Interest In Tuberculosis Research Articles

Frequency of abnormal findings on chest radiograph after positive PPD in children and adolescents in an urban setting in the United States

BackgroundChest radiographs (CXR) for tuberculosis (TB) screening in children are valuable in high-burden settings. However, less certain in low prevalence contexts. In the United States, positive PPD is sufficient to treat for “latent” TB, or TB infection in asymptomatic patients. ObjectiveWe sought to determine frequency of abnormal CXR findings after a positive purified protein derivative (PPD) test at a tertiary pediatric center in the United States. MethodA retrospective evaluation was conducted of patients (0–18 years) with a CXR after a positive PPD (e.g., known exposure, employment, migratory requirements or before immunosuppression) between 2011 and 2021. Clinical information, demographics, and reason for PPD were recorded from health record. CXRs were evaluated using initial report and by a pediatric radiologist with special interest in TB and 8 years of experience. ResultOf 485 patients, median [interquartile range (IQR)] age 8.5[3.3–14.4], abnormal CXRs were described in 5 (1%). Most common reasons for PPD included: close contact with someone with TB or with high risk for TB. Most patients 373 (76.9%) received treatment for latent TB, and 111 (22.9%) no treatment. One patient (0.2%) received treatment for active disease. Radiographic findings included isolated lymphadenopathy (n = 2), consolidation (n = 1), pleural fluid/thickening (n = 1) and a patient with lymphadenopathy and a calcified nodule (n = 1). ConclusionIn our experience, prevalence of chest radiographs findings for patients with positive PPD was very low. Moreover, no cases of severe disease were seen and those with abnormal findings would not merit treatment change under current WHO guidelines.

Hand Tuberculosis: a Common Disease at an Uncommon Site

Tuberculosis (TB) is one of the major health problems in developing countries. India has the highest TB burden with approximately 27% of global TB [6]. (India TB Report 2018 Revised National TB Control Programme (2018)). The most common form of tuberculosis constitutes pulmonary tuberculosis. Among extra pulmonary tuberculosis, the musculoskeletal tuberculosis accounts for about 10–15% cases (Mohd Altaf Mir, Imran Ahmad, Mihd Yaseen (2016) World J Plast Surg 5(3):313–318). Hand involvement is seen in 10% of patients with musculoskeletal disease. There has been recent interest in tuberculosis of the hand because of a rising incidence owing to increasing numbers of immigration, an aging population, and immunosuppressed people including affected patients with human immunodeficiency virus [3,7] (Centre for Disease Control (1995) MMWR 14:1–16), Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Omawi M (2011) J Hand Surg 36:1413–1422). Tuberculous tenosynovial disease (TBTS) is the most common presentation of hand tuberculosis. In the hand, the flexor tendon sheath and radio-ulnar bursae are the most common sites of tenosynovitis. Tuberculosis of hand is more commonly seen in the dominant hand of the male population (Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Omawi M (2011) J Hand Surg 36:1413–1422). Here, we present a case of TBTS affecting extensor compartment of dominant hand in a post renal transplant immunosuppressed individual.

Global tuberculosis research and its future prospects

Tuberculosis is the infectious disease that causes the most deaths each year in the world. Around 25% of the population is estimated to be infected with, Mycobacterium tuberculosis, the bacteria that gives rise to the disease, and more than one and a half million people die each year from this cause. A rigorous bibliometric analysis has been developed around tuberculosis disease, and the most remarkable results are presented in this paper. It is observed that interest in tuberculosis is growing, and the control of its spread has become one of the main health priorities in the world, with the United States, the United Kingdom, and India, leading the research in this area. On the other hand, it has been observed that there are two main health concerns around the tuberculosis: drug-resistant tuberculosis and co-infection with HIV. Finally, conclusions are offered, playing a frontline role in science policy decisions and research performance evaluations.

Identification of HLA-A2-Restricted Mycobacterial Lipoprotein Z Peptides Recognized by T CellsFrom Patients With ActiveTuberculosis Infection.

Identification of HLA-restricted peptides derived from mycobacterial antigens that are endowed with high affinity and strong antigenicity is not only of interest in tuberculosis (TB) diagnostics and treatment efficacy evaluation, but might also provide potential candidates for the development of therapeutic vaccines against drug-resistant TB. Our previous work demonstrated that lipoprotein Z (LppZ) displayed high immunogenicity and antigenicity in active TB patients. In the present study, ten HLA-A2-restricted LppZ peptides (LppZp1-10) were predicted by bioinformatics, among which LppZp7 and LppZp10 were verified to possess high affinity to HLA-A2 molecules using T2 cell-based affinity binding assay. Moreover, results from ELISpot assay showed that both LppZp7 and LppZp10 peptides were able to induce more IFN-γ producing cells upon ex vivo stimulation of PBMC from HLA-A2+ active TB (ATB) patients as compared to those from healthy controls (HCs). Also, the numbers of LppZp7 and LppZp10-specific IFN-γ producing cells exhibited positive correlations with those of ESAT-6 peptide (E6p) or CFP-10 peptide (C10p) in ATB. Interestingly, stimulation with LppZp7/p10 mixture was able to induce higher intracellular expression of IFN-γ and IL-2 cytokines in CD8+ and CD4+ T cells from ATB as compared to HC, associated with lower expression of TNF-α in both CD8+ and CD4+ T cells. Taken together, HLA-A2-restricted LppZp7 and LppZp10 peptides display high immunoreactivity in HLA-matched ATB patients demonstrated by high responsiveness in both CD8+ and CD4+ T cells. With the ability to induce strong antigen-specific cellular responses, LppZp7 and LppZp10 are of potential value for the future applications in the prevention and control of TB.

A survey of the tuberculosis physician workforce in the country of Georgia.

A well-trained and sufficient tuberculosis (TB) workforce is essential for disease control, especially in an era of newly implemented diagnostics and medications. However, there are few reports on the status of the TB workforce in many endemic countries. To evaluate the demographics, salary, career satisfaction, and attitudes towards the field of TB among the physician TB workforce in the country of Georgia. A cross-sectional study of physicians in the current Georgian National TB Programme (NTP) using an anonymous 31-item questionnaire. Among 184 NTP physicians countrywide, 142 (77%) were contacted and 138 (75%) completed questionnaires. The median age was 56 years (interquartile range 50-64); most (81%) were female. The monthly salary from TB work was USD205 for 50% of respondents. Nearly half (47%) received an additional salary from another source. Many physicians (65%) indicated that they were satisfied with their work, but over half (55%) were unsatisfied with reimbursement. While most physicians (78%) were concerned about the lack of interest in TB, only 36% would recommend a career in TB care. While the current TB workforce in Georgia finds their work fulfilling, an ageing workforce, low salaries and perceived lack of interest in the field are a matter of concern for future TB control.

Quantitative approach for cardiac risk assessment and interpretation in tuberculosis drug development

Cardiotoxicity is among the top drug safety concerns, and is of specific interest in tuberculosis, where this is a known or potential adverse event of current and emerging treatment regimens. As there is a need for a tool, beyond the QT interval, to quantify cardiotoxicity early in drug development, an empirical decision tree based classifier was developed to predict the risk of Torsades de pointes (TdP). The cardiac risk algorithm was developed using pseudo-electrocardiogram (ECG) outputs derived from cardiac myocyte electromechanical model simulations of increasing concentrations of 96 reference compounds which represented a range of clinical TdP risk. The algorithm correctly classified 89% of reference compounds with moderate sensitivity and high specificity (71 and 96%, respectively) as well as 10 out of 12 external validation compounds and the anti-TB drugs moxifloxacin and bedaquiline. The cardiac risk algorithm is suitable to help inform early drug development decisions in TB and will evolve with the addition of emerging data.

OSHA'S Increased Interest in Tuberculosis

OSHA'S Increased Interest in Tuberculosis

Diagnosis of bovine tuberculosis: review of main techniques.

Bovine tuberculosis (BTB) remains an important economic and zoonotic problem in Latin America. Traditionally, the fight against BTB is initiated by the implementation of routine diagnostic tests for certification of free properties. The diagnosis of BTB can be made by direct and indirect methods, in which we can mention clinical, post mortem, histopathological, immunological, bacteriological and molecular methods. The renewal of scientific interest in tuberculosis in recent year has led to develop and improve methods of diagnosis, prevention, control and eradication of BTB. The aim of this review is to present and discuss different diagnosis methods of BTB.

Alan Robert Somner

Alan Robert Somner was educated at the Edinburgh Academy and qualified in 1946 at the University of Edinburgh Medical School. After house jobs at the Edinburgh Royal Infirmary he did...

Extrapulmonary tuberculosis in the wrist presenting as a ganglion cyst-like mass: A case report

There has been recent interest in tuberculosis of the hand because of its rising incidence. Musculoskeletal tuberculosis accounts for only 20% of cases of tuberculosis. The most common musculoskeletal sites are the spine, hip and knee. Hand involvement is seen in 10% of patients with musculoskeletal tuberculosis. This study reports an unusual case of extrapulmonary tuberculosis in the soft tissues of the wrist, presenting as a ganglion cyst-like lesion with concurrent lung cancer. The condition occurred in a 55-year-old woman with underlying rheumatoid arthritis that had been diagnosed 3 years previously and was under control with regular medication. For several months the patient had noted a metapharyngeal joint mass in her right wrist and hand. The unmovable soft mass was approximately 2cm×2cm in the metapharyngeal joint and 4.5cm×4.5cm in the wrist, and displayed local tenderness and limited range of motion. Under the impression of a ganglion cyst-like soft tissue mass, the patient underwent marginal excision. However, the pathological report indicated tuberculosis. Antituberculosis treatment was prescribed. Simultaneously, lung cancer was also diagnosed. The patient then received chemotherapy and regular follow-up. Although the case described here is rare, preoperative evaluation can help considerably in early detection of cancer. Additionally, postoperative pathology can help define tuberculosis. Medical treatment plays a major role in tuberculosis.

Tuberculosis of the Hand

There has been recent interest in tuberculosis of the hand because of a rising incidence owing to increasing numbers of immigration, an aging population, and immunosuppressed people including affected patients with human immunodeficiency virus. In this article, we review the epidemiology, bacteriology, pathophysiology, diagnosis, and principles of treatment of tuberculosis of the hand. The second part of the report emphasizes the classification of hand tuberculosis (cutaneous lesions, tenosynovitis, bursitis, osteomyelitis, arthritis, and tuberculous hypersensitivity reactions) along with the classic presentations of each of these hand lesions.

Questionnaire about impression and knowledge of tuberculosis in employees and students in a university hospital

The aim of the study is to search the efficient way for the prevention of nosocomial tuberculosis (TB) infection in a university teaching hospital. Through a questionnaire, informations on the degree of interest in TB, on the way how they try to learn about TB infection, and on basic knowledge of TB epidemiology were obtained. The study subjects were most employees including physicians, nursing staffs, medical technicians, pharmacists, clerks as well as medical and dental students, who were younger than 40 years. The study was done from 1999 through 2001, and a total of 2,159 questionnaires in which age, sex and occupational category were completely described were analyzed. Out of total participants, 61.8% participants showed interest in TB, however, only 3.0% had actually attended lecture meeting or collected materials on TB infection. Out of 619 nursing staffs, 431 (69.6%) felt anxiety for TB infection and the disease, and it was significantly higher than the other occupational groups. Of 2,159 participants, 1,472 (68.2%) participants desired to have health examination for TB. On the other hand, less than 50% participants including physicians answered correctly to questions about basic knowledge of TB epidemiology. Through the present study, it was suggested that employees and students in a university hospital do not voluntarily learn about TB, or do not have enough knowledge on TB in spite of their anxiety or interest, but that they are well prepared to obtain essential informations on the prevention of TB infection. Thus, it would be worthwhile to establish a system of education and health examination for the prevention of nosocomial TB infection. On the other hand, the degree of interest in and anxiety about TB in clerical employees was relatively low. Since they have some risk of TB infection through a service at window, the strengthening of health education on TB for them would be necessary.

Tuberculosis epidemiology in the Asia–Pacific region

Abstract: The Asia–Pacific region accounts for about 20% of the global burden of tuberculosis (TB). However, there are a wide variety of TB problems between countries and areas. This variety could be described in three dimensions: (i) historical trends of the TB epidemics, closely related to the advent of industrialization or urbanization; (ii) success in modern TB control in the early days; and (iii) expansion of the directly observed therapy, short course (DOTS) strategy during the past 20 years. Moreover, these dimensions have been subject to the ‘health infrastructure’ based on such social goods as people's education, economic standards, and social security or stability. The Asia–Pacific Region offers very good examples to illustrate the roles of these factors in leading to such a variety of TB problems as seen today. Thus, this region was the first to achieve the global target of DOTS by the end of 2005, that is to detect 70% of patients and to treat them with DOTS, and to successfully cure 85% of those detected.However, we should remember that we are currently challenged by TB combined with HIV infection and AIDS; TB with drug‐resistance, especially multidrug‐resistant (MDR) or extensively drug resistant (XDR) forms; TB in people with special risk factors, for example diabetes and senility; and other medical and socioeconomic problems. At the same time, we have to be careful about the premature loss of people's interest in TB, due to illusion or unfounded optimism, especially among medical professionals and the government.

Tuberculosis, a neglected opportunity?

Historically, tuberculosis (TB) has fallen firmly in the group of ‘neglected diseases’—diseases in which pharmaceutical companies have been reluctant to invest due to a perception of low commercial potential. According to the World Health Organization (WHO), an estimated 1.7 million deaths resulted in 2004 from TB, and the global prevalence of TB was 14.6 million1. However, more than 80% of people with TB live in sub-Saharan Africa or Asia2, where spending on healthcare is low and access to drugs is limited. Owing to the low commercial interest in treating TB, no new drug class has been introduced for over 30 years. The current market is dominated by generic products. Relatively few international drug manufacturers market TB therapies; exceptions are Sanofi-Aventis, Pfizer and Sandoz (Novartis’s generics division). However, over the past 10–15 years, several factors have emerged, which are contributing to increased research and development (R&D) activity in TB treatment. The prevalence of TB grew significantly in the late 1980s and 1990s, driven by cases in sub-Saharan Africa, but also by a resurgence in both the US and Europe, where TB had been considered an eradicated disease. The WHO identified TB as a global health emergency in 1993 and launched the Global Plan to Stop TB, which focused on early TB diagnosis and reliable access to treatment. In areas of high HIV prevalence, coinfection with TB and HIV has become a critical issue, fuelling the increase in TB cases. Coinfection not only increases the proportion of individuals with TB who develop active disease, but also presents treatment challenges owing to interactions between TB and HIV drugs. Increased incidence of multidrug-resistant TB (MDR-TB) has further complicated effective disease management and created a demand for new treatments that are effective against resistant disease strains. The Global TB Alliance, a nonprofit organization working with public and private sectors to accelerate R&D in TB, was established in 2000. The TB Alliance has raised substantial funding for clinical research and is now the leading developer of new TB drugs, with agents in all phases of development. Nonprofit investment has been a key factor in stimulating interest in TB R&D within the pharmaceutical industry. Most products in the TB pipeline are joint projects between private and nonprofit organizations. The TB Alliance received donations of $39 million and $14 million from the Dutch and Irish governments, respectively3,4. In addition, the Bill & Melinda Gates Foundation provided grants of $25 million in 2000 and a further $104 million in 2006 (ref. 5).

Diagnostic accuracy of chest radiography in detecting mediastinal lymphadenopathy in suspected pulmonary tuberculosis

Objective: To estimate the diagnostic accuracy of chest radiography in the detection of chest lymphadenopathy in children with clinically suspected pulmonary tuberculosis. Methods: Design: Prospective cross sectional study. Setting: A...

Epidemiology of cutaneous tuberculosis in Japan: a retrospective study from 1906 to 2002.

Interest in tuberculosis has recently been revived, especially in association with the onset of acquired immunodeficiency syndrome (AIDS). In Japan, the incidence of tuberculosis has declined since the 1950s, but has shown a tendency to increase in the past 10 years. To determine the patterns of prevalence of cutaneous tuberculosis in Japan, data for cutaneous tuberculosis cases recorded between 1906 and 2002 were obtained from the dermatologic clinic of Kyushu University Hospital. The population of tuberculosis-infected patients was stratified into groups encompassing 10-year periods. Each patient group was then classified as having true tuberculosis or tuberculid, as well as being classified by gender. The total number of patients with cutaneous tuberculosis analyzed was 1324. The incidence of cutaneous tuberculosis, both true tuberculosis and tuberculid, decreased between 1906 and 1935, increased between 1936 and 1955, and decreased again from 1955. The incidence of true tuberculosis was higher than that of tuberculid between 1906 and 1925. The incidence rates of true tuberculosis and tuberculid were equal from 1926 to 1945, and since 1946 the incidence of tuberculid has been higher than that of true tuberculosis. The incidence of tuberculid decreased between 1986 and 1995, but showed a dramatic increase between 1996 and 2000. The frequency of cutaneous tuberculosis was highest in the 10-49 year age group before 1980, but since 1981 has been highest in groups over 40 years of age. The incidence of cutaneous tuberculosis in Japan is decreasing and shows a shift towards older generations. However, there is an increase in the incidence of tuberculid, especially in elderly female patients.

Mycobacterial isolations in captive elephants in the United States.

Interest in tuberculosis in elephants has been increasing over the past several years in the United States. Several techniques have been used to diagnose mammalian tuberculosis. Currently, the test considered most reliable for diagnosis of TB in elephants is based on the culture of respiratory secretions obtained by trunk washes.

Heroes and evidence

J Thorac Cardiovasc Surg 2002;124:11-3

Isolated tuberculosis of posterior elements of spine: magnetic resonance imaging findings in 33 patients.

Study of magnetic resonance imaging (MRI) of tuberculosis of spine to determine the incidence and features of isolated tuberculous involvement of the posterior spinal elements. To describe the MRI findings in patients with isolated tuberculous involvement of the posterior spinal elements. Spinal tuberculosis is more common in the eastern countries than in the western world. Recently, there has been a renewed interest in tuberculosis in the west because of its re-emergence, especially in immunocompromised patients (e.g., HIV). The classic radiologic picture of "two vertebral disease with the destruction of the intervertebral disc" is easily recognized and readily treated, but its atypical forms are often misdiagnosed and mistreated. A total of 33 patients 13-53 years of age (16 men, 17 women; mean age 28.30 years) with proven tuberculosis of posterior element of the spine were retrospectively evaluated. The clinical and imaging data were studied in all 33 patients. Involvement occurred from C2 to L5 vertebral levels. Most commonly, involvement was seen in the thoracic vertebrae (16 patients, 48.5%) followed by lumbar vertebrae (13 cases, 39.4%) and cervical vertebrae (4 patients, 12.1%). The laminae were most commonly involved (24 patients, 72.7%; 8 bilateral, 16 unilateral) followed by pedicles (20 patients, 60.6%; 6 bilateral, 14 unilateral), articular processes (19 patients, 57.5%; 5 bilateral, 14 unilateral), spinous processes (19 patients, 57.5%), and transverse processes (12 cases, 36.4%; 5 bilateral, 7 unilateral). Bone destruction and marrow changes were seen in all patients. Involvement of the entire posterior arch was seen in eight patients. A total of 23 patients revealed extraspinal soft tissue collections. Intraspinal extradural granulation tissue/abscess was seen in 11 patients. Spinal cord was either displaced or compressed in 15 patients, and abnormal high signal intensity intrinsic cord changes were seen in eight patients. In tuberculosis of the posterior element of the spine, MRI is extremely useful in evaluating the extent of involvement and response to therapy of isolated tuberculosis of posterior elements. Involvement of posterior elements due to tuberculosis is not so uncommon.

Introducing the Fifth Edition of theCanadian Tuberculosis Standards

The fifth and latest edition of the Canadian Tuberculosis Standards is now available through the offices of the Canadian Lung Association (CLA), and the individual provincial and territorial lung associations. Since the publication of the last edition of the Canadian Tuberculosis Standards (1) of the CLA and Canadian Thoracic Society (CTS), there has been renewed interest in the global resurgence of tuberculosis. In Canada, the epidemiology of tuberculosis reflects the many important challenges for tuberculosis control: an increasing proportion, now 64%, of all patients with tuberculosis in Canada are born outside Canada; there has been limited success in reducing the incidence of tuberculosis among aboriginal peoples, particularly in western Canada and the Territories; and tuberculosis-human immunodeficiency virus coinfection and drug resistance are growing problems. As a result, there has been increasing collaboration between the various tuberculosis stakeholders in the country including the provincial and territorial tuberculosis control programs, Health Canada, Citizenship and Immigration Canada and the CLA/CTS. It is altogether fitting, therefore, that the fifth edition of the Canadian Tuberculosis Standards has been coproduced by the CLA/CTS and the Division of Tuberculosis Prevention and Control at the Centre for Infectious Disease Prevention and Control, Health Canada. Some may ask, why a fifth edition of the Standards in such close succession to the fourth, published in 1996? Perhaps the best answer is the need to prepare ourselves in the new millennium to better respond to two major tuberculosis elimination initiatives: a National Tuberculosis Elimination Strategy issued by Medical Services Branch, Health Canada in 1992, with the aim of eliminating tuberculosis in First Nations peoples by the year 2010; and a National Consensus Conference on Tuberculosis, such as the one held in 1997, sponsored by Health Canada, at which there was agreement by conference participants on an interim elimination goal of a 5% reduction in the number of tuberculosis cases in Canada each year. Historically, the Canadian medical and public health communities have had a genuine interest in tuberculosis, with many notable persons and organizations having made significant regional, national and international contributions in the field. The fifth edition of the Standards draws upon a cross-section of current Canadian epidemiological, medical microbiological, respirological, infectious disease and public health expertise in tuberculosis (see appended Table of