Cases Of Pulmonary Tuberculosis Research Articles

Diagnostic Role of Serum Adenosine Deaminase In Smear-negative Pulmonary Tuberculosis

Background: Diagnosis of tuberculosis is not always easy, particularly if it is a case of sputum smear-negative pulmonary tuberculosis (SNPTB). Patients with respiratory symptoms resembling SNPTB are difficult to differentiate based on clinical features, chest X-ray, and Xpert MTB/RIF negativity. So, additional diagnostic test with high sensitivity and specificity is needed to increase the yield of the ongoing diagnostic strategy for SNPTB. Adenosine deaminase (ADA) is now being widely used for the diagnosis of TB particularly in effusion fluids due to its simplicity, low cost, and quick available results, it is not always possible to access effusion fluids and therefore, it would be helpful to take advantage of serum levels. Therefore, the purpose of the study was to assess the role of serum ADA in the diagnosis of SNPTB. Methods: This cross-sectional analytical study was conducted in Dhaka Medical College & Hospital, Dhaka from March 2019 to September 2021. A total of 140 patients were included in this study and divided into two groups according to selection criteria: Group I (SNPTB, n=62), and Group II (non-TB pulmonary diseases, n=78). ADA estimation was carried out using the sensitive colorimetric method described by Guisti and Galanti with a BIOSIC kit. After the collection of all the required data, analysis was done by SPSS 24.0. Results: The mean age of the study patients was 48.02 ± 9.60 years (23-73 years) with male predominance in both Group I and Group II (71 % and 60.3%, respectively, p>0.05). Non-TB pulmonary cases were significantly older than SNPTBpatients (52 ± 8.56 vs 43.02 ± 8.49 years, p<0.001). SNPTB patients had a significantly higher frequency of cough, fever, and weight loss compared to non-TB pulmonary cases (p<0.05). In contrast, chest pain and shortness of breath were more frequent in Group II than in Group I (p<0.05). Serum ADA was significantly higher among SNPTB patients compared to non-TB pulmonary cases (48.16 ± 12.13 vs 18.64 ± 7.85 IU/L, p<0.001). ROC analysis of serum ADA in the diagnosis of patients with SNPTB found an AUC of 0.9850 (95% CI, 0.969-1.00) which was statistically significant (p<0.001). A cut-off value of serum ADAe”33 IU/L showed sensitivity, specificity, NPV, PPV, and accuracy of 93.55%, 94.87%, 94.87%, 93.55%, and 94.29%, respectively to correctly diagnose SNPTB cases. Conclusion. This study finding stated that serum ADA may be a useful marker to distinguish SNPTB from non-TB respiratory diseases. However, further study with a more generalized study population is recommended. Bangladesh J Medicine 2024; 35: 61-69

Comparison of treatment adherence among TB patients with and without COVID-19 in South India

AimThe present study aimed to compare the adherence to anti-TB treatment among post-COVID-19 pulmonary TB cases and TB patients without a history of COVID-19 in South India. MethodsA prospective, cross sectional study was conducted in all drug-sensitive pulmonary tuberculosis patients in National TB Elimination Program. The research investigates the impact of the COVID-19 pandemic on TB management, considering both subjective and objective measures of adherence. Data were collected using a validated instrument for subjective assessment and urine metabolite testing for objective evaluation. ResultsThe results reveal significant differences (p < 0.05) between subjective and objective adherence measures, emphasizing the need for accurate and comprehensive assessment methods. However, there is no statistically significant difference (p > 0.05) in adherence to anti-TB treatment among post-COVID-19 pulmonary TB cases and TB patients without a history of COVID-19 in South India. The reason for non-adherence in both groups were ATT side effects, loss of daily wages, forgetting to take medication and lazy to take medications. ConclusionThe study concluded that there is no statistically significant difference (p > 0.05) in adherence to anti-TB treatment among post-COVID-19 pulmonary TB cases and TB patients without a history of COVID-19.

Characteristics of TB cases without documented sputum culture in the United States, 2011-2021.

<sec id="st1"><title>BACKGROUND</title>Culture-based diagnostics are the gold standard for diagnosing pulmonary TB (PTB). We characterized culture practices by comparing cases with documented sputum culture to those without.</sec><sec id="st2"><title>METHODS</title>Using multivariable logistic regression, we examined associations between PTB case characteristics and no documented sputum culture reported to the U.S. National TB Surveillance System during 2011-2021.</sec><sec id="st3"><title>RESULTS</title>Among 69,538 PTB cases analyzed, no sputum culture attempt was documented for 5,869 (8%). Non-sputum culture specimens were documented for 54%, 80%, and 89% of cases without documented sputum culture attempts among persons aged <15 years, 15-64, and 65+ years, respectively; bronchial fluid and lung tissue were common non-sputum specimens among cases in persons >15 years old. Having no documented sputum culture was associated with age <15 years (aOR 23.84, 99% CI 20.09-28.27) or ≥65 years (aOR 1.22, 99% CI 1.07-1.39), culture of a non-sputum specimen (aOR 6.57, 99% CI 5.93-7.28), residence in a long-term care facility (aOR 1.58, 99% CI 1.23-2.01), and receiving TB care outside of a health department (aOR 1.79, 99% CI 1.61-1.98).</sec><sec id="st4"><title>CONCLUSIONS</title>Inability to obtain sputum from children and higher diagnostic suspicion for disease processes that require tissue-based diagnostics could explain these findings.</sec>.

Detection of &lt;i&gt;M. tuberculosis&lt;/i&gt; Using Cartridge-Based Technology in Patients with Negative Sputum Microscopy Results in a Regional Laboratory

The objective: to evaluate results of M. tuberculosis detection and testing drug susceptibility to rifampicin using molecular genetic methods in tuberculosis patients with a negative sputum smear microscopy result.Subjects and Methods. Pulmonary tuberculosis patients registered in Arkhangelsk Region from 2016 to 2020 were enrolled in the study; those patients were notified as new cases and relapses with a negative sputum smear microscopy result before treatment and had results of molecular genetic testing (MGT) (Xpert MTB/RIF MTB/RIF) and BACTEC MGIT 960 available.Results. 479 people (40%) were registered as pulmonary tuberculosis cases with a negative sputum smear microscopy result. MGT was performed in 327 (68%) patients. A positive result of MGT was received in 120 (37%) patients, a positive result of BACTEC MGIT 960 was received in 165 (50%) people. Concordance of results was observed in 70% of cases. In 136 (41%) people, both tests did not detect Mycobacterium tuberculosis, in 95 (29%) both tests showed a positive result. Discrepancies between the results of two tests were observed in 30% of cases. In 71 (22%) cases, culture growth was observed in BACTEC MGIT 960 with negative results of MGT. In 8% of cases, DNA of Mycobacterium tuberculosis was detected, but there was no culture growth on the nutrient medium. 43/120 (36%) cases of resistance to rifampicin were detected. The median time from sputum collection to initiation of MDR-TB treatment based on sputum MGT results made 18 (IQR 10–29) days. Molecular genetic testing makes it possible to promptly detect the majority of TB patients with a negative sputum smear result, and reduce the time for drug susceptibility testing, which allows this testing to be used as the first test when examining for pulmonary TB.

Epidemiology of first-and second-line anti-tuberculosis drug resistance profile in new pulmonary tuberculosis cases in addis ababa metropolitan area, ethiopia

Epidemiology of first-and second-line anti-tuberculosis drug resistance profile in new pulmonary tuberculosis cases in addis ababa metropolitan area, ethiopia

Trends in imported infections among migrants and travellers to Spain: a decade of analysis through the +Redivi network (2012-2022).

High-speed global travel, increased trade, world population growth, migration, urbanisation and climate change have favoured the emergence and spread of pathogens. We aimed to analyse the evolution of imported infections in Spain during 2012-2022 and the potential impact of some of the abovementioned factors on differential morbidity patterns. In this retrospective study (January/2012 to December/2022), we analysed data collected by the +Redivi network across 25 health centres. The network's standardised database records new cases of imported infections, including patient demographics, travel history, pre-travel advice and diagnostic information. To assess outcome rates over time and potential interactions, we constructed penalised weighted models to reduce the bias related to a low event rate and used weighted logistic regression for morbidity outcomes. We recorded 25 632 episodes, comprising 13 913 migrants, 4047 visiting friends and relatives (VFR) immigrants, 392 VFR travellers and 7280 travellers. Most immigrants came from South America (48.3%), Sub-Saharan Africa (28.5%), North Africa (6.6%), South Central Asia (5.4%) and Central America/Caribbean (5.3%). The most common regions visited by travellers were Sub-Saharan Africa (33.5%), South America (24.5%), Central America/Caribbean (13.5%), Southeast Asia (12%) and South Central Asia (10%). The proportion of diagnoses of malaria, strongyloidiasis and unspecified self-limiting febrile syndrome < 3weeks remained unchanged during the study period. An increased frequency of diagnosis was reported for schistosomiasis, blastocystosis, giardiasis, dengue, diarrhoea, new cases of HIV, latent and pulmonary tuberculosis; a decrease was reported for syphilis, chikungunya fever, Chagas disease and eosinophilia. We detected interactions between time and sex or type of participant across the different diagnoses. Our study underscores the importance of epidemiological data in understanding infectious diseases dynamics among travellers and migrants, emphasising how demographic shifts, migration trends and healthcare policies affect disease profiles. Comprehensive data play an essential role in enhancing public health policies and travel advice.

Comparative whole genome sequence analysis of mycobacterium tuberculosis isolated from pulmonary tuberculosis and tuberculous lymphadenitis cases in northwest ethiopia: Genomic diversity, transmission dynamics and in-silico molecular drug resistance

Comparative whole genome sequence analysis of mycobacterium tuberculosis isolated from pulmonary tuberculosis and tuberculous lymphadenitis cases in northwest ethiopia: Genomic diversity, transmission dynamics and in-silico molecular drug resistance

Spatial Analysis of Pulmonary Tuberculosis Incidence in Kupang City in 2019-2021

Abstract Introduction: Pulmonary tuberculosis has a fairly high number of cases in several regions of Indonesia, including Kupang City. In 2019, tuberculosis cases in Kupang City amounted to 667 cases, in 2020 it increased to 693 cases and in 2021 it decreased to 419 cases. This study aims to analyze the factors that influence the incidence of pulmonary tuberculosis which are studied in a spatial analysis model.Methods : This research is a quantitative research with an analytical observational design using an approach to Geographic Information Systems (GIS). This study aims to see the autocorrelation of population density, poor families, and healthy homes with the incidence of pulmonary tuberculosis and to see the pattern of relationships that are formed.The data used in this research is secondary data taken from related agencies. The samples in this study were 11 community health centers in Kupang City, namely Naioni Health Center, Alak Health Center, Manutapen Health Center, Sikumana Health Center, Penfui Health Center, Bakunase Health Center, Oebobo Health Center, Oepoi Health Center, Pasir Panjang Health Center, Kupang City Health Center, and Oesapa Community Health Center. Spatial analysis uses computer programs, namely the QGIS and GeoDa applications. QGIS was used to produce a map of the distribution of pulmonary tuberculosis cases in 11 health centers in Kupang City in 2019-2021 and the GeoDa application was used to see the pattern of TB distribution in Kupang City in 2019-2021, in general or globally through the LISA (Local Indicators Spatial Autocorrelation) tests.Results: Based on the results of the LISA (Local Indicators Spatial Autocorrelation) bivariate test, it shows that population density, poor families, and healthy housing coverage have no relationship with the incidence of TB in Kupang City (p-value &gt; 0.05) and show a random pattern of case distribution (Morans Index ' I is smaller than E[I] = -0.1000). However, in 2019-2020, the Morans I Index value covering healthy homes was greater than E[I] = -0.1000, which shows a clustered pattern of case distribution.Conclusion: It was concluded that there was no positive spatial autocorrelation between population density, poor families, and healthy homes with the incidence of pulmonary tuberculosis in Kupang City in 2019-2021

Retrospective Analysis of Tuberculosis Epidemiology in Okara, Pakistan

Tuberculosis, commonly called T.B., is a persistent bacterial illness attributed to Mycobacterium tuberculosis. Tuberculosis (T.B.) is a prevalent infectious disease that results in millions of deaths each year, particularly in low-income countries. A retrospective study was conducted between December 1, 2022, and April 30, 2023. Sputum smear microscopy was performed on all individuals suspected of having the T.B. condition. Out of the entire pool of 711 cases under suspicion, 227 cases, which accounts for 31.93% of the total, were confirmed positive for Tuberculosis. The male population is more susceptible to T.B. infection than their female counterparts, with a distribution of 59.47% and 40.53%, respectively. The age group of 30-44 years exhibited the highest rate of pulmonary tuberculosis cases at 24.67%, whereas the age group of 60-74 years recorded the highest percentage of cases at 25.56%. Based on our research, it was determined that the incidence of Tuberculosis exhibited a statistically significant increase within the overall populace of Okara District. The objective of the present study was to examine the Prevalence of Tuberculosis (T.B.) infection and raise awareness among the population regarding T.B. infection in the Okara district of Punjab, Pakistan. Effective disease control and elimination require appropriate management, diagnosis, treatment, and public consciousness.

Integrating systemic immune-inflammation index, fibrinogen, and T-SPOT.TB for precision distinction of active pulmonary tuberculosis in the era of mycobacterial disease research.

The clinical challenge of differentiating suspected tuberculosis with positive T-SPOT.TB results persist. This study aims to investigate the utility of the Systemic Immune-Inflammation Index (SII), Fibrinogen, and T-SPOT.TB in distinguishing between active pulmonary tuberculosis (PTB) and non-tuberculous lung diseases. A retrospective analysis included 1,327 cases of active PTB with positive T-SPOT.TB results and 703 cases of non-tuberculous lung diseases from May 2016 to December 2020 at Meizhou People's Hospital. These were designated as the case group and the control group, respectively. The detection indicators of T-SPOT.TB: Early Secreted Antigenic Target 6 (ESAT-6), Culture Filtrate Protein 10 (CFP-10), as well as SII and Fibrinogen levels-were compared and analyzed for association and joint diagnostic value between the two groups. The case group showed higher values of ESAT-6, CFP-10, SII, and Fibrinogen compared to the control group (all p < 0.001). In the case group, SII and Fibrinogen did not correlate with ESAT-6 and CFP-10 (∣rs∣ all < 0.3) but were positively correlated with C-reactive protein (CRP; rs all > 0.3). SII and Fibrinogen values in smear-positive pulmonary tuberculosis were higher than in smear-negative cases (all p < 0.05). The optimal diagnostic thresholds for ESAT-6, CFP-10, SII, and Fibrinogen in differentiating between active PTB and non-tuberculous lung diseases were 21.50 SFCs/106 PBMC, 22.50 SFCs/106 PBMC, 2128.32, and 5.02 g/L, respectively. Regression logistic analysis showed that ESAT-6 < 21.5 (OR: 1.637, 95% CI: 1.311-2.043, p < 0.001), CFP-10 < 22.5 (OR: 3.918, 95% CI: 3.138-4.892, p = 0.025), SII < 2128.32 (OR: 0.763, 95% CI: 0.603-0.967, p < 0.001), and FIB < 5.02 (OR: 2.287, 95% CI: 1.865-2.806, p < 0.001) were independent risk factors for active PTB. The specificity for ESAT-6 + CFP-10, ESAT-6 + CFP-10 + SII, ESAT-6 + CFP-10 + FIB, and ESAT-6 + CFP-10 + SII + FIB was 82.5%, 83.2%, 95.8%, and 80.1%, respectively, while sensitivity was 52.6%, 53.0%, 55.8%, and 44.7%, and positive predictive values were 85.0%, 85.6%, 84.1%, and 89.6%, respectively. SII and Fibrinogen are positively correlated with the degree of tuberculosis inflammation and the bacterial load of Mycobacterium tuberculosis. The combined detection of SII, Fibrinogen, and T-SPOT.TB is significant in distinguishing between active PTB with positive T-SPOT.TB results and non-tuberculous lung diseases.

Comparative Study of Vitamin D Levels in Newly Diagnosed Tuberculosis and a Normal Population

Background and Objectives: Tuberculosis (TB) is an ancient disease caused by Mycobacterium tuberculosis, a member of the Mycobacterium tuberculosis complex. It contributes to significant morbidity and mortality. Treatment of TB poses a considerable challenge because of emerging drug resistance and the longer duration of therapy. Various past studies, both in vitro and in vivo, have established the role of vitamin D in the pathogenesis and treatment of TB. Results of in vivo studies are inconsistent, and this study aims to determine vitamin D levels and their association with newly diagnosed TB (pulmonary and extrapulmonary) cases and normal populations. Material and Methods: A Prospective Case-Control study with 116 subjects (58 cases and 58 controls) was conducted over two years. 29 cases of pulmonary TB and 29 cases of extrapulmonary TB constituted 58 cases of TB. Vitamin D levels were measured and compared in both the cases and controls. Data analysis was carried out using SPSS software 22.0. Results: The prevalence of vitamin D deficiency was 68.96% in the cases, while it was 51.72% in the controls. The reported median and quartile of serum vitamin D levels were 14.35 ng/mL (8.65, 25.48) in the TB group and 19.08 ng/mL (13.92, 26.17) in the control group. There was a significant statistical difference between the TB and non-TB populations with a p-value of 0.029 on the Mann–Whitney test. Conclusion: Vitamin D deficiency was more prevalent in individuals with TB than those without TB.

Impact of Anti Tubercular Drugs on Biochemical Changes in Newly Diagnosed Tuberculosis Patients

Background: The disease tuberculosis (TB) continues to be a major global health concern, with high rates of morbidity and mortality, particularly in developing nations. It affects multiple organs and has the ability to alter metabolic processes. The purpose of this study was to ascertain how patients' serum biochemical markers were affected by tuberculosis and the medications used to treat it. Objective: The aim of this study is to evaluate impact of anti-tubercular drugs on biochemical changes in newly diagnosed tuberculosis patients. Methods: The cross-sectional observational study was conducted in Netrokona Medical College Hospital, Netrokona, from 1st January 2022 to 31st December 2023. A total of 120 newly diagnosed cases of pulmonary tuberculosis were enrolled and analyzed in this study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, majority 48 (40.0%) of the patients were in 31 - 40 years age group and 28 (23.3%) patients were in 41 - 50 years age group, Mean±SD of age was 36.13±11.03 years. Most of the patients 69 (57.50%) were male and 51 (42.50%) patients were female. Most of the patients 87 (72.5%) were in normal range (18.5 – 29.9 kg/m2), 15 (11.7%) of the patients were underweight (&lt;18.5) and 19 (15.8%) of the patients were overweight (&gt;30). Serum Glutamic Oxaloacetic Transaminase and Serum Glutamic Pyruvic Transaminase level were 18.00 (4.01), 21.04 (3.16) before treatment but after treatment the level became 20.10 (3.52), 22.57 (4.41). Urea and Creatinine level were 18.20 (2.31), 0.63 (0.15) before treatment but after treatment 20.01 (5.34) and 0.53 (0.13). After treatment by anti-tubercular drug gastrointestinal adverse drug effects were nausea 3 (2.5%), vomiting 6 (5.0%), diarrhea 3 (2.5%) and abdominal pain 5 (4.2%), followed by itching ......

Analysis on time delay of tuberculosis among adolescents and young adults in Eastern China.

Tuberculosis (TB) is recognized as a significant global public health concern. Still, there remains a dearth of comprehensive evaluation regarding the specific indicators and their influencing factors of delay for adolescents and young adults. All notified pulmonary TB (PTB) patients in Jiaxing City were collected between 2005 and 2022 from China's TB Information Management System. Logistic regression models were conducted to ascertain the factors that influenced patient and health system delays for PTB cases, respectively. Furthermore, the impact of the COVID-19 pandemic on local delays has been explored. From January 1, 2005 to December 31, 2022, a total of 5,282 PTB cases were notified in Jiaxing City, including 1,678 adolescents and 3,604 young adults. For patient delay, female (AOR: 1.18, 95%CI: 1.05-1.32), PTB complicated with extra-pulmonary TB (AOR: 1.70, 95% CI: 1.28-2.26), passive case finding (AOR: 1.46, 95% CI: 1.07-1.98) and retreatment (AOR: 1.52, 95% CI: 1.11-2.09) showed a higher risk of delay. For health system delay, minorities (AOR: 0.69, 95% CI: 0.53-0.90) and non-students (AOR: 0.83, 95% CI: 0.71-0.98) experienced a lower delay. Referral (AOR: 1.46, 95% CI: 1.29-1.65) had a higher health system delay compared with clinical consultation. Furthermore, county hospitals (AOR: 1.47, 95% CI: 1.32-1.65) and etiological positive results (AOR: 1.46, 95% CI: 1.30-1.63) were associated with comparatively high odds of patient delay. Contrarily, county hospitals (AOR: 0.88, 95% CI: 0.78-1.00) and etiological positive results (AOR: 0.67, 95% CI: 0.59-0.74) experienced a lower health system delay. Besides, the median of patient delay, health system delay, and total delay during the COVID-19 pandemic were significantly lower than that before. In general, there has been a noteworthy decline in the notification rate of PTB among adolescents and young adults in Jiaxing City while the declining trend was not obvious in patient delay, health system delay, and total delay, respectively. It also found factors such as gender, case-finding method, and the hospital level might influence the times of seeking health care and diagnosis in health agencies. These findings will provide valuable insights for refining preventive and treatment strategies for TB among adolescents and young adults.

Private Sector Involvement in Tuberculosis Control in An Urban City of Western India– A Cross-Sectional Study

Background: In India, TB diagnosis and treatment practices among Private Practitioners (PPs) vary widely and are not properly regulated by the national TB program. Despite their irrational and inequitable practises, PPs remain an important and preferred primary care provider for many people. The study was done to with the objectives to describe different diagnosis and treatment practices of Tuberculosis among private practitioners and their involvement in National Tuberculosis Elimination Program (NTEP). Material and Methods: A cross sectional study was performed among 303 PPs during October 2020 to March 2021 by using stratified random sampling to select private practitioners based on their speciality. Results: Most preferred investigation was Chest X ray (45.2%) followed by sputum smear microscopy (29.7%). Only 71.3% PPs practiced the correct regimen for new cases of Pulmonary TB according to NTEP. More than half of the PPs had TB training (59.7%). Majority of the PPs (90.1%) were involved in NTEP mainly by referral of TB patients to local government centres for treatment purpose. Conclusion: Preferred investigation for diagnosis of pulmonary TB was chest X-ray followed by sputum examination among PPs. The treatment regimen and duration of treatment varies among PPs as per their clinical judgement and practice.

Coinfection with Leprosy and Tuberculosis: A Case Series in Malagasy Patients.

Leprosy and tuberculosis are two of the oldest and most common mycobacterial infections, caused by Mycobacterium leprae and Mycobacteium lepramatosis for leprosy and Mycobacterium tuberculosis for tuberculosis. Dual infections have been known since ancient times; however, cases remain rarely reported in the literature, even in countries where both diseases are endemic, such as Madagascar. We report a case series of simultaneous occurrence of leprosy and tuberculosis. In this retrospective study, we reviewed the medical records of patients with leprosy registered at the Department of Dermatology, University Hospital Befelatanana, Antananarivo, Madagascar, between January 2012 and June 2021. Patients with leprosy and diagnosed as coinfected by tuberculosis were included in the study. Of the 120 leprosy cases observed during the study period, coinfection with leprosy and tuberculosis was found in five patients. The mean age was 43.4 (SD 13.2) ranging, 21-59 years. Male gender was predominant (4/5). Four patients presented with lepromatous leprosy, and one with borderline lepromatous leprosy. Three patients experienced leprosy reaction. Four cases of pulmonary tuberculosis and one case of multifocal tuberculosis were observed. The diagnosis of leprosy preceded tuberculosis in four cases, and a coinfection diagnosis was made simultaneously in one case. The average time to develop tuberculosis was 38.8 (SD 10.2) months. HIV infection, malnutrition, alcohol consumption, and long-term corticosteroid therapy were the immunosuppressive factors reported in our patients. Three patients received concomitant multidrug therapy for leprosy and tuberculosis. Dermatologists should be aware of the importance of screening patients affected by leprosy for latent or active tuberculosis to prevent morbidity and mortality due to coinfection and to reduce the risk of acquired resistance to rifampicin, which is the greatest risk of this association.

Timely Pulmonary Tuberculosis Diagnosis Based on the Epidemiological Disease Spectrum: Population-Based Prospective Cohort Study in the Republic of Korea.

Timely pulmonary tuberculosis (PTB) diagnosis is a global health priority for interrupting transmission and optimizing treatment outcomes. The traditional dichotomous time-divided approach for addressing time delays in diagnosis has limited clinical application because the time delay significantly varies depending on each community in question. We aimed to reevaluate the diagnosis time delay based on the PTB disease spectrum using a novel scoring system that was applied at the national level in the Republic of Korea. The Pulmonary Tuberculosis Spectrum Score (PTBSS) was developed based on previously published proposals related to the disease spectrum, and its validity was assessed by examining both all-cause and PTB-related mortality. In our analysis, we integrated the PTBSS into the Korea Tuberculosis Cohort Registry. We evaluated various time delays, including patient, health care, and overall delays, and their system-associated variables in line with each PTBSS. Furthermore, we reclassified the scores into distinct categories of mild (PTBSS=0-1), moderate (PBTBSS=2-3), and severe (PBTBSS=4-6) using a multivariate regression approach. Among the 14,031 Korean patients with active PTB whose data were analyzed from 2018 to 2020, 37% (n=5191), 38% (n=5328), and 25% (n=3512) were classified as having a mild, moderate, and severe disease status, respectively, according to the PTBSS. This classification can therefore reflect the disease spectrum of PTB by considering the correlation of the score with mortality. The time delay patterns differed according to the PTBSS. In health care delays according to the PTBSS, greater PTB disease progression was associated with a shorter diagnosis period, since the condition is microbiologically easy to diagnose. However, with respect to patient delays, the change in elapsed time showed a U-shaped pattern as PTB progressed. This means that a remarkable patient delay in the real-world setting might occur at both apical ends of the spectrum (ie, in both mild and severe cases of PTB). Independent risk factors for a severe PTB pattern were age (adjusted odds ratio 1.014) and male sex (adjusted odds ratio 1.422), whereas no significant risk factor was found for mild PTB. Timely PTB diagnosis should be accomplished. This can be improved with use of the PTBSS, a simple and intuitive scoring system, which can be more helpful in clinical and public health applications compared to the traditional dichotomous time-only approach.

Providing A Half Sitting Position to Pulmonary Tuberculosis Patients In The Seruni Treatment Room At The Central General Hospital

The lungs are one of the vital organs in the human body. To be precise, it is a respiratory (breathing) organ which is related to the respiratory and circulatory systems (blood circulation). Pulmonary tuberculosis is a contagious infectious disease caused by Mycobacterium tuberculosis. Meanwhile, Relapsed Pulmonary Tuberculosis is a patient with Pulmonary Tuberculosis who is declared cured or has had complete treatment and then comes back for treatment with a positive test result for a cough with phlegm from Acid-Fast Basil. The aim of this study was to determine the risk factors for pulmonary tuberculosis at the Central General Hospital of South Sulawesi. This research uses a cross sectional approach. The population in this study includes the case population, namely pulmonary tuberculosis sufferers who experienced a recurrence and the control population, namely pulmonary tuberculosis sufferers who have been declared cured. The sample in this study was all data on patients with Relapsed Pulmonary Tuberculosis who received treatment at the Central General Hospital of South Sulawesi Province. Data analysis was carried out univariate and bivariate using the chi square test. The results of the study can be concluded that there is no relationship between age and the incidence of relapse of pulmonary tuberculosis. The problem and diagnosis determined is to fulfill the need to breathe normally and the inability to fulfill the need to eat and drink enough. Meanwhile, the nursing intervention that was prepared was directed at helping to control the patient's low-fat and low-salt diet regarding sitting therapy in the Semi-Fowler position. This theory can be applied and applied well in treatment focused on pulmonary tuberculosis cases. For pulmonary tuberculosis patients who experience shortness of breath, improve the quality of their breathing by performing the semi-Fowler position as a non-pharmacological therapy.

Prevalence Of Rifampicin Resistance in New Cases Of Pulmonary Tuberculosis In Children

Objective: The research aims to determine the prevalence of rifampicin resistance in newly diagnosed pediatric pulmonary tuberculosis cases, investigating the frequency of resistance to this first-line antibiotic. By doing so, it seeks to provide insights into rifampicin's effectiveness as a treatment and contribute to understanding drug-resistant tuberculosis in children. Methods: The investigation employed a cross-sectional design to evaluate the presence of rifampicin resistance in newly diagnosed pediatric pulmonary tuberculosis cases. Executed in Lahore, Pakistan, it adopted a convenience sampling strategy with a sample size of 100. The research entailed screening children displaying symptoms of TB, acquiring written consent, and gathering demographic and clinical data, encompassing bacterial load and evidence of antibiotics. Sputum samples were processed employing the Xpert MTB/RIF assay. Statistical analyses, encompassing descriptive statistics and prevalence calculations, were executed utilizing the SPSS software. The investigation underscored the significance of resilient diagnostics, early identification, and tailored interventions for the management of drug-resistant TB in children. Results: The study provides valuable insights into rifampicin resistance among children with pulmonary tuberculosis. These findings highlight the importance of regular monitoring and appropriate treatment strategies to combat drug-resistant tuberculosis in pediatric populations. Further research and interventions are warranted to minimize the emergence and spread of drug-resistant strains in this vulnerable population. Conclusion: The study highlights the need for continuous monitoring of drug resistance patterns in children with tuberculosis, particularly concerning rifampicin, a crucial first-line antibiotic. The higher resistance rate suggests exploring alternative treatment options, optimising drug regimens, and developing interventions to prevent and manage drug-resistant tuberculosis effectively in children. Keywords: Antibiotics, Disease, Paeds, Resistance, Susceptibility, Tuberculosis.

Integrated plasma proteomics identifies tuberculosis-specific diagnostic biomarkers.

BACKGROUNDNovel biomarkers to identify infectious patients transmitting Mycobacterium tuberculosis are urgently needed to control the global tuberculosis (TB) pandemic. We hypothesized that proteins released into the plasma in active pulmonary TB are clinically useful biomarkers to distinguish TB cases from healthy individuals and patients with other respiratory infections.METHODSWe applied a highly sensitive non-depletion tandem mass spectrometry discovery approach to investigate plasma protein expression in pulmonary TB cases compared to healthy controls in South African and Peruvian cohorts. Bioinformatic analysis using linear modeling and network correlation analyses identified 118 differentially expressed proteins, significant through 3 complementary analytical pipelines. Candidate biomarkers were subsequently analyzed in 2 validation cohorts of differing ethnicity using antibody-based proximity extension assays.RESULTSTB-specific host biomarkers were confirmed. A 6-protein diagnostic panel, comprising FETUB, FCGR3B, LRG1, SELL, CD14, and ADA2, differentiated patients with pulmonary TB from healthy controls and patients with other respiratory infections with high sensitivity and specificity in both cohorts.CONCLUSIONThis biomarker panel exceeds the World Health Organization Target Product Profile specificity criteria for a triage test for TB. The new biomarkers have potential for further development as near-patient TB screening assays, thereby helping to close the case-detection gap that fuels the global pandemic.FUNDINGMedical Research Council (MRC) (MR/R001065/1, MR/S024220/1, MR/P023754/1, and MR/W025728/1); the MRC and the UK Foreign Commonwealth and Development Office; the UK National Institute for Health Research (NIHR); the Wellcome Trust (094000, 203135, and CC2112); Starter Grant for Clinical Lecturers (Academy of Medical Sciences UK); the British Infection Association; the Program for Advanced Research Capacities for AIDS in Peru at Universidad Peruana Cayetano Heredia (D43TW00976301) from the Fogarty International Center at the US NIH; the UK Technology Strategy Board/Innovate UK (101556); the Francis Crick Institute, which receives funding from UKRI-MRC (CC2112); Cancer Research UK (CC2112); and the NIHR Biomedical Research Centre of Imperial College NHS.

Mycobacterium tuberculosis-dependent monocyte expression quantitative trait loci, cytokine production, and TB pathogenesis.

The heterogeneity of outcomes after Mycobacterium tuberculosis (Mtb) exposure is a conundrum associated with millennia of host-pathogen co-evolution. We hypothesized that human myeloid cells contain genetically encoded, Mtb-specific responses that regulate critical steps in tuberculosis (TB) pathogenesis. We mapped genome-wide expression quantitative trait loci (eQTLs) in Mtb-infected monocytes with RNAseq from 80 Ugandan household contacts of pulmonary TB cases to identify monocyte-specific, Mtb-dependent eQTLs and their association with cytokine expression and clinical resistance to tuberculin skin test (TST) and interferon-γ release assay (IGRA) conversion. cis-eQTLs (n=1,567) were identified in Mtb-infected monocytes (FDR<0.01), including 29 eQTLs in 16 genes which were Mtb-dependent (significant for Mtb:genotype interaction [FDR<0.1], but not classified as eQTL in uninfected condition [FDR≥0.01]). A subset of eQTLs were associated with Mtb-induced cytokine expression (n=8) and/or clinical resistance to TST/IGRA conversion (n=1). Expression of BMP6, an Mtb-dependent eQTL gene, was associated with IFNB1 induction in Mtb-infected and DNA ligand-induced cells. Network and enrichment analyses identified fatty acid metabolism as a pathway associated with eQTL genes. These findings suggest that monocyte genes contain Mtb-dependent eQTLs, including a subset associated with cytokine expression and/or clinical resistance to TST/IGRA conversion, providing insight into immunogenetic pathways regulating susceptibility to Mtb infection and TB pathogenesis.