Number Of TB Cases Research Articles

Sputum smear conversion and treatment outcomes among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia: A 9-years data analysis.

Drug-resistant tuberculosis (DR-TB) has become a public health problem throughout the world and about one-third of deaths were attributed to DR-TB from antimicrobial resistance which contributes to 10% of all TB deaths. Sub-Saharan Africa, particularly Ethiopia accounts for a significant number of TB cases. However, the scanty evidence on DR-TB contributing factors could affect the level of this deadly case tackling program. Therefore, this study aimed to assess the factors affecting sputum smear conversion and treatment outcomes among patients with DR-TB in Health facilities in Eastern Ethiopia. A cross-sectional study design was employed from 10 October to 10 November 2021, in the health facilities providing DR-TB services in Harari Region and Dire Dawa city administration. The medical records of 273 DR-TB patients from 10 January 2013 to 27 December 2021, were reviewed using structured checklists. Data were entered into Epidata 3.1 version and exported to STATA 14 version for analysis. The outcome variables were Initial Sputum conversion (converted vs. not-converted) and treatment outcome (Unfavorable vs. Favorable). Sputum examination was performed using both Acid-fast bacillus (AFB) smear microscopy and Löwenstein-Jensen (LJ) culture technique. A binary logistic regression analysis was used to assess the association of independent variables with the first month sputum smear conversion, while a conditional logistic regression model was used to assess the association of treatment outcome with explanatory variables. The associations were reported using adjusted odds ratios (AORs) at a 95% confidence interval. A total of 273 DR-TB patients were included in this study. The unfavorable DR-TB treatment outcome was significantly associated with the history of chewing khat (AOR = 4.38, 95% CI = 1.62, 11.84), having bilateral lung cavity on baseline chest X-ray (AOR = 12.08, 95% CI = 1.80, 2.57), having greater than 2+ smear result at baseline (AOR = 3.79, 95% CI = 1.35, 10.59), and poor adherence (AOR = 2.9, 95% CI = 1.28, 6.82). The sputum smear non-conversion at first month was significantly associated with being Human Immune Virus (HIV)-negative (AOR = 0.37, 0.17, 0.82), having low baseline BMI (AOR = 0.54, 95% CI = 0.29, 0.97), baseline culture > 2++ (AOR = 0.15, 95% CI = 0.05, 0.49) and having greater than 2+ sputum smear result (AOR = 0.09, 95% CI = 0.012, 0.67). Patients with normal chest X-ray at baseline had 3.8 times higher chance of sputum smear conversion on first month (AOR = 3.77, 1.11, 12.77). The overall initial sputum smear conversion and the treatment success rate among DR-TB patients were 52.75 and 66.30%, respectively. The Baseline underweight, HIV-negative, baseline smear > 2+, baseline culture > 2++, and clear lung on baseline X-ray were associated with smear conversion and history of khat chewing, bilateral lung cavity at baseline, having greater than 2+ smear results at baseline, and patients with poor treatment adherence had hostile treatment outcomes. So, strengthening and implementing nutrition assessment and patient counseling during directly observed therapies (DOTs) service and drug compliance could result in early sputum conversion and better treatment outcomes. DR-TB patients with high bacterial load and abnormal lungs on radiologic examination at baseline could need special attention during their course of treatment.

Tuberculosis infections during the COVID-19 pandemic: Comparing USA and global tuberculosis in 2019 and 2020

Background: Tuberculosis (TB) was the worldwide leading cause of mortality from a single infectious agent before the coronavirus disease 2019 (COVID-19) pandemic. The incidence of TB infections has continually declined since 2000, but the COVID-19 pandemic has reversed this trend. In 2020, global health officials reported a 21% drop in documented cases relative to TB cases in 2019. Although previous studies evaluated the impact of the COVID-19 pandemic on global TB cases, we are not aware of reports that compared U.S. and global TB cases during the COVID-19 pandemic. Objective: To analyze prepandemic and pandemic volumes of TB cases within the United States and compare findings with global TB volumes. Methods: This descriptive study used data from the Centers for Disease Control and Prevention to compare reported TB cases in the United States in 2019 and 2020. TB cases from the United States were compared with data about global TB cases. Results: The COVID-19 pandemic was associated with decreased TB testing and cases in the United States. The five states with the highest number of TB cases remained the same in 2019 and 2020, and included California, Texas, New York, Florida, and New Jersey. In these states, TB predominantly occurred in non‐U.S.-born residents and most patients solely presented with pulmonary manifestations. In the United States, the most substantial risk factor for TB was diabetes mellitus. Conclusion: The COVID-19 pandemic decreased access to TB services and discouraged patients from seeking TB care, which inadvertently disrupted international and U.S. TB surveillance systems. Given the decline in documented TB cases, leaders may need to anticipate an increase in TB cases and begin to aggressively reallocate resources to improve TB detection and care to mitigate the recent changes.

PEMODELAN KASUS TUBERKULOSIS (TB) DI NUSA TENGGARA BARAT MENGGUNAKAN MODEL REGRESI BINOMIAL NEGATIF

ABSTRACTTuberculosis is a direct infectious disease caused by bacteria (Mycobacterium tuberculosis). The number of TB cases in NTB in 2020 decreased by 16.58% from 2019. This needs to be analyzed to find out what factors influence tuberculosis so that the number of tuberculosis cases can be minimized. Data on the number of TB cases is count data, so the analysis used to model is Poisson regresi regression. In Poisson regression analysis, the phenomenon of overdispersion often occurs. If there is overdispersion, Poisson regression is not suitable for modeling the data because it will produce biased parameter estimates. One of the methods used to overcome overdispersion in Poisson regression is Negative Binomial regression. The results of the analysis show that there are four variables that are significant to the number of TB cases, namely population density (), number of health centers (), number of nursing staff (), and the percentage of households that have access to proper sanitation () with the model . The results of selecting the best model show that the Negative Binomial Regression model is better than the Poisson regression model based on the criteria for the goodness of the Deviance and AIC models.

The Condition of Mycobacterium Tuberculosis Lineages and Resistances in Indonesia

Background: Tuberculosis is a disease caused by Mycobacterium tuberculosis. Indonesia ranks second worldwide in TB incidence in the country.
 Content: The spread of the disease is happening across Indonesia. Each area of Indonesia had different types of lineage M. tuberculosis and TB incidence number. Drug resistance is threatening to society and it needs full attention and immediate medication to control the disease. Therefore, this paper is composed of reviews from 10 journals that reported drug resistance TB in several different locations in Indonesia using different methods available.
 Conclusion: The number of TB cases and their lineages differ in each area in Indonesia, one of which is due to the availability of diagnostic tools and level of self-awareness in each area. There are reported findings of drug resistance TB in Indonesia that are concerning. Currently, many TB treatments are under development to produce the best therapy to treat the disease.

Analisis Program Pengendalian Tuberkulosis dengan Strategi DOTS di Puskesmas Manutapen Kupang

Background: Tuberculosis (Tb) is a global challenge for public health problems, including Indonesia. Kupang is the city in East Nusa Tenggara (NTT) that has the highest number of Tb cases with a Success Rate (SR) about 85% in 2017. However, in 2018 the SR rate decreased to about 81%. Adherence to taking medication can have an effect on increasing the SR rate. In NTT, had many cases of withdrawal problems caused by Tb patient not taking medication regularly. The Tb control Program in NTT is based on the Directly Observed Treatment Short Course (DOTS) Strategy that focuses on case finding and cure rates. The five components of DOTS are: 1) Political commitment 2) Case finding 3) Standard treatment 4) Drug management and availability systems 5) Monitoring, recording and reporting system. The purpose of this study is to analyze the implementation of DOTS strategy in Manutapen Public Health Center (Puskesmas)Methods: This study was a descriptive qualitative method with used in-depth interviews. The main informants were three health officer participants from the Puskesmas. Triangulation informants were one participant of the Disease Control and Prevention Program of the Kupang Health Officer, one PMO participant, and one Tb patient participant.Result: Tb control with DOTS strategy encountered obstacles including a lack of political commitment related to funding new Tb cases, the high workload made the Tb officers unable to monitor the patients, and unreported cases.Conclusion: Tuberculosis control program with the DOTS strategy in Manutapen Public Health Center kupang was not optimalized.

Smoking and Tuberculosis Risk: High Attributable Risk in a Low- Incidence Environment

Objectives: To evaluate the potential impact of smoking cessation strategies on TB incidence in Victoria, Australia.
 Methods: A previously validated model of TB in migrants was adapted to concentrate on the attributable TB risk arising from smoking. This model included realistic estimates of population smoking rates, and incorporation of risk factors for TB disease such as smoking, HIV and diabetes. A baseline scenario was compared with an alternative scenario in which a hypothetical public health strategy eliminating smoking was introduced.
 Outcome measures: The primary outcome was the number of TB cases in the Australian state of Victoria in the year 2050. Secondary outcomes considered were total case burden during the period considered and the population attributable fraction of TB cases related to smoking.
 Results: Under the baseline scenario, a median of 318 cases of TB occurred in the target year of 2050, corresponding to an estimated incidence of 3.5 cases/100,000 population. The alternative scenario, where no smoking occurred, found 272 cases (2.95 cases/100,000 population) occurring in 2050; a 14.5% reduction in TB cases. Over the entire period considered, 1650 fewer cases of TB occurred in the alternative scenario, suggesting a population attributable fraction of 11.2% of TB cases from smoking in the Australian context.
 Conclusions: Smoking cessation strategies may have disproportionate benefits in TB incidence reduction. Such benefits should be considered in additional to other well-recognised population health effects from smoking reduction.

Effect of different interventions for latent tuberculosis infections in China: a model-based study

BackgroundTuberculosis (TB) has a serious impact on people’s health. China is one of 30 countries that has a high TB burden. As the currently decreasing speed of the incidence of TB, the WHO’s goal of “End TB Strategy” is hard to achieve by 2035. As a result, a SEIR model that determines the impact of different tuberculosis preventive treatments (TPTs) in different age groups, and the effect of different interventions on latent TB infections (LTBIs) in China is developed.MethodsA Susceptible-Exposed-Infectious-Recovered (SEIR) model was established. Goodness-of-fit tests were used to assess model performance. Predictive analysis was used to assess the effect of different interventions on LTBIs and achieving the goals of the “End TB Strategy”.ResultsThe Chi-square test indicated the model provided a good statistical fit to previous data on the incidence of TB (χ2 = 0.3085, p > 0.999). The 1HP treatment regimen (daily rifapentine + isoniazid for 4 weeks) was most effective in reducing the number of TB cases by 2035. The model indicated that several strategies could achieve the 2035 target of the “End TB Strategy”: completion of active case finding (ACF) for LTBI and TPT nation-wide within 5 years; completion of ACF for LTBIs and TPT within 2 years in high-incidence areas; completion of TPT in the elderly within 2 years; or introduction of a new vaccine in which the product of annual doses and vaccine efficiency in the three age groups above 14 years old reached 10.5 million.ConclusionThe incidence of TB in China declined gradually from 2005 to 2019. Implementation of ACF for LTBIs and TPT nation-wide or in areas with high incidence, in the elderly, or administration of a new and effective vaccine could greatly reduce the number of TB cases and achieve the 2035 target of the “End TB Strategy” in China.

Spatial-Temporal Epidemiology of COVID-19 Using a Geographically and Temporally Weighted Regression Model

This article describes the application of spatial statistical epidemiological modeling and its inference and applies it to COVID-19 case data, looking at it from a spatial perspective, and considering time-series data. COVID-19 cases in Indonesia are increasing and spreading in all provinces, including Kalimantan. This study uses applied mathematics and spatiotemporal analysis to determine the factors affecting the constant rise of COVID-19 cases in Kalimantan. The spatiotemporal analysis uses the Geographically Temporally Weighted Regression (GTWR) model by developing a spatial and temporal interaction distance function. The GTWR model was applied to data on positive COVID-19 cases at a scale of 56 districts/cities in Kalimantan between the period of January 2020 and August 2021. The purpose of the study was to determine the factors affecting the cumulative increase in COVID-19 cases in Kalimantan and map the spatial distribution for 56 districts/cities based on the significant predictor variables. The results of the study show that the GTWR model with the development of a spatial and temporal interaction distance function using the kernel Gaussian fixed bandwidth function is a better model compared to the Ordinary Least Squares (OLS) model. According to the significant variables, there are various factors affecting the rise in cases of COVID-19 in the region of Kalimantan, including the number of doctors, the number of TB cases, the percentage of elderly population, GRDP, and the number of hospitals. The highest factors that affect COVID-19 cases are the high number of TB cases, population density, and the lack of health services. Furthermore, an area map was produced on the basis of the significant variables affected by the rise in COVID-19 cases. The results of the study provide local governments with decision-making recommendations to overcome COVID-19-related issues in their respective regions.

Differences in Survival Rates of HIV Patients with Pulmonary TB and Extra Pulmonary TB at General Hospital Haji Adam Malik in 2015-2018

Introduction: The number of TB cases in Indonesia was increasing and it is estimated that one in five is extrapulmonary TB, is believed that there is a high mortality rate for extrapulmonary TB. Aim: To assess difference in survival rates of HIV patients with pulmonary TB and extra pulmonary TB. Results: Based on Fisher's Exact test, it was found that there was no statistical difference survival rates of HIV patients with pulmonary TB and extra-pulmonary TB at H. Adam Malik Hospital in 2015-2018 (p=0.303). The mean survival of HIV patients with extrapulmonary TB was 4.3; and pulmonary TB patients was 3.5. Overall mean survival is 4.5 years. It was concluded that HIV patients with pulmonary TB was 1.21 times more likely to die than HIV patients with extrapulmonary TB (HR: 1.21; 95% CI 0.76-1.92). Conclusion: HIV patients with pulmonary TB had a lower survival rate than HIV patients with extrapulmonary TB but it was not statistically significant. The 50% survival rate for HIV patients with extrapulmonary TB is 4.3 years and for pulmonary TB is 3.5 years Keywords: HIV, co-infection, pulmonary TB, extrapulmonary TB, survival rates

A Bayesian conditional autoregressive with INLA: A case study of tuberculosis in Java, Indonesia

Most disease risk mapping models are modeled by using the Bayesian approach. In this approach, the posterior distribution is typically estimated by using Markov Chain Monte Carlo (MCMC) method. However, it is known that the MCMC method suffers from convergence issues and requires a high demand for computational resources. This study aims to identify potential covariates in tuberculosis reduction and to map the relative risk of tuberculosis disease in the Java region by using Bayesian Conditional Autoregressive (CAR) with Integrated Nested Laplace Approximation (INLA). The posterior distribution of Bayes was estimated analytically using INLA that resulting in a more efficient, fast, and accurate inference. The results showed that Besag York Mollié (BYM) has the smallest Deviance Information Criterion (DIC) and Mean Absolute Deviance (MAD), so this model gives the best prediction. The significant covariates in reducing the number of TB cases in Java are percentages of healthy homes, household clean and healthy behavior, non-smokers, and complete tuberculosis treatment. In addition, 52.1% of districts/cities in Java were found to have a relative risk greater than one, and most of them were located in West Java.

Risk Factors of Pulmonary Tuberculosis in the Working Area of Perumnas Public Health Center Kendari City

Kendari City is the area with the highest number of TB cases in Southeast Sulawesi Province with a total of 488 cases in 2019. Preliminary data at the Perumnas Public Health Center showed that there were 49 TB cases in 2019. This study aims to determine the risk factors for the incidence of pulmonary TB in the Work Area. Public Health Center. This study uses a case control design. The study population was 105 patients, with a sample consisting of 44 case samples and 44 control samples, which were taken by simple random sampling. Data analysis using Chi Square test and Odds Ratio. From the results of the study, it was found that there were significant risk factors between smoking habits (OR = 5,156), contact history (OR = 8,333), occupancy density (OR = 2,544), knowledge (OR = 3,852) and ventilation (OR = 3,071) with the incidence of pulmonary tuberkulosis. The conclusion of this study is smoking habits, contact history, occupancy density, knowledge, and ventilation are risk factors for the incidence of pulmonary tuberkulosis at the Perumnas Public Health Center. Therefore, it is suggested to the health workers of the Puskesmas are expected to continue to provide health promotion and improve work programs related to pulmonary TB in order to increase knowledge and awareness of the community to prevent transmission of pulmonary TB.

Genetic diversity and drug susceptibility of Mycobacterium tuberculosis in a city with a high prevalence of drug resistant tuberculosis from Southeast of Mexico

BackgroundMexico is on the top five countries with the highest number of TB cases in America continent, nevertheless, information about genotypes circulating is practically unknown. Considering the above this study aims to characterize the genetic diversity of TB in the city of Veracruz, México.MethodsA cross-sectional study was conducted among positive smear samples from patients living in Veracruz City, samples were cultured, and first-line drug profiles determined. Genotyping was made by spoligotyping and MIRU-VNTR 24 loci. Associations of lineages, clusters, and variables were also analyzed.ResultsAmong the 202 isolates analyzed resistance to at least one drug was observed in 60 (30%) isolates and 41(20%) were multidrug-resistant. Three major lineages were identified: L4/Euro-American (88%), L1/Indo-Oceanic (9%), and L2/East Asian (3%). The Euro-American lineage included more than six sublineages, the most abundant were: H (32%), T (23%), LAM (18%), and X (12%). 140 isolates (70%) were placed in 42 SITs patterns.ConclusionsThese results provide the first baseline data on the genetic structure of TB in the city of Veracruz. Sublineages H, X and LAM were predominant; however, it was founded an important diversity of genotypes that could contribute to the dispersion of TB and explain the high prevalence. This information might be useful for the development of further interventions to reduce impact of TB.

Antimycobacterial activity of acetone extract and isolated metabolites from folklore medicinal lichen Usnea laevis Nyl. against drug-sensitive and multidrug-resistant tuberculosis strains

Ethnopharmacological relevanceTuberculosis (Tb) is one of the most infectious diseases caused by Mycobacterium tuberculosis (M.t) with almost 2 million deaths yearly. Although many Tb control programs have been organised, there is an elevated number of Tb cases due to the appearance of extremely drug-resistant and multidrug-resistant (MDR) Tb strains. In the cultures of Venezuelan Andes, fruticose lichen Usnea laevis Nyl. (Usneaceae) with folklore name ‘Barba de Piedra, Tusinya’ is used as a natural remedy for Tb. Aim of the studyThis study was performed to provide a scientific rationale for the folklore usage of U. laevis in treating Tb by validating its antimycobacterial activity against two drug-sensitive and four MDR-Tb strains. Materials and methodsThe mycobacterial inhibitory activities of acetone extract (Ul), fractions (F1-10), and isolated metabolites (1–4) of U. laevis were evaluated against M.t H37Ra using 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide reduction menadione assay (XRMA). Furthermore, Ul and 1–4 were subjected to antimycobacterial activity against M.t H37Ra, Mycobacterium smegmatis, and four MDR-Tb (MDR-A8, MDR-V791, MDR-R and MDR-40) strains using resazurin microtitre plate assay (REMA) and cytotoxicity against THP-1 macrophages using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and their selectivity index values were also calculated. ResultsInitially, Ul has shown prominent inhibitory activity (IC50 value: 5.44 ± 0.36 μg/ml) and four of its fractions (F1, F2, F5 and F7) also exhibited the best inhibitory activity (IC50 values ranged from 7.46 ± 0.19 to 71.38 ± 2.57 μg/ml) against M.t H37Ra using XRMA. Purification of these bioactive fractions identified four metabolites, namely usnic acid (1), atranorin (2), salazinic acid (3), and lobaric acid (4). From the MIC values of REMA, it was identified that Ul, 1 and 4 were more effective in inhibiting the growth of all four MDR-Tb strains, compared to first-line drug rifampicin. Interestingly, Ul has shown better antimycobacterial activity than 1–4 and rifampicin against MDR-Tb strains may be due to the synergistic effect of its metabolites. Also, the IC50 values of Ul and 1–4 on THP-1 macrophages were found to be far higher than MIC values against tested Tb strains, indicating that THP-1 macrophages were not harmfully affected at concentrations that were effective against Tb strains. Further, the calculated selectivity index values revealed the more active and non-toxicity of Ul, 1 and 4 against MDR-Tb strains than rifampicin. ConclusionsThe current study lends the first evidence for the presence of antimycobacterial metabolites in U. laevis. The results exposed the Andean folklore use of U. laevis for treating Tb, and the key biomarker metabolites were found to be 1 and 4. Hence, it can be concluded that U. laevis can be used as a potential source for the novel drug development for MDR-Tb.

Situation Analysis of Tuberculosis to Accelerate the Role of All Regional Stakeholders in Kendal

BACKGROUND: The prevalence of TB in Kendal Regency from 2007 to 2011 has inclined to increment. In 2007, TB prevalence was 55 per 100,000 population, and it became 121 per 100,000 population in 2011.
 AIM: The present study aims at obtaining Kendal district government policy to decrease the number of TB cases in the Kendal Regency.
 METHODS: The method of situation analysis involved secondary and primary data analysis, field survey, confirmation, cost calculation, and matriculation of various factors of multivariate analysis.
 RESULTS: There are some Problems of TB found from the Situation Analysis in Kendal Regency is related to the Topography of Kendal Regency, which is located both in the highlands and coastal areas because as an indicator of high-risk areas for TB transmission and the development of TB germs, poverty and high population at Kendal Regency result in the job scarcity, the educational background within the productive age in 2014 was low. Also, most of the people are tobacco farmers, which was included in a predisposing factor associated with some TB caused by prolonged nicotine exposure.
 CONCLUSION: Recommendations as TB Advocacy Actions relevant to the Health Office and Regional Working Unit’s action plan that can be carried out immediately is a workshop on the preparation of health service standards as promotive, preventive, curative, and rehabilitative health services; the development of equal energy or human resources standards the addition of P2M personnel, especially TB, online recording and reporting systems need to be initiated for facilitating access; counseling TB through mass media to be accessible to the community; and cross-sectoral collaboration between Community Health Center.

The Roles of Civil Society Organization and Budget Allocations in Controlling Tuberculosis in Indonesia: The Case Study of PW Aisyiyah Aceh

The number of TB cases in Aceh in 2018 reached 8471 cases; 240 (2.8%) of them occurred among children. The number of real cases in the community was estimated to be higher than that figure. The success of TB control was influenced by many factors, including the role of civil society organizations. This research was conducted to analyze the roles of civil society organizations in controlling TB cases in the community. A case study was conducted at PW Aisyiyah Aceh using an economic evaluation methodology for tracking health account funds for TB control activities (2011-2013) compared to achieving targets. The study showed that PW Aisyiyah has played a significant role in controlling TB cases in Aceh through a number of community engagement activities included the TB Care Group; the TB Community activities, High-Risk Group Outreach activities; direct TB and MDR-TB patients monitoring; and assisted and providing TB care information and networking. PW Aisyiyah Aceh has allocated Rp. 844 million per year for TB activities with an allocation for promotive/preventive activities of 22.3%. The allocation for indirect activities reached 77.5%. PW Aisyiyah Aceh has the opportunity to develop a Public-Private mix funding scheme to increase the organization roles in TB control programs in the future. PW Aisyiyah is also suggested to increase budget allocations for promotive and preventive public health activities in addition to direct curative activities which have been done so far in achieving the main mission of PW Aisyiyah as a civil society organization in Indonesia.

Analysis of Implementation of Tuberculosis Control and Prevention Program in Purwoyoso Primary Healthcare Center, Semarang City

ABSTRACTTuberculosis (TB) is one of the ten main causes of the highest mortality rate worldwide. The number of TB cases in Purwoyoso Primary Healthcare Center increased by 61 cases or up to 93 cases in 2019. The success rate of treatment performed in the primary healthcare center reached 72%, still not achieving the national target rate. This study analyzed the implementation of TB prevention and control program in Purwoyoso Primary Healthcare Center for tracking patients with TB and achieving the success rate analyzed from inputs, processes, and outputs according to the national target rate. This study used a qualitative method and a case-study approach through observation and in-depth interviews. There were 7 informants selected using purposive sampling. This study performed data collection, reduction, and verification. The results show different inputs, such as health worker layoffs, and double work load in the fieldwork, abrupt training, and absence of an evaluation, budgeting that was not focused on case tracking and report, resulted in suboptimal processes, such as suboptimal health promotion efforts, case tracking and report, as well as control of risk factors. Hence, the number of cases being reported and the success rate of treatment as the outputs would not be optimal.Keywords: Program analysis, Tuberculosis, Primary Healthcare Center

Recent epidemiological trends in extrapulmonary TB in Galicia, Spain.

OBJECTIVE: To describe the epidemiological trends and characteristics of extrapulmonary tuberculosis (EPTB) in Galicia, Spain, from 2000 to 2019.METHODS: This was a retrospective cohort study based on data from the Galician TB information system.RESULTS: Of the total number of TB cases (n = 15,871), 5,428 (34.2%) had EPTB. The absolute number of cases and incidence of EPTB decreased dramatically (from 480 cases and 17.8 cases/100,000 in 2000, to 172 and 6.4 cases/100,000 in 2019, respectively), with a mean annual decrease of respectively 64% and 4.7% for absolute cases and incidence rates. The risk for EPTB was higher in men than in women (RR 3.86, 95% CI 3.66-4.07). The most frequent age group was 15-44 years (2,234 patients, 41.2%); overall reductions per age group were 82% (0-14 years), 75% (15-44 years), 44% (45-64 years) and 63% (≥65 years), with statistically significant differences. The most frequently locations were the pleura (1,916 cases; 35.3%) and the lymph nodes (1,504; 27.7%).CONCLUSION: The incidence of EPTB in Galicia has decreased significantly in the last 20 years. The epidemiological characteristics have not changed, except for the number of patients with risk factors. This improvement of EPTB epidemiological trends coincides with the implementation of the programme for the prevention and control of TB, which suggests that it has been very effective in the control of the EPTB.

Retrospective study of pulmonary and extrapulmonary tuberculosis cases in Giza Governorate during the period of 2014\u20132018

BackgroundTuberculosis in Egypt is a main public health problem. Egypt is categorized among the mid-level incidence countries. The objective of this work is to study the epidemiology of TB in Giza Governorate during the period from 2014 to 2018.ResultsThis study revealed that the total number of TB cases in Giza Governorate during the period from 2014 to 2018 was 3357 (2035 males and 1322 females including 199 children) with the highest number of cases in 2017 (n=770 cases). The highest incidence occurred in the age group 18–65 years (86.3%%, 78.8%, 83.8%, 84.2%, and 87.1%) and male gender (56.8%, 62.8%, 59.9%, 61.3%, and 61.5%) during the study period, respectively, and in urban residence, the higher percentage occurred in PTB than EPTB in 2014, 2015, 2016, and 2018 (66.2%, 58.9%, 57.3%, and 55.5%), respectively, while the incidence of the extra PTB was higher than PTB in 2017 (51.6% versus 48.4%). The increased incidence of new cases (92.9%, 89.6%, 92.7%, 91.8%, and 92.9%) during the 5 studied years are smear-positive and cure outcome (86.3%, 87.7%, 88.7%, 83.4%, and 83.4%, respectively)ConclusionYoung, middle-aged male, and new smear-positive cases were highest in percentage. The highest percentage of PTB (66.2%) was registered in 2014, and the highest percentage of EPTB (51.6%) was registered in 2017. The increased percentage of cure outcome was during the period from 2014 to 2018 in Giza Governorate.

Treatment outcomes and predictive factors for multidrug-resistant TB and HIV coinfection in Rio de Janeiro State, Brazil.

BACKGROUND: Brazil ranks 14th worldwide in the number of TB cases and 19th in terms of TB-HIV co-infected cases. This study aims at identifying clinical and demographic factors associated with unsuccessful treatment outcomes (loss to follow-up, treatment failure and death) of HIV-positive patients with multidrug-resistant TB (MDR-TB) in Rio de Janeiro State, Brazil.METHODS: This was a retrospective cohort study of MDR-TB cases notified from 2000 to 2016 in RJ. Cox proportional hazard regression models were used to assess risk factors associated with unsuccessful treatment in HIV-positive patients with MDR-TB.RESULTS: Among 2,269 patients, 156 (6.9%) were HIV-positive and had a higher proportion of unsuccessful treatment outcomes (52.6%) than HIV-negative cases (43.7%). All HIV-positive cases with extensively drug-resistant TB (XDR-TB) had unsuccessful treatment outcomes. Multivariate analysis shows that previous MDR-TB treatment (HR 1.97, 95% CI 1.22-3.18) and illicit drugs use (HR 1.68, 95% CI 1.01-2.78) were associated with a greater hazard of unsuccessful treatment outcomes, while 6-month culture conversion (HR 0.48, 95% CI 0.27-0.84) and use of antiretroviral therapy (ART) (HR 0.51, 95% CI 0.32-0.80) were predictors of reduced risk.CONCLUSIONS: Unsuccessful treatment was higher among HIV patients with MDR-TB than among HIV-negative patients. Prompt initiation of ART and effective interventions are necessary to improve treatment adherence and prevent retreatment cases.

Implementasi Program Penanggulangan TB Paru dengan Strategi Directly Observed Treatment Shortcourse di Puskesmas Panyabungan Jae Kabupaten Mandailing Natal

TB cases in Southeast Asia contribute 40% of the world's TB cases and causes the highest mortality in Indonesia. Panyabungan Jae Health Center (PJHC) itself has the highest number of TB cases in Mandailing Natal Regency. This study, therefore, aimed to determine the implementation of the TB Control Program with the Directly Observed Treatment Shortcourse Strategy (DOTS) at PJHC.Qualitative methods with descriptive approach was used for this research. In-depth interviews was conducted with 5 informants in July 2020. The data were analyzed using data reduction, data presentation, and conclusion drawing.The research found that communication between the TB program officer and the DOTS strategy worked well in the PJHC as well as the disposition, resources and bureaucratic structures. Political commitment in the DOTS strategy with cross-sectoral cooperation has an important influence in the handling of TB cases,however village authorities have not played a role in efforts to reduce for number of TB cases. The patients had lack of understanding about TB and some localshad views TB as a disease caused by poison becomes an obstacle in treating patients. TB prevention with the DOTS strategy at the PJHC runs according to standard guidelines, and complemented by the Puskesmas innovation "Tor Tor Libas TB".The MNDHO officersare advised to collaborate with entire stakeholders in overcoming TB by strengthening education in the form of routine counseling to increase public knowledge about TB