Risk Factors For Tuberculosis Research Articles

Drivers of sex differences in the South African adult tuberculosis incidence and mortality trends, 1990–2019

Males have higher tuberculosis incidence and mortality rates than females. This study aimed to assess how sex differences in tuberculosis incidence and mortality could be explained by sex differences in HIV, antiretroviral treatment (ART) uptake, smoking, alcohol abuse, undernutrition, diabetes, social contact rates, health-seeking patterns, and treatment discontinuation. We developed an age-sex-stratified dynamic tuberculosis transmission model and calibrated it to South African data. We estimated male-to-female (M:F) tuberculosis incidence and mortality ratios, the effect of the abovementioned factors on the M:F ratios and PAFs for the tuberculosis risk factors. Over the period 1990–2019, the M:F ratios for tuberculosis incidence and mortality rates persisted above 1.0, and the figures reached 1.70 and 1.65, respectively, by the end of 2019. In 2019, HIV contributed greater increases in tuberculosis incidence among females than males (54.5% vs. 45.6%); however, females experienced more reductions due to ART than males (38.3% vs. 17.5%). PAFs for tuberculosis incidence due to alcohol abuse, smoking, and undernutrition, in men were 51.4%, 29.5%, and 16.1%, respectively, higher than females (30.1%, 15.4%, and 10.7%, respectively); the PAF due to diabetes was higher in females than males (22.9% vs. 17.5%). Lower health-seeking rates in males accounted for a 7% higher mortality rate in men. The higher burden of tuberculosis in men highlights the need to improve men’s access to routine screening and ensure earlier diagnosis. Sustained efforts in providing ART remain critical in reducing HIV-associated tuberculosis. Additional interventions to reduce alcohol abuse and tobacco smoking are also needed.

Low body mass index is associated with diminished plasma cytokines and chemokines in both active and latent tuberculosis.

Low body mass index (BMI) is a major risk factor for tuberculosis (PTB). Low BMI can impair the immune system and thus might affect TB incidence. We examined the plasma levels of Type 1, Type 17, pro-inflammatory, Type 2 and regulatory cytokines and CC and CXC chemokines in PTB and latent TB (LTB) individuals with low BMI (LBMI) or normal BMI (NBMI). Our data show that PTB is associated with significantly lower levels of IFNγ, TNFα, IL-2, IL-17A, IL-6, IL-12, IL-4 and IL-5 cytokines but significantly higher levels of IL-10, TGFβ and GM-CSF in LBMI compared to NBMI. Similarly, PTB is also associated with significantly lower levels of CCL2, CCL3, CCL11, CXCL1, CXCL9 and CXCL10 chemokines in LBMI compared to NBMI. Our data reveals that LTB is associated with significantly lower levels of IFNγ, TNFα, IL-2, IL1β, IL-12, IL-13 cytokines but significantly higher levels of IL-10, TGFβ, IL-4 and IL-22 in LBMI compared to NBMI. Similarly, LTB is also associated with significantly lower levels of CCL2, CXCL1, CXCL9 and CXCL10 and significantly higher levels of CCL1, CCL3, and CCL4 in LBMI compared to NBMI. Thus, LBMI has a major impact on the cytokine and chemokine milieu of both PTB and LTB and might predispose to the increased risk of tuberculosis by this immunomodulatory effect.

Prevalence and Associated Risk Factors of TB in People with HIV in Pakistani Population

Background: Mycobacterium tuberculosis infects 1/3rd of the world’s population. The second most common cause of death globally is tuberculosis TB. It has resulted in more than 2 million deaths annually. Due to the immunodeficiency in HIV patients’ opportunistic infections can easily get through the human defence system. TB infection is among the most common opportunistic infection present in PLHIV. Aim: To check the prevalence and associated risk factors of TB in patients having HIV in Pakistani population. Study Design: Descriptive cross-sectional study. Methodology: 138 patients above 18 years of age irrespective of gender, diagnosed with HIV undergoing antiretroviral therapy ART were included in the study. All the participants were screened for TB next. Following symptoms were noted current fever, cough, night sweats for more than 2 weeks, weight loss of more than 3 kg in last 4 weeks. A detailed physical examination was carried out. X-ray chest was done and findings suggestive of TB were noted. Further confirmation of TB was carried out using sputum microscopy taking spot sputum sample and the morning sputum sample. TB was further classified as pulmonary, extra pulmonary or mixed. The analysis of the data was done using SPSS 25.0. Results: Males constituted 90(65.2%) and females were 48(34.8%). Mean age of the patients was 36.1± 12.7 years. Tb was positive in 47(34.1%) of the cases diagnosed with HIV. Tb was more prevalent among younger age group (21-40 years) in PLHIV (p=0.3). Male patients having HIV were more at risk of developing TB as compared to females (p=0.5) as the disease (HIV) progressed from mild to severe stage the risk of contracting TB increases significantly (0.001). Literacy rate and CD4+ cell count was not significant risk factors. Practical Implication: Due to the emerging danger of the HIV, this study helped researchers investigate the risk factors associated with TB in people suffering from HIV. Conclusion: TB was present in 34.1% of the HIV affected individuals. The greatest risk for developing TB was among male gender with advanced stage HIV, younger age groups, those with No INH prophylaxis and a positive family history of TB. Keywords: antiretroviral therapy (ART), Human immunodeficiency virus HIV, INH prophylaxis, tuberculosis (TB)

Characteristics of Pulmonary Tuberculosis Patients Based on Age, Gender, and Education in the Pondidaha Public Health Center

According to the World Health Organization (WHO), tuberculosis (TB) is a global public health emergency because tuberculosis is widespread and difficult to treat. The researchers in this study tried to segment the tuberculosis sufferers in the Pondidaha Health Center service area based on age, gender, and level of education. Workplace analysis was carried out at the Pondiha Health Center. There were 35 subjects. SPSS was the analysis software used. According to the results of this study, age is not the main risk factor for tuberculosis. There was no relationship between a lower education level and an increased risk of tuberculosis. Gender does not play a significant role in the development of tuberculosis.
 Keywords: Age, Education, Gender, Pulmonary Tuberculosis

Mycobacterium tuberculosis genotypes in an ethnically diverse area with millions of pilgrims and thousands of immigrants

BackgroundImmigration is considered as a risk factor of tuberculosis (TB). Qom province receives millions of pilgrims and significant numbers of immigrants each year. Most of the immigrants to Qom, arrive from neighboring TB-endemic countries. This study aimed to identify the current circulating Mycobacterium tuberculosis genotypes in Qom province using 24-locus MIRU-VNTR genotyping.MethodsEighty six M. tuberculosis isolates were collected during 2018–2022 from patients referring to Qom TB reference laboratory. The DNA of isolates was extracted and followed by 24 loci MIRU-VNTR genotyping which performed using the web tools available on MIRU-VNTRplus.ResultsOf 86 isolates, 39 (45.3%) were of Delhi/CAS genotype, 24 (27.9%) of NEW-1, 6 (7%) of LAM, 6 (7%) of Beijing, 2 (2.3%) of UgandaII, 2 (2.3%) of EAI, 1 of S (1.2%) and 6 (7%) did not match with profiles present in MIRUVNTRplus database.ConclusionsAbout half of the isolates belong to Afghan immigrants; which warns health policy makers about the future situation of TB in Qom. Also, the similarity of Afghan and Iranian genotypes provides evidence that immigrants partake in the circulation of M. tuberculosis. This study underpin the studies about the circulating M. tuberculosis genotypes, their geographical distribution, the association of TB risk factors with these genotypes and the impact of immigration on the situation of TB in Qom province.

The prevalence and risk factors for tuberculosis among healthcare workers in Yogyakarta, Indonesia.

Healthcare workers (HCWs) are at risk of contracting TB, particularly when in high tuberculosis (TB) burden settings. Routine surveillance data and evidence are limited on the burden of TB amongst HCWs in Indonesia. We aimed to measure the prevalence of TB infection (TBI) and disease among HCWs in four healthcare facilities in Yogyakarta province in Indonesia, and explore risk factors for TBI. A cross-sectional TB screening study targeted all HCWs from four pre-selected facilities (1 hospital, 3 primary care) in Yogyakarta, Indonesia. Voluntary screening included symptom assessment, Chest X-ray (CXR), Xpert MTB/RIF (if indicated) and tuberculin skin test (TST). Analyses were descriptive and included multivariable logistic regression. Of 792 HCWs, 681 consented (86%) to the screening; 59% (n = 401) were female, 62% were medical staff (n = 421), 77% worked in the one participating hospital (n = 524), and the median time working in the health sector was 13 years (IQR: 6-25 years). Nearly half had provided services for people with TB (46%, n = 316) and 9% reported ever having TB (n = 60). Among participants with presumptive TB (15%, n = 99/662), none were diagnosed microbiologically or clinically with active TB disease. TBI was detected in 25% (95% CI: 22-30; n = 112/441) of eligible HCWs with a TST result. A significant association was found between TB infection and being male (adjusted Odds Ratio (aOR) 2.02 (95%CI: 1.29-3.17)), currently working in the participating hospital compared to primary care (aOR 3.15 (95%CI: 1.75-5.66)), and older age (1.05 OR increase per year of life between 19-73 years (95%CI: 1.02-1.06)). This study supports prioritisation of HCWs as a high-risk group for TB infection and disease, and the need for comprehensive prevention and control programs in Indonesia. Further, it identifies characteristics of HCWs in Yogyakarta at higher risk of TBI, who could be prioritised in screening programs if universal coverage of prevention and control measures cannot be achieved.

Epidemiology and factors associated with Extra-pulmonary tuberculosis in a Low-prevalence area

BackgroundTuberculosis is a global public health problem. Extra-pulmonary tuberculosis accounts for an increasing proportion of cases worldwide, although information about epidemiological, clinical, or microbiological factors is lacking. MethodsWe conducted a retrospective observational study of tuberculosis cases diagnosed between 2016 and 2021, classified into Pulmonary and Extra-pulmonary tuberculosis. Univariable and multivariable logistic regression models were used to investigate risk factors of Extra-pulmonary tuberculosis. Results20.9% of overall cases were classified as Extra-pulmonary tuberculosis, with a rising trend from 22.6% in 2016 to 27.9% in 2021. Lymphatic tuberculosis accounted for 50.6% of cases, followed by pleural tuberculosis (24.1%). 55.4% of cases belonged toforeign-born patients. Microbiological culture tested positive in 92.8% of Extra-pulmonary cases. Logistic regression analysis showed that women were more predisposed to develop Extra-pulmonary tuberculosis (aOR 2.46, 95% CI 1.45–4.20) as well as elderly patients (aged ≥ 65 years) (aOR 2.47, 95% CI 1.19–5.13) and persons with previous history of tuberculosis (4.99, 95% CI 1.40–17.82). ConclusionsExtra-pulmonary Tuberculosis have increased within our study period. A profound decline occurred in 2021 tuberculosis cases, probably due to COVID-19. Women, elderly population, and persons with previous history of tuberculosis are at higher risk of developing Extra-pulmonary tuberculosis in our setting.

Epidemiological characteristics and risk factors of multidrug-resistant tuberculosis in Luoyang, China.

We aimed to examine the prevalence of multidrug-resistant tuberculosis (MDR-TB) in Luoyang, China, identify related risk factors, inform clinical practices, and establish standardized anti-tubercular treatment regimens. We conducted a retrospective analysis of high-resolution melting curve (HRM) data from 17,773 cases (2,748 of which were positive) between June 2019 and May 2022 to assess the prevalence of MDR-TB and to identify its associated risk factors. Between June 2019 and May 2022, out of the 17,773 HRM results, 2,748 were HRM-positive, and 312 were MDR-TB cases. The detection rates for HRM-positive and MDR-TB were 17.0 and 12.1% for males, and 12.4 and 8.2% for females, respectively. The MDR-TB detection rate was higher in the urban areas (14.6%) than in the rural areas (10.6%) and more common among individuals under 51 years of age (14.1%) than those over 50 years of age (9.3%). Notably, the rate of detecting MDR-TB was 18.3% higher in new male patients than in new female patients, which was at 10.6%, and this difference was statistically significant (p < 0.001). Moreover, the rate of MDR detection in females who had received anti-tuberculosis treatment (21.3%) was higher than that in males (16.9%). In the multivariate model that considered the results of the sputum smear and detection time, MDR-TB was positively correlated with a history of tuberculosis (TB) treatment, being male, being younger than 51 years, and living in urban areas. Local TB infections are complex and diverse; therefore, more comprehensive monitoring methods are needed to curb the spread of MDR-TB.

The mutational signatures of poor treatment outcomes on the drug-susceptible Mycobacterium tuberculosis genome.

Drug resistance is a known risk factor for poor tuberculosis (TB) treatment outcomes, but the contribution of other bacterial factors to poor outcomes in drug-susceptible TB is less well understood. Here, we generate a population-based dataset of drug-susceptible Mycobacterium tuberculosis (MTB) isolates from China to identify factors associated with poor treatment outcomes. We analyzed whole-genome sequencing (WGS) data of MTB strains from 3196 patients, including 3105 patients with good and 91 patients with poor treatment outcomes, and linked genomes to patient epidemiological data. A genome-wide association study (GWAS) was performed to identify bacterial genomic variants associated with poor outcomes. Risk factors identified by logistic regression analysis were used in clinical models to predict treatment outcomes. GWAS identified fourteen MTB fixed mutations associated with poor treatment outcomes, but only 24.2% (22/91) of strains from patients with poor outcomes carried at least one of these mutations. Isolates from patients with poor outcomes showed a higher ratio of reactive oxygen species (ROS)-associated mutations compared to isolates from patients with good outcomes (26.3% vs 22.9%, t-test, p=0.027). Patient age, sex, and duration of diagnostic delay were also independently associated with poor outcomes. Bacterial factors alone had poor power to predict poor outcomes with an AUC of 0.58. The AUC with host factors alone was 0.70, but increased significantly to 0.74 (DeLong's test, p=0.01) when bacterial factors were also included. In conclusion, although we identified MTB genomic mutations that are significantly associated with poor treatment outcomes in drug-susceptible TB cases, their effects appear to be limited.

Point-of-care ultrasound for tuberculosis diagnosis in children: a Médecins Sans Frontières cross-sectional study in Guinea-Bissau

ObjectiveDescription of tuberculosis (TB)-focused point-of-care ultrasound (POCUS) findings for children with presumptive TB.DesignCross-sectional study (July 2019 to April 2020).SettingSimão Mendes hospital in Bissau, a setting with high TB, HIV, and...

Detection of Tuberculosis in Toddlers and its Risk Factor at East Perak Health Center Surabaya

Introduction: Tuberculosis is a contagious disease that can grow fast due to its transmissibility through aerosols. One of the countries with the highest tuberculosis rates is Indonesia with a case fatality rate of 11.59%. This study's objective was to examine the relationship between the physical condition of the house and the immune system and the incidence of tuberculosis in toddlers in Surabaya. Methods: This study used an analytic survey research design with a case control research methodology. The case population consisted of pediatric patients aged 0-5 years who were clinically diagnosed with pulmonary tuberculosis. The Chi-Square test was used to analyze bivariate data with a confidence level of 0.05 (α = 5%). Results and Discussion: The physical condition of the house that influenced the incidence of tuberculosis in toddlers were room temperature (p = 0.009; OR = 8.300; CI = 1.480-46.936) and room humidity (p = 0.000; OR = 7.600; CI = 1.609-35.906) while the immune system that affected the incidence of tuberculosis in toddlers were history of tuberculosis sufferers in the family (p = 0.018; OR = 6.000; CI = 1.266-28.498) and exclusive breastfeeding (p = 0.003; OR = 10.000; CI = 1.998-50.042). Conclusion: Houses with inadequate room temperature and humidity have an increased risk of tuberculosis development. Moreover, tuberculosis risk factors include a history of exclusive breastfeeding and a family history of tuberculosis. Health promotion by community health centers is expected to increase awareness of pediatric tuberculosis.

Demographic risk factors for extra-pulmonary tuberculosis: a rising public health threat in Bhutan

BackgroundRecently, extra-pulmonary tuberculosis (EPTB) has been increasingly reported in Bhutan, rising from 26% in 2001 to 39% in 2010. In 2016, almost half (49%) of all reported TB cases were classified as EPTB. Thus, this study was conducted to understand the epidemiology and identify risk factors contributing to increasing notification of EPTB in Bhutan. MethodsA case-control study was conducted by recruiting all 110 cases of nationally notified EPTB (Extrapulmonary bacteriologically confirmed/EPBC) as cases and 235 Pulmonary TB (Pulmonary bacteriologically confirmed/PBC) as controls. Data were collected on socio-demography, clinical and diagnostic, behavioral and lifestyle and environmental exposures using a structured questionnaire between April and September, 2018. ResultsThe median age of the cases was 25 years, ranged 9–79 years. Lymphatic TB was predominant (n = 78; 70.91%) followed by genitourinary TB (n = 4 (3.64%). The likelihood of EPTB decreased with increase in age (p = 0.023). The odds of EPTB in females was 1.65 times higher than the males (p = 0.038). Increase in Body Mass Index (adjusted odds ratio (AOR): 1.1; 95% confidence interval (CI): 1.052–1.200) and urban residency were (AOR 1.6; 95% CI 1.016–2.805) were found to have higher odds of developing EPTB. ConclusionFemales, urban residents, and those with higher BMI are at increased risk of developing EPTB. These at-risk groups can be used to target limited public health resources to control EPTB in Bhutan.

An analysis of risk factors for Multidrug Resistant Tuberculosis (MDR-TB): a hospital-based study

Multidrug Resistant Tuberculosis (MDR-TB) is the world's most serious problem and one of the leading causes of death. Because of its difficult diagnosis, high rates of treatment failure, and death, MDR-TB is a new challenge in TB control programs. The study aims to identify and analyze the risk factors of Multidrug Resistant Tuberculosis (MDR-TB). The study used a case control study design and was conducted at the Labuang Baji Hospital in Makassar City, Indonesia. The sample was 140 people consisting of 70 in the case group and 70 in the control group. Purposive sampling was used to collect the data. Data were analyzed using STATA program with Multiple Logistic Regression. Significant risk factors of Multidrug Resistant Tuberculosis (MDR-TB) were duration of treatment (OR= 5.655 [Cl 95%: 2.507-12.999]; p&lt;0.001), previous treatment history (OR= 4.833 [Cl 95%: 2.092-11.525]; p&lt;0.001), PMO factor (OR= 3.106 [Cl 95%: 1.227-8.338]; p=0.008), compliance with drugs (OR= 10.961 [Cl 95%: 4.640-26.40]; p&lt;0.001), drug side effects (OR=2.521 [Cl 95%: 1.070-6.126]; p=0.020) and protective factor is the complexity of drug regimen (OR= 0.329 [Cl 95%: 0.136-0.768]; p=0.005). It can be concluded that compliance with drugs is a dominant risk factor for MDR-TB. Improved TB control programs by monitoring the treatment of patients who experienced treatment failure (dropout) probably will increase treatment adherence and cut off MDR-TB transmission.

Undiagnosed and missed active pulmonary tuberculosis during mass gatherings: a prospective cross-sectional study from the Hajj pilgrimage

Mass gatherings increase the risk of infectious diseases transmission including tuberculosis (TB). The Hajj pilgrimage to Mecca, Saudi Arabia, is attended by over 2 million pilgrims many of whom are from high TB-burden countries, and has been linked to increased risk of TB acquisition among travellers. We investigated the burden of undiagnosed and missed active pulmonary TB (PTB) among Hajj pilgrims symptomatic for cough. The study was conducted among hospitalised and non-hospitalised travellers attending the Hajj pilgrimage in 2016 and 2017. Questionnaires were used to collect relevant data and sputum samples were collected from participants and processed using the Xpert MTB-RIF assay. Non-hospitalised pilgrims (n = 1510) originating from 16 high and medium TB-burden countries were enrolled. Undiagnosed, rifampicin-sensitive, active PTB was identified in 0.7%. Comorbidities (adjOR = 5.9 [95% CI = 1.2-27.8]), close contact with a TB case (adjOR = 5.9 [95% CI = 1.2-27.8]), cough in household (adjOR = 4.46 [95% CI = 1.1-19.5]), and previous TB treatment (adjOR = 10.1 [95% CI = 4.1-98.1]) were independent risk factors for TB. Of the hospitalised pilgrims (n = 304), 2.9% were positive for PTB, and 2.3% were missed, including a rifampicin-resistant case. History of TB treatment was associated with increased risk of TB (adjOR = 8.1 [95% CI = 1.3-48.7]). International mass gatherings may play an important role in the global epidemiology of TB. Preventive measures should be directed to reducing the risk of TB importation and transmission during Hajj and other similar events.

Prevalence, distribution, and risk factors of bovine tuberculosis in dairy cattle in central China.

Bovine tuberculosis (bTB) is one of the priority epidemic diseases in dairy cattle in China. Continuous surveillance and evaluation of the control programs will help on improving the efficiency of bTB control policy. We designed this study to investigate both animal and herd level prevalence of bTB, as well as to determine the associated factors in dairy farms in Henan and Hubei provinces. A cross-sectional study was conducted from May 2019 to September 2020 in central China (Henan and Hubei provinces). We sampled 40 herds in Henan and six herds in Hubei via stratified systematic sampling and administrated a questionnaire consisting of 35 factors. A total of 4900 whole blood samples were collected from 46 farms, including 545 calves <six months old and 4355 cows ≥six months old. This study demonstrated a high animal-(18.65%, 95% CI: 17.6-19.8) and herd-level (93.48%, 95%CI: 82.1-98.6) prevalence of bTB in dairy farms in central China. The Least Absolute Shrinkage and Selection Operator (LASSO) and negative binomial regression models showed that herd positivity was associated with the practice of introducing new animals (RR = 1.7, 95%CI: 1.0-3.0, p=0.042), and changing the disinfectant water in the wheel bath at the farm entrance every three days or less (RR = 0.4, 95%CI: 0.2-0.8, p=0.005) which reduced the odds of herd positivity. In addition, the result illustrated that testing cows with a higher age group (≥ 60 months old) (OR=1.57, 95%CI: 1.14-2.17, p=0.006) and within the early stage of lactation (DIM=60-120 days, OR=1.85, 95%CI: 1.19-2.88, p=0.006) and the later stage of lactation (DIM≥301 days, OR=2.14, 95%CI: 1.30-3.52, p=0.003) could maximize the odds of detecting seropositive animals. Our results have plenty of benefit to improve bTB surveillance strategies in China and elsewhere in the world. The LASSO and the negative binomial regression models were recommended when dealing with high herd-level prevalence and high dimensional data in questionnaire-based risk studies.

Risk for multidrug-resistant tuberculosis in patients treated with anti-tumor necrosis factor agents.

There are few studies on medical conditions associated with the development of drug-resistant TB. We investigated the risk factors for the occurrence of multidrug-resistant (MDR) tuberculosis (TB) in patients with pulmonary TB. Based on claims data from the Health Insurance Review and Assessment service in South Korea, we retrospectively investigated patients aged 18 years or older with active pulmonary TB who were treated with anti-TB therapy between January 1, 2008, and February 28, 2021. Among 248,176 patients with pulmonary TB who underwent anti-TB therapy, 2.0% were identified as having MDR-TB. MDR-TB showed male predominance compared to patients without MDR-TB, and patients with MDR-TB were younger. The risk for MDR-TB in patients treated with anti-TB therapy was 3.26 times higher in patients who received anti-tumor necrosis factor (TNF) agents before prescription of anti-TB medications than in those who had never been exposed to anti-TNF agents after adjusting for other TB risk factors (age, sex, inhaled corticosteroid, diabetes mellitus, liver disease, pneumoconiosis, and organ or blood recipients). The risk for MDR-TB was also increased in males and younger patients. Treatment with an anti-TNF agent could be a driver of MDR-TB in patients with pulmonary TB.

Methylprednisolone Promotes Mycobacterium smegmatis Survival in Macrophages through NF-κB/DUSP1 Pathway

Mycobacterium tuberculosis (M. tuberculosis) is the causative agent of tuberculosis. As an important component of host immunity, macrophages are not only the first line of defense against M. tuberculosis but also the parasitic site of M. tuberculosis in the host. Glucocorticoids can cause immunosuppression, which is considered to be one of the major risk factors for active tuberculosis, but the mechanism is unclear. To study the effect of methylprednisolone on the proliferation of mycobacteria in macrophages and try to find key molecules of this phenomenon. The macrophage line RAW264.7 infected by M. smegmatis was treated with methylprednisolone, and the intracellular bacterial CFU, Reactive Oxygen Species (ROS), cytokine secretion, autophagy, and apoptosis were measured. After the cells were treated with NF-κB inhibitor BAY 11-7082 and DUSP1 inhibitor BCI, respectively, the intracellular bacterial CFU, ROS, IL-6, and TNF-α secretion were detected. After treatment with methylprednisolone, the CFU of intracellular bacteria increased, the level of ROS decreased, and the secretion of IL-6 and TNF-α decreased in infected macrophages. After BAY 11-7082 treatment, the CFU of M. smegmatis in macrophages increased, and the level of ROS production and the secretion of IL-6 by macrophages decreased. Transcriptome high-throughput sequencing and bioinformatics analysis suggested that DUSP1 was the key molecule in the above phenomenon. Western blot analysis confirmed that the expression level of DUSP1 was increased in the infected macrophages treated with methylprednisolone and BAY 11-7082, respectively. After BCI treatment, the level of ROS produced by infected macrophages increased, and the secretion of IL-6 increased. After the treatment of BCI combined with methylprednisolone or BAY 11-7082, the level of ROS produced and the secretion of IL-6 by macrophages were increased. methylprednisolone promotes the proliferation of mycobacteria in macrophages by suppressing cellular ROS production and IL-6 secretion through down-regulating NF-κB and up-regulating DUSP1 expression. BCI, an inhibitor of DUSP1, can reduce the level of DUSP1 in the infected macrophages and inhibit the proliferation of intracellular mycobacteria by promoting cellular ROS production and IL-6 secretion. Therefore, BCI may become a new molecule for host-directed therapy of tuberculosis, as well as a new strategy for the prevention of tuberculosis when treated with glucocorticoids.

Thiopurines are an independent risk factor for active tuberculosis in inflammatory bowel disease patients.

The use of thiopurines is an independent risk factor for active tuberculosis in patients with inflammatory bowel disease.

Prevalence and risk factors of bovine tuberculosis in slaughtered cattle, Malawi

Bovine tuberculosis (bTB) is an infectious disease with significant socioeconomic, animal, and public health impacts. However, the prevalence of bTB remains largely unclear in Malawi due to a paucity of information. Additionally, the existence of multiple risk factors is postulated to enhance bTB transmission in animals. A cross-sectional survey to estimate the prevalence of bTB, animal characteristics and identify associated risk factors was conducted from slaughtered cattle at three major regional abattoirs (southern, central and northern regions) in Malawi. Out of a total of 1547 cattle examined, 154 (9.95%) had bTB-like lesions in various visceral organs and lymph nodes; one sample per animal was collected, processed, and cultured in the in the BACTEC Mycobacterial growth indicator tube (MGIT) 960 system. From the 154 cattle that showed tuberculous like lesions, only 112 were positive on MGIT and 87 were confirmed to have M. bovis based on multiplex PCR. Cattle from the southern region (odds ratio (OR) = 1.96, 95% CI: 1.03–3.85) and central region (OR = 2.00, 95% CI: 1.16–3.56) were more likely presented with bTB-like lesions at slaughter than from the northern region. The risk of having bTB-like lesions was higher in females (OR = 1.51, CI: 1.00–2.29), older cattle (OR = 2.17, CI: 1.34–3.37), and crossbreeds (OR = 1.67, 95% CI: 1.12–2.47) than in males, younger animals, and Malawi Zebu breed, respectively. The high prevalence of bTB is of critical concern and necessitates active surveillance and strengthening of the current control strategies under a One Health (OH) approach at the animal-human interface.

Effects of smoking on the severity and transmission of pulmonary tuberculosis: A hospital-based case control study.

There is a high incidence of both smoking and tuberculosis (TB) in China. This study examined the risk factors for severe pulmonary TB (PTB) and positive tubercle bacilli in sputum. We conducted a retrospective case-control study in a tertiary hospital from January 2017 to December 2018 (n = 917). The clinical and biological characteristics of patients were collected, and univariable and multivariable logistic regression analyses were performed to assess the factors associated with smoking in terms of the severity and transmission of PTB. Positive tubercle bacilli in sputum and severe PTB were much higher in smoking patients. Together with nutrition status, heavy smoking exhibited a 284% greater risk in severe PTB. Positive tubercle bacilli in sputum was significantly associated with hypoproteinemia and smoking regardless of the status, duration, and degree. Because cigarette smoking was strongly and inversely associated with hypoproteinemia, we conclude that smoking plays a critical role in the severity and transmission of PTB. Smoking cessation interventions should be employed to prevent severe PTB and decrease the transmission of PTB.