International Journal of Tuberculosis and Lung Disease最新文献

Stigma is a barrier to care for people affected by TB and HIV in Uganda, where these conditions remain endemic. While scales have been adapted and validated to measure stigma among TB-affected households in Uganda, there is a need for scales that measure the experiences of persons with TB (PWTB).We adapted the Van Rie 12-item individual perspectives TB scale and 10-item individual perspectives HIV scale for use in Uganda through cross-cultural discussions with a multidisciplinary research team and four cognitive interviews with community health workers and PWTB. We then conducted a cross-sectional study administering each scale to 125 PWTB. We performed exploratory factor analysis, evaluated internal validity, and assessed convergent validity with perceived social support.Exploratory factor analysis yielded a one-factor solution for both scales, with marginal model fit (standardised root mean square residual = 0.09 for TB, = 0.07 for HIV). There was evidence of convergent validity through a positive correlation of the TB (r = 0.22, p = 0.01) and HIV stigma (r = 0.22, p = 0.01) scales with perceived social support. Both scales had good internal validity (Cronbach's α = 0.86 for TB, = 0.87 for HIV).Adapted scales to measure perceived HIV and TB stigma among PWTB in Uganda demonstrated promising psychometric properties by removing one and two items, respectively..

Chemotherapy to prevent TB is a core component of care for persons living with HIV (PLHIV). There are few reports describing adherence to TB prevention under programmatic conditions in high TB burden settings.We measured adherence to daily isoniazid (INH) preventive treatment (IPT) using a commercially available colourimetric assay to detect urine INH metabolites among PLHIV who self-reported INH ingestion within the preceding 24 h. Enrollee characteristics associated with non-adherence despite self-reported INH ingestion were identified in multivariate log-binomial regression. Interoperator reliability for the detection of INH metabolites was calculated among three independent operators.Self-reported INH ingestion and metabolite data were known for 300 PLHIV. INH metabolite was detected in 112 (68.7%) of 163 PLHIV who self-reported INH ingestion in the preceding 24 h. The prevalence of alcohol consumption was significantly higher among INH-non-adherent PLHIV compared with INH-adherent PLHIV (adjusted prevalence ratio 2.43, 95% CI 1.16-5.12). Two-way interoperator reliability ranged from κ 0.86 to κ 0.94.Compared with self-reported 24-h INH ingestion in a high TB-HIV-incidence programmatic setting, biometric adherence to IPT was suboptimal in this sample of PLHIV. Alcohol consumption was the only potentially modifiable risk factor significantly associated with INH non-adherence. Colourimetric interpretation reliability across three operators was moderate/strong..

TB remains a significant global health challenge, particularly for children, who are often more susceptible to severe disease and complications.This study provides a comprehensive analysis of TB epidemiology and treatment outcomes in people under 18 years of age in Kazakhstan between 2018 and 2023, utilising a nationwide database that covers the entire country, with a focus on drug-susceptible (DS-TB) and drug-resistant TB (DR-TB) cases.During the study period, 3,317 pediatric TB cases were registered, with 76% being DS-TB and a significant proportion being girls and adolescents over 15 years of age. Our findings show a declining trend in TB notification and prevalence from 2018 to 2020, followed by a plateau in subsequent years. According to the data, young children under 5 years of age had the lowest TB caseload. Logistic regression analysis revealed that adolescents of 15-17 years of age had higher odds of unsuccessful treatment, while DR-TB patients had better outcomes than DS-TB patients.The study highlights the need for targeted interventions, improved diagnostic capabilities, and continuous public health efforts to address the burden of TB in children, especially in high-risk regions..

Annually, over 3 million people develop TB but are not diagnosed and treated. We aimed to characterize the mobility patterns and activity locations of people with TB in an urban, high-burden setting to inform future active case-finding (ACF) efforts.We conducted a population-based TB prevalence survey in Nairobi, Kenya, in 2022. Participants aged ≥15 years with TB symptoms or a suggestive chest X-ray submitted sputum for Xpert Ultra and culture. We collected data on individual activity locations and mobility and evaluated their association with the risk of pulmonary TB.The prevalence survey enrolled 6,369 participants across nine clusters. There were significant differences in mobility patterns and activity locations between sexes and age groups. Mobility factors were not significantly associated with TB. In the adjusted analysis, age group 45-54 (OR 2.45), male sex (OR 2.95), and use of a social activity location (OR 1.96) were significantly associated with a higher risk of TB.We did not find a significant association between mobility patterns and TB, but there was a positive association between reported 'social' activity locations and TB. Identification of 'social' activity locations, particularly bars, provides important insight into possible venues for spatially-targeted ACF activities..

Spirometry is the gold standard for diagnosing chronic obstructive respiratory diseases (CORD), but it is not widely available in primary healthcare in Vietnam. We aimed to validate a simple CORD Screening Questionnaire (CORD-SQ) for the Vietnamese population to screen subjects requiring spirometry.In a cross-sectional study, 589 volunteers seen in a primary healthcare unit were submitted to the CORD-SQ. This questionnaire included four items (cumulative smoking, history of tuberculosis, current breathlessness and wheezing or whistling) with a total score ranging from 0 to 6. The cut-off point of the CORD-SQ was previously determined as a predictor of CORD, which was last defined by spirometry (forced expiratory volume in 1 second/forced vital capacity < lower limit of normal) measured in each subject.The prevalence of CORD was 10% among the 517 subjects with non-asthmatic history. With a cut-off point of 2 for the CORD-SQ, the sensitivity and specificity were 69% and 91%, respectively, with a 46% positive predictive value and 94% negative predictive value. The area under the receiver operating characteristic curve of the CORD-SQ to discriminate the CORD was 0.83 (95% CI 0.75-0.90).In the non-asthmatic Vietnamese primary health care population, the simple CORD-SQ efficiently identifies the people at risk of CORD, requiring spirometry..