Tuberculosis Notification Rates Research Articles

IJCM_256A: Trend in Tuberculosis Notification in Solapur district: Analysis from 2015 to 2022

Background: India contributes approximately 25% of the missing cases of tuberculosis (TB) globally. Even though ~50% of patients with TB are diagnosed and treated within India’s private sector, few are notified to the public healthcare system. India’s TB notification policy mandates that all patients with TB are notified through Nikshay (TB notification portal). We undertook this study to assess how mandatory notification has influenced the number of TB cases reported in the Nikshay portal from the private sector from Solapur district between 2015 and 2022. Objective: To evaluate the contribution of mandatory notification in enhancing TB notification in Solapur district between 2015 and 2022. Methodology: This study employed a quantitative observational approach, using record-based data extracted from the laboratory register and the Nikshay portal. The analysis period spanned from 2015 to 2022, allowing for an in- depth evaluation of TB notification trends before and after the implementation of the mandatory notification policy in 2018. Data was compiled and analysed using MS-Excel. Frequencies, means, and proportions used to effectively describe tuberculosis (TB) case notifications in both the private and public sectors were used. Results: Between 2015 and 2022, Solapur district experienced a variable but overall increasing trend in TB notification rates. In 2015, the TB notification rate was 58.15 per 100,000 population, which increased to 90.69 by 2022. The annual presumptive TB examination rates showed significant growth over the years. In 2015, the rate was 628 per 100,000 population, which escalated to 1965 by 2022. Conclusion: This rise is indicative of enhanced TB case detection, especially after the implementation of the mandatory notification policy and increase in presumptive TB examination rates is attributed to the rising use of advanced diagnostic methods such as CBNAAT and TrueNAT.

TB among refugees from Ukraine in European countries

<sec id="st1"><title>BACKGROUND</title>Since the Russian Federation’s invasion of Ukraine, millions of refugees have moved to neighbouring European countries. We assessed the burden of TB in these refugees and surveyed screening approaches.</sec><sec id="st2"><title>METHODS</title>We conducted a survey among 30 European Union/European Economic Area and 13 other European countries, requesting population data on migrant residents and refugees with country of birth (COB) Ukraine, the number of TB notifications among people with COB Ukraine and countries’ screening policies for refugees from Ukraine.</sec><sec id="st3"><title>RESULTS</title>In 2021, the number of migrants born in Ukraine was 1.7 million in the 34 responding countries, and increased with 5.2 million refugees from Ukraine to 6.9 million in 2022. These countries notified 207 TB cases in people with COB Ukraine in 2021 (TB notification rate 12.0/100,000) and 887 in 2022 (TB notification rate 12.8/100,000), of which 228 (26%) had multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB). TB notification rates were higher in countries advising screening for all (16.9/100,000) or specific groups of refugees from Ukraine (14.7/100,000) compared to those without screening (7.2/100,000).</sec><sec id="st4"><title>CONCLUSION</title>TB rates found in people from Ukraine were lower than the expected rate of 44 per 100,000, but higher in host countries recommending screening. Our study underscores the need for adequate TB health services for refugees from Ukraine to ensure tailored diagnosis and treatment, especially for MDR/RR-TB.</sec>

Trends in the Notification Rates and Treatment Outcome of Tuberculosis in Shandong Province, China, 2005-2021.

To analyze the time trends in the notification rates of registered tuberculosis (TB) and bacteriologically confirmed TB in Shandong Province. And analyze the changes in TB treatment outcomes during 2005-2021. The information of TB patients registered in the Shandong Information Center for Disease Control and Prevention (CDC) was collected during 2005-2021. We calculated the notification rates of registered TB and bacteriologically confirmed TB. Moreover, we calculated the year-to-year change rate of TB in treatment outcomes before and after COVID-19. The time trends were analyzed using the joinpoint regression method and illustrated as the annual percentage change (APC) of notification rates. A total of 236,898 cases of TB were diagnosed during 2005-2021, of which 51.11% were bacteriologically confirmed cases. Since 2008, the notification rates of registered TB have declined. The notification rates of bacteriologically confirmed TB had been declining during 2005-2016, then remained stable after 2016. In subgroup, the notification rates of both registered TB and bacteriologically confirmed TB were higher among men, rural residents, and people aged ≥ 60 years. Compared with clinically confirmed TB, bacteriologically confirmed TB has shown higher rates of poor outcomes since 2008 and higher case fatality rate since 2005. The rate of poor outcomes remained stable during 2008-2019. However, after the COVID-19 outbreak, the rate of poor outcomes and case fatality rate of TB has risen significantly. After unremitting efforts to fight against TB, the notification rates of registered TB and bacteriologically confirmed TB declined in Shandong Province. The rate of poor outcomes remained stable during 2008-2019, then rise significantly after the COVID-19 outbreak. In the context of the long-term existence of COVID-19, further efforts should be made in TB diagnosis and treatment among high-risk population, especially with regard to males, rural residents and older adults.

IJCM_310A: Active Case Finding for Tuberculosis in outreach centres of a medical college in Puducherry, India: A Mixed Methods Study on Outcomes and Implementation Challenges

Background: Tuberculosis is the leading cause of death from a curable infectious disease and is responsible for 9.9 million new cases and 1.3 million deaths. Over 95% of TB deaths occur in low and middle-income countries. The WHO TB statistics for India for 2021 give an estimated incidence figure of 2,590,000 million cases. In Puducherry, 4500 cases were notified in the same year, with a TB notification rate of 226 per lakh population. ACF has potential benefits but also challenges, which need to be carefully assessed when developing and implementing ACF policies. Objectives: 1) To understand the experiences of healthcare workers during the implementation of Active Case Finding (ACF) activities 2) To assess the implementation of ACF using the feasibility indicators. Methodology: Qualitative interviews (IDI & FGD) were conducted among healthcare workers (Nodal Officers, Medical Officers, and Medical Interns) involved in the ACF to enumerate their experiences during the survey and the implementation challenges they faced. Additionally, a set of feasibility indicators from the literature (Hemant et al.2023) was identified to assess the implementation of ACF in outreach centres of a medical college in Puducherry. Results: Three overarching themes emerged through qualitative interviews: awareness of ACF and TB, implementation challenges, and mechanisms to overcome the challenges. Feasibility indicators will be elicited upon completion of data curation and analysis. Conclusion: The intricate details involved in the implementation of ACF would be understood through the experiences of Health Care Workers as well as quantitative estimation of ACF implementation.

Tuberculosis in people of Ukrainian origin in the European Union and the European Economic Area, 2019 to 2022.

Approximately five million Ukrainians were displaced to the EU/EEA following the Russian invasion of Ukraine. While tuberculosis (TB) notification rates per 100,000 Ukrainians in the EU/EEA remained stable, the number of notified TB cases in Ukrainians increased almost fourfold (mean 2019-2021: 201; 2022: 780). In 2022, 71% cases were notified in three countries, and almost 20% of drug-resistant TB cases were of Ukrainian origin. Targeted healthcare services for Ukrainians are vital for early diagnosis and treatment, and preventing transmission.

Impact of annual TB screening on stone quarry workers in high-incidence Portuguese municipalities.

<sec id="st1"><title>SETTING</title>The Portuguese municipalities of Penafiel and Marco de Canaveses are high TB incidence areas, where stone quarry workers represent a vulnerable population.</sec><sec id="st2"><title>OBJECTIVE</title>To assess the annual rate of TB infection (ARI) in stone quarry workers and to compare it with the TB notification rate in the general community.</sec><sec id="st3"><title>DESIGN</title>An annual TB infection screening strategy using interferon-gamma release assay (IGRA) was implemented in 2018 for workers from high-risk stone quarries. A prospective cohort was enrolled and workers screened in periods of 2 years were included. IGRA-positive workers were referred for preventive treatment. ARI was calculated as the proportion of workers with IGRA conversion.</sec><sec id="st4"><title>RESULTS</title>Of the 232 IGRA-negative workers in 2018, 20 tested positive in 2019 (8.6% ARI). Of 171 IGRA-negative workers in 2019, eight tested positive in 2021 (4.7% in 2 years). Two of the 150 IGRA-negative workers in 2021 tested positive in 2022 (1.3% ARI). ARI decreased by 84.9% between 2019 and 2022. In the two municipalities, the TB notification rate declined 23.9% between 2018 and 2021.</sec><sec id="st5"><title>CONCLUSION</title>A more pronounced reduction in ARI was observed among stone quarry workers regularly screened for TB infection compared to the notification rate among the general population in high-incidence municipalities. A screening strategy for high-risk populations, together with enforced community measures, could foster risk reduction in the community.</sec>.

Impacts of armed conflicts on tuberculosis burden and treatment outcomes: a systematic review

ObjectivesThis systematic review aimed to summarise existing literature on the impacts of armed conflicts on tuberculosis burden and treatment outcomes.DesignA systematic review following the Preferred Reporting Items for Systematic Reviews...

Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China

BackgroundThe disease burden of tuberculosis (TB) was heavy in Hainan Province, China, and the information on transmission patterns was limited with few studies. This atudy aims to further explore the epidemiological characteristics and influencing factors of TB in Hainan Province, and thereby contribute valuable scientific evidences for TB elimination in Hainan Province.MethodsThe TB notification data in Hainan Province from 2013 to 2022 were collected from the Chinese National Disease Control Information System Tuberculosis Surveillance System, along with socio-economic data. The spatial–temporal and population distributions were analyzed, and spatial autocorrelation analysis was conducted to explore TB notification rate clustering. In addition, the epidemiological characteristics of the cases among in-country migrants were described, and the delay pattern in seeking medical care was investigated. Finally, a geographically and temporally weighted regression (GTWR) model was adopted to analyze the relationship between TB notification rate and socio-economic indicators. The tailored control suggestions in different regions for TB elimination was provided by understanding epidemiological characteristics and risk factors obtained by GTWR.ResultsFrom 2013 to 2022, 64,042 cases of TB were notified in Hainan Province. The estimated annual percentage change of TB notification rate in Hainan Province from 2013 to 2020 was − 6.88% [95% confidence interval (CI): − 5.30%, − 3.69%], with higher rates in central and southern regions. The majority of patients were males (76.33%) and farmers (67.80%). Cases among in-country migrants primarily originated from Sichuan (369 cases), Heilongjiang (267 cases), Hunan (236 cases), Guangdong (174 cases), and Guangxi (139 cases), accounting for 53%. The majority (98.83%) of TB cases were notified through passive case finding approaches, with delay in seeking care. The GTWR analysis showed that gross domestic product per capita, the number of medical institutions and health personnel per 10,000 people were main factors affecting the high TB notification rates in some regions in Hainan Province. Different regional tailored measures such as more TB specialized hospitals were proposed based on the characteristics of each region.ConclusionsThe notification rate of TB in Hainan Province has been declining overall but still remained high in central and southern regions. Particular attention should be paid to the prevalence of TB among males, farmers, and out-of-province migrant populations. The notification rate was also influenced by economic development and medical conditions, indicating the need of more TB specialized hospitals, active surveillance and other tailored prevention and control measures to promote the progress of TB elimination in Hainan Province.

Pulmonary tuberculosis notification rate in Shenzhen, China during 2010-2019: spatial-temporal analysis (Preprint)

Pulmonary tuberculosis notification rate in Shenzhen, China during 2010-2019: spatial-temporal analysis (Preprint)

Influential Factors of Tuberculosis Notification Rates in Turkey: A Provincial-Level Spatial Analysis.

The total annual count of reported tuberculosis (TB) cases continues to decline throughout Turkey. Recognizing the regions with high and low burdens and revealing the factors affecting TB notification rates may play a role in guiding national control programs. This study aimed to analyze the spatial distribution of TB notification rates from 2005 to 2018 and evaluate the factors contributing to TB rates. In this ecological study, we used freely available open data from the Internet. We employed global and local spatial autocorrelation analysis to identify the spatial distribution and the clusters with low and high burdens. We conducted an ordinary least square regression model, spatial lag model, and spatial error model. The best-fitting model was selected via model parameters. Throughout the study period, the provinces in West Marmara Region (Edirne, Kırklareli, Tekirdağ, Çanakkale) were consistently in a high-burden cluster. In univariate ordinary least square regression, population density, the proportion of contacts screened for TB, the proportion of TB contacts who received prophylaxis, TB dispensary count, mean particulate matter 10 levels, and gross domestic product were found to be positively associated with TB notification rate. The best-fitting multivariate spatial lag model revealed that the proportion of contacts screened for TB (β, z-value: 0.89, 2.21) positively affected TB notification rate. The high TB burden in West Marmara Region should warn policymakers to maintain a focused approach to controlling TB in this area. This study showed the importance of contact tracing efforts to prevent the underdetection of TB cases.

Excess tuberculosis risk during and following incarceration in Paraguay: a retrospective cohort study

The increased risk of tuberculosis (TB) among people deprived of liberty (PDL) is due to individual and institution-level factors. We followed a cohort of PDL from 5 prisons in Paraguay to describe the risk of TB during incarceration and after they were released. We linked a 2013 national census of prisons with TB records from the TB Program from 2010 to 2021 to identify TB notifications among incarcerated and formerly incarcerated individuals. We used multivariable Cox regression models to quantify the risk of TB during and following incarceration and to identify risk factors associated with TB. Among 2996 individuals incarcerated, 451 (15.1%) were diagnosed with TB. Of these, 262 (58.1%) cases occurred during incarceration and 189 (41.9%) occurred in the community after release. In prison, the hazard ratio of developing TB was 1.97 (95% CI: 1.52-2.61) after six months of incarceration and increased to 2.78 (95% CI: 1.82-4.24) after 36 months compared with the first six months. The overall TB notification rate was 2940 per 100,000 person-years. This rate increased with the duration of incarceration from 1335 per 100,000 person-years in the first year to 8455 per 100,000 person-years after 8 years. Among former prisoners, the rate of TB decreased from 1717 in the first year after release to 593 per 100000 person-years after 8 years of follow up. Our study shows the alarming risk of TB associated with prison environments in Paraguay, and how this risk persists for years following incarceration. Effective TB control measures to protect the health of people during and following incarceration are urgently needed. Paraguay National Commission of Science and Technology grant CONACYT PIN 15-705 (GS, GES, SA).

Key drivers of the TB epidemic in Suriname and priority actions to reduce incidence and mortality

BACKGROUND: The WHO has recently published updated guidance for national strategic planning for TB. To address the TB epidemic comprehensively, it is necessary to conduct an epidemiological review as part of the situation analysis in the national strategic plan.METHODS: A descriptive epidemiological study was conducted using data from the national TB register for the period of 2010???2020. Simple frequencies were calculated for demographic and clinical variables. Trends in TB notification rates for the period 2010???2020 were also calculated.RESULTS: TB notification rates between 2011 (24.3/100,000) and 2019 (23.9/100,000) remained almost the same. The HIV status was known for 97.1% of TB cases, 22.7% of whom had HIV co-infection; 10.9% of patients with detected Mycobacterium tuberculosis were also resistant to rifampicin. Case fatality rate for all cases was 13.0%. Of the identified contacts, 66% were screened; 28.3???47.5% of those with TB infection started treatment, 63.3???75.9% of whom completed treatment.CONCLUSION: The review identified the following areas of concern: no decline in TB rates, high proportion of TB-HIV co-infection, high rate of resistance to rifampicin, high casefatality rates and suboptimal contact investigation care cascade. The review was used to inform interventions and key actions to reduce TB morbidity and mortality in Suriname.

Active screening for tuberculosis among high-risk populations in high-burden areas in Zhejiang province, China

ObjectivesTuberculosis (TB) is a major global public health concern. Although the incidence of TB in China is declining, the country continues to face many challenges regarding TB control. This study aimed to develop an active case finding (ACF) strategy for high-risk populations in areas with high TB burden and evaluate the effectiveness of the ACF strategy for early TB detection in patients to reduce TB transmission. Study designThis was a descriptive study. MethodsFrom May to October 2019, active TB screening was conducted in Zhejiang Province, China. Overall, 24 high-burden townships were chosen as study sites. Residents aged ≥65 years, suffering from diabetes, diagnosed with HIV/AIDS, or with a history of TB were mobilized for screening. Chest radiography was performed for all participants in the community. Sputum specimens were collected for sputum smear tests and cultures at county-level TB-designed hospitals. A professional medical team performed the final diagnoses. ResultsOverall, 130,643 residents were included, accounting for 8.85% of the total population in the selected areas. After screening, 89 confirmed cases and 419 suspected cases were identified. The detection rates for suspected and confirmed cases were 320.72/100,000 and 68.12/100,000, respectively. Individuals with a history of TB accounted for a large proportion of detected cases, and the detection rate was higher among males than in females. This study identified 10.5% of reported cases in the selected areas in 2019. In Zhejiang province, compared with the previous year, the rates of TB notification in 2019 and 2020 declined by 7.0% and 7.4%, respectively, compared with the previous year. However, the TB notification rate in 2019 was almost the same as that in 2018 (a decline of 2.5%) but sharply declined in 2020 (14.4%) in the screened areas. ConclusionsOur findings suggest that the ACF strategy may have helped to maintain the downward trends in TB notification rates by detecting patients with TB and suspected cases in the short term.

TB NOTIFICATION IN CHILDREN: THE EXPERIENCE OF TARGETED COMMUNITY DEMAND CREATION AMIDST INSECURITY IN IMO STATE, NIGERIA

This paper explores the challenges and successes of tuberculosis (TB) notification in children amidst a backdrop of insecurity in Imo State, Nigeria. Emphasizing targeted community demand creation strategies, the study investigates the intricate relationship between insecurity, community engagement, and pediatric TB detection. Drawing upon a comprehensive literature review, this research delves into the epidemiology, diagnosis, and treatment of TB in children, the ramifications of insecurity on healthcare access in Imo State, and effective community engagement strategies in healthcare initiatives. The literature findings underscore the substantial burden of TB among children and the distinct hurdles faced in environments characterized by insecurity. The prevailing insecurity in Imo State significantly disrupts healthcare services, leading to delays in TB diagnosis and treatment initiation. Nevertheless, the review identifies community engagement approaches as a promising avenue for bolstering TB notification rates in pediatric populations. These approaches empower local communities to actively participate in the identification and management of TB cases, ultimately contributing to the enhancement of pediatric TB notification. A conceptual framework, derived from amalgamated literature, elucidates the intricate interplay between insecurity, community engagement, and TB notification. This study highlights the pivotal role of community-driven interventions in mitigating the challenges posed by insecurity in Imo State, Nigeria, and presents actionable recommendations for the development of healthcare policies and programs tailored to the region. This research not only augments our comprehension of TB notification among children within insecure contexts but also provides valuable insights into the broader domain of community-based healthcare interventions. It underscores the exigency for customized strategies to address TB in pediatric populations in regions marked by insecurity, ultimately contributing to the amelioration of health outcomes for children in Imo State, Nigeria, and analogous settings&#x0D; Keywords: TB, Children, Community, Nigeria.

Possibilities of Detecting an Epidemic Focus of Tuberculosis Infection in an Indicator Patient with a Positive Immunological Test for Tuberculosis

Relevance. In connection with the advent of new diagnostic immunological tests, it became possible to determine a potential focus of infection not only through the identification of patients with tuberculosis, but also through the identification of patients infected with M. tuberculosis, who still do not have manifestations of a local form of the disease. This made it possible to search for persons who were infected with an unknown source of tuberculosis infection in order to conduct an in-depth epidemiological investigation and detect hitherto unknown foci of tuberculosis. Aims. To study the effectiveness of identifying the source of infection in the environment of a patient with a positive immunological test for tuberculosis («indicator» patient). Materials and methods. 1) A retrospective study of the data of all 30 patients with tuberculosis in the period from 2014 to 2019 in Moscow, identified by indicator patients with a positive immunological test, was carried out. 2) A cohort of patients with latent tuberculosis infection with and without HIV infection (Moscow) was studied in the period 2020–2021. to determine the prevalence of latent infection in the close circle of communication of indicator patients. Results. Patients with tuberculosis, forming hidden foci and identified by the indicator patients infected by them with a latent infection, in 56.7% of cases were not examined for tuberculosis for 2–10 years, in 50.0% they suffer from tuberculosis with registered bacterial excretion, in 46.7% of cases are internal or external migrants. The prevalence of latent tuberculosis infection among indicator patients is 10%, which is many times higher than the prevalence of latent tuberculosis infection among the permanent population of Moscow (less than 1%), in HIV-infected risk groups (up to 5%), in known foci of tuberculosis on average in Moscow (5%). The TB notification rate in the environment of indicator patients with latent tuberculosis infection is 38.8 per 100,000 of the corresponding group and exceeds that among the permanent population of Moscow by 5.4 times. Conclusion. A modified epidemiological investigation aimed at examining the environment of persons with latent TB infection among adults makes it possible to identify TB patients who have infected indicator patients and to identify other infected patients.

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.

Time series analysis on tuberculosis cases in Kazakhstan from 2014 to 2025

Abstract Tuberculosis (TB) is a major cause of morbidity and mortality worldwide. The seasonal autoregressive integrated moving average (SARIMA) model is widely used for forecasting infectious disease incidence, including TB. However, there is a lack of comprehensive research on TB epidemiology and predictions for the future in Kazakhstan. Therefore, this study adopted a time series analysis of 72 monthly observations of reported TB cases in Kazakhstan from 2014-2019. The study used monthly health data from 2014-2019 for TB cases obtained from large-scale administrative records. The methodology involved using the Augmented Dickey-Fuller test for determining stationarity, ACF and PACF for identifying model parameters, and AIC/BIC for selecting the best SARIMA model, which was evaluated based on R2 score, MAE, and MAPE. The modeling dataset comprised monthly TB notification rates from 2014 to 2018, while the forecasting dataset comprised data from 2019. The findings suggest that the SARIMA model demonstrated some efficacy in predicting TB notification rates, although there remains scope for enhancing its precision. The time series was stationary after the first difference (ADF test: t-value of -3.25, P &amp;lt; 0.001) and not a white noise (P &amp;lt; 0.01). Based on ACF and PACF graphs, a SARIMA (0,1,0) (0,1,0)12 model was deemed to be the most appropriate forecasting model, with an R2 score of 0.43, MAE of 89.73 and MAPE of 0.08. To develop effective forecasting models for TB incidence, this study examined monthly TB cases in Kazakhstan from 2014 to 2019 and analyzed the seasonal patterns of TB occurrence. It is important to note that these results are preliminary and necessitate additional validation. Future studies will include correlation analyses between TB cases and meteorological data, using more recent data for TB cases, and evaluating various TB incidence forecasting models. Key messages • A SARIMA model developed for TB in Kazakhstan showed decreasing trend using time series analysis. • Evidence-based strategies for TB prevention &amp; control, and importance of monitoring &amp; forecasting TB incidence highlighted in this study.

The differences in tuberculosis notifications and outcomes among males and females in Colombo, Sri Lanka

Introduction: More males than females are reported with tuberculosis (TB). Assessment of disparities between the two groups would permit adopting targeted interventions.Objectives: To describe the differences in notification rates, sputum investigations and treatment outcomes of male and female TB patientsMethods: A descriptive follow-up study was conducted among 2169 adult TB patients registered in the Colombo District Tuberculosis Register using registry data. Comparisons were made between males and females using Chi-squared test and risk ratio (RR).Results: Males had a higher TB notification rate (161 per 100 000) than females (79 per 100 000) and the highest notification rates were observed in 65-74-year-old age category in both groups. A higher proportion of males than females had pulmonary TB (78.2% in males and 59.7% in females; p&lt;0.05). More males than females had a positive (RR=1.09; 95% CI: 1.05, 1.13) or high-grade sputum smear result (RR=1.15; 95% CI: 1.01, 1.31). Both groups had similar sputum conversion rates at the end of acute phase (80.4% vs. 84.1%). More males were lost to follow up compared to females (10.7% vs. 3.1%, p&lt;0.05).Conclusions &amp; Recommendations: The observed differences between males and females highlight the need to examine TB data disaggregated by sex and to have more sensitive diagnostics for females.

Tuberculosis Notification in Jordan, 2016-2020.

The burden of tuberculosis (TB) in Jordan is largely unknown due to the paucity of high-quality data, under-reporting, and a lack of good quality vital registration system. This study aimed to assess the characteristics of TB patients in Jordan, determine the TB notification rate and assess the trend of TB notification in Jordan between 2016 and 2020. Methods: This study analyzed the TB Surveillance data in Jordan for the period 2016-2020. The obtained data included information on age, gender, nationality, marital status, date of symptoms onset and date of diagnosis, and site of TB. Results: During the period 2016-2020, a total of 1711 patients (989 women and 722 men) were diagnosed with and treated for tuberculosis. The mean (SD) age of patients was 30.1 (17.2) years. Almost half of them (48.4%) were Jordanians. The majority of non-Jordanian patients were from Syria, Philippines, and Bangladesh. Two thirds of patients (66.0%) had pulmonary TB and 34.0% had extra-pulmonary TB. Almost half (50.7%) of the patients were diagnosed within one month of the symptoms' onset. The average annual TB notification rate during 2016-2020 was 3.32 per 100,000 pop (4.08 per 100,000 women and 2.64 per 100,000 men). The average annual standardized notification rate was 4.13 per 100,000 pop (4.52 per 100,000 women and 3.52 per 100,000 men). The overall age-standardized notification rate increased from 3.88 per 100,000 pop in 2016 to 4.58 per 100,000 pop in 2019 and declined to 2.46 per 100,000 pop in 2020. The trend in TB notification differed significantly according to gender. While the notification increased in the last three years among women, it decreased significantly among men. Conclusions: While TB notification increased in the last three years among women, it decreased significantly among men. There is a need to ensure that the national TB plans set clear targets for reducing the burden of TB.

Geographic patterns and hotspots of pediatric tuberculosis: the role of socioeconomic determinants.

Children are an important demographic group for understanding overall tuberculosis epidemiology, and monitoring of childhood tuberculosis is essential for appropriate prevention. The present study sought to characterize the spatial distribution of childhood tuberculosis notification rates in continental Portugal; identify high-risk areas; and evaluate the association between childhood tuberculosis notification rates and socioeconomic deprivation. Using hierarchical Bayesian spatial models, we analyzed the geographic distribution of pediatric tuberculosis notification rates across 278 municipalities between 2016 and 2020 and determined high-risk and low-risk areas. We used the Portuguese version of the European Deprivation Index to estimate the association between childhood tuberculosis and area-level socioeconomic deprivation. Notification rates ranged from 1.8 to 13.15 per 100,000 children under 5 years of age. We identified seven high-risk areas, the relative risk of which was significantly above the study area average. All seven high-risk areas were located in the metropolitan area of Porto or Lisbon. There was a significant relationship between socioeconomic deprivation and pediatric tuberculosis notification rates (relative risk = 1.16; Bayesian credible interval, 1.05-1.29). Identified high-risk and socioeconomically deprived areas should constitute target areas for tuberculosis control, and these data should be integrated with other risk factors to define more precise criteria for BCG vaccination.