1. Clinical Prognostic Indicators & Treatment Monitoring
- BMI recovery during M/XDR-TB treatment was a strong predictor of survival; nearly 70% of patients gained weight, and lack of weight gain (especially among underweight and normal BMI patients) was linked to a fivefold increase in mortality.
- Early weight change during treatment (3–6 months) emerged as a potential independent prognostic factor for survival.
- Highlights the importance of integrating BMI monitoring and nutritional interventions into TB programs.
See also: Hsien-Ho Lin TB Lab
2. Diagnostic Advancements and Test Performance
- GeneXpert enabled rapid, accurate TB and rifampicin resistance detection within two hours, supporting early treatment.
- Second-generation IGRAs showed superior sensitivity (~90%) and fewer indeterminate results compared to traditional IGRAs, especially in smear-negative and extrapulmonary TB cases.
- Lower false negatives and improved performance across HIV and diabetes patients make these new IGRAs promising for routine use.
See also: Jago Beasiswa
3. TB and Comorbidity Management (Diabetes Focus)
- Historical and current data affirm that diabetes significantly increases TB risk, especially with poor glycemic control.
- Dual burden (TB-DM) remains prevalent in high-incidence regions, necessitating integrated care approaches.
- Evidence also suggests bidirectional interaction, with TB potentially worsening glucose tolerance.
4. Early Detection Strategies & Screening Value
- Two-way TB screening among DM patients using symptom checklists and imaging uncovered TB cases that might be missed in routine care.
- Even with a low confirmation rate, the study demonstrated operational feasibility and value of systematic screening in high-risk populations.
- Reinforces the need to combine symptoms, imaging, and sputum tests for robust case identification.
5. Biomarker and Immunologic Insights
- A 16-gene transcriptomic signature (COR) was successfully validated for predicting TB progression in two African cohorts.
- The COR signature, regulated by type I and II interferons, suggests interferon activity as a preclinical marker for TB.
- Transition from RNA-seq to PCR-based platforms makes gene expression tools more accessible for broader screening and risk stratification.
References:
- Chakhaia, T., Blumberg, H.M., Kempker, R.R., Luo, R., Dzidzikashvili, N., Chincharauli, M., Tukvadze, N., Avaliani, Z., Stauber, C. and Magee, M.J., 2025. Lack of weight gain and increased mortality during and after treatment among adults with drug-resistant tuberculosis: a retrospective cohort study in Georgia, 2009–2020. ERJ Open Research.
- Hariyanto, S.W., Avidati, H., Ulfah, U., Nurlaily, A.N. and Tejaningrum, K.D., Tuberculosis Screening in Patients with Diabetes Mellitus at the Internal Medicine Clinic of UGM Academic Hospital: Descriptive Study. Academic Hospital Journal, 7(1), p.8.
- Petruccioli, E., Scriba, T.J., Petrone, L., Hatherill, M., Cirillo, D.M., Joosten, S.A., Ottenhoff, T.H., Denkinger, C.M. and Goletti, D., 2016. Correlates of tuberculosis risk: predictive biomarkers for progression to active tuberculosis. European Respiratory Journal, 48(6), pp.1751-1763.
- Wati, N., Mu’awanah, I.A.U. and Amalia, A.A., 2024. Pulmonary Tuberculosis Incidence Rate with Genexpert Examination Method at Mlati II Public Health Center, Sleman In 2020-2023. International Journal of Health, Economics, and Social Sciences, 6(4), pp.1124-1129.
- Cadena, J., Rathinavelu, S., Lopez-Alvarenga, J.C. and Restrepo, B.I., 2019. The re-emerging association between tuberculosis and diabetes: lessons from past centuries. Tuberculosis, 116, pp.S89-S97.
- Whitworth, H.S., Badhan, A., Boakye, A.A., Takwoingi, Y., Rees-Roberts, M., Partlett, C., Lambie, H., Innes, J., Cooke, G., Lipman, M. and Conlon, C., 2019. Clinical utility of existing and second-generation interferon-γ release assays for diagnostic evaluation of tuberculosis: an observational cohort study. The Lancet Infectious Diseases, 19(2), pp.193-202.
Yoseph Leonardo Samodra
TBC 069
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