Positive Pulmonary Tuberculosis Research Articles

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity

Background Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

Prevalence of latent TB infection among childhood contacts of adults with sputum positive pulmonary TB

BackgroundTuberculosis is a global public health challenge. More stringent activities are needed for evaluation of ongoing TB transmission. The study was aimed at estimating the prevalence of LTBI in children below 15 years who are household contacts of adults with sputum positive pulmonary TB and identify the determinants involved in TB transmission. The compliance and incidence of adverse events were also studied. MethodologyAn observational study was conducted among 194 children below 15 years who were in contact with 145 adults with smear positive pulmonary TB. All children below 5 years underwent TST and were offered LTBI chemoprophylaxis as per NTEP program while IGRA was used to diagnose LTBI in children above 5 years. A structured questionnaire was used to collect data on determinants of TB transmission. Children were followed up during the LTBI treatment period for assessing compliance and the adverse effects. ResultsThe prevalence of LTBI among the study participants was 15.4 %. Children who received LTBI treatment showed good acceptance with a drug compliance of 98.5 % and only 21 % showed adverse events, all of which were minor. Malnutrition (p value-0.03), overcrowding (P value = 0.014) and exposure to tobacco smoke (p value = 0.000) were identified as the socio-demographic determinants affecting TB transmission. ConclusionChildren below 15 years are at high risk of contracting TB from household adult contacts. Overcrowding, malnutrition and exposure to tobacco smoke being the determinants of TB transmission, screening programmes should prioritise children exposed to such situations, especially in resource limited settings like India.

Diagnostic accuracy of high resolution computed tomography (HRCT) of chest in diagnosing sputum smear positive and sputum smear negative pulmonary tuberculosis (PTB).

Objective: To assess the diagnostic accuracy of high resolution computed tomography (HRCT) of chest in diagnosing sputum smear positive and negative pulmonary tuberculosis (PTB). Study Design: Cross-sectional study. Setting: Tertiary Care Hospital, Kharian Cantt. Period: Oct 2021 to April 2022. Methods: The retrospective reviews of medical records of patients undergone HRCT chest and sputum for AFB smear and culture due to pulmonary tuberculosis (PTB) suspicion were included. The HRCT and AFB findings for sample size of 220 was compared. SPSS was used to stratify outcomes on basis of sputum smear results. Diagnostic accuracy of HRCT chest was calculated by taking AFB as gold standard. The AFB findings and HRCT outcomes were compared through correlation analysis and paired t-test with p value < 0.05 considered as significant. Results: The sensitivity was found to be 86.23% with specificity of 86.48%, positive predictive value of 86.23%, negative predictive value of 86.48% and diagnostic accuracy of 86.36% for HRCT for diagnosing pulmonary tuberculosis (PTB). Conclusion: HRCT chest affirms high diagnostic potential for pulmonary tuberculosis (PTB) and should be used as a routine diagnostic tool for the disease.

Spatial-temporal distribution characteristics of etiologically positive pulmonary tuberculosis in Jiangsu Province from 2011 to 2021

Objective: To analyze the spatial-temporal distribution of etiologically positive pulmonary tuberculosis (PTB) at the county (city, district) unit in Jiangsu Province from 2011 to 2021 to provide evidence for the implementation and adjustment of prevention and control strategies of PTB in Jiangsu Province. Methods: The registration data of etiologically positive PTB patients in Jiangsu Province from 2011 to 2021 were collected from the Tuberculosis Management Information System in the China Information System of Disease Control and Prevention. Data on the permanent population were from the statistical yearbook of each county (city, district) in Jiangsu Province. Geoda 1.18.0 software was used to analyze the global and local spatial autocorrelation and explore the spatial clustering. SaTScan 10.1 software was used to analyze the spatial-temporal clusters, and ArcGIS 10.7 software was used to visualize the spatial-temporal clusters. Results: A total of 128 240 etiological positive PTB cases were registered in Jiangsu Province from 2011 to 2021, with an average annual registration rate of 13.99/100 000. The registration rate showed an overall upward trend (trend χ2=63.49, P<0.001) after 2017, and the etiologically positive rate showed an overall upward trend (trend χ2=3 710.86, P<0.001). The annual Moran's I values ranged from 0.107 to 0.343, which showed a spatial clustering distribution. The results of local spatial autocorrelation analysis showed that there were "high-high" clustering areas in Jiangsu Province each year, showing a dynamic distribution, and most of the areas were distributed in the central and southern regions of Jiangsu Province, with the largest number (7) in 2015 and the smallest number (1) in 2011. A total of 4 spatial-temporal clustering areas were explored by spatial-temporal scanning analysis (all P<0.001), among which the first-level clustering area covered 3 counties (cities, districts), namely Changshu, Taicang, and Xiangcheng District of Suzhou, and the clustering time was from 2011 to 2015. The secondary clustering areas covered 24 counties (cities, districts), mainly covering Jiangsu's central and northern regions, such as Huai'an, Suqian, and Yancheng. The third-level clustering areas covered 26 counties (cities, districts); the fourth-level clustering area was the Gaochun District of Nanjing, with the clustering period from 2017 to 2021. Conclusions: From 2011 to 2021, the etiologically positive PTB registration rate at the county (city, district) level in Jiangsu Province had obvious spatial-temporal clustering characteristics. The clustering areas included the northern areas with relatively backward economies and the southern areas with better economic development. Multiple measures should be taken to prevent and control PTB according to the specific situation in different regions.

Risk factors and treatment outcome of smear positive pulmonary tuberculosis patients: A five-year study in the North of Iran.

It is essential to constantly review the risk factors and treatment outcomes of tuberculosis (TB). This study evaluated some important risk factors of TB over five years. Between 2013 and 2018, all available information and possible risk factors related to TB patients were analyzed from the TB registry program of the health district of Gorgan, Iran. Among 349 TB patients, 194 (55.59%) were males and 167 (47.85%) had at least a comorbidity. The death rate was higher in the age group more than 65 years (p < 0.001), the low-educated group (P = 0.012), and patients with underlying diseases, especially diabetes (p < 0.001). In total, univariate and multivariate statistical analyzes showed that having comorbidity (OR = 4.34; 95% CI 1.49 - 13.49), as well as, being jobless (OR = 3.07; 95% CI 1.19 - 8.59) were the main factors influencing the adverse events. According to the study, aging, underlying diseases, and cultural poverty include a higher share of the main risk factors for active TB and/or treatment outcomes. By considering these risk factors and training the medical staff continually, we can reduce the time of TB diagnosis, and prevent it from spreading.

Risk factors of treatment interruptions among drug-sensitive and drug-resistant pulmonary tuberculosis patients - A study from South Delhi, New Delhi, India

BackgroundA variety of factors influence adherence to the lengthy duration of anti-tuberculosis treatment, making it a complicated and dynamic problem. The objective of this study was to investigate the treatment interruption patterns using pre-defined criteria among a cohort of pulmonary tuberculosis patients and to elicit the associated factors. MethodsThis prospective, observational study was conducted between October 2016 to May 2018. All smear and culture positive pulmonary tuberculosis patients (age ≥ 14 years) enrolled between October 1, 2016 to March 31, 2017 across 3 Designated Microscopy Centers (DMCs) were included and followed up till end of treatment for outcome in drug-sensitive, and till interim outcome at 6 months for drug-resistant TB patients. Patterns and reasons for interruptions were recorded as per the study protocol. Results171 patients were enrolled in this study, of which 135 (78.94 %) were on Category-I and Category-II treatment (drug-sensitive tuberculosis), 23 (13 %) were multidrug-resistant (MDR) and 13 (8 %) were extensively drug resistant (XDR) tuberculosis patients. Among the drug-sensitive group, 65 (48 %) patients completed their treatment without any interruption while 70 (52 %) patients interrupted with at least one missed dose. Among the 36 MDR/XDR patients, 19 (53 %) patients did not interrupt treatment, but 17 (47 %) patients interrupted with at least one missing dose. The 87 patients in both sub-groups interrupted for 232 times/episodes of which 140 were short and 84 were long interruptions. The main reasons for interruption were found to be busy schedule in 63 (29 %) patients, adverse drug reactions in 40 (18.4 %) and comorbidities in 43 (19.8 %) patients. Feeling of early improvement/no improvement in 23 (10.5 %) patients, addictions in 27 (12.4 %) patients, lack of family support in 14 (6.4 %), unawareness of dosage and duration of treatment in 7 (3.20 %) patients were other common reasons. ConclusionThe plurality of patients studied were found to be in the younger age group i.e., 14–25 years (n = 75), constituting nearly 44 % of all the patients included and male treatment interrupters (62 %) outnumbered the females (38 %), possibly owing to work schedule or addictions. The majority of interruptions were related to patient related factors (93.5 %), followed by DOTS provided factors (6.40 %) and system related factors (3.01 %). Further studies should be conducted to classify the factors of treatment interruptions in detail and also to study the impact of these interruptions’ patterns on final outcomes.

Burden of type 2 diabetes among pulmonary and extra pulmonary tuberculosis patients diagnosed in a tertiary care institute in Puducherry

Background: Most often diabetes and tuberculosis present together and complicate each other at many levels. Studies show people with diabetes were at three times higher risk of developing tuberculosis. Study done in Kerala have reported that the prevalence of diabetes is higher among males and among smear positive pulmonary tuberculosis cases. Objective was to measure the burden of type 2 diabetes mellitus among pulmonary and extra pulmonary tuberculosis patients diagnosed in a tertiary care institute in Puducherry. Methods: Data was obtained from National tuberculosis elimination programme (NTEP) referral register of Pondicherry Institute of Medical Science. All the patients who have diagnosed to have tuberculosis from January 2022 to July 2022 were included. Diabetic status among pulmonary and extrapulmonary tuberculosis patients was also collected. Results: Among the patients with tuberculosis, 67% of patients were males. A total of 38.8% of cases were found to have diabetes and out of these cases, 23.8% of patients were known case of diabetes and 16.4%of cases were patients with newly diagnosed diabetes. It is observed that, among patients with pulmonary tuberculosis, 32.8% of cases and among patients with extrapulmonary tuberculosis 5.9% of cases were found to have diabetes. Conclusions: The present study showed that burden of type 2 diabetes mellitus was more among pulmonary tuberculosis.

Education of TB Cadres About Health Promotion of The Lung TB Program Using Vidio and Digital Liefate Media

Background: TB is the main cause of death by infectious agents and is one of the 10 causes of death from all diseases . Indonesia is currently in third place in contributing to tuberculosis cases in the world after India and China. Every year there are 582,000 new cases, of which 259,970 are BTA positive pulmonary tuberculosis. The number of TB patient discoveries in Indonesia in the last 5 years has fluctuated, recorded in 2017 at 446,732, in 2018 it increased to 570,289 and in 2019 it was 543,874, in 2020 there were 393,323 cases and in 2021 it decreased to 385,295 cases . with a Case Detection Rate (CDR) figure of 47%. Jambi Province's TB program achievement nationally is in the bottom 31st place, namely 26% (Jambi Health Office, 2022)&#x0D; Method: This research is a type of quantitative research using a pre-experimental design method, type one group pretest-posttest design, which is a research activity that provides an initial test (pretest) before being given treatment, after being given treatment, then giving a final test (posttest). This research was carried out on 50 cadres in the working area of the Putri Ayu Community Health Center, Jambi City.&#x0D; Result: The average knowledge score before training was 57.4 and after training it increased to 75.2 . The results of educational activities for cadres in the working area of the P Utri Ayu Community Health Center show a level of success with indications of a positive response from cadres by showing increased knowledge through pre and posttest methods during training . From the results of the pretest and posttest through the T-test measurement for paired samples, a significance value or p value of 0.000 (p &lt; 0.005) was obtained.&#x0D; Conclusion: there is a significant difference between the knowledge scores of health cadres before and after participating in the training

Prevalence of Diabetes Mellitus Among Newly Detected Sputum Positive Pulmonary Tuberculosis Patients and Associated Risk Factors

Background and Objectives: Tuberculosis (TB) and Diabetes Mellitus (DM) co-morbidity are of rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum-positive pulmonary TB patients registered in the District Tuberculosis Centre and also to assess the risk factors of DM among TB patients. Methods: In a cross-sectional study newly detected sputum-positive pulmonary TB patients were screened for DM (those having symptoms of DM). Further, they were diagnosed by doing random blood glucose levels (≥200 mg/dl.). Mean, standard deviation (SD), Chi-square and Freeman-Halton Fisher exact test were used to know the significant association. p value less than 0.05 was considered statistically significant. Results: A total of 215 TB patients were included in the study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (&gt;46 years), educational status, smoking habits, alcohol consumption, physical activity, presence of symptoms of DM and family H/o DM. Interpretation and Conclusion:Routine screening for DM is mandatory because of the increasing prevalence which may help in early diagnosis and also reduce the complication by proper management which in turn helps in the successful outcome of TB treatment.

Impact of human immunodeficiency virus on category I pulmonary tuberculosis cases in a tertiary care hospital: a case control study

Background: Tuberculosis (TB) is an opportunistic infection (OI). OIs are infections that occur more often or are more severe in people with weakened immune systems than in people with healthy immune systems. Human immunodeficiency virus (HIV) weakens the immune system, increasing the risk of TB in people with HIV. This case control study was done to assess the impact of HIV on clinical aspects and treatment outcome of newly diagnosed bacteriologically positive pulmonary tuberculosis. Methods: This study was done among unmatched 75 cases and 75 controls who were pulmonary TB and TBHIV co-infected patients. Data were collected using a pretested, structured, interviewer-administered questionnaire and was analyzed using descriptive and analytical statistics. Results: Total 150 patients were enrolled in the study out of which 75 patients had HIV-TB co-infection while remaining 75 patients were diagnosed as pulmonary TB. Treatment success rates are 74.7 % (56/75) for TB-HIV co-infected patients and 82.7% (62/75) for pulmonary TB patients. TB-HIV co-infected patients had a higher risk of an unsuccessful treatment outcome [(p = 0.232) with OR and 95% CI of 0.68 (0.28-1.36)]. The risk of unsuccessful treatment outcome was associated with family history of TB, Tobacco use, low BMI. Conclusions: TB treatment success rate is good as compared to the WHO minimum requirement. Successful treatment outcome is lower among patients with HIV infection, tobacco use, low BMI, &lt;200 /mm3 CD4 count patients. Therefore, due emphasis should be given to these high-risk groups.

Treatment Outcome Monitoring by Using Sputum Conversion Rate of Tuberculosis Patients in Pkd Kinta, Malaysia

Introduction: A control programme termed Directly Observed Treatment Short-Course (DOTS) is adopted to promote early TB detection and effective TB treatment. An indicator of a successful DOTS programme is the Sputum Conversion Rate (SCR) which is obtained at the end of the two-month intensive treatment to measure the treatment outcome by SCR. The present study determined the association between several factors and the SCR among TB patients attending the DOTS clinic at the Kinta District Health Office (PKD Kinta) in 2017. Methods: The factors included are sociodemographic factors, physical factors, knowledge, attitude, and practice of TB patients. All groups of 150 sputum smear positive pulmonary TB patients enrolled for treatment at PKD Kinta between January and September 2017 were recruited for this study by the cross-sectional questionnaire method. A statistical analysis was performed to determine the association between the variables and the SCR of the TB patients in the DOTS programme. Results: At the end of the two-month intensive period, an SCR of 96.0% was obtained. According to the statistical analysis of the association among sociodemographic factors and SCR, there are no statistical differences between the variables. Similarly, no association was found between the physical characteristics and SCR in the current study. Conclusion: SCR methods are perfect methods used in regular medicine to monitor TB cases’ treatment. The identification of factors influencing the DOTS programme is critical to ensuring the program’s success in eradicating TB in society.

Prevalence and incidence of symptomatic pulmonary tuberculosis based on repeated population screening in a district in Ethiopia: a prospective cohort study

ObjectiveIn Ethiopia, one-third of the estimated tuberculosis cases are not detected or reported. Incidence estimates are inaccurate and rarely measured directly. Assessing the ‘real’ incidence under programme conditions is useful...

Socio Clinical Profile of MDR TB Cases: A Study at DR –TB Center, SCB Medical College &amp; Hospital

Introduction India accounts for about one-fourth of the global burden of MDR-TB. This study aims to evaluate clinical profile and factors associated with tuberculosis drug resistance among patients from eastern India. Method All the MDR-TB cases registered under RNTCP PMDT services were included in the study between 1st April-2013 to 31st March 2014. This observational study was carried out by the Department of Pulmonary Medicine, SCB Medical College, Cuttack. Result Between April 2013 and March 2014, the IRL ATDC Center collected a total of 2205 sputum samples. Out of 2205, 245 (11%) had both INH and Rifampicin, 68 (3%), INH resistance, 359 (16.3%), and 51 (2.3%) had sputum contaminated with report awaiting. Mean age MDR TB was 35.6 (Standard deviation 13.769). The study shows 14.3% of the TB patients were illiterate. Out of 126 cases of MDR-TB presented with 140 co- morbidities at DR-TB Center. Discussion High rate of drug resistance pattern was found among the new sputum smear positive pulmonary tuberculosis patients and also high MDR tuberculosis. Risk factors such as age, sex, smoking, and alcoholism were independently associated with pulmonary MDR-TB. Our study concluded that young age, male sex, smear positivity, treatment failure, and the combination of smoking and alcoholism were identified as risk factors for Tuberculosis mortality.

Use of standardised patients to assess tuberculosis case management by private pharmacies in Patna, India: A repeat cross-sectional study.

As the first point of care for many healthcare seekers, private pharmacies play an important role in tuberculosis (TB) care. However, previous studies in India have showed that private pharmacies commonly dispense symptomatic treatments and broad-spectrum antibiotics over-the-counter (OTC), rather than referring patients for TB testing. Such inappropriate management by pharmacies can delaye TB diagnosis. We assessed medical advice and OTC drug dispensing practices of pharmacists for standardized patients presenting with classic symptoms of pulmonary TB (case 1) and for those with sputum smear positive pulmonary TB (case 2), and examined how practices have changed over time in an urban Indian site. We examined how and whether private pharmacies improved practices for TB in 2019 compared to a baseline study conducted in 2015 in the city of Patna, using the same survey sampling techniques and study staff. The proportion of patient-pharmacist interactions that resulted in correct or ideal management, as well as the proportion of interactions resulting in antibiotic, quinolone, and corticosteroid are presented, with standard errors clustered at the provider level. To assess the difference in case management and the use of drugs across the two cases by round, a difference in difference (DiD) model was employed. A total of 936 SP interactions were completed over both rounds of survey. Our results indicate that across both rounds of data collection, 331 of 936 (35%; 95% CI: 32-38%) of interactions were correctly managed. At baseline, 215 of 500 (43%; 95% CI: 39-47%) of interactions were correctly managed whereas 116 of 436 (27%; 95% CI: 23-31%) were correctly managed in the second round of data collection. Ideal management, where in addition to a referral, patients were not prescribed any potentially harmful medications, was seen in 275 of 936 (29%; 95% CI: 27-32%) of interactions overall, with 194 of 500 (39%; 95% CI: 35-43%) of interactions at baseline and 81 of 436 (19%; 95% CI: 15-22%) in round 2. No private pharmacy dispensed anti-TB medications without a prescription. On average, the difference in correct case management between case 1 vs. case 2 dropped by 20 percent points from baseline to the second round of data collection. Similarly, ideal case management decreased by 26 percentage points between rounds. This is in contrast with the dispensation of medicines, which had the opposite effect between rounds; the difference in dispensation of quinolones between case 1 and case 2 increased by 14 percentage points, as did corticosteroids by 9 percentage points, antibiotics by 25 percentage points and medicines generally by 30 percentage points. Our standardised patient study provides valuable insights into how private pharmacies in an Indian city changed their management of patients with TB symptoms or with confirmed TB over a 5-year period. We saw that overall, private pharmacy performance has weakened over time. However, no OTC dispensation of anti-TB medications occurred in either survey round. As the first point of contact for many care seekers, continued and sustained efforts to engage with Indian private pharmacies should be prioritized.

Role of Serum CA 125 Level in the Diagnosis of Pulmonary Tuberculosis

Background: Pulmonary tuberculosis (PTB) persists as a great public health problem in Bangladesh. Although many diagnostic tools are invented but the diagnosis continues to rely on smear microscopy, culture and chest radiography. Other non-conventional approaches include detection of immunological response and the search for biochemical markers. Cancer Antigen 125 (CA-125) was considered a promising one and have been reported in few instances. Methods: This study was a hospital based cross-sectional analytical study conducted at department of Medicine in Rangpur Medical college Hospital, Bangladesh for 24-months following approval of the protocol. Total 100 people with pulmonary tuberculosis either smear positive or smear negative gene X pert positive were selected and analysed in this study. Written informed consent were taken from all subjects. After taking written consent from each patient, detailed clinical history, physical examination and relevant investigations including serum CA 125 level were done for every patient. Reflection of CA 125 positivity were calculated on the basis of smear positive and smear negative gene X pert MTB/RIF positive pulmonary tuberculosis. Collected data were noted down in separate case record form. After removing consistency and compilation, final data analysis was done in the statistical program Statistical Package for Social Science (SPSS) version 23.0.P-value of &lt;0.05 was considered to indicate statistical significance. Results: Of total 100 patients, mean age was 36.68 ± 12.57 SD (years) with slight male predominance with Male female ratio was 2.13:1. Overall elevated CA-125 was found in 88% cases with mean value 90.82 ± 74.28 IU/mL. Mean level of CA- 125 among sputum smear positive cases 74.69±49.51 IU/mL (37-153 IU/mL). Among 50 smear negative gene Xpert positive cases, 24% had serum CA-125 level &lt;35 IU/mL (19.73±11.86 IU/mL) and rest 76% had e”35 IU/mL (134.51±86.74 IU/mL). Smear negative &amp; gene Xpert positive cases has statistically significant higher level of CA-125 cases in comparison to smear positive cases (P-value &lt;0.05). Conclusion: More than two thirds of the pulmonary tuberculosis patients had higher level CA-125 and smear negative-Xpert positive cases had significantly higher level than smear positive cases. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 206

Tuberculous Meningitis in Male Child and Cavitary Pulmonary Tuberculosis in Mother: Concurrent Familial Infective Disease as Evidence of Recent Transmission from Mother to Baby!

Tuberculosis (TB) is one of the leading causes of mortality in children worldwide, but there remain significant challenges in diagnosing and treating TB infection and disease. Tuberculous (TB) meningitis is the commonest infectious disease of the central nervous system in paediatric and geriatric cases. Childhood TB is an indication of failing TB control in the community. It allows disease persistence in the population. Tuberculosis can be prevented in children by diagnosing and treating cases of active TB amongst adults, as paediatric cases always acquire it passively from household contact of adults suffering from TB as disease in adults is multibacillary. Although significant data is available for the prevention of childhood extra-pulmonary and disseminated TB, offering Bacillus Calmette-Guerin (BCG) vaccination, it is still not routinely offered during vaccination. In this case report, a two-year child with a history of failure to thrive and constitutional symptoms diagnosed with disseminated extra-pulmonary TB presenting as TB meningitis with a history of contact with the mother suffering from active sputum positive pulmonary TB receiving anti-TB treatment. Child was evaluated with CT brain plain and contrast and documented meningeal enhancement. Cerebrospinal fluid analysis revealed tuberculous etiology in presence of lymphocytic predominance and raised ADA level in fluid. CSF fluid sent for cartridge based nucleic acid amplification test documented MTB genome with rifampicin sensitivity. We retrospectively analysed mothers’ sputum examination and observed higher grades of sputum AFB and her cartridge based nucleic acid amplification test revealed MTB genome with rifampicin sensitivity. Child and mother were treated with standard protocol recommended by NTEP (National Tuberculosis elimination program). In conclusion, we recommend BCG vaccination to all newborns, and tuberculin skin testing and isoniazid prophylaxis to the contact of adults with sputum positive pulmonary TB cases in India to prevent transmission of disease from mother to baby. A high index of suspicion is must while evaluating these cases and all possible measures should be taken to confirm tuberculosis to have successful treatment outcome.

WITHDRAWN: Prevalence of Diabetes Mellitus among Newly Detected Sputum Positive Pulmonary Tuberculosis Patients and Associated Risk Factors: A Cross-sectional Study

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Scale-Up of Rifapentine and Isoniazid for Tuberculosis Prevention Among Household Contacts in 2 Urban Centers: An Effectiveness Assessment.

Scaling up a shorter preventive regimen such as weekly isoniazid and rifapentine (3HP) for 3 months is a priority for tuberculosis (TB) preventive treatment (TPT). However, there are limited data on 3HP acceptability and completion from high-burden-TB countries. We scaled up 3HP from 2018 to 2021 in 2 cities in Pakistan. Eligible participants were household contacts of persons diagnosed with TB disease. Participants were prescribed 3HP after ruling out TB disease. Treatment was self-administered. We analyzed the proportion who completed 3HP. In Karachi, we verbally screened 22 054 household contacts of all ages. Of these, 83% were clinically evaluated and 3% were diagnosed with TB. Of household contacts without TB disease, 59% initiated the 3HP regimen, of which 69% completed treatment. In Peshawar, we verbally screened 6389 household contacts of all ages. We evaluated 95% of household contacts, of whom 2% were diagnosed with TB disease. Among those without TB disease, 65% initiated 3HP, of which 93% completed. Factors associated with higher 3HP completion included residence in Peshawar (risk ratio [RR], 1.35 [95% confidence interval {CI}: 1.32-1.37]), index patient being a male (RR, 1.03 [95% CI: 1.01-1.05]), and index patient with extrapulmonary TB compared to bacteriologically positive pulmonary TB (RR, 1.10 [95% CI: 1.06-1.14]). The age of the index patient was inversely associated with completion. We observed a high level of acceptance and completion of 3HP in programs implemented in 2 cities in Pakistan, with differences observed across the cities. These findings suggest that 3HP can be effectively scaled up in urban settings to improve the reach and impact of TPT.

Screening of Pulmonary Tuberculosis in Household Contacts With Acid Fast Bacteria (AFB) Positive Pulmonary Tuberculosis Patients in Ciwangi Village, Balubur Limbangan Subdistrict, Garut District

Background &amp; Objective Tuberculosis is an infectious disease caused by acid-fast bacteria, namely Mycobacterium tuberculosis, which mainly attacks the lungs. Pulmonary tuberculosis is a global health problem with the second deadliest case after HIV/AIDS infection, and ranks third with the most TB cases after India and China. The main source of transmission is patients with active TB pulmonary tuberculosis who can transmit to people around them. This study aims to determine whether pulmonary TB transmission occurs in people who are in household contact with patients with acid-fast bacteria pulmonary TB active. Method This study is descriptive, using the Ziehl neelsen examination method, with a total sampling technique, conducted on 34 people who are in household contact with pulmonary TB patients in Ciwangi Village, Balubur District, Limbangan. Result Based on the examination results in people who are in contact with people with TB, the results are negative, the presence of the bacteria that cause TB. Conclusion The results of Pulmonary Tuberculosis screening conducted on 34 people from 13 heads of families, it can be concluded that the results of TB microscopy with the Ziehl neelsen technique were negative.

Development of a new cellular immunological detection method for tuberculosis based on HupB protein induced IL-6 release test.

As a virulence factor, HupB plays important roles in the survival of MTB after infection and modulates the host immune response. In the current study, we aim to explore a new cellular immunological detection method for tuberculosis infection detection based on HupB protein. HupB was used to stimulate PBMCs extracted from pulmonary tuberculosis (PTB) patients, and secreted cytokines was examined. Then, we constructed a single center and a multi-center clinical trials to collect PBMCs from PTB patients, nPTB patients, or healthy volunteers to verify our findings. Cytokine's screening illustrated that IL-6 was the only cytokine released after HupB stimulation. Single-center and multi-center clinical trials showed that HupB stimulation significantly increased the level of IL-6 in the supernatant of PBMCs from PTB patients. Then we compared the specificity and sensitivity of HupB induced IL-6 release assay with ESAT-6 and CFP10 induced interferon γ release assay (IGRA), and found in smear positive PTB patients, the specificity and sensitivity of HupB induced IL-6 release assay was better than IGRA, and in smear negative PTB patients, the sensitivity was better. Combination of both assays provided an improved specificity and sensitivity for tuberculosis diagnosis. This study explored an immunological detection method for tuberculosis infection cells based on HupB protein-induced IL-6 release test, which can be used to enhance the diagnosis diagnostic accuracy of TB.