TB TW ID etc.

d'Elbée, M., Harker, M., Mafirakureva, N., Nanfuka, M., Nguyet, M.H.T.N., Taguebue, J.V., Moh, R., Khosa, C., Mustapha, A., Mwanga-Amumpere, J. and Borand, L., 2024. Cost-effectiveness and budget impact of decentralising childhood tuberculosis diagnosis in six high tuberculosis incidence countries: a mathematical modelling study.  EClinicalMedicine ,  70 , p.102528. Diagnosing tuberculosis (TB) in children is challenging due to difficulties in collecting sputum samples and the paucibacillary nature of pulmonary TB in children. Alternative specimen collection methods like induced sputum and gastric aspirate require specialized equipment and trained personnel, which are often unavailable at primary health centers (PHC) and sometimes even at district hospitals (DH). As a result, many children with symptoms suggestive of TB do not receive appropriate diagnostic tests, even at the DH level. Stool samples can be collected more easily in young children across various settings and can be u

Fuady, A., Hutanamon, T., Herlinda, O., Luntungan, N. and Wingfield, T., 2024. Achieving universal social protection for people with tuberculosis.  The Lancet Public Health ,  9 (5), pp.e339-e344. Global tuberculosis strategies focus more on biomedical approaches, with little emphasis on poverty alleviation and socioeconomic support, despite the recognized importance of social protection. Advocacy still favors biomedical investment, risking that commitments to social protection remain rhetorical due to underinvestment. Universal health coverage (UHC) lacks provisions to protect individuals from the socioeconomic impacts of tuberculosis, such as income loss, unemployment, and associated costs like transportation and accommodation. UHC also neglects broader social determinants like stigma and discrimination related to tuberculosis, focusing mainly on health-care access. There is a need for universal health and social coverage (UHSC), which integrates health and social care policies, gove

Tariq, M., Zafar, S., Waheed, A., Afzal, N., Razzaq, R. and Batool, F., 2023. Prevalence of Various Forms of Active Tuberculosis in Patients with Diabetes. THE THERAPIST (Journal of Therapies & Rehabilitation Sciences), pp.33-37. Pathophysiological Mechanisms Linking Diabetes Mellitus (DM) to Tuberculosis (TB): Diminished cellular immunity in DM patients. Impaired alveolar macrophage function. Reduced interferon gamma levels. Pulmonary microangiopathy. Inadequate micronutrient levels. Bidirectional Relationship Between TB and DM: TB and DM coexistence highlights the interaction between a communicable and a non-communicable disease. The co-occurrence is particularly significant in low and middle-income nations. Increased TB Risk in DM Patients: Higher prevalence of various forms of active tuberculosis in patients with diabetes. DM exacerbates the burden of TB, creating a dual health challenge.  

Kirimi, E.M., Muthuri, G.G., Ngari, C.G. and Karanja, S., 2024. A Model for the Propagation and Control of Pulmonary Tuberculosis Disease in Kenya. Discrete Dynamics in Nature and Society, 2024(1), p.5883142. Increasing the screening of asymptomatic and latently infected individuals reduces infection transmission to susceptible populations. The combination of vaccination, screening, and treatment of all forms of pulmonary tuberculosis is the most effective intervention for reducing disease transmission. A combination of screening and treatment for all forms of pulmonary tuberculosis is more effective than combining vaccination with treatment of only symptomatic individuals. Treating only the symptomatic population is identified as the least effective intervention for curtailing infection transmission. More attention should be directed towards screening and treating latent infections and asymptomatic infectious populations. Screening and treating latent infections reduce the development

Wulandari, D.A., Hartati, Y.W., Ibrahim, A.U. and Pitaloka, D.A.E., 2024. Multidrug-resistant tuberculosis. Clinica Chimica Acta, 559, p.119701. Multidrug-resistant tuberculosis (MDR-TB) is defined by resistance to at least rifampicin (RIF) and isoniazid (INH). MDR-TB arises from inadequate treatment practices, such as incomplete treatment, insufficient drug doses and durations, poor drug quality, and transmission from individuals with drug-resistant TB. Resistance in MTB (Mycobacterium tuberculosis) results from spontaneous chromosomal mutations. There are ten gene variants linked to resistance against first-line anti-TB medications, including katG, inhA, ahpC, kasA, and Ndh for INH, and rpoB for RIF. Drug resistance occurs primarily through two mechanisms: primary resistance from exposure to a resistant MTB strain and secondary resistance due to poor treatment adherence. Classification of Drug-Resistant TB Mono-resistant TB: Resistant to one first-line anti-TB drug only. Isoniazid-r

Lin, H.H., Dowdy, D., Dye, C., Murray, M. and Cohen, T., 2012. The impact of new tuberculosis diagnostics on transmission: why context matters. Bulletin of the World Health Organization, 90, pp.739-747. Faster Decline in Tuberculosis Burden: The use of a new diagnostic tool is expected to reduce the burden of pulmonary tuberculosis more rapidly compared to continued reliance on smear microscopy. Influence of Contextual Factors: The impact of the new diagnostic tool on tuberculosis epidemiology is significantly influenced by contextual factors that are unrelated to the tool's performance. Greatest Impact in Certain Settings: The epidemiological impact of the new tool is most significant in areas where access to tuberculosis care is good but where existing diagnostic strategies have low sensitivity, such as limited access to chest X-rays for smear-negative cases. Lesser Impact in Equipped Laboratories: The new diagnostic tool may have a lesser impact at the population level if implem

Lestari, B.W., Nijman, G., Larasmanah, A., Soeroto, A.Y., Santoso, P., Alisjahbana, B., Chaidir, L., Andriyoko, B., Van Crevel, R. and Hill, P.C., 2024. Management of drug-resistant tuberculosis in Indonesia: a four-year cascade of care analysis. The Lancet Regional Health-Southeast Asia, 22:100294. Low Identification and Diagnosis: Only about a third of estimated TB cases at risk of DR-TB were identified and reported, with only a tenth of the estimated true DR-TB cases diagnosed. Inadequate Diagnostic Support: Approximately half of the treatment regimens were supported by phenotypic drug susceptibility testing (pDST). High Unsuccessful Treatment Outcomes: Nearly half of all patients initiating treatment had an unsuccessful outcome. Significant Delays in Treatment: Delays between diagnosis and treatment were substantial, particularly for patients living further away, those with employment, and those with a history of private sector engagement. Impact of Undetected DR-TB: Undetecte

Lin, H.H., Ezzati, M., Chang, H.Y. and Murray, M., 2009. Association between tobacco smoking and active tuberculosis in Taiwan: prospective cohort study. American journal of respiratory and critical care medicine, 180(5), pp.475-480. ·        Current smoking is associated with a twofold increase in active TB risk compared to never-smokers, with the risk escalating based on the number of cigarettes, years of smoking, and pack-years. ·        Smoking accounts for 17% of TB cases in the studied population, highlighting its significant contribution to TB incidence. ·        The risk of TB is higher in current smokers than in former smokers, suggesting a reduced hazard among those who quit smoking. ·        The risk of smoking-related TB is greater in individuals under 65, potentially due to early depletion of susceptible populations among older smokers. ·        Smoking impairs key pulmonary defense mechanisms, increasing susceptibility to TB upon exposure to the pathogen.

Lin, H., Shin, S., Blaya, J.A., Zhang, Z., Cegielski, P., Contreras, C., Asencios, L., Bonilla, C., Bayona, J., Paciorek, C.J. and Cohen, T., 2011. Assessing spatiotemporal patterns of multidrug-resistant and drug-sensitive tuberculosis in a South American setting. Epidemiology & Infection, 139(11), pp.1784-1793. Geographic information enhances understanding of the spatial and temporal spread of TB and aids in documenting MDR TB outbreaks. Spatiotemporal analysis alone does not reveal the mechanisms behind increased MDR TB transmission. The low cost of georeferencing tools and free software like Google Earth makes this approach appealing for resource-limited settings. Integrating spatial data into standard TB collection tools can improve early, targeted interventions, leading to timely treatment and reduced MDR TB transmission.  

Lin, H.H., Langley, I., Mwenda, R., Doulla, B., Egwaga, S., Millington, K.A., Mann, G.H., Murray, M., Squire, S.B. and Cohen, T., 2011. A modelling framework to support the selection and implementation of new tuberculosis diagnostic tools. The International journal of tuberculosis and lung disease, 15(8), pp.996-1004. · Different diagnostic strategies may be more effective in regions with varying levels of HIV-associated or drug-resistant TB and differing healthcare infrastructure. · Tests that don't require multiple visits can reduce patient costs and minimize follow-up losses. · Early detection of TB may lead to better treatment outcomes for patients. · New diagnostic tools might reduce delays in the lab but could create new bottlenecks in other parts of the healthcare system. · Changes in diagnostic patterns can shift demand in other areas of the health system. · While accurate diagnostic tools are important, they alone won't guarantee bet

van Crevel, R.; Critchley, J.A. The Interaction of Diabetes and Tuberculosis: Translating Research to Policy and Practice. Trop. Med. Infect. Dis. 2021, 6, 8. Increased Risk : People with diabetes have a 2–3 times higher risk of developing TB compared to non-diabetic individuals. Altered TB Presentation : Diabetes alters TB symptoms, with more severe presentations, higher TB scores, more cavitation, and a longer time to achieve smear or culture negativity. Worsened Treatment Outcomes : Diabetes, especially when poorly controlled, worsens TB treatment outcomes, including doubling the risk of death during treatment. Increased Bacterial Load : Diabetes may increase the bacterial load of Mycobacterium tuberculosis, leading to prolonged infectiousness. Screening Challenges : Screening diabetes patients for TB may have low yield, except in high TB incidence areas. Risk scores for identifying undiagnosed diabetes among TB patients need further validation. Drug Interactions : Rifampicin increa

Park, S.W., Shin, J.W., Kim, J.Y., Park, I.W., Choi, B.W., Choi, J.C. and Kim, Y.S., 2012. The effect of diabetic control status on the clinical features of pulmonary tuberculosis. European journal of clinical microbiology & infectious diseases, 31, pp.1305-1310. TB patients with diabetes (DM) were older, predominantly male, and had more comorbidities like hypertension and cardiovascular disease compared to those without DM. No differences in symptoms, radiographic findings, or AFB positivity on sputum smear tests between controlled diabetics and non-diabetics. Diabetic TB patients had more cavities, especially in uncontrolled diabetics, but no differences in the number of involved lobes or location of involvement. Higher AFB positivity on sputum smear in TB patients with DM (59.5%) vs. without DM (40.4%), with uncontrolled diabetics showing an even higher rate (65.8%). Uncontrolled diabetes was linked to more cavities and higher rates of positive culture conversion at two months.

Baker, M.A., Lin, H.H., Chang, H.Y. and Murray, M.B., 2012. The risk of tuberculosis disease among persons with diabetes mellitus: a prospective cohort study. Clinical Infectious Diseases, 54(6), pp.818-825. Diabetes mellitus (DM) increases the risk of developing tuberculosis disease. DM shares several risk factors for tuberculosis, including older age, unemployment, and low educational status. Patients with more severe DM are at a higher risk for tuberculosis. The mechanisms by which DM increases susceptibility to tuberculosis (and possibly other infectious diseases) are not yet well understood. Tuberculosis elimination efforts must include a focus on DM, a prevalent condition expected to increase in many areas with high and moderate tuberculosis burdens. Abstract Background : Evidence suggests a causal link between diabetes mellitus and tuberculosis risk. However, to date, few studies have used a prospective design to estimate the impact of diabetes on tuberculosis in a general popul

Manjourides, J., Lin, H.H., Shin, S., Jeffery, C., Contreras, C., Santa Cruz, J., Jave, O., Yagui, M., Asencios, L., Pagano, M. and Cohen, T., 2012. Identifying multidrug resistant tuberculosis transmission hotspots using routinely collected data. Tuberculosis, 92(3), pp.273-279. Identification of MDRTB transmission hotspots in parts of the study area is crucial. Resources to interrupt the transmission of resistant disease should be prioritized in these regions. Further investigation, such as a molecular epidemiological study, might validate these findings and identify causes or specific high-risk locations. Possible reasons for higher transmission in these areas: Delayed diagnosis and treatment of infectious MDRTB patients Higher population density or more respiratory contacts Circulation of particularly transmissible MDR strains Detecting high-risk areas suggests that geographically targeted interventions could be effective. Programmatically, resources for detecting and treating MDRT

Lee C-H, Lee M-C, Lin H-H, Shu C-C, Wang J-Y, et al. (2012) Pulmonary Tuberculosis and Delay in Anti-Tuberculous Treatment Are Important Risk Factors for Chronic Obstructive Pulmonary Disease. PLoS ONE 7(5): e37978. doi:10.1371/journal.pone.0037978 [TB0045] ·        Tuberculosis (TB) is an independent and long-lasting risk factor for developing chronic obstructive pulmonary disease (COPD). ·       The impact of TB on the risk of developing COPD is sustained for at least six years after TB diagnosis. ·       There is a dose-response relationship between delay in anti-TB treatment and the risk of developing COPD. ·       Delayed treatment can aggravate airway destruction and accelerate the development of COPD. ·       Early diagnosis of pulmonary TB and prompt initiation of appropriate anti-TB treatment are imperative. Improving the quality of TB diagnosis and treatment may help prevent some COPD cases. ·       Clinicians should maintain a high index of suspicion for COPD in pa

Langley, I., Doulla, B., Lin, H.H., Millington, K. and Squire, B., 2012. Modelling the impacts of new diagnostic tools for tuberculosis in developing countries to enhance policy decisions. Health care management science, 15, pp.239-253. [TB0044] Different diagnostic strategies for tuberculosis (TB) may vary in cost-effectiveness based on local factors such as prevalence of HIV, drug resistance, and access to health facilities. The discrete-event simulation (DES) tool helps assess diagnostic methods, particularly for multidrug-resistant TB (MDR-TB), at central reference facilities. DES is useful for policymakers to evaluate the impact of TB diagnostic tools in resource-limited settings, enhancing decision-making processes. Incorporating a disease transmission component into the DES enhances the model’s predictive capabilities, providing insights into TB incidence and its effects on health system and patient outcomes. A visual and interactive DES tool aids national policymakers in valida