Incidence Of Tuberculosis Research Articles

Regional disparities in BCG vaccination coverage and tuberculosis incidence in infants among Brazilian states.

Bacillus Calmette-Guerin (BCG) vaccination and tuberculosis (TB) incidence in children under 1 year of age are critical public health indicators in Brazil. The coronavirus disease 2019 pandemic disrupted vaccination coverage (VC), potentially impacting TB incidence. Understanding regional disparities in VC and TB incidence can inform targeted interventions. We conducted an observational and ecological study using BCG vaccination data (2019-21) and TB incidence (2020-22) for all births in Brazil. Data were collected from public health databases, stratified by state, and analyzed using descriptive and analytical statistics to explore VC and TB incidence. Between 2019 and 2021, average BCG VC was 79.59%, with significant variation among states (P < .001). Only four states achieved minimum recommended coverage (>90%). TB incidence varied significantly among states (P = .003). There was a notable decline in VC from 2019 (90.72%) to 2021 (78.67%) (P < .001). This study highlights regional disparities in BCG VC and TB incidence among Brazilian states. Lower VC post-pandemic may increase TB incidence, requiring targeted interventions in states with inadequate coverage. The findings underscore the importance of sustaining vaccination programs amidst public health crises and implementing strategies to enhance access and uptake.

Geographical targeting of active case finding for tuberculosis in Pakistan using hotspots identified by artificial intelligence software (SPOT-TB): study protocol for a pragmatic stepped wedge cluster randomised control trial

IntroductionPakistan has significantly strengthened its capacity for active case finding (ACF) for tuberculosis (TB) that is being implemented at scale in the country. However, yields of ACF have been lower...

How useful is chest x-ray in addition to routine QuantiFERON® in the detection of latent tuberculosis prior to biologics?

Screening for latent tuberculosis (TB) infection is recommended prior to commencing some biologics with QuantiFERON®/interferon gamma-releasing assay (IGRA) and chest x-ray (CXR) recommended on the BAD biologics checklist. QuantiFERON® is highly sensitive while CXR is poorly sensitive and poorly specific. In our cohort of 995 patients, 2.3% had a positive IGRA and 8.3% had any abnormality on CXR with just 0.8% suggestive of TB. Patients were just as likely to have an abnormal CXR if they had a positive or negative IGRA (p=0.927). We suggest that routine screening with IGRA alone is sufficient in the dermatology population particularly in the setting of a low TB incidence country such as the United Kingdom.

Risk factors for tuberculosis among close IGRA-negative contacts of persons with infectious tuberculosis in Singapore

ObjectivesContacts of patients with infectious tuberculosis (TB) testing positive on interferon-gamma release assay (IGRA) are followed up to exclude active disease. However, identifying factors that predispose IGRA-negative contacts to TB could improve screening and follow-up strategies in a medium TB burden country such as Singapore. MethodsWe conducted a retrospective study of IGRA-negative contacts aged ≥2 years identified during contact investigation between January 2014 and December 2022. We examined the risk factors associated with developing active TB among contacts previously testing IGRA-negative, using univariate and multivariable logistic regression and odds ratios with 95% confidence intervals. ResultsOf 60,377 IGRA-negative contacts, 150 developed TB disease, and half were notified within 23 months of index patient diagnosis. IGRA-negative contacts of a smear-positive index patient were more likely to develop TB. Independent risk factors for TB were age >50 years, Malay ethnicity, having diabetes or end-stage renal failure, a “family” relationship with the index patient, or exposure in a dormitory or nursing home. ConclusionsIdentifying risk factors could help optimise follow-up strategies and preventive treatment in IGRA-negative individuals. The incidence rate of TB in this group was 150 per 100,000 population, substantially higher than in the community, with a median 92 weeks to develop disease. Findings suggest that follow-up should be extended to 24 months for contacts with these risk factors.

Suppression of host gene expression is associated with latent TB infection: a possible diagnostic biomarker

The World Health Organization End TB strategy aims for a 90% reduction of tuberculosis (TB) incidence by 2035. Systematic testing and treatment of latent TB infection (LTBI) among contacts of active TB patients is recommended as one of the ways to curtail TB incidence. However, there is a shortage of tools to accurately diagnose LTBI. We assessed the appropriateness of whole blood host transcriptomic markers (TM) to diagnose LTBI among household contacts of bacteriologically confirmed index cases compared to HIV negative healthy controls (HC). QuantiFERON-TB Gold Plus Interferon gamma release assay (IGRA) and reverse-transcriptase quantitative PCR were used to determine LTBI and quantify TM expression respectively. Association between TM expression and LTBI was evaluated by logistic regression modelling. A total of 100 participants, 49 TB exposed (TBEx) household contacts and 51 HC, were enrolled. Twenty-five (51%) TBEx individuals tested positive by IGRA, and were denoted as LTBI individuals, and 37 (72.5%) HC were IGRA-negative. Expression of 11 evaluated TM was significantly suppressed among LTBI compared to HC. Out of the 11 TM, ZNF296 and KLF2 expression were strongly associated with LTBI and successfully differentiated LTBI from HC. Paradoxically, 21 (49%) TBEx participants who tested IGRA negative exhibited the same pattern of suppressed TM expression as IGRA positive (LTBI-confirmed individuals). Results suggest that suppression of gene expression underlies LTBI and may be a more sensitive diagnostic biomarker than standard-of-care IGRA.

Incidence and predictors of tuberculosis among HIV-infected children after initiation of antiretroviral therapy in Ethiopia: A systematic review and meta-analysis.

Globally, Tuberculosis (TB) is the main cause of morbidity and mortality among infectious disease. TB and Human Immune Virus (HIV) are the two deadly pandemics which interconnected each other tragically, and jeopardize the lives of children; particularly in Sub-Saharan Africa. Therefore, this review was aimed to determine the aggregated national pooled incidence of tuberculosis among HIV- infected children and its predictors in Ethiopia. An electronic search engine (HINARI, PubMed, Scopus, web of science), Google scholar and free Google databases were searched to find eligible studies. Quality of the studies was checked using the Joanna Briggs Institute (JBI) quality assessment checklists for cohort studies. Heterogeneity between studies was evaluated using Cochrane Q-test and the I2 statistics. This review revealed that the pooled national incidence of tuberculosis among children with HIV after initiation of ART was 3.63% (95% CI: 2.726-4.532) per 100-person-years observations. Being Anemic, poor and fair ART adherence, advanced WHO clinical staging, missing of cotrimoxazole and isoniazid preventing therapy, low CD4 cell count, and undernutrition were significant predictors of tuberculosis incidence. The study result indicated that the incidence of TB among HIV- infected children is still high. Therefore, parents/guardians should strictly follow and adjust nutritional status of their children to boost immunity, prevent undernutrition and opportunistic infections. Cotrimoxazole and isoniazid preventive therapy need to continually provide for HIV- infected children for the sake of enhancing CD4/immune cells, reduce viral load, and prevent from advanced disease stages. Furthermore, clinicians and parents strictly follow ART adherence.

Optimizing the cascade of prevention to protect people from tuberculosis: A potential game changer for reducing global tuberculosis incidence.

The provision of tuberculosis preventive treatment is one of the critical interventions to reduce tuberculosis incidence and ultimately eliminate the disease, yet we still miss appropriate tools for an impactful intervention and treatment coverage remains low. We used recent data, epidemiological estimates, and research findings to analyze the challenges of each step of the cascade of tuberculosis prevention that currently delay the strategy implementation. We addressed research gaps and implementation bottlenecks that withhold key actions in tuberculosis case finding, testing for tuberculosis infection, provision of preventive treatment with safer, shorter regimens and supporting people to complete their treatment. Empowering communities to generate demand for preventive therapy and other prevention services in a holistic manner and providing adequate financial support to sustain implementation are essential requirements. The adoption of an effective, universal monitoring and evaluation system is a prerequisite to provide general and granular insight, and to steer progress of the tuberculosis infection strategy at global and local level.

Trend of pulmonary tuberculosis and rifampicin-resistance among tuberculosis presumptive patients in Central Tigray, Ethiopia; 2018 -2023: a six-year retrospective study

BackgroundTuberculosis (TB) is a major public health concern in the developing countries. Moreover, the emergence of multidrug-resistant tuberculosis is challenging. However, there are no organized data on the trends of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis in the study area.MethodsA retrospective cross-sectional study was conducted to fill the information gap in Central Tigray at St. Mary General Hospital between 2018 and 2023. Data were collected from the GeneXpert™ tuberculosis registration logbooks using standard checklists and analyzed using Statistical Package for Social Science version 22. After performing logistic regression, a p-value < 0.05 with a corresponding 95% confidence interval was considered statistically significant. Moreover, chi square test for trend was performed to assess the percentage of annual detection of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis during the study years.ResultPresumptive pulmonary tuberculosis patients with complete data (n = 3696) were included in the study. The overall prevalence of pulmonary tuberculosis was 11.7%, of which 8.1% were resistant to rifampicin. The study revealed that the incidence of pulmonary tuberculosis has been increasing, mainly in the recent four years. Likewise, an increase in rifampicin-resistant Mycobacterium tuberculosis was observed with considerable fluctuations. Age, human immunodeficiency virus infection, and presumptive rifampicin-resistant Mycobacterium tuberculosis infection were significantly associated with the presence of pulmonary tuberculosis. Moreover, pulmonary tuberculosis was more prevalent among participants in the productive-age group.ConclusionAlthough there have been fluctuations, an increasing of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis has been observed in recent years. Hence, prevention and treatment strategies for tuberculosis should be strengthened to alleviate the burden of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis in the study area.

Diabetes Mellitus as a Risk Factor for Tuberculosis: A Community Based Case Control Study.

Prevention of diabetes in the general population can help reduce the incidence of tuberculosis. Hence it is necessary to document that diabetes is strongly associated with tuberculosis as a risk factor. To study if diabetes is associated with tuberculosis compared to controls. A community based case-control study was carried out. 215 newly diagnosed cases of tuberculosis on treatment for not more than three months were selected randomly from the randomly selected tuberculosis unit. 215 neighbourhood controls were selected. They were matched for the age group of ± 10 years and sex. Fasting blood sugar (FBS) was estimated using a glucometer. Tobacco chewing, residence and family history of TB were significantly more in cases (P < 0.05). Mean BMI was significantly lower in cases compared to controls. The proportion of TB cases among the known cases of diabetes was 67% compared to 33% in controls, which was statistically significant. Mean FBS was significantly higher in cases compared to controls (P < 0.05). The odds of cases being diabetic was 2.456 times more than those of controls. On binary logistic regression, diabetes was an independent risk factor for tuberculosis. Other independent risk factors were tobacco chewing, and family history of TB. Family history of tuberculosis, and tobacco chewing were positively associated with tuberculosis whereas body mass index was negatively associated with tuberculosis. Diabetes was significantly associated with tuberculosis.

Edukasi Program (Toss TBC) di Dukuh Grogolan Desa Jatimulya Kabupaten Tegal

Helping the government to solve TB disease, the community service team organized community service activities by providing material about TBC Toss. The activity was carried out on May 27, 2024 in Grogolan Hamlet, Jatimulya Village, Suradadi District, Tegal Regency. This activity provides education to the public related to the Toss TBC program from the government so that people avoid TB disease. The activity is to expose TBC Toss material, lung examination, and correct cough Ethics. The enthusiasm of the community was very pronounced, shown by the many people who asked the dedication team. With this education, it is expected that the incidence of tuberculosis in Tegal Regency can decrease.

Socialization and Evaluation of The Level of Compliance of Tuberculosis Patients to The Use Anti-Tuberculosis Drugs to Pharmacy Students of The Lubuk Pakam Medical Health Institute in 2023

The incidence of Tuberculosis (TB) is a health issue that must be paid attention to, especially at the Limapuluh Community Health Center. This health center is a health service center in the Fifty District which experiences a high incidence of TB, with the number of TB cases in 2022 increasing from the previous year. The level of patient compliance with treatment is one of the determining factors for the success of therapy. This study aims to provide an understanding of the factors that influence the level of compliance of TB patients with the use of Anti-Tuberculosis Drugs (OAT) at the Limapuluh Community Health Center. The method of service carried out is in the form of communication, information and education related to the use of Anti-Tuberculosis Drugs. The socialization was carried out online through a zoom meeting with the presentation of material and continued with a pretest and posttest as a measuring tool regarding the increase in participants' understanding of the material presented. This activity was carried out on January 06, 2024 at 10.00-12.00 WIB. The results of this service are the counseling material provided to students seen from the posttest results which show that the understanding and increase in knowledge of the participants is good compared to the results of the previous pretest points. In conclusion, students who take part in this activity can further explore the factors that affect patient compliance in taking OAT drugs so that similar activities can be carried out regularly to prevent errors in the use of Anti Tuberculosis drugs.

Acute Leukemia and Latent Tuberculosis Infection in Italy: Quantiferon-Tb Test Screening in a Low Tuberculosis Incidence Country.

Identification of latent tuberculosis infection (LTBI) is a critical step of tuberculosis surveillance, especially in low-incidence countries. However, it is limited to situations with a higher probability of developing active disease, e.g., patients with hematological malignancies. According to guidelines, in TB non-endemic countries, no clear screening program is established at diagnosis for patients with acute leukemia (AL). The primary endpoint of this study was to establish the prevalence of LTBI in patients with a diagnosis of AL using QuantiFERON (QFT)-TB. Secondarily, radiological and clinical features driving the increased risk of LTBI were evaluated. QFT-TB screening was performed before induction or consolidation in all patients with AL (myeloid and lymphoid) treated at our Institution between October 2019 and August 2023. We accrued 62 patients, of whom 7 (11,3%) tested positive, without any symptoms or signs of active TB, and 2 (3,2%) resulted as indeterminate. All positive patients started prophylaxis with isoniazid 300 mg daily, while patients whose test was indeterminate did not receive any prophylaxis. Active TB was excluded by imaging, as well as microscopic, cultural, and molecular examination on bronchoalveolar lavage if signs of any infection were detected. During the 46 months of observation, no patients developed TB reactivation. Despite the low sample size, 1/10 of our patients had prior TB exposure, hinting that LTBI could be more common than expected in Italy. This finding suggests implementing TB screening in the pre-treatment setting, particularly at a time when more active treatments are becoming available also for patients ineligible for intensive chemotherapy.

Chronic Generalized Periodontitis in a Patient with Infiltrative Pulmonary Tuberculosis

Currently, the World Health Organization, in its annual Global Tuberculosis Report, notes an increase in the incidence of tuberculosis in the world associated with the failure of health systems. In 2022, 7.5 million people worldwide were diagnosed with tuberculosis, the highest rate since 1995. In the Russian Federation, the stabilization of reduced morbidity and mortality rates from tuberculosis infection is currently being determined. Patients with tuberculosis often have comorbid and concomitant diseases, which are one of the main causes that impressively affect the diagnosis and treatment of inflammatory periodontal diseases. There is a pathogenetic relationship and aggravation of the course of diseases. The aim of the study is to analyze the course of chronic generalized periodontitis in a patient with pulmonary tuberculosis and to select personalized therapy. A clinical case of combined pathology (dental and infectious diseases) is presented, which was observed on the basis of the pulmonary therapeutic department of the N.S. Pokhvisneva KUZ in the VOKPTD. The conducted studies allowed us to conclude about the positive effect of a personalized approach in treatment.

Trends of tuberculosis incidence among medical workers in the Vinnytsіa region

Trends of tuberculosis incidence among medical workers in the Vinnytsіa region

Uncommon presentation of gastrointestinal tuberculosis-A case series

Tuberculosis (TB) is a common disease in underdeveloped countries. Of all tuberculosis cases worldwide, 28% were reported from India. The most prevalent site of infection is the lungs (pulmonary TB), whereas extrapulmonary tuberculosis (EPTB) is less common. The most common form of EPTB in India is Lymph Node TB, which accounts for around 35% of total EPTB cases. Splenic tuberculosis incidence is 8 % whereas tuberculosis of pancreas and gall bladder is extremely rare. Pancreatic and gallbladder tuberculosis (GT) is extremely rare and presents with non-specific features. The clinical manifestations of EPTB are variable, imitate other diseases, and are usually confused with other diseases. Thus, it is crucial to be cautious and highly suspicious of EPTB infection in endemic areas. Probability of developing EPTB in immunocompromised patients is higher than in immunocompetent patients. The burden of EPTB in HIV patients ranges from 15 to 20% of all TB cases in HIV-negative patients, while in HIV-positive people, it accounts for around 40–50% of new TB cases. Histopathological examination (HPE) and positive Acid-Fast Bacilli (AFB) smears are used to make the diagnosis. ATT is given to such patients for 6 months. Due to such a diverse presentation of TB, here, we report a case series of extrapulmonary TB occurring in the abdomen in, pancreas, gallbladder, and spleen.

Communicable diseases in Ukraine during the period of 2018–2023: Impact of the COVID-19 pandemic and war

BackgroundBy examining 2018–2023 data, this study explored the intricate impact of the Russian invasion, ongoing COVID-19 pandemic, and environmental disruptions on communicable diseases in Ukraine. This conflict exacerbates challenges in disease surveillance and healthcare, compounding stress among the population. MethodsLeveraging the Centers for Disease Prevention Control's surveillance system, the study employs active and passive surveillance, utilizing medical records and laboratory reports. Notification rates gauge the incidence of communicable diseases, offering insights into trends during the study period. ResultsWhile salmonellosis, shigellosis, and rotavirus incidence are decreasing overall, there is a surge in viral hepatitis A, chronic hepatitis B, and C. This conflict hampers hepatitis C management, as evidenced by decreased numbers of treatment centers and patient enrollment. The prevalence of cough cases will increase in 2023, emphasizing the importance of sustained vaccination. The incidence of tuberculosis will increase in 2023 despite a general decrease. ConclusionThis study underscores the urgent need for sustained efforts and adequate resources, infrastructure, and international support to mitigate public health challenges in conflict-ridden Ukraine. Prioritizing vaccination programmes and enhancing healthcare accessibility in affected regions are crucial.

Utilizing whole genome sequencing to delineate relapse and reinfection tuberculosis on the Canadian prairies

RATIONALE Recurrent tuberculosis (TB) accounts for 5% of the Canadian TB burden. Recurrence can occur from relapse or reinfection. Identifying reinfection has implications for developing control policies. OBJECTIVE The objectives of this study were to quantify reinfection in recurrent TB using whole genome phylogenetic and single nucleotide polymorphism (SNP) and compare with epidemiological and clinical parameters from the Canadian prairies. METHODS DNA sequences of Mycobacterium tuberculosis isolates from recurrent TB cases along with epidemiological and clinical parameters were collected from Alberta and Saskatchewan. Inclusion criteria were two or more culture positive notifications age ≥17 years. SNP and phylogenetic tree scale differences (TIP) were used to determine the relapse and reinfection categories. RESULTS Of 7,627 notifications of TB disease, 533 were recurrent. 93 pairs (180 cases) were culture positive from which 26 (50 cases) were available for sequencing. 19 cases with SNP and TIP values ≤25 and ≤.001 were classified relapse. Seven SNP and TIP values >160 and >.001 were classified reinfection. Five of seven reinfections were Indigenous cases from high TB incidence areas. The non-sequenced and sequenced pairs differed only in age. CONCLUSIONS Recurrent culture positive TB is uncommon on the Canadian prairies and is more likely to be relapse. Reinfection is more likely in Indigenous persons living in high TB incidence communities. A limitation was the risk of selection bias since only 28% of eligible cases were sequenced. Since we did not know the non-sequenced reinfection risk, we could only conclude that the non-sequenced and sequenced categories were similar.

Factors Affecting Extrapulmonary Tuberculosis Reinfection in Pulmonary Tuberculosis Patients in Gorontalo City

Tuberculosis is a disease caused by the bacteria Mycobacterium tuberculosis. Tuberculosis does not only occur in the lungs, which is called pulmonary tuberculosis but can occur outside the lung organs, which is called extrapulmonary tuberculosis. Reinfection from Pulmonary tuberculosis to Extrapulmonary tuberculosis can occur due to several factors. This study aims to determine the factors that can influence the occurrence of reinfection Extrapulmonary tuberculosis in pulmonary tuberculosis sufferers. Method Analytical research with a cross-sectional approach. The number of samples was 49 samples of Pulmonary tuberculosis sufferers who underwent initial diagnosis at the Anatomical Pathology Laboratory, Prof. Dr. Hi. Aloei Hospital. Saboe Gorontalo City. The results of the study showed that the variables Adherence to treatment (p: 0.047), and BCG Vaccine (p: 0.018) were &lt; α value: 0.05, while the significance value of comorbidity for EPTB Reinfection was (p: 0.991). The conclusion is that adherence to treatment and the BCG vaccine have a significant effect on the incidence of reinfection Extrapulmonary tuberculosis (EPTB) in patients with pulmonary tuberculosis (PTB), while comorbidities do not have a significant effect on the incidence of reinfection Extrapulmonary tuberculosis (EPTB) in patients with pulmonary tuberculosis (PTB).

Insights into the Effects of Ligand Binding on Leucyl-tRNA Synthetase Inhibitors for Tuberculosis: In Silico Analysis and Isothermal Titration Calorimetry Validation.

Incidences of drug-resistant tuberculosis have become common and are rising at an alarming rate. Aminoacyl t-RNA synthetase has been validated as a newer target against Mycobacterium tuberculosis. Leucyl t-RNA synthetase (LeuRS) is ubiquitously found in all organisms and regulates transcription, protein synthesis, mitochondrial RNA cleavage, and proofreading of matured t-RNA. Leucyl t-RNA synthetase promotes growth and development and is the key enzyme needed for biofilm formation in Mycobacterium. Inhibition of this enzyme could restrict the growth and development of the mycobacterial population. A database consisting of 2734 drug-like molecules was screened against leucyl t-RNA synthetase enzymes through virtual screening. Based on the docking scores and MMGBSA energy values, the top three compounds were selected for molecular dynamics simulation. The druggable nature of the top three hits was confirmed by predicting their pharmacokinetic parameters. The top three hits-compounds 1035 (ZINC000001543916), 1054 (ZINC000001554197), and 2077 (ZINC000008214483)-were evaluated for their binding affinity toward leucyl t-RNA synthetase by an isothermal titration calorimetry study. The inhibitory activity of these compounds was tested against antimycobacterial activity, biofilm formation, and LeuRS gene expression potential. Compound 1054 (Macimorelin) was found to be the most potent molecule, with better antimycobacterial activity, enzyme binding affinity, and significant inhibition of biofilm formation, as well as inhibition of the LeuRS gene expression. Compound 1054, the top hit compound, has the potential to be used as a lead to develop successful leucyl t-RNA synthetase inhibitors.

Epidemiology and antimicrobial resistance of Mycobacterium spp. in the United Arab Emirates: a retrospective analysis of 12 years of national antimicrobial resistance surveillance data.

The Eastern Mediterranean Regional Office (EMRO) region accounts for almost 8% of all global Mycobacterium tuberculosis (TB) cases, with TB incidence rates ranging from 1 per 100,000 per year in the United Arab Emirates (UAE) to 204 per 100,000 in Djibouti. The national surveillance data from the Middle East and North Africa (MENA) region on the epidemiology and antimicrobial resistance trends of TB, including MDR-TB remains scarce. A retrospective 12-year analysis of N = 8,086 non-duplicate diagnostic Mycobacterium tuberculosis complex (MTB complex) isolates from the UAE was conducted. Data were generated through routine patient care during the 2010-2021 years, collected by trained personnel and reported by participating surveillance sites to the UAE National Antimicrobial Resistance (AMR) Surveillance program. Data analysis was conducted with WHONET, a windows-based microbiology laboratory database management software developed by the World Health Organization Collaborating Center for Surveillance of Antimicrobial Resistance, Boston, United States (https://whonet.org/). A total of 8,086 MTB-complex isolates were analyzed. MTB-complex was primarily isolated from respiratory samples (sputum 80.1%, broncho-alveolar lavage 4.6%, pleural fluid 4.1%). Inpatients accounted for 63.2%, including 1.3% from ICU. Nationality was known for 84.3% of patients, including 3.8% Emiratis. Of UAE non-nationals, 80.5% were from 110 countries, most of which were Asian countries. India accounted for 20.8%, Pakistan 13.6%, Philippines 12.7%, and Bangladesh 7.8%. Rifampicin-resistant MTB-complex isolates (RR-TB) were found in 2.8% of the isolates, resistance to isoniazid, streptomycin, pyrazinamide, and ethambutol, was 8.9, 6.9, 3.4 and 0.4%, respectively. A slightly increasing trend of resistance among MTB-complex was observed for rifampicin from 2.5% (2010) to 2.8% (2021). Infections due to MTB-complex are relatively uncommon in the United Arab Emirates compared to other countries in the MENA region. Most TB patients in the UAE are of Asian origin, mainly from countries with a high prevalence of TB. Resistance to first line anti-tuberculous drugs is generally low, however increasing trends for MDR-TB mainly rifampicin linked resistance is a major concern. MDR-TB was not associated with a higher mortality, admission to ICU, or increased length of hospitalization as compared to non-MDR-TB.