Adult Tuberculosis Research Articles

Undernutrition and its predictors among tuberculosis patients in Southwest Ethiopia

BackgroundAdult tuberculosis (TB) patients experience significant undernutrition globally, especially in developing countries. While some studies have explored the prevalence and factors influencing undernutrition in this group, comprehensive large-scale investigations covering diverse health facilities and populations are lacking. This study aims to evaluate the prevalence of undernutrition and its associated factors among adult TB patients in public hospitals in southwest Ethiopia.MethodAn institution-based cross-sectional study design was conducted from March 01 to April 15, 2023, in public hospitals in the southwest region, of Ethiopia. A total of 239 adult TB patients who were directly observed in TB treatment were selected via systematic sampling. A structured questionnaire was adapted from a review of different literature. Data were cleaned and entered into EPI info version 7, then analyzed with SPSS Version 22. A bivariable analysis was done to evaluate associations at (p < 0.25), and then multiple logistic regression models were computed to identify independent predictors of undernutrition among TB patients at (p < 0.05).ResultsA total of 239 respondents participated with a response rate of 100%. The prevalence of undernutrition among adult TB patients was 43.93%. Of the 239 TB patients, the majority (91.6%) were new TB cases. Family size >5 (AOR 3.23 [1.16–9.01]), household average income <2,000 birr (AOR 5.64 [2.12–14.99]), type of TB (AOR 2.8 [1.25–6.51]), and positive HIV status of the study participant (AOR 3.23 [1.16–9.01]) were the independent predictors of undernutrition among adult TB patients.Conclusion and recommendationsUndernutrition among adult tuberculosis (TB) patients is notably high compared to other settings. Key predictors include a family size greater than five, a monthly income below 2,000 birr, HIV status, and pulmonary TB. Early screening and diagnosis of undernutrition, along with nutritional interventions, should be integrated into the routine care for all adult TB patients.

Early introduction of IL-10 weakens BCG revaccination’s protection by suppressing CD4+Th1 cell responses

BackgroundThe Bacillus Calmette-Guérin (BCG) vaccine, currently the sole authorized vaccine against tuberculosis (TB), demonstrates limited effectiveness in safeguarding adolescents and adults from active TB, even when administered as a booster with either BCG itself or heterologous vaccine candidates. To effectively control the persistent epidemic of adult TB, it is imperative to investigate the mechanisms responsible for the suboptimal efficacy of the BCG prime-boosting strategy against primary Mycobacterium tuberculosis (M.tb) infection.MethodsC57BL/6J mice were immunized with the BCG vaccine either once or twice, followed by analysis of lung tissue to assess changes in cytokine levels. Additionally, varying intervals between vaccinations and detection times were examined to study IL-10 expression across different organs. IL-10-expressing cells in the lungs, spleen, and lymph nodes were analyzed through FACS and intracellular cytokine staining (ICS). BCG-revaccinated IL-10−/− mutant mice were compared with wild-type mice to evaluate antigen-specific IgG antibody and T cell responses. Protection against M.tb aerosol challenge was evaluated in BCG-revaccinated mice, either untreated or treated with anti-IL-10R monoclonal antibody.ResultsIL-10 was significantly upregulated in the lungs of BCG-revaccinated mice shortly after the booster immunization. IL-10 expression peaked in the lungs 3–6 weeks post-revaccination and was also detected in lymph nodes and spleen as early as 2 weeks following the booster dose, regardless of the intervals between the prime and booster vaccinations. The primary sources of IL-10 in these tissues were identified as macrophages and dendritic cells. Blocking IL-10 signaling in BCG-revaccinated mice—either by using IL-10−/− mutant mice or administering anti-IL-10R monoclonal antibody increased levels of antigen-specific IFN-γ+ or IL-2+ CD4+ T cells, enhanced central and effector memory CD4+ T cell responses, and provided better protection against aerosol infection with 300 CFUs of M.tb.ConclusionOur findings are crucial for formulating effective immunization strategies related to the BCG vaccine and for developing efficacious adult TB vaccines.Graphical abstract

An Assessment of KAP Towards LTBI in Under-5 Children among Physicians Treating Adult/Adolescent TB Patients in Dhaka City

<i>Introduction:</i> LTBI is the precursor to TB, making early detection and treatment of infected children vital to preventing pediatric morbidity and mortality. This study assesses the knowledge, attitudes, and practices of physicians treating adult and adolescent TB patients in managing LTBI among under-5 children in Dhaka. <i>Aim of the study:</i> The aim of the study was to evaluate the knowledge, attitude, and practices of physicians treating adult and adolescent tuberculosis patients in Dhaka City regarding the diagnosis and management of latent tuberculosis infection (LTBI) in under-5 children. <i>Methods: </i>This six-month cross-sectional, semi-qualitative study was conducted from January to June 2020 at the Department of Paediatrics in five Dhaka hospitals, involving 50 physicians treating adult and adolescent TB patients. Data were collected through standardized questionnaires, with consent obtained, and qualitative responses categorized and scored using SPSS Version 25.0. <i>Result: </i>Among 50 physicians, most were aged 30-39, and 62% had recent TB training. Knowledge of latent tuberculosis infection (LTBI) was limited, with only 14% accurately defining it, while 88% acknowledged isoniazid preventive therapy (IPT) availability. Only 12% inquired about family members of pulmonary TB patients, and 10% asked about under-five children. A significant 80% had no involvement in managing LTBI in children, with just 6% prescribing IPT. Additionally, 84% believed IPT could cause drug resistance, and those with recent training scored higher in knowledge. <i>Conclusion: </i>This KAP study identifies key barriers to LTBI tracing and IPT/TPT implementation in children under five, emphasizing the need for structured training to enhance physician practices.

Population-based cohort study examining the association between weight loss and pulmonary tuberculosis in adults

Population-based cohort study examining the association between weight loss and pulmonary tuberculosis in adults

Challenging case of disseminated tuberculosis in an immunocompetent adult.

Disseminated tuberculosis (TB) is a TB infection involving two or more noncontiguous sites. It is a challenging medical care due to its misleading presentation. Although it is associated with immunodepression, rare cases have been described in immunocompetent patients.We report the case of a 27-year-old immunocompetent man who presented with an altered general condition and dyspnea. Chest computed tomography (CT) revealed pulmonary masses and mediastinal lymphadenopathy. Sputum smear microscopy for acid-fast bacilli was negative. Scannoguided transparietal lung biopsy was performed twice with inflammatory tissue in histological study. A surgical lung biopsy was then made. The histopathology report confirmed TB involving lung, pleura and lymph nodes. A few days after antituberculosis therapy was started, the patient developed psychomotor slowing related to quadriportal hydrocephalus. He benefited from ventriculoperitoneal bypass. Polymerase chain reaction for detection of Mycobacterium TB was positive in cerebrospinal fluid.In conclusion: The diagnosis of disseminated TB is challenging owing to its non-specific clinical and radiological presentation and the frequent negativity of biological fluids for tubercle bacilli. Molecular biology should always be considered in front of lingering symptoms, particularly in endemic areas, given their speed and sensitivity, thus avoiding invasive diagnostic procedures, as was the case with our patient.

Disseminated Tuberculosis in an Immunocompetent Adult: A Rare Clinical Presentation and Diagnostic Challenge

Disseminated tuberculosis (TB) is a rare and life-threatening form of TB, particularly when it occurs in immunocompetent individuals. A 52-year-old diabetic male presented with tachypnea, tachycardia, and chronic low back pain. Comprehensive imaging revealed pulmonary involvement, lumbosacral vertebral destruction (L5-S1), genitourinary TB, hepatitis, and psoas abscesses. Ultrasound-guided drainage and CB-NAAT analysis confirmed Mycobacterium tuberculosis. Given the patient's deranged liver function tests, a modified antitubercular therapy regimen, including levofloxacin, amikacin, and ethambutol, was administered. The patient demonstrated significant clinical improvement, with resolution of symptoms and normalization of liver function on follow-up. This case underscores the diagnostic complexity of disseminated TB in immunocompetent patients, highlighting the importance of early detection and individualized treatment. Further research is needed to develop standardized treatment protocols, particularly for cases involving multi-organ involvement and liver dysfunction.

Identification of Post-Tuberculosis Lung Function Impairment Early during the Course of Treatment.

Tuberculosis (TB) is a leading cause of morbidity and mortality and an important contributory factor to chronic lung disease. TB-associated permanent lung damage manifests with varying levels of respiratory disability long after TB has been successfully treated, which is a condition known as post-TB lung disease (PTLD). This study assessed whether lung function impairment associated with PTLD occurs early during TB treatment. Using a cross-sectional design, we enrolled newly diagnosed adult TB patients aged ≥18 years who had received anti-TB medication for ≥2 months from a large treatment center in northern Nigeria. We used spirometry and the Global Lung Initiative 2012 reference equations for African Americans to assess and characterize lung function for enrolled participants (N = 94). The median age (range) of participants was 34 (18-72) years. Approximately 5.3% (n = 5) of participants exhibited features of abnormal lung function, 4.2% (n = 4) showed features of obstructive lung abnormality, and 1.1% (n = 1) showed restrictive lung abnormality. Compared with historical patients recruited ≥6 months after TB treatment in the same center, our participants had significantly lower forced expiratory volume in one second and forced vital capacity values. Our findings suggest an opportunity for early intervention for primary and secondary prevention of PTLD to reduce the impact of severe respiratory impairment.

Sociodemographic factors affecting knowledge levels of tuberculosis patients in New Delhi

ABSTRACT Background: Sociodemographic factors can significantly influence the knowledge level of tuberculosis (TB) patients, affecting the overall health outcomes. Due to lack of awareness and the stigma associated with TB, Indian TB elimination efforts are facing challenges. Patients with less information are more likely to experience delays in diagnosis and proper care. Method: A cross-sectional study was conducted in New Delhi across 26 operational National TB Elimination Program districts, involving 200 adult pulmonary TB patients receiving treatment from April to August 2020. A structured questionnaire guided the interviews, followed with bivariate analysis and descriptive statistics used for analysis. Results: Predominantly, residents of semiurban regions accounted for the highest proportion (70.5%), followed by urban areas (20.5%), with rural areas/slums comprising a minority (9%). Notably, a significant majority (94.5%) reported residing in individually owned dwellings, with shared accommodations limited to a minority (5.5%). Sanitary facilities varied, with 77% possessing personal toilets, 18.5% utilizing private facilities, and only 4.5% relying on public toilets. Awareness levels about TB reflected moderate awareness among 56% of participants, good knowledge among 41%, and minimal awareness (poor knowledge) among only 3% of respondents. Conclusion: Age, sex, socioeconomic level, kind of lodgings, malnutrition, and personal cleanliness should all be taken into account for TB treatment adherence. A new set of frameworks should be developed to enhance the living circumstances of high-risk populations and patients who are living in crowded locations since sharing a room or a house in a populated region increases the risk of TB transmission.

Evaluation of short-course for private doctors in managing children tuberculosis as part of a public-private mix in Surabaya, Indonesia.

This study aimed to improve the private doctor's role in discovering and managing cases of childhood tuberculosis (TB) according to the Directly Observed Treatment Short-course program. This quasi-experimental study with a pre-post design described 75 private doctors (intervention group) who assisted over two months in finding suspected TB children and 75 private doctors (control group). This study used descriptive quantitative data analysis. Sixty-three of the 75 doctors (84%) attended a course to assist suspected tuberculosis children with a moderate level of knowledge (60.0%). Most suspected tuberculosis children had close contact with adult tuberculosis patients (48.1%). The findings indicated that the intervention group, consisting of skilled private doctors, identified a greater number of children believed to have tuberculosis compared to the control group. There has been an increase in the identification of suspected tuberculosis children by private doctors who were through courses and the provision of routine assistance..

Relationship between knowledge and adherence to use of TB drugs in adults in Idaman Banjarbaru Hospital

Background: Worldwide, tuberculosis (TB) is the disease that causes the highest mortality rate. One of the causes is the bacteria Mycobacterium Tuberculosis. Knowledge and adherence are very important in TB treatment to achieve therapeutic success. Objectives: This study aims to see the relationship between the level of knowledge and adherence to taking medication for adult TB patients at Idaman Banjarbaru Hospital. Methods: This type of research is descriptive research with a cross-sectional research design prospectively taken in March - June 2023. The number of patients was 42 people using the total sampling technique. Data were collected through an online questionnaire and then analyzed using the SPSS Fisher Exact test with a 95% confidence level. Results: The results showed that patients had a good level of knowledge of as many as 32 people (76.2%) and had less knowledge of as many as 10 people (23.8%). The value of patient compliance in taking medication was 29 people (69%), and disobedient as many as 13 people (31%). Conclusion: The results of the statistical analysis concluded that there was a relationship between knowledge and compliance with taking medication in TB patients at Idaman Banjarbaru Hospital (p < 0.05).

Sociocultural features of lifestyle modifications among TB–diabetes comorbid patients in Satara, India and its implications for planning self-management interventions for TB–diabetes comorbid patients

BackgroundLifestyle modifications (LM) are crucial in managing comorbid Tuberculosis (TB) and Diabetes Mellitus (DM) patients, significantly impacting treatment outcomes and overall health. In view of this, a study was conducted to clarify sociocultural features associated with LM among TB–diabetes comorbid patients.MethodsA cross-sectional descriptive study among randomly selected 180 adult TB–diabetes-comorbid-patients was conducted using a semi-structured interview schedule. Mann–Whitney-U-test was used to examine differences in means between patterns of distress (PDs) and perceived causes (PCs) regarding TB and Diabetes for two identified LM strategies among comorbid patients. Stepwise logistic regression was used to study factors associated with these LM strategies.ResultsTB–diabetes-comorbid-patients reporting physical symptoms as PDs preferred to follow the LM-1 strategy for TB and LM-2 for Diabetes. In contrast, patients reporting health-illness-injury-related causes follow LM-2 for TB and LM-1 for Diabetes. Further patients reporting hypertension for Diabetes (AOR = 2.916, 95% CI 0.9262–9.1788) and concerns-about-the-course-of-TB-illness (AOR = 3.746, 95% CI 1.4683–9.5593) as PDs were 3–4 times more likely to follow LM-1. While those reporting prior illnesses (AOR = 4.255, 95% CI 1.3941–12.9837) and sanitation (AOR = 5.242, 95% CI 1.2028–22.8446) as PCs for TB were 4–5 times follow LM-2. Patients who perceived consumption of alcohol as PCs of Diabetes were 10 times more likely to stop addictions (AOR = 9.680, 95% CI 2.5555–36.6639) and follow the LM-2 strategy.ConclusionGiven significant associations of sociocultural features with LM strategies, consideration of sociocultural features vis-à-vis these strategies is indispensable for managing TBDM comorbidity, emphasizing the need for developing comprehensive, patient-centred self-management interventions to enhance adherence and improve health outcomes.

Insights into tuberculosis burden in Karachi, Pakistan: A concurrent adult tuberculosis prevalence and child Mycobacterium tuberculosis infection survey.

Pakistan is one of the five highest tuberculosis burden countries globally. We estimated prevalence of adult bacteriologically confirmed pulmonary tuberculosis and annual risk of Mycobacterium tuberculosis (M. tuberculosis) infection in children aged 2-4 years in Karachi, Pakistan. The survey design enabled exploration of tuberculosis burden by whether the population had previously been exposed to widespread tuberculosis active case-finding (ACF) activities or not. We conducted a concurrent adult pulmonary tuberculosis prevalence survey and a child M. tuberculosis infection survey using interferon gamma release assays in four districts (Korangi, South, West and Central). A cluster-based unequal probability random sampling method was employed with the a priori plan to oversample Korangi district which had been the focus of tuberculosis ACF activities since 2011. We defined Korangi district as the 'prior ACF' zone and remaining districts as the 'no prior ACF' zone. Between March 2018 and May 2019, 34,962 adults (78·5% of those eligible) and 1,505 children (59·9%) participated. Overall estimated prevalence of bacteriologically confirmed pulmonary tuberculosis was 387 cases per 100,000 population (95% CI 276-498) with a prevalence of 421 cases [95% CI 276-567] per 100,000 in the 'no prior ACF' and 279 cases [95% CI 155-403] per 100,000 in the 'prior ACF' zone. We estimated the annual risk of M. tuberculosis infection in children to be 1·1% (95% CI 0·7-1·5) in the 'no prior ACF' zone and 0·6% (95% CI 0·3-1·1) in the 'prior ACF' zone. We observed consistent differences in the population distribution of tuberculosis between the 'prior ACF' and 'no prior' ACF zones with a trend towards lower estimates of burden and M. tuberculosis transmission in the 'prior ACF' zone. A plausible explanation is that intensive ACF activities that have been ongoing in Korangi district for the preceding years have noticeably reduced the burden of tuberculosis and transmission.

Factors associated with hospitalization and mortality in adult and pediatric extrapulmonary tuberculosis at a tertiary care hospital in Central India

Background Comorbidities complicate the management of tuberculosis (TB) and have become an essential part of the end TB strategy to eradicate TB. However, pulmonary TB has received the most attention, and little is known about the impact of comorbidities and other factors on outcomes in patients with extrapulmonary tuberculosis (EPTB). Objectives Our aim was to analyze the factors associated with hospitalization and mortality in EPTB at a hospital in Central India, using non-TB patients with similar clinical presentations as a comparison. Methods Patients with presumptive EPTB were prospectively enrolled and followed up until the end of treatment or for at least 6 months. Detailed demographic and clinical information was collected for all participants, and patients were categorized as TB or non-TB using a composite reference standard. Multivariate logistic regression was used to analyze the impact of various clinical findings and risk factors on hospitalization and mortality. Results A total of 276 patients were categorized as TB cases and 175 as non-TB cases. Factors associated with hospitalization in children were younger age and non-adenitis site of disease. In adults, factors associated with mortality were older age, non-adenitis site of disease and HIV infection regardless of TB diagnosis, while diabetes mellitus increased the odds of mortality in EPTB patients. Conclusion Our results show that comorbidities increase the odds of death in both TB and non-TB patients in low-resource settings. This argues for a shift away from the traditional vertical management of diseases in these areas and supports a continued focus on building robust healthcare systems.

Hubungan Pengetahuan dan Sikap dengan Perilaku Pencegahan Penularan TB pada Penderita TB Paru Dewasa di Puskesmas Pakis Aji

Background: Tuberculosis (TB) is the biggest cause of death after cardiovascular disease and respiratory tract disease, the number one type of infectious disease which is still a problem in Indonesia and the world. Jepara Regency is currently recorded as a district with TB case findings reaching 107.96. And the development of Tuberculosis cases at the Pakis Aji Community Health Center, Jepara Regency in 2021 was 36 sufferers. The aim of this research is to determine the relationship between knowledge and attitudes and behavior to prevent transmission of Tuberculosis disease in adult Tuberculosis sufferers in the Pakis Aji Community Health Center working area, Jepara Regency. Method: This research is an analytical observational study with a cross sectional approach. In this research, observations or measurements of variables are carried out at a time determined by the researcher. This research uses the Quota Sampling technique. Data collection was carried out by direct interviews guided by a questionnaire. Results: The results of the study show that there is no relationship between respondents' knowledge and behavior in preventing Tuberculosis transmission in the Pakis Aji Community Health Center working area, Jepara Regency with a p value of 0.531 > 0.05. Meanwhile, the relationship between attitudes and behavior to prevent Tuberculosis transmission shows that there is a relationship with a p value of 0.013 < 0.05. Conclusion: the behavior of preventing tuberculosis transmission in the Pakis Aji Community Health Center working area, Jepara Regency is still not optimal, which is influenced by several factors from the sufferer or family. Advice that can be given to sufferers and their families is to implement recommendations for preventing Tuberculosis transmission from health agencies, providing support and motivation to TB sufferers so they can break the chain of transmission of Tuberculosis.

Addressing the challenges in laboratory confirmation of paediatric tuberculosis: the role of induced sputum specimen

Tuberculosis (TB) remained the single leading infectious cause of ill health and death globally until the COVID-19 pandemic occurred. Tuberculosis contributes significantly to childhood mortality of about 16% among HIV-negative children worldwide. Childhood tuberculosis is a significant epidemiological tool as childhood TB represents recent transmission in the community and reflects the presence of an infected adult. Previously clinical research, diagnostic methods, and therapeutic discoveries have focused on adult tuberculosis to the neglect of childhood tuberculosis. Limited pediatric surveillance data, poor case ascertainment, and limited resources and capabilities have hindered the attainment of the true burden of childhood tuberculosis in countries with high tuberculosis disease burden. The difficulty in characterising the true burden of tuberculosis is mainly from the difficulty in obtaining adequate and reliable diagnostic samples to confirm TB in children. Sputum induction has proven to be feasible and effective in several LMIC settings. Gene Xpert MTB/Rif; polymerase chain reaction, performed on induced sputum samples is more sensitive in the detection of paucibacillary TB in children as compared to sputum smear testing. This allows for early diagnosis and timely initiation of therapy. It is necessary that we continue to utilize the available tools to improve TB diagnosis in children and ensure we meet End TB and SDG goal 3 targets on time

The Feasibility of using Liver Function Indices and FibroScan in combination to predict the occurrence of anti-tuberculosis drug-induced liver injury in patients with liver disease

Background: The study aims to assess the feasibility of using a combined approach of liver function indices and FibroScan measurements as a predictive tool for the early detection of anti-tuberculosis drug-induced liver injury (DILI) in patients with existing liver disease. Methods: A retrospective cohort study was conducted, including adult tuberculosis patients with documented liver disease. Liver function was assessed using standard biochemical parameters, and FibroScan examinations were performed to determine liver stiffness measurement (LSM). Patients were monitored for clinical and biochemical signs of DILI throughout treatment. Logistic regression models and Receiver Operating Characteristic (ROC) curves were used for data analysis. Statistical significance was set at p < 0.05. Results: Patients who developed DILI showed significantly higher levels of ALT, AST, total bilirubin, GGT, and LSM, with strong positive correlations between these markers and DILI occurrence. Logistic regression analysis revealed elevated ALT, AST, TBIL, and GGT were strongly associated with an increased likelihood of DILI. The area under the ROC curves indicated excellent predictive accuracy of these parameters. A nomogram for predicting DILI based on the combined biomarkers was established. Conclusion: The study demonstrates the feasibility of utilizing liver function indices and FibroScan measurements in combination to predict anti-tuberculosis DILI. The results highlight the importance of baseline liver health assessment and offer promising implications for clinical practice, aiding in individualized risk estimation and therapeutic decision-making for patients with liver disease initiating anti-tuberculosis therapy. Further validation in larger cohorts is warranted to strengthen the predictive model.

Risk factors of tuberculosis in children with adult household tuberculosis contact

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

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

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

Nutritional status, food security and other correlates among adult tuberculosis patients in a block of Murshidabad district, West Bengal.

Tuberculosis (TB) and malnutrition are epidemiologically interrelated two major public health problems in India. Food security also influences nutritional status. This aspect needs evaluation in diverse geographical areas. This study aimed to assess the level of food security, nutritional status and correlates among adult TB patients in a block of Murshidabad, West Bengal. This cross-sectional study was undertaken in the Nabagram block of Murshidabad district during April-July 2023. All adult (≥18 years) patients registered under the Tuberculosis Unit of the block during a reference period of 6 months (October 2022-March 2023) were considered study subjects. Eighty such eligible participants recruited randomly were interviewed with a pre-designed schedule for socio-demographic and programmatic characteristics. Household food security was measured using a validated U.S. Household Food Security Survey Module. Anthropometric measurements were taken, and nutritional status was determined based on body mass index. Statistical Package for the Social Sciences (SPSS) version 26 was used for analysis. Among 80 TB patients, 51% were underweight and 20% were severely underweight. The majority (90%) of them had high or marginal food security, and 10% had low or very low food security. On multivariable logistic regression, Hindu religion (adjusted odds ratio (AOR): 6.74, 95% confidence interval (CI): 2.12-29.39), presence of any chronic morbidity (AOR: 11.61, 95%CI: 2.71-49.78) and receipt of dietary counselling by a health worker (AOR: 7.25, 95%CI: 1.22-43.13) appeared as predictors of underweight. Underweight among TB patients is quite prevalent in the area, and few programmatic interventions are influencing factors. This underscores the importance of nutritional counselling services and the universal provision of Poshan benefits.

Higher blood manganese level associated with increased risk of adult latent tuberculosis infection in the US population.

The associations between blood heavy metal levels and latent tuberculosis infection (LTBI) have not been fully elucidated. The aim of this study was to investigate the potential association between blood heavy metal levels and LTBI in adults using National Health and Nutrition Examination Survey data from 2011 to 2012. We enrolled 1710 participants in this study, and compared the baseline characteristics of participants involved. Multivariate logistic regression analysis, restricted cubic splines (RCS) analysis, along with subgroup analysis and interaction tests were utilized to explore the association between blood manganese (Mn) level and LTBI risk. Participants with LTBI had higher blood Mn level compared to non-LTBI individuals (p < 0.05), while the levels of lead, cadmium, total mercury, selenium, copper, and zinc did not differ significantly between the two groups (p > 0.05). In the fully adjusted model, a slight increase in LTBI risk was observed with each 1-unit increase in blood Mn level (OR = 1.00, 95% CI: 1.00-1.01, p = 0.02). Participants in the highest quartile of blood Mn level had a threefold increase in LTBI risk compared to those in the lowest quartile (OR = 4.01, 95% CI: 1.22-11.33, p = 0.02). RCS analysis did not show a non-linear relationship between blood Mn level and LTBI (non-linear p-value = 0.0826). Subgroup analyses and interaction tests indicated that age, alcohol consumption, and income-to-poverty ratio significantly influenced LTBI risk (interaction p-values<0.05). Individuals with LTBI had higher blood Mn level compared to non-LTBI individuals, and higher blood Mn level associated with increased LTBI risk.