Tuberculosis Infection In Patients Research Articles

Assessment of tuberculosis transmission probability in three Thai prisons based on five dynamic models.

This study aimed to assess and compare the probability of tuberculosis (TB) transmission based on five dynamic models: the Wells-Riley equation, two Rudnick & Milton-proposed models based on air changes per hour (ACH) and liters per second per person (L/s/p), the model proposed by Issarow et al, and the Applied Susceptible-Exposed-Infected-Recovered (SEIR) TB transmission model. This study also aimed to determine the impact of model parameters on such probabilities in three Thai prisons. A cross-sectional study was conducted using data from 985 prison cells. The TB transmission probability for each cell was calculated using parameters relevant to the specific model formula, and the magnitude of the model agreement was examined by Spearman's rank correlation and Bland-Altman plot. Subsequently, a multiple linear regression analysis was conducted to investigate the influence of each model parameter on the estimated probability. Results revealed that the median (Quartiles 1 and 3) of TB transmission probability among these cells was 0.052 (0.017, 0.180). Compared with the pioneered Wells-Riley's model, the remaining models projected discrepant TB transmission probability from less to more commensurate to the degree of model modification from the pioneered model as follows: Rudnick & Milton (ACH), Issarow et al., and Rudnick & Milton (L/s/p), and the applied SEIR models. The ventilation rate and number of infectious TB patients in each cell or zone had the greatest impact on the estimated TB transmission probability in most models. Additionally, the number of inmates in each cell, the area per person in square meters, and the inmate turnover rate were identified as high-impact parameters in the applied SEIR model. All stakeholders must urgently address these influential parameters to reduce TB transmission in prisons. Moreover, further studies are required to determine their relative validity in accurately predicting TB incidence in prison settings.

Tuberculosis infection in patients with inflammatory bowel diseases. Clinacal cases

In most cases Tuberculosis (TB) affects the lungs, but 10-15% of patients have extrapulmonary TB localisations, that is difficult to diagnose. TB is more spread among patients having the human immunodeficiency virus and among those who receive immunosuppressive therapy, specifically in patients with inflammatory bowel disease requiring long-term treatment with immunosuppressants and/or biologics. The symptoms of intestinal TB are nonspecific and may include chronic diarrhea, weight loss, fever and ascites. Differential diagnosis includes Crohn's disease, malignant neoplasms, periappendiceal abscesses, yersiniosis, etc. The article presents cases showing similarity of the intestinal form of TB with Crohn's disease, complexity dealing, diagnosing and treating patients with inflammatory bowel disease also having latent tuberculosis infection.

The use of urine lipoarabinomannan for establishing pulmonary TB in HIV patient: case report and systematic review

Introduction: Indonesia is still the country that provides the second-largest estimated number of TB cases worldwide. Several patients had TB with HIV-positive. HIV-positive patients with symptoms suggestive of pulmonary tuberculosis often difficult to produce sputum of sufficient quality. Lateral flow lipoarabinomannan examination with urine specimens is expected to be easy, inexpensive, fast, and accurate point-of-care testing. The aim of this research was to assess the sensitivity and specificity of the lateral flow method in detecting lipoarabinomannan (LAM) from urine specimens in HIV-positive patients with suspected pulmonary tuberculosis. Sputum cultures were utilised as a reference standard. Case Description: A 21-year-old male patient came to the clinic complaining of a cough that had not subsided since the previous month. Cough felt throughout the day with a little white phlegm. The patient admitted to having high-risk sexual behavior and had been tested positive for HIV but had not started antiretroviral therapy. The laboratory examination results showed that the leukocyte count was 3600/mm3 and the radiological examination revealed a chest X-ray within normal limits. The patient had been tested for sputum smears with negative results but was still advised to start TB treatment. The patient has not started treatment because he feels that his sputum smear test results are negative. Currently, the patient is not willing to have his sputum checked again. The polyclinic doctor knows the lipoarabinomannan (LAM) examination that uses urine specimens to diagnose TB but does not yet know its effectiveness for this patient. Conclusion: In this case report, the patient was unwilling to do a diagnostic test related to the TB. The systematic review was that the Alere Determine™ TB LAM Ag may not be clinically applicable for diagnosing tuberculosis infection in patients living with HIV at this time. However, Fujifilm SILVAMP TB LAM® could be regarded as a supplementary tool to the established diagnostic protocol for tuberculosis in HIV-positive patients.

Isoniazid-induced hepatotoxicity in patients with latent tuberculosis – Experience from a tuberculosis center

BackgroundAlthough the prevalence of isoniazid-induced hepatotoxicity (IIH) has been documented in patients with tuberculosis, its prevalence in latent tuberculosis infection (LTBI) patients is less studied. The aim of this study was to investigate the prevalence of IIH in a group of LTBI patients who received isoniazid monotherapy. MethodsRetrospective cohort study including patients who underwent isoniazid monotherapy for LTBI in an outpatient clinic between January 1st, 2020, and June 30th, 2021. ResultsA total of 274 cases were analyzed. About half (50.4 %) were male; median age was 53 years-old (minimum: six; maximum 89). The most common comorbidities were dyslipidemia (25.5 %), body mass index between 25 and 30 kg/m2 (20.4 %), obesity (14.7 %) and chronic hepatic disease (CHD; 12.8 %). 47.4 % had systemic inflammatory diseases. Significant elevation of liver enzymes was documented in 27 % of patients. IIH was documented in 20.4 % of patients; there was a statistically significant relation with dyslipidemia (p < 0.001), CHD (p = 0.023), psoriasis (p = 0.025), spondyloarthropathies (p = 0.017) and male sex (p = 0.042). Dyslipidemia showed a strong correlation to IIH (adjusted odds ratio: 8.045). ConclusionPatients with dyslipidemia had an adjusted odds ratio of 8.045 to develop IIH. Future multicentric studies should be started to better explore this relation, as well as treatment options.

Alternative biomarkers of tuberculosis infection in patients with immune-mediated inflammatory diseases

Alternative biomarkers of tuberculosis infection in patients with immune-mediated inflammatory diseases

Modulation of lncRNA NEAT1 overturns the macrophages based immune response in M. tuberculosis infected patients via miR-373 regulation.

There is a lack of studies which explore and clarify the interactions that occur between host macrophage and Mycobacterium tuberculosis with regard to microRNA such as LNCNEAT1 and miR-373. The current study determines the mechanisms involved in the control of M. tuberculosis infection by macrophage using LNCNEAT1 and miR-373. The researchers collected different samples from healthy individuals, pulmonary TB patients, and samples like hMDMs cells and H37Rv infected MTB to determine the concentrations of inflammatory factors. The impact of NEAT1 and miR-373 upon macrophages was analyzed in NEAT1-specific siRNA (si-NEAT1), NEAT1 over-expression vector (pcDNA3.1-NEAT1), miR-373 mimic, miR-373 inhibitor (anti-miR-373), and negative control, and macrophages infected with H37Ra. The results inferred that among pulmonary TB patients, NEAT1 got heavily expressed while the expression level of miR-373 was poor. The number of inflammatory factors with pulmonary TB was notably higher. This got further amplified in macrophages after being infected with H37Ra, while no such observations found for miR-373. During post-transfection, low concentration of inflammatory factors was observed while the cells in si-NEAT1 group got proliferated in low volume compared to both pcDNA3.1-NEAT1 group and NEAT1 negative control group. However, the capability of apoptosis was higher compared to the other two groups (p < 0.05). There was an increase observed in inflammatory factors as well as proliferation in anti-miR-373 group compared to miR-373 mimics and miR-373-negative control group while a significant decline was observed in apoptosis. LNCNEAT1 aggravated the number of inflammatory factors in macrophages that got infected with MTB while on the other end, it mitigated both phagocytosis as well as the cellular immunity of macrophages. In addition to this, it enhanced the proliferation of infected cells and inhibited apoptosis via targeted regulation of miR-373, thus resulting in the development of TB.

T Cell Response in Tuberculosis-Infected Patients Vaccinated against COVID-19.

Many studies have focused on SARS-CoV-2 and Mycobacterium tuberculosis (Mtb) co-infection consequences. However, after a vaccination plan against COVID-19, the cases of severe disease and death are consistently controlled, although cases of asymptomatic and mild COVID-19 still happen together with tuberculosis (TB) cases. Thus, in this context, we sought to compare the T cell response of COVID-19-non-vaccinated and -vaccinated patients with active tuberculosis exposed to SARS-CoV-2 antigens. Flow cytometry was used to analyze activation markers (i.e., CD69 and CD137) and cytokines (IFN-γ, TNFα, IL-17, and IL-10) levels in CD4+ and CD8+ T cells upon exposure to SARS-CoV-2 peptides. The data obtained showed that CD8+ T cells from non-vaccinated TB patients present a high frequency of CD69 and TNF-α after viral challenge compared to vaccinated TB donors. Conversely, CD4+ T cells from vaccinated TB patients show a high frequency of IL-10 after spike peptide stimulus compared to non-vaccinated patients. No differences were observed in the other parameters analyzed. The results suggest that this reduced immune balance in coinfected individuals may have consequences for pathogen control, necessitating further research to understand its impact on clinical outcomes after COVID-19 vaccination in those with concurrent SARS-CoV-2 and Mtb infections.

Clinical and epidemiological features of the detection and course of the infectious disease tuberculosis depending on the presence of concomitant pathology

The article is devoted to the most pressing issues of studying the clinical and epidemiological features concerning the detection and course of tuberculosis infection in patients with concomitant pathologies. Such pathologies include cancer, diseases of the endocrine system, of the respiratory system (chronic bronchitis, pneumoconiosis), gastric ulcer, pathology of the urinary system, exhaustion due to insufficient nutrition, smoking. Using genetically engineered biological drugs (GEBPs) in practice reduces the activity of inflammatory phenomena due to suppression of the immune response, but increases the risk of developing infectious diseases, primarily tuberculosis. Immunosuppressive therapy in organ transplant patients is also associated with the risk of developing tuberculosis. A special nature of immune disorders develops during HIV infection, a comorbid disease in patients with tuberculosis. The diseases listed above create a medical risk group in patients with immunocompromise, which is the basis for the development of tuberculosis. In addition to the risk of developing infection, patients with concomitant diseases have unfavorable results from treatment of tuberculosis, which does not allow achieving abacillation in a short time, thereby maintaining a reservoir of infection in society. In this regard, the purpose of our research was to study the clinical and epidemiological features of the detection and course of tuberculosis infection in patients with concomitant pathology A study was conducted using a continuous sampling method for the period from December 2020 to August 2021. 67 medical records of an inpatient at the state budgetary healthcare institution “Republican Clinical Anti-TB Dispensary” (Ufa) were analyzed. The groups were formed based on the detection of concomitant pathology (main, n=33) and its absence (control, n=34). To achieve the goal of the study, a comparative analysis of methods for detecting tuberculosis and clinical manifestations of tuberculosis was performed; prevalence of the process, detection of the fact of bacterial excretion and drug sensitivity from December 2020 to August 2021. 67 case histories of Mycobacterium tuberculosis (MBT) in patients of the studied groups were analyzed. Statistical data processing was performed using licensed software Statistica 6.0 when calculating two types of data: discrete and interval. To assess the chances of detecting the studied factor in both groups, the indicator (OR) was used to calculate the 95% confidence interval (CI). Interval indicators were studied by t-test for independent samples, with Livigne's correction.

A critical review of risk factors influencing the prevalence of extensive drug-resistant tuberculosis in India.

Globally, extensive drug-resistant tuberculosis (XDR-TB) is a major element to cause morbidity and death among tuberculosis patients. The present study identifies the vital risk variables contributing to XDR-TB prevalence in India. Scopus, PubMed/Medline, Science Direct, and Google Scholar databases were searched thoroughly for the articles, using medical subject heading as a key term published between the years 2012 and 2022. According to the inclusion criteria, 11 publications were selected. Socioeconomic characteristics include employment, educational attainment, undernourishment, and the rest, and demographic factors such as gender, age, and more. Were examined in the review, whereas alcoholics, smoking, and diabetes mellitus were investigated under comorbidities and behavioral risk factors. We observed that noncompliance, poor knowledge, and insufficient health-care facilities could significantly accelerate the spread of XDR-TB, and the present review imparts a remarkable and detailed evaluation of XDR-TB. The study analysis is markedly useful for policymakers as well as researchers to discover and implement effective solutions for tuberculosis-infected patients.

Latent Tuberculosis Infection in Patients with Oncological Pathology Based on Skin Test with Recombinant Tuberculosis Allergen

Введение. Возникновение туберкулёза у лиц из групп высокого онкологического риска и активное выявление заболевания остаётся актуальной проблемой здравоохранения. У больных с онкологическими заболеваниями снижение иммунитета и иммуносупрессивная терапия могут привести к прогрессированию латентной туберкулёзной инфекции. Цель. Выявление наличия латентной туберкулёзной инфекции у больных со злокачественными новообразованиями различной локализации с помощью кожной пробы с аллергеном туберкулёзным рекомбинантным. Методы исследования. По архивным историям болезни изучены данные иммунологического обследования пациентов с помощью пробы с аллергеном туберкулёзным рекомбинантным на наличие латентной туберкулёзной инфекции у 132 больных с верифицированным диагнозом злокачественной опухоли различных локализаций, поступивших в Воронежский областной противотуберкулёзный диспансер в течение 2011-2022 гг. для исключения наличия активного туберкулёза органов дыхания. Среди них было 100 (75,76 %) мужчин и 32 (24,24 %) женщины в возрасте от 44 до 86 лет. Наличие латентной туберкулёзной инфекции у пациентов подтверждалось положительной реакцией на пробу с аллергеном туберкулёзным рекомбинантным. Результаты. Установлено, что пациенты с онкологическими заболеваниями в 37,1 % случаев имеют латентную туберкулёзную инфекцию и, следовательно, повышенный риск прогрессирования туберкулёза. При наличии у больных остаточных неактивных туберкулёзных изменений в различных органах латентная туберкулёзная инфекция наблюдается чаще, чем при их отсутствии — 53,8 % против 30,1 % (p &lt; 0,05). Заключение. При выявлении и подготовке к лечению больных с онкологическими заболеваниями целесообразным является обследование их на латентный туберкулёз с помощью кожной пробы с аллергеном туберкулёзным рекомбинантным с последующим решением вопроса о необходимости профилактической терапии и наблюдения.

P-472 Evaluation of the usefulness of the QuantiFERON-TB gold in-tube test for the detection of latent mycobacterium tuberculosis infections in patients underwent autologous stem cell transplantation

P-472 Evaluation of the usefulness of the QuantiFERON-TB gold in-tube test for the detection of latent mycobacterium tuberculosis infections in patients underwent autologous stem cell transplantation

Diagnostic challenge of tuberculosis in systemic lupus erythematosus: a case report and literature review.

Patients with systemic lupus erythematosus (SLE) are at increased risk of tuberculosis (TB) infection due to immune dysfunction and immunosuppressive therapy. We present a case study of a 40-year-old woman with systemic lupus erythematosus (SLE). Initially, she was diagnosed with a lupus flare based on her clinical symptoms and laboratory results. However, upon further investigation, positive polymerase-chain reaction results for M. tuberculosis in the cerebrospinal fluid and lung parenchymal changes on chest computed tomography scan were indicative of TB infection. There was initial uncertainty regarding whether TB had triggered a flare-up of SLE or if TB was merely mimicking the symptoms of a SLE flare-up. However, as increasing the prednisolone dose did not have a positive effect and the patient's condition improved significantly with anti-TB treatment alone, it became clearer that the deterioration observed upon admission was primarily due to TB progression rather than an SLE flare-up. Additionally, we review the current literature on TB and SLE, including risk factors, diagnostic challenges, and treatment considerations, highlighting the importance of considering TB infection in patients with SLE who present with overlapping manifestations. Prompt diagnosis and treatment are essential for improving outcomes in these patients.

Medical, social and demographic characteristics of tuberculosis patients among the female military and female family members of the military

Relevance. Health preservation and promotion of among female population is fundamental for healthy demographics and national safety of the Russian Federation. Nowadays the female military make up approximately 8% of active military corps of the Russian Federation Armed Forces. At the same time, service in the army spans within active reproductive age. A woman’s health is largely determined by her social status, level of education, marital status, stress resistance and other factors.The objective is to assess medical, social and demographic characteristics of tuberculosis among social groups of the female military and female family members of the military.Methods. Individual and community medical records (medical histories, annual reports of healthcare services in military districts) were analyzed to identify medical, social and demographic characteristics of the female military, infected with tuberculosis (group 1, n = 62), and female family members of the military (group 2, n = 38), who had received treatment in the referral military medical institution from 2012 throughout 2021. Mathematical and statistic processing were carried out using Statistica10.0 software packages.Results and discussion. Nowadays, tuberculosis incidence in the female military of the Russian Armed Forces is within the limits of epidemic well-being. Unlike general Russian population, no case of HIV infection was detected among the female military infected with tuberculosis and having undergone medical examination from 2012 throughout 2021. A lot of healthcare professionals (17.7%) were registered among the tuberculosis-infected female family members of the military. Clinical forms of tuberculosis were dominated by infiltrative pulmonary tuberculosis (48.4%). Concomitant diseases in the studied cohort of tuberculosis-infected female patients were prevailed by gynecological (35.4%), endocrine (17.7%) and cardiovascular (12.9%) disorders.Conclusion. In the future the study of social, demographic and clinical characteristics of tuberculosis in the female military and female family members of the military allows to provide more targeted prevention, treatment and rehabilitation.

The prevalence of latent tuberculosis infection in patients with chronic kidney disease: A systematic review and meta-analysis

ObjectiveTo estimate the prevalence of latent tuberculosis infection (LTBI) in chronic kidney disease (CKD) patients. MethodsThis study was conducted following the PRISMA guidelines. We identified, 3694 studies from the whole search, and 59 studies were included. Each study's quality was assessed using JBI checklist. We employed STATA version 17 for statistical analysis. We assessed heterogeneity using I2 heterogeneity test. Publication bias was assessed using funnel plot and Egger's test. We estimated the pooled LTBI prevalence in CKD patients along with 95%CI. ResultsThe pooled prevalence of LTBI among CKD patients using data collected from 53 studies having 12,772 patients was 30.2% (95%CI; 25.5, 34.8). The pooled prevalence among pre-dialysis, hemodialysis, peritoneal dialysis, and renal transplanted patients was 17.8% (95%CI; 3.3, 32.4), 34.8% (95%CI; 29.1, 40.5), 25% (95%CI; 11, 38), and 16% (95%CI; 7, 25), respectively. The pooled prevalence of LTBI stratified by the laboratory screening methods was 25.3% (95%CI: 20.3–30.3) using TST, 28.0% (95%CI; 23.9–32.0) using QFT, and 32.6%, (95%CI: 23.7–41.5) using T-SPOT. ConclusionThere is high prevalence of LTBI among CKD patients mainly in patients on dialysis. Thus, early diagnosis and treatment of LTBI in CKD patients should be performed to prevent active TB in CKD patients.PROSPERO registration number: CRD42022372441.

Workplace interventions to overcome stigma and depression in patients with Multiple drug-resistant tuberculosis (MDR TB)

Introduction: MDR-TB is an infectious disease that can cause death and stigma for those infected. MDR-TB patients with depression are at risk for LTFU, which will worsen their condition and strengthen the stigma they receive. Case report: A 52-year-old female psychiatric interview and assessment using the Beck Depression Inventory (BDI) found that BDI score of 4 (no depression), and the patient adhered to TB treatment. She was found to be laid off, and an assessment using the BDI to detect depression in the patient found potential stigma in the patient, such as being laid off from work, prohibited from teaching face-to-face, and shunned by colleagues. Interventions given were prescribing Fluoxetine 20 mg per day and Clobazam 10 mg per day, a brief intervention using the FRAMES technique, psychoeducation about disease and drug effects and the duration of treatment, and an office visit. A worksite intervention was performed by the patient's husband. Antituberculosis drugs were monitored by both a pulmonologist and a psychiatrist. Her work-related problems were resolved through interventions at the school with psychoeducation about drug-resistant tuberculosis, the transmission method, the duration of treatment, and the side effects of the treatment. The results of the last sputum examination after one month of treatment showed drug resistance, and the patient was advised to undergo 18 months of treatment. The patient could finally work offline with fewer responsibilities after getting negative laboratory test results twice in a row. Conclusion Work-related psychosocial interventions are required to address rejection at work, which results in depression and nonadherence to treatment. Liaison services with social interventions at work in drug-resistant tuberculosis-infected patients are necessary to improve their quality of life and maintain their treatment adherence.

Combined Detection of IFN-γ and Lymphocyte Subsets with Activation Indicators in the Clinical Application of Mycobacterium Tuberculosis Infection at Different Times

The immune status of mycobacterium tuberculosis (MTB) infection is essential for the diagnosis and treatment of this disease. In this work, we aim to evaluate the clinical significance of the combination of serum IFN-γ, IGRAs (Interferon-Gamma Release Assay), lymphocyte subset with activation indicators detection in active and latent tuberculosis infection patients. For this study, anticoagulant whole blood were collected from 45 active tuberculosis (AT group), 44 latent tuberculosis (LT group) and 32 healthy controls (HCs group). The serum IFN-γ and IGRAs detected by chemiluminescence, and the percentage of lymphocyte subsets and activated lymphocytes detected by flow cytometry. The results showed combined IGRAs, serum IFN-γ and NKT cells not only has good diagnostic efficiency for the AT, but also provides a laboratory diagnostic method to distinguish AT from LT. Activation indicator of CD3+HLA-DR+T and CD4+HLA-DR+T can effectively distinguish LT from HCs. While combined CD3+T, CD4+T, CD8+CD28+T, Treg and CD16+CD56+CD69+ cells can distinguish AT from HCs. This study showed combined direct detection of serum IFN-γ and IGRAs as well as lymphocyte subsets with activation indicators which may provide laboratory basis for the diagnosis and differential diagnosis of active and latent MTB infection.

Study of tuberculosis and other infections among children (age 2 to 18 years) with multitransfused thalassemia major

Background: In India, beta thalassemia is prevalent across the country, with an average frequency of carriers being 3-4%. Infection is the major cause of morbidity and mortality in thalassemia, so regular screening is required for this disease. Methods: Ethical clearance taken from institutional ethical committee. 150 thalassemia patients were enrolled in study after informed written consent. The medical histories were obtained from the patients and their files. Clinical examination was done including anthropometry, general examination, and systemic examination. MT and chest X-ray (CXR) were done for screening of tuberculosis infection. Blood samples were taken for S. ferritin, S. creatinine, serum glutamic pyruvic transaminase (SGPT), human immunodeficiency virus (HIV), and hepatitis B surface antigen (HBsAg) tests. Transfusion and other detail were taken like iron chelator, folic acid (FA) and calcium supplements. Results: In this study, out of 150 patients, 4 patients were RVD positive and 34 patients were HCV positive. No Patients found HBsAg positive. No patient had Montoux test reactive and chest X-ray positive finding. Conclusions: : Increase frequency of transfusion-related infection (hepatitis C, B, and HIV) in multi-transfused thalassemia. No correlation was found between tuberculosis infection and thalassemia patients in this screening study.

Comparison of Two Tuberculosis Infection Tests in a South American Tertiary Hospital: STANDARD F TB-Feron FIA vs. QIAreachTM QuantiFERON-TB

Tuberculosis (TB) is one of the most prevalent respiratory diseases in the world. In 2020 there were at least 9.9 million new infections, with 1.5 million deaths. Approximately 10% of people infected with Mycobacterium tuberculosis develop the disease during the first 2 to 5 years after infection. In South America, the diagnosis of Latent Tuberculosis Infections (LTBI) continues to be performed through the Mantoux tuberculin skin test (TST). The objective of our study was to compare the sensitivity of a new immunofluorescence IGRA test against a widely available IGRA kit on the market. Close contact with infectious TB patients, HIV patients, or immunocompromised for another cause were recruited. Two interferon-gamma release assay (IGRA) diagnostic kits were used and compared with TST. 76 patients were recruited, 93.42% were Chilean nationality, and 98.68% of the patients did not have immunosuppression. The sensitivity of the new technique was 88.89%, and the specificity was 92.50% in the study population compared to the IGRA previously used. In the subgroup older than 36 years, the sensitivity was 95.65%, and the specificity was 89.47%. IGRA techniques are a new resource in clinical laboratories to make an accurate diagnosis of LTBI in the region of the Americas. In our population, the greatest benefit of this new IGRA would be observed in people over 36 years of age, where the sensitivity of the technique was like that of the currently available test.

Host determinants of TB disease as targets for HDTs development: A study protocol

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major global health challenge. New diagnostic and therapeutic strategies are required to curb TB transmission. Here we outline a protocol to validate inflammatory proteins as potential biomarkers of TB disease and to evaluate the candidate genes as potential targets for host-directed therapy (HDT) development. Blood will be isolated from healthy, latent TB infected (LTBI) individuals and TB patients, and expression profiles of genes of interest will be determined using qPCR. A human monocytic cell line will be utilized to knock down genes of interest and to evaluate their contribution to Mtb infection. Pharmaceutical interception of target genes will be performed in peripheral blood mononuclear cells (PBMCs) infected with Mtb. This work will result in identification of TB associated inflammatory markers that can also be targeted for HDT development.

Designing, Development, and Evaluation of an Informatics Platform for Enhancing Treatment Adherence in Latent Tuberculosis Infection Patients: A Study Protocol

Introduction: Digital health interventions are gradually being incorporated into the management of tuberculosis to ensure treatment adherence, but only a small number of trials focusing on latent tuberculosis infection (LTBI) care have tested and evaluated them. It is anticipated that 170 million persons with LTBI may eventually develop active TB; thus, treatment of LTBI patients is an important aspect, along with ensuring treatment adherence. Digital platforms can be beneficial to ensure treatment adherence in LTBI patients, as various studies have shown the positive impact of digital interventions in improving patients’ treatment adherence and treatment outcome. This study aims to explore the various available digital interventions worldwide for treatment adherence in LTBI patients and develop an informatics platform for enhancing treatment adherence in LTBI patients. Methods: This will be a quasi-experimental study divided into three phases. In the first phase, a scoping review method will be used to conduct a systematic literature review using the PRISMA tool to report on various digital interventions focused on treatment adherence in LTBI patients. In the second phase, a text message-based digital platform will be developed, and in the third phase of the study, an evaluation of the digital platform will be done using qualitative and quantitative questionnaires. The study will be conducted using a mixed-methods approach between January 2023 and December 2023. The sample size will be 162 participants, of whom 81 will be assigned to an intervention group and 81 will receive the usual care from the respective chest clinic as a control group. Results: A descriptive analysis of demographic variables and other variables will be done. Continuous variables will be described as mean ± standard deviation (M ± SD), medians (inter-quartile ranges) (M (IQR)), and medians (5th percentile to 95th percentile) (P5-P95). A two-sample independent T-test, the chi-square test, and the Mann-Whitney test will be used for comparisons between groups. Treatment success between control and intervention will be compared through a chi-square test. Conclusions: The key finding of the study will be an understanding of the efficiency of digital platforms for improving treatment adherence in latent TB patients in India.