Incidence Rate Of TB Research Articles

Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)

BackgroundTuberculosis (TB) is a major public health issue in South Asia and accounts for a large share of the global TB burden. Despite global efforts to curb TB incidence and mortality, progress in South Asia has been uneven, necessitating focused regional analysis to guide effective interventions. This study aims to analyse the trends in the TB burden in South Asia from 1990 to 2021 and project future TB incidence rates up to 2031. MethodsThis study utilized data from the Global Burden of Disease (GBD) 2021 results to analyse trends in age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) rates (ASDR) associated with TB in South Asia from 1990 to 2021. Joinpoint regression analysis was employed to identify significant trends, whereas ARIMA models were used to project future TB incidence rates up to 2031. ResultsThis study revealed significant declines in the ASIR, ASPR, ASDR, and ASMR related to TB in South Asia over the past three decades. Prominent reductions were found in Bangladesh and Bhutan, whereas India, Pakistan, and Nepal continue to bear the highest TB burdens. The ARIMA model projections indicate a continued decline in TB incidence across the region, although the extent of the decline varies by country, with less favourable trends observed in Nepal and Pakistan. The analysis also highlights tobacco use, high fasting plasma glucose, and high body mass index as significant risk factors contributing to the TB burden. ConclusionsSubstantial progress has been made in reducing the TB burden in South Asia; however, sustained and intensified efforts are needed, particularly in countries with inconsistent progress. These findings emphasize the need for targeted interventions to meet the WHO End TB Strategy (WETS) targets by 2035. Continuous monitoring and adaptive strategies will be crucial in maintaining and accelerating progress toward TB elimination in South Asia.

Feasibility of eliminating tuberculosis by shortening the diagnostic delay: A retrospective analysis and modelling study in China during the pre-COVID-19 era

ObjectiveDelays in the diagnosis and treatment of pulmonary tuberculosis (PTB) can increase the risk of transmission, thereby posing a significant risk to public health. Early diagnosis is considered to play a crucial role in eliminating TB. Rapid testing, active case finding, and health education are effective strategies for reducing tuberculosis diagnosis delays (TDDs). This study aimed to quantitatively compare the impact of reducing the TDD on incidence rates among student and non-student groups, thus exploring the efficacy of shortening the TDD for ending the TB epidemic and providing a reference for achieving the target incidence rate for ending TB. MethodsWe used unsupervised hierarchical clustering analysis and non-parametric tests to characterize the epidemiological characteristics of TDD. Additionally, a dynamic transmission model was used to quantify the impact of shortening the TDD on the incidence rates of TB among the two groups. ResultsThere was an initial increase in the TDD, followed by a decrease. Longer TDDs were observed in the northeastern region of China. Farmers, middle and high school students, middle-aged, elderly individuals and males exhibited relatively longer TDDs. A significant reduction in the incidence rate of PTB was observed when the TDD was decreased by 50 %. However, only reducing the TDD among non-students could achieve the goal of ending TB (i.e., achieving a minimum reduction of 63.00 %). ConclusionsTDD remains a serious risk to public health, and non-students were shown to experience longer TDD. Shortening the TDD is crucial for reducing the incidence rates of TB, especially among non-students. It is essential to develop a highly sensitive and effective system for eliminating TB among non-students.

A dynamic hybrid model for efficient tuberculosis incidence rate prediction

ABSTRACT Tuberculosis remains a global health challenge, predicting its incidences is crucial for effective planning and intervention strategies. This study combines AutoRegressive Integrated Moving Average (ARIMA) and Nonlinear AutoRegressive with exogenous input (NARX) models as an innovative approach for TB incidence rate prediction. The performance of the proposed model (ARIMA-NARX) was evaluated using standard metrics (MSE, RMSE, MAE, and MAPE), and it was refined to achieve the best average predictive accuracies with an MSE: 0.0622, RMSE: 0.0851, MAE: 0.07520, and MAPE: 0.05535 followed by NARX 0.1597, 0.3189, 0.2724, and 0.3366, and ARIMA (2,0,0) 0.7781, 0.5959, 0.6524, and 0.6080 Models. These findings are expected to shed light on the TB incidence rate, providing valuable information to policymakers such as the World Health Organization (WHO) and health professionals. The developed model can potentially serve as a predictive tool for proactive TB control and intervention strategies in the region and the world at large.

Genetic Characterization and Population Structure of Drug-Resistant Mycobacterium tuberculosis Isolated from Brazilian Patients Using Whole-Genome Sequencing.

The present study aimed to determine the genetic diversity of isolates of Mycobacterium tuberculosis (Mtb) from presumed drug-resistant tuberculosis patients from several states of Brazil. The isolates had been submitted to conventional drug susceptibility testing for first- and second-line drugs. Multidrug-resistant (MDR-TB) (54.8%) was the most frequent phenotypic resistance profile, in addition to an important high frequency of pre-extensive resistance (p-XDR-TB) (9.2%). Using whole-genome sequencing (WGS), we characterized 298 Mtb isolates from Brazil. Besides the analysis of genotype distribution and possible correlations between molecular and clinical data, we determined the performance of an in-house WGS pipeline with other online pipelines for Mtb lineages and drug resistance profile definitions. Sub-lineage 4.3 (52%) was the most frequent genotype, and the genomic approach revealed a p-XDR-TB level of 22.5%. We detected twenty novel mutations in three resistance genes, and six of these were observed in eight phenotypically resistant isolates. A cluster analysis of 170 isolates showed that 43.5% of the TB patients belonged to 24 genomic clusters, suggesting considerable ongoing transmission of DR-TB, including two interstate transmissions. The in-house WGS pipeline showed the best overall performance in drug resistance prediction, presenting the best accuracy values for five of the nine drugs tested. Significant associations were observed between suffering from fatal disease and genotypic p-XDR-TB (p = 0.03) and either phenotypic (p = 0.006) or genotypic (p = 0.0007) ethambutol resistance. The use of WGS analysis improved our understanding of the population structure of MTBC in Brazil and the genetic and clinical data correlations and demonstrated its utility for surveillance efforts regarding the spread of DR-TB, hopefully helping to avoid the emergence of even more resistant strains and to reduce TB incidence and mortality rates.

Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014–2021

BackgroundTuberculosis (TB) remains a pressing public health issue, posing a significant threat to individuals' well-being and lives. This study delves into the TB incidence in Chinese mainland during 2014–2021, aiming to gain deeper insights into their epidemiological characteristics and explore macro-level factors to enhance control and prevention.MethodsTB incidence data in Chinese mainland from 2014 to 2021 were sourced from the National Notifiable Disease Reporting System (NNDRS). A two-stage distributed lag nonlinear model (DLNM) was constructed to evaluate the lag and non-linearity of daily average temperature (℃, Atemp), average relative humidity (%, ARH), average wind speed (m/s, AWS), sunshine duration (h, SD) and precipitation (mm, PRE) on the TB incidence. A spatial panel data model was used to assess the impact of demographic, medical and health resource, and economic factors on TB incidence.ResultsA total of 6,587,439 TB cases were reported in Chinese mainland during 2014–2021, with an average annual incidence rate of 59.17/100,000. The TB incidence decreased from 67.05/100,000 in 2014 to 46.40/100,000 in 2021, notably declining from 2018 to 2021 (APC = -8.87%, 95% CI: -11.97, -6.85%). TB incidence rates were higher among males, farmers, and individuals aged 65 years and older. Spatiotemporal analysis revealed a significant cluster in Xinjiang, Qinghai, and Xizang from March 2017 to June 2019 (RR = 3.94, P < 0.001). From 2014 to 2021, the proportion of etiologically confirmed cases increased from 31.31% to 56.98%, and the time interval from TB onset to diagnosis shortened from 26 days (IQR: 10–56 days) to 19 days (IQR: 7–44 days). Specific meteorological conditions, including low temperature (< 16.69℃), high relative humidity (> 71.73%), low sunshine duration (< 6.18 h) increased the risk of TB incidence, while extreme low wind speed (< 2.79 m/s) decreased the risk. The spatial Durbin model showed positive associations between TB incidence rates and sex ratio (β = 1.98), number of beds in medical and health institutions per 10,000 population (β = 0.90), and total health expenses (β = 0.55). There were negative associations between TB incidence rates and population (β = -1.14), population density (β = -0.19), urbanization rate (β = -0.62), number of medical and health institutions (β = -0.23), and number of health technicians per 10,000 population (β = -0.70).ConclusionsSignificant progress has been made in TB control and prevention in China, but challenges persist among some populations and areas. Varied relationships were observed between TB incidence and factors from meteorological, demographic, medical and health resource, and economic aspects. These findings underscore the importance of ongoing efforts to strengthen TB control and implement digital/intelligent surveillance for early risk detection and comprehensive interventions.Graphical

International Migration, Refugees, and Spread of Tuberculosis in Brazil: Analysis of Clusters, Trends, and Associated Factors (2010-2021).

International migration is a global phenomenon with significant implications on the health-disease process due to exposures along transit routes and local/destination epidemiological indicators. We aimed to analyze the transmission and spread of tuberculosis among international migrants and refugees from a spatiotemporal perspective and the associated factors. This was an ecological study of cases of tuberculosis in international migrants in Brazil, between 2010 and 2021. Annual incidence rates were calculated and spatiotemporal scan techniques were used to identify municipalities at risk. Multiple logistic regression was used to identify factors associated with tuberculosis in international migrants. A total of 4037 cases of tuberculosis were reported in Brazil in international migrants. Municipalities at risk for this event were identified using the spatiotemporal scan technique, and a cluster was identified with ITT: +52.01% and ETT: +25.60%. A higher probability of TB infection was identified in municipalities with a TB incidence rate >14.40 cases/100 inhabitants, population >11,042 inhabitants, Gini index >0.49, and illiteracy rate >13.12%. A lower probability was found in municipalities with average per capita household income >BRL 456.43. It is recommended that health authorities implement monitoring and rigorous follow-up in affected areas to ensure proper diagnosis and treatment completion for international migrants, preventing disease spread to other communities.

Factors Related to the Incident of Pulmonary Tuberculosis in the Working Area of the Tarok Health Center Payakumbuh Citi West Sumatra Province 2023

Tuberculosis is a disease caused by the bacteria Mycobacterium tuberculosis. Tarok Health Center has the highest incidence rate of pulmonary TB in Payakumbuh City in 2022. In 2019 the CNR of TB cases was 178 per 100,000 populations. In 2020, the number of CNR TB cases was 112 per 100,000 populations. The CNR of TB in 2021 was 122 per 100,000 populations, in 2022 the CNR of TB cases will be 56 cases with a CNR of 284 per 100,000 populations. This research uses quantitative methods with case control methodology. The total sample was 88 samples; the research was carried out from September to October 2023 with analysis using the chi-square statistical test. This research shows that there is a relationship between ventilation area (0.005), humidity (0.031), temperature (0.029) and contact history (0.017) with the incidence of pulmonary TB in the working area of the Tarok Health Center, Payakumbuh City, then no relationship was found between floor type (=1) and residential density (0.052) and the incidence of pulmonary TB in the working area of the Tarok Health Center, Payakumbuh City.

Prevalence estimates of tuberculosis infection in adults in Denmark: a retrospective nationwide register-based cross-sectional study, 2010 to 2018.

BackgroundTuberculosis (TB) elimination requires identifying and treating persons with TB infection (TBI).AimWe estimate the prevalence of positive interferon gamma release assay (IGRA) tests (including TB) and TBI (excluding TB) in Denmark based on TBI screening data from patients with inflammatory bowel disease (IBD) or inflammatory rheumatic disease (IRD).MethodsUsing nationwide Danish registries, we included all patients with IBD or IRD with an IGRA test performed between 2010 and 2018. We estimated the prevalence of TBI and positive IGRA with 95% confidence intervals (CI) in adolescents and adults aged 15-64 years after sample weighting adjusting for distortions in the sample from the background population of Denmark for sex, age group and TB incidence rates (IR) in country of birth.ResultsIn 13,574 patients with IBD or IRD, 12,892 IGRA tests (95.0%) were negative, 461 (3.4%) were positive and 221 (1.6%) were indeterminate, resulting in a weighted TBI prevalence of 3.2% (95% CI: 2.9-3.5) and weighted positive IGRA prevalence of 3.8% (95% CI: 3.5-4.2) among adults aged 15-64 years in the background population of Denmark. Unweighted TBI prevalence increased with age and birthplace in countries with a TB IR higher than 10/100,000 population.ConclusionEstimated TBI prevalence is low in Denmark. We estimate that 200,000 persons have TBI and thus are at risk of developing TB. Screening for TBI and preventive treatment, especially in persons born in high TB incidence countries or immunosuppressed, are crucial to reduce the risk of and eliminate TB.

Assessing the social burden of tuberculosis and trends in TB targets: A focus on sustainable development goals

BackgroundTuberculosis (TB) is a serious public health issue that is linked to social burden and unfavourable health outcomes. With regards to the Sustainable Development Goals (SDG) targets, this study evaluated the social burden endured by patients and analyzed catastrophic costs, and measured TB incidence and death rates. MethodsCross sectional study, with 312 TB patients registered with the National Tuberculosis Elimination Programme (NTEP) were studied. Social burden, direct and indirect costs, and catastrophic costs were evaluated. TB incidence and death rates are calculated. ResultsThe majority of participants (70.8%) were men and married. Patients in substantial numbers reported losing their jobs and having limited access to community events. While divorcees, older age groups, and women were more likely to experience direct catastrophic costs, men and 33–44 years age group were more likely to experience indirect catastrophic costs. The overall catastrophic expenses exceeding 20% of income were observed in male patients, those over 55 years, and patients from nuclear families. The TB incidence rate decreased by 1.8% between 2017 and 2019, with a substantial reduction among males but an alarming increase among females. The death rate experienced a slight rise of 0.27%, with higher rates observed in females compared to males. ConclusionPersistent social stigma and the presence of catastrophic costs associated with tuberculosis remain prevalent issues. A multifaceted approach, including enhancing access to healthcare services, implementing awareness campaigns aimed at reducing stigma, expanding TB control and prevention programs is needed. Government interventions aimed at alleviating financial burdens are crucial.

The Effects of the Coronavirus Pandemic on the Indicators of the End Tuberculosis Strategy: A Literature Review

Coronavirus disease 2019 (COVID-19) had severely taken a toll on the health system in all nations from the wealthiest to the poorest countries. The disruption to the health system was not only due to the direct effects of the COVID-19 pandemic but also the pressure it caused to stretch the health systems beyond their capability indirectly. The purpose of this review was to explore the effects of the COVID-19 pandemic on the indicators of the end tuberculosis strategy. Methods: Articles were searched from scientific search engines such as CINAHL Plus (EBSCO), PubMed, Google Scholar, Medline, ProQuest, APA Psych, INFO as well as manual searches through Google and Google Scholar search engines. Both quantitative and qualitative studies that showed the impact or effects of the COVID-19 pandemic on TB diagnosis, TB patient management, treatment initiation, treatment adherence, patients’ loss to follow up were included. A total of 375 articles were screened, and 12 full-text articles were ultimately included in the review. Findings: The extracted impact were synthesized thematically into three indicators of the end TB strategy: impact on TB incidence rate; impact on TB deaths; Impact on catastrophic costs due to TB. Conclusion: The COVID-19 pandemic has affected the three indicators of the end TB strategy and has significantly reversed the global TB progress in the fight to end TB epidemic. This has increased the risk of TB incidence, deaths, and the severity of economic impact on TB-affected households. Therefore, there is a need for countries to take step forward and develop intervention strategies that will help them to resolve the damage caused by the pandemic on the achieve the targets to end TB. This study could improve strategies implementation regarding the management of TB disease.

Effect of integrating traditional care with modern healthcare to improve tuberculosis control programs in Ethiopia: a protocol for a cluster-randomized controlled trial

BackgroundTuberculosis (TB) remains a major cause of morbidity and mortality in the world, despite being a preventable and curable disease. The World Health Organization (WHO) End-TB Strategy, aligned with the Sustainable Development Goals (SDGs), sets a target of reducing the TB mortality rate by 95%, TB incidence rate by 90%, and catastrophic costs due to TB by 2035, compared with a 2015 level. To achieve these ambitious targets, several interventions have been implemented in the last few years, resulting in major progress toward reducing the burden of TB. However, over one-third of the global TB cases remained undetected and never received treatment. Most of those undetected cases were found in low- and middle-income countries such as Ethiopia. Though several interventions were implemented to increase TB case detection and mitigate catastrophic costs associated with TB, sustaining these interventions in resource-constrained settings remains challenging. Consequently, an alternative method is needed to increase TB case detection while decreasing diagnosis delays and catastrophic costs. Therefore, this study aimed to integrate traditional TB care into modern TB care to improve TB control programs, including early TB case detection, and reduce catastrophic costs in high TB burden settings such as Ethiopia.MethodsA cluster randomized controlled trial will be conducted in northwest Ethiopia to determine the effectiveness of integrating traditional care with modern TB care. The intervention will be conducted in randomly selected districts in the South Gondar Zone. The control group will be an equal number of districts with usual care. The intervention comprised three key components, which include referral linkage from traditional to modern health care; training of health professionals and traditional care providers in three different rounds to increase their knowledge, attitude, and skills toward the referral systems; and TB screening at traditional health care sites. The primary outcomes of interest will be an increase in case detection rate, and the secondary outcomes of interest will be decreased diagnosis delays and catastrophic costs for TB patients. Data will be collected in both the intervention and control groups on the main outcome of interest and a wide range of independent variables. Generalized linear mixed models will be used to compare the outcome of interest between the trial arms, with adjustment for baseline differences.DiscussionThis cluster-randomized controlled trial study will assess the effectiveness of a strategy that integrates traditional healthcare into the modern healthcare system for the control and prevention of TB in northwest Ethiopia, where nearly 90% of the population seeks care from traditional care systems. This trial will provide information on the effectiveness of traditional and modern healthcare integration to improve TB case detection, early diagnosis, and treatment, as well as reduce the catastrophic costs of TB.Trial registrationClinicalTrials.gov NCT05236452. Registered on July 22, 2022.

TB treatment using family members, treatment supporters and self-administered therapies in rural Papua New Guinea.

Papua New Guinea (PNG) has one of the world's highest TB incidence rates. It is difficult for patients to access TB care in remote provinces due to insufficient infrastructure and challenging terrain, making varied, targeted delivery models for treating TB necessary. To assess treatment outcomes using self-administered treatment (SAT), family-supported treatment and community-based directly observed therapy (DOT) via treatment supporter (TS) in the PNG context. A retrospective, descriptive analysis of routinely collected data from 360 patients at two sites in 2019-2020. All patients were assigned a treatment model based on risk factors (adherence or default) and offered patient education and counselling (PEC), family counselling and transportation fees. End-of-treatment outcomes were assessed for each model. Treatment success rates among drug-susceptible TB (DS-TB) were good overall: 91.1% for SAT, 81.4% for family-supported treatment and 77% for DOT patients. SAT was strongly associated with favourable outcomes (OR 5.7, 95% CI 1.7-19.3), as were PEC sessions (OR 4.3, 95% CI 2.5-7.2). By considering risk factors when determining their treatment delivery model, strong outcomes were seen in all three groups. Multiple modes of treatment administration, tailored to individuals' needs and risk factors, is a feasible, effective, patient-centred care model for hard-to-reach, resource-limited settings.

Disease burden of tuberculosis and post-tuberculosis in Inner Mongolia, China, 2016–2018 — based on the disease burden of post-TB caused by COPD

BackgroundTuberculosis (TB) remains one of the most serious infectious diseases worldwide. China has the second highest TB burden globally, but existing studies have mostly neglected the post-tuberculosis (post-TB) disease burden. This study estimated the disease burden of TB and post-TB in Inner Mongolia, China, from 2016 to 2018.MethodsPopulation data were collected from TB Information Management System. Post-TB disease burden was defined as the burden caused by Chronic Obstructive Pulmonary Disease (COPD) occurring after patients with TB were cured. To estimate the incidence rate of TB, standardized mortality rate, life expectancy, and cause eliminated life expectancy, using descriptive epidemiological, abridged life table and cause eliminated life table. On this basis, the Disability-Adjusted Life Years (DALY), Years Lived with Disability (YLD) and Years of Life Lost (YLL) due to TB were further be estimated. The data were analyzed using Excel 2016 and SPSS 26.0. Joinpoint regression models were used to estimate the time and age trends of the disease burden of TB and post-TB.ResultsThe TB incidence in 2016, 2017, and 2018 was 41.65, 44.30, and 55.63/100,000, respectively. The standardized mortality in the same period was 0.58, 0.65, and 1.08/100,000, respectively. From 2016 to 2018, the total DALYs of TB and post-TB were 5923.33, 6258.03, and 8194.38 person-years, and the DALYs of post-TB from 2016 to 2018 were 1555.89, 1663.33, and 2042.43 person-years. Joinpoint regression showed that the DALYs rate increased yearly from 2016 to 2018, and the rate of males was higher than that of females. TB and post-TB DALYs rates showed a rising tendency with increasing age (AAPC values were 149.6% and 157.0%, respectively, P < 0.05), which was higher in the working-age population and elderly.ConclusionThe disease burden of TB and post-TB was heavy and increased year by year in Inner Mongolia from 2016 to 2018. Compared with the youngster and females, working-age population and the elderly and males had a higher disease burden. Policymakers should be paid more attention to the patients’ sustained lung injury after TB cured. There is a pressing need to identify more effective measures for reducing the burden of TB and post-TB of people, to improve their health and well-being.

Geographical evolutionary pathway of global tuberculosis incidence trends

BackgroundsTuberculosis (TB) remains a serious public health and human development problem, especially in developing countries. Despite the effectiveness of directly observed therapy, short course programs in reducing transmission and progression of TB, poverty reduction and socioeconomic development remain crucial factors in decreasing TB incidence. However, the geographical pathway on the planet is not yet clear.ObjectivesThis study was to reconstruct the geographical evolutionary process of TB in 173 countries and territories from 2010 to 2019 to analyze the socioeconomic determinants that impact the global TB epidemic. In addition, the TB incidence in 2030 was predicted.MethodsThis study analyses TB incidence data from 173 countries and territories between 2010 and 2019. The Geotree model would be used to reconstruct the geographical evolutionary process of TB, which provides a simplified schema for geo-visualizing the trajectories of TB incidence and their socioeconomic drivers. Additionally, to estimate the future TB incidence in 2030, a multilevel model was utilized in conjunction with the hierarchical nature of the Geotree based on a stratified heterogeneity analysis.ResultsGlobal TB incidence was found to be associated with the country type and development stages. Between 2010 and 2019, the average TB incidence rate in 173 countries and territories was -27.48%, with marked spatially stratified heterogeneity by country type and development stage. Low-income and lower-middle-income countries were most vulnerable to TB. Upper-middle-income countries experienced a faster decline in TB incidence than high-income countries, and TB incidence generally decreased as the development stage increased, except for the lower-middle development stage in 2019.The highest average rate of decline in TB incidence was observed in the upper-middle development stage of high-income countries, with a reduction of 45.24%. Meanwhile, 37 high-income countries in the high development stage demonstrated an average rate of change of -13.93%. Socioeconomic determinants, including gross domestic product per capita, urbanization rate, and sociodemographic index, were found to inhibit TB incidence. Based on current trends, the predicted average global TB incidence in 2030 is 91.581 per 100,000 population.ConclusionsThe trajectories of the global TB incidence have been reconstructed to formulate targeted public health responses. To eliminate TB, countries at similar development stage can draw on the experiences of countries at higher development stages that are tailored to their unique characteristics. By learning from successful TB control strategies, countries can take strategic steps toward eradicating TB and improving public health outcomes.

Analysis of Pulmonary Tuberculosis Incidence in the City of Bukittinggi in 2018-2020

Pulmonary tuberculosis (pulmonary TB) is still a major problem of infectious diseases in Indonesia, including in the city of Bukittinggi. Data for 2022 shows that Bukittinggi City has the highest TB incidence rate in West Sumatra Province, namely 199/100.00 population. The aim of this research is to analyze the incidence of pulmonary TB in Bukittinggi City in 2018-2020. The research method was carried out using an observational descriptive design with an epidemiological approach, spatially based on Geographic Information Systems (GIS) and pulmonary TB control policies. The results showed that the highest incidence rate of pulmonary TB was in Guguk Panjang District which had the highest density, while the lowest cure rate was in Aur Birugo Tigo Baleh District.

Modelling Outcome of Drug Resistant Tuberculosis and Drug Susceptible Tuberculosis Patients in Oyo State

TB is perhaps the most important contagious disease in the world and the leading cause of mortality by an infectious disease. As a result, WHO declared that achieving the reduction in TB incidence rate for achievement of the 90-90-90 target of the END-TB strategy will be an illusion, if something severe is not done. Therefore, it is imperative to assess the visibility of achieving the END-TB goal in the country (Nigeria) by assessing the success of TB treatments so far in the country. Hence, this paper aims to model the outcome of drug-resistant-tuberculosis and drug-susceptible-tuberculosis patients in Oyo state of Nigeria using the logit function of estimating binary logistic regression model vis-à-vis identifying the success of these TB treatments. At baseline, based on WHO categorization, the study revealed the commonest cases of patients receiving DS-TB seen are ‘New’ (90.5%) followed by relapse after failure (4.2%). Contrarily, the commonest cases of patients receiving DR-TB seen are treatment after failure (44.3%), new (27.5%) and relapse after failure cases (20.6%). Four months after starting treatment, 91.5% and 3.2% were reportedly alive and dead respectively for patients receiving DS-TB treatment while 85.3% and 11.5% were reportedly alive and dead respectively for receiving DR-TB treatment. Hence, the percentage success of DS-TB recorded was higher than the recorded for DR-TB patients. Furthermore, the chi-square results for DS-TB patients indicated that mortality significantly associated with DS-TB categorised patients (i.e. Relapse) and HIV status (i.e. Negative). Also, for the DR-TB patients, the results depicted that mortality significantly associated with DR-TB categorised patients (i.e. TAF, Treatment after Loss to Follow Up and New), both HIV status and Sputum Smear status (i.e. Positive). Nevertheless, among other findings, the binary logistic regression model estimations revealed that categorised New patients and Sputum Smear status unfavourably and significantly predicted the treatment outcome (mortality) of DS-TB and DR-TB patients. As well, categorised Relapse patients unfavourably and significantly predicted the treatment outcome (mortality) of DR-TB patients. Thus, the DS-TB method of treatment is recommended in order to achieve the target goal of the END-TB strategy in Oyo state Nigeria.

Pre-sensitization with tuberculosis and non-tuberculosis mycobacteria and its impact on TB incidence in different age groups: Chengalpattu BCG trial revisited

Individuals pre-sensitized with Mycobacterium tuberculosis (MTB), non-tuberculosis mycobacteria, and its impact on TB incidence are relatively unexplored in a high TB burden setting. We conducted secondary data analysis of a double-blind, randomized Chengalpattu BCG trial, India. Induration to Purified Protein Derivative (PPD)-S and PPD-B were proxies for exposures to MTB and M. intracellulare respectively. Optimum cut-off for PPD-S and B were determined using Receiver-Operating Characteristic curves and induration ≥12 mm for PPD-S and ≥10 mm for PPD-B were considered strong reaction. Incidence rates of culture positive pulmonary TB per 100,000 person-years (PY) were calculated. Of 270,043 individuals with skin test results, children <14 years (n = 109,383, 64% showed strong-reaction to PPD-B and 17% to PPD-S) and adults between 25 and 34 years (n = 40,292, 98% were strong reactors to PPD-B and 73% to PPD-S). Overall incidence rate was lower in individuals with PPD-S < PPD-B (136, 95% CI: 130–141/100,000 PY) compared to individuals with PPD-S > PPD-B (447, 95% CI: 427–468/100,000 PY). Incidence rates of culture positive pulmonary TB was affected by early age of exposure to cross-reactive mycobacterial antigens represented by PPD-B and exposure to MTB represented by PPD-S during adolescence and early adulthood.

Tuberculosis screening and early diagnostics in adolescents in Primorsky Krai

Aim. To define the objectives of phthisiatric service with respect to organizing screening for tuberculosis infection (TB) and early diagnostics among adolescents in Primorsky Krai.Material and Methods. The data of epidemiological monitoring conducted by the Primorsky Regional TB Dispensary in 1994–2021 were analyzed. The TB incidence, clinical structure of newly-diagnosed cases, phases of the tuberculosis process, as well as the presence of bacterial excretion were assessed. At a level of 0.95, the statistical hypothesis of equal shares was tested under an alternative hypothesis.Results. The implementation of mass immunodiagnostics using the recombinant tuberculosis allergen (TBA) by medical organizations, which are joint into a unified medical network, improves screening efficiency of TB among adolescents. This is confirmed by a decreased TB incidence rate and improved clinical structure of newly-diagnosed cases. The prevalence of secondary TB forms in the clinical structure of newly-diagnosed cases in adolescents justifies the importance of annual fluorographic examination. Annual RTA testing and fluorographic examination of the chest in adolescents once every six months should be a priority anti-tuberculosis measure.Conclusions. TB in adolescents remains to be a serious phthisiological problem. An effective system of screening and early detection of TB in adolescents should include mass immunodiagnostics and, with an interval of six months, fluorographic examination of the chest.

Evolução espaço-temporal da incidência de tuberculose em indígenas e não indígenas no Brasil, no período de 2011 a 2022

ABSTRACT Objective: To describe the space-time evolution of TB incidence rates (TI) in indigenous and non-indigenous people, according to the Federative Units (UF) of Brazil, from 2011 to 2022. Methods: Ecological, temporal, and spatial study on new tuberculosis cases in Brazil among indigenous and non-indigenous populations. Data from the Notifiable Diseases Information System (Sinan) were collected from 2011 to 2022 and stratified by Federal Unit, explored and statistically analyzed using R software version 4.2.3. Results: The mean TI among indigenous populations in Brazil was 71.7 new cases per 100,000 inhabitants, while for non-indigenous populations it was 28.6/100,000 inhabitants. The regions of the country that presented the highest (mean) incidence among indigenous populations were: Central-West (102.8/100,000 inhabitants), Southeast (99.6/100,000 inhabitants), and North (79.9/100,000 inhabitants). For non-indigenous populations the highest incidence was in the North region (36.5/100,000 inhabitants), followed by the Southeast (31.3/100,000), and the Northeast (27,4/100,000 inhabitants). The analysis showed that the highest incidence of TB cases among indigenous populations occurred in the states of: SP, RO, RJ, MS, MT e PA. Conclusion: High incidence of the disease compared to the non-indigenous population show the need for a specific approach to address the health needs of these populations. Regional disparities in incidence indicate the need to address socioeconomic and infrastructure issues that affect the health of indigenous populations.

Assessment Knowledge, Attitude, and Practice Toward Tuberculosis Among Syrian People: An online cross-sectional study

Background: TB was reported to have the highest mortality rate among other infectious diseases in 2018 worldwide. Syria and other low-income countries have a higher incidence rate of TB in comparison to high-income countries. Stigma toward TB is extremely high in low-income countries like Syria, and these stigma delays patients from seeking healthcare facilities. Our purpose in this study is to assess the Syrian's knowledge, attitudes, and practices toward TB and understand their Practice related to this disease. &#x0D; &#x0D; Methods: An online cross-sectional questionnaire was distributed between15 September 7 October 2022, among Syrians to assess their knowledge, attitudes, and practices toward TB. This questionnaire was adapted from a published study, and the inclusion criteria were all male and female Syrian citizens aged 18 or above. The survey was divided into four questions: the first section assessed sociodemographics, and the other sections were about knowledge, attitude, and practices, respectively. Using IBM SPSS V. 28.0, the data were submitted to descriptive and multivariate logistic regression analyses.&#x0D; &#x0D; Results: About (38.6%) of the 1407 participants in this research were male. The research participants' knowledge scores indicated that 78.1% have excellent knowledge. However, 54.1% of interviewees agreed that shaking someone's hand may transmit tuberculosis. Regarding attitude, more than two-thirds (85.7%) of the participants in the survey had an optimistic outlook. Accordingly, most participants (81.3%) had effective TB preventive and control practices. Participants aged 61 to 70 had more TB knowledge than other age groups (P value&lt;0.05; mean=6.63, SD=1.13). Participants with chronic illness had a more positive attitude toward tuberculosis than those without (P value&lt;0.05) (mean=2.17, SD=0.63). Participants with a university degree demonstrated more TB practice than those with lower levels of education (mean=6.17, SD=0.85). Participants with a university degree were expected to have 4.38 times more TB knowledge than those without formal education (P 0.05). Participants with a university degree were projected to practice tuberculosis 10.63 times more often than those without education (P 0.001).&#x0D; &#x0D; Conclusion: Our results indicate that there is poor knowledge regarding the route of transmission of TB; therefore, more efforts should be made to raise awareness about TB transmission, as understanding these facts is a crucial aspect in mitigating the incidence of TB. Consequently, individuals reported poor practices toward TB; for that reason, educating individuals about good practices toward TB should take priority in Syria as war has destroyed the understructure of the healthcare system.