Search

aim,3,4 Ioana Munteanu,2,3,6 Cristina Popa,2,3 Mădălina Burecu,2,3 Paula Rusu,3 Andreea Cioacată,2 Ioana Mădălina Moșteanu,2,7 Antonela Dragomir1– 31Pneumology II Department, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; 2Pneumology Clinic, "Marius Nasta" Institute of Pneumology, Bucharest, Romania; 3Tuberculosis Screening Program, "Marius Nasta" Institute of Pneumology, Bucharest, Romania; 4Research Department, "Marius Nasta" Institute of Pneumology, Bucharest, Romania; 5Faculty of Economic Cybernetics, Statistics and Informatics, The Bucharest University of Economic Studies, Bucharest, Romania; 6Faculty of Medicine, "Titu Maiorescu" University, Bucharest, Romania; 7Faculty of Medicine, University of Medicine and Pharmacy Craiova, Craiova, Romania Correspondence: Dragoș Băiceanu; Alexandru Stoichiță, "Marius Nasta" Institute of Pneumology, 90 Viilor Street, Bucharest, 050159, Romania, Tel +4 0749 574 412, Email [email protected] ; [email protected] Introduction: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) in kidney transplant (KT) recipients is an important opportunistic infection with higher incidence and prevalence than in the general population and is associated with important morbidity and mortality. We performed an extensive literature review of articles published between 1 January 2000 and 15 June 2022 to provide an evidence-based review of epidemiology, pathogenesis, diagnosis, treatment and outcomes of TB in KT recipients. We included all studies which reported epidemiological and/or outcome data regarding active TB in KT, and we approached the diagnostic and treatment challenges according to the current guidelines. Prevalence of active TB in KT recipients ranges between 0.3–15.2%. KT recipients with active TB could have a rejection rate up to 55.6%, a rate of graft loss that varies from 2.2% to 66.6% and a mortality rate up to 60%. Understanding the epidemiological risk, risk factors, transmission modalities, diagnosis and treatment challenges is critical for clinicians in providing an appropriate management for KT with TB. Among diagnostic challenges, which are at the same time associated with delay in management, the following should be considered: atypical clinical presentation, association with co-infections, decreased predictive values of screening tests, diverse radiological aspects and particular diagnostic methods. Regarding treatment challenges in KT recipients with TB, drug interactions, drug toxicities and therapeutical adherence must be considered. [ABSTRACT FROM AUTHOR]