Tuberculosis Patients Research Articles

Retrospective analysis of the clinical utility of multi-cytokine profiles in smear-negative pulmonary tuberculosis.

To evaluate cytokine profiles and interferon-gamma release assay (IGRA) for their diagnostic capabilities in the differentiation of tuberculosis (TB) from non-TB conditions, as well as smear-negative pulmonary tuberculosis (SNPT) from smear-positive pulmonary tuberculosis (SPPT). A total of 125 participants were included, 77 of whom had TB and 48 who didn't, and demographic, clinical, and laboratory data were collected, including cytokine levels and IGRA results. The TB patients were further divided into 2 subgroups: SNPT (n=42) and SPPT (n=35). Compared to non-TB, the TB group had lower BMI, higher WBC, neutrophils, monocytes, ESR and CRP (p<0.05). TB patients showed higher IL-2, IL-6, IFN-γ, IL-8 (p<0.001) and higher IGRA positivity (88.3% versus [vs.] 29.2%, p<0.001). Between SNPT and SPPT, moderate effect sizes were observed for IFN-α, IL-2, IL-10, IL-8 (Cohen's d 0.59-0.76), with lower IGRA positivity in SNPT (81.0% vs. 97.1%, p=0.015). ROC analysis indicated IFN-α, IL-2, IL-10, IL-8 had moderate accuracy for SNPT diagnosis (AUCs 0.668-0.734), and combining these improved accuracy (AUC 0.759, 80% sensitivity, 64.2% specificity). A multi-biomarker approach combining these cytokines demonstrates enhanced diagnostic accuracy for tuberculosis.

Clinical and microbiological characteristics of a hospital outbreak of Candida auris in a referral hospital in Lima, Peru.

Candida auris, a multidrug-resistant fungal pathogen, has received considerable attention owing to its recent surge, especially in South America, which coincides with the ongoing global COVID-19 pandemic. Understanding the clinical and microbiological characteristics of outbreaks is crucial for their effective management and control. This retrospective observational study aimed to characterize a C. auris outbreak at a Peruvian referral hospital between January 2021 and July 2023. Data were collected from hospitalized patients with positive C. auris culture results. Microbiological data and antifungal susceptibility test results were analysed. Additionally, infection prevention and control measures have been described. Statistical analysis was used to compare the characteristics between the infected and colonized patients. Thirty-three patients were identified, mostly male (66.7%), with a median age of 53 years. Among them, 18 (54.5%) were colonized, and 15 (45.5%) were infected. Fungemia was the predominant presentation (80%), with notable cases of fungemia in tuberculosis patients with long-stay devices for parenteral anti-tuberculosis therapy. Seventy-five percent of the isolates exhibited fluconazole resistance. Echinocandins were the primary treatment, preventing fungemia recurrence within 30 days. Infected patients had significantly longer hospital stays than colonized patients (100 vs. 45 days; p = .023). Hospital mortality rates were 46.7% and 25% in the infected and fungemia patients, respectively. Simultaneous outbreaks of multidrug-resistant bacteria were documented. This study underscores the severity of a C. auris outbreak at a referral hospital in Peru, highlighting its significant impact on patient outcomes and healthcare resources. The high prevalence of fluconazole-resistant isolates, leading to prolonged hospital stay and high mortality rates, particularly in cases of fungemia, underscores the critical need for effective infection prevention and control strategies.

Hematological Parameters in Patients with Pulmonary Tuberculosis and its Presentation among Favorable and Unfavorable Treatment Outcomes.

Tuberculosis (TB) management continues to be a challenge globally; weakened immunity plays a significant role in the reactivation of TB. There is limited information on hematological parameters in patients with pulmonary TB and its association with outcome. We present hematological parameters of newly diagnosed sputum-positive pulmonary TB patients enrolled in a randomized, clinical trial that assessed the efficacy and safety of 3 and 4 regimens using moxifloxacin. Blood hematological parameters at baseline, comparison of the baseline and end of treatment values, including the monocytes by lymphocytes ratio (M/L), neutrophil lymphocyte ratio (N/L), and platelet lymphocyte ratio (P/L) between the patients with favorable and unfavorable TB treatment outcome, and among different age group and sex presented in this paper. Among the total 1059 patients, 782 were males, the mean hemoglobin (HB) ± standard deviation (SD) was 11.5 g/dL ± 2.0, the mean white blood cell (WBC) count ± SD was 9800 ± 3009 and the mean platelet count (in lakhs) ± SD was 4.24 ± 1.42 cells/uL. There was an increase from baseline in the mean hemoglobin, eosinophil, and lymphocyte count and a decrease in mean neutrophil, monocyte counts to the end of treatment. There was a decrease in baseline mean total WBC count posttreatment, both in favorable (10,271 cells/uL ± 3007 SD to 6689 cells/uL ± 1837 SD, [P ≤ 0.001]), and unfavorable TB outcome patients. An increase in HB, and a decrease in WBC count, M/L, N/L, and P/L ratio is possible at the end of TB treatment and future studies to correlate blood hematology parameters with TB treatment outcome.

Not Your Usual Exposure: Tuberculosis Contact Investigation Related to Contaminated Bone Allograft

Background: Mycobacterium tuberculosis transmission through contaminated bone allograft product is unusual and was first described in 2021 with a second outbreak in 2023. In July 2023, Michigan Medicine conducted contact tracing for healthcare personnel (HCP), patients, and visitors following exposure to an immunocompromised patient with surgical site infection and subsequent widely disseminated tuberculosis (bacteremia, pulmonary, lymphadenopathy) following spinal fusion with bone allograft in April 2023. The patient was in the emergency department, operating room (OR), and inpatient units for 9 days prior to initiation of Airborne Precautions (AP). Methods: Michigan Medicine is a 1,107 bed academic hospital. HCP are screened for tuberculosis with interferon-gamma release assay (IGRA) testing upon hire and following tuberculosis exposure. Exposure testing includes baseline IGRA testing and follow-up testing at 10-12 weeks post exposure. Exposure criteria for this investigation was defined as sharing room airspace with the tuberculosis patient prior to initiation of airborne precautions or Central Sterile Processing Department (CSPD) staff involved with instrument decontamination without the use of a respirator. Of note, universal masking with surgical masks was not required during this time for staff and patients/visitors, with the exception of CSPD and OR staff. Contact tracing was performed by Infection Prevention and Occupational Health Services managed all test results and conversions. Results: 176 employees from perioperative care areas (n=30), CSPD (n=7), OR (n=9) and inpatient units (n=130) were IGRA tested. Five employee conversions were identified: one surgeon, one circulating OR nurse, two CSPD decontamination staff, and one respiratory therapist. At time of detection, none of the conversions had evidence of active tuberculosis. Additionally, 46 patients and visitors were tested with zero conversions. HCP compliance with IGRA testing was initially 15% before engagement from hospital and unit leadership and human resources. With intervention, employee compliance reached 100%. Conclusion: Despite standard use of surgical masks for OR and CSPD staff, aerosolization of infected bone graft material played an important role in tuberculosis transmission during surgery and instrument cleaning. Respiratory therapy practices in the ICU setting likely also increased risk for pulmonary tuberculosis transmission. Achieving 100% HCP compliance for baseline and follow-up IGRA testing is challenging and requires engagement of both unit and hospital leadership and human resources to ensure all HCP are tested.

Formulation and characterization of Pyrazinamide loaded pegylated polypropylene imine dendrimer and its alteration in the pharmacokinetics

Abstract Current study aimed to build a dendrimer for tuberculosis treatment that was loaded with pyrazinamide. The medication pyrazinamide was loaded onto a PEGylated poly(propylene-imine) dendrimer. When it comes to tailored drug delivery, dendrimers are just plain awesome. Investigations into improving the drug loading capacity are being conducted on the free dendrimer, and the synthesised pyrazinamide loaded dendrimer. According to multiple studies, the core Ethylene Diamine (EDA)-PPI dendrimers of the ethylene diamine initiator can be effectively modified by PEGylation. This effort will increase therapeutic value and minimise changes in plasma concentration by carrying out drug transportation at a controlled rate. The therapeutic intervention for tuberculosis patients is enhanced by this feature. A pyrazinamide drug-loaded dendrimer was prepared in separate batches with varying concentrations; the optimal formulation was chosen and given to a rabbit, with the plasma concentration compared to that of the pure drug. Various pharmacokinetic parameters were calculated and the optimized formulation showed excel in the pharmacokinetic parameters.

Trend of pulmonary tuberculosis and rifampicin-resistance among tuberculosis presumptive patients in Central Tigray, Ethiopia; 2018 -2023: a six-year retrospective study

BackgroundTuberculosis (TB) is a major public health concern in the developing countries. Moreover, the emergence of multidrug-resistant tuberculosis is challenging. However, there are no organized data on the trends of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis in the study area.MethodsA retrospective cross-sectional study was conducted to fill the information gap in Central Tigray at St. Mary General Hospital between 2018 and 2023. Data were collected from the GeneXpert™ tuberculosis registration logbooks using standard checklists and analyzed using Statistical Package for Social Science version 22. After performing logistic regression, a p-value < 0.05 with a corresponding 95% confidence interval was considered statistically significant. Moreover, chi square test for trend was performed to assess the percentage of annual detection of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis during the study years.ResultPresumptive pulmonary tuberculosis patients with complete data (n = 3696) were included in the study. The overall prevalence of pulmonary tuberculosis was 11.7%, of which 8.1% were resistant to rifampicin. The study revealed that the incidence of pulmonary tuberculosis has been increasing, mainly in the recent four years. Likewise, an increase in rifampicin-resistant Mycobacterium tuberculosis was observed with considerable fluctuations. Age, human immunodeficiency virus infection, and presumptive rifampicin-resistant Mycobacterium tuberculosis infection were significantly associated with the presence of pulmonary tuberculosis. Moreover, pulmonary tuberculosis was more prevalent among participants in the productive-age group.ConclusionAlthough there have been fluctuations, an increasing of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis has been observed in recent years. Hence, prevention and treatment strategies for tuberculosis should be strengthened to alleviate the burden of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis in the study area.

Identification and role of differentially expressed genes/proteins between pulmonary tuberculosis patients and controls across lung tissues and blood samples.

Differentially expressed genes/proteins (DEGs/DEPs) play critical roles in pulmonary tuberculosis (PTB) diagnosis and treatment. However, there is a scarcity of reports on DEGs/DEPs in lung tissues and blood samples in PTB patients. We aim to identify the DEGs/DEPs in lung tissues and blood samples of PTB patients and investigate their roles in PTB. The lung granulomas and normal tissues were collected from PTB patients for proteomic and transcriptomic analyses. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) analyses annotated the functions of DEGs/DEPs. The GSE107994 data set was downloaded to identify the DEGs/DEPs in peripheral blood. The common DEGs and DEPs were identified. A nomogram was established. Pearson correlation analysis was conducted. Eighty-three DEGs/DEPs were identified. These DEGs/DEPs were mainly enriched in the movement of cell or subcellular components, regulation of cellular component biogenesis, and actin filament-based process as well as in the pathways of inositol phosphate metabolism, adherens junction, phosphatidylinositol signaling system, leukocyte transendothelial migration, regulation of actin cytoskeleton, and tight junction. There were eight common DEGs/DEPs (TYMP, LAP3, ADGRL2, SIL1, LMO7, SULF 1, ANXA3, and PACSIN3) between the lung tissues and blood samples. They were effective in predicting tuberculosis. Moreover, the activated dendritic cells, macrophages, monocytes, neutrophils, and regulatory T cells were significantly positively correlated with TYMP (r > .50), LAP3 (r > .50), SIL1 (r > .50), ANXA3 (r > .5), andPACSIN3 (r < .50), while negatively correlated with LMO7 (r < -0.50) (p < .05). ADGRL2 and SULF1 did not have a significant correlation (p > .05). The sample size was small. Eight common DEGs/DEPs of lung tissues and blood samples were identified. They were correlated with immune cells and demonstrated predictive value for PTB. Our data may facilitate the diagnosis and treatment of PTB.

Inducing Cell Death of THP-1 Monocyte and Peripheral Blood Mononuclear Cell by Serum-derived Exosomes of Tuberculosis Patients

Inducing Cell Death of THP-1 Monocyte and Peripheral Blood Mononuclear Cell by Serum-derived Exosomes of Tuberculosis Patients

Molecular Characterization of Mycobacterium tuberculosis Strains Recovered from Newly Diagnosed Tuberculosis Patients with HIV Coinfection in Northwestern Russia

Molecular Characterization of Mycobacterium tuberculosis Strains Recovered from Newly Diagnosed Tuberculosis Patients with HIV Coinfection in Northwestern Russia

Interpersonal communication approach in addressing TB stigma in Bandung City

Background: Tuberculosis (TB) patients face medical challenges and stigmatization from their surroundings. The Terjang Foundation is actively working to combat societal stigma towards TB patients. Purpose: This research analyzes the Terjang Foundation’s interpersonal communication approach to combating stigma towards TB patients. By understanding and assessing the communication methods employed by the foundation, the study aims to contribute to developing effective strategies for reducing the negative stigma associated with TB. Methods: This research utilizes a qualitative research method with a case study approach. In-depth interviews, field observations, and literature reviews are conducted to gather relevant data and insights. Results: The results of this study indicate that the Terjang Foundation employs five positive attitudes in their interpersonal communication approach to combat stigma towards TB patients: openness, empathy, positivity, equality, and supportiveness. These attitudes contribute to fostering an environment that challenges the negative stigma associated with TB. Continuous and frequent communication is crucial in combating stigma, promoting understanding and empathy, and disseminating accurate information. Empathy and equality emerge as prominent positive attitudes consistently demonstrated in communication. Conclusion: The study concludes that maintaining an ongoing and frequent communication process is essential for combating stigma in interpersonal communication efforts. Implications: The research findings have both practical and theoretical implications. Practically, the study emphasizes the importance of adopting positive attitudes, such as empathy and equality, in interpersonal communication strategies to reduce stigma towards TB patients. These insights can guide organizations, healthcare providers, and policymakers in developing effective communication campaigns and interventions to combat stigma related to TB and other diseases.

Hubungan Dukungan Sosial terhadap Kepatuhan Pengobatan Pada Pasien Tuberkulosis di Asia: Tinjauan Naratif

Introduction: Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis and continues to be a global health concern, particularly in Asian countries. Objective: This narrative review aims to identify the importance of social support in relation to treatment adherence among TB patients in Asia. Methods: The method employed is a narrative review, utilizing the Scopus and Proquest databases from 2017 to 2023 with the same keywords and BOOLEAN operators such as "AND" and "OR." Articles related to adherence, social support, adult TB patients, and research conducted in Asia are included in the study. Results: The results reveal 15 articles related to the relationship between social support and adherence included in this narrative review. Various instruments were used, with some employing existing questionnaires, while others were developed by the researchers themselves. Additionally, some studies did not specifically report the instruments used. Forms of social support provided were utilized as reinforcement in treatment adherence. Conclusion: The forms of social supports, such as emotional, instrumental, and informational support, primarily from family, play a crucial role in TB treatment adherence in Asia.

Assessment of Nutritional Status among Tuberculosis Patients: A Survey-Based Study

Assessment of Nutritional Status among Tuberculosis Patients: A Survey-Based Study

Drug Resistance and Mutation Patterns Among Tuberculosis Patients in National Tuberculosis and Leprosy Training Centre Zaria

Drug Resistance and Mutation Patterns Among Tuberculosis Patients in National Tuberculosis and Leprosy Training Centre Zaria

Hubungan Efek Samping Obat Anti Tuberkulosis (OAT) dengan Kepatuhan Berobat Pada Pasien Tuberkulosis di Puskesmas Jongaya Makassar

Tuberculosis is a direct infectious disease caused by Mycobacterium tuberculosis, which mainly affects the lungs and is transmitted through airborne droplets or sputum from TB patients with positive BTA. The morbidity and mortality of tuberculosis is a serious problem, mainly due to the side effects of Anti-Tuberculosis Drugs (OAT). This study aims to determine the relationship between OAT side effects and treatment compliance of pulmonary tuberculosis patients at the Jongaya Makassar Health Center. This study used a cross-sectional approach with quantitative methods, involving 49 respondents selected using the Slovin formula. The research instruments were OAT side effects questionnaire and treatment compliance questionnaire, with data analysis conducted univariately and bivariately using Chi Square test. The results showed that most respondents experienced low side effects and had a high level of treatment compliance. In conclusion, there is a significant relationship between OAT side effects and treatment compliance of tuberculosis patients at the Jongaya Makassar Health Center, where the lower the perceived side effects, the higher the level of treatment compliance.

Socialization and Evaluation of The Level of Compliance of Tuberculosis Patients to The Use Anti-Tuberculosis Drugs to Pharmacy Students of The Lubuk Pakam Medical Health Institute in 2023

The incidence of Tuberculosis (TB) is a health issue that must be paid attention to, especially at the Limapuluh Community Health Center. This health center is a health service center in the Fifty District which experiences a high incidence of TB, with the number of TB cases in 2022 increasing from the previous year. The level of patient compliance with treatment is one of the determining factors for the success of therapy. This study aims to provide an understanding of the factors that influence the level of compliance of TB patients with the use of Anti-Tuberculosis Drugs (OAT) at the Limapuluh Community Health Center. The method of service carried out is in the form of communication, information and education related to the use of Anti-Tuberculosis Drugs. The socialization was carried out online through a zoom meeting with the presentation of material and continued with a pretest and posttest as a measuring tool regarding the increase in participants' understanding of the material presented. This activity was carried out on January 06, 2024 at 10.00-12.00 WIB. The results of this service are the counseling material provided to students seen from the posttest results which show that the understanding and increase in knowledge of the participants is good compared to the results of the previous pretest points. In conclusion, students who take part in this activity can further explore the factors that affect patient compliance in taking OAT drugs so that similar activities can be carried out regularly to prevent errors in the use of Anti Tuberculosis drugs.

Erythrocyte sedimentation rate in new cases of pulmonary tuberculosis patients

Erythrocyte sedimentation rate in new cases of pulmonary tuberculosis patients

Evaluation of molecular diagnosis of tuberculosis and resistance to rifampicin with GeneXpert® MTB/RIF in Algeria

1) To evaluate the contribution of the GeneXpert® MTB/RIF (GX) test in the diagnosis of pulmonary and extra-pulmonary tuberculosis compared to culture. 2) To compare the rifampicin results resistance obtained by GX with the phenotypic sensitivity test. Retrospective study carried out over a period of five years, from May 2017 to June 2022 at the microbiology laboratory of the Central army Hospital Mohamed Seghir Nekkache, Algiers (Algeria). The pulmonary and extrapulmonary clinical specimens were collected, cultivated, tested by GX PCR and direct examination by Ziehl-Neelsen staining. The study of sensitivity to antituberculosis drugs was performed according to the proportion method on liquid medium Bactec MGIT 960 (or on solid medium Lowenstein-Jensen at the Algerian Pasteur Institute). 310 samples were included in the final analysis of the study, of which 156 were of pulmonary origin and 154 of extrapulmonary origin. Mycobacterium tuberculosis complex (MTBC) was detected in 95 samples from 88 tuberculosis patients (sex ratio 2,03 and middle age 37 years) with 49 cases of pulmonary tuberculosis and 39 cases of extra-pulmonary tuberculosis. For 2 cases, the GX was positive while the culture was negative and for 11 cases, the GX was negative while the culture was positive. Thus, in our study and compared to culture, GX showed an overall sensitivity of 88.2%, a specificity of 98.6%, a positive predictive value (PPV) of 96.4% and a negative predictive value (NPV) of 95.2%. The analysis of the data according to the type of samples, the sensitivity, specificity, PPV and NPV of GX for the pulmonary and extrapulmonary samples were 96.3% vs. 77.0%, 98.0% vs. 99.1%, 96.2% vs. 96.5% and 98.0% vs. 92.7% respectively. The sensitivity of GX for disco-vertebral, lymph node, meningeal and pleural tuberculosis were 100%, 90.0%, 71.4% and 57.1% respectively. The sensitivity of GX for pulmonary tuberculosis compared to microscopy was 96% vs. 68%. The comparison of the results of detection of resistance to rifampicin by GX and by phenotypic methods showed perfect agreement. A good sensitivity of GX compared to microscopy was revealed. The GX is a useful tool for the diagnosis of pulmonary tuberculosis, especially in smear-negative cases. The sensitivity of GX in extrapulmonary tuberculosis varied depending on the location of the infection. A negative result by GX does not exclude tuberculosis and cases of resistance to RIF detected by GX must be confirmed by phenotypic method.

Overview of rapid molecular test (RMT)–gene xpert mtb/rif ultra results in pulmonary tuberculosis patients based on the history of therapy

Overview of rapid molecular test (RMT)–gene xpert mtb/rif ultra results in pulmonary tuberculosis patients based on the history of therapy

Medication Adherence Through Structured mHealth Education In Pulmonary TB: A Literature Review

Introduction: Pulmonary tuberculosis (TB) is a global health concern. The lengthy treatment process, which lasts at least 6 months, can lead to non-adherence due to boredom, resulting in reluctance to continue treatment. In foreign countries, non-adherence is addressed through interventions such as the use of mobile phones or mHealth, and several studies have highlighted the benefits of mHealth for TB patients. Objective: This study aims to describe the benefits of mHealth on the adherence of TB patients, including treatment evaluation, self-efficacy, and medication adherence. Methods: A literature review was conducted to analyze selected studies and generate new ideas. Discussion: By reviewing and analyzing 10 selected journals, it was concluded that mHealth applications and video Directly Observed Treatment, Short-course (vDOTS) are highly effective in improving medication adherence among pulmonary TB patients. Recommendations: Further research is encouraged to develop mHealth applications that enhance medication adherence among TB patients and to test their effectiveness

Challenges of Screening and Investigations of Contacts of Patients with Tuberculosis in Oyo and Osun States, Nigeria.

Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of screening and investigation of contacts of patients with TB in Oyo and Osun State, Nigeria. This descriptive-qualitative study was conducted in eight Local Government Areas with high TB burdens. Twenty-four focus group discussions and 30 key informant interviews were conducted among TB patients, household TB contacts, and government TB staff, among others. Respondents ages ranged from 17-85 years with a mean of 42.08 ± 14.9 years, and (4.0%) had a postgraduate degree. This study identified that the majority of TB contacts who tested negative for TB were unwilling to be placed on TB preventive therapy because of the belief that only a sick person should take drugs. Also, hostility from the TB contacts to the contact tracers during the house-to-house screening of presumptive TB cases due to community stigma associated with TB was another existing gap reported in TB contact investigations. The findings emphasise the importance of tailored approaches in TB prevention and control, addressing challenges in testing and contact investigations; this necessitates investments in community engagement strategies to enhance the cooperation of TB contacts.