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Who: The study involved diabetic mellitus (DM) patients aged 15 years and older attending selected public health facilities in Ethiopia, with 14,119 DM patients screened for tuberculosis (TB) and 652 symptomatic individuals enrolled; participants were predominantly female, urban residents, and living mainly with type II DM, many with long-standing disease and multiple comorbidities.
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What: The study found a high TB burden among DM patients, with an overall TB prevalence of 11.2% among TB-presumptive individuals and a point prevalence of 517 per 100,000 among all screened DM patients; pulmonary TB was most common, and younger age, cigarette smoking, contact with TB cases, HIV infection, poor glycemic control, insulin-only treatment, and longer duration of diabetes were independently associated with TB.
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When: Data were collected over a one-year period from January to December 2023.
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Where: The study was conducted in 11 public health facilities across five regions of Ethiopia—Oromia, Southern Ethiopia, Sidama, Addis Ababa, and Dire Dawa—with laboratory confirmation performed at the national reference laboratory.
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Why: The research aimed to address limited national evidence on the epidemiology of TB among diabetic patients in Ethiopia, a setting with high TB endemicity and a rising burden of diabetes, to inform integrated TB–DM screening and prevention strategies.
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How: A multicenter cross-sectional design was used, incorporating symptom-based TB screening, standardized questionnaires, and laboratory diagnostics including smear microscopy, culture, and Xpert MTB/RIF Ultra assays, with multivariable logistic regression applied to identify factors independently associated with TB.
Who
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Participants: Close contacts of pulmonary or laryngeal tuberculosis (TB) cases in Singapore
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Population size:
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22,355 contacts attended screening
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19,397 had valid QFT-Plus results
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Eligibility: Immunocompetent individuals ≥5 years old (QFT-Plus); immunocompromised contacts received T-SPOT.TB; children <5 years received TST
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Key subgroups:
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Contacts with TB disease
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“Stringent Converters” (recent TB infection)
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All others with TB infection (likely remote infection)
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What
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Study focus: Evaluation of the CD8⁺ T-cell response measured by the QFT-Plus assay for its ability to:
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Predict active TB disease
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Identify recent TB infection (TBI)
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Key findings:
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TB disease and recent TBI (stringent conversion) were significantly associated with stronger CD8⁺ responses (TB2–TB1 IFN-γ >0.6 IU/mL)
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TB2 tube responses increased diagnostic sensitivity for TB disease (from 84.6% to 95.2%)
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Higher IFN-γ levels in TB1 and TB2 tubes were observed in TB disease and recent TBI compared with other TBI cases
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Conclusion: CD8⁺ IFN-γ responses in QFT-Plus may help identify individuals at higher risk of TB disease or recent infection who could benefit from further investigation or TB preventive treatment (TPT)
When
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Data collection period: January 2018 to October 2018
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Relevant program timeline:
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TPT implemented since 1998
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QFT-GIT introduced from 2006
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QFT-Plus used from December 2017
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Where
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Setting: Nationwide TB contact screening in Singapore
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Clinical site: TB Contact Clinic (TBCC)
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Laboratory: Tan Tock Seng Hospital Microbiology Laboratory
Why
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To improve identification of:
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Individuals with active TB disease
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Those with recent TB infection, who are at higher risk of progression
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To assess whether CD8⁺ responses in QFT-Plus add value beyond standard IGRA positivity in a setting with high background TB infection
How
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Study design: Retrospective observational analysis
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Testing strategy:
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Initial and post-window QFT-Plus testing (≥8 weeks after exposure)
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Chest radiography for IGRA-positive or high-risk contacts
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Key definitions:
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Stringent Converters: IFN-γ increase from <0.35 to >0.7 IU/mL, excluding results in the uncertainty zone
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CD8⁺ response: TB2–TB1 IFN-γ difference >0.6 IU/mL