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Though many initiatives and monetary benefits are incorporated under RNTCP/NTEP, many patients might incur some out-of-pocket expenditure (OOP) related to diagnosis, treatment, and hospitalization. Such costs lead to further poverty and default. This study estimated OOP costs. A cross-sectional mixed method study was conducted in 2020. Data were collected from two selected UHCs (both public and private sectors) from all eight administrative zones. A total of 278 newly registered drug-sensitive tuberculosis patients at different stages of treatment were enrolled, and 18 IDIs were done after obtaining the consent. Among 278, 231 (83%) were seeking the treatment from the public sector and 47 (17%) from the private sector. The average direct, indirect, and total costs were Rs. 8812, Rs. 4825, and Rs. 13,637, respectively. Extra food and supplements are the major field of expenditure for those enrolled in the public sector. Higher costs were incurred by the private sector patients. Longer distances, a long waiting time, belief systems, and unavailability of facilities or drugs were the common reasons for not visiting the public sector. IDI results also supported the cost heads. The majority of the expenses occurred at the private settings before diagnosis. IDIs suggested to changes in the programmatic approach toward migrants, industrial workers, and women. [ABSTRACT FROM AUTHOR]

In histories of preventing and treating tuberculosis, many physicians came to prioritize the place and role of the home by the late nineteenth and early twentieth centuries. This was as true in the West as it was in the late Ottoman Empire. Also common, practices of scapegoating the poor and other marginalized populations as TB's sources and carriers were pervasive. In this article, we examine how ideas of health, TB, and home converged to accentuate class in the ostensibly objective public health literature and propaganda of late Ottoman and early republican Turkey. Analyzing both textual and graphic narratives found in primary sources written in Ottoman Turkish, our study explores how officials – lacking resources and alternatives – opted to pursue ambitious public health propaganda campaigns to at least achieve broad educational inoculation of the population. In doing so, rudimentary matters of treatment were taught and legislated in ways that aligned with the contemporary propagation of national citizenship. [ABSTRACT FROM AUTHOR]

Background: Family support in patients with tuberculosis (TB) in a concept that does not have definition and attributes that clarify the evolution of the concept, its usefulness, and practicality in the context of science. Objective: To clarify the progress of the concept of family support in patients with TB in the nursing area through the concept analysis technique. Data Source: We searched the databases MEDLINE (via PubMed), EMBASE, Google Scholar, ScienceDirect, Ovid Nursing, and Scopus. The keywords used were "family support," "tuberculosis," and "nursing" combined with the Boolean operator "AND" as follows: ((family support) AND (tuberculosis)) AND (nursing). Method of Revision: The method of concept analysis proposed by Hupcey and Morse was used, which consists of four principles: epistemological, linguistic, logical, and pragmatic. Results and Discussion: Epistemologically, it was established that family support offers a positive influence that facilitates and strengthens interrelationships with the other; linguistically, it was found that its definition as support and trust is consistent with the literature; logically, it was determined that there are theories that address family support and family interrelationships as a priority source for treatment; and in the pragmatic, the maturity of the concept is not declared, but the presence of empirical indicators that validate the attributes in science is declared. Conclusion: The use of the methodology contributed to the identification of the attributes of the concept and some definitions, instruments, and usefulness in different disciplines. [ABSTRACT FROM AUTHOR]

Background: India, with the highest global burden of tuberculosis (TB) and drug-resistant TB, aims to eliminate TB by 2025. Yet, limited evidence exists on drug resistance patterns and retreatment among patients with silico-tuberculosis. This study explores these patterns and assesses the impact of silicosis on TB retreatment in India. Methods: This secondary data analysis stems from a larger retrospective cohort study conducted in Khambhat, Gujarat, between January 2006 and February 2022. It included 138 patients with silico-tuberculosis and 2,610 TB patients without silicosis. Data from the Nikshay TB information portal were linked with silicosis diagnosis reports from the Pneumoconiosis Board using the unique Nikshay ID as the linking variable. Drug-resistant TB was defined as resistance to any anti-TB drug recorded in Nikshay. Retreatment refers to TB patients who have previously undergone anti-TB treatment for one month or more and need further treatment. Recurrent TB denotes patients who were previously declared cured or had completed treatment but later tested positive for microbiologically confirmed TB. Multivariable logistic regression was used to determine the impact of co-prevalent silicosis on drug resistance and retreatment. Results: Patients with silico-tuberculosis showed a higher proportion of retreatment compared to those without silicosis (55% vs. 23%, p < 0.001). Notably, 28% of patients with silico-tuberculosis were recurrent TB cases, compared to 11% among those without silicosis. Regarding drug resistance, the silico-tuberculosis group exhibited a higher rate (6% vs. 3%), largely due to rifampicin resistance (5% vs. 2%, p = 0.022). Co-prevalent silicosis was associated with a 2.5 times greater risk of drug-resistant TB (adjusted OR 2.5, 95% CI, 1.1–5.3; p = 0.021). Additionally, patients with silico-tuberculosis had a fourfold increased risk of retreatment for TB (adjusted OR 4, 95% CI, 3–6; p < 0.001). Conclusions: Co-prevalent silicosis significantly elevates the risk of drug resistance, recurrence, and retreatment among TB patients in India. This study indicates a need for improved treatment protocols and suggests that future research should focus on randomized controlled trials to evaluate appropriate anti-TB regimen and duration of therapy for this high-risk group. Given India's goal to eliminate TB by 2025, addressing the challenges posed by silico-tuberculosis is critical. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Lifestyle modifications (LM) are crucial in managing comorbid Tuberculosis (TB) and Diabetes Mellitus (DM) patients, significantly impacting treatment outcomes and overall health. In view of this, a study was conducted to clarify sociocultural features associated with LM among TB–diabetes comorbid patients. Methods: A cross-sectional descriptive study among randomly selected 180 adult TB–diabetes-comorbid-patients was conducted using a semi-structured interview schedule. Mann–Whitney-U-test was used to examine differences in means between patterns of distress (PDs) and perceived causes (PCs) regarding TB and Diabetes for two identified LM strategies among comorbid patients. Stepwise logistic regression was used to study factors associated with these LM strategies. Results: TB–diabetes-comorbid-patients reporting physical symptoms as PDs preferred to follow the LM-1 strategy for TB and LM-2 for Diabetes. In contrast, patients reporting health-illness-injury-related causes follow LM-2 for TB and LM-1 for Diabetes. Further patients reporting hypertension for Diabetes (AOR = 2.916, 95% CI 0.9262–9.1788) and concerns-about-the-course-of-TB-illness (AOR = 3.746, 95% CI 1.4683–9.5593) as PDs were 3–4 times more likely to follow LM-1. While those reporting prior illnesses (AOR = 4.255, 95% CI 1.3941–12.9837) and sanitation (AOR = 5.242, 95% CI 1.2028–22.8446) as PCs for TB were 4–5 times follow LM-2. Patients who perceived consumption of alcohol as PCs of Diabetes were 10 times more likely to stop addictions (AOR = 9.680, 95% CI 2.5555–36.6639) and follow the LM-2 strategy. Conclusion: Given significant associations of sociocultural features with LM strategies, consideration of sociocultural features vis-à-vis these strategies is indispensable for managing TBDM comorbidity, emphasizing the need for developing comprehensive, patient-centred self-management interventions to enhance adherence and improve health outcomes. [ABSTRACT FROM AUTHOR]

Amid the global health crisis instigated by COVID-19, the resurgence of tuberculosis (TB) has underscored the urgent need for innovative solutions. With TB claiming 1.6 million lives in 2021, it remains a formidable challenge, particularly in underdeveloped regions. Central to Mycobacterium tuberculosis (Mtb) pathogenesis is the decaprenylphosphoryl-β-D-ribose oxidase (DprE1)/decaprenylphosphoryl-2-keto-β-D-erythropentose reductase (DprE2) complex, pivotal for synthesizing decaprenylphosphoryl-arabinofuranose (DPA), a critical component of mycobacterial cell walls. DprE1 has emerged as a prime therapeutic target, with several inhibitors in clinical trials. This review elucidates the indispensability of DprE1, examines existing ligands, and delineates key considerations for the development of next-generation anti-TB therapeutics. Our analysis highlights the potential of DprE1 inhibitors to revolutionize TB treatment, emphasizing the need for continued research and development in this area to address the evolving landscape of TB and drug resistance. [ABSTRACT FROM AUTHOR]

Context Nutritional interventions substantially improve tuberculosis (TB) treatment outcomes and prevent complications. However, there is limited evidence about the connections between having nutritional support and TB treatment adherence. Objective The aim of this study was to determine the effectiveness of nutritional support in improving treatment adherence among patients with TB. Data Sources Databases, including PubMed, Embase (Ovid), Web of Science, and Scopus, were comprehensively reviewed to identify relevant studies reporting the impacts of nutritional support on TB treatment adherence. Data Extraction Two authors independently screened the title, abstracts, and full article texts to identify eligible studies and assess the risk of bias. Observational and interventional studies were included. Data Analysis A narrative synthesis approach was used to summarize the findings qualitatively. Results From the search, 3059 publications were identified; of these, 8 studies were included in this systematic review. Three types of nutritional interventions were identified: food baskets (eg, energy, micronutrient- or macronutrient-enriched food support), nutritional advice and guidance, and incentives for buying foods. Although 5 studies reported that nutritional support significantly improved treatment adherence in patients with TB, 3 studies showed that nutritional support had no effect on TB treatment adherence. Conclusions Providing nutritional support may improve adherence to TB treatment. However, more well-powered, high-quality trials are warranted to demonstrate the effect of nutrition support on cost-effectively improving adherence to TB treatment. Systematic Review Registration PROSPERO registration no. CRD42023392162. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) in children under 15 years often results in airway compression, with bronchus intermedius (BI) being the most common site. Endoscopic enucleations can be used to remove lymph nodes and establish an airway in severe cases. Both rigid and flexible bronchoscopy are suitable, with alligator forceps being preferred for its ability to extract tissue. Recent studies have also explored cryoprobe enucleation. Case Presentation: An HIV-positive boy with persistent symptoms after 9 months of TB treatment was diagnosed based on his mother's and sister's Xpert MTB/RIF positive status. He was started on 4-drug TB treatment, but the child remained clinically symptomatic with abnormal chest X-ray and unconfirmed TB. Bronchoscopy was performed, revealing complete obstruction of BI due to caseating granulomas causing collapse of the right middle and lower lobes. Cryotherapy was used to recanalize the airway, and follow-up bronchoscopy confirmed patent BI. Conclusion: While cryotherapy was effective in the restoration of airway patency in this case, there is a lack of knowledge about its use in children. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary tuberculosis (PTB) remains a life-threatening disease in Tanzania, with negative physical, financial, economic and psychosocial consequences to individuals and the society. It mainly lowers the quality of life of patients, survivors and their families, especially those in the poorest and socially deprived categories. Objectives: To report and discuss a qualitative study that assessed the nature of social support desired and received by PTB patients and survivors. Participants were given a chance to share their experiences and their perceptions on whether the social support they desired had an impact on their treatmentseeking behaviour and treatment adherence. Methods: Face-to-face interviews were conducted with the three aforementioned groups, purposively selected at a TB clinic between October 2020 and March 2021. The questions covered topics related to the types of social support desired and the sources of support during and after treatment, if any. Interviews were concluded until no new information was obtained. Data analysis was facilitated using NVivo 12 software. Results: Participants pointed out a need for psychosocial, financial, and material support during and after treatment. However, they sometimes miss support from family/household members or the rest of the community. Because of this experience, they lived with difficulties, facing hardships when required to pay out of pocket for transport during the care-seeking. Survivors testified experience of a denial of support by even their close relatives who regarded them as no longer needing it after recovering. Patients and survivors also reported experience of social isolation as they were believed able to transmit PTB infections. Limited psychological support at the contacted TB clinics was another experience reported. TB clinic staff's experiences confirmed almost all the experiences shared by their clients. With limited support, resilience and self-care were identified as key mechanisms for coping. Conclusion: Complete recovery from PTB is possible, but reverting to a normal life is difficult without social support. Policies and programs need to increase opportunities for social support for TB patients and survivors. Doing so is likely to improve TB-related treatment, care-seeking practices, and adherence. [ABSTRACT FROM AUTHOR]

In the context of the evolving global health landscape shaped by the COVID-19 pandemic, tuberculosis (TB) is gaining renewed attention as a reemerging threat even in low-endemic countries. Immunological tests such as the tuberculin skin test (TST) and interferon-gamma release assay (IGRA) are pivotal in identifying tuberculosis infection (TBI). However, their inability to distinguish between past and ongoing infection poses a diagnostic challenge, possibly leading to the unnecessary treatment of a significant portion of the population with potential side effects. This review delves into the concept of incipient tuberculosis (ITB), a dynamic, presymptomatic stage characterized by heightened Mycobacterium tuberculosis complex (MTC) metabolic activity and replication that result in minimal radiological changes, signifying a transitional state between TBI and TB. Key focus areas include epidemiological factors, underlying pathogenesis, imaging findings, and the ongoing challenges in the identification of individuals with ITB through the development of new biomarkers and the use of whole-genome sequencing-based analyses to implement early treatment strategies. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Our study analyzed the main manifestations of tuberculous pleurisy (TBP) in children under medical thoracoscopy (MT). This article aimed to explore the clinical application value of MT in the diagnosis and treatment of TBP in children. METHODS: In our study, we selected 23 TBP patients diagnosed in our hospital. We analyzed the clinical data and thoracoscopic morphology of these patients. At the same time, we also observed the pathological manifestations, acid-fast staining, and treatment effects of the patient's diseased tissue under MT. RESULTS: The MT clinical findings of TBP patients include pleural hyperemia and edema, miliary nodules, scattered or more white nodules, simple pleural adhesion, wrapped pleural effusion, massive cellulose exudation, yellow-white caseous necrosis, pleural hyperplasia and hyperplasia, and mixed pleural necrosis. The positive rate of pleural biopsy was 73.91% and that of acid-fast staining was 34.78%. The main pathologic types of these patients were tuberculous granulomatous lesions (16 cases), caseous necrosis (5 cases), and fibrinous exudative, multinucleated giant cell and other inflammatory cell infiltration lesions (13 cases). The average time of diagnosis of the 23 patients was 8.32 days (5.0-16.0 days), and they were transferred to specialized hospitals for treatment after diagnosis. The mean time of chest drainage was 3.0-5.0 days after treatment. The average time for their body temperature to return to normal was 3.31 days (2.0-5.0 days). CONCLUSION: Thoracoscopic lesions of TBP in children are varied. The use of MT is not only helpful for the early diagnosis and treatment of TBP. It also protects and improves lung function. Therefore, the use of MT has high clinical value. [ABSTRACT FROM AUTHOR]

Tuberculosis lesion of the upper respiratory tract in most cases is a secondary disease and develops as a result of the introduction of a specific pathogen in patients suffering from pulmonary tuberculosis. Against the background of the deterioration of the general epidemiological situation of tuberculosis, its course has changed in the direction of aggravation of the process and an increase in diseases of extrapulmonary tuberculosis. It is known that silver nanoparticles restore the sensitivity of drug-resistant strains of tuberculosis microbacteria to chemotherapy drugs, and their growth is suppressed. The purpose of the study is to evaluate the effectiveness of the use of silver--containing drugs for the treatment of patients with tuberculosis of the upper respiratory tract. As a result of the study, it was found that silver nanoparticles demonstrate anti-tuberculosis activity. At the same time, the dose-dependent nature of the suppressive activity of nanoparticles was established. Argitos at a concentration of 3.3% showed higher therapeutic activity in the treatment of laryngeal tuberculosis compared with standard anti-tuberculosis drugs. [ABSTRACT FROM AUTHOR]

Objective To assess the effectiveness of a community-based tuberculosis and leprosy intervention in which village health teams and health workers conduct door-to-door tuberculosis screening, targeted screenings and contact tracing. Methods We conducted a before-and-after implementation study in Uganda to assess the effectiveness of the community tuberculosis intervention by looking at reach, outputs, adoption and effectiveness of the intervention. Campaign 1 was conducted in March 2022 and campaign 2 in September 2022. We calculated percentages of targets achieved and compared case notification rates during the intervention with corresponding quarters in the previous year. We also assessed the leprosy screening. Findings Over 5 days, campaign 1 screened 1 289 213 people (2.9% of the general population), of whom 179 144 (13.9%) fulfilled the presumptive tuberculosis criteria, and 4043 (2.3%) were diagnosed with bacteriologically-confirmed tuberculosis; 3710 (91.8%) individuals were linked to care. In campaign 2, 5 134 056 people (11.6% of the general population) were screened, detecting 428 444 (8.3%) presumptive tuberculosis patients and 8121 (1.9%) bacteriologically-confirmed tuberculosis patients; 5942 individuals (87.1%) were linked to care. The case notification rate increased from 48.1 to 59.5 per 100 000 population in campaign 1, with a case notification rate ratio of 1.24 (95% confidence interval, CI: 1.22--1.26). In campaign 2, the case notification rate increased from 45.0 to 71.6 per 100 000 population, with a case notification rate ratio of 1.59 (95% CI: 1.56--1.62). Of the 176 patients identified with leprosy, 137 (77.8%) initiated treatment. Conclusion This community tuberculosis screening initiative is effective. However, continuous monitoring and adaptations are needed to overcome context-specific implementation challenges. [ABSTRACT FROM AUTHOR]

Multidrug-resistant tuberculosis (MDR-TB) is a global health concern. Standard treatment involves the use of linezolid, a repurposed oxazolidinone. It is associated with severe adverse effects, including myelosuppression and mitochondrial toxicity. As such, it is imperative to identify novel alternatives that are better tolerated but equally or more effective. Therefore, this review aims to identify and explore the novel alternative oxazolidinones to potentially replace linezolid in the management of TB. The keywords tuberculosis and oxazolidinones were searched in PubMed to identify eligible compounds. The individual drug compounds were then searched with the term tuberculosis to identify the relevant in vitro, in vivo and clinical studies. The search identified sutezolid, tedizolid, delpazolid, eperezolid, radezolid, contezolid, posizolid and TBI-223, in addition to linezolid. An additional search resulted in 32 preclinical and 21 clinical studies. All novel oxazolidinones except posizolid and eperezolid resulted in positive preclinical outcomes. Sutezolid and delpazolid completed early phase 2 clinical studies with better safety and equal or superior efficacy. Linezolid is expected to continue as the mainstay therapy, with renewed interest in drug monitoring. Sutezolid, tedizolid, delpazolid and TBI-223 displayed promising preliminary results. Further clinical studies would be required to assess the safety profiles and optimize the dosing regimens. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis complex (MTBC). Antituberculosis drugs given to active TB sufferers consist of 3 or 4 combinations. Tuberculosis treatment is divided into intensive phase treatment (2 weeks) and continuation phase (16 weeks / 4 months). Interferon gamma (IFN γ) is a protein belonging to the cytokine family which plays a role in eliminating MTB bacteria through a cell-mediated immunity mechanism. The aim of this study was to analyze differences in gamma interferon levels in the intensive phase and advanced phase of tuberculosis treatment. This research method is an analytical observational study with a cross-sectional design (cross sectional study). The research design used was a randomized post test only control group design. Data were analyzed using the Kruskal Wallis test with statistical test results obtained with a p value of 0.033 (> 0.05), meaning there was a difference in IFN γ levels in the intensive phase and advanced phase of tuberculosis treatment. [ABSTRACT FROM AUTHOR]

Introduction: The high morbidity and mortality of tuberculosis has led to the development of numerous therapeutic interventions during the pre-antibiotic era. In 1894, Forlanini proposed the technique of collapse therapy, using spontaneous pneumothorax. In 1926, Bernou developed the oleothorax technique to induce an iatrogenic collapse of the lung through the instillation of oil into the pleural cavity, which was subsequently removed. Nowadays, there are few patients that still represent a living testimony of this historic technique and have been described through traditional radiology. Case Presentation: We report the case of a patient with evidence of a right oleothorax that was investigated not only with traditional radiology but also with the use of chest ultrasonography. Ultrasounds were able to show peculiar characteristics of the oleothorax, including its particular echogenicity, the rigidity and static nature of the collection, the presence of peripheral calcifications, and the negative impact of the collection on diaphragmatic mobility and excursion. Conclusion: To our knowledge, this is the first report of an ultrasound description of oleothorax. We have observed that ultrasound examination, in cases of basal oleothorax, is able to add information regarding its radiological appearance and physiopathological implications on ventilatory mechanics and diaphragmatic distress. Established Facts: Oleothorax is a rare finding in today's clinical practice, demonstrating a historical therapy for pulmonary tuberculosis. Oleothorax has been occasionally described using conventional radiology, such as chest X-ray or chest CT. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the factors associated with extended length of stay (LOSE) for patients with tuberculosis (TB) in China, and construct a nomogram to predict it. In addition, the impact of extended hospital stay on short-term readmission after discharge was assessed. Methods: A retrospective observational study was conducted at Changsha Central Hospital, from January 2018 to December 2020. Patients ( ≥ 18 years who were first admitted to hospital for TB treatment) with non-multidrug-resistant TB were selected using the World Health Organization's International Classification of Diseases, 10th Revision (ICD-10-CM), and the hospital's electronic medical record system. Results: A multivariate logistic regression analysis was used to evaluate the associations between TB and LOSE. The relationship between length of hospital stay and readmission within 31 days after discharge was assessed using a univariate Cox proportional risk model. A total of 14 259 patients were included in this study (13 629 patients in the development group and 630 in the validation group). The factors associated with extended hospital stays were age, smear positivity, extrapulmonary involvement, surgery, transfer from other medical structures, smoking, chronic liver disease, and drug-induced hepatitis. There was no statistical significance in the 31-day readmission rate of TB between the LOSE and length of stay ≤ 14 days groups (hazards ratio: 0.92, 95% CI: 0.80-1.06, P = 0.229). Conclusion: LOSE with TB was influenced by several patient-level factors, which were combined to construct a nomograph. The established nomograph can help hospital administrator and clinicians to identify patients with TB requiring extended hospital stays, and more efficiently plan for treatment programs and resource needs. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Tuberculosis (TB) is a main health in global issue. Depression may associate with treatment period, income, and self-stigma that impacts on Tuberculosis recover. TB that shows more than six months of treatment period can identify as Multi Drug Resistant (MDR). The purpose of this study is to understand whether Depression can be predicted based on age, economic status, treatment period and self-stigma. Method: Respondents were identified from twelve community health centres using cross sectional approach. The sample characteristics were included adult, in the process of Tuberculosis treatment minimum one month; get the same multidrug standard in the TB treatment. The number of the sample was 180 respondents who selected using accidental sampling technique. Information was collected using demographic factors, treatment period, depression, and self-stigma questionnaire on pulmonary Tuberculosis. A multiple linear regression model was applied to determine depression predictors of Tuberculosis. Results: The findings identified a significant difference between the four factors and depression on Tuberculosis patients with p-value of 0.001 in each variable. Regression analysis indicated that predictor unstandardized coefficients ß between self-stigma and age was -0.165, economic status was -0.385, treatment period was 0.118 and level of depression was 0.320. Conclusion: This study found that age and economic status have a negative correlation as depression predictor. Both length of treatment period and self-stigma have a positive correlation as depression predictor. The longer TB treatment period, they would have experienced depression. [ABSTRACT FROM AUTHOR]

Background: More than half of the people with Tuberculosis (TB) symptoms in India seek care from the private sector. People with TB getting treatment from private sector in India are considered to be at a higher risk for receiving suboptimal quality of care in terms of incorrect diagnosis and treatment, lack of treatment adherence support with a high loss to follow-up rate that could eventually increase their risk of drug resistance. The current study aims at documenting the approach and efforts taken by the Kerala state to partner with the private health care delivery providers for ensuring quality TB care to the people with presumed TB reaching them. Methods: A case study approach was adopted with review of all available literature followed by five Key Informant Interviews to understand the case through a primary descriptive exploration. Grounded theory approach was used to generating the single theory of the case itself that explains it. Results: Kerala state has taken a variety of interventions to ensure universal access to TB care for citizens reaching the private sector with documented improvement in the quality of TB care. Key learnings from these initiatives were (i) patients need to be at the centre of partnerships, (ii) good governance is essential for ensuring Universal Health Coverage in a mixed health system, (iii) data intelligence is required to guide partnerships, (iv) identification of the correct 'problems' is crucial for effective design of partnerships and (v) a platform for meaningful dialogue of key stakeholders is needed. Conclusion: Kerala experience demonstrated that if governments take a proactive role in engaging the private sector, in an informed and evidence-based way, they can leverage the advantages of the private sector while protecting the public health interest. [ABSTRACT FROM AUTHOR]

Objective •This retrospective study aimed to determine the prevalence and risk factors of combined pulmonary embolism (PE) among patients with pulmonary tuberculosis (TB), as well as evaluate the clinical efficacy of anticoagulation in combination with anti-tuberculosis therapy. Methods • A total of 96 TB patients were included in the study. Among them, 31 patients had combined PE (PE group) and 65 patients did not have PE (no-PE group). Various indicators including lung images, clinical symptoms, blood tests, coagulation function, and others were analyzed to identify risk factors for combined PE in TB patients. Within the PE group, patients were divided into a combined treatment group (received anticoagulation therapy alongside anti-tuberculosis treatment) and a control group (received only anti-tuberculosis treatment). The effectiveness of anticoagulation, serological indexes, and incidence of adverse reactions were compared between the two groups. Results • The prevalence of combined PE in TB patients was 32.29%. Encapsulated effusion or upper lobe predominance, dyspnea, and high creatinine levels were identified as risk factors for combined PE in TB patients. The combined treatment group showed a significantly higher anticoagulation efficiency rate (95.00%) compared to the control group (72.73%). After treatment, serum D-dimer levels were significantly lower in the rivaroxaban group compared to the warfarin group. The incidence of adverse reactions did not differ significantly between the two groups. Conclusion • Combined PE was found in 32.29% of TB patients. Encapsulated effusion or upper lobe predominance, dyspnea, and high creatinine levels were identified as risk factors for combined PE in TB patients. Anticoagulation combined with anti-tuberculosis therapy was effective and safe for managing TB patients with combined PE. [ABSTRACT FROM AUTHOR]

Objective • To analyze the short-term and long-term efficacy of Osteoset artificial bone graft fusion mixed with rifampicin for injection in the treatment of sacroiliac joint tuberculosis. Methods • A retrospective analysis was carried out on 70 patients diagnosed with sacroiliac joint tuberculosis who were admitted and underwent surgical treatment in our orthopedics department between April 2014 and May 2020. The patients were divided into three groups based on the different bone graft materials used: autogenous bone graft group (25 cases), simple lesion removal group (18 cases), and drugloaded calcium sulfate bone graft group (27 cases). General information and surgical details of the three groups were compared. Sacroiliac X-ray and CT scans were performed at regular intervals to record pre- and post-treatment erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, bone graft fusion rates at 6, 12, and 18 months post-surgery, Majeed score for functional evaluation, and postoperative complications. Results • There was no statistically significant difference in operation time, intraoperative bleeding, and intraoperative pus removal volume among the three groups of patients (P > .05). Postoperatively, 70 patients were followed up, and the serum levels of ESR and CRP in all three groups of patients were significantly reduced at 3 months after surgery (P < .05). In the autogenous bone graft group, the bone graft fusion rates were 24.00% (6/25) at 6 months postoperatively, 76.00% (18/25) at 12 months, and 96.00% (24/25) at 18 months. In the simple lesion removal group, the bone graft fusion rates were 16.67% (3/18) at 6 months postoperatively, 27.78% (5/18) at 12 months, and 55.56% (10/18) at 18 months. In the drug-loaded calcium sulfate bone graft group, the bone graft fusion rates were 18.52% (5/27) at 6 months postoperatively, 55.56% (15/27) at 12 months, and 81.48% (22/27) at 18 months. In the autogenous bone graft group, the postoperative Majeed score averaged (91.47±4.13) points, with 13 cases rated as excellent and 10 cases rated as good, resulting in an excellent and good rate of 92.00% (23/25). The Majeed scores at 6, 12, and 18 months postoperatively were (67.19±4.22) points, (80.28±5.83) points, and (91.47±4.13) points, respectively. Among them, there were 4 excellent and 3 good cases at 6 months postoperatively, with an excellent and good rate of 28.00% (7/25). At 12 months postoperatively, there were 8 excellent and 10 good cases, with an excellent and good rate of 72.00% (18/25). At 18 months postoperatively, there were 13 excellent and 10 good cases, with an excellent and good rate of 92.00% (23/25). In the simple lesion removal group, the Majeed scores at 6, 12, and 18 months postoperatively were (59.17±3.95) points, (69.84±5.16) points, and (76.22±8.76) points, respectively. There were 2 excellent and 2 good cases at 6 months postoperatively, with an excellent and good rate of 22.22% (4/18). At 12 months postoperatively, there were 4 excellent and 3 good cases, with an excellent and good rate of 38.89% (7/18). At 18 months postoperatively, there were 5 excellent and 5 good cases, with an excellent and good rate of 55.56% (10/18). In the drug-loaded calcium sulfate bone graft group, the Majeed scores at 6, 12, and 18 months postoperatively were (63.24±4.17) points, (77.39±5.50) points, and (86.64±7.03) points, respectively. There were 3 excellent and 3 good cases at 6 months postoperatively, with an excellent and good rate of 22.22% (6/27). At 12 months postoperatively, there were 9 excellent and 7 good cases, with an excellent and good rate of 59.26% (16/27). At 18 months postoperatively, there were 10 excellent and 12 good cases, with an excellent and good rate of 81.48% (22/27). The Majeed scores for all three groups of patients showed a significant increase in the three follow-up evaluations compared to pre-treatment (P < .05). Conclusion • Drug-loaded Osteoset artificial bone graft fusion is a safe and effective method for treating bone defects after the debridement of sacroiliac joint tuberculosis lesions. It has fewer postoperative complications and achieves bone graft fusion in a shorter time compared to simple lesion removal methods. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a prevalent bacterial infection caused by Mycobacterium tuberculosis (Mtb), primarily affecting the lungs, with rising incidence rates. Drug-resistant TB strains, including multidrug-resistant (MDR) and extensively drug-resistant (XDR) types, pose challenges with poor treatment success rates and increased mortality. Demographic factors and genomic patterns contribute to drug resistance, emphasizing the need for new drugs targeting specific genomic patterns. Methods: This study analyzes the impact of demographics, treatment outcomes, and genomic mutations on drug-resistant TB using pattern identification techniques and whole-genome sequencing to discover therapeutic targets. This study primarily focused on the identification and analysis of MDR and XDR strains, considering various demographic characteristics and treatment outcomes. A dataset comprising 2,602 observations was utilized, and pattern recognition techniques were employed to identify significant features. Additionally, the study employs the whole-genome sequencing (WGS) pipeline to identify single nucleotide polymorphisms (SNPs) that result in new mutations in drug-resistant Mtb strains. Results: The findings of the study revealed that XDR and MDR non-XDR TB were the most prevalent types of drug resistance, and they were associated with unfavorable treatment outcomes, including death or treatment failure. Males exhibited a higher susceptibility to both XDR and MDR non-XDR TB compared to females. The age of onset for both types of resistance was approximately 40 years. Among the observed variants in 31 commonly occurring genes. Conclusion: These findings introduce a novel set of therapeutic targets specific to MDR and XDR Mtb types, which warrant further investigation for potential therapeutic interventions. [ABSTRACT FROM AUTHOR]

Both tuberculosis (TB) and COVID-19 are infectious diseases with similar clinical manifestations, which mainly affect the lungs. Clinical studies have revealed that the immunosuppressive drugs taken by COVID-19 patients can affect the immunological functions in the body, which can cause the patients to contract active TB via a new infection or reinfection, and the co-infection of the two diseases portends a clinical complexity in the management of the patients. Thus, this paper presents a mathematical model to study the dynamics and control of COVID-19-TB co-infection. The full model of the co-infection is split into two submodels, namely, the TB-only and the COVID-19-only models. The equilibria of the disease-free and endemic situations of the two sub-models are shown to be globally asymptotically stable when their control reproduction numbers ... o > 1, respectively. However, the disease-free equilibrium of the co-infection model was found to lose its global stability property when the reproduction number RF o < 1, therefore exhibiting a backward bifurcation. Uncertainty and sensitivity analysis of the associated reproduction number of the full model has been performed by using the Latin hypercube sampling/Pearson rank correlation coefficient (LHS/PRCC) method. The rate of transmission of COVID-19 and the proportions of individuals vaccinated with Bacillus Calmette-Gu'erin (BCG) and against COVID-19 were found to be highly significant in the spread and control of COVID-19-TB co-infection. Furthermore, the simulation results show that decreasing the COVID-19 transmission rate and increasing the proportion of people vaccinated with BCG and against COVID-19 can lower the number of cases of COVID-19-TB co-infection. Therefore, measures to reduce the transmission rate and the provision of adequate resources to increase the proportions of people vaccinated against TB and COVID-19 should be implemented to minimize the cases of co-infection. [ABSTRACT FROM AUTHOR]

Aims To outline the demographic, clinical, laboratory characteristics, and treatment outcomes of tuberculosis (TB) patients who used substances. Methods This retrospective cohort study compared 50 TB patients who used substances with a matched random sample of 100 TB patients who did not use substances between 2007 and 2017. Treatment failure was defined as a sputum smear or culture that tested positive after 5 months of treatment, loss to follow-up, unevaluated patients, or death. Results TB patients who used substances were typically younger, experienced homelessness, smokers, and had fewer chronic diseases than those who did not use substances. They also were hospitalized for longer periods, their treatment durations were longer, had higher rates of multidrug resistant strains, increased rates of treatment failure, and higher mortality. Individuals whose treatment failed predominantly originated from the former Soviet Union, experienced homelessness, and had chronic diseases compared with those whose treatment was successful. In the multivariate analysis, homelessness [odds ratios (OR) = 6.7], chronic diseases (OR = 12.4), and substance use (OR = 4.0) were predictors of treatment failures. Conclusions TB patients who used substances were more likely to have treatment failure. Targeted interventions, including early diagnosis and enhanced support during treatment, are essential to achieve treatment success in this vulnerable population, in addition to TB-alcohol/drug collaborative activities. [ABSTRACT FROM AUTHOR]

Background: In 2021, there were approximately 450,000 cases of drug-resistant tuberculosis (DR-TB) worldwide. The treatment of DR-TB historically included expensive and toxic injectable drugs leading to adverse effects including ototoxicity and Electrocardiogram (ECG) abnormalities. This study described the perspectives of healthcare providers and people with DR-TB on the usability of simplified audiometry and ECG for monitoring treatment adverse effects. Methods: A qualitative study was conducted in December 2019 across four provinces in Mozambique, namely Maputo, Gaza, Zambézia, and Nampula. Sixteen outpatient primary care health facilities equipped with simplified Audiometry and/or ECG devices (specifically, SHOEBOX Audiometer® and/or SmartHeart Pro ECG®) installed for at least 6 months before the study initiation were selected. The data was collected using in-depth interviews (IDI) and Focus Group Discussions (FGD) techniques. Interviews were audio-recorded, transcribed verbatim in Portuguese, coded, and analyzed using Nvivo 12 software®. We generated two themes and fit our results into a conceptual framework consisting of three domains in the implementation of technological innovations in health. Results: A total of 16 healthcare providers and 91 people undergoing treatment for DR-TB were enrolled in the study. Most people with DR-TB had experienced audiometry testing and demonstrated a good understanding of the assessments. Conversely, while most healthcare providers demonstrated robust knowledge of the importance of both audiometry and ECG assessments, they were not confident in managing ECG devices and interpreting the results. Conclusions: While healthcare providers demonstrated a consolidated understanding of the importance of audiometry, the limited number of devices and lack of training were constraints, impeding optimal usage and service delivery. [ABSTRACT FROM AUTHOR]

Background: Blitar district was in the last second position in East Java Province, achieving low Tuberculosis recovery and treatment of the national target by 2022. Therefore, it is necessary to support surveillance systems as a prerequisite for providing information as decision-making material. Purpose: to describe the quality of the tuberculosis surveillance system based on its approach and attributes. Methods: This research was an evaluation study design on the tuberculosis surveillance system in 2022. Respondents totaled 19 people. Data was collected by interview using a questionnaire and document study using a checklist. Data was analyzed by comparing the system approach and surveillance attributes to existing guidelines. The data was presented in tables and narratives. Results: Evaluation of tuberculosis surveillance systems based on input, process, and output was available by surveillance guidelines. Evaluation of the surveillance attributes showed that the flexible system has high data quality, high sensitivity, timeliness, and high stability. However, the system is not simple in operation, has low acceptability of the network, and has low positive predictive value because the suspect detection is too loose and not representative. Conclusion: The implementation of the tuberculosis surveillance system has largely been carried out well, supported by several complete surveillance attributes. It is necessary to provide standard operational procedures for recording and reporting, improve coordination with the network to manually and electronically report suspected tuberculosis, and optimize the Mantoux test in children. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis is a major cause of mortality worldwide. Prisoners in Guiana have multiple risk factors. The primary objective of this study was to describe tuberculosis occurring in prison and after release in French Guiana between 2008 and 2020. Secondary objectives were to identify tuberculosis risk factors and determine annual incidences. Methods: A retrospective cohort study of tuberculosis cases was carried out at the Guiana prison between 2008 and 2020. Data were collected from prison registers and cross-referenced with the list of tuberculosis notifications in French Guiana. Results: A total of 36 cases of tuberculosis were studied. Incidence was high, at 263/100,000 per year, higher than elsewhere in France and comparable to that in Brazil. Despite visibly effective screening on entry, with little evidence of intra-prison circulation of tuberculosis, 39% of patients were diagnosed within two years of leaving prison (76% were symptomatic). This could be explained by the high prevalence of latent forms (LTI). Discussion: Continued screening on entry, in combination with annual radiological and clinical screening, and reinforced follow-up on release seem indicated to improve patient management and the search for possible LTI. [ABSTRACT FROM AUTHOR]

The Indian national tuberculosis (TB) prevalence survey conducted during 2019–2021 revealed a 31% TB infection (TBI) burden among individuals above 15 years of age. India has an ambitious plan of eliminating TB by 2025, 5 years ahead of the global agenda, thus focusing on the burden of TBI and management of TBI with TB preventive treatment (TPT) is of utmost importance in achieving the same. States in India adopt different models of implementation of testing and treating the TBI. Some of the states select subcontracting agencies to provide end-to-end TPT and some do adopt the in-house mechanism using the existing health system in providing the same. Moreover, the "Programmatic Management of TPT in India" guideline prioritizes population group for TPT based on elevated risk of progression from infection to TB disease or increased likelihood of exposure to TB disease. Given the background, we propose two models of implementation of TBI diagnosis using interferon-gamma release assay and treatment; one using a subcontracting agency and the other one using the existing health system machinery to test and treat the TBI. [ABSTRACT FROM AUTHOR]

In Peru, tuberculosis is among the first 15 causes of death in the entire nation and is considered endemic. The problem of abandoning treatment emerges as a major challenge in their fight. In this sense, the objective of this study was to design an efficient binary logistic regression model on sociodemographic factors for the prediction of abandonment of tuberculosis treatment in Peruvian patients. It was an observational, cross-sectional, and analytical research, where we worked with 362 subjects who made up the control and case groups. A data collection form was used, and data processing was carried out with the statistical programs RStudio and IBM SPSS Statistics. It is concluded that the male gender presents a higher proportion of cases of pulmonary tuberculosis, increasing the probability of harm when faced with associated factors. The length of hospitalization and the lack of clear information about laboratory tests are risks for abandoning treatment and the consumption of hallucinogenic substances also increases the probability of abandonment. It is concluded that there is a notable absence of evaluations with a predictive approach since most previous studies have adopted a purely explanatory approach. [ABSTRACT FROM AUTHOR]

Tuberculosis is known as one of "the great masqueraders" due to unusual and nonspecific symptoms it presents, which causes a challenge in diagnosis. There are rare radiological pulmonary patterns described in some case reports such as lung mass and bilateral pulmonary nodules similar to primary lung cancer or pulmonary metastases. We present a case of a 42-year-old man who was admitted to the emergency room due to pain and increased testicular volume. His chest tomography revealed a right lung mass and bilateral pulmonary nodules with a diffuse distribution. Therefore, based on clinical and radiological results, we suspected malignancy. His testicular fluid drainage resulted in a positive Ziehl Neelsen staining. The patient received anti-tuberculosis treatment for 1 month showing clinical and tomographic improvement. Pulmonary tuberculosis can present unusual radiological patterns. Therefore, we suggest that it should be considered in the differential diagnosis of patients with clinical and radiological characteristics of metastatic or primary lung disease. Diagnosis should be aided by invasive interventions. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis, which primarily affects the lungs but can also involve other organs, including the kidneys. TB has the potential to result in the development of chronic renal failure and requires prompt diagnosis and treatment for effective management. Renal TB can lead to various complications, including renal failure, perinephritis, perinephric abscesses, fistulae, psoas abscesses, and non-functioning kidneys. Additionally, TB-associated nephropathy is an infrequent variant of glomerulonephritis characterized by the deposition of immune complexes containing TB antigens in the kidney's glomeruli. [ABSTRACT FROM AUTHOR]

Global tuberculosis (TB) eradication is undermined by increasing prevalence of emerging resistance to available drugs, fuelling ongoing demand for more complex diagnostic and treatment strategies. Early detection of TB drug resistance coupled with therapeutic decision making guided by rapid characterisation of pre-treatment and treatment emergent resistance remains the most effective strategy for averting Drug-Resistant TB (DR-TB) transmission, reducing DR-TB associated mortality, and improving patient outcomes. Solid- and liquid-based mycobacterial culture methods remain the gold standard for Mycobacterium tuberculosis (MTB) detection and drug susceptibility testing (DST). Unfortunately, delays to result return, and associated technical challenges from requirements for specialised resource and capacity, have limited DST use and availability in many high TB burden resource-limited countries. There is increasing availability of a variety of rapid nucleic acid-based diagnostic assays with adequate sensitivity and specificity to detect gene mutations associated with resistance to one or more drugs. While a few of these assays produce comprehensive calls for resistance to several first- and second-line drugs, there is still no endorsed genotypic drug susceptibility test assay for bedaquiline, pretomanid, and delamanid. The global implementation of regimens comprising these novel drugs in the absence of rapid phenotypic drug resistance profiling has generated a new set of diagnostic challenges and heralded a return to culture-based phenotypic DST. In this review, we describe the available tools for rapid diagnosis of drug-resistant tuberculosis and discuss the associated opportunities and challenges. [ABSTRACT FROM AUTHOR]

This paper discusses the stability analysis of the model for the spread of tuberculosis and the effects of treatment. It is shown the analyze the dynamic behavior of the model to investigate the local stability properties of the model equilibrium point. The Routh-Hurwitz criterion is used to analyze local stability at the disease-free equilibrium point, while the Transcritical Bifurcation theorem is used to investigate the local stability properties of the endemic equilibrium point. The discussion results show that the equilibrium point's stability properties depend on the value of the basic reproduction number, which is calculated based on the Next Generation Matrix (NGM). When the basic reproduction number value is less than one, then the disease-free equilibrium point is locally asymptotically stable, whereas if it is more than one, then the endemic equilibrium point is locally asymptotically stable. Numerical simulations are included to explain the dynamic behavior of disease spread and to understand the effectiveness of tuberculosis treatment in a given population. The simulation results show that treatment in the infected individual phase is known to be more effective than treatment in latent individuals. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis treatment interruption increases the risk of poor treatment outcomes and the occurrence of drug resistant Tuberculosis. However, data on the incidence and predictors of tuberculosis treatment interruption are still scarce in Ethiopia, as well as in the study area. Therefore, this study aimed to assess the incidence and predictors of treatment interruption among patients on tuberculosis treatment in Nekemte public healthcare facilities, Oromia region, Western Ethiopia, from July 1, 2017, to June 30, 2021. Methods: A retrospective cohort study design was conducted among 800 patients enrolled in anti-tuberculosis treatment during the study period. Data were collected from patient cards who were enrolled in treatment from July 1, 2017 to June 30, 2021. Epidata version 3.2 was used for data entry, and STATA version 14 was used for analysis. A multivariable Cox regression model with a 95% confidence interval (CI) and adjusted hazard ratio (AHR) was used to identify the significant predictors at a p value < 0.05. Finally, the log likelihood ratio, and a Cox-Snell residual graph was used to check the adequacy of the model. Results: A total of 800 patients were followed for a median time of 2.3 (95% CI: 2.20-2.36) months, and with a maximum follow-up time of 11.7 months. The overall incidence rate of treatment interruption was 27.4 per 1000 (95% CI: 22.8-32.8) person-month observations. Age 18-34 years (AHR = 1.8, 95% CI: 1.02-3.18), male (AHR = 1.63, 95% CI: 1.1-2.42), rural residence (AHR = 3, 95% CI: 1.98-4.64), presence of comorbidity (AHR = 10, 95% CI: 5.47-18.27) and lack of treatment supporters on the treatment follow-up (AHR = 2.82, 95% CI: 1.9-4.41) were found to be significant predictors of treatment interruption. Conclusion: A high incidence rate of interruption was observed among TB patients in public health facilities in Nekemte town. Health facilities should provide supportive care for patients with co-morbidities and consider interventions that target middle-aged patients from rural areas that reduce treatment interruptions. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to review the transbronchial brushing cytology and histological specimens of endobronchial tuberculosis (EBTB) and to explore the morphological features, diagnostic pitfalls, and dilemmas. Material and Methods: Transbronchial brushing cytology and concurrent biopsy specimens obtained between July 2017 and June 2020 were reviewed. EBTB was confirmed based on the clinical response to the anti-TB treatment in addition to the positive findings of at least one of the following methods: Acid-fast bacilli stain (AFB), auramine-rhodamine stain (A-R), detection of TB bacterial DNA (TB-DNA) by polymerase chain reaction, T-cell spot test (T-spot), and typical pathologic changes of TB on cytology or bronchoscopy biopsy. A total of 72 confirmed cases were studied. Results: Of the 72 patients, 42/72 (58.3%) and 30/72 (41.7%) were female and male patients, respectively. Bronchoscopic findings revealed five subtypes of EBTB, including inflammation infiltration, ulceration necrosis, granulation hyperplasia, cicatrices stricture, and tracheobronchial malacia. AFB, A-R, TB-DNA, and T-spot were positive in 39, 26, 33, and 46 cases, respectively. The detection rate of necrosis in the cytological specimens (90.3%) was significantly higher than that in the biopsy specimens (77.8%; P < 0.01). The percentage of Langhans giant cells detected by cytology (13.9%) was significantly lower than that detected by the pathological examinations of the tissues (38.9%) (P < 0.01). The detection rates of metaplastic squamous cells and epithelioid cells showed no significant difference with respect to the cytology and biopsy findings. In addition to the two patients who had concurrent carcinomas, atypical cells were reported in nine patients through cytopathological diagnosis, among them two were suspected to have carcinomas, two were with the impression that spindle cell neoplasms could not be excluded, and the other five were considered as reactive atypia. Moreover, one biopsy could not rule out the well-differentiated squamous cell carcinoma. Conclusion: Some morphological variations may cause challenges in cytological evaluation. Moreover, diagnostic dilemmas can occur even in the assessments of tissue pathology. [ABSTRACT FROM AUTHOR]

Objective: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which causes disease in all organs, 80% of which are in the lungs, and can sometimes spread to other organs. It can lead to death in untreated or inadequately treated patients. Treatment of tuberculosis is very difficult due to the resistance of mycobacteria to many chemicals and disinfectants, antibiotics, and chemotherapeutics, especially in immunocompromised patients (HIV, Human Immunodeficiency Virus); this disease is very common. Therefore, in recent years, the search for new drugs to be used to treat tuberculosis has increased worldwide. We aim to determine the effect of orientin and vitexin on M. tuberculosis strains. Materials and Methods: In this study, the effects of orientin and vitexin against M. tuberculosis standard strains (M. tuberculosis H37Ra and M. tuberculosis H37Rv) and six-clinical M. tuberculosis strains. The inoculum was prepared using a positive BACTEC "Mycobacteria Growth Indicator Tube" containing 7H9 Broth. Microplate Presto Blue Method and rifampicin were used as standard antibiotics in the anti-mycobacterial assay. Results: Orientin and vitexin showed a mycobactericidal effect on tuberculosis strains depending on the concentration. Orientin and vitexin have not been tested on current clinical strains of M. tuberculosis before. In this respect, it is the first report describing the anti-mycobacterial activity of both orientin and vitexin. Conclusion: These results indicate that orientin and vitexin may be helpful for further investigations into their role in inhibiting M. tuberculosis. They have a possibility of new anti-mycobacterial drug candidates in the near future. [ABSTRACT FROM AUTHOR]

This document discusses the issue of tuberculosis (TB) in the Dominican Republic (DR) and the broader context of TB globally. It highlights the challenges of TB diagnosis, including the underutilization of recommended tests and the lack of access to drug sensitivity tests. Treatment outcomes for TB and HIV co-infection and drug-resistant TB are also discussed. The document emphasizes the importance of early and accurate diagnosis in preventing the spread of TB and improving treatment outcomes. It suggests strategies such as decentralized healthcare delivery, community-based interventions, and stigma reduction to address the challenges of TB in the DR and other affected regions. [Extracted from the article]

Bedaquiline resistance is increasingly observed in the treatment of rifampicin-resistant tuberculosis (TB), yet standardized regimens for managing bedaquiline-resistant TB are lacking. Studies indicate a high proportion of bedaquiline-resistant cases have previously been treated for TB, and often involve strains resistant to quinolones. Regular monitoring of the culture status in patients receiving bedaquiline resistance treatment is advised. Methods such as experimental evolution, protein modeling, genome sequencing, and phenotypic analysis have been instrumental in identifying the mechanisms of bedaquiline resistance. Specifically, variants in the Rv0678 transcriptional repressor of the MmpS5-MmpL5 efflux system are linked to this type of resistance. Bayesian probability estimates show promise in determining the genotypic-phenotypic association for bedaquiline resistance, suggesting potential utility in clinical practice. Future research should explore the practical application of Bayesian probabilities in managing bedaquiline resistance. Sequencing-based technologies are anticipated to play a vital role in the early detection and management of drug-resistant TB strains. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis (Mtb). Mtb affects not only the respiratory system but also other body organs, such as the lungs, leading to pulmonary and extrapulmonary TB, the brain, and the spine. Aspilia pluriceta from Meru Betiri National Park in Indonesia is one plant with potential for Mycobacterium tuberculosis. This study aimed to determine the antituberculosis activity of extracts and fractions of Aspilia pluriceta against Mycobacterium tuberculosis H37Rv. Aspilia pluriceta was extracted by maceration with methanol, and the crude methanol extract was fractionated successively with hexane, dichloromethane (DCM), and ethyl acetate. The phytochemical of the crude extract was determined by TLC and visualised by spraying with appropriate staining reagents. The crude extract and fractions of Aspilia pluriceta at concentrations 25, 100, 500, and 1000 µg/mL, respectively, were tested against the H37Rv strain of Mycobacterium tuberculosis using the resazurin method and analysed by an ELISA reader. Isoniazid, a first-line drug used in the treatment of tuberculosis, was used as the positive control agent. The phytochemical screening test revealed the presence of saponins, alkaloids, tannins, flavonoids, and terpenes. The results of anti-TB showed that the ethyl acetate fraction exhibited the most potent activity against Mycobacterium tuberculosis H37Rv with an IC50 value of 0.48 µg/mL. The crude extract and other fractions exhibited low activity against the tested organism. The findings showed that the plant holds potential for phytochemicals with antituberculosis activity, which could be further explored through bioactivity-guided isolation for leads against Mycobacterium tuberculosis. [ABSTRACT FROM AUTHOR]

Multidrug-resistant tuberculosis (MDR-TB) is a global health concern. Standard treatment involves the use of linezolid, a repurposed oxazolidinone. It is associated with severe adverse effects, including myelosuppression and mitochondrial toxicity. As such, it is imperative to identify novel alternatives that are better tolerated but equally or more effective. Therefore, this review aims to identify and explore the novel alternative oxazolidinones to potentially replace linezolid in the management of TB. The keywords tuberculosis and oxazolidinones were searched in PubMed to identify eligible compounds. The individual drug compounds were then searched with the term tuberculosis to identify the relevant in vitro, in vivo and clinical studies. The search identified sutezolid, tedizolid, delpazolid, eperezolid, radezolid, contezolid, posizolid and TBI-223, in addition to linezolid. An additional search resulted in 32 preclinical and 21 clinical studies. All novel oxazolidinones except posizolid and eperezolid resulted in positive preclinical outcomes. Sutezolid and delpazolid completed early phase 2 clinical studies with better safety and equal or superior efficacy. Linezolid is expected to continue as the mainstay therapy, with renewed interest in drug monitoring. Sutezolid, tedizolid, delpazolid and TBI-223 displayed promising preliminary results. Further clinical studies would be required to assess the safety profiles and optimize the dosing regimens.

Background: Completion of tuberculosis (TB) treatment presents several challenges to patients, including long treatment duration, medication adverse-effects and heavy pill burden. WHO emphasize the need for patient-centered TB care, but such approaches require understanding of patient experiences and perceptions. Methods: In 2020, we nested a qualitative study within a clinical trial that recruited 128 HIV-TB co-infected adults in Kampala receiving rifampicin-based TB treatment, alongside anti-retroviral therapy. A purposively selected sub-sample of 46 trial participants contributed to nine gender segregated focus group discussions. Of these, 12 also participated in in-depth interviews. Sessions were recorded, transcribed verbatim and translated from local languages into English. Thematic analysis focused on drug adverse-effects, use of self-prescribed medications and barriers to treatment adherence. Results: Patients seemed more concerned about adverse effects that clinicians sometimes overlook such as change in urine color. Those who remembered pre-treatment counselling advice were disinclined to manage adverse-effects by self-prescription. Difficulty in accessing a medical practitioner was reported as a reason for self-medication. Obstacles to adherence included stigma (especially from visible adverse-effects like “red urine”), difficulties with pill size and number, discomfort with formulation and medication adverse effects. Conclusion: Tailored pre-treatment counselling, improved access to clinical services, and simpler drug administration will deliver more patient-centered care.

CDC recommends testing persons at increased risk for tuberculosis (TB) infection as part of routine health care, using TB blood tests, when possible, and, if a diagnosis of latent TB infection (LTBI) is made, prescribing a rifamycin-based, 3- or 4-month treatment regimen (short-course) to prevent the development of TB disease. In 2022, approximately three quarters (73%) of reported TB cases in the United States occurred among non–U.S.-born persons. To assess TB-related practices among health care providers (HCPs) in the United States, CDC analyzed data from the 2020–2022 Porter Novelli DocStyles surveys. Approximately one half (53.3%) of HCPs reported routinely testing non–U.S.-born patients for TB, and of those who did, 35.7% exclusively ordered recommended blood tests, 44.2% exclusively ordered skin tests, and 20.2% ordered TB skin tests and blood tests. One third (33.0%) of HCPs reported prescribing recommended short-course LTBI treatment regimens, and 4.0% reported doing none of the treatment practices available for patients with LTBI (i.e., prescribing short-course regimens, longer course regimens, or referring patients to a health department). Further efforts are needed to identify and overcome barriers for providers to test for and treat persons at risk for TB. [ABSTRACT FROM AUTHOR]

Background The lateral flow urine lipoarabinomannan assay, Determine TB LAM (Determine LAM), offers the potential for timely tuberculosis (TB) treatment among people with human immunodeficiency virus (PWH). Methods In this cluster-randomized trial, Determine LAM was made available with staff training with performance feedback at 3 hospitals in Ghana. Newly admitted PWH with a positive World Health Organization four-symptom screening for TB, severe illness, or advanced HIV were enrolled. The primary outcome was days from enrollment to TB treatment initiation. We also reported the proportion of patients with a TB diagnosis, initiating TB treatment, all-cause mortality, and Determine LAM uptake at 8 weeks. Results We enrolled 422 patients including 174 (41.2%) in the intervention group. The median CD4 count was 87 (interquartile range [IQR], 25–205) cells/μL, and 32.7% were on antiretroviral therapy. More patients were diagnosed with TB in the intervention compared with the control group: 59 (34.1%) versus 46 (18.7%) (P <.001). Time to TB treatment remained constant, but patients were more likely to initiate TB treatment (adjusted hazard ratio, 2.19 [95% CI, 1.60–3.00]) during the intervention. Of patients with a Determine LAM test available, 41 (25.3%) tested positive. Of those, 19 (46.3%) initiated TB treatment. Overall, 118 patients had died (28.2%) at 8 weeks of follow-up. Conclusions The Determine LAM intervention in real-world practice increased TB diagnosis and the probability of TB treatment but did not reduce time to treatment initiation. Despite high uptake, only half of the LAM-positive patients initiated TB treatment. [ABSTRACT FROM AUTHOR]