WHO Global Tuberculosis Report Research Articles

Roadmap for ending TB in China by 2035: The challenges and strategies.

Tuberculosis (TB) is one of the top ten causes of death worldwide, taking the lives of over a million people annually. In addition to being a serious health issue, TB is also closely linked to eradicating poverty according to the Sustainable Development Goals (SDGs) of the United Nations (UN). All UN members have committed to ending the TB epidemic by 2030. China has one of the highest TB loads worldwide, ranking third in the world on many TB burden indices. The national strategy for TB control is aimed at creating a collaborative network and integrating TB treatment into the medical system. According to the WHO's global TB report, China is expected to have 748,000 new cases of TB in 2022 and an incidence of 52 cases per 100,000 people. Ending TB remains a huge challenge and requires comprehensive control strategies in China. In this work, we have discussed the challenges of TB prevention and control in China and proposed specific measures to end TB.

Monoresistance to Rifampicin: An Uncharted Territory in The Management of Drug-Resistant Tuberculosis

Tuberculosis (TB) disease caused by the bacilli Mycobacterium tuberculosis (MTB) is a chronic disease, mostly involving the lungs but can also involve other parts of the body, which if left untreated may lead to severe illness which can be fatal. Worldwide, TB is the 13th leading cause of death. TB occurs in every part of the world but its distribution is heterogenous. As per WHO global TB report, the biggest quantum of cases occurs in the South and South-Eastern Asian region (46%). Africa contributes to 23% with Western pacific taking 18% of the burden of TB [1].

Drug-Induced Hypersensitivity Reaction and Re-Introduction of Anti-Tubercular Drugs (ATT): A Case Report and Review of Literature

Tuberculosis (TB) is a communicable disease caused by the bacillus Mycobacterium tuberculosis and is the leading cause of death by a single infectious agent overall. According to the WHO Global TB Report, India contributes to 26% of the global burden of TB. Currently, a four-drug regimen comprising Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol is approved for the treatment of drug-sensitive TB. The management of cutaneous adverse drug reactions to anti-tubercular drugs is akin to a double-edged sword, with discontinuation of ATT increasing the risk of developing disseminated and drug-resistant tuberculosis, and continuation leading to persistence or exacerbation of the adverse drug reaction (ADR). The risk of developing an ADR to anti-tubercular therapy (ATT) varies from 8 to 85% in various studies [10]. The prevalence of rashes associated with ATT shows that the maculopapular rash (42.5%) is the most frequently observed type, followed by urticarial, lichenoid, DRESS, AGEP, and exfoliative dermatitis (17). The drugs associated with Cutaneous ADRs from the lowest to the highest risk are Isoniazid, Rifampicin, Pyrazinamide, Ethionamide, Cycloserine, Ethambutol, Para-aminosalicylic acid (PAS), and Streptomycin (25). We present a case and approach to the re-introduction of first-line anti-tubercular drugs after hypersensitivity with fixed-dose combinations.
 Keywords: Tuberculosis, Mycobacterium tuberculosis, adverse drug reaction, anti-tubercular therapy

Studying the efficacy of isolation as a control strategy and elimination of tuberculosis in India: A mathematical model

India has the highest burden of both tuberculosis (TB) and multidrug-resistant TB (MDR-TB) based on the WHO Global TB Report 2019. Although the available data suggest that the total TB incidence has declined, the absolute number of new cases is still increasing. The number of reported TB cases in India in 2018 was 2.2 million, which was 1.5 million in 2009. About 47% increment in TB case notification in India within a decade shows a persistent public health problem. India contributes about 22% of the World's TB burden. Indian National Strategic Plan 2017-2025, sets out the government plans to eliminate TB by 2025. However, the milestone seems unrealistic to achieve the TB eradication goal by 2025. We developed a five-dimensional mathematical model to understand the TB dynamics in India and investigate the possibility of the earliest TB eradication time frame. The model stratifies the entire TB class into three different classes as drug-sensitive (DS), MDR, and isolated classes. The effective reproduction number, equilibrium points, and stability analysis of the model were carried out. This model predicts the total estimated cases of DS-TB and MDR-TB from 2018 to 2035 through numerical simulation and suggests that TB may be eliminated by 2035 in India if the treatment success rate could be achieved to 95%, by contact tracing and isolating at least 50% of MDR-TB.

A study of analysis on prevalence, serological marker and prognosis of tuberculosis in tertiary care hospital

BackgroundTuberculosis is an infectious disease responsible for a significant cause of ill health. According to the WHO global tuberculosis report 2021. 9.9 million cases fell sick with TB in 2020. Significantly, the prevalence of tuberculosis in India is 25%. ObjectiveTo analyze the prevalence of tuberculosis in the suburban areas of the metropolitan city in South India. To analyze the serological marker and prognosis of tuberculosis among males and females. To determine the importance of molecular testing - PCR confirmation on TB after AFB smear. MethodsA retrospective study to analyze 462 patients enrolled by the respiratory medicine department on suspecting pulmonary- 356 (M−264 & F-92) and extra-pulmonary-106 (M-73&F-33) patients and diagnosed Zhiel-Neelsen staining, Mantoux test, Chip-based RT-PCR test, Erythrocyte sedimentation rate, and analyzed serological test such as C-Reactive Protein, Chemiluminescence immune assay. Results23 patients were positive in Ziehl-Neelsen staining, 65 were positive in molecular True-Nat PCR test, Mantoux skin test induration in 10 patients, 98 TB Positive patients examined in the serological analysis, 1 & 3 patients reacted in HIV/HBsAg, and HBsAg test respectively, by chemiluminescence immunoassay, 8 PTB and 4 EPTB and 47 non-TB patients were positive in C-reactive protein, 46 TB and 94 non-TB patients detected abnormal values out of these 160 patients in ESR test. ConclusionThe Prevalence of tuberculosis is significantly rising, especially in the middle-aged population. The rapid molecular diagnostics to detect TB are highly sensitive and specific. Serological markers are essential for the analysis of disease prognosis and need to focus on the guidance of DOTS and RNTCP to End TB.

EFEKTIFITAS POSISI ORTHOPNEA TERHADAP PENURUNAN SESAK NAFAS PADA PASIEN TB PARU

The incidence of tuberculosis according to the WHO Global Tuberculosis report 2016, tuberculosis occupies the second position with the highest TB burden in the world. Pulmonary TB is an inflammatory disease of the lung parenchyma caused by the bacterium Mycobacterium tuberculosis. Pulmonary TB can cause respiratory system disorders. Breathing is a condition in which air containing O2 enters the body and removes CO2 from the body as a residue of oxidation. The purpose of the study was to determine the effectiveness of the orthopnea position on the reduction of shortness of breath in pulmonary TB patients in RSUP H. Adam Malik Medan. Research design. Quasi-experimental with a two-group pretest-posttest design approach. To determine the effectiveness before and after the orthopnea position to decrease shortness of breath in pulmonary TB patients. The sample was 50 respondents, 25 for the intervention group, and 25 for the control group, using the purposive sampling technique. The study found that the mean value in the intervention group was 26,64 decreased to 21,36 and the control group was 24,80 to 24,88. Dependent test results in the intervention group obtained a value of p = 0.000 or p < 0.05 and the control group obtained a value of p = 0.161 or p> 0.05 so the intervention group had an effect and the control group had no effect. Suggestions are the effectiveness of respiratory frequency in pulmonary TB patients while the control group only measures the respiratory frequency, there is no effectiveness in pulmonary TB patients.

Pengaruh sanitasi lingkungan fisik rumah, sosial budaya dan kontak serumah terhadap kejadian Tuberkulosis Paru di Pulau Bengkalis Kabupaten Bengkalis

The degree of public health is influenced by four factors, namely environment, behavior, health services, and heredity. Data from 2019 WHO Global Tuberculosis Report, Indonesia ranks third with the highest tuberculosis cases in the world. The purpose of this study was to analyze the sanitary conditions of the house environment (temperature, humidity, type of floor, ventilation, lighting), socio-culture (trust), and household contact against the incidence of pulmonary tuberculosis on Bengkalis Island. This research is an analytical study with a case-control design. This research was conducted on Bengkalis Island, namely in two sub-districts (Bengkalis District and Bantan District) and in the working area of Puskesmas Bengkalis, Puskesmas Pematang Duku, Puskesmas Selatbaru and Puskesmas Teluk Pambang. The data used are quantitative data sourced from observations, interviews, and questionnaires. The research sample was 80 people consisting of 40 cases and 40 controls. Data analysis was performed by multiple logistic regression tests. The results of the study concluded that the most dominant variable affecting the incidence of pulmonary tuberculosis was temperature with a p-value of 0.008. Confounding variables for tuberculosis incidence were ventilation, floor type, lighting, and confidence. The multivariate model formed is fit/fit for use. Based on the results of the calculation of the equation, it can be concluded that if a person has temperature risk factors, humidity risk factors, ventilation risk factors, floor type risk factors, lighting risk factors, trust risk factors, and household contact risk factors, then he will have a chance of suffering from pulmonary tuberculosis by 94 percent (with a probability value of 0.94).

Multidrug-resistant tuberculosis in Sierra Leone

Tuberculosis has persisted as a human challenge since antiquity. The WHO's Global Tuberculosis Report of 2021 indicated that there were 9·5 million cases and 1·5 million deaths due to tuberculosis in 2021, surpassing deaths attributable to HIV and ranking as the second leading infectious cause of death after COVID-19.1 The impact of the tuberculosis pandemic has been felt most profoundly in Sierra Leone and 30 other countries with a high tuberculosis burden, mostly countries of lower wealth index, which collectively account for almost 90% of the global burden of the disease.

Predoperačná optimalizácia pacienta s multirezistentnou formou tuberkulózy pri kombinovanej farmakologickej a nefarmakologickej liečbe

Tuberculosis is a communicable infectious disease in majority caused by bacillus Mycobacterium tuberculosis. Lungs are the most often targeted body tissue where infection can spread. Although lung tuberculosis is well curable by combinations of antituberculotic drugs, more serious drug-resistant forms occur. WHO Global Tuberculosis Report provides information about almost half million of new resistant cases and rising multidrug resistant tuberculosis (MDR-TB) together with serious extensively drug resistant tuberculosis (XDR-TB). Resistant species increase cost of hospitalization and prolong length of stay in hospital. Combination of pharmacological and surgical (non-pharmacological) treatment strategy brings successful tuberculosis cure to certain group of patients. Adequate preoperative optimalization and interdisciplinary approach are essential points of effectual surgical care in combination with pharmacological treatment.

Assessment of Knowledge, Attitude and Practice (KAP) in Tuberculosis patients

Tuberculosis (TB) is a highly contagious airborne disease caused by Mycobacterium tuberculosis that primarily affects the lungs. TB is a significant and major public health emergency globally. According to the WHO Global Tuberculosis Report 2020, 10 million people developed TB disease in the year 2019. The main objective of the study was to assess the level of knowledge, attitude and practice in TB patients. The study also reveals the association between KAP and the demographics of the subjects. An observational study was employed to collect data from a total of 71 subjects. Both quantitative and qualitative statistical analysis were adopted. From the findings, the mean age of the study population was 45.5 ± 13.96 years. Over 15.50% of subjects appeared to have adequate knowledge, 87.33% of subjects had a fair attitude, and around 58% of subjects were reported to have good practices towards TB. A weak positive correlation between knowledge and attitude (p = 0.051), weak positive correlation between knowledge and practice (p = 0.138) whereas, a significant and moderately positive correlation between attitude and practice (p = 0.002) was observed. The mean knowledge scores of graduates and post-graduates were higher in comparison with other study subjects. The study findings showed that the majority of subjects had several misconceptions about TB and hence prioritized interventions and more awareness programs at the root levels are needed to aid TB control and eradication.

Hubungan faktor lingkungan fisik, sosial dan ekonomi dengan kejadian Tuberkulosis Paru di Kecamatan Tambang Kabupaten Kampar

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis which mostly attacks the lungs and can also attack other organs. Tuberculosis is transmitted by smear positive tuberculosis patients, Tuberculosis germs are transmitted through the air when the patient coughs and sneezes so that the germs spread in the air in the form of droplets (sputum sparks), so people can become infected if they inhale the droplet into the respiratory tract (Ministry of Health Republic of Indonesia, 2014 ). According to Achmadi (2010) risk factors for tuberculosis transmission are environmental and behavioral factors. Environmental factors include ventilation, occupancy density, temperature, lighting and humidity. Whereas behavioral factors include smoking, spitting or sputum in any place, coughing or sneezing not closing the mouth and habit of not opening the window. Based on the results of a survey in Indonesia by the Directorate General of Communicable Disease Eradication and Environmental Health (2011), the high incidence of pulmonary TB is caused by a lack of knowledge. Knowledge of tuberculosis sufferers will affect the attitude and behavior such as throwing up spit or sputum that can be carelessly a source of transmission for people around him. Prabu in Fitriani (2013) explained that family heads who have an income below the regional minimum wage (UMR) will consume foods with nutrient levels that are not in accordance with the needs of each family member so that they have an nutritional status that is lacking and will make it easier to contract infectious diseases including Lung TB. According to WHO the number of cases of tuberculosis is ranked above HIV / AIDS. In 2016 there were an estimated 10.4 million new cases of tuberculosis or 142 cases / 100,000 population, 60% of new cases occurred in 6 (six) countries namely India, Indonesia, China, Nigeria, Pakistan and South Africa, and Indonesia ranked second (WHO Global Tuberculosis Report, 2017). Based on data on Indonesia's health profile in 2018 the number of tuberculosis cases in Indonesia in 2017 was 420,994 cases and increased in 2018 to reach 511,873 cases (Ministry of Health Republic of Indonesia, 2018). The number of pulmonary tuberculosis in Riau Province in 2018 is 11,135 cases (Ministry of Health of the Republic of Indonesia, 2018). Based on data on the health profile of Kampar Regency in 2017, tuberculosis is an environmentally-based direct infectious disease that ranks second with a total of 1,071 cases after diarrheal disease with a total of 1,076 cases. The number of positive AFB cases in 2017 in Kampar District reached 1071 cases, with the highest number of sufferers found in Tambang District, 78 cases. In 2018 the number of TB cases was 1079 cases, with the highest cases also occurring at the Tambang Health Center with a total of 67 cases and 43 new cases, followed by the Siak Hulu I Health Center with a total of 57 cases (Dinkes District Health Office, 2018). Based on this, this study aims to analyze and the risk of the relationship between the physical, social and economic environment with the incidence of pulmonary tuberculosis in Tambang District, Kampar Regency.

In the Shadows of the COVID-19 Pandemic

In the Shadows of the COVID-19 Pandemic

Application Pis (Indonesia Wellness Progrsam) PK Model with Decision and Matriarchal Patriarchal Family of Compliance on the Family of the Suffering of Disease TB Lung Health in the Work Remu City Sorong

Background : Indonesia Healthy Family Approach (PIS PK) is done by visiting the family, with the target
 and the target is a PK PIS family. Indonesia has a health problem that is in the public spotlight in 2018,
 namely the high number of cases of pulmonary tuberculosis (TB). Based on 2016 WHO Global Tuberculosis 
 Report, Indonesia ranks second with the highest TB burden in the world. This includes many cases that
 have not been detected and have not been treated and have not been reported. In the family structure and
 cultural dimensions based on decision making known as Patriakal and Matriakal. By knowing the pattern of
 household decision making, it can also be seen whether there is dominance in a household.
 The Research Objective : Knowing overview and analyze the application of PIS PK (Healthy Indonesia
 Program) model of decision making patriarchal and matriarchal families on treatment compliance in family
 members who suffer from pulmonary tuberculosis in Puskesmas Remu Sorong.
 Research design : Quantitative and qualitative research. Quantitative research method is case control design
 The qualitative research method is phenemoenology . The population in this study is the manager of the PK
 PIS program and all family members who suffer from TB in the work area of the Remu Puskesmas in Sorong
 City. The sample in this study amounted to 32 respondents.
 Results : They have been done and they have the document but not maximum home visits, and patients
 taking the medicine lazy. Test using the Old Ratio (OR) with an estimate of 8.333 means that the application
 of PIS PK in accordance with the guidelines on matriarchal decision making is 8 times the risk of being
 folded from patriarchal decision making. The implementation of PIS PK in accordance with the guidelines
 for medication compliance 10 times the risk of compliance with treatment compliance .
 Conclusion : Application of PIS PK has documents, but not optimal, PIS Application of PK with decision
 model testing friendly old ratio of 8 times the risk in decision-making, and PK of the compliance application
 PIS treatment 10-fold risk of adherent treatment. Suggestions for community health centers as a result of
 data collection to the community to discuss further interventions and empower the community.

No time to waste: preventing tuberculosis in children

Tuberculosis takes the life of one in five children developing the disease. 1 WHOGlobal tuberculosis report: 2019. World Health Organization, Geneva2019 Google Scholar Data from the pre-chemotherapy era suggest very young children are at highest risk for tuberculosis after exposure, and highly susceptible to the most severe forms of the disease. 2 WHOLatent tuberculosis infection: updated and consolidated guidelines for programmatic management. World Health Organization, Geneva2018 Google Scholar , 3 Marais BJ Gie RP Schaaf HS et al. The clinical epidemiology of childhood pulmonary tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis. 2004; 8: 278-285 PubMed Google Scholar As a result, tuberculosis control efforts among children in high-burden countries are focused on those below 5 years of age. 2 WHOLatent tuberculosis infection: updated and consolidated guidelines for programmatic management. World Health Organization, Geneva2018 Google Scholar One of the most important efforts is provision of tuberculosis preventive therapy after tuberculosis exposure, yet only one in four children below 5 years of age who might benefit from life-saving preventive therapy will receive it. 1 WHOGlobal tuberculosis report: 2019. World Health Organization, Geneva2019 Google Scholar In resource-constrained high-burden countries, fewer than 1% of children at least 5 years of age receive preventive therapy. 1 WHOGlobal tuberculosis report: 2019. World Health Organization, Geneva2019 Google Scholar The risk of tuberculosis in children after close exposure: a systematic review and individual-participant meta-analysisThe risk of developing tuberculosis among exposed infants and young children is very high. Most cases occurred within weeks of contact investigation initiation and might not be preventable through prophylaxis. This suggests that alternative strategies for prevention are needed, such as earlier initiation of preventive therapy through rapid diagnosis of adult cases or community-wide screening approaches. Full-Text PDF

Identification of mycolic acid forms using surface-enhanced Raman scattering as a fast detection method for tuberculosis.

BackgroundTuberculosis (TB) is the ninth leading cause of death worldwide and the leading cause from a single infectious agent, based on the WHO Global Tuberculosis Report in 2017. TB causes massive health care burdens in many parts of the world, specifically in the resource constrained developing world. Most deaths from TB could be prevented with cost effective early diagnosis and appropriate treatment.PurposeConventional TB detection methods are either too slow as it takes a few weeks for diagnosis or they lack the specificity and accuracy. Thus the objective of this study was to develop a fast and efficient detection for TB using surface enhanced Raman scattering (SERS) technique.MethodsSERS spectra for different forms of mycolic acids (MAs) that are both synthetic origin and actual extracts from the mycobacteria species were obtained by label-free direct detection mode. Similarly, we collected SERS spectra for γ-irradiated whole bacteria (WB). Measurements were done using silver (Ag) coated silicon nanopillar (Ag SNP) as SERS substrate.ResultsWe report the SERS based detection of MA, which is a biomarker for mycobacteria species including Mycobacterium tuberculosis. For the first time, we also establish the SERS spectral characterization of the three major forms of MA – αMA, methoxy-MA, and keto-MA, in bacterial extracts and also in γ-irradiated WB. We validated our findings by mass spectrometry. SERS detection of these three forms of MA could be useful in differentiating pathogenic and nonpathogenic Mycobacterium spp.ConclusionsWe have demonstrated the direct detection of three major forms of MA – αMA, methoxy-MA, and keto-MA, in two different types of MA extracts from MTB bacteria, namely delipidated MA and undelipidated MA and finally in γ-irradiated WB. In the near future, this study could pave the way for a fast and efficient detection method for TB, which is of high clinical significance.

The Practice of Home-based Direct Observer Treatment of Patients with Positive Pulmonary Tuberculosis (DOT – TB) at Kebumen District of Indonesia

Background: Tuberculosis (TB) is a major global health problem, even though TB can be prevented and treated. The WHO Global Tuberculosis Report 2015 reported 1.5 million deaths from TB, of which 1.1 million were TB with HIV-negative and 0.4 million were HIV-positive tuberculosis. As many as 25% of deaths from TB were in productive ages between 15 to 54 years. Low adherence is a major cause of treatment failure, drop-out and the rising number of cases of MDR (Multi Drugs Resistance). Adherence is also a key to improve the cure rate of treatment of TB patients. Home-based Direct Observer Treatment of patients with positive pulmonary Tuberculosis (DOT–TB) or in Bahasa Indonesia also known as Pengawas Minum Obat (PMO) may improve adherence and increase the TB cure rate and success rate. The DOT-TB has tasks to oversee, remind, motivate and assist TB patients who are undergoing the treatment process. Background of DOT–TB in improving adherence needs to be explored by examining their experiences, which can be expressed by using a phenomenological qualitative study to explore the meaning and significance of their experiences. Objectives: This study aimed to explore the efforts of DOT–TB in performing their duties, the constraints arising from these efforts, benefits, and expectations of the DOT–TB position.Methods: This study applied a qualitative approach with descriptive phenomenological methodology. The number of informants were 21 people divided into groups of DOT–TB whose patients were perfectly recovered (7 people), groups of DOT–TB whose patients were drop-out or failed (7 people) and a group of 7 TB programmers. Each group participated in the Focus Group Discussion (FGD) for 90-120 minutes.Results: The results of the study indicate that the presence of DOT–TB is very important and necessary in the management of TB. The biggest challenge of DOT–TBs in performing their duties are communication barriers due to differences in hierarchy and social status in the society. Their sense of hesitancy was a major challenge of DOT–TB in charge. According to respondents, the ideal DOT–TB is someone close to the patients, has patience, compassion, enough knowledge about TB and good communication skills.Conclusions: In order to perform their duties well, DOT–TBs require training concerning tuberculosis and communication.

Beyond the Numbers: Interpreting WHO's Global Tuberculosis Report 2016 to Inform TB Policy and Practice in the East African Community

By 2000, 5 East African Community (EAC) member states—Uganda, Kenya, Tanzania, Rwanda, and Burundi—had adopted the World Health Organization’s (WHO’s) policy of directly observed treatment short-course (DOTS) for tuberculosis (TB). This policy is meant to speed up the control of TB through effective diagnosis and treatment. However, the rate of reduction of TB burden has been slow, and as of 2016, 3 EAC member states—Uganda, Kenya, and Tanzania—are still categorised as high TB burden countries. We analysed WHO’s Global Tuberculosis Report 2016 and drew key lessons to inform policy and practice for effective control of TB. From the report, we acknowledge the existence of national TB control policies operationalised through national TB control programmes in all EAC member states. However, we found persistent underfinancing of the TB control programmes; low national coverage of TB diagnostic and treatment services, meaning that many TB cases are most likely going undetected; and deaths due to lack of treatment. We also found poor reporting practices; for example, there was no data on the number of cases detected with rapid diagnostics in Uganda and Tanzania, which was unexpected since there are more than 170 Xpert MTB/RIF machines for rapid diagnosis of TB in the 2 countries. We recommend comprehensive implementation of existing TB policy, including adequate financing, universal access to diagnosis and treatment, and socioeconomic empowerment of affected communities, all of which are critical for ending TB in East Africa and the world at large.

Beyond the Numbers: Interpreting WHO's Global Tuberculosis Report 2016 to Inform TB Policy and Practice in the East African Community

By 2000, 5 East African Community (EAC) member states—Uganda, Kenya, Tanzania, Rwanda, and Burundi—had adopted the World Health Organization's (WHO's) policy of directly observed treatment short-course (DOTS) for tuberculosis (TB). This policy is meant to speed up the control of TB through effective diagnosis and treatment. However, the rate of reduction of TB burden has been slow, and as of 2016, 3 EAC member states—Uganda, Kenya, and Tanzania—are still categorised as high TB burden countries. We analysed WHO's Global Tuberculosis Report 2016 and drew key lessons to inform policy and practice for effective control of TB. From the report, we acknowledge the existence of national TB control policies operationalised through national TB control programmes in all EAC member states. However, we found persistent underfinancing of the TB control programmes; low national coverage of TB diagnostic and treatment services, meaning that many TB cases are most likely going undetected; and deaths due to lack of treatment. We also found poor reporting practices; for example, there was no data on the number of cases detected with rapid diagnostics in Uganda and Tanzania, which was unexpected since there are more than 170 Xpert MTB/RIF machines for rapid diagnosis of TB in the 2 countries. We recommend comprehensive implementation of existing TB policy, including adequate financing, universal access to diagnosis and treatment, and socioeconomic empowerment of affected communities, all of which are critical for ending TB in East Africa and the world at large.

Targeting PknB, an eukaryotic-like serine/threonine protein kinase of Mycobacterium tuberculosis with phytomolecules

Tuberculosis (TB), caused by Mycobacterium tuberculosis is one of the most lethal communicable disease globally. As per the WHO Global TB Report (2015), 9.6 million cases were reported in year 2014 alone. The receptor-like protein kinase, PknB is crucial for sustained mycobacterial growth. Therefore, PknB can be a potential target to develop anti-tuberculosis drugs. In present study, we performed a comparative study to investigate binding efficacies of three phytomolecules namely, Demethylcalabaxanthone, Cryptolepine hydrochloride and Ermanin. 3D structures of PknB and phytomolecules were retrieved from Protein Data Bank (PDB ID: 2FUM) and PubChem Chemical Compound Database, respectively. PknB was set to be rigid and phytochemicals were kept free to rotate. All computational simulations were carried out using Autodock 4.0 on Windows platform. In-silico study demonstrated a strong complex formation (large binding constants and low ΔG) between phytomolecules and target protein PknB of Mycobacterium tuberculosis. However, Demethylcalabaxanthone was able to bind PknB more strongly (Kb=6.8×105M−1, ΔG=−8.06kcal/mol) than Cryptolepine hydrochloride (Kb=3.06×105M−1, ΔG=−7.58kcal/mol) and Ermanin (Kb=9.8×104M−1, ΔG=−6.9kcal/mol). These in silico analysis indicate that phytomolecules are capable to target PknB protein efficiently which is vital for mycobacterial survival and therefore can be excellent alternatives to conventional anti-tuberculosis drugs.

Trends in Tuberculosis Epidemiology among Children in the Democratic Republic of Congo

Setting: The epidemiology of tuberculosis (TB) among children in the Democratic Republic of Congo (DRC) is not well known. Objective: This study aimed to describe the trends in TB epidemiology among children in the DRC and to compare these trends in children and adults. Design: Data from the National TB program, the WHO Global TB Report, and a demographic survey of health in the DRC were retrospectively analyzed. The study period was from 1995 to 2014. The notification rate, absolute incidence and incidence rate of TB per 100,000 population were reported. Results: In 2014, 12,785 (12.6% of adult cases) TB cases were reported in children and 101,303 in adults. Among children, 3438 (26.89%) had PTB+; 2828 (22.11%) had PTB–; and 6519 (50.98%) had extrapulmonary TB (EPTB). Children under 5 years had a lower reported prevalence of TB (184 cases). The incidence rate per 100,000 population was 10 in children and 181 in adults. The TB incidence decreased between 2010 (11.47) and 2014 (10.46). The proportion of children in overall cases of PTB+ was 4% to 5% in all districts. Conclusion: Caring for childhood TB remains a challenge in the DRC. Improved diagnostic procedures and effective training of providers who care for childhood TB are needed.