increase in the number of positive or borderline results due to QFT changes, and decrease in the number of tuberculosis outbreak incidents and infectious patients likely contributed to the increase and decrease in the number of LTBI notifications in 2011 and 2012, respectively.

Tuberculosis in Patients with Systemic Lupus Erythematosus: Five Year Experience of a Single Center in Northern Taiwan

Objective: Tuberculosis (TB) is one of the most severe infectious diseases worldwide. Previous studies have shown a higher prevalence of TB infection in patients with systemic lupus erythematosus (SLE) in South-East Asia, including Taiwan. This study aimed to analyze cases of TB in patients with SLE in a single center from 2008 to 2013. Methods: We retrospectively reviewed the medical records of patients with SLE who were followed up at National Taiwan University Hospital from May, 2008 to April, 2013, including both inpatient and outpatient departments. Age, gender, disease duration, medications, cause of death, and treatment response to TB were documented and analyzed. Results: A total of 1615 patients with SLE were enrolled in this study. TB was diagnosed in 18 patients, with a prevalence rate of 1.11%. The average age of the patients with SLE and TB was 50 ± 14.4 years, with a female to male ratio of 13:5, and 56% of the patients had extrapulmonary involvement. The patients with SLE and TB were significantly older than the non-TB group (p=0.027). The prevalence of TB was also higher in the male and patients with late-onset SLE. The TB-related mortality rate was 5.5%. Most patients received glucocorticoids, and the mean daily dosage was 12.1 ± 8.7 mg prednisolone or equivalent. Conclusion: The average age of the patients with SLE and TB was older than that of those without TB. In patients with SLE, TB may be a particularly important issue in males, patients with late-onset SLE, and in older patients with concomitant steroid use.

High Prevalence of Tuberculosis Infection in HIV-1 Exposed Kenyan Infants

Infants born to HIV-1 infected mothers may have increased risk for tuberculosis (TB), but the prevalence of TB infection in this population is undefined. In contrast to tuberculin skin tests that are confounded by recent bacille Calmette-Guérin (BCG) vaccination, TB interferon gamma release assays (IGRAs) do not cross-react with BCG and enable detection of TB infection in infancy. In a nested observational cohort of HIV-1 infected Kenyan mothers and their infants, we conducted T-SPOT.TB assays on cryopreserved peripheral blood mononuclear cells from 6-month-old infants without prior active TB. Maternal and infant correlates of infant TB infection were assessed. One hundred and eight-two infants were tested with T-SPOT.TB. Of 128 infants with determinate T-SPOT.TB results, the prevalence of a positive T-SPOT.TB was 10.9% [95% confidence interval (CI): 6.1-17.7%]. All infants were BCG-vaccinated and 7.0% were HIV-1 infected. Positive infant T-SPOT.TB was associated with maternal active TB (odds ratio: 15.5, 95% CI: 1.3-184; P = 0.04) and prolonged infant fever (>1 month) (odds ratio: 18.8, 95% CI: 1.6-223; P = 0.03). We observed a high prevalence of TB infection in 6-month-old HIV-1 exposed infants. Improved TB detection and prevention are warranted in HIV-1 exposed infants at high risk for active TB disease.