Pulmonary Tuberculosis Research Articles

Prediction of tuberculosis-specific mortality for older adult patients with pulmonary tuberculosis

BackgroundThis study aims to identify risk factors associated with tuberculosis-specific mortality (TSM) in older adult patients with pulmonary tuberculosis (TB) and to develop a competing risk nomogram for TSM prediction.MethodsWe conducted a retrospective cohort study and randomly selected 528 older adult pulmonary TB patients hospitalized in designated hospitals in Henan Province between January 2015 and December 2020. The cumulative incidence function (CIF) was calculated for both TSM and non-tuberculosis-specific mortality (non-TSM). A Fine and Gray proportional subdistribution hazards model and a competing risk nomogram were developed to predict TSM in older adult patients.ResultsThe 5-year cumulative incidence functions (CIFs) for TSM and non-TSM were 9.7 and 9.4%, respectively. The Fine and Gray model identified advanced age, retreatment status, chest X-rays (CXR) cavities, and hypoalbuminemia as independent risk factors for TSM. The competing risk nomogram for TSM showed good calibration and excellent discriminative ability, achieving a concordance index (c-index) of 0.844 (95% confidence interval [CI]: 0.830–0.857).ConclusionThe Fine and Gray model provided an accurate evaluation of risk factors associated with TSM. The competing risk nomogram, developed using the Fine and Gray model, provided accurate and personalized predictions of TSM.

Clinical and imaging features of co-existent pulmonary tuberculosis and lung cancer: a population-based matching study in China

BackgroundCo-existent pulmonary tuberculosis and lung cancer (PTB-LC) represent a unique disease entity often characterized by missed or delayed diagnosis. This study aimed to investigate the clinical and radiological features of patients diagnosed with PTB-LC.MethodsPatients diagnosed with active PTB-LC (APTB-LC), inactive PTB-LC (IAPTB), and LC alone without PTB between 2010 and 2022 at our institute were retrospectively collected and 1:1:1 matched based on gender, age, and time of admission. Symptoms and clinicopathological features were compared among the three groups of patients. Logistic regression was employed for risk factor analysis.ResultsCompared to LC or IAPTB-LC, patients with APTB-LC exhibited higher proportions of weight loss (p < 0.001) and fever (p < 0.001) at the time of diagnosis. Additionally, radiological features such as nodules (p = 0.007), tree-in-bud (p < 0.001), cavitation (p < 0.001), and calcification (p < 0.001) were significantly more prevalent in APTB-LC patients compared to the other groups. Patients with APTB-LC were more susceptible to lymph node involvement (p < 0.001) and distant metastasis (p = 0.006) compared to those with IAPTB-LC or LC alone. Additionally, in comparison to LC alone, patients with IAPTB-LC exhibited more complex symptoms, imaging features, and lymph node metastases. Logistic regression results indicated that factors such as BMI, fever, patchy shadow, cavitation, neck or supraclavicular lymph node metastasis, and liver injury favor the diagnosis of APTB-LC over LC alone. The pre-diagnostic model exhibited robust performance, achieving area under the curve (AUC) values of 0.864 in the training set and 0.830 in the test set.ConclusionOur results indicate that PTB-LC is a distinct disease characterized by complex clinicopathological features and a more aggressive nature. Based on our findings, we recommend conducting TB-related tests for LC patients who exhibit relevant risk factors or are identified as high-risk cases according to the pre-diagnostic model.

Pneumology : what's new in 2024

In 2024, several important innovations have enriched the management of respiratory diseases, including pulmonary hypertension, tuberculosis, COPD, and obstructive sleep apnea syndrome (OSAS). Notable advancements include the introduction of sotatercept in Switzerland for pulmonary arterial hypertension and mediastinal cryobiopsies, reflecting a shift toward more personalized medicine. Meanwhile, biologic therapies for COPD offer promising perspectives, and a potential path is emerging for shortening the treatment of certain forms of tuberculosis. These developments open the door to new therapeutic options, with the hope of enhancing care and delivering meaningful clinical benefits to patients.

Epidemiological and clinical profile of rifampicin-sensitive and -resistant pulmonary tuberculosis in sites of displaced persons due to the 2022-2024 floods in N'Djamena, Chad

Patients with rifampicin-resistant tuberculosis (RR-TB) may remain a source of infection longer than rifampicin-susceptible tuberculosis (RS-TB). The objective of this study was to detect active cases of rifampicin-susceptible and -resistant tuberculosis in displaced persons sites in the 9th District of N’Djamena. This observational, cross-sectional and analytical study was conducted among 418 contacts of the displaced persons, including 285 in the Walia site and 133 in the Toukra site. Data were collected using a pre-tested, semi-structured questionnaire administered by an interviewer. The identification of active cases of tuberculosis among the displaced persons was carried out by an interview to verify the presence or absence of TB symptoms. The TB-LAMP molecular technique was used to detect active tuberculosis among symptomatic and asymptomatic contacts. Instead, a GeneXpert analysis was carried out to detect cases of tuberculosis sensitive and resistant to rifampicin. TB-LAMP detected 76 (5.5%) cases of active TB among 418 displaced persons, including 11 lost to follow-up and 65 new cases. Female patients were more dominant (59.21%) than males (40.78%), and the age of patients ranged from 12 to 65 years, with a mean age of 38.5 years with a sex ratio of 1.45 in favor of females. Loss of appetite (31%), asthenia (20.0%) and cough (16%) were the most common symptoms. GeneXpert confirmed the 76 positive cases of Mycobacterium tuberculosis, of which 8 (10.52%) were resistant and 69 (90.78%) were sensitive to rifampicin. HIV1/2 immunochromatographic tests detected 12 (15.78%) cases of HIV/tuberculosis coinfection among the positive cases. This study highlighted the emergence of strains of the Mycobacterium tuberculosis complex resistant and sensitive to rifampicin. Regular and effective screening of RR-TB contacts is necessary to stop transmission in displaced persons sites in Chad, Africa and even worldwide. Keywords: Flood, displaced person, Mycobacterium tuberculosis, resistance, rifampicin, molecular technique, Chad.

Programmatic diagnostic accuracy and clinical utility of Xpert MTB/XDR in patients with rifampicin-resistant tuberculosis in Georgia

Abstract Background Xpert MTB/XDR (Cepheid, USA) is recommended for drug susceptiblity testing in patients with tuberculosis (TB) by the World Health Organization (WHO) with potential for rapid detection of isoniazid and fluoroquinolones resistance. However, diagnostic accuracy and clinical utility in a programmatic setting are unknown. Methods We evaluated accuracy and clinical utility of Xpert XDR in patients with rifampicin-resistant pulmonary TB during programmatic implementation in Georgia between July 2022 and August 2024, using phenotypic drug susceptibility testing (DST) as reference standard. Results 140 patients were tested with Xpert MTB/XDR and phenotypic DST, and 94.9% and 33.8% had isoniazid and fluoroquinolone resistance by phenotypic DST respectively. Xpert MTB/XDR showed 99.2% sensitivity (95% CI 95.5-100%) and 100% specificity (95% CI 54.1-100%) for isoniazid resistance. Sensitivity and specificity for fluoroquinolone resistance were 88.4% (95% CI 74.9-96.1%) and 100% (95% CI 95.6-100%). Including indeterminate/invalid Xpert MTB/XDR results, 17.4% (8/46) and 6.2% (8/129) of patients with phenotypic fluoroquinolone and isoniazid resistance were missed, respectively. Median turn-around time for Xpert MTB/XDR was 1 day (IQR 1-3) and median time to treatment was 4 days (IQR 1-7). Phenotypic DST results took a median of 43 days (IQR 29-63) longer than Xpert MTB/XDR results. 95% (115/121, 95% CI 89.5-98.2%) of patients had fluoroquinolones appropriately prescribed based on Xpert XDR result. Conclusions Progammatic data confirms high accuracy of Xpert MTB/XDR, although below WHO target product profile targets for fluoroquinolones, with significantly faster time-to-results than phenotypic DST.

Predictors of Pulmonary Tuberculosis Prevention in Surabaya, Indonesia

Background: Pulmonary tuberculosis (TB) continues to pose a critical public health challenge in Indonesia, characterized by high transmission rates, particularly within household settings. Despite extensive efforts to mitigate the spread of TB, persistent barriers such as low adherence to prevention and treatment protocols hinder progress. Identifying the factors that influence adherence is essential to optimizing the efficacy of intervention strategies. This study aims to investigate the key predictors influencing adherence to preventive measures for pulmonary TB transmission in Surabaya City. Methods: A quantitative research design employing a cross-sectional approach was utilized. Data were collected from 225 pulmonary TB patients attending community health centers in Surabaya City between September and December 2023. The variables examined included demographic characteristics, perceived benefits, barriers, susceptibility, severity, and self-efficacy. Statistical analysis was conducted using multiple logistic regression, with significance set at p&lt;0.05. Results: Significant predictors of adherence included age (p=0.048; OR=0.413), gender (p=0.009; OR=0.328), socioeconomic status (p=0.033; OR=3.052), perceived benefits (p=0.009; OR=10.086), barriers (p=0.007; OR=0.704), and self-efficacy (p=0.005; OR=29.335). Patients aged above 45 years, those reporting higher perceived benefits, and those with greater self-efficacy demonstrated higher adherence to TB prevention measures. These findings underscore the importance of self-efficacy, perceived benefits, and socioeconomic factors as significant determinants of adherence. The study's contribution lies in its exploration of adherence predictors within a high-risk population, offering valuable insights to inform targeted public health interventions. Conclusion: Age, perceived benefits, barriers, and self-efficacy emerged as critical predictors of adherence to pulmonary TB prevention strategies in Surabaya City. Interventions aimed at strengthening self-efficacy and providing targeted educational programs for younger populations are recommended to enhance TB control efforts. Additionally, integrating these findings into broader public health frameworks, such as national TB control strategies, can amplify their impact and contribute to improved health outcomes.

Factors associated with tuberculosis treatment initiation among bacteriologically negative individuals evaluated for tuberculosis: An individual patient data meta-analysis.

Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative bacteriological test result. There is limited information on the factors that determine clinicians' decisions to initiate TB treatment when initial bacteriological test results are negative. We performed a systematic review and individual patient data meta-analysis using studies conducted between January 2010 and December 2022 (PROSPERO: CRD42022287613). We included trials or cohort studies that enrolled individuals evaluated for TB in routine settings. In these studies, participants were evaluated based on clinical examination and routinely used diagnostics and were followed for ≥1 week after the initial test result. We used hierarchical Bayesian logistic regression to identify factors associated with treatment initiation following a negative result on an initial bacteriological test (e.g., sputum smear microscopy (SSM), Xpert MTB/RIF). Multiple factors were positively associated with treatment initiation: male sex [adjusted odds ratio (aOR) 1.61 (1.31, 1.95)], history of prior TB [aOR 1.36 (1.06, 1.73)], reported cough [aOR 4.62 (3.42, 6.27)], reported night sweats [aOR 1.50 (1.21, 1.90)], and having HIV infection but not on ART [aOR 1.68 (1.23, 2.32)]. Treatment initiation was substantially less likely for individuals testing negative with Xpert [aOR 0.77 (0.62, 0.96)] compared to smear microscopy and declined in more recent years. We were not able assess why clinicians made treatment decisions, as these data were not available. Multiple factors influenced decisions to initiate TB treatment despite negative test results. Clinicians were substantially less likely to treat in the absence of a positive test result when using more sensitive, PCR-based diagnostics.

Profound Immunosuppression with Reversed CD4:CD8 Ratio in a Tuberculosis Patient with Acquired Immunodeficiency Syndrome: A Case Report

Background: The co-occurrence of tuberculosis (TB) and acquired immunodeficiency syndrome (AIDS) presents a formidable clinical challenge due to the synergistic impact on the immune system. This case report describes a patient with TB/AIDS co-infection exhibiting profound immunosuppression characterized by a severely diminished CD4 count and an unusual reversal of the CD4:CD8 ratio. Case presentation: A 39-year-old male presented with symptoms indicative of both TB and advanced HIV infection, including shortness of breath, weight loss, and oral thrush. Physical examination revealed bilateral lung crackles. Laboratory investigations confirmed pulmonary TB and revealed a critically low CD4 count (6 cells/µL), and a CD8 count of 71 cells/µL, resulting in a reversed CD4:CD8 ratio of 0.08. The patient's HIV viral load was markedly elevated at 598,403 copies/mL. This case underscores the complex interplay between TB and HIV, highlighting the profound impact of co-infection on immune system function. The patient's severely depleted CD4 count and the atypical CD4:CD8 ratio reflect the advanced stage of HIV infection and the superimposed TB. The findings emphasize the need for close monitoring and aggressive management of co-infected patients to mitigate the risk of opportunistic infections and disease progression. Conclusion: This case report documents a rare and severe presentation of TB/AIDS co-infection with profound immunosuppression and a reversed CD4:CD8 ratio. It serves as a reminder of the significant morbidity and mortality associated with advanced HIV and TB co-infection, particularly in cases of delayed diagnosis or suboptimal treatment adherence.

Common comorbidities among tuberculosis patients in Western Sudan during the Sudan armed conflict

Background: Tuberculosis continues to be the primary cause of death from infectious diseases globally. In low- and middle-income countries, TB significantly contributes to morbidity and mortality, particularly among patients with comorbidities such as HIV infection, diabetes mellitus, smoking, depression, chronic obstructive pulmonary disease, and pulmonary TB. HIV co-infection elevates the risk of progression to developed tuberculosis (TB) disease. This study evaluated comorbidity in tuberculosis among patients attending El-Obeid Teaching Hospital during the armed conflict from 2023 to 2024. Methodology: This descriptive retrospective study took place in the respiratory department of El-Obeid Teaching Hospital in North Kordofan State, Sudan. The study examined 751 patients diagnosed with tuberculosis, alongside detailed coverage files from the early years of the Sudan war. We collected the data in August 2024. We developed a thorough data collection sheet and methodically organized all pertinent data. Results: Of the 751 patients, 692 received a tuberculosis (TB) diagnosis without any comorbidities, making up 92% of the cohort. The remaining 59 patients, accounting for 8%, had TB with comorbidities: 40% with diabetes mellitus (DM), 29% with HIV, 15% with hypertension (HIN), and 7%, 6%, and 3% with chronic kidney disease (CKD), bronchial asthma, and cardiac disease, respectively. The majority of patients were over 60 years old, comprising 37% of the cohort. The majority of the patients were unemployed, and their tuberculosis treatment outcomes were complete. Conclusion: Tuberculosis (TB) with comorbidity is more prevalent in diabetic patients than in those with HIV. We recommend regular screening for chronic comorbid diseases to improve treatment outcomes and minimize complications. Additionally, promoting outpatient care is essential for improving TB management, and further surveillance is necessary to fully understand the extent of the issue.

Analysis of Significance of CARD11 and MYO1G Expression in Pulmonary Tuberculosis and Its Predictive Value for Prognosis of Recurrence

Pulmonary tuberculosis (PTB) is one of the most common infectious diseases worldwide, with extremely high morbidity and mortality. An in-depth understanding of the molecular pathogenesis of PTB is crucial for finding novel diagnostic and therapeutic approaches in the future. In this study, we identified 52 differentially expressed genes (DEGs), which consisted of 422 nodes and 2853 edges, from the GSE34608 dataset in the Gene Expression Omnibus (GEO) database. These DEGs were composed of 422 nodes and 2,853 edges. Functional enrichment analysis revealed that CARD11 and MYO1G are closely related to T-cell activation. Upon further clinical case analysis, we found that the expression of CARD11 and MYO1G in the peripheral blood of patients with PTB were lower than those of healthy individuals, demonstrating excellent diagnostic value for both PTB diagnosis and prognosis of recurrence. Thus, CARD11 and MYO1G are promising indicators for assessing PTB in the future.

Safety, Efficacy and Pharmacokinetics of daily optimised doses of Rifampicin for the Treatment of Tuberculosis: A Systematic Review and Bayesian Network Meta-Analysis.

Higher than standard doses of rifampicin could improve the treatment outcome of drug-susceptible tuberculosis without compromising the safety of patients. We performed a systematic review of prospective clinical studies including adults with pulmonary and extrapulmonary TB receiving rifampicin doses above 10mg/kg/day. We extracted the data on overall adverse events (AE), hepatic AE, sputum culture conversion (SCC) at week 8, recurrence, mortality, and pharmacokinetics. We performed a Bayesian network meta-analysis (NMA) using a random-effects model. In 19 studies, 2033 out of 3654 participants received rifampicin doses higher than 10mg/kg/day. The NMA showed an increased risk of overall and hepatic AE for the 40mg/kg/day dose (RR 4.8, 95% CrI 1.1; 25, and 15.00, 95% CrI 1.1; 58.0, respectively), but no other doses, including 50mg/kg/day showed such an increase. Increasing doses improved sputum culture conversion at week 8 (RR 1.3, 95% CrI 1.1; 1.7 for SCC with 35mg/kg/day). Optimal doses of rifampicin may be between 25 and 35mg/kg/day, but should be tailored at the individual or, at least, at the population level.

Mitigation of Air Pollution and its Impact on the Lung Health of Tuberculosis Patients, a Prospective Cohort Study from Rural India

Our respiratory system is a primary target of the harmful effects of poor indoor and outdoor air quality; therefore, the present study was undertaken in rural settings of Solan district of HP on 23 Pulmonary tuberculosis patients diagnosed at the Secondary Care level hospital of Solan in 2018 and 2019. Their lung function assessment was undertaken with Spirometry at the beginning and after six months of anti-tubercular treatment (ATT). Accordingly, air quality (indoor and outdoor) was assessed and the Air Quality Index (AQI) was computed. In total 300 participants in ten villages of the selected patients were selected to create awareness vis a vis literacy on the significance of air quality management for ensuring human health, especially tuberculosis management. Air pollution-abating plants were introduced in residential settings (indoor and outdoor) of selected patients. The study indicated that per unit AQI improvement of 16.6, 11.86 and 13.91 due to created literacy and environmental amelioration by introducing plants and enhancing air circulation/ventilation resulted per unit increase in the lung health index of tubercular patients with each of 0.0005 units of improvement in air quality. Capacity building on air quality management improved air quality as well as lung health of tubercular patients.

A large geno-spatial cluster of multi-drug resistant tuberculosis outbreak in a western district of Thailand.

The growing issue of drug resistance, particularly multidrug-resistant TB (MDR-TB), has exacerbated this problem. The rise of drug resistance TB is a severe global health concern. In Thailand, a persistent community outbreak of primary MDR-TB has been confirmed in the Tha Maka district of Kanchanaburi province, with an increasing prevalence of MDR-TB among newly diagnosed pulmonary tuberculosis cases. It was the first site in Thailand where a cluster of MDR-TB, caused by the Asian African 3 Modern Beijing strain, and XDR-TB, caused by L2.1, outbreaks were reported. This study aims to assess the MDR-TB outbreak in detail by characterizing the genomic profiles of the prevalent MDR-TB strains and examining their geographical distribution within the affected district. Through whole-genome sequencing (WGS) and bioinformatic analysis of 188 MTB isolates, the study identified three major phylogenetic lineages: the East Asian lineage (L2, 92 %), the Indo-Oceanic lineage (L1, 5.9 %), and the Euro-American lineage (L4, 2.1 %). The detailed sub-lineage distribution offers valuable insights into the predominant genetic clusters of M. tuberculosis within the sampled population. Notably, Lineage 2, specifically the L2.2.M3 sub-lineage, stood out as the dominant strain of MDR-TB, accounting for 77.7 % of the isolates. This finding underscores the significant prevalence of the L2.2.M3 sub-lineage and its potential role in the local transmission dynamics of tuberculosis. The high proportion and genetic homogeneity of the L2.2.M3 cluster among MDR-TB patients may indicate the strain's adaptation for more effective transmission within the Thai population. The increasing prevalence of this pathogenic strain could significantly impact tuberculosis control programs. Early diagnosis and contact tracing with chemotherapeutic preventive therapy for MDR-TB will be essential in inhibiting the spread and reactivation of these strains. Additionally, further studies are needed to prospectively identify transmission routes through contact tracing and real-time genotypic methods. It will also be crucial to ensure that future vaccines and/or recommended chemoprophylaxis therapy for MDR-TB will provide protection against these emerging strains.

An epidemiological assessment of health status among a cohort of tuberculosis survivors: prospective research in a western Indian city

An epidemiological assessment of health status among a cohort of tuberculosis survivors: prospective research in a western Indian city

When tuberculosis makes you deaf

Tuberculous otomastoiditis is a rare and serious infection that most often occurs in association with pulmonary involvement. It is easy to diagnose when the two pathologies are associated and isolated. We herein report the case of a patient initially hospitalized for Pseudomonas aeruginosa necrotising otitis externa (NOE), which delayed the diagnosis of tuberculous otomastoiditis. The 50-year-old patient was hospitalized for NOE and concurrently presented with pulmonary tuberculosis. NOE was associated with temporal bone lysis with carotid canal involvement. Despite appropriate treatment, NOE evolution was unfavourable. Two months later, the patient underwent a mastoidectomy to evacuate a mastoid abscess. In a deep tissue sample, tuberculosis complex was detected by PCR assay. For 12months, the patient underwent for pulmonary and osseous tuberculosis. While the clinical course was favourable but deafness occurred subsequently. An association of P.aeruginosa NOE and tuberculous otomastoiditis is a highly exceptional event.

IgA vasculitis with nephritis accompanied by pulmonary tuberculosis: a case report.

A 69-year-old Japanese man developed abdominal pain, purpura, proteinuria, and hematuria while receiving treatment for pulmonary tuberculosis. A skin biopsy revealed IgA-positive leukocytoclastic vasculitis, and a renal biopsy showed IgA-positive mesangial proliferative glomerulonephritis with crescent formation. Based on these findings, we diagnosed IgA vasculitis with nephritis (IgAVN) and initiated treatment. The patient's abdominal symptoms improved following factor XIII supplementation and corticosteroids. Corticosteroids were administered, and after 5months, the proteinuria was in complete remission. Although IgAVN often follows a prior infection, it is rarely complicated by tuberculosis. In this case, staining for galactose-deficient IgA1, which is specifically positive in IgA nephropathy and IgAVN, was positive. Nephritis-associated plasmin receptor staining was also positive, suggesting some involvement of infectious glomerulonephritis. Therefore, the patient was considered to have IgAVN associated with pulmonary tuberculosis. In adult-onset cases, IgAVN is often severe. This patient was presented with adult-onset nephrosis and International Study of Kidney Disease in Children grade IIIb IgAVN, suggesting a poor prognosis. Therefore, we immediately initiated treatment with corticosteroids, factor XIII supplementation, a renin-aldosterone-system inhibitor, and a sodium-glucose cotransporter 2 inhibitor. The patient recovered uneventfully with no worsening of tuberculosis.

Prevalence of pulmonary tuberculosis and associated factors among adults living with HIV/AIDS in Ethiopia, systematic review and meta-analysis

BackgroundTuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains a global health crisis, especially in sub-Saharan Africa, where high human immune virus (HIV) prevalence exacerbates the problem. The co-infection of TB and HIV creates a deadly combination, increasing susceptibility and complicating disease progression and treatment. Ethiopia, classified as a high-burden country, faces significant challenges despite efforts to reduce co-infection rates. The rise of multidrug-resistant TB further complicates diagnosis and management, highlighting the urgent need for intensified efforts to combat this dual epidemic.MethodsStudies searched through the search engine of Cochrane Library, PubMed, Web of Science, Google Scholar. Data from included studies was extracted, organized in Excel, and then analyzed using STATA 17. The overall effect across all studies was calculated using a random-effect model. Potential publication bias and heterogeneity in the results between studies were assessed using Egger’s test, forest plot, and I² statistic, respectively.ResultsAccording to this systematic review and meta-analysis, the overall prevalence of pulmonary tuberculosis(PTB) among adults living with human immune virus /aquered immune deficieciency syndrome(HIV/AIDS) in Ethiopia was 15% (95% CI: 8-23%). Several factors were independently associated with pulmonary tuberculosis, including CD4 count below 200 cells/mm³ (OR = 4.491, 95% CI: 1.0001–8.132), WHO clinical stage III (OR = 4.487, 95% CI: 2.264–6.710)), WHO clinical stage IV (OR = 6.905, 95% CI: 5.239–8.571), smokers (AOR = 3.749, 95% CI: 2.626–5.271), ambulatory adults (AOR = 1.887, 95% CI: 1.439–2.335).ConclusionThis systematic review and meta-analysis found a significant 15% pooled prevalence of pulmonary tuberculosis (PTB) among adults living with HIV/AIDS in Ethiopia. The prevalence was notably higher in individuals with lower CD4 counts, advanced HIV stages (III and IV), and in smokers. These findings underscore the need for early detection, targeted interventions, and integrated TB control programs with HIV care to mitigate the burden of PTB in this population.

Revolutionizing diagnosis of pulmonary Mycobacterium tuberculosis based on CT: a systematic review of imaging analysis through deep learning

Revolutionizing diagnosis of pulmonary Mycobacterium tuberculosis based on CT: a systematic review of imaging analysis through deep learning

Analyses of blood-derived host biomarkers for pulmonary tuberculosis diagnosis in human immunodeficiency virus co-infected individuals in sub-Saharan Africa: a systematic review and meta-analysis

Analyses of blood-derived host biomarkers for pulmonary tuberculosis diagnosis in human immunodeficiency virus co-infected individuals in sub-Saharan Africa: a systematic review and meta-analysis

Characteristics, Knowledge, Attitudes, and Practices for Pulmonary Tuberculosis Prevention

Characteristics, Knowledge, Attitudes, and Practices for Pulmonary Tuberculosis Prevention