Spread Of Tuberculosis Research Articles

Studi Prevalensi dan Faktor Risiko Penyebaran Penyakit Tuberkulosis Paru pada Warga Binaan di Lembaga Pemasyarakatan Kelas IIA Jember

The World Health Organization (WHO) estimates that Mycobacterium tuberculosis, the single agent causing pulmonary tuberculosis (TB), infects 1.8 billion people, or around one-quarter of the world's total population. In Indonesia, there are an estimated 969,000 cases of pulmonary TB, including 443,235 reported cases. Prison is a high transmission site for pulmonary TB. Prison circumstances, such as high occupancy capacity, inadequate ventilation and nutrition, difficulties accessing health care, inadequate treatment, and weak patient immunity, are some of the variables influencing this. Knowledge on the origins, transmission, preventative strategies, and early diagnosis of pulmonary TB infection is essential for the prisoner in order to change attitudes toward pulmonary TB infection. This study used a descriptive approach to generate a description of the prevalence and risk factors for the spread of pulmonary tuberculosis in the Prison of Jember Class IIA. Based on the WHO-recommended screening technique, 4 male prisoners in the Prison of Jember Class IIA (8.5%) tested positive for pulmonary tuberculosis. There are various aspects that are difficult to include into environmental health standards, particularly infectious diseases like pulmonary tuberculosis, such as the density of people in a single cell room and the construction of the building and the services housed inside it. Policymakers must pay attention to the requirement to create appropriate isolation rooms and, at the very least, satisfy room standards for patients suffering from pulmonary tuberculosis.

ACTIVITIES OF THE DEPARTMENTS OF THE ‟ALL-RUSSIA LEAGUE FOR FIGHTING TUBERCULOSIS” IN KOSTROMA PROVINCE IN 1911-1918

The article is devoted to the little-studied problem of the activity of departments of the “all-Russia League for Fighting Tuberculosis” in Kostroma Province. The sources are the documents of the State Archive of Kostroma Region. An attempt is made to establish the extent of the department of “all-Russia League for Fighting Tuberculosis” in the territory of Kostroma Province. The activities carried out by the League’s departments are considered on extensive factual material. The author comes to the conclusion that the activities of the departments of the “all-Russia League for Fighting Tuberculosis” were able to contain the spread of tuberculosis in Kostroma Province to a certain extent. The practical significance of the study lies in the possibility of using the regional experience of the League’s departments in fighting the social diseases, such as tuberculosis, in modern society.

MATHEMATICAL MODELLING OF PRIMARY INFECTION TUBERCULOSIS WITH ASTHMA AS A SECOND INFECTION

Tuberculosis is an infectious disease caused by Mycobacterium Tuberculosis. Tuberculosis patients undergoing long-term tuberculosis treatment have a high risk to get asthma as a second infection. A person suffering from asthma cannot recover. Asthma therapy is only to control the development of asthma so that asthma does not get worse. In this study we discusses the spread of tuberculosis with asthma as a secondary infection. We perform the model into system of non- linear differential equation that consist of six equation because the population divided into six sub-population which are susceptible, infected by tuberculosis, undergoing tuberculosis treatment, infected by asthma, undergoing asthma treatment and recovered from tuberculosis. From the model that has been formed, we perform the analysis to obtain the equilibrium point and the basic reproduction number. Then we show the local stability of the equilibrium point and perform simulations to provide an illustration. From the analytical result, we got that the spread influence by recruitment rate, infection rate, natural death rate, tuberculosis treatment rate and death rate because of tuberculosis.

Rationally Designed Novel Phenyloxazoline Synthase Inhibitors: Chemical Synthesis and Biological Evaluation to Accelerate the Discovery of New Antimycobacterial Antibiotics.

The uncontrolled spread of drug-resistant tuberculosis (DR-TB) clinical cases necessitates the urgent discovery of newer chemotypes with novel mechanisms of action. Here, we report the chemical synthesis of rationally designed novel transition-state analogues (TSAs) by targeting the cyclization (Cy) domain of phenyloxazoline synthase (MbtB), a key enzyme of the conditionally essential siderophore biosynthesis pathway. Following bio-assay-guided evaluation of TSA analogues preferentially in iron-deprived and iron-rich media to understand target preferentiality against a panel of pathogenic and non-pathogenic mycobacteria strains, we identified a hit, i.e., TSA-5. Molecular docking, dynamics, and MMPBSA calculations enabled us to comprehend TSA-5's stable binding at the active site pocket of MbtB_Cy and the results imply that the MbtB_Cy binding pocket has a strong affinity for electron-withdrawing functional groups and contributes to stable polar interactions between enzyme and ligand. Furthermore, enhanced intracellular killing efficacy (8 μg/mL) of TSA-5 against Mycobacterium aurum in infected macrophages is noted in comparison to moderate in vitro antimycobacterial efficacy (64 μg/mL) against M. aurum. TSA-5 also demonstrates whole-cell efflux pump inhibitory activity against Mycobacterium smegmatis. Identification of TSA-5 by focusing on the modular MbtB_Cy domain paves the way for accelerating novel anti-TB antibiotic discoveries.

Routing and Logistics of Pulmonary Tuberculosis Patients During Selection for Surgical Treatment in the Republic of Bashkortostan

Introduction. Surgical intervention is recognized as an integral part of pulmonary tuberculosis treatment. Optimal routing of pulmonary tuberculosis patients to surgical treatment essentially improves the effectiveness of tuberculosis treatment. The paper is aimed at analyzing the routing of pulmonary tuberculosis patients to surgical treatment in the Republic of Bashkortostan. Materials and methods. The paper presents the structure of Republican Clinical Tuberculosis Dispensary, describes the routing of patients followed by the TB Service of the Republic of Bashkortostan, indicates a significant role of telehealth technologies in providing specialized medical care for patients with pulmonary tuberculosis. In addition, the paper introduces the quantitative data and structure of surgical interventions performed in the TB Surgery Unit of the Republican Clinical Tuberculosis Dispensary. Results and discussion. According to the conducted analysis, the TB Service of the Republic of Bashkortostan complies with the regulatory documents of the Russian Federation, thus ensuring the most complete coverage of pulmonary tuberculosis patients in need of thoracic surgery. Conclusion. Timely routing of patients to a TB surgery unit enables effective treatment, differential diagnosis, and abacillation of patients to be provided, thereby reducing the spread of tuberculosis in the region.

QSAR modeling, molecular docking, dynamic simulation and ADMET study of novel tetrahydronaphthalene derivatives as potent antitubercular agents

BackgroundTuberculosis is an air-borne contagious disease caused by slow-growing Mycobacterium tuberculosis (Mtb). According to Global Tuberculosis Report 2022, 1.6 million people were infected by tuberculosis in 2021. The continuing spread of drug-resistant tuberculosis (TB) is one of the most difficult challenges to control the tuberculosis. So new drug discovery is essential to the treatment of tuberculosis. This study aims to develop a QSAR model to predict the antitubercular activity of tetrahydronaphthalene derivatives. The QSARINS was used in this study to develop the QSAR predictive model.ResultsA number of tetrahydronaphthalene derivatives with MIC90 values were obtained from the literature to develop the QSAR predictive model. The compounds were divided into two sets: a training set consisting of 39 compounds and a test set containing 13 compounds. The best predictive Model 4 has R2: 0.8303, Q2LOO: 0.7642, LOF: 0.0550, Q2-F1: 0.7190, Q2-F2: 0.7067, Q2-F3: 0.7938 and CCCext: 0.8720. Based on the developed QSAR equation, the new compounds were designed and subjected to molecular docking, molecular dynamics and ADMET analysis.ConclusionIn the QSAR model, the molecular descriptors of MATS8s, Chi4, bcutv8, Petitjeant and fr_aniline were highly influenced the antitubercular activity. The developed QSAR model helps to predict the antitubercular activity of tetrahydronaphthalene derivatives.

Implementation of national whole-genome sequencing of Mycobacterium tuberculosis, National Public Health Laboratory, Singapore, 2019-2022.

The National Tuberculosis Programme (NTBP) monitors the occurrence and spread of tuberculosis (TB) and multidrug-resistant TB (MDR-TB) in Singapore. Since 2020, whole-genome sequencing (WGS) of Mycobacterium tuberculosis isolates has been performed at the National Public Health Laboratory (NPHL) for genomic surveillance, replacing spoligotyping and mycobacterial interspersed repetitive unit-variable number tandem repeats analysis (MIRU-VNTR). Four thousand three hundred and seven samples were sequenced from 2014 to January 2023, initially as research projects and later developed into a comprehensive public health surveillance programme. Currently, all newly diagnosed culture-positive cases of TB in Singapore are prospectively sent for WGS, which is used to perform lineage classification, predict drug resistance profiles and infer genetic relationships between TB isolates. This paper describes NPHL's operational and technical experiences with implementing the WGS service in an urban TB-endemic setting, focusing on cluster detection and genomic drug susceptibility testing (DST). Cluster detection: WGS has been used to guide contact tracing by detecting clusters and discovering unknown transmission networks. Examples have been clusters in a daycare centre, housing apartment blocks and a horse-racing betting centre. Genomic DST: genomic DST prediction (gDST) identifies mutations in core genes known to be associated with TB drug resistance catalogued in the TBProfiler drug resistance mutation database. Mutations are reported with confidence scores according to a standardized approach referencing NPHL's internal gDST confidence database, which is adapted from the World Health Organization (WHO) TB drug mutation catalogue. Phenotypic-genomic concordance was observed for the first-line drugs ranging from 2959/2998 (98.7 %) (ethambutol) to 2983/2996 (99.6 %) (rifampicin). Aspects of internal database management, reporting standards and caveats in results interpretation are discussed.

Epidemiologic surveillance system for drug-resistant tuberculosis in the Republic of Tajikistan: problems and ways of its improvement

Objective. Development of recommendations for improving the system of epidemiological surveillance of drug-resistant tuberculosis.Material and methods. The surveillance system for drug-resistant tuberculosis in Dushanbe and the Rudaki district was evaluated, following the guidelines provided by the US Centers for Disease Control and Prevention (CDC). Results. The tuberculosis (TB) surveillance framework is multifaceted with multiple reporting tiers. The reporting forms provided by the government do not provide information on the indicators needed to track the spread of multidrug-resistant TB. An evaluation of timeliness revealed that appropriate treatment commenced promptly in 52% of cases (42 out of 80): 54% (29 out of 54 cases) in Dushanbe and 50% (13 out of 26) in the Rudaki district. Delays were associated with multiple drug resistance in comparison to other types of drug resistance (OR-4.3; 95% CI 1.7-11.1), outpatient in contrast to inpatient treatment (OR-5.3; 95% CI 1.1-27.0).Conclusion. The epidemiological surveillance system for TB with drug-resistant strains in both regions achieves its intended goals and objectives. However, the system’s flexibility, timeliness, and acceptability require further refinement.

Knowledge, Attitude and Practice towards Tuberculosis and its Treatment in Qassim Region, Saudi Arabia: A Cross-sectional Study

Purpose: Tuberculosis (TB) remains a major public health concern worldwide and is considered one of the leading causes of death globally. Presently, TB control remains a global struggle, despite a decline in the percentage of cases. In Saudi Arabia, the annual incidence rate of TB is 12 per 100,000 individuals. Although TB incidence has decreased in the country, it has not been fully controlled. Awareness and public education are important in preventing the spread of TB. The objective of this study is to evaluate the knowledge, attitudes, and practices (KAP) regarding TB and its treatment within the community, while also examining potential gender differences in KAP. Methods: A cross-sectional survey was carried out online among the general population in the Qassim Region of Saudi Arabia, and statistical analysis was performed using multivariate logistic regression, chi-square, and t-tests. Results: A total of 450 participants were included in the study; 71.6% of respondents were males, and most of the respondents (71.3%) had a high level of education. Slightly more than half (55.3%) of the respondents have a good level of knowledge. The total percentage of people who have positive attitudes is 46.7%. Within gender, analysis shows that about 48.4% of males and 42.2% of females have a positive attitude. The total percentage of people who have a good practice is 82.4%. Within gender, analysis shows that females (91.4%) have a good practice compared to males (78.9%). The multivariate logistic regression analysis showed that having a family history of TB was independently associated with a higher level of knowledge, whereas younger age was associated with a positive attitude. On the other hand, gender and education were independently associated with the practice. Conclusion: The knowledge and attitude towards TB among the targeted population were generally moderate, with slightly higher levels of knowledge observed among females. Furthermore, a positive trend of good practices was observed within the study population, particularly among females

Forecasting trends in the tuberculosis epidemic situation using a simulation dynamic model

Introduction Sverdlovsk region still has a high prevalence of HIV infection and tuberculosis, which affects the effectiveness of anti-tuberculosis measures. The new coronavirus infection for a number of years makes it necessary to redistribute the limited health care resources of the subject of the Russian Federation. This determines the need to develop science-based methods for analyzing and forecasting the development of the epidemic process in tuberculosis infection in the region.The aim of the work is to scientifically substantiate the method of forecasting the epidemic situation of tuberculosis on the territory of the subject with a set of municipalities with the construction of mathematical models and application of artificial intelligence.Materials and methods The source material for the study was statistical data obtained in 2007–2012 from state statistical reporting forms: Form No. 8 “Information about diseases with active tuberculosis”, Form No. 33 “Information about tuberculosis patients”, Forms 089u/tub, data from the Federal Register of Tuberculosis Patients, police registers of tuberculosis patients in health care institutions of Sverdlovsk region. Information processing was carried out using MS Excel, complex analytical tables of absolute values and epidemiological coefficients were compiled. Using artificial intelligence technology, a mathematical simulation dynamic model of the tuberculosis epidemic situation at the regional level and in the context of 63 municipalities of the Sverdlovsk region was developed.Results Comparison of the forecast values made in 2017 with the actual values of 2018–2021 revealed a reliable coincidence of the trend of movement of tuberculosis epidemiological indicators in the region, the maximum deviation was no more than 14.8 %.Discussion The proposed dynamic model made it possible to identify, reliably calculate and graphically display trends in the movement of the values of the studied characteristics of the tuberculosis epidemic process, despite the insignificant discrepancy between actual and forecast values.Conclusion The forecast results obtained using the simulation dynamic model can be used in practice for operational resource planning of resources for the implementation of measures to counter the spread of tuberculosis at the regional level.

The potential mechanism of the progression from latent to active tuberculosis based on the intestinal microbiota alterations

IntroductionTuberculosis (TB) poses a serious challenge to global health systems. The altered intestinal microbiota is associated with the pathogenesis of TB, but the exact links remain unclear. Methods16 S rDNA sequencing was performed to comprehensively detect the changes in the intestinal microbiota of feces from active TB (ATB), latent TB infection (LTBI) and healthy controls (HC). ResultsThe rarefaction curves demonstrated the sequencing results' validity. The alpha diversity was lowest in ATB, while highest in HC. Boxplot of beta diversity showed significant differences in every two groups. LDA Effect Size (LEfSe) Analysis revealed differences in probiotic bacteria like Romboutsia, Bifidobacterium and Lactobacillus in LTBI, and pro-inflammatory bacteria like R. gnavus, Streptococcus and Erysipelatoclostridium in ATB, corresponding to the cluster analysis. PICRUST2 analysis revealed the pentose phosphate pathway was active in ATB and LTBI (more active in ATB). The differences between the groups are statistically significant at the P<0.05 level. ConclusionOur study indicated that from LTBI to ATB, some intestinal microbiota inhibit the synthesis of interferon (INF)-γ and interleukin (IL)-17, promoting the survival and spread of Mycobacterium tuberculosis (M. tb). In addition, the metabolites secreted by intestinal microbiota and dysbiosis in intestine also have an effect on the development of LTBI to ATB.

MXene-incorporated C60NPs and Au@Pt with dual-electric signal outputs for accurate detection of Mycobacterium tuberculosis ESAT-6 antigen

Rapid and effective detection of Mycobacterium tuberculosis (MTB) is the crux of minimizing tuberculosis (TB) spread. Consequently, a new electrochemical aptasensor based on dual-signal output for ultrasensitive detection of MTB early secreted antigenic target 6 (ESAT-6) antigen was developed. Especially, a new nanocomposite MXene/C60NPs/Au@Pt was synthesized for signal generation and amplification. In this biosensing architecture, dual independent signal outputs were achieved by coupling the electrochemical redox activity of fullerene nanoparticles (C60NPs) with the effective electrocatalytic activity of Au@Pt nanoparticles. MXene possesses a large specific surface area, allowing densely loaded of these two electroactive materials, further improved sensing capability. In addition, specific ESAT-6 antigen binding aptamers were attached to Au@Pt to create the tracer label. With a typical sandwich format along with the introduction of the gold nanoparticle-loaded molybdenum disulfide (MoS2–Au) as the sensing interface, the limit of detection (LOD) of the proposed aptasensor was 2.88 fg mL−1 (DPV measurement) and 13.50 fg mL−1 (IT measurement), respectively, with a broad linear range of 100 fg mL−1 to 50 ng mL−1. Significantly, it exhibited better specificity and accuracy with a sensitivity of 97.5% and a specificity of 96.7% to distinguish healthy donors, other lung diseases and TB patients compared to commercial ELISA assay, holding a promising prospect in clinical diagnosis.

Heterogeneity of Mycobacterium tuberculosis Strains Circulating in Panama's Western Region.

Tuberculosis remains a challenge in both rural and urban areas. Although a majority of countries display a higher burden in urban areas compared with rural areas, Panama continues to report the highest mortality rate in Central America. Urban areas, such as Panama City, report a high tuberculosis burden, whereas Panama's western region, including the provinces of Chiriquí, Bocas del Toro (both semiurban) and Ngäbe-Bugle (rural), show a lower burden. We aimed to identify highly transmitted Mycobacterium tuberculosis strains within rural and semiurban settings of Panama's western region during a 3-year period (2017, 2019, 2021). We randomly selected 87 M. tuberculosis isolates from a biobank from Panama's western region and analyzed them using allele-specific oligonucleotide polymerase chain reaction and 24-mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR). Our results show only 11.7% (10/85) of M. tuberculosis strains identified as prevalent A-Beijing, B-Haarlem, or C-LAM Strains. We found a low prevalence of A, B, and C M. tuberculosis strains in both rural and semirural settings compared with isolates collected from the Eastern Colon Province. MIRU-VNTR genotyping revealed a high degree of diversity with no clusters with single loci variation of ≥ 2 loci. These results support the notion that tuberculosis prevalence in the rural and semiurban western region of Panama are not due to previously described highly transmitted strains but is influenced instead by other health determinants, including poor health system access and a lack of systematic transmission chain monitoring. For remote rural and semiurban settings, we recommend allocating resources to reinforce efforts to prevent tuberculosis spread.

Multivariate Analysis Approach to Factor-Affected Tuberculosis Disease

Tuberculosis is a disease caused by infection with the mycobacterium tuberculosis complex. Tuberculosis attack organ besides the lung, such as the pleura, lining of the brain, lining of the heart, lymph gland, bones, joint, skin, intestines, kidney, urinary tract, and genital. This disease is found in densely populated settlements with poor sanitation, lack of ventilation and sunlight and lack of rest. Moreover, the factors that will be analyzed in this research are Population Density (X1), Number of HIV/AIDS (X2), number of toddlers who experience nutrition (X3), Number of toddlers who experience BCG immunization (X4), number of toddlers who get exclusive breastfeeding (X5), Total families with PHBS (X6), number of residents with healthy homes (X7), number of families with clean water facilities (X8), number of families with ownership of latrine sanitation (X9), number of families with have landfills (X10), number of families have management waste place (X11), number of elementary education facilities (X12), Number of junior school education facilities (X13), Number of senior school education facilities (X14), Number of institutions fostered by neighborhood health (X15), Number of Posyandu (X16), Number Life Expectancy (X17), Literacy Rate (X18), Human Development Index (X19), Number of Tuberculosis sufferers (X20). This research aims to analyze what variables influence each other on the prevalence rate of tuberculosis in the city of Surabaya. The method used in this research is a multivariate analysis using factor analysis, cluster analysis, biplot analysis and discriminant analysis. This discriminant analysis determines accuracy by calculating the value (1-APER). The resulting research the Number of HIV/AIDS, number of residents with healthy homes, and Number of families with ownership of Sanitation (latrine, landfills, waste management) have a high correlation with the spread of tuberculosis in Surabaya. Meanwhile, areas with a high rate of tuberculosis are Tambaksari, Wonokromo, Sawahan, and Semampir. The classification analysis accuracy level was 90.32% and the accuracy of the resulting model or discriminant function was very high. So that discriminant analysis can be used for predicting the accuracy of tuberculosis prevalence rates.

Prevalence of pulmonary tuberculosis in post-coronavirus disease patients

Abstract Context Post-coronavirus disease 2019 (COVID-19) disease patients are immunocompromised, especially those who have a history of hospitalization during the COVID time and steroid use during hospitalization. Such patients are very susceptible to opportunistic infections and must be assessed proactively. Patients and methods This was a cross-sectional study on 125 post-COVID-19-positive patients 28 days after being COVID negative confirmed by an RT-PCR test. Sputum/bronchoalveolar lavage samples were taken for analysis. Statistical analysis used SPSS, version 20.0 was used for the analysis. A P value less than 0.05 was considered statistically significant. Results Out of 119 sputum samples assessed, 15 were AFB positive, and Mycobacterium tuberculosis (MTB) was detected in 16 patients by the GeneXpert assay, out of which 15 were sensitive to rifampicin and one was resistant. Bronchoalveolar lavage was performed in nine patients where two were found AFB-positive, and MTB was detected in two patients by the GeneXpert, out of which one was rifampicin sensitive and one was rifampicin resistant. Conclusions A significant portion of the world population has latent tuberculosis (TB) infection, and the COVID-19 disease may have led to an increase in the incidence of active TB. A proactive approach is needed for the diagnosis of TB and to control the spread of TB.

Tuberculosis Trends in the Sverdlovsk Region

Introduction: Medical and social importance of a continuous decrease in tuberculosis morbidity and mortality remains high implementation of tuberculosis control programs involves the analysis of current regional trends in the epidemic situation and interdepartmental cooperation in taking comprehensive measures to prevent the spread of this infectious disease. Objective: To analyze local trends and features of the spread of tuberculosis in the population of the Sverdlovsk Region. Materials and methods: Based on the results of a retrospective and prospective study for 2012–2022, we analyzed tuberculosis incidence, prevalence and mortality rates, bacterial carriage, drug resistance, combination with HIV infection, and the structure of clinical forms of tuberculosis in the Sverdlovsk Region. The data were retrieved from the reports of the Federal State Statistics Service, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), Ministries of Health of the Russian Federation and the Sverdlovsk Region, the Federal Register of Tuberculosis Patients, and departmental statistics of prison health care. Results: We observed a decline in the regional tuberculosis incidence, prevalence and death rates over the study period that were consistently higher than the national averages. The proportion of patients with bacterial excretion, multidrug resistance, and tuberculosis/HIV coinfection was increasing among the incident cases while the proportion of cases of disseminated and intrathoracic lymph node tuberculosis was rising in the structure of clinical forms. The main regional factors influencing the epidemiological situation of tuberculosis include a large number of prisoners and a higher prevalence of HIV infection among the general population. Conclusion: Based on the analysis of the situation, further implementation of a set of measures for interdepartmental cooperation for monitoring and combating tuberculosis is envisaged by the regional program.

Borderline rpoB mutations transmit at the same rate as common rpoB mutations in a tuberculosis cohort in Bangladesh.

The spread of multidrug-resistant tuberculosis (MDR-TB) is a growing problem in many countries worldwide. Resistance to one of the primary first-line drugs, rifampicin, is caused by mutations in the Mycobacterium tuberculosis rpoB gene. So-called borderline rpoB mutations confer low-level resistance, in contrast to more common rpoB mutations which confer high-level resistance. While some borderline mutations show lower fitness in vitro than common mutations, their in vivo fitness is currently unknown. We used a dataset of 394 whole genome sequenced MDR-TB isolates from Bangladesh, representing around 44 % of notified MDR-TB cases over 6 years, to look at differences in transmission clustering between isolates with borderline rpoB mutations and those with common rpoB mutations. We found a relatively low percentage of transmission clustering in the dataset (34.8 %) but no difference in clustering between different types of rpoB mutations. Compensatory mutations in rpoA, rpoB, and rpoC were associated with higher levels of transmission clustering as were lineages two, three, and four relative to lineage one. Young people as well as patients with high sputum smear positive TB were more likely to be in a transmission cluster. Our findings show that although borderline rpoB mutations have lower in vitro growth potential this does not translate into lower transmission potential or in vivo fitness. Proper detection of these mutations is crucial to ensure they do not go unnoticed and spread MDR-TB within communities.

A qualitative exploration of factors that influence the uptake of tuberculosis services by low-skilled migrant workers in Singapore

IntroductionSingapore relies heavily on migrant workers to build its country and harbours a relatively large population of these workers. Importantly, tuberculosis (TB) remains a pernicious threat to the health of these workers and in line with the United Nations High-Level Meeting in 2023, this paper aims to uncover the qualitative discourse facing migrant workers’ uptake of TB services and provide policy recommendations to enable more equitable access to TB services for this population.MethodsIn-depth interviews were carried out with the migrant worker population recruited from a non-governmental organisation in Singapore that serves migrant workers through the provision of primary healthcare services, counselling, and social assistance. Interviews stopped once thematic saturation was achieved and no new themes and subthemes were found.ResultsA total of 29 participants were interviewed, including 16 Bangladeshis and 13 Chinese, aged between 22 and 54 years old, all worked in the construction sector. Four key themes emerged. They are (1) General TB knowledge: Misconceptions are prevalent, where we found that participants were aware of the disease but did not possess a clear understanding of its pathophysiology and associated health effects, (2) Contextual knowledge and perception of associated policies related to TB in Singapore: low awareness among migrant workers as participants’ accounts depicted a lack of information sources in Singapore especially on issues related to healthcare including TB, (3) Attitude to towards TB: Motivation to seek treatment is underpinned by ability to continue working and (4) Stigma: mixed perception of how society views TB patients. The gaps identified in migrant workers’ TB knowledge, their attitude towards the disease and their perception of the availability of TB-related services is despite Singapore’s efforts to curb community spread of TB and its proactive initiatives to reduce the prevalence.ConclusionOur study illuminates the various aspects that policymakers need to home in on to ensure this vulnerable group is sufficiently supported and equitably cared for if they develop active TB during their stay in Singapore as they contribute to the nation’s economy. Leveraging the COVID-19 pandemic as a window of opportunity to improve overall healthcare access for vulnerable groups in Singapore can be a starting point.

A fractional-order tuberculosis model with efficient and cost-effective optimal control interventions

This study is concerned with applying fractional calculus in modelling tuberculosis (TB) transmission dynamics. A new six-dimensional fractional-order mathematical model in the sense of the Caputo derivative operator is formulated to capture memory effects in the spread process of tuberculosis. Some key features such as vaccination, forces of TB infection, and exogenous re-infection by two actively infectious classes are considered. Banach fixed point theory is employed to prove the existence and uniqueness of a solution for the fractional-order model. Equilibrium points and effective reproduction number of the model are determined. Analysis reveals that the model exhibits backward bifurcation where stable TB-free and TB-present equilibrium points co-exist when the effective reproduction number is below unity. Some sensitive parameters of the model are identified to help design intervention measures against the disease. Hence, four time-dependent controls, namely advocacy effort against infection and re-infection, vaccination control, prophylaxis against latent infection, and treatment control, are considered to form a fractional-order optimal control model. The controls are characterized using Pontryagin’s maximum principle. Efficiency and cost-effectiveness assessments are conducted to quantify the most efficient and cost-effective intervention plan to minimize TB spread in the population. Behaviours of the fractional-order TB model at varying values of the order of the Caputo derivative are extensively explored to show memory effects in the transmission dynamics of the disease.

Historical Policies, Biological Principles, and Causes of Pandemic of Tuberculosis in the U. S.

The late 19th and early 20th centuries in the United States saw a boom in immigration, which brought with it the unintended consequence of disease transmission. Tuberculosis was one of the most lethal diseases at the time which had significant impacts on both the economy and society. The spread of tuberculosis was exacerbated by the poor sanitary conditions and overcrowded living conditions in urban areas. This paper analyzes the underlying causes of tuberculosis and their relationship to immigration policies and rapid urbanization, critically analyzing the impact of immigration policies, urban public policy challenges, the tuberculosis prevalence connection between Europe and the United States, and the role of medical advancements, hygiene practices, and government regulations in reducing US tuberculosis cases. The history of the spread of tuberculosis in the US can inform future strategies for establishing better disease preparedness and response systems.