Treatment Of Tuberculosis Patients Research Articles

Aspek Hukum Penanganan Pasien Tuberkulosis Berbasis Perlindungan Hak Asasi Manusia

Handling of tuberculosis patients in a legal context based on the protection of human rights has been carried out through juridical instruments in various laws and regulations. However, the complexity of the challenge of providing effective care while respecting patient rights is often overlooked. This research uses a normative juridical research type, with a statutory and conceptual approach. Library collection of legal materials. Analysis uses qualitative descriptive. Research results: (1) Protection of human rights in treating tuberculosis patients is carried out by considering ethics and legality governing access to health services, patient privacy, and participation in decision making. (2) Policies that are more inclusive and sensitive to patients' human rights, including community empowerment and increasing awareness about tuberculosis, are needed to increase the effectiveness of tuberculosis treatment while respecting individual dignity and rights. The implication is that there is an integration of human rights principles in the regulations for treating tuberculosis to achieve sustainable and fair health goals for all.

Compliance Level and Side Effects in the Treatment of Tuberculosis Patients: A Study from Indonesia

Compliance Level and Side Effects in the Treatment of Tuberculosis Patients: A Study from Indonesia

Characteristics, knowledge, attitude, and practice of pharmacy personnel in supporting tuberculosis treatment: A multicenter cross-sectional study in a high-burden tuberculosis country

BackgroundPositive roles of community pharmacy in tuberculosis (TB) care have been widely reported. However, the actual practice of supporting TB treatment is not optimal yet. Therefore, we analyzed the current practice of community pharmacy personnel and its factors in supporting the successful treatment of TB patients in Indonesia, aiming to develop strategies for effective and sustainable TB practice models for the community pharmacy. MethodsWe performed a cross-sectional survey in 3 areas representing Indonesia's eastern, central, and western parts. Development and validation of the questionnaire were conducted to assess 4 domains, that is, characteristics, knowledge, attitudes, and practice of community pharmacy personnel in supporting the successful treatment of TB patients. Data were collected with purposive convenience sampling using online and offline questionnaires. Descriptive analyses were used to summarize factors in each domain, while binary logistic regression was used to analyze the associated factors of the practice. ResultsThirty-five questionnaire items indicated a valid instrument, and the study successfully included 844 participants who comprised pharmacists (n = 473, 56%) and pharmacy assistants (n = 371, 44%). Although most of the knowledge items were correctly answered by more than 60% of the participants, items related to TB signs, risk groups, drug regimens, and medicine uses were still less than 60%. This was in line with exposure to updated TB training in only 51% of the participants (n = 426). Most of the participants had a positive attitude toward their professional role (n = 736, 87%), capability (n = 646, 77%), and consequences (n = 655, 78%) in supporting TB treatment. However, this was not aligned with the actual practice of supporting TB treatment, intensively performed by only 1.3% of participants (n = 11). We identified several factors associated with the practice, that is, a pharmacy assistant background (P < 0.05), short working time (P < 0.05), experience in TB training (P < 0.001), and a positive attitude (P < 0.001). ConclusionsThis study highlighted a limited number of community pharmacy personnel practicing as TB treatment supporters in Indonesia. An interventional package considering the identified factors is needed to develop effective and sustainable practices in the real world.

Prevalence, treatment outcomes and determinants of TB/HIV coinfection: A 4-year retrospective review of national tuberculosis registry in a country in a MENA region

BackgroundThe co-occurrence of tuberculosis (TB) and AIDS (HIV) has emerged as a significant public health challenge. This study investigated the epidemiological factors and treatment outcomes of TB in individuals based on their HIV status in Iran. MethodsThe current study was a descriptive-analytical cross-sectional study that focused on new patients diagnosed with TB in Iran between 2018 and 2021. Patients’ data were sourced from the National Tuberculosis Registry database of Iran. A multiple logistic regression model was used to investigate the relationship between the most important influencing factors and TB/HIV coinfection. ResultsOver a 4-year period, a study was conducted on 25,011 new TB patients out of 30,762 registered in the national database. TB and HIV were coinfected in 672 cases (2.68%). The highest number of coinfection cases were found in patients with smear-negative pulmonary tuberculosis (249 patients, 37.05%) and extrapulmonary tuberculosis (123 patients, 18.19%). TB patients with coinfection had a median TB treatment duration of three months longer than others. The success rate of TB treatment was lower in patients with coinfection (437 patients, 65.02%) than in non-coinfection patients (20,302 patients, 83.41%). Treatment success probability in smear-positive pulmonary tuberculosis patients with and without coinfection was lower than other types of TB. Logistic regression analysis showed that having a TB risk factor was the strongest predictor of coinfection, with an odds ratio of 29.73 (95% CI: 22.05–40.07), followed by having an HIV risk factor with an odds ratio of 17.52 (95% CI: 13.68–22.45). ConclusionsThe findings of this research offer significant insights into the potential causes of HIV coinfection in individuals with TB, which could be used to inform the development of policies and strategies aimed at enhancing the identification and treatment of TB patients who are at risk of TB/HIV coinfection and to promote optimal health status for patients with TB.

Delays in health seeking, diagnosis and treatment for tuberculosis patients in Mongolia: an analysis of surveillance data, 2018-2021.

Early diagnosis and treatment of infectious tuberculosis (TB) is essential to the attainment of global targets specified in the End TB Strategy. Using case-based TB surveillance data, we analysed delays in health seeking, diagnosis and treatment among TB patients in Mongolia from 2018 to 2021. We calculated the median and interquartile range (IQR) for "diagnostic delay," defined as the time from symptom onset to diagnosis, subdivided into "health-seeking delay" (time from symptom onset to first visit to a health facility) and "health facility diagnostic delay" (time from first health facility visit to diagnosis), and for "treatment delay," defined as the time from diagnosis to start of treatment. We also calculated "total delay," defined as the time from symptom onset to treatment start. Based on data for 13 968 registered TB patients, the median total delay was estimated to be 37 days (IQR, 19-76). This was mostly due to health-seeking delay (median, 23 days; IQR, 8-53); in contrast, health facility diagnostic delay and treatment delay were relatively short (median, 1day; IQR, 0-7; median, 1day; IQR, 0-7, respectively). In 2021, health-seeking delay did not differ significantly between men and women but was shorter in children than in adults and shorter in clinically diagnosed than in bacteriologically confirmed TB cases. Health-seeking delay was longest in the East region (median, 44.5days; IQR, 20-87) and shortest in Ulaanbaatar (median, 9; IQR, 14-64). TB treatment delay was similar across sexes, age groups and types of TB diagnosis but slightly longer among retreated cases and people living in Ulaanbaatar. Efforts to reduce TB transmission in Mongolia should prioritize decreasing delays in health seeking.

Magnitude and factors associated with delay in treatment-seeking among new pulmonary tuberculosis patients in public health facilities in Habro district, eastern Ethiopia.

In developing nations, almost two-thirds of people with active tuberculosis (TB) remain undetected and untreated. Delays in seeking treatment increase the severity of the illness, the likelihood of mortality, and the risk of the infection spreading to others in the community. Thus, this study aimed to assess the magnitude of delay in treatment-seeking and its associated factors among new adult pulmonary tuberculosis patients attending public health facilities in Habro District, West Harerge Zone, Oromia Region, Eastern Ethiopia. A health facility-based cross-sectional study design was conducted among 420 randomly selected patients with pulmonary tuberculosis who visited public health facilities in Habro District from September 5 to October 5, 2022. Binary logistic regression analysis was used to determine the relationship between the dependent and independent variables, and a 95% confidence interval was used to select significant variables. Twenty-one days after the start of their illness, 62.38% (95% CI: 57.4%, 66.6%) of the patients sought an initial consultation. Being female (AOR = 2.14, 95% CI: 1.26, 3.65), having poor knowledge about TB (AOR = 3.10, 95% CI: 1.77, 5.43), having no contact history with TB patients (AOR = 3.52, 95% CI: 1.29, 9.58), having clinically diagnosed pulmonary tuberculosis (AOR = 2.16, 95% CI: 1.26, 3.67), and living a long distance from the nearest health facility (AOR = 2.87, 95% CI: 1.31, 6.23) were important predictors contributing to TB patient treatment delay. In the current study, more than three-fifths of TB patients delayed seeking treatment. Thus, awareness of tuberculosis should be created, especially targeting females and communities found at a distance from the health facility. Additionally, health professionals should emphasise the importance of getting medical attention early and knowing how to suspect and identify tuberculosis symptoms.

The impact of prior SARS-CoV-2 infection on host inflammatory cytokine profiles in patients with TB or other respiratory diseases.

Tuberculosis (TB) and COVID-19 are the two leading causes of infectious disease mortality worldwide, and their overlap is likely frequent and inevitable. Previous research has shown increased mortality in TB/COVID-coinfected individuals, and emerging evidence suggests that COVID-19 may increase susceptibility to TB. However, the immunological mechanisms underlying these interactions remain unclear. In this study, we aimed to elucidate the impact of prior or concurrent COVID-19 infection on immune profiles of TB patients and those with other respiratory diseases (ORD). Serum and nasopharyngeal samples were collected from 161 Gambian adolescents and adults with either TB or an ORD. Concurrent COVID-19 infection was determined by PCR, while prior COVID-19 was defined by antibody seropositivity. Multiplex cytokine immunoassays were used to quantify 27 cytokines and chemokines in patient serum samples at baseline, and throughout treatment in TB patients. Strikingly, TB and ORD patients with prior COVID-19 infection were found to have significantly reduced expression of several cytokines, including IL-1β, TNF-α and IL-7, compared to those without (p<0.035). Moreover, at month-six of anti-TB treatment, seropositive patients had lower serum Basic FGF (p=0.0115), IL-1β (p=0.0326) and IL-8 (p=0.0021) than seronegative. TB patients with acute COVID-19 coinfection had lower levels of IL-8, IL-13, TNF-α and IP-10 than TB-only patients, though these trends did not reach significance (p>0.035). Our findings demonstrate that COVID-19 infection alters the subsequent response to TB and ORDs, potentially contributing to pathogenesis. Further work is necessary to determine whether COVID-19 infection accelerates TB disease progression, though our results experimentally support this hypothesis.

Recurrence of pulmonary tuberculosis in India: Findings from the 2019-2021 nationwide community-based TB prevalence survey.

Recurrent Tuberculosis patients contribute to a significant proportion of TB burden in India. A nationwide survey was conducted during 2019-2021 across India among adults to estimate the prevalence of TB. A total of 322480 individuals were screened and 1402 were having TB. Of this, 381 (27.1%) had recurrent TB. The crude prevalence (95% CI) of recurrent TB was 118 (107-131) per 100,000 population. The median duration between episodes of TB was 24 months. The proportion of drug resistant TB was 11.3% and 3.6% in the recurrent group and new TB patients respectively. Higher prevalence of recurrent TB was observed in elderly, males, malnourished, known diabetics, smokers, and alcohol users. (p<0.001). To prevent TB recurrence, all treated tuberculosis patients must be followed at least for 24 months, with screening for Chest X-ray, liquid culture every 6 months, smoking cessation, alcohol cessation, nutritional interventions and good diabetic management.

Effort to Control Pulmonary Tuberculosis (TB) in the Community through Tuberculosis Alert Health Cadre Training

Tuberculosis (TB) alert health cadre training is an important thing that can be done to help control TB in the community. TB control includes increasing early detection and adherence to treatment for TB patients. To solve TB problems in the community, a synergy of roles is needed between health workers and the community, one of which is through empowering health cadres by increasing their capacity. We conducted interactive TB control health education training program that aim to improve health cadre knowledge, attitudes, and practice in early detection of TB and assistance to Drug Swallowing Supervisors/”Pengawas Menelan Obat (PMO)”. The training was provided using lecture method, two-way discussion, and demonstration for one day by internal medicine specialists, assisted by multi-professional students from medical and nursing program. A total of 36 health cadres from Sumberharjo village participated in this training. Before and after the training, cadres took pre-test and post-test. The survey results were analyzed statistically using descriptive quantitative methods for the respondent’s characteristics, whereas the score of knowledge, attitude, and practice were analyzed using nonparametric test. The median and the minimum-maximum of the pre-test score before training for knowledge was 10.5(7-13), attitude score was 15(11-15), and practice score was 15(8-15). Meanwhile, the median and the minimum-maximum post-test score after training for knowledge was 11(8-14), attitude score was 15(10-15), and practice score was 15(10-15). The results of statistic test obtained were p=0.003 for knowledge, p=0.272 for attitude, and p=0.111 for practice. It showed that there was a significant difference in the cadre's knowledge scores before and after training, but there were no significant differences in their attitudes and practice scores before and after training. Training for health cadres is recommended to increase capacity of health cadre, especially the knowledge of health cadre controlling TB in the community.

2958. Investigating the mechanisms of persistent inflammation and the association with non-communicable diseases (NCDs), Tuberculosis (TB) recurrence, and other infections

Abstract Background TB continues to be a major cause of morbidity and mortality worldwide. Despite successful completion of anti-tuberculosis therapy (ATT), studies indicate that TB survivors (post-TB) have a significantly higher risk of mortality compared to the general population, primarily due to increased incidence of non-communicable diseases (NCDs; cardiovascular disease, cancer, lung disease) and recurrent infections. Furthermore, a considerable proportion of TB patients exhibit persistent inflammation even after ATT. Methods We enrolled 325 individuals with microbiologically confirmed pulmonary TB, diagnosed between 2014 and 2020. Blood samples were obtained at baseline and 12- months (6-months after completing antimicrobial therapy) to evaluate persistent inflammation. Plasma C-reactive protein (CRP) was used to measure inflammation. Lipid peroxidation (LP) was measured by oxidized (HNE) LDL. Redox capacity was measured via the Trolox assay. Immune activation was measured by the Indoleamine 2,3 dioxygenases (IDO) enzyme by measuring the Kynurenine-Tryptophan ratio. Results After successful TB treatment, 62% of participants exhibited persistent elevation of CRP (P&amp;lt; 0.001) (Figure 1a). Univariate analysis of the first 186 participants revealed no association between elevated post-TB inflammation and HIV status (Fig. 1B), gender, or age. Individuals with increased CRP levels had a lower redox capacity compared to those whose CRP normalized at the end of ATT (P&amp;lt; 0.001) (Figure 2). Analysis of Oxidized LDL in successfully treated TB patients demonstrated that low antioxidant capacity also had persistent LP (Figure 2b). IDO activity was increased among TB participants with high CRP, which persisted even after successful therapy in participants with high and low CRP levels (Figure 3). Fig 1a: CRP was evaluated on TB participants and their asymptomatic, healthy household contacts. The median CRP of the healthy contacts was &amp;lt;2 mg/L, whereas the median CRP for TB participants at baseline was 21 and decreased to 8 at the end of successful therapy (EOT). Previous studies have demonstrated that CRP levels &amp;gt;3 mg/L are associated with increased CVD risk . 62% (111/186) of TB participants have CRP levels &amp;gt;3 mg//L at the end of TB therapy. Fig 1b: All TB participants living with HIV (PLWH) are started on ART, with &amp;gt;90% having a viral load &amp;lt;1000 at end of therapy (EOT). At EOT, TB participants without HIV do not have lower CRP levels compared to PLWHIV, preliminarily suggesting HIV is not driving the persistent inflammation. Fig2a: The Trolox antioxidant capacity was evaluated on TB Participants with High CRP &amp;gt;3mg/L (n:36) vs Low CRP &amp;lt;3mg/L (n:32) and Healthy Controls (n:32). Conclusion This study shows that a substantial proportion of TB participants exhibit persistent inflammation and IDO activity even after ATT. Among TB participants who do not normalize inflammation at the end of successful therapy, there is also persistent LP and decreased redox capacity. This suggests that there is a bidirectional malignant relationship between LP and redox capacity. Potentially, this suggests that mitigating lipid peroxidation may help decrease post-TB inflammation. Fig2b: Oxidized LDL was measured in TB individuals with High levels of CRP High CRP &amp;gt;3mg/L (n:16) vs Low CRP &amp;lt;3mg/L (n:16) and Healthy Controls (n:4) Fig3 Plasma Kynurenine to Tryptophan ratio was evaluated in TB individuals with persistent augmented levels of CRP (n:19) at baseline and Heathy Controls. At the end of Therapy the KYN:TRYP was evaluated in TB individuals with high (n:22) and Low CRP levels (n:17) Disclosures All Authors: No reported disclosures

Hubungan Jumlah Monosit Dan Nilai Laju Endap Darah (LED) Terhadap Lama Pengobatan Pasien Tuberculosis

Tuberculosis (TBC) is a bacterial infection caused by Mycobacterium tuberculosis. The duration of TBC treatment is routinely 6 months; otherwise, resistance will develop. TBC can increase leukocytes, including monocytosis as an inflammatory response and an elevated ESR.  The aim of this study was to determine the relationship between the number of monocytes and the ESR value on the duration of tuberculosis treatment in patients at the Respira Lung Hospital, Yogyakarta City. The study was conducted in June and July 2023 at the Respira Pulmonary Hospital in Yogyakarta City. The study sample was 32 tuberculosis patients and blood was drawn to determine the monocyte number and ESR value. The results showed that the average number of monocytes was 7% (normal), the ESR value was 41.59 mm/hour (high) with the average duration of tuberculosis treatment for respondents was 3 months. Spearman test obtained Sig p&lt;0.05.  This study concluded that there is a correlation between the number of monocytes and the ESR value on the duration of TB treatment in patients at the Respira Lung Hospital in Yogyakarta City, with the direction of the relationship reversed.

Health Education In Increasing Self-Efficacy In The Treatment Of Tuberculosis Patients At Tamalanrea Makassar Health Center

Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis which spreads through the air (Airborne disease).symptoms of cough with phlegm for 2 weeks or more.Disease prevalenceTB (Tuberculosis)as many as 845,000 with a death rate reaching 98,000 cases, treatment coverage is only 67%, several factors cause unhealthy housing, education and non-compliance with treatment inutritional indicators, immune levels, greatly influence the quality of life of tuberculosis sufferers so that there is a need to increase self-efficacy in managing the disease,with education about the infectious disease tuberculosis The research method used was pre-experimental with a one group pre-test and post-test design with a sample size of 36 people. The instrument we used was a pre- and post-questionnaire and provided intervention in the form of health education. The results of the research showed that after health education was carried out, the Negative Ranks data showed that respondents' scores from pre-post 3 respondents experienced a decrease in self-efficacy regarding tuberculosis treatment after health education, while the positive ranks data showed that 12 respondents' scores from pre-post experienced an increase. Self-efficacy towards tuberculosis treatment after health education, and the tie data shows that 21 respondents got a fixed score from pre-post after health education. The results of the Wilcoxon statistical test obtained a p value = (0.020) &lt;α (0.05), and so The alternative hypothesis (Ha) is accepted. The conclusion is that there is an influence of health education on increasing self-efficacy in the treatment of tuberculosis sufferers at the Tamalanrea Makassar Community Health Center

Exploring Community Participation in Prevention and Care of Tuberculosis from Patients’, Healthcare Providers’ and Community Member’s Perspective, In Wolayta Zone, SNNPR, Ethiopia. A Qualitative Study

Background: In developing countries, tuberculosis (TB) continues to be the major cause of morbidity and mortality. To reduce the loss of lives and economical burden that TB poses up on citizens, early case detection and successful treatment of infected cases are very essential mainly with active community participation in prevention and care of TB. This study was aimed to explore community participation in prevention and care of TB in Wolayta Zone of SNNPR, Ethiopia. Method: Descriptive phenomenological research methodology was employed in the study. A total 24 participants were chosen using purposive sampling technique. Participants in the study were from various sections of society. Of these, 14 were TB patients on TB treatment and former TB patients who were recovered, 8 were health professionals and 2 were Key Informants which were selected from the community to provide key information. Data were gathered through focus groups and in-depth interviews. Using the Open Code and Colaizi 7 steps of descriptive phenomenological method data analysis  was used. Interviews were audio recorded, verbatim transcribed, translated, and  exhaustive description was written. Results: Community participation in prevention and care of TB in study area was high. Preventive participation and supportive participations were identified and these participations have their own goals in TB prevention and care. Preventive participation has focused on early case finding strategies like referring the suspect cases for TB diagnosis and contact tracing. Supportive participation has focused on treatment success such physical, economical, psychological and social supports which increase the patients adherence to treatment and as result increases treatment success rate. Conclusion. Our study revealed highto moderate  community participation in tuberculosis   prevention and care in the the study area. The finding is that the TB prevention and care strategy for eliminating TB will be operationally effective. In cumulative effect, the region might be able to meet the WHO's recommendations for the community TB prevention and care plan, which call for case notification of more than 70% and an 85% success rate for treatment and all seek to eliminating TB by 2030. Therefore, the study emphasizes the necessity for effective communication to be established between community and the health institutions. To further raise TB notification and treatment success rates, all feasible methods of utilizing community participation in TB care are advised.

Rifampicin induced acute thrombocytopenia with skin rashes: a case report

Rifampicin is an essential component of the treatment regimen for tuberculosis. Extensive clinical experience has shown that the drug has mild adverse effect, but on rare occasions, it can cause life threatening adverse reactions like thrombocytopenia. Blajchman et al first described rifampicin-induced thrombocytopenia in 1970. Since then, almost 40 cases have been documented in the literature and a recent review by Cooper and Ghanima included rifampicin in the group of not uncommon drugs that cause immune-mediated thrombocytopenia. Diagnosis of drug-induced immune thrombocytopenia is by identifying clinical symptoms and a careful evaluation of the suspected causative drug. The physician treating tuberculosis patients must be aware of this rare life-threatening complication, when we detected early, is completely reversible.

Clinical Utility of Contezolid-Containing Regimens in 25 Cases of Linezolid-Intolerable Tuberculosis Patients.

Linezolid is increasingly used in the treatment of multidrug-resistant (MDR) M. tuberculosis (TB) with good efficacy; however, its clinical use is limited by intolerable adverse events (AEs). This usually results in dose adjustment or even discontinuation. Contezolid is a new oxazolidinone antibiotic with in vitro antibacterial activity against MDR TB equivalent to linezolid, but its safety and efficacy in MDB TB treatment has not been established. We conducted a retrospective study on 25 TB patients who received both linezolid and contezolid in Beijing Chest Hospital from January 1, 2022, to January 31, 2023. All patients received linezolid-containing anti-TB regimen first and then switched to contezolid-containing regimens due to the intolerable linezolid-related AEs. Most (68%, 17/25) of the patients were diagnosed with RR-TB or MDR-TB. A total of 30 AEs were reported in these patients. About 26.7% (8/30) of the AEs were Grade 3 (severe) in severity. After switching to contezolid-containing anti-TB regimens for at least 1 month, the linezolid-related AEs were resolved or improved in 90% of the cases. Clinical improvement was observed in all patients after treatment with contezolid-containing regimen, with negative results of sputum culture and/or smear for M. tuberculosis in 84% of the patients. Contezolid can be the first choice instead of linezolid to combine with other anti-TB drugs if necessary. Well-designed clinical trials are required to further confirm the safety and efficacy of contezolid in the treatment of TB patients.

Influential factors of tuberculosis in mainland China based on MGWR model.

Tuberculosis (TB), as a respiratory infectious disease, has damaged public health globally for decades, and mainland China has always been an area with high incidence of TB. Since the outbreak of COVID-19, it has seriously occupied medical resources and affected medical treatment of TB patients. Therefore, the authenticity and reliability of TB data during this period have also been questioned by many researchers. In response to this situation, this paper excludes the data from 2019 to the present, and collects the data of TB incidence in mainland China and the data of 11 influencing factors from 2014 to 2018. Using spatial autocorrelation methods and multiscale geographically weighted regression (MGWR) model to study the temporal and spatial distribution of TB incidence in mainland China and the influence of selected influencing factors on TB incidence. The experimental results show that the distribution of TB patients in mainland China shows spatial aggregation and spatial heterogeneity during this period. And the R2 and the adjusted R2 of MGWR model are 0.932 and 0.910, which are significantly better than OLS model (0.466, 0.429) and GWR model (0.836, 0.797). The fitting accuracy indicators MAE, MSE and MAPE of MGWR model reached 5.802075, 110.865107 and 0.088215 respectively, which also show that the overall fitting effect is significantly better than OLS model (19.987574, 869.181549, 0.314281) and GWR model (10.508819, 267.176741, 0.169292). Therefore, this model is based on real and reliable TB data, which provides decision-making references for the prevention and control of TB in mainland China and other countries.

Effect of gaseous pollutant and greenness exposure on mortality during treatment of newly treated tuberculosis patients: a provincial population-based cohort study.

Previous studies addressing the impact of environmental factors on TB prognosis are scarce, with only some studies examining the effect of particulate pollutants on TB mortality. Moreover, few studies have evaluated the effects of multiple gaseous pollutants and greenness exposures on newly treated TB patients on a large population scale. Through the Centers for Disease Control and Prevention, data were collected from January 1, 2015 to December 31, 2020 for newly treated TB patients in Anhui Province, China. Data on gaseous pollutants sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone were collected through the National Earth System Science Data Center of China. Normalized vegetation index data were obtained through NASA. The Cox proportional risk model was also applied to calculate the hazard ratios of SO2, NO2, CO, O3, and NDVI with 95% confidence intervals for mortality among newly treated TB patients. Multifactorial Cox regression analysis showed that for every 0.10μg/m3 increase in SO2, the risk of death among newly treated TB patients increased by 13.2% (HR = 1.132, 95% CI: 1.045-1.1.225), for every 10μg/m3 increase in NO2, the risk of death among newly treated TB patients increased by 11.4%, and for each 0.1 mg/m3 increase in CO, the risk of death among newly treated TB patients increased by 5.8%. For each 0.1 increase in NDVI 250m-buffer and 500m-buffer, the risk of death among newly treated TB patients decreased by 8.5% and 6.4%, respectively. The effect of gaseous pollutants on mortality decreased progressively with elevated greenness exposure when greenness exposure was grouped from low to high. Gaseous pollutants are a risk factor during the treatment of newly treated TB patients and greenness exposure is a protective factor. Higher greenness exposure reduces the risk of death due to exposure to gaseous pollutants.

Evaluating the effectiveness of first-Line anti-tuberculosis in Al Dhafra Hospitals

Background: Tuberculosis (TB) continues to be a significant public health issue despite extensive efforts to control it. The standard treatment for TB involves the use of first-line anti-TB drugs administered at a standard dose. However, the effectiveness of this treatment can vary between individual patients, resulting in differing cure rates.&#x0D; Methodology:  The objective of this retrospective study was to assess the effectiveness and safety of first-line generic anti-TB medications administered at Liwa Hospital in the Al Dhafra Region. Data was collected from the electronic medical records of 140 TB patients admitted to Liwa Hospital from January to December 2022. The study included patients with positive acid-fast bacillus (AFB) or polymerase chain reaction (PCR) test results, indicating active TB infection. Patients resistant to first-line anti-TB medications or with lung cancer were excluded. Data collected included demographic information, length of stay conversion time, hospital admission, prescribed medications, treatment duration, and treatment outcomes.&#x0D; Results: This study observed an average length of stay of 21 days for patients treated with first-line generic anti-TB medications at Liwa Hospital. Over 80% of the patients were discharged within 30 days of admission, indicating a positive response to the medications. Approximately 13% of the patients required a longer duration of treatment and were discharged between 30 and 60 days after admission. Only 5% of the patients had a prolonged stay of over 60 days, most of whom had co-morbidities or rifampicin resistance, but achieved AFB conversion within three months. The average conversion time for patients was 25 days, with over 92% achieving conversion within two months.&#x0D; Conclusion: This study demonstrated the efficacy and safety of first-line generic anti-TB medications in treating TB patients at Liwa Hospital. The majority of patients responded well to the medications, leading to discharge within 30 days.&#x0D; Keywords: Tuberculosis, Ethambutol, Pyrazinamide, Rifampicin, Isoniazid, First line drugs, Anti TB drugs

Classification and characterisation of extracellular vesicles-related tuberculosis subgroups and immune cell profiles.

Around the world, tuberculosis (TB) remains one of the most common causes of morbidity and mortality. The molecular mechanism of Mycobacterium tuberculosis (Mtb) infection is still unclear. Extracellular vesicles (EVs) play a key role in the onset and progression of many disease states and can serve as effective biomarkers or therapeutic targets for the identification and treatment of TB patients. We analysed the expression profile to better clarify the EVs characteristics of TB and explored potential diagnostic markers to distinguish TB from healthy control (HC). Twenty EVs-related differentially expressed genes (DEGs) were identified, and 17 EVs-related DEGs were up-regulated and three DEGs were down-regulated in TB samples, which were related to immune cells. Using machine learning, a nine EVs-related gene signature was identified and two EVs-related subclusters were defined. The single-cell RNA sequence (scRNA-seq) analysis further confirmed that these hub genes might play important roles in TB pathogenesis. The nine EVs-related hub genes had excellent diagnostic values and accurately estimated TB progression. TB's high-risk group had significantly enriched immune-related pathways, and there were substantial variations in immunity across different groups. Furthermore, five potential drugs were predicted for TB using CMap database. Based on the EVs-related gene signature, the TB risk model was established through a comprehensive analysis of different EV patterns, which can accurately predict TB. These genes could be used as novel biomarkers to distinguish TB from HC. These findings lay the foundation for further research and design of new therapeutic interventions aimed at treating this deadly infectious disease.

Leucocyte Counts and Derivatives as Inflammatory Indicators in Active Tuberculosis

Tuberculosis (TB) is a disease of public health concern in Nigeria as the country is listed among the 30 high TB burden countries in the world. It is caused by Mycobacterium tuberculosis, an airborne pathogen. Tuberculosis disease is a manifestation of an active state of the infection when host immune response has been overwhelmed. Leucocytes participate in immune response, and traditionally, the total and differential counts have been useful in offering general outlook on inflammation as well as immunodeficiency. Lately, leucocyte derivatives such as neutrophil-tolymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) have been reported as bettermarkers of inflammation in some disease conditions. This study assessed total and differential leucocyte counts together with the derivatives in active tuberculosis infection among 80 tuberculosis patients and equal number of matched controls. Total and differential leucocyte counts were determined using standard haematology autoanalyzer, while the ratios were mathematically derived. Data were analyzed and hypotheses tested using student’s t-test on statistical package for social sciences (SPSS) version 21. A p-value of ≤0.05 was considered as statistically significant. Neutrophil-lymphocyte ratio was significantly higher in TB patients,while lymphocyte-monocyte ratio was significantly lower in TB patients than the control. Furthermore, neutrophil-lymphocyte ratio was significantly higher, while the lymphocytemonocyte ratio was significantly lower in TB patients at diagnosis (n=26) in comparison withthose on treatment (n=54). There is derangement in leucocyte derivatives in association with tuberculosis. These derivatives improved significantly as anti-TB treatment progressed. Therefore, these variables could serve as useful indicators in the monitoring of treatment for TB patients.&nbsp