Incidence Of Tuberculosis Research Articles

Эпидемиологические аспекты заболеваемости туберкулезом в Российской Федерации

INTRODUCTION: Tuberculosis is an infectious disease that affects, among other things, the lungs, and is a serious public health problem worldwide. It is the leading cause of death among infectious diseases. AIM: Epidemiological analysis of morbidity with tuberculosis in the Russian Federation (RF) for 2000–2001. MATERIALS AND METHODS: The report forms No. 8 ‘Information on Morbidity with Active Tuberculosis’, No. 33 ‘Information on Patients with Tuberculosis’, national reports ‘On the State of Sanitary and Epidemiological Well-Being of the Population in the Russian Federation’, the data from the Federal Center for monitoring measures to counteract proliferation of tuberculosis in the Russian Federation, were used. A retrospective epidemiological analysis of the morbidity of RF population with tuberculosis for the period from 2000 to 2021 was carried out. Statistical data processing was performed using the free R computing environment (version 4.1.2) and MS Excel 2019 software package in Windows 11. RESULTS: Tuberculosis holds leading positions in the structures of morbidity, mortality, and economic damage from chronic infectious diseases. The long-term average annual morbidity rate was 67.4 per 100 thousand population; a decrease in morbidity is noted (Tav.gr. = -2.1%). According to the results of the analysis, groups at risk of contagion with tuberculosis were identified (by age, gender, social status, place of residence). High levels of tuberculosis incidence were noted in the Siberian (96.4 per 100 thousand) and Far Eastern (98.8 per 100 thousand) federal districts. An inverse correlation was found between the morbidity of the population and preventive fluorographic examinations. CONCLUSION: Over the past 22 years (2000–2021), there has been an improvement in the epidemiological situation for tuberculosis in the Russian Federation: morbidity decreased by 66% and has a moderate downward trend at an average rate of 2.1% per year, the prevalence decreased by 68%, mortality — by 74%. Despite this, tuberculosis is proliferating among the active, able-bodied population (risk group 35–44 years of age). The disease twice more often affects men compared to women. An increase in the coverage of the population with preventive examinations for tuberculosis (more than 65%) will help reduce the incidence of this infection.

Association between ambient temperature, PM2.5 and tuberculosis in Northwest China

ABSTRACT Existing evidence suggested that the risk of tuberculosis (TB) infection was associated to the variations in temperature and PM2.5. A total of 9,111 cases of TB were reported in Ningxia Hui Autonomous Region, China from 2013 to 2015 on a daily basis, and 57.2% of them were male. The TB risk was more prominent for a lower temperature in males (RR of 1.724, 95% CI: 1.241, 2.394), the aged over 64 years (RR of 2.241, 95% CI: 1.554, 3.231), and the high mobility occupation subpopulation (RR of 2.758, 95% CI: 1.745, 4.359). High concentration of PM2.5 showed a short-term effect and was only associated with an increased risk in the early stages of exposure for the female, and aged 36–64 years group. There were 15.06% (1370 cases) of cases of TB may be attributable to the temperature, and 2.94% (268 cases) may be attributable to the increase of PM2.5 exposures. Low temperatures may be associated with significantly increase in the risk of TB, and high PM2.5 concentrations have a short-term association on increasing the risk of TB. Strengthening the monitoring and regular prevention and control of high risk groups will provide scientific guidance to reduce the incidence of TB.

Trends and Projection of the Incidence of Active Pulmonary Tuberculosis in Southwestern China: Age-Period-Cohort Analysis.

The control of pulmonary tuberculosis (PTB) is critical for achieving the vision of World Health Organization's End TB goal. This study analyzes the temporal trends in PTB incidence associated with age, period, and birth cohorts from 2006 to 2020 in Yunnan, China; projects the PTB burden till 2030; and explores the drivers of PTB incidence. The aggregated PTB incidence rates between 2005 and 2020 were obtained from the National Notifiable Disease Reporting System. We used the age-period-cohort model to evaluate the age, period, and cohort effects on PTB incidence. We applied the Bayesian age-period-cohort model to project future PTB incidence from 2021 to 2030. We applied the decomposition algorithm to attribute the incidence trends to population aging, population growth, and age-specific changes from 2006 to 2030. From 2006 to 2020, the PTB incidence in Yunnan was relatively stable, although the absolute number showed an increase. The net drift was -1.56% (95% CI -2.41% to -0.70%). An M-shaped bimodal local drift and a longitudinal age curve were observed. The overall local drift was below zero for most age groups except for the age groups of 15-19 years (2.37%, 95% CI -0.28% to 5.09%) and 50-54 years (0.41%, 95% CI -1.78% to 2.64%). The highest risk of PTB incidence was observed in the age group of 65-69 years, and another peak was observed in the age group of 20-24 years. Downward trends were observed for both period and cohort effects, but the cohort effect trends were uneven. A higher risk was observed for the birth cohorts of 1961-1970 (rate ratio [RR]1961-1965=1.10, 95% CI 0.88-1.38; RR1966-1970=1.11, 95% CI 0.92-1.37) and 2001-2010 (RR2001-2005=0.92, 95% CI 0.63-1.34; RR2006-2010=0.84, 95% CI 0.45-1.58) than for the adjacent cohorts. The Bayesian age-period-cohort model projected that PTB incidence will continually increase from 2021 to 2030 and that PTB incidence in 2030 will be 2.28 times higher than that in 2006. The age-specific change was the leading cause for the growing PTB disease burden. Although there are several levels and measures for PTB control, the disease burden is likely to increase in the future. To bridge the gap of TB-free vision, our study suggests that public health policies be put in place soon, including large-scale active case-finding, priority prevention policies for high-risk older adult and young adult populations, and reduction of possible grandparent-grandchildren transmission patterns.

Integrated Network Pharmacology Approach to Evaluate Bioactive Phytochemicals of Acalypha indica and Their Mechanistic Actions to Suppress Target Genes of Tuberculosis.

Mycobacterium tuberculosis is responsible for tuberculosis (TB) all over the world. Despite tremendous advancements in biomedical research, new treatment approaches, and preventive measures, TB incidence rates continue to ascend. The herbaceous plant Acalypha indica, also known as Indian Nettle, belongs to the Euphorbiaceae family and is known as one of the most important sources of medicines and pharmaceuticals for the medical therapy for a range of ailments. However, the precise molecular mechanism of its therapeutic action is still unknown. In this study, an integrated network pharmacology approach was employed to explore the potential mechanism of A. indica phytochemicals against TB. The active chemical components of A. indica were collected from two independent databases and published sources, whereas SwissTargetPrediction was used to identify the target genes of these phytochemicals. GeneCards and DisGeNET databases were employed to retrieve tuberculosis-related genes and variants. Following the evaluation of overlapped genes, gene enrichment analysis and PPI network analysis were performed using the DAVID and STRING databases, respectively. Later, to identify the potential target(s) for the disease, molecular docking was performed. A. indica revealed 9 active components with 259 potential therapeutic targets; TB attributed 694 intersecting genes from the two data sets; and both TB and A. indica overlapped 44 potential targets. The in-depth analysis based on the degree revealed that AKT1 and EGFR formed the foundation of the PPI network. Moreover, docking analysis followed by molecular dynamics simulations revealed that phytosterol and stigmasterol have higher binding affinities to AKT1 and EGFR to suppress tuberculosis. This study provides a convincing proof that A. indica can be exploited to target TB after experimental endorsement; further, it lays the framework for more experimental research on A. indica's anti-TB activity.

Literature Study: Risk Factors for Tuberculosis in Children

Tuberculosis (TB) is one of the most deadly diseases in the world. Every day nearly 4,400 people lose their lives due to tuberculosis and nearly 300,000 people fall ill due to this disease. The aim of this research is to find out what factors influence the incidence of tuberculosis in children. The method used in this research is literature review. The results show that risk factors that influence the incidence of pulmonary tuberculosis in children include parental knowledge, nutritional status, BCG immunization status, history of contact with sufferers, exposure to cigarette smoke and residential density

Evaluating Serum Calcium and Magnesium Levels as Predictive Biomarkers for Tuberculosis and COVID-19 Severity: A Romanian Prospective Study.

In Romania, the highest incidence of tuberculosis (TB) within the European Union was reported in 2020, highlighting a significant health challenge. This is compounded by the COVID-19 pandemic, which has severely impacted healthcare services, including TB management. Both TB and COVID-19, diseases with considerable morbidity and mortality, have shown potential links to electrolyte imbalances. We conducted a prospective study at Victor Babes Hospital, Romania on 146 patients (74 with TB, 72 with COVID-19) between December 2021 and July 2023. This study assessed correlations between disease severity and serum calcium and magnesium levels, as well as pulmonary function. Adult patients with confirmed diagnoses and comprehensive medical records were included, excluding those with chronic respiratory diseases or unrelated electrolyte imbalances. Statistical analysis utilized the Kruskal-Wallis test and Dunn's procedure for non-normally distributed data. Low serum calcium and magnesium levels were significantly correlated with severe forms of TB and COVID-19, suggesting their potential as biomarkers of disease progression. Patients with more severe TB (i.e., multiple cavities) exhibited significantly lower serum calcium (p = 0.0049) and magnesium levels (p = 0.0004). ROC analysis revealed high AUC values for serum calcium and serum magnesium in predicting COVID-19 severity, indicating their potential as biomarkers. This study demonstrates a significant association between lower serum calcium and magnesium levels and increased TB severity. Similarly, these electrolytes show promise as predictive markers for COVID-19 severity. These findings could serve as biomarkers for predicting the severity of TB and COVID-19, offering potential utility in clinical decision-making.

Tuberculous trochanteric bursitis in an immunocompetent patient

Musculoskeletal Tuberculosis occurs in 1%–3% of patients with tuberculosis, and Tuberculous trochanteric bursitis (TTB) is responsible for 1%, assuming it as a rare clinical condition, especially if it occurs in immunocompetent patients. This is a case report about a 51 years old man, with pain in right trochanteric area, without swelling or inflammatory signs, 1 year of evolution. About 20 years ago, he suffered an infected traumatic local hematoma. Ultrasound revealed trochanteric bursitis. He was then submitted to a bursectomy. Histological study revealed chronic necrotizing granulomatous bursitis, with negative Acid-Fast Bacillus (AFB) Tests. After 6 mouths the patient suffer relapse of his complains. The MRI revealed intraosseous edema of the great right trochanter, inflammation of adjacent soft tissues and small infratrochanteric collection. Analytically, CRP of 1.24 mg/dl and positive interferon Gamma. A new bursectomy and curettage were performed with sequestrectomy. Lowestein culture was positive for AFB, it was identified protein MPT64, and a positive DNA Mycobacterium tuberculosis complex research. It was associated medical treatment with antibiotics (12 months). Currently with clinical and imaging improvement, without relapse, after 1 and a half years of follow-up. Usually, TTB arises from the reactivation of an unknown primary infection, whose clinical presentation is often vague, characterized by chronic symptoms. This condition should be considered in the diagnostic discussion whenever a case of recurrent bursitis arises despite the treatment instituted. With the decline in the incidence of tuberculosis, the number of clinical cases of TTB described in the recent literature has decreased considerably, with special attention being given to the reporting and sharing of these cases, with the goal of keeping this diagnosis in perspective in the discussion and orientation of cases of trochanteric bursitis.

The Medicine Boxes on Compliance with Taking Anti-Tuberculosis Medication in Tuberculosis Patients: Case Study

Background: Tuberculosis (TB) is a chronic, infectious disease that is still a health problem in society, including Indonesia. India is still the second country contributing to the highest incidence of TB in the world after India. The aim research was to present an analysis of the successes and challenges in implementing the medicine box implementation strategy to increase TB patient compliance with ANTI-TUBERCULOSIS MEDICATION treatment. Methods: The method used is descriptive with a case study approach through parenting with the problem of maintaining medication non-adherence in Tuberculosis patients. Data was collected using interview methods, direct observation, and medical records. Results: The results of using the medicine box for three days on Mr It was found that there was a gradual increase in compliance with taking medication after using it. Applying this medicine box is practical in increasing compliance with taking medication experienced by Tuberculosis patients Conclusion: Therefore, nurses are expected to be able to teach how to use the medicine box according to standard operating procedures (SOP) so that patients and their families can practice again at home

Lessons Learned from the COVID-19 Pandemic: Simulation of the Tuberculosis Epidemic as a Function of Population Coverage with Screening

The COVID-19 pandemic has led to the discontinuation of many support programs for tuberculosis patients worldwide, and lower coverage of population with screening for tuberculosis.The objective: To build a model describing the spread of tuberculosis depending on the population coverage with preventive screening, and to obtain a long-term forecast of the infection spread using this model.Subjects and Methods. We analyzed official statistical data on incidence, mortality, preventive screening coverage (PSC), and revalence of sputum smear-positive tuberculosis in the Russian Federation from 2008 to 2021. The model was built up based on fluctuations in those rates in 2020, when there was a sharp reduction in tuberculosis control interventions due to the COVID-19 pandemic. Statistical analysis was performed using the R Software (v.4.2.1).Results. A simple mathematical model describing the dependence of incidence and sputum smear-positive tuberculosis in the current year on sputum smear-positive tuberculosis in the past year and population coverage with preventive screening in the current and past years was built up. The adjusted coefficient of determination of the model (adjusted R-squared) was 0.9969, which meant that the model contained almost no random components. It showed that tuberculosis cases missed due to low population coverage with preventive screening lead to future spread of tuberculous infection and a significant increase in the number of new tuberculosis cases. Comparison of projected rates and data for 2022 demontrated correct formation of models. However, the projected rates were slightly higher than the actual rates for 2022 due to the influence of factors other than the population coverage with preventive screening for tuberculosis.Conclusions. The findings demonstrate the need for mass screening of the population in the context of significant spread of tuberculosis infection for timely detection of patients with sputum smear-positive tuberculosis.

Global tuberculosis burden in Russia and the world as a public health problem (historical and analytical review)

Based on an analysis of archive materials, scientific publications and official statistics obtained from 56 sources, the global tuberculosis burden was assessed. In 1918 in Russia, tuberculosis mortality made 360 cases per 100,000 population, exceeding that in other industrial countries: in England this rate was 113.0; in the USA – 148.0; in Switzerland – 201.0; in Italy – 209.0; in France – 226.0; in Germany – 230.0; and in Japan (1920) – 234 cases respectively. Having undergone colossal socio-economic catastrophes like no other country, Russia achieved significant success in the fight against tuberculosis: in 1913, tuberculosis incidence was 733.0 per 100,000 population, tuberculosis mortality was 276.8; while in 2021 these made 31.1 and 4.3 respectively. In 2021, WHO excluded Russia from the list of countries with a high burden of tuberculosis. However, in Russia as well as in the other BRICS countries, the burden of MDR TB and TB/HIV co-infection still remains high, which requires allocation of resources to reduce their spread.

Upaya Pengelolaan Tuberkulosis Paru Dalam Kedokteran Keluarga

Tuberculosis (TB) is an infectious disease caused by infection with Mycobacterium tuberculosis complex, which is the most frequently found bacteria and is transmitted between humans via the air route. The incidence of TB in Indonesia in 2020 was 301 per 100,000 population. Therefore, family doctors play an important role in promoting health and preventing TB disease, identifying risk factors, clinical problems, and providing management to patients by implementing holistic family doctor services based on evidence based medicine through a patient centered and family approach, the main problem This patient did not wear PPE when in direct contact with other patients while working at PKM Tanah Pasir. In this case report, primary data was obtained through anamnesis (autoanamnesis), physical examination and home visits to complete family data, psychosocial and environmental data. Patient Mr. R, 45 years old, underwent routine TB treatment at the Tanah Pasir Community Health Center and was diagnosed two months ago. The patient has normal nutritional status. Pharmacological and non-pharmacological interventions are carried out for patients in the form of education about TB disease for patients and their families. The results of the evaluation of the intervention are that the patient has started to do physical activity and the family has supported the patient's routine treatment.

OVERVIEW OF CHEST RADIOGRAPH AND CLINICAL SYMPTOMS OF PEDIATRIC PULMONARY TUBERCULOSIS PATIENT IN PROF. DR. I.G.N.G NGOERAH HOSPITAL JANUARY 2021 – JUNE 2022

Tuberculosis (TB) is an infectious disease whose incidence is still quite high in Indonesia. The increasing incidence of pediatric pulmonary TB is still happening today. The diagnosis of pediatric pulmonary TB is still a hot topic because the chest radiograph and clinical symptoms are not typical and are often found in other diseases. The aim of the research is to know the overview of chest radiograph and clinical symptoms of pediatric pulmonary TB patients. This research was conducted at Prof. RSUP. Dr. I.G.N.G Ngoerah January 2021 – June 2022 using a cross-sectional descriptive method and medical record data as source with total sample is 30 people. Univariate analysis was performed using the Statistical Package for the Social Science (SPSS) version 26.0 for MacOS. The results of the study are majority of pediatric pulmonary TB patients at RSUP Prof. Dr. I.G.N.G Ngoerah January 2021 – June 2022 is female (60%), age group 11-16 years (50%), abnormal chest radiograph (96.7%), asymptomatic (63.3%), lymphadenopathy of hilar/paratracheal lymph nodes with/without parenchymal consolidation (96.7%), cough symptoms (30%). Children with pulmonary TB at RSUP Prof. Dr. I.G.N.G Ngoerah January 2021 – June 2022 is dominated by female gender, age group 11-16 years, abnormal chest radiograph, asymptomatic, lymphadenopathy of hilar/paratracheal lymph nodes with/without parenchymal consolidation and symptoms of cough.

Pulmonary Thromboembolism in Multidrug-Resistant Tuberculosis: A Case Series Highlighting the Importance of Early Diagnosis and Management

Background: Pulmonary tuberculosis (PTB) is an established cause of arterial and venous thrombosis. With the rising incidence of multidrug-resistant tuberculosis (MDR TB), which has a prolonged treatment course, pulmonary thromboembolism in such cases further complicates the treatment outcome in terms of mortality and morbidity. TB causes systemic hypercoagulability, which may lead to both arterial and venous thrombosis. Therefore, it is important for treating physicians to be aware of the entity and have a sharp watch for the development of Pulmonary thromboembolism in cases of MDR TB. The Case: We present the association of pulmonary thromboembolism (PTE) with MDR TB in three young males who developed pulmonary thromboembolism during the treatment of MDR TB, along with their management using anticoagulant agents. Conclusion: PTE in cases of TB is rare but fatal. High suspicion of PTE in patients with MDR TB will help in diagnosing the dreaded condition early and aid in reducing preventable mortality with PTE. Early recognition, prompt diagnosis, and management is the key to saving the lives of those with this fatal complication.

Metastatic sarcoma mimicking pulmonary tuberculous.

Due to high incidence of tuberculosis in Taiwan, there is a tendency for overdiagnosis of tuberculosis. Differential diagnosis between malignant diseases and pulmonary tuberculosis is extremely important for us.

Risk of tuberculosis after endoscopic resection and gastrectomy in gastric cancer: nationwide population-based matched cohort study.

This study aimed to investigate the association between gastrectomy and endoscopic resection for gastric cancer and the subsequent tuberculosis incidence. We conducted a nationwide matched cohort study using data from the Korea National Health Insurance Service from 2013 to 2019. We created two cohorts: patients who underwent gastrectomy and those who had endoscopic resection. Each patient was matched 1:1 with an unexposed individual based on index year, age, sex, income, and various comorbidities. The primary outcome was the incidence of tuberculosis during the follow-up period. Our study comprised 90,886 gastrectomy patients and 46,759 endoscopic resection patients. The tuberculosis incidence was significantly higher in the gastrectomy group compared to its matched non-gastrectomy group (IRR 1.69, 95% CI 1.43-1.99, p < .001). In contrast, there was no significant difference in tuberculosis incidence between the endoscopic resection group and its matched non-resection group (IRR 0.95, 95% CI 0.75-1.19, p = 0.627). The Kaplan-Meier cumulative incidence also did not differ between the two groups. However, tuberculosis incidence significantly increased in the first year after endoscopic resection. Gastrectomy for gastric cancer is associated with a higher incidence of subsequent tuberculosis, while no significant association was observed for endoscopic resection. However, tuberculosis incidence increases significantly during the first year after endoscopic resection.

Time Series Modeling of Tuberculosis Cases in India from 2017 to 2022 Based on the SARIMA-NNAR Hybrid Model.

Tuberculosis (TB) is still one of the severe progressive threats in developing countries. There are some limitations to social and economic development among developing nations. The present study forecasts the notified prevalence of TB based on seasonality and trend by applying the SARIMA-NNAR hybrid model. The NIKSHAY database repository provides monthly informed TB cases (2017 to 2022) in India. A time series model was constructed based on the seasonal autoregressive integrated moving averages (SARIMA), neural network autoregressive (NNAR), and, SARIM-NNAR hybrid models. These models were estimated with the help of the Bayesian information criterion (BIC) and Akaike information criterion (AIC). These models were established to compare the estimation. A total of 12,576,746 notified TB cases were reported over the years whereas the average case was observed as 174,677.02. The evaluating parameters values of RMSE, MAE, and MAPE for the hybrid model were found to be (13738.97), (10369.48), and (06.68). SARIMA model was (19104.38), (14304.15), and (09.45) and the NNAR were (11566.83), (9049.27), and (05.37), respectively. Therefore, the NNAR model performs better with time series data for fitting and forecasting compared to other models such as SARIMA as well as the hybrid model. The NNAR model indicated a suitable model for notified TB incidence forecasting. This model can be a good tool for future prediction. This will assist in devising a policy and strategizing for better prevention and control.

Venous thromboemboliс complications and tuberculosis: is there an interaction?

Venous thromboembolic complications (VTEC) haven’t lost their status as an important medical and social problem for many decades. There are about 300 thousand people die from VTEC in Russia every year. Another significant problem for our country is tuberculosis. Tuberculosis is one of the most common severe infections in the world, most often occurs as a chronic disease and can induce VTEC due to a variety of synergistically acting factors. Previously published studies examined the interaction between tuberculosis and VTEC, but they were based on the data obtained from countries with a high incidence of tuberculosis and a low prevalence of venous thrombosis. An analysis of the literature has shown that tuberculous inflammation determines all three interrelated components of the Virchow’s triad: endothelium inflammatory damage, venous stasis and hypercoagulability. In addition, treatment regimens for the disease with the inclusion of rifampicin also contribute to the development of VTEC due to the pronounced procoagulant properties of the drug. Another equally important agent that potentiates hypercoagulation is the HIV virus, which affects the endothelium and immunocompetent cells. Currently available epidemiological data indicate that HIV infection is associated with an increased risk of VTEC in 2-10 times compared to the general population of the same age. In this context, tuberculosis and HIV/TB co-infection can be considered as a large reversible risk factor for the development of VTEC and included in the prognostic risk assessment scales for acute venous thrombosis and embolism.

Toxicological Profiling of Potential Shikimate Kinase Inhibitors Against Mycobacterium tuberculosis.

Over the last decade, Mycobacterium tuberculosis has mutated into a putative 'superbug', as treatments against it have failed due to increasing antimicrobial resistance. As a result, the rising incidence of multidrug-resistant tuberculosis (MDR-TB) is posing a significant public health threat, thus, the need to develop effective drugs for MDR-TB has become an urgent priority. To identify new drug candidates for the treatment of MDR-TB, the present study was based on mycobacterial shikimate kinase (MtSK) as the pharmacological target. One hundred potential MtSK inhibitors were identified from literature and database searches to identify compounds that were designed to specifically function as MtSK antagonists. The ADME properties of these compounds were evaluated by using the SwissADME web tool. ProTox-II software was also used to investigate any potential endocrine disrupting effects, mediated through their interaction with oestrogenic and/or androgenic receptors. This study also aimed to predict LD50 values of potential drug candidates that would be active against the standard H37Rv strain of M. tuberculosis, by using the ProTox-II in silico tool. The molecules for which no structural hazard alerts were identified with these software tools were further subjected to molecular docking analyses and molecular dynamic simulations to estimate their ability to interact with the MtSK enzyme. Preliminary results from SwissADME indicated that 30 molecules were drug-like, due to their physicochemical and pharmacokinetic properties. However, subsequent analysis with ToxTree and ProTox-II indicated that only three of these 30 drug-like molecules were suitable for taking forward into further in vitro experiments. This study, which is based on the use of commonly used open-source in silico tools, identified new MtSK ligands for potential use in the development of new drugs for the therapeutic management of tuberculosis. An initial prediction of their safety profile was also generated.

Spatial distribution and determinants of tuberculosis incidence in Mozambique: A nationwide Bayesian disease mapping study

IntroductionMozambique is a high-burden country for tuberculosis (TB). International studies show that TB is a disease that tends to cluster in specific regions, and different risk factors (HIV prevalence, migration, overcrowding, poverty, house condition, temperature, altitude, undernutrition, urbanization, and inadequate access to TB diagnosis and treatment) are reported in the literature to be associated with TB incidence. Although Mozambique has a higher burden of TB, the spatial distribution, and determinants of TB incidence at the sub-national level have not been studied yet for the whole country. Therefore, we aimed to analyze the spatial distribution and determinants of tuberculosis incidence across all 154 districts of Mozambique and identify the hotspot areas. MethodWe conducted an ecological study with the district as our unit of analysis, where we included all cases of tuberculosis diagnosed in Mozambique between 2016 and 2020. We obtained the data from the Mozambique Ministry of Health and other publicly available open sources. The predictor variables were selected based on the literature review and data availability at the district level in Mozambique. The parameters were estimated through Bayesian hierarchical Poisson regression models using Markov Chain Monte Carlo simulation. ResultsA total of 512 877 people were diagnosed with tuberculosis in Mozambique during our five-year study period. We found high variability in the spatial distribution of tuberculosis incidence across the country. Sixty-two districts out of 154 were identified as hotspot areas. The districts with the highest incidence rate were concentrated in the south and the country's central regions. In contrast, those with lower incidence rates were mainly in the north. In the multivariate analysis, we found that TB incidence was positively associated with the prevalence of HIV (RR: 1.23; 95 % CrI 1.13 to 1.34) and negatively associated with the annual average temperature (RR: 0.83; 95 % CrI 0.74 to 0.94). ConclusionThe incidence of tuberculosis is unevenly distributed across the country. Lower average temperature and high HIV prevalence seem to increase TB incidence. Targeting interventions in higher-risk areas and strengthening collaboration between HIV and TB programs is paramount to ending tuberculosis in Mozambique, as established by the WHO's End TB strategy and the Sustainable Development Goals.

The prevalence of tuberculosis infection among foreign-born Canadians: a modelling study.

The prevalence of tuberculosis infection is critical to the design of tuberculosis prevention strategies, yet is unknown in Canada. We estimated the prevalence of tuberculosis infection among Canadian residents born abroad. We estimated the prevalence of tuberculosis infection by age and year of migration to Canada for people from each of 168 countries by constructing country-specific and calendar year-specific trends for annual risk of infection using a previously developed model. We combined country-specific prevalence estimates with Canadian Census data from 2001, 2006, 2011, 2016 and 2021 to estimate the overall prevalence of tuberculosis infection among foreign-born Canadian residents. The estimated overall prevalence of tuberculosis infection among foreign-born people in Canada was 25% (95% uncertainty interval [UI] 20%-35%) for census year 2001, 24% (95% UI 20%-33%) for 2006, 23% (95% UI 19%-30%) for 2011, 22% (95% UI 19%-28%) for 2016 and 22% (95% UI 19%-27%) for 2021. The prevalence increased with age at migration and incidence of tuberculosis in the country of origin. In 2021, the estimated prevalence of infection among foreign-born residents was lowest in Quebec (19%, 95% UI 16%-24%) and highest in Alberta (24%, 95% UI 21%-28%) and British Columbia (24%, 95% UI 20%-30%). Among all foreign-born Canadian residents with tuberculosis infection in 2021, we estimated that only 1 in 488 (95% UI 185-1039) had become infected within the 2 preceding years. About 1 in 4 foreign-born Canadian residents has tuberculosis infection, but very few were infected within the 2 preceding years (the highest risk period for progression to tuberculosis disease). These data may inform future tuberculosis infection screening policies.