International Journal of Mycobacteriology最新文献

Background: Gender-related barriers significantly impede care-seeking for tuberculosis (TB), leading to poor treatment outcomes. This study aimed to assess changes in knowledge and beliefs following a training program on gender-transformative TB programming among stakeholders in Southern Nigeria.

Methods: A cross-sectional pretest/posttest design was employed to evaluate the training's effectiveness among participants from September 2023 to March 2024. A 2-day training session was conducted using a standardized training manual. Participants included members of TB civil society organizations and other relevant stakeholders. A standardized questionnaire was administered before and after the training.

Results: Of the 304 respondents, 160 (52.6%) were aged 40 years or younger, with a mean age of 39.6 (±10.5) years; 184 (60.5%) were female. The mean pretest knowledge score was 7.20 (±1.16), which increased to 8.44 (±1.12) posttraining (t = -15.20; P < 0.001). Similarly, the mean score for the gender responsiveness to the TB programming scale improved from 30.6 (±5.4) pretest to 32.8 (±4.9) posttest (P < 0.001).

Conclusion: The training significantly enhanced stakeholders' knowledge of TB and their understanding of gender responsiveness in TB programming. These findings underscore the necessity for ongoing sensitization of TB service providers and the promotion of TB education and stigma reduction efforts to ensure gender-responsive and inclusive TB service delivery. Continuous awareness initiatives are essential to challenge deep-rooted negative sociocultural beliefs and gender norms affecting TB programming.

Background: This study aims to identify the factors associated with favorable treatment outcomes of tuberculosis (TB) patients registered at two hospitals and two urban health centers in Lusaka, Zambia in 2022.

Methods: A retrospective cohort study was conducted, focusing on patients who were either cured or completed treatment, defined as having favorable treatment outcomes. Unfavorable treatment outcomes included treatment failure, death, lost to follow-up, or not evaluated.

Results: A total of 2945 patients were registered, of whom, 2071 (70.3%) were males and 1346 (45.7%) were bacteriologically confirmed cases. The overall treatment success rate across the facilities was 88.2%. Multiple regression analysis revealed that patients with contact details were 2.16 (95% confidence interval [CI]: 1.30-3.61) times more likely to achieve favorable treatment outcomes compared to those without. Conversely, for each year of increasing age, the likelihood of favorable outcomes decreased by 0.99 (95% CI: 0.98-1.00) times. Patients with unknown HIV status were 0.0079 (95% CI: 0.0024-0.0259) times more likely to have favorable outcomes compared to those who were HIV negative. In addition, patients treated at Facilities A and B had 4.8 (95% CI: 2.7-8.4) and 1.8 times (95% CI: 1.1-3.0), respectively, higher odds of favorable outcomes than those at Facility D.

Conclusion: Healthcare providers should prioritize collecting contact details and testing HIV, especially in older adults with presumptive TB. Early diagnosis and proactive management strategies are essential for improving treatment outcomes.

Background: Neglected tropical diseases (NTDs) significantly impact the physical and mental well-being of affected individuals, particularly in Nigeria. This study aims to evaluate the effectiveness of integrating mental health services with self-care practices for individuals suffering from leprosy, Buruli ulcer (BU), and lymphatic filariasis (LF). The role of trained Healthcare Workers (HCWs) and NTD champions (NTD-Cs) will be explored to enhance health outcomes in this population.

Methods: A cluster-randomized controlled trial was conducted in four local government areas (clusters) with the highest incidence of leprosy, BU, or LF. Clusters were purposively selected and randomized into intervention and control groups: three clusters received interventions, while one served as a control. The intervention arms include (a) Mental health and self-care interventions by NTD-Cs. (b) Mental health and self-care interventions by HCWs. (c) Self-care interventions only by HCWs. d) Control group receiving standard care. Data were collected at baseline and postintervention using validated questionnaires, including the Patient Health Questionnaire and World Health Organization Quality of Life (QOL-BREF), among others. The intervention will last for 8 months, with monthly self-help group meetings providing support and resources.

Results: The study aims to provide evidence on the effectiveness of integrated mental health and self-care interventions for NTD patients by evaluating outcomes such as mental health status, quality of life (QOL), and socioeconomic factors.

Conclusion: This trial aims to inform policy and practice by demonstrating the potential benefits of integrating mental health services within the care framework for individuals affected by NTDs in Nigeria. If successful, the findings will contribute to the enhancement of healthcare delivery and may be incorporated into the National Tuberculosis and Leprosy Control Program for broader implementation across the country.Trial registration: PACTR Registration number: PACTR202404852537141.https://pactr.samrc.ac.za/Default.aspx?Logout=TrueRetrospectively registered.

Background: Tuberculosis (TB) poses a significant public health challenge, particularly because it can exist in an asymptomatic latent phase. Latent TB infection indicates the presence of Mycobacterium tuberculosis without clinical symptoms. Effectively distinguishing between active and latent TB is essential, especially in regions with high TB prevalence, as it may help reduce transmission rates. This study aims to evaluate C1q as a potential biomarker for differentiating active TB from latent forms.

Methods: This prospective cross-sectional study was conducted from January 2017 to February 2018, involving HIV-negative adults aged 18 and older attending TB clinics. Participants were categorized based on clinical symptoms, imaging results, and laboratory tests into active or latent TB. Blood samples were collected to assess serum C1q levels, which were then compared between the two groups.

Results: Out of 81 patients referred for TB evaluation, 38 were diagnosed with active TB. The overall median C1q level was 6.46 μg/ml (interquartile range 4.66-10). The active TB group exhibited significantly elevated C1q levels (10.21 μg/ml) compared to the latent TB group (6.03 μg/ml, P < 0.001). The area under the receiver operating characteristic curve for C1q in distinguishing active from latent TB was 0.74 (95% confidence interval, 0.63-0.85), with sensitivity varying between 61% and 82% at different threshold values.

Conclusions: C1q shows potential as a reliable and easily obtainable biomarker for differentiating active TB from latent infection, demonstrating high sensitivity. These results underscore the need for further research to explore the clinical application of C1q in TB diagnostics.

Background: All-oral regimens, including bedaquiline, are now standard in shorter treatment regimens (STRs) for multidrug-resistant tuberculosis (MDR-TB). Resistance or intolerance to drugs in STR often necessitates a switch to longer treatment regimens (LTRs). This study aims to identify the factors associated with this transition in MDR-TB patients.

Methods: We conducted a retrospective analysis of medical records from MDR-TB patients treated with STR at Haji Hospital, Surabaya, between January 2022 and January 2023. Data on drug-resistance profiles, determined by drug-susceptibility testing (DST), and line probe assay, as well as adverse effects, were collected.

Results: Among 20 eligible patients, 8 (40.0%) switched from STR to LTR within the first 4 months. Resistance was observed in 62.5% of these patients for pyrazinamide, 25.0% for high-dose isoniazid, and 12.5% for levofloxacin. The overall prevalence of pyrazinamide resistance was 25.0%. A history of prior antitubercular treatment was significantly associated with pyrazinamide resistance (P = 0.015; RR - 16.000; confidence interval 95% 1.274-200.917).

Conclusion: Pyrazinamide resistance is a major factor for switching from STR to LTR in MDR-TB patients, particularly among those with previous TB treatment. Rapid DST for pyrazinamide is essential for the early identification of resistance and timely adjustments to treatment regimens.

Nontuberculous mycobacterial surgical site infections (SSIs) have a distinct course of disease with diagnosis and treatment presenting challenges. Thirty-seven patients who underwent various procedures and then developed late SSI due to nontuberculous mycobacteria included in this case series. Samples were sent for diagnosis. Patients were started on a regime of levofloxacin with azithromycin. Multiple patients required repeat surgical intervention. The duration of treatment varied from 4 to 6 months. Complete resolution of symptoms occurred in all patients. Nontuberculous mycobacterial infections can be challenging to diagnose and treat. A high degree of clinical suspicion is warranted to limit morbidity.

Foreign body aspiration (FBA) is a common issue in children, particularly boys, and can be life-threatening. Early removal of the foreign body (FB) leads to recovery, but delayed diagnosis may cause complications such as granuloma, recurrent pneumonia, and atelectasis. This condition often results from a child's curiosity, with factors such as inadequate swallowing reflex and activity during eating contributing to the risk. The right bronchus is the most common site for FB impaction. In this case, a child presented with persistent productive cough and shortness of breath. Initial computed tomography scans suggested pneumonia and mucoid impaction in the right lung, raising concern for tuberculosis due to a family history. However, further ultrasound and clinical findings confirmed FBA. The FB, a pen cap, was removed via bronchoscopy, and the patient's symptoms resolved. Follow-up care was provided to ensure continued recovery.

Background: Several discoveries about leprosy indicate that Mycobacterium leprae transmission mainly occurs by inhalation, and the nose is a major port of entry and exit. Molecular probes have shown certain potential for the detection and identification of M. leprae in patients. The aim of this study was to identify M. leprae in nasal swab specimens using polymerase chain reaction (PCR)-based assays followed by gene sequencing methods. This observational study examines 64 anterior nasal swab samples taken from pretreatment leprosy patients, on-treatment and completed leprosy treatment in Bulukumba, South Sulawesi, Indonesia.

Methods: samples were analyzed by molecular detection methods according to the standard methods at the Clinical Microbiology Laboratory of Hasanuddin University. Descriptive statistics were utilized to summarize patient demographics and outcomes.

Results: This study uses PCR to detect the M. leprae deoxyribonucleic acid (DNA) from nasal swab specimens. Data were collected from 64 patients with a percentage of male patients 51.54%. Based on the age category, the group 45-46 years was the most frequent (39.05%). PCR detection proline-rich antigen gene of a 531 bp DNA fragment from M. leprae, was positive in eight patients, and they were multibacillary. Furthermore, PCR was positive in 5 (31.25%) of 16 new leprosy patients, 2 (8.69%) of 23 on-treatment patients, and 1 (4%) of 25 treatment completed patients. Based on the results of the phylogenetic tree and analysis of 8 positive results detected by M. leprae from leprosy patients, almost all samples have a level of similarity, except for sample Ua7.

Conclusions: M. leprae cannot grow in vitro, so molecular diagnostic tools were used to confirm the disease. This study predominantly of males with the age above 45 years of age being the most common. Eight M. leprae were positive from nasal swab leprosy patients. The sequencing findings provide insight into the genetic diversity of the genus M. leprae, so it is necessary to consider the detection of whole-genome sequence.

Background: Pyrazinamide is one of the antitubercular drugs used for 2 months in the intensive phase. One of the adverse effects of pyrazinamide is hyperuricemia, with a symptom of arthralgia. This study aims to analyze the incidence of hyperuricemia and arthralgia and their causality in pulmonary tuberculosis (TB) patients undergoing treatment in the intensive phase.

Methods: It was an analytic observational study with a prospective cohort design. Three ml of blood from each pulmonary TB patient was withdrawn to examine uric acid levels before and after 2 months of treatment with pyrazinamide. The Wilcoxon test was used to analyze changes in uric acid levels and the Chi-square test to analyze the association between uric acid levels and arthralgia. Naranjo algorithm is used to analyze the causality of hyperuricemia.

Results: Twenty pulmonary TB patients met the inclusion criteria in this study. Eight out of 12 (60%) TB patients showed uric acid levels ≥7 mg/dl and 8 of them (66.6%) showed symptoms of arthralgia. The median uric acid level increased significantly before (5.14 mg/dl) and after 2 months of treatment (7.74 mg/dl), P-value = 0.001. Uric acid levels ≥7 mg/dl were significantly associated with arthralgia (P-value = 0.017; odds ratio 14.00; 95% confidence interval 1.25-156.61). Based on the Naranjo algorithm, those with hyperuricemia, eight and four patients had a total score of 7 and 8, respectively, which are classified as probable.

Conclusion: Uric acid levels significantly increased during the intensive phase. Pulmonary TB patients with hyperuricemia are a risk factor for arthralgia.

Background: The number of tuberculosis (TB)-related morbidities and mortalities is still high in the South-east Asian region. This study was performed to characterize and visualize the post-coronavirus disease 2019 (COVID-19) TB research in South Asian Association for Regional Cooperation (SAARC).

Methods: The Web of Science Core Collection database was utilized. A total of 4822 documents were included in the final analysis according to the predefined eligibility criteria. The data were exported to the R package and VOSviewer software for factorial analysis and network visualization, respectively.

Results: The included documents were published in English between 2020 and 2024 in 1255 journals. These documents were authored by 17005 authors (3.53 authors/document). The authors collaboration index was noticed 3.61. In total, 74.16% documents were published as the article. The highest number of documents were published in 2022 (n = 1089). The documents published in 2020 received the highest number of mean total citations per article (n = 8.64). The most published journal was Cureus Journal of Medical Science (n = 228). The most prolific author was Gupta A (n = 115). The most active institution was the All India Institute of Medical Sciences (n = 587). The top most trending topics were Mycobacterium tuberculosis, TB elimination, molecular docking, extrapulmonary TB, Cartridge Based Nucleic Acid Amplification Test, and multidrug resistance. India was the most productive country and had the strongest research collaboration with the United States of America (USA), the United Kingdom (UK), and South Africa. Pakistan was mainly collaborating with the USA, the UK, Saudi Arabia, and China. The India and Pakistan collaboration was observed only in 66 documents.

Conclusion: There is a poor output of scientific publication on TB in most SAARC countries. However, it is recognized that India has produced the highest number of scientific publications. The detection of undiagnosed post-COVID-19 pandemic TB cases is crucial to control further cases in the region. An effective regional cooperation should be established among institutions, universities, and countries to achieve the World Health Organization End TB goals.