Spread Of Tuberculosis Research Articles

Application of geospatial multi-agent system for simulation of different aspects of tuberculosis transmission

BACKGROUND. The article presents the modeling of the epidemiological picture of tuberculosis (TB) using a multi-agent system. This is to provide an in-depth multi-agent modeling study with comprehensive strategies related to TB treatment and prevention.
 OBJECTIVE. To develop an algorithm that uses the capabilities of artificial intelligence and neural networks to build a geospatial model of TB transmission.
 MATERIALS AND METHODS. This study involves the development of an algorithm that uses the potential of artificial intelligence to create a geospatial model that highlights the different routes of TB transmission. The simulation process itself is characterized by a number of key stages, including initialization of the city, calibration of health parameters, simulation of the working day, spread of infection, evolution of disease trajectories, rigorous statistical calculations and transition to the next day. A comprehensive description of the course of active TB according to official data of the World Health Organization is given. Each agent is provided with an appropriate and consistent model that includes relevant health attributes and necessary rules for their dynamic evolution.
 RESULTS AND DISCUSSION. The process of modeling the transmission of TB in the urban landscape has been thoroughly investigated. Attributes and functional dependencies are divided into three different groups: static (or deterministic), stochastic, and empirical. Empirical parameters that determine the contagiousness of TB patients are subjected to careful analysis, during which the dynamic nature of their actual contagiousness is carefully compared. Therefore, the empirical parameters that determine infectivity are carefully established, which additionally allows for the quantitative determination of the level of TB infection. A complex simulation is presented that illustrates the spread of TB in a completely healthy environment devoid of any preventive or therapeutic measures. This simulation serves as a crucial study of the spread of the disease. To test the adequacy of the model and its sensitivity to the main parameters that determine the course of TB, a series of experiments using three different approximations, namely: a basic model, a model that includes mortality factors and a comprehensive model covering all relevant aspects, was conducted. Statistics used in this context include the number of infected and latent persons, recoveries and deaths. The article presents a comparative analysis between statistical information and a model that offers a comprehensive picture of the state of health of each person. The model allows careful monitoring of various factors, such as interpersonal contacts, place of residence, workplace, modes of transport used to move from place to place, and other vital aspects of a person’s life, together contributing to a more complete understanding of the dynamics of the disease.
 CONCLUSIONS. The calculations show the stability of the results and the absence of large fluctuations. The obtained statistical values of infected, latent and recovered people correlate with known medical data, and therefore, confirm the adequacy of the proposed model. This model allows tracking and analyzing the life and behavior of each agent, which allows for a detailed assessment and analysis of the spread of TB, as well as to develop a strategy to prevent the spread of this infection.

Aisyiyah Organization Communication Network In Tuberculosis Prevention In North Sumatra

The purpose of this study was to analyze the communication network built by the Aisyiyah organization in the prevention of Tuberculosis (TB) in North Sumatra. Aisyiyah as Lembaga autonomy Muhammmadiyah who became one of the government fatners in the eradication of tuberculosis. Eradication of tuberculosis is something that must be done in breaking the chain of the spread of tuberculosis that is of concern to the world because the disease is very fast spreading and is the no. 2 deadly disease after HIV Aids. Transmission is through people infected with tuberculosis coughing and removing mycobacterium bacteria. The research methods used are descriptive through qualitative approaches. The informant in this study was the Head of Aisyiyah Region of North Sumatra, TB-HIV Care Aisyiyah Team of North Sumatra. Data collection techniques through interviews, observations, and documentation. The results showed that the communication network built by Aisyiyah North Sumatra in the prevention of Tuberculosis by forming TB-HIV Care Aisyiyah. Cadres as implementers who plunge into the community to the village level in helping to provide services in collaboration with puskesmas services. Cadres in carrying out this humanitarian task always put forward human values by not paying attention to race, religion, or ethnicity. For cadres to be able to carry out tasks in the field are given debriefing that supports competence in the form of knowledge related to TB, effective communication and evaluation, and reporting, in addition, cadres in performing their duties are provided facilities such as jackets of pinaster marks, participant cards as TB cadres. . As for the reporting made by cadres so that sufferers, suspects more easily obtain drug services that can later be obtained from the nearest health center whose treatment is provided by the government for free. The recruitment of these cadres is usually done through Aisyiyah studies or can be done through other channels such as through social media, and in coordination with other organizations or associations such as the PKK Mother

Prevalence and Associated Risk Factors of Tuberculosis among Smear positive Contact Individuals in Port Sudan

Background: Tuberculosis is a necrotizing granulomatous multisystem infectious disease that caused by mycobacterium, mainly mycobacterium tuberculosis, It is a serious global health problem that represent the commonest infectious cause of death. Many risk factors contribute in spread of tuberculosis, these factors include environmental factors, host factors and factors related to organism. Contact with smear positive patients is a major risk factors as every infectious patient can transmit the organism to ten to fifteen persons; therefore, contact tracing being an important element in DOTS (Direct Observed Therapy Strategy), because early detection and early management of cases prevent complication and improve the outcome. Objectives: This study aims to determine the prevalence and assess risk factors of tuberculosis among TB smear positive contact whose registered in Port Sudan chest hospital TBMU center during third and fourth quarters; June to December 2023. Methodology: This is a descriptive cross sectional community base study, Port Sudan, eastern Sudan, from June 2023 to December 2023. Result: The study shows that prevalence of tuberculosis among smear positive contact individual is 4.6%s. And it shows other associated risk factors has a role in spread of the disease. Conclusion: The prevalence of tuberculosis among smear positive contact individuals in Port Sudan is low comparing to literature and other studies due to strong tuberculosis program and stigma also play a role in this reduction. Tuberculosis spread more among female and elder contact as the spend more time in the home. And immunosuppression, poor ventilation and crowded household play an essential role in spread of tuberculosis.

SPREADING PATTERN OF INFECTIOUS DISEASES: SUSCEPTIBLE INFECTED RECOVERED MODEL WITH VACCINATION AND DRUG-RESISTANT CASES (APPLICATION ON TB DATA IN INDONESIA)

Mycobacterium tuberculosis is the causative agent of the infectious illness tuberculosis (TB). Indonesia is the world's third-highest TB burden country. TB transmission is prevented by the BCG vaccination. A directly observed treatment, short-course (DOTS) treatment approach can cure TB illness. Recurrent TB may occur due to either relapse or reinfection with drug-resistant bacteria. The goals of this article are formulating the SVITR model with relapse and drug-resistant cases, applying the model to the TB data in Indonesia, determining the model accuracy, determining the spreading pattern and interpreting the result, and simulating the parameters. Literature study and application methods are used in this research. The SVITR model with relapse and drug-resistant cases is a first-order nonlinear differential equation system. The model is applied to TB in Indonesia based on annual data from Indonesian Health Profile, World Bank, and WHO. The model is solved by the fourth-order Runge-Kutta method. The model is accurate enough to explain the spread of TB in Indonesia with a MAPE value of 15,5%. The spreading pattern of tuberculosis infection is upward from 2010 to 2050. In 2050, there are still 8.115.976 TB cases in Indonesia. Hence in 2050, Indonesia's free of TB target has yet to be achieved. Simulation is conducted by increasing BCG vaccination to 95%, reducing contact with TB patients to 5%, increasing treatment to 95%, and lowering relapses and drug-resistant cases to 0.00005%, so the Indonesia free of TB target in 2050 can be achieved from 2042.

Perspectives on development and advancement of new tuberculosis vaccines

Tuberculosis (TB) remains a leading cause of death worldwide and is estimated to have caused 1.3 million deaths worldwide in 2022. Approximately one quarter of the world's population are infected with Mycobacterium tuberculosis, of whom up to 10% will progress to developing active TB disease. Achieving the World Health Organization End TB Strategy targets of a 95% reduction in TB mortality and a 90% reduction in TB incidence worldwide by 2035 remains a daunting task. The continuing spread of multidrug-resistant TB adds another obstacle to achieving global TB control. Larger funding pledges coupled with technological advances have recently enabled the enhancement of TB vaccine development efforts. These are yielding a pipeline of over 17 products currently in different stages of clinical trials. Emerging promising phase I and II trial results and advancement to phase III trials have necessitated “vaccine preparedness” in parallel so that a smooth transition from any positive clinical trial result to phase IV evaluation and implementation into policy and practice can follow. Promotion of a human rights–based approach, which recognizes and upholds the fundamental rights of all affected by the disease, is essential to ensure universal access to quality TB vaccines, regardless of their background or personal circumstances.

On the onset and dispersal of a major MDR TB clone among HIV-negative patients, Tunisia

BackgroundTo carry out a whole genome sequencing (WGS)-based investigation on the emergence and spread of the largest multidrug-resistant tuberculosis (MDR TB) outbreak that has been thriving among HIV-negative patients, Tunisia, since the early 2000s.MethodsWe performed phylogeographic analyses and molecular dating based on a WGS dataset representing 68 unique Mycobacterium tuberculosis isolates, covering almost the entire MDR TB outbreak for the time period 2001–2016.ResultsThe data indicate that the ancestor of the MDR TB outbreak emerged in the region of Bizerte, as early as 1974 (95% CI 1951–1985), from where it spread to other regions by 1992 (95% CI 1980–1996). Analysis of a minimum spanning tree based on core genome Multilocus Sequence Typing (cgMLST) uncovered the early spill-over of the fitness-compensated MDR TB strain from the prison into the general population. Indeed, cases with history of incarceration were found to be directly or indirectly linked to up to 22 new outbreak cases (32.35%) among the non-imprisoned population. By around 2008, the MDR TB outbreak strain had acquired additional resistance, leading to an XDR phenotype.ConclusionsWGS allowed refining our understanding of the emergence and evolution of the largest MDR TB outbreak in Tunisia, whose causative strain has been circulating silently for almost 26 years before. Our study lends further support to the critical role of prisons-related cases in the early spread of the outbreak among the general population. The shift to an XDR phenotype of such an epidemic clone prompts an urgent need to undertake drastic control measures.

Lipoarabinomannan-based tuberculosis diagnosis using a fiber cavity ring down biosensor.

Despite existing for millennia, tuberculosis (TB) remains a persistent global health challenge. A significant obstacle in controlling TB spread is the need for a rapid, portable, sensitive, and accurate diagnostic test. Currently, sputum culture stands as a benchmark test for TB diagnosis. Although highly reliable, it necessitates advanced laboratory facilities and involves considerable testing time. In this context, we present a rapid, portable, and cost-effective optical fiber sensor designed to measure lipoarabinomannan (LAM), a TB biomarker found in patients' urine samples. Our sensing approach is based on the applications of phase shift-cavity ringdown spectroscopy (PS-CRDS) to an optical fiber cavity created by two fiber Bragg gratings. A tapered fiber is spliced inside the optical cavity to serve as the sensing head. We functionalize the tapered fiber surface with anti-LAM antigen CS-35 through a unique chemistry, creating a strong affinity for LAM molecules. We measure the phase difference between the cavity transmission and the reference modulating signal at the cavity output. The measured phase is directly proportional to the injected LAM concentrations in aqueous solutions over the sensing head. Our demonstrated sensor provides a detection limit of 10 pg/mL and a sensitivity of 0.026°/pg/mL. This sensor holds promise for numerous applications in the healthcare sector, particularly in low-resource settings.

Worldwide Swine Tuberculosis-Positive Rate and Associated Risk Factors, 1966-2020: A Systematic Review and Meta-Analysis.

Background: Tuberculosis (TB) is a chronic, zoonotic infectious disease caused by Mycobacterium tuberculosis that infects not only humans but also animals such as pigs, cows, buffaloes, sheep, and goats. Among them, pigs are one of the main food animals in the world. If pigs are infected with M. tuberculosis, meat products will be negatively affected, causing economic losses to the livestock industry. There is currently no systematic epidemiological assessment of swine TB in the world, so it is important to know the prevalence of swine, and these data are currently lacking, so we performed a statistical analysis. Results: We searched 6791 articles and finally included data from 35,303 pigs from 15 countries or territories, showing a combined prevalence of TB in pigs of 12.1% (95% confidence interval [CI]: 9.2 to 15.9). Among them, the prevalence rate of swine TB in Europe was 15.2% (95% CI: 11.1 to 20.7, 2491/25,050), which was higher compared with other continents, and the difference was significant; the positive rate of PCR method was higher in the detection method subgroup, which was 15.7% (95% CI: 8.0 to 31.0, 376/2261); Mycobacterium bovis was detected in pigs in the M. tuberculosis typing group (9.5%, 95% CI: 6.7 to 13.5, 1364/21,430). The positive rate is higher compared with Mycobacterium capris. Conclusion: This systematic review and meta-analysis is the first to determine the global prevalence of TB in swine herds. Although the seroprevalence of swine TB in this article is very low, the harm of TB cannot be ignored. It is important to take effective control and preventive measures to stop the spread of TB to reduce the impact of diseased pigs on animal husbandry and human health.

Inhibiting the oligomerization of mycobacterial DNA-directed RNA polymerase (RNAP) using natural compound via in-silico techniques

Mycobacterium tuberculosis (Mtb) is responsible for the spread of tuberculosis (TB). The current study employed virtual screening of 2569 natural compounds against the DNA-directed RNA polymerase (RNAP) of Mtb to identify the possible binders that can inhibit its function. The in-silico methodology included molecular docking to the compounds, further, the stability and flexibility of the best complexes were studied using molecular dynamics simulation, the MM/GBSA binding free energy technique with energy decomposition, PCA, FEL, steered MD simulation, and umbrella sampling. Individual virtual screenings were conducted for the five RNAP subunits (chains A, B, C, D, and E) to identify a compound capable of inhibiting RNAP oligomerization. A promising compound, isoestradiol 3-benzoate, exhibited a low binding score (−7.28 ​kcal/mol to −8.21 ​kcal/mol) and showed binding ability with all subunits of the protein. Thus, the five complexes with isoestradiol 3-benzoate were selected for molecular dynamics simulation analysis. Furthermore, RMSD showed that isoestradiol 3-benzoate bound with chain E showed the lowest RMSD of 0.49 ​nm, while with chains A and B it had the most stable and consistent conformations with RMSD of 1.75 ​nm and 1.2 ​nm, respectively. The H-bond between isoestradiol 3-benzoate and chains C and E showed the highest occupancy (58.27 ​%, 45.33 ​%, and 50.80 ​%, 42.25 ​%, 11.75 ​%). Moreover, the MMPBSA technique showed that isoestradiol 3-benzoate had a strong association with chains B and C (ΔGbind ​= ​−126.25 ​± ​2.03 and −129.27 ​± ​2.25). Additionally, free energy decomposition, PCA, FEL-steered MD simulation, and umbrella sampling were also performed to validate the association of the ligand with the protein. Isoestradiol 3-benzoate binds strongly to chains B and E; therefore, it should be considered as viable candidate for inhibiting the formation of RNAP protein complex, concluded in this study.

Modern tuberculosis prevention and control programs at the regional level

The article presents an assessment of the effectiveness of measures to prevent the spread of tuberculosis in the Omsk region, where modern approaches and directions of the national strategy of tuberculosis elimination are realized. The qualitative and quantitative changes in the cohorts of first-detected cases of tuberculosis for the analyzed period of 2015 - 2021 are noted. Actual directions of tuberculosis prevention for the Omsk region are revealed.

Interaction between air pollutants and meteorological factors on pulmonary tuberculosis in northwest China: A case study of eight districts in Urumqi.

Meteorological factors and air pollutants are associated with the spread of pulmonary tuberculosis (PTB), but few studies have examined the effects of their interactions on PTB. Therefore, this study investigated the impact of meteorological factors and air pollutants and their interactions on the risk of PTB in Urumqi, a city with a high prevalence of PTB and a high level of air pollution. The number of new PTB cases in eight districts of Urumqi from 2014 to 2019 was collected, along with data on meteorological factors and air pollutants for the same period. A generalized additive model was applied to explore the effects of meteorological factors and air pollutants and their interactions on the risk of PTB incidence. Segmented linear regression was used to estimate the nonlinear characteristics of the impact of meteorological factors on PTB. During 2014-2019, a total of 14,402 new cases of PTB were reported in eight districts, with March to May being the months of high PTB incidence. The exposure-response curves for temperature (Temp), relative humidity (RH), wind speed (WS), air pressure (AP), and diurnal temperature difference (DTR) were generally inverted "U" shaped, with the corresponding threshold values of - 5.411 °C, 52.118%, 3.513m/s, 1021.625hPa, and 8.161 °C, respectively. The effects of air pollutants on PTB were linear and lagged. All air pollutants were positively associated with PTB, except for O3, which was not associated with PTB, and the ER values for the effects on PTB were as follows: 0.931 (0.255, 1.612) for PM2.5, 1.028 (0.301, 1.760) for PM10, 5.061 (0.387, 9.952) for SO2, 2.830 (0.512, 5.200) for NO2, and 5.789 (1.508, 10.251) for CO. Meteorological factors and air pollutants have an interactive effect on PTB. The risk of PTB incidence was higher when in high Temp-high air pollutant, high RH-high air pollutant, high WS-high air pollutant, lowAP-high air pollutant, and high DTR-high air pollutant. In conclusion, both meteorological and pollutant factors had an influence on PTB, and the influence on PTB may have an interaction.

ЯК ВПЛИНЕ ВІЙНА В УКРАЇНІ НА ЕПІДЕМІЧНУ СИТУАЦІЮ З ТУБЕРКУЛЬОЗОМ: МІРКУВАННЯ ФАХІВЦІВ

To determine the leading trends regarding the impact of the war in Ukraine on the situation with tuberculosis (TB) in real time, professional sources of information were analyzed. Publications regarding the impact of the war in Ukraine on the epidemic situation with TB are mainly of an overview nature. An increase in morbidity, mortality and worsening of other epidemiological indicators are predicted. Possible spread of multidrug-resistant tuberculosis (MDR-TB) and TB/HIV confections is of special concern, as even before the war Ukraine ranked second in Europe for the burden of HIV infection, fourth for the spread of TB and fifth in the world for MDRTB. The impact of war on the health of the population and the medical care system is determined by many factors, including damage to the country's infrastructure, overcrowding, deterioration of sanitary conditions, forced displacement of the population, insufficient availability of medical care, lack of adequate supply of water and food, mental overload, financial difficulties etc. The war affects patient care and the effectiveness of the health care system, which means poor TB detection rates, coverage of preventive examinations, and limited access to health care in general. This problem requires an immediate and comprehensive research and develop a set of measures to restore the full provision of medical care for this disease. Establishing the determinants of TB risk caused by the war will allow offering practical health care measures that should reduce the negative impact of the war on the epidemic situation with TB in Ukraine. Key words: tuberculosis, epidemic situation, war.

Rapid Detection of M. tuberculosis and Its Resistance to Rifampicin and Isoniazid with the mfloDx™ MDR-TB test.

Rapid detection of tuberculosis (TB) and its resistance are essential for the prompt initiation of correct drug therapy and for stopping the spread of drug-resistant TB. There is an urgent need for increased use of rapid diagnostic tests to control the threat of increased TB and multidrug-resistant TB (MDR-TB). EMPE Diagnostics has developed a multiplex molecular diagnostic platform called mfloDx™ by combining nucleotide-specific padlock probe-dependent rolling circle amplification with sensitive lateral flow biosensors, providing visual signals, similar to a COVID-19 test. The first test kit of this platform, mfloDx™ MDR-TB can identify Mycobacterium tuberculosis (MTB) complex and its clinically significant mutations in the rpoB and katG genes and in the inhA promotor contributing resistance to rifampicin (RIF) and isoniazid (INH), causing MDR-TB. We have evaluated the performance of the mfloDx™ MDR-TB test on 210 sputum samples (110 from suspected TB cases and 100 from TB-negative controls) received from a tertiary care center in India. The clinical sensitivity for detecting MTB compared to acid-fast microscopy and mycobacteria growth indicator tube (MGIT) cultures was 86.4% and 84.9%, respectively. All the 100 control samples were negative indicating excellent specificity. In smear-positive sputum samples, the mfloDx™ MDR-TB test showed a sensitivity of 92.5% and 86.4% against MGIT culture and Xpert MTB/RIF, respectively. The clinical sensitivity for the detection of RIF and INH resistance in comparison with MGIT drug susceptibility testing was 100% and 84.6%, respectively, while the clinical specificity was 100%. From the above evaluation, we find mfloDx™ MDR-TB to be a rapid and efficient test to detect TB and its multidrug resistance in 3 h at a low cost making it suitable for resource-limited laboratories.

Modeling the effects of vaccine efficacy and rate of vaccination on the transmission of pulmonary tuberculosis

Numerous prevention intervention strategies have been developed to curtail the spread of pulmonary tuberculosis to susceptible populations. However, pulmonary tuberculosis continues to claim many lives worldwide. In this paper, a deterministic mathematical model incorporating an asymptomatic infectious population, considering vaccine efficacy, and vaccination rate, has been formulated. The model includes asymptomatic infectious individuals since they spread infections incessantly to susceptible populations without being noticed, thus contributing to the high transmission rate. Sensitivity and numerical analysis have been conducted to investigate the impact of varying vaccine efficacy and vaccination rates on the transmission of pulmonary tuberculosis infections from the asymptomatic infectious population. The sensitivity and numerical results show that an increase in vaccine efficacy reduces the asymptomatic infectious population and subsequently lowers the transmission rate of infections. Moreover, an increase in vaccine efficacy was shown to reduce the control reproduction number due to asymptomatic infectious individuals, thereby decreasing the transmission of pulmonary tuberculosis to susceptible populations. Further results indicate that an increase in vaccination rate reduces the control reproduction number due to asymptomatic infectious individuals, consequently lowering the rate of infection transmission. These findings emphasize the need to develop a vaccine of higher efficacy to reduce infection transmission to susceptible populations by the asymptomatic infectious individuals. Additionally, the results underscore the importance of increasing vaccination rates to eradicate pulmonary tuberculosis from the population.

Experiences of families living with tuberculosis patients in the North West province, South Africa.

The families living with tuberculosis (TB) patients play a vital role in the care of these patients. Little is known about the experiences of families living with family members who are infected with TB. The aim of the study was to explore and describe the experiences of families having a member or members diagnosed with TB. The study was conducted in the Ngaka Modiri Molema district in the North West province of South Africa. This was a qualitative study using a descriptive phenomenological approach. Ten families with member(s) who had TB were purposively selected. Data were collected through face-to-face, semi-structured individual interviews that were recorded. Data were analysed using Colaizzi's seven steps. The following essential meanings emerged: family members' caregiving experiences, family members' challenging experiences, and family members' health literacy experiences. Families had a lack of TB knowledge, which was associated with their poverty and with community health nurses not being committed to patient education. In poor, rural settings, nurses need to support families with adequate TB knowledge to limit the spread of TB and achieve the best treatment outcomes. Family involvement is vitally important in TB health promotion. Health promotion is a crucial tool for achieving comprehensive health and social growth. Wider interventions concentrating on families are beneficial for promoting health and preventing TB.

Factors determining successful treatment outcome among notified tuberculosis patients in Belagavi district of North Karnataka, India

IntroductionIndian government has implemented various strategies to track newly diagnosed tuberculosis (TB) cases and ensure follow-up for registered cases. Appropriate measures have been adapted to combat the spread of TB. Success of the treatment determines the effectiveness of the national TB control program. AimPresent study analyzed the recorded data to study the clinico-epidemiological profile and explore the factors that might influence treatment outcome among notified tuberculosis patients. Design and settingsA retrospective cohort study was conducted using secondary data in Belagavi district. Subjects and methodsData of TB patients notified and registered under Nikshay portal in the year 2019 were collected from the district tuberculosis office and factors influencing treatment outcome were analyzed. Statistical analysisDescriptive statistics, bivariate and multivariate logistic regression analysis were used to analyze the data. ResultsThe study revealed that females, younger age group, absence of comorbidities, having extra-pulmonary TB, smear-negative pulmonary TB, and new TB patients exhibited a statistically significant association with successful treatment outcome. ConclusionIn the study area, the mean treatment success rate (83.8 %) aligned with the national success rate of 82 %. Early detection of tuberculosis may help in increasing treatment success rates. Delivering comprehensive counseling to TB patients regarding the disease, its treatment and management plays a decisive role in achieving successful treatment outcomes.

Analysis and optimal control problem for a fractional mathematical model of tuberculosis with smoking consideration

This article studies a mathematical model of the fractional order of tuberculosis (TB). It describes the dynamics of the spread of tuberculosis among smokers. The purpose of this research is to protect vulnerable people against the virus. According to the survey results, the required model has an equilibrium point: the disease-free equilibrium point Ef. We also analyze the local stability of this equilibrium point of the model, using the basic reproduction number R0 calculated according to the new generation method. In our model, we include three controls that represent: restricting individual contact, treatment, and sensitization. This article aims at reducing the number of infected smokers and non-smokers using an optimal control strategy and a fractional derivation. The maximum principle of Pontryagin is used to describe optimal controls with Caputo-derived fractional over time and the optimal system is resolved iteratively. The numerical simulation is presented according to the method presented by Matlab.

Mathematical modeling and optimal control of tuberculosis spread among smokers with case detection

<p>Tuberculosis (TB) remains one of deadly infectious diseases worldwide. Smoking habits are a significant factor that can increase TB transmission rates, as smokers are more susceptible to contracting TB than nonsmokers. Therefore, a control strategy that focused on minimizing TB transmission among smokers was essential. The control of TB transmission was evaluated based on the case detection rate. Undetected TB cases often resulted from economic challenges, low awareness, negative stigma toward TB patients, and health system delay (HSD). In this study, we developed a mathematical model that captured the dynamics of TB transmission specifically among smokers, incorporating the effects of case detection. Our innovative approach lied in the integration of smoking behavior as a key factor in TB transmission dynamics, which has been underexplored in previous models. We analyzed the existence and stability of the TB model equilibrium based on the basic reproduction number. Additionally, parameter sensitivity analysis was conducted to identify the most influential factors in the spread of the disease. Furthermore, this study investigated the effectiveness of various control strategies, including social distancing for smokers, TB screening in high-risk populations, and TB treatment in low-income communities. By employing the Pontryagin maximum principle, we solved optimal control problems to determine the most effective combination of interventions. Simulation results demonstrated that a targeted combination of control measures can effectively reduce the number of TB-infected individuals.</p>

Endometrial tuberculosis in post-menopausal female: case report and review

Background: One of the rare forms of extrapulmonary tuberculosis (TB) is female genital tract TB, which often occurs as a result of TB spreading to the genital organs via the bloodstream or lymphatic system, with the primary lesion usually going undetected for many years. Case Presentation: A case of 68 years old female was presented, with a known case of hypertension on antihypertensive medications, who came to the emergency department complaining of abdominal distention that was evolved 4 months earlier, associated with loss of appetite and consequent loss of weight. CT imaging revealed mild thickening of the endometrium but with no evidence of malignancy. Hysteroscopy showed a mass-like lesion, encapsulated and well-formed, from which a biopsy was taken and sent to the histopathology, and the acid-fast bacilli special stain was identified, and diagnosed as endometrial TB. Conclusion: Endometrial TB is not a common condition in women at menopausal age. Hence, it is recommended that all patients with a positive imaging finding whether with or without vaginal losses undergo aggressive evaluation for endometrial TB. In addition, elaborative research needs to be conducted to generate further evidence-based data regarding such conditions.

Lessons Learned from the COVID-19 Pandemic: Simulation of the Tuberculosis Epidemic as a Function of Population Coverage with Screening

The COVID-19 pandemic has led to the discontinuation of many support programs for tuberculosis patients worldwide, and lower coverage of population with screening for tuberculosis.The objective: To build a model describing the spread of tuberculosis depending on the population coverage with preventive screening, and to obtain a long-term forecast of the infection spread using this model.Subjects and Methods. We analyzed official statistical data on incidence, mortality, preventive screening coverage (PSC), and revalence of sputum smear-positive tuberculosis in the Russian Federation from 2008 to 2021. The model was built up based on fluctuations in those rates in 2020, when there was a sharp reduction in tuberculosis control interventions due to the COVID-19 pandemic. Statistical analysis was performed using the R Software (v.4.2.1).Results. A simple mathematical model describing the dependence of incidence and sputum smear-positive tuberculosis in the current year on sputum smear-positive tuberculosis in the past year and population coverage with preventive screening in the current and past years was built up. The adjusted coefficient of determination of the model (adjusted R-squared) was 0.9969, which meant that the model contained almost no random components. It showed that tuberculosis cases missed due to low population coverage with preventive screening lead to future spread of tuberculous infection and a significant increase in the number of new tuberculosis cases. Comparison of projected rates and data for 2022 demontrated correct formation of models. However, the projected rates were slightly higher than the actual rates for 2022 due to the influence of factors other than the population coverage with preventive screening for tuberculosis.Conclusions. The findings demonstrate the need for mass screening of the population in the context of significant spread of tuberculosis infection for timely detection of patients with sputum smear-positive tuberculosis.