Prevalence Of TB Research Articles

Genotypic and phenotypic diversity of Mycobacterium tuberculosis strains from eastern India.

Whole genome sequencing has been used to investigate the genomic diversity of M. tuberculosis in the northern and southern states of India, but information about the eastern part of the country is still limited. Through a sequencing-based strategy, this study seeks to comprehend the diversity and drug resistance pattern in the eastern region. A total of 102 M. tuberculosis isolates from North East (n = 54), and Odisha (n = 48) were sequenced along with 7 follow up isolates from Sikkim. The pre-XDR and XDR isolates diagnosed as per the NTEP diagnostic algorithm were subjected for phenotypic second-line liquid culture drug susceptibility testing in MGIT-960 system. After filtering out low quality isolates based on taxonomic classification and depth of coverage, variant calling was performed. We observed a high prevalence of multi-drug resistant TB (MDR-TB) lineage 2 (52/54) isolates in northeast whereas there was a mixed representation of lineage 1 (30/48) & lineage 3 (11/48) in Odisha. The MDR-TB isolates from Sikkim posed a high rate (51/53) of fluoroquinolone resistance and pairwise SNV distances (≤10) indicating possible local transmission events in the region. We observed occurrence of genetic variations in genes associated with bedaquiline and delamanid resistance. Our findings show the diversity of M. tuberculosis vary across the eastern regions, in north eastern states lineage 2 has a dominant presence while lineage 1 and 3 has mixed representation in Odisha. The high prevalence of fluoroquinolone resistance in north eastern region associated with variations in gyrA gene and may have been caused by local transmission events based on genomic similarities.

Wealth-based inequalities in tuberculosis prevalence among households having children and young adults in India: insights from Indian demographic and health surveys (2015–2021)

BackgroundTuberculosis (TB) remains a significant health concern in India, especially among households with children and young adolescents aged 6–17 years. Despite ongoing research, there is a knowledge gap regarding specific risk factors for TB within this demographic. This study aims to bridge this gap by examining the association between TB and various socio-demographic factors, including socioeconomic status, nutritional status, and environmental conditions.Data and methodsUtilizing data from the National Family Health Survey (NFHS) 4th and 5th round (2015-16 and 2019-21), this study conducted a comprehensive cross-sectional analysis. Unadjusted and Adjusted Logistic regression is utilized to identify key factors influencing TB. Furthermore, Wagstaff decomposition analysis is applied, to quantifying the factors that contributes to the inequalities in social determinants on the wealth-related inequality observed in the prevalence of TB.ResultsThe study observed a notable decline in TB prevalence from 1.7 to 1.2% among individuals from households having children and young adolescents aged 6–17 years. Additionally, factors like the use of unclean cooking fuel, lack of electricity, and unimproved toilet facilities were associated with increased TB prevalence. Wealth-based inequality in TB prevalence was also evident, with the burden falling disproportionately on poorer households. Unclean fuel is the most significant determinant of wealth-based inequality in TB, contributing to nearly 2/5th (18.5% in NFHS-4) of the observed inequality. Notably, gender did not significantly influence TB prevalence.ConclusionThe decline in TB prevalence in India correlates with improvements in socio-economic and living conditions, as evidenced by increased access to better housing, clean fuel, and sanitation facilities. The study underscores the need for integrated public health strategies that address both medical and socio-environmental determinants of TB. Improving socio-economic conditions, alongside targeted healthcare interventions, appears vital in reducing the TB burden in high-prevalence settings like India. This research emphasizes the importance of comprehensive approaches to combat pediatric TB, combining clinical care with enhancements in living standards and access to basic amenities.

Latent tuberculosis prevalence in healthcare workers in Laos: a cross-sectional study

BackgroundIndividuals with latent tuberculosis infection (LTBI) have a high risk of active infection, morbidity and mortality. Healthcare workers are a group who have increased risk of infection and onward transmission to their patients and other susceptible individuals; however, LTBI is often undiagnosed, and individuals are asymptomatic. Interferon gamma release assays (IGRA) can detect evidence of TB infection in otherwise asymptomatic individuals and are a good indication of LTBI. Laos, a resource limited country in southeast Asia, has limited data on TB prevalence in the general population or in healthcare workers. This study aimed to estimate the prevalence of LTBI in Lao healthcare workers in Vientiane Capital.MethodsHealthcare workers from high-risk departments from 3 central hospitals in Laos were included (n = 196) and venous blood was tested by IGRA. A questionnaire was administered to determine their knowledge, attitude and practice towards TB and LTBI.Results10.2% of the participants were positive by IGRA, none of whom were previously aware of their TB status. The questionnaire revealed that knowledge and awareness of TB and LTBI were low.DiscussionA significant proportion of healthcare workers in this study had evidence of LTBI infection. These individuals were unaware of their TB status and we suggest that testing and treatment, as well as prevention strategies, should be routinely administered in Lao hospitals.

The impact of the war in Ukraine on the prevalence of MDR/RR-TB in Poland.

The 2022 invasion of Ukraine by the Russian Federation triggered a refugee crisis, affecting the multidrug-/rifampicin-resistant TB (MDR/RR-TB) prevalence in neighbouring countries. This study examines the epidemiological trends and characteristics of MDR/RR-TB patients in Poland, focusing on the relative contribution of Ukrainian refugees. Data from the Polish National Tuberculosis Registry and EPIC Project database, covering MDR/RR-TB cases reported between 2010 and Q1 2024, were analysed. The study included 794 MDR/RR-TB cases, showing a demographic shift post-2022. During the 10-year period up to 2021, a median of 48 MDR/RR-TB cases were reported annually in Poland. After 2022, these numbers doubled: 104 cases were reported in 2022 and 101 cases in 2023. Simultaneously, the number of Ukrainian MDR/RR-TB patients increased from 77 (13%) during 2010-2021 to 127 (58%) from 2022 to Q1 2024. Poland is observing an increased number of cases of MDR/RR-TB associated with the large number of displaced Ukrainian citizens who are now residing in Poland. There is a need to monitor the epidemiology of MDR/RR-TB and seek optimal screening and management strategies for TB among refugees from countries with high MDR/RR-TB incidence in Poland and Europe.

Prevalence and factors associated with TB among presumptive TB patients in war-affected areas of North Wollo, Ethiopia.

TB is a leading infectious disease globally, with war and displacement significantly increasing its burden. In Ethiopia, ongoing conflict and displacement have worsened health conditions, yet data on TB prevalence and resistance remain scarce. This study aimed to determine the prevalence of TB, rifampicin-resistant TB (RR-TB), and associated factors among presumptive TB patients in hospitals during the ongoing crisis. A cross-sectional study was conducted with 273 presumptive TB participants, recruited via convenience sampling. Data on socio-demographic and behavioural factors were collected through interviews using a pre-tested structured questionnaire. Sputum samples were examined using the Xpert MTB/RIF molecular assay. Binary logistic regression was used to analyse the association between independent variables and TB. Variables with a P value ≤0.25 in the univariate analysis were included in the multivariable regression to identify independent predictors, with a P value ≤0.05 considered statistically significant. Among the 273 study participants, 47 were confirmed to have Mycobacterium tuberculosis, resulting in a prevalence of 17.2%. Of the 47 patients diagnosed with M. tuberculosis, 17 (36.2%) were found to have rifampicin-resistant strains. Previous contact with displaced persons [adjusted odds ratio (AOR): 4.237; 95% CI: 1.67-10.762; P value: 0.002), contact with TB-infected individuals (AOR: 5.644; 95% CI: 2.46-12.96; P value: <0.01) and being HIV positive (AOR: 3.074; 95% CI: 1.26-7.50; P value: 0.014) were the significant predictors for TB. Our study revealed a troubling prevalence of RR-TB, underscoring the adverse effects of war and displacement on healthcare services. Significant associations with predictors like HIV infection and close contact with TB-infected individuals necessitate targeted interventions.

Interventions to enhance corporate sector engagement in tuberculosis response in Africa: a scoping review protocol

IntroductionTuberculosis (TB) is a significant public health crisis in Africa. TB control programmes implemented by various state and non-state actors in different African countries over the years have recorded significant...

The burden of subclinical TB in Nigeria.

This study is a retrospective review of a large-scale systematic TB screening project conducted in six states of Nigeria. To determine the magnitude and characteristics of subclinical TB and the relative contributions of bacteriological versus clinical diagnosis in its identification in Nigeria. Data were retrospectively analysed from six states of Nigeria, where parallel screening with any TB symptoms and chest X-ray (CXR) with artificial intelligence (AI) was used for active case finding. Diagnosis of TB among presumptive was confirmed using either bacteriological tests or clinical review of CXR. Out of 8,516 presumptive identified during the project, 172 (2.0%) had no TB symptoms (males: 73.8%, females: 26.2%). The overall prevalence of TB among all presumptive was 21.9% (n = 1,867), including 62 (3.3%) subclinical TB and 1,805 (97.3%) active TB cases. The proportion of clinical diagnosis using CXR was significantly higher in the subclinical TB group than in the active TB group (79.0% vs. 63.5%; P = 0.012, OR = 2.2, 95% CI 1.17-4.03). Subclinical TB contributed 3.3% of the large TB burden in this study (22 per 100 presumptive). These cases would have been missed if only symptom-based TB screening had been employed.

Cytokines Levels and Anti-tuberculosis Drug Resistance among HIV Seropositive Patients in Ibadan, Southwest, Nigeria

Susceptibility to TB disease rises on mutations in cytokine receptors which ultimately lead to defective signaling and alter the immune surveillance and bacterial killing. Therefore, this study was undertaken to investigate the association between cytokines and anti-TB drug resistances. A total of 217 people living with human immunodeficiency virus at University College Hospital, Ibadan were recruited. Venous blood and sputum samples were collected. Sputum samples were cultured for Mycobacterium tuberculosis complex and characterized using standard methods. Anti-TB drug resistance was detected using phenotypic and genotypic methods. Cytokines levels (IL-10 and IFN-Y) were estimated using ELISA method. Association between cytokines and anti-TB drug resistance was determined using linear regression analysis. There were 105(48.4%) males and 112(51.6%) females with a mean age of 42.95 ± 8.286 years and a range of 28-65 years. The prevalence of TB among PLHIV was found to be 19.1% with male having higher rate than female (P&lt;0.05), and highest rate among aged ≥40. There was no significant association between cytokines (IL-10 and IFN-y) and sex of the subjects (P&gt;0.05). However, females had higher IFN-y level of 231.06±61.81 IU/ml when compared to 227.53±57.92 IU/ml obtained from males. The prevalence of multi-drug resistance TB was 11.9% with Rifampicin resistance having the highest rate of 5.5%. There was no significant association between cytokines (IL-10 and IFN-y) and sex, but age group &gt;40 years had higher IL-10 and IFN-y level of 226.53±52.39 IU/ml and 232.41±66.63 IU/ml respectively. There was an association between high cytokines levels and anti-TB drug resistance (P&lt;0.05). Highest cytokines levels; IL-10 (401.00±7.07 IU/ml) and IFN-Y (401.00±7.07 IU/ml) were recorded in Levofloxacin resistance. There was an association between high cytokines levels and genotypic anti- TB drug resistance (P&lt;0.05) with highest cytokines levels; IL-10 (400.12±12.37 IU/ml) and IFN-Y (472.87±31.93 IU/ml) recorded in Rifampicin resistance. This entire study revealed that there is high prevalence of MDR-TB among PLHIV, with Rifampicin monoresistance having the highest resistance rate among the drugs tested, and pro and inflammatory cytokines (IL-10 and IFN-y) play significant role in the development of Multi Drug Resistant-Tuberculosis among people living with HIV.

Clonal Diversity and Spatial Dissemination of Drug-resistant Mycobacterium tuberculosis Complex among HIV Seropositive Patients in Southwest Nigeria

Mycobacterium tuberculosis complex display relatively static genomes and 99.9% nucleotide sequence identity. Studying the evolutionary history of such monomorphic bacteria is a difficult and challenging task. Therefore, this study was undertaken to investigate the clonal diversity and spatial dissemination of drug-resistant M. tuberculosis complex among HIV seropositive clients in Southwest Nigeria. A total of two-hundred and seventeen (217) consented HIV positive (case subjects) and fifty (50) non-HIV positive controls were recruited for this study. Two Sputum samples were collected from each participant in two consecutive days. The samples were divided into two parts: one part was decontaminated using NAOH-NALC method and aseptically cultured for Mycobacteria on Lowenstein-Jensen (LJ) medium with and without pyruvate. Mycobacterial isolates were characterized using conventional and molecular methods. Anti-TB drug sensitivity test was done using 1% proportion conventional method on LJ. MTBC isolates were sequenced using Genetic Analyzer 3130xl sequencer. Genetic relatedness and clonal diversity (phylogenetic analysis) of MTBC isolates were done using Bio- Edit software and MEGA 6. Out of 217 HIV positive participants, 105(48.4%) were male, while 112(51.6%) were female. Twenty-six (26(52.0%)) of the control subjects were male, while 24(48.0%) were females. The overall prevalence of TB among PLHIV was found to be 19.1%. The prevalence of NTM among PLHIV was found to be 2.8% with M. intracellulare being the predominant organism isolated. Participants’ age was found to be significantly associated with TB (P&lt;0.05), however there was no significant association between TB and sex of the participants (P&lt;0.05). The prevalence of culture confirmed drug-resistant TB (DR-TB) among PLHIV was found to be 11.9%, with Rifampicin having the highest monoresistance rate of 5.5%. The overall prevalence of MDR-TB among PLHIV was found to be 9.2%. The phylogenetic analysis of M. tuberculosis strains revealed same clone of all isolates. All PLHIV should be screened for drug-resistant TB especially MDR-TB as the prevalence of primary MDR-TB is high among them. Further study like 3R gene-based studies of adaptation and evolution is needed to facilitate further epidemiological studies of these bacteria.

A comparison of stochastic and deterministic dynamics of tuberculosis model

. Tuberculosis is a deadly infectious disease leading to a major health concern in Southern India while there are major obstacles to controlling its spread. Here, we present a mathematical model with five compartments. We categorize the infected compartment into two subcategories: latent TB-infected individuals and active TB-infected individuals. By introducing white noise in a deterministic system, we formulate a stochastic system. We investigate the model in deterministic and stochastic framework, followed by data calibration using TB infection data from Kanyakumari District in South India from 2019 to 2023. In the deterministic model, we derive the disease-free and endemic equilibrium points, compute the basic reproduction number, and examine their stability. Moreover, we perform sensitivity analysis to evaluate how variations in model parameters affect TB prevalence. In addition, we study the uniqueness of solutions of stochastic model. After that we derive the conditions for disease extinction and stochastic permanence, and execute extensive simulations to capture the variability and randomness in TB transmission dynamics. This study signifies that stochastic dynamics is richer than deterministic one in the way of mitigation TB transmission.

Sputum availability and quality in country-level TB prevalence surveys.

Sputum availability and quality in country-level TB prevalence surveys.

Impact of isoniazid monoresistance on overall and vulnerable patient populations in Taiwan

ABSTRACT Isoniazid is an early bactericidal anti-tuberculosis (TB) agent and isoniazid mono-resistance TB is the most prevalent drug-resistant TB worldwide. Concerns exist regarding whether resistance to isoniazid would lead to delayed culture conversion and worst outcomes. From January 2008 to November 2017, adult culture-positive pulmonary TB patients receiving isoniazid, rifampicin, pyrazinamide, and ethambutol were identified through Taiwan Center for Disease Control database and were followed until the end of 2017. Primary outcomes included time to sputum culture conversion (SCC) within two months. Secondary outcomes included death and unfavourable outcomes at the end of 2nd month. A total of 37,193 drug-susceptible and 2,832 isoniazid monoresistant pulmonary TB patients were identified. Compared with no resistance, isoniazid monoresistance was not associated with a delayed SCC (HR: 0.99, 95% CI: 0.94─1.05, p = 0.8145), a higher risk of 2-month mortality (HR: 1.19, 95% CI: 0.92─1.53, p = 0.1884), and unfavourable outcomes at 2nd month (OR: 1.05, 95% CI: 0.97─1.14, p = 0.2427). Isoniazid monoresistance was associated with delayed SCC (HR: 0.90, 95% CI: 0.83─0.98, p = 0.0099) and a higher risk of unfavourable outcomes (OR:1.18, 95% CI: 1.05─1.32, p = 0.0053) in patients aged between 20 and 65, and delayed SCC in patients without underlying comorbidities (HR: 0.90, 95% CI: 0.81─0.98, p = 0.0237). Isoniazid mono-resistant TB had a comparable outcome with drug-susceptible TB at the end of the intensive phase. Healthy, and non-elderly patients were more likely to had culture persistence, raising concerns about disease transmission in these subgroups and warranting early molecular testing for isoniazid resistance.

Self-reported prevalence of tuberculosis: unveiling spatial representation in the districts of Tamil Nadu.

The objective of the current study was to estimate the self-reported individual-level crude prevalence and cluster-level adjusted prevalence of TB for the districts of Tamil Nadu and to understand the spatial distribution of TB cases through spatial autocorrelation and hotspot analysis. National Family Health Survey (NFHS) data, gathered during 2014-2015 (NFHS-4) and 2019-2021 (NFHS-5), were used in the current study to estimate district-wise, individual-level crude and cluster-level adjusted TB prevalence per 100 000 population in Tamil Nadu. This was illustrated with the help of spatial geographic representation for various districts of Tamil Nadu using SPSS and QGIS software. The spatial autocorrelation and hotspot analysis were performed using Geoda software. The overall self-reported individual-level crude prevalence of TB was 337 (95% CI 302 to 375) and 169 (95% CI 144 to 197) per 100 000 population, whereas the cluster-level adjusted prevalence of TB was 356 (95% CI 311 to 405) and 184 (95% CI 154 to 219) per 100 000 population in NFHS-4 and NFHS-5, respectively. This study highlights those geographical areas with high rates of TB prevalence. This information would be useful for the state and district programme managers to identify areas of high TB prevalence where interventions can be focused.

The effect of corticosteroids in developing active pulmonary tuberculosis among patients with COVID-19.

Corticosteroids can reduce the mortality rate among patients with severe COVID-19 pneumonia. However, opportunistic infections such as Mycobacterium tuberculosis are of concern, especially among those on high doses of corticosteroids. It is unknown whether the risk of developing subsequent TB infection is high or not among COVID-19 patients on high doses of corticosteroids. Hence, this study was conducted to address this gap of knowledge. We conducted a retrospective, cross-sectional study at the King Chulalongkorn Memorial Hospital from October 12, 2022 to June 30, 2023. Two hundred forty-three participants with documented COVID-19 diagnosis on high dose corticosteroids were enrolled into the study. Baseline characteristics and risk factors of developing TB were collected. The prevalence of TB was significantly different among participants with chronic kidney disease (CKD) stages 2-4 and chronic lung diseases. The incidence of TB post 1-year diagnosis of COVID-19 was 4 out of 243 patients (1.6%) or 1,646 cases per 100,000 person-year. The mortality rate among subsequent TB group was significantly much higher than the non-TB group (50% vs 0.4%; p-value = 0.001). COVID-19 participants on high doses of corticosteroids also were co-infected with other infections such as bacteria (37.1%), fungi (5.3%), and Pneumocystis jirovecii (PJP) (1.2%). We found that the incidence of TB in participants with COVID-19 on high doses of corticosteroids was 11 times higher than the general population. Therefore, we recommend screening for latent TB among these patients to prevent/early diagnose TB disease.

Addressing gaps in the diagnosis of TB in children

Since 2000, efforts to develop new treatments for TB have been promising, but diagnosing TB, especially in children, remains a challenge. This issue of the Journal includes the first in a series of articles related to TB in children, highlighting new diagnostic tests that do not rely on sputum, and have great potential for improving diagnosis and treatment initiation. Key to a reduction in TB prevalence, experts are engaging with communities to find undiagnosed cases and combat the stigma of TB. International collaborations are also central to integrating novel diagnostics and providing support for these vulnerable populations.

Assessment of Hematological Parameters in Mycobacterium Tuberculosis-Infected Patients at Hayatabad Medical Complex, Peshawar, Pakistan

Background: Mycobacterium tuberculosis is a major causative agent of pulmonary tuberculosis, significantly contributing to morbidity and mortality worldwide. In South Asia, including Pakistan, TB remains a primary cause of prolonged hospital stays and economic burden. It primarily affects the lungs and can alter various hematological parameters.Objective: To assess the prevalence and characterize the hematological features of pulmonary tuberculosis patients at Hayat Abad Medical Complex, Peshawar, Pakistan.Methods: A descriptive cross-sectional study was conducted from April to August 2024. A total of 220 sputum samples were collected from male and female patients of all ages with suspected TB. TB was confirmed in 31 patients using TB PCR. Hematological parameters, including WBC, RBC, Hb, HCT, MCV, MCH, and platelets, were analyzed using a Sysmex hematology analyzer. Data were analyzed using SPSS version 25.Results: The prevalence of TB was 14% (31/220). All confirmed TB patients had elevated WBC and neutrophil counts (100%), decreased Hb and HCT (100%), and reduced MCV (96%). Lymphopenia was present in 90% of the cases.Conclusion: Hematological deviations can be cost-effective markers for early TB diagnosis in resource-limited settings.

Determinants of transmission prevention behavior among Tuberculosis patients in Surabaya, Indonesia

BackgroundTuberculosis (TB) is associated with significant morbidity and mortality, causing significant health challenges globally. Meanwhile, Indonesia ranks second worldwide in terms of TB prevalence, with East Java being among the most affected provinces. Surabaya, in particular, a major city reported approximately 4.628 cases in 2021, underscoring the urgent need to prevent transmission through behavior of patients. Therefore, this study aimed to analyze determinants of transmission behavior among TB patients in Surabaya, Indonesia. MethodsThe methodology used in this study was a cross-sectional design and the participants were 144 TB patients at three community health centers in Surabaya, selected using simple random sampling. Variables including knowledge level, supportive behavior, and medication adherence were analyzed and data collection was carried out using a structured questionnaire. Additionally, data analysis was performed with statistical methods to determine the significance of variables. ResultsThe results showed that knowledge (P-value = <0.001), supportive behavior (P-value = 0.001), and medication adherence (P-value = 0.004) had a significant effect on transmission prevention behavior among TB patients. ConclusionBased on our results, it was concluded that higher knowledge level, supportive behavior, and medication adherence had a significant correlation with increased social support provided by patients in preventing and controlling TB transmission. Therefore, there is a need to implement targeted programs to enhance prevention behavior.

Prevalence and associated factors of TB and HIV coinfections among adult inmates with presumptive pulmonary TB in a Kenyan prison

BackgroundTuberculosis (TB) is more than ten times higher in prisons compared to the general population, and HIV-infected persons are at increased risk of developing active TB and death. In the World Health Organization (WHO) African region, however, where the TB and HIV coinfections are highest, and prisons rarely factored in national disease surveillance, epidemiological data to inform TB control interventions in correctional facilities is limited. In this study, we assessed the prevalence of TB and HIV coinfections, as well as the factors associated with coinfections in our study setting.MethodsThis was a prospective cross-sectional study among 157 adult (≥ 18 years) prisoners presenting with symptoms of pulmonary TB at Shimo La Tewa Prison, Kenya, between January and June 2023. The study excluded those with a history of anti-TB drugs use or on treatment follow-up and collected demographic and clinical characteristics data using a questionnaire. Sputum samples were collected and processed immediately using Xpert® MTB/RIF assay or stored at 4 °C for three (3) days in case of delay.ResultsThe overall prevalence of TB among inmates with presumptive pulmonary TB was 10.2%, 95% CI 6.37–16.91% (16/157), HIV 19.1%, 95% CI 13.73–25.97% (30/157). All the TB cases were positive for HIV (16/16, 100%), translating to TB/HIV coinfection of 10.2%, 95% CI 6.37–16.91% (16/157), and there was no rifampicin resistance. TB and HIV coinfection cases were found among underweight (100%, 16/16) prisoners. The independent factors associated with TB and HIV coinfections were education level (adjusted OR = 0.17, p = 0.007), smoking history (adjusted OR = 3.01, p = 0.009) and illegal drug use history (adjusted OR = 4.55, p = 0.044).ConclusionWe report a high prevalence of pulmonary TB and HIV coinfections among adult inmates with presumptive pulmonary TB in Kenya, with education level, smoking status, and illegal drug use as the independent factors associated with the coinfection. The authority should take measures to protect HIV-positive prisoners from TB, focusing on education, nutrition, smoking, and illegal drug use.

Clinical Profile and Treatment Outcome of H-mono/Polydrug-resistant Tuberculosis: A Single-center Retrospective Study

Background: Isoniazid-monoresistant tuberculosis (Hr-TB) is the most prevalent drug-resistant TB. It often precedes multidrug-resistant TB (MDR-TB) and poses a major threat in the fight against TB control. The treatment outcome in Hr-TB and polydrug-resistant TB (PDR-TB) other than MDR still remains unclear. Aim: The aim of the study is to determine the clinical characteristics and treatment outcome in H-mono/PDR-TB under programmatic conditions. Materials and Methods: The study design was retrospective observational. It was conducted at the respiratory medicine department of a tertiary care institute in Mumbai. The medical records for bacteriologically confirmed TB patients diagnosed between July 2021 and December 2022 were reviewed. A total of 827 patients were enrolled and among them 46 patients with H-mono/PDR-TB were analyzed. The demographic data, clinical characteristics, and treatment outcomes were recorded. Results: Among 46 patients of isoniazid mono-resistant/PDR-TB analyzed from 827 bacteriologically confirmed TB, 24 were women with a mean age of 30.5 years. Twenty-five (54.34%) were resistant to isoniazid and the remaining 21 (45.66%) were PDR-TB. Primary Hr-TB was detected in 43 (93%) patients. The KatG mutation in 30 (65.2%) patients was the most common form of isoniazid (INH) mono resistance followed by inhA mutation 16 (34.8%). The fluoroquinolone (FQ)-based treatment regime as per national program guidelines had favorable outcomes in 42 (91.3%). However, unfavorable outcome with progression to MDR was observed in 3 (6.52%) and death in 1 (2.18%) patients. Conclusion: H-mono/PDR-TB is the most prevalent DRTB and most of them have primary resistance to isoniazid. Availability of first and SL LPA and limited DST with FQ-based regime under the national program has improved treatment outcomes in Hr-TB/PDR-TB.

Impact of the COVID-19 pandemic and migration on tuberculosis notifications: a retrospective analysis with 5-year data from three centers.

We aimed to determine the incidence of TB among immigrants and non-immigrants in Sanliurfa, Türkiye between 2018 and 2022 and to examine the effect of COVID-19 on the incidence, location, and drug resistance patterns of tuberculosis. This study was a retrospective review of patients diagnosed with tuberculosis in Şanlıurfa Tuberculosis Dispensary between January-2018 and May-2022. Patients were assessed in terms of age, sex, site of tuberculosis, and drug resistance profiles before and during the COVID-19 pandemic. A total of 887 patients with TB were included in the study. The mean age of patients diagnosed with tuberculosis was 40.63 ± 17.50 years. Of the total number of patients diagnosed, 50.7% were women, 85.8% were Turkish citizens, and 91.9% were new cases. Comparing the rate of positive cultures between the pre-COVID-19 and COVID-19 periods revealed a statistically significant rate of positive culture during the COVID-19 period (p < 0.001). In terms of mortality, the mean age of the patients who died was 60.2 ± 18.4 years and that of the survivors was 39.1 ± 16.6 years; these values were statistically significant (p < 0.001). Among the patients who survived, the rate of pulmonary tuberculosis was statistically significantly higher than that of extrapulmonary tuberculosis (p < 0.001). The prevalence of pulmonary TB is high and the proportion of women is increasing. During the COVID-19 period, the number of patients diagnosed with TB decreased, but interestingly, the rate of positive cultures remained high, and the rate of resistance to INH also decreased. The results revealed rates similar to those reported by the World Health Organization.