Risk Factors For Tuberculosis Research Articles

Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities.

Tuberculosis (TB) and cachexia are clinical entities that have a defined relationship, making them often found together. TB can lead to cachexia, while cachexia is a risk factor for TB. This article reviews cachexia in Tuberculosis patients in Southeast Asian and African regions by conducting a comprehensive literature search across electronic databases such as PubMed, Google Scholar, and Research Gate between 2013 and 2024 using keywords including 'Africa', 'cachexia', 'prevalence', 'implications', 'tuberculosis', and 'Southeast Asia. This article utilized only studies that satisfied the inclusion criteria, revealing knowledge gaps and untapped opportunities for cachexia in TB across Southeast Asian and African regions. Many Southeast Asian and Western Pacific patients initially receive a tuberculosis diagnosis. Sub-Saharan African countries are among the 30 high TB burden nations, according to the WHO. Food inadequacy and heightened energy expenditure can impair the immune system, leading to latent TB and subsequently, active infection. Symptoms needing attention: shortness of breath, productive cough, hyponatremia at 131mmol/l, hypoalbuminemia at 2.1g/dl, elevated aspartate transaminase at 75U/l, increased lactate dehydrogenase at 654, and normocytic anemia. Comorbidities, such as kidney disease, cardiovascular disease, and asthma, can influence the nutritional status of individuals with TB. While efforts like screening, contact tracing, and utilizing gene Xpert to detect TB cases were implemented, only a few proved effective. It is essential to conduct further studies, including RCTs, in Southeast Asia and Africa to evaluate and manage cachexia in TB patients.

The effect of smoking on nontuberculous mycobacterial pulmonary disease and tuberculosis: a nationwide retrospective cohort study.

Although smoking is an established risk factor for Mycobacterial infection, the association between smoking and nontuberculous mycobacterial pulmonary disease (NTM-PD) remains unclear. We evaluated the association between smoking and NTM-PD and tuberculosis (TB) using a population-based South Korean nationwide cohort. Using the Korean National Health Insurance Database, we screened individuals over 20years of age who underwent the national health screening program in 2009. Out of 3,774,308 eligible populations, we identified 2,964 and 26,112 cases of newly developed NTM-PD and TB, respectively. We used multivariate Cox proportional hazards models to estimate the adjusted hazard ratios (aHRs) of risk factors for NTM-PD and TB. The incidence rates for developing NTM-PD and TB were 0.08 and 0.68 per 1,000 person-years, respectively. Current smokers (aHR 0.63, 95% confidence interval [CI] 0.56-0.71) and current heavy smokers (≥ 20 pack-years, aHR 0.74, 95% CI 0.63-0.86) were at lower risk for NTM-PD development than never smokers. On the contrary, current smokers (aHR 1.19, 95% CI 1.15-1.23) and current heavy smokers (aHR 1.27, 95% CI 1.22-1.33) had a higher risk for TB development than never smokers. These trends were augmented if individuals started smoking before age 20years. In subgroup analyses stratified by age, these trends were prominent in the 40-64years age range. Current smoking was associated with a decreased risk of NTM-PD and increased risk of TB. These risks were augmented by early smoking initiation and in the middle age population.

Malnutrition in tribal people living with tuberculosis in India: A systematic review & meta-analysis.

Background & objectives Tuberculosis (TB) remains a persistent public health challenge in India. The country also has high proportions of malnutrition in different areas, making the population susceptible to TB. Among vulnerable populations, such as tribal communities, TB and malnutrition pose significant threats. Tribal populations exhibit disproportionately higher TB prevalence rates compared to non-tribal groups. Also, malnutrition prevalence among tribal communities far exceeds national averages in India. Amidst fragmented data, a systematic review of nutritional status among tribal populations with TB in India is imperative to inform comprehensive intervention strategies. Methods Cross-sectional, case-control, cohort and interventional studies reporting the nutritional status of active TB affected individuals among tribal populations in India were specifically included if terms such as "malnutrition" or "low BMI" were used. This systematic review followed PRISMA guidelines and was registered with PROSPERO (CRD42020168328). The data was assessed using a random-effects model and standardized mean with 95% confidence interval (CI). The I2 statistics indicated heterogeneity. Publication bias was evaluated using funnel plots. Results Out of 124 studies, 20 were selected for initial screening, 15 were excluded due to a lack of appropriate data, and five were included for the final analysis. The pooled prevalence estimates of malnutrition among Indian tribes living with TB was 514 per 1000 people, with 95% CI: 232-791. The sensitivity analysis showed that no individual study influenced the estimation of pooled prevalence. Interpretation & conclusions In the background of India, contributing considerably to the burden of TB-related morbidity and mortality alongside undernutrition, reviews have underscored undernutrition as the predominant risk factor for TB, affecting over 50 per cent of the population in some States. This situation is exacerbated among the tribal communities in India due to the dual burdens of undernutrition and TB being more pronounced. Our systematic review consolidates evidence from five studies, revealing the prevalence of malnutrition among tribal TB patients. Conducting well-planned implementation research to address this dual burden among the underprivileged population would help achieve the ambitious goal of a TB-free India 2025.

Risk factors for multidrug-resistant tuberculosis: a predictive model study

Risk factors for multidrug-resistant tuberculosis: a predictive model study

The impact of diabetes mellitus on tuberculosis recurrence in Eastern China: a retrospective cohort study

BackgroundThe comorbidity of tuberculosis (TB) and diabetes mellitus (DM) is a significant global public health issue. This study aims to explore the recurrence risk and related factors of active pulmonary TB, specifically focusing on the impact of DM.MethodsA retrospective cohort study was conducted in Lianyungang City, Jiangsu Province, Eastern China by recruiting 12,509 individuals with newly diagnosed pulmonary TB between 2011 and 2019. The Cox proportional hazards models were performed to identify risk factors of recurrence and assess the association between DM and recurrence. The hazard ratio (HR) and 95% confidence interval (CI) were used to estimate the strength of the association.ResultsAfter a median follow-up period of 5.46 years, we observed 439 recurrent cases (incident recurrence rate: 6.62 per 1000 person-years). Males (HR: 1.30, 95% CI: 1.03–1.64), patients aged ≥ 60 years (HR: 1.39, 95% CI: 1.15–1.70), DM (HR: 2.40, 95% CI: 1.68–3.45), and etiologic positivity in the initial episode (HR: 2.42, 95% CI: 2.00-2.92) had a significantly increased risk of recurrence.ConclusionsRecurrence of pulmonary TB patients who have completed treatment, especially those who also suffer from DM, should be a concern. Enhanced follow-up and targeted surveillance of these high-risk groups are needed.

HIV, malnutrition, and noncommunicable disease epidemics among tuberculosis-affected households in east and southern Africa: A cross-sectional analysis of the ERASE-TB cohort.

As a result of shared social and structural risk factors, people in households affected by tuberculosis may have an increased risk of chronic conditions; at the same time, tuberculosis screening may be an opportunity for interventions. We sought to describe the prevalence of HIV, nutritional disorders, and noncommunicable diseases (NCDs) among members of tuberculosis-affected households in 3 African countries. A part of a multicountry cohort study, we screened for tuberculosis, HIV, nutritional disorders (underweight, anaemia, overweight/obesity), and NCDs (diabetes, hypertension, and chronic lung disease) among members of tuberculosis-affected households aged ≥10 years in Mozambique, Tanzania, and Zimbabwe. We describe the prevalence of these conditions, their co-occurence within individuals (multimorbidity) and household-level clustering. Of 2,109 household contacts recruited, 92% (n = 1,958, from 786 households) had complete data and were included in the analysis. Sixty-two percent were female, median age was 27 years, and 0.7% (n = 14) were diagnosed with co-prevalent tuberculosis. Six percent of household members (n = 120) had previous tuberculosis, 15% (n = 294) were living with HIV, 10% (n = 194) had chronic lung disease, and 18% (n = 347) were anaemic. Nine percent of adults (n = 127) had diabetes by HbA1c criteria, 32% (n = 439) had hypertension. By body mass index criteria, 18% household members (n = 341) were underweight while 29% (n = 549) were overweight or obese. Almost half the household members (n = 658) had at least 1 modifiable tuberculosis risk factor. Sixty-one percent of adults (n = 822) had at least 1 chronic condition, one in 4 had multimorbidity. While most people with HIV knew their status and were on treatment, people with NCDs were usually undiagnosed and untreated. Limitations of this study include use of point-of-care HbA1c for definition of diabetes and definition of hypertension based on single-day measurements. Households affected by tuberculosis also face multiple other health challenges. Integrated approaches to tuberculosis screening may represent an opportunity for identification and treatment, including prioritisation of individuals at highest risk for tuberculosis to receive preventive therapy.

Association of variant vitamin statuses and tuberculosis development: a systematic review and meta-analysis

Background Several studies have suggested an association between vitamin deficiency and the development of tuberculosis; however, the precise impact remains unclear. This study aimed to elucidate the relationship between distinct vitamin statuses and the occurrence of tuberculosis. Materials and methods Retrieval was conducted using several databases without language restrictions to capture the eligible studies on tuberculosis and vitamin status. Pooled odds ratios (ORs), relative risks (RRs), and hazard ratios (HRs) were used with 95% confidence intervals (CIs) to clarify the relationship between the different vitamin statuses (A, B, D, and E) and the occurrence of tuberculosis. Subgroup analysis, sensitivity analysis, meta-regression analysis, and Galbraith plot were performed to determine sources of heterogeneity. Potential publication biases were detected using Begg’s test, Egger’s test, and the trim-and-fill test. Results We identified 10,266 original records from our database searches, and 69 eligible studies were considered in this study. The random-effect model showed that people with tuberculosis may exhibit vitamin A deficiency (OR = 10.66, 95%CI: 2.61–43.63, p = .001), while limited cohort studies showed that vitamin A supplementation may reduce tuberculosis occurrence. Additionally, vitamin D deficiency was identified as a risk factor for tuberculosis development (RR = 1.69, 95%CI: 1.06–2.67, p = .026), and people with tuberculosis generally had lower vitamin D levels (OR = 2.19, 95%CI: 1.76–2.73, p < .001) compared to other groups. No publication bias was detected. Conclusions This meta-analysis indicated that people with tuberculosis exhibited low levels of vitamins A and D, while vitamin D deficiency was identified as a risk factor for tuberculosis. More randomized controlled interventions at the community levels should be recommended to determine the association between specific vitamin supplementation and tuberculosis onset.

Audit of risk factors of drug-sensitive, drug-resistant tuberculosis disease, a case-control study of patients registered under NTEP, Gujarat

ABSTRACT Background: Characterizing risk factors for drug-resistant tuberculosis (TB) is critical to guide targeted interventions in high-burden settings like India. We aimed to identify socioeconomic, lifestyle, and clinical factors associated with drug-sensitive and drug-resistant TB acquisition. Materials and Methods: A comparative cross-sectional study recruited 350 bacteriologically confirmed TB patients registered under the National Tuberculosis Elimination Program (NTEP) in Gujarat, India, and 300 matched participants without active/past TB. Multinomial logistic regression analyzed risk factors for 200 drug-sensitive and 150 drug-resistant TB cases compared to participants without active or past TB. Results: Key factors independently associated with higher adjusted odds ratios (aOR) of both TB types included low socioeconomic status (SES) (drug-sensitive TB: aOR 1.7, 95% CI 1.2-2.5; drug-resistant TB: aOR 2.2, 95% CI 1.3-3.7), crowding (&gt;5 persons/room) (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 1.9, 95% CI 1.2-2.9), undernutrition (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 2.0, 95% CI 1.2-3.2), smoking (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.3; drug-resistant TB: aOR 1.7, 95% CI 1.1-2.7), and indoor air pollution (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.2; drug-resistant TB: aOR 1.8, 95% CI 1.2-2.8). Conclusion: Marked social determinants and clinical risks drive heightened susceptibility for both TB types in India, while prior inadequate treatment and nosocomial exposures selectively enable additional drug resistance. Holistic prevention policies jointly targeting transmission, vulnerability, and curative factors are imperative.

Evaluation of the Tuberculosis Infection Care Cascade Among Pregnant Individuals in a Low-Tuberculosis-Burden Setting.

In the United States, tuberculosis (TB) screening is recommended for pregnant individuals with TB risk factors. We conducted a retrospective study of perinatal TB infection testing and treatment in a tertiary health system. Of 165 pregnant individuals with positive TB infection tests, only 9% completed treatment within 4.6 years of follow-up.

Type 2 diabetes mellitus as an independent risk factor of pulmonary tuberculosis: A hospital based cross-sectional study

Background: The growing frequency of infectious and non-communicable illnesses on a global scale is primarily associated with the changing patterns observed in epidemiology. Diabetes mellitus (DM) significantly leads to the development of tuberculosis (TB) and less effective treatment outcomes if not identified early. Objective: This study aims to investigate type 2 DM as a risk factor for TB infection.Methods: Participants in this cross-sectional research study comprised DM patients who reported cough complaints at the TB treatment center and the internal medicine department of Zainoel Abidin Hospital. Random blood glucose and glycated hemoglobin (HbA1c) levels were measured in all respondents. The Chi-Square test assesses the association between DM and Pulmonary TB.Results: There are 48 DM patients with new pulmonary TB, an averageage of 53 years (SD 9.1). Most of them have symptoms of cough for more than 2 weeks (85.4%), loss of body weight (77.1%), chest pain (58.3%), and loss of appetite (72.9%). The high HbA1c levels were associated with TB, as detected by Xpert MTB/RIF assay and typical radiographic signs (p&lt;0.05). DM patients with increased HbA1c were found to have a two times chance of showing results from a chest x-ray typical of TB and probability of TB infection (PR: 2.850, 95% CI (1.152-7.053); 2.745, 95% CI (0.969-7.780)) respectively.Conclusion: DM patients had two times the risk of lung damage based on chest X-rays and having TB. DM may seriously compromise the efficacy of TB control programs and impede a nation's progress toward TB elimination.

Frequency and risk factors for Miliaria Tuberculosa in Bangui

Introduction: We conducted this study to describe the epidemiological and clinical profiles of patients with tuberculosis miliaria and to identify risk factors for the disease. Methodology: This was a case-control study of patients with tuberculosis miliaria (cases) and non-tuberculosis (controls), who were followed between 1 April 2010 and 31 December 2017 at the Friendship Hospital in Bangui. Results: A total of 192 patients were included, including 96 cases of miliaria tuberculosa and 96 controls. The mean age was 40.9±14.1 years [20; 87] for cases compared to 36.6+4.4 years [20; 45] for controls. The sex ratio was 1.2 in cases compared to 1 in controls. The in-hospital frequency of miliary tuberculosis was 15.5% out of a total of 621 tuberculosis cases. The frequency of TB/HIV co-infection was 69.7% (108/155). The median CD4 T cell count was 100/mm3 [1; 646] in cases versus 100/mm² [1; 1079] in controls. The case fatality rate was 35.4% compared to 33.3% for controls. HIV infection was the risk factor for miliary tuberculosis (p = 0.04; OR=2.1[1.1-4.5]). Ko Conclusion: In the Central African Republic, the hospital incidence of tuberculosis miliaria in Bangui is high, and HIV is associated with its occurrence. Effective preventive measures could reduce the incidence of this disease. Keywords: Miliary tuberculosis, epidemiology, Bangui.

Overview of Tuberculosis: Causes, Symptoms and Risk Factors

Tuberculosis (TB) remains a global health threat, exacerbated by factors such as drug resistance, co-infections, and social determinants of health. This comprehensive review examines various aspects of TB, including epidemiology, pathophysiology, diagnosis, treatment, prevention, and control measures. The bacterium Mycobacterium tuberculosis causes TB and primarily affects the lungs, although it can also affect other organs. Risk factors for TB include poverty, malnutrition, overcrowded living conditions, and immunocompromised states such as HIV/AIDS. Symptoms of TB include cough, fever, weight loss, and night sweats, but can vary depending on the site of infection. Diagnosis typically involves clinical evaluation, imaging studies, and microbiological testing, with rapid molecular tests such as the Xpert MTB/RIF assay revolutionizing TB diagnostics. Treatment consists of multidrug therapy for six to nine months, with drug-resistant TB requiring longer and more complex regimens. Prevention and control efforts focus on early case detection, treatment adherence, infection control measures, and Bacille Calmette-Guérin (BCG) vaccine vaccination. TB research and innovation aim to develop new diagnostics, drugs, and vaccines to improve TB control and treatment outcomes. Challenges to TB control include stigma, healthcare access barriers, and the rise of drug-resistant TB strains. Collaboration and advocacy efforts are essential for addressing TB in special populations, high-risk settings, and co-infection scenarios. Integrating a One Health approach, harnessing technology, and addressing climate change impacts is critical for advancing TB control efforts and achieving the goal of ending the global TB epidemic.

Tuberculosis risk in patients with Crohn's disease on biologics: a retrospective analysis of the Japanese Medical Claims Database.

Treatment using tumor necrosis factor-α (TNF-α) inhibitors is one of the risk factors for active tuberculosis (TB) in patients with Crohn's disease (CD). Biologics, such as ustekinumab (UST) and vedolizumab (VDZ), are less likely to cause opportunistic infections. However, large-scale studies for active TB and biologics other than TNF-α inhibitors are limited. We aimed to investigate the association between biologics and active TB utilizing a Japanese medical claims database. We analyzed retrospectively the association of the risk of active TB development with treatment using TNF-α inhibitors and other biologics (UST and VDZ) in patients with CD using the Japanese Medical Data Vision (MDV) database between April 2008 and June 2022. The durations of each biologic and biologic-free treatment were calculated for each patient. Univariate and multivariate analyses were performed using the Cox proportional hazards model, with the utilization of biologics considered as time-dependent covariates. We included 28,811 patients with CD in MDV database. Finally, 17,169 patients were analyzed. In total, 7,064 patients were categorized as biologic-naïve, while 10,105 were classified as biologic-experienced. Seventeen patients developed active TB, including 7 on infliximab, 5 on adalimumab, and 5 on no biologics. None of the patients treated with UST and VDZ developed active TB. Multivariate analysis suggested that TNF-α inhibitors were the risk factors for active TB (hazard ratio, 3.66; P= 0.020). TNF-α inhibitors, but not UST or VDZ, are risk factors for active TB in Japanese patients with CD.

Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe

ObjectivesTuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/105 in the background population. MethodsWe included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models. ResultsAmong 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up (PYFU), corresponding to 1.87/1000 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/1000 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and >12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count <200 cells/mm3, HIV RNA >100,000 copies/mL, injecting drug use and heterosexual transmission. ConclusionsTB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation.

Drug resistance in drug-resistant tuberculosis patients with and without diabetes mellitus: a comparative analysis

BackgroundThis dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a global public health concern. This study aims to compare drug resistance in drug-resistant tuberculosis (DR-TB) patients with and without DM and analyse the risk factors of multidrug-resistant tuberculosis (MDR-TB).MethodsA total of 893 DR-TB patients were admitted to Wenzhou Central Hospital between January 2018 and December 2022. After excluding 178 cases with incomplete clinical and laboratory data, 715 patients were included in the study. These patients were then categorized into two groups based on the presence of type 2 DM: the DM group (160 cases) and the non-DM group (555 cases). Demographic information, baseline clinical characteristics, laboratory and imaging test results, clinical diagnoses, and other relevant data were collected for analysis. Statistical analysis was conducted on demographic information, clinical parameters, drug resistance spectrum, and risk factors for multidrug resistance.ResultsIn both the DM and non-DM groups, the order of resistance to first-line anti-tuberculosis drugs is isoniazid, streptomycin, rifampicin, and ethambutol. There is no significant difference in the proportion of mono-resistant tuberculosis, polydrug-resistant tuberculosis, and multidrug-resistant tuberculosis between the two groups (P > 0.05). The prevalence of MDR-TB in both groups shows a downward trend between 2018 and 2022, but the trend is not statistically significant (P > 0.05). Among patients without DM, residence in rural areas, retreatment of tuberculosis, pulmonary cavity, and uric acid ≥ 346 µmol/L are identified as independent risk factors for MDR-TB. Among patients with DM, residence in rural areas, retreatment of tuberculosis, pulmonary cavity, and HbA1c ≥ 9.8% were identified as independent risk factors for MDR-TB.ConclusionIsoniazid is the most resistant drug among DR-TB patients with and without DM. There is no statistically significant difference in drug resistance patterns between the two groups. Some progress has been made in the prevention and control of DR-TB in this area, but the effect is not very significant. There are differences in the risk factors of MDR-TB between patients with and without DM.

Risk factors of pulmonary tuberculosis in Indonesia: A case-control study in a high disease prevalence region.

Tuberculosis (TB) remains one of the most widespread infectious diseases in the world, with high mortality and morbidity rates, contributing to a significant disease burden, particularly in developing countries. The aim of this study was to determine the risk factors of TB among the population aged 17 years (late adolescent) and above in one of the high TB prevalence countries, Indonesia. A case-control study was conducted in Banda Aceh, Indonesia, involving newly diagnosed pulmonary TB patients who visited one of the eleven community health centers in Banda Aceh. The controls were individuals matched by age and sex who lived near the cases and had no TB infection. A total of 16 risk factors were assessed. Hierarchical multivariable logistic regression models were used to examine the association between the risk factors and the occurrence of TB. A total of 196 cases and 196 controls were included in the study. Multivariable logistic regression analysis identified 11 independent predictors for the occurrence of TB after controlling possible confounders. Patients who lived in houses with insufficient light exposure were 77 times more likely to develop TB compared to those living in houses with sufficient light exposure (adjusted odds ratio (AOR): 77.69; 95%CI: 27.09, 222.79). The study also showed that people who had close contact with TB patients (AOR: 25.39; 95%CI: 2.10, 306.52), had poor knowledge of TB (AOR: 24.2; 95%CI: 6.89, 85.17), had comorbidities (AOR: 4.49; 95%CI: 1.35, 14.89), insufficient food utilization (AOR: 3.41; 95%CI: 1.51, 7.71), negative preventive behavior (AOR: 3.39; 95%CI: 1.49, 7.72), low education level (AOR: 3.08; 95%CI: 1.26, 7.55), and insufficient housing humidity (AOR: 2.89; 95%CI: 1.18, 7.12) were associated with increased the odds of having TB. Being employed, having income above minimum wage, and having good nutritional intake were protective factors for developing TB. In conclusion, the determinants of TB among people aged 17 years and older are a clear indication of the need for TB prevention programs targeting not only individual risk factors but also environmental risk factors, particularly providing adequate housing conditions. This study provided useful information that might help to develop and adopt effective policies for TB control in Indonesia.

Risk factors of tuberculosis in children with adult household tuberculosis contact

Background Since children are more likely than adults to become infected with Mycobacterium tuberculosis or suffer from tuberculosis (TB), it is important to identify the risk factors of TB in children with adult household TB contacts. Objective To identify the risk factors of TB in children with adult household TB contacts. Methods This cross-sectional study was conducted at the Pediatric Respirology Inpatient Ward and Outpatient Clinic at Dr. Soetomo Hospital, Surabaya, Indonesia, using medical records of hospitalized patients from 2010 to 2018. Patients were children below 18 years of age who had a history of adult TB household contact(s). We analyzed age at TB diagnosis, nutritional status, BCG vaccination status, and HIV status as possible risk factors of TB. Results A total of 367 children with adult household TB contacts were included in our study. Age of &lt;5 years (OR 8.38; 95%CI 3.78 to 18.21; P&lt;0.001), severe malnutrition (OR 8.88; 95%CI 1.19 to 66.27, P&lt;0.05), absence of BCG scar (OR 2.96; 95%CI 1.32 to 6.62, P&lt;0.05), and positive HIV status (OR 6.72; 95%CI 1.72-38.49, P&lt;0.05) were risk factors for contracting active TB. Conclusion Age of &lt;5 years, severe malnutrition, absence of BCG scar, and positive HIV status are significant risk factors for active TB in children with adult household TB contacts.

Nutritional Deficiencies, Vitamin D Levels, and other Risk Factors in Pediatric Tuberculosis Patients

Background: Tuberculosis (TB) is a major world health challenge affecting more than 9 million people every year of which more than 1 million are children. It presents non-specific symptoms and for this reason has been described as a silent epidemic, especially in the diagnosis of childhood TB, especially in bacteriological confirmation. Understanding the risk factors of TB in children is therefore important. Objectives: to describe socio-economic, environmental, and health related characteristics of childhood TB patients in Nowshera, Pakistan, and their risk factors in order to propose public health interventions. Study design: A Cross-Sectional-Study Place and duration of study : This research study is proposed to be conducted in Nowshera Medical College / Nowshera Medical College / Qazi Hussain Ahmed Medical Complex situated in Nowshera, Khyber Pakhtunkhwa province of Pakistan over a period of eight months starting from the first of 03 March 2022 to 03 December 2022 Materials and Methods: A cross-sectional study was carried out at the DOTS-center of Nowshera Medical College / Qazi Hussain Ahmed Medical Complex Nowshera from 1st March to 31st October 2022 and comprised of 130 patients. In this study, Convenience sampling (Non probability) was used. The data was collected by a structured questionnaire and analyzed by statistical package for the social sciences (SPSS version 24). Quantitative data were described by measures of central tendencies; mean and standard deviation and qualitative data were described by frequencies and percentages. Chi-square test was used to test the relationship between variables where the level of statistical significant was set at P ≤ 0. 05. Results: Participants included mainly the study population of children aged 0-15 years, and the gender was equally split throughout boy 50% and girls 50%. A large percentage (69. 2%) were from low income earners’ homes, and 66. 9% of the respondents were from rural areas. Subjects’ Body Mass Index (BMI) varied from less than 18 to more than 25. Of special interest, 43. 8% of the children with TB had not been administered BCG vaccination. The source of infection, that is, contact with an adult TB patient, was reported in 43. 8% while the rest were in the 56. 2 % who had no such history. Conclusion: childhood TB in the population under study is significantly related with some factors namely; direct contact with TB patients, low economic status, crowded housing, poor ventilation and malnutrition

Analyzing risk factors of tuberculosis using type-2 interval-valued trapezoidal fuzzy numbers with Einstein aggregation operators extended to MCDM

The principal motive of this work is to evolve and initiate an extension from interval-valued fuzzy sets to type-2 interval-valued fuzzy sets (T2IVFS) related to weighted aggregation functions containing the Einstein operator. The chief reason for this extension is that the constancy of the terms can also be taken into data during the aggregation operation. The main goal of this article is to compose the aggregation operators and their characteristics such as the Type-2 interval-valued fuzzy Einstein weighted arithmetic aggregating operator (T2IVFEWA), Type-2 interval-valued fuzzy Einstein weighted geometric aggregating operator (T2IVFEWG), and the characteristics are expressed. At last, to intimate the effectiveness of the suggested approach and explicate the purpose of these operators, a hybrid multi-criteria decision-making problem (MCDM) to select the best risk factor for Tuberculosis (TB) is considered and the result is compared with the outcome of the existing operators and methods. Additionally, a sensitivity analysis was conducted to verify the robustness of the proposed decision-making process.

Painful Enlarging Cervical Mass in Young Male.

A 32-year-old male who recently immigrated from Kenya presented to the emergency department (ED) with a painful, enlarging, right-sided neck mass for eight weeks duration. Point-of-care ultrasound was used to reveal a large cystic mass with internal septations and numerous hypoechoic round lesions. Initial tuberculosis blood test ordered in the ED was positive with cultures ultimately growing Mycobaceterium tuberculosis. Scrofula should be considered in the differential in patients presenting with enlarging neck masses who have epidemiological risk factors for tuberculosis.