Pub Date : 2025-07-11DOI: 10.1016/j.jctube.2025.100551
James T. Gaensbauer , Seanne P. Buckwalter , Juan Antonio Solon , Jaime Montoya , Concepcion F. Ang , Vera S. Antonios , Nancy L. Wengenack , Irene Sia
{"title":"Defining the role for Mycobacterium tuberculosis PCR testing from stool samples","authors":"James T. Gaensbauer , Seanne P. Buckwalter , Juan Antonio Solon , Jaime Montoya , Concepcion F. Ang , Vera S. Antonios , Nancy L. Wengenack , Irene Sia","doi":"10.1016/j.jctube.2025.100551","DOIUrl":"10.1016/j.jctube.2025.100551","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100551"},"PeriodicalIF":1.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-04DOI: 10.1016/j.jctube.2025.100548
Dingyi Liu , Wenjing Wang , Yue Hou , Xiaoyi Gao , Wenzhao Xu , Tong Liang , Zhaogang Sun
Background
Tuberculosis (TB) is an infectious disease that poses a global hazard to public health. Clinically, the small number and low concentration of Mycobacterium tuberculosis (M.tb) in some specimens make TB difficult to detect in the laboratory and affect the sensitivity of diagnosis.
Methods
M.tb in clinical sputum specimens was purified and concentrated using the double membrane filtration concentration method (DMFCM), which was compared with existing methods and evaluated for application.
Results
DMFCM removes 40–80% of impurities from 80.53% of specimens while concentrating M.tb by up to 3.366 times. In microscopy examination, compared with the direct smear method (DSM), the sensitivity with DMFCM of the test was increased from 58.33% to 73.61%. For quantitative real-time PCR (qPCR), the positive rate of the sputum specimens treated with the DMFCM (37/42) was higher than that treated with centrifugation (35/42). In terms of cultures, treatment of sputum specimens with DMFCM reduced the time required to determine a positive result to 75% of the time required compared to the MGIT 960 liquid cultures, and increased the rate of positivity.
Conclusions
The M.tb in the culture solution after DMFCM treatment is purer and more concentrated, which can effectively improve the positive rate of detection.
{"title":"A method for purifying and concentrating Mycobacterium tuberculosis in sputum specimens: The double-membrane filtration and concentration method (DMFCM)","authors":"Dingyi Liu , Wenjing Wang , Yue Hou , Xiaoyi Gao , Wenzhao Xu , Tong Liang , Zhaogang Sun","doi":"10.1016/j.jctube.2025.100548","DOIUrl":"10.1016/j.jctube.2025.100548","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) is an infectious disease that poses a global hazard to public health. Clinically, the small number and low concentration of Mycobacterium tuberculosis (<em>M.tb</em>) in some specimens make TB difficult to detect in the laboratory and affect the sensitivity of diagnosis.</div></div><div><h3>Methods</h3><div><em>M.tb</em> in clinical sputum specimens was purified and concentrated using the double membrane filtration concentration method (DMFCM), which was compared with existing methods and evaluated for application.</div></div><div><h3>Results</h3><div>DMFCM removes 40–80% of impurities from 80.53% of specimens while concentrating <em>M.tb</em> by up to 3.366 times. In microscopy examination, compared with the direct smear method (DSM), the sensitivity with DMFCM of the test was increased from 58.33% to 73.61%. For quantitative real-time PCR (qPCR), the positive rate of the sputum specimens treated with the DMFCM (37/42) was higher than that treated with centrifugation (35/42). In terms of cultures, treatment of sputum specimens with DMFCM reduced the time required to determine a positive result to 75% of the time required compared to the MGIT 960 liquid cultures, and increased the rate of positivity.</div></div><div><h3>Conclusions</h3><div>The <em>M.tb</em> in the culture solution after DMFCM treatment is purer and more concentrated, which can effectively improve the positive rate of detection.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100548"},"PeriodicalIF":1.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-03DOI: 10.1016/j.jctube.2025.100550
Seulki Kim , A Reum Kim , Seungjin Lim , Su Jin Lee , Moonsuk Bae
Background
Tuberculosis (TB)-associated hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal condition characterized by a hyperinflammatory response. Bone marrow TB poses unique diagnostic and therapeutic challenges, often leading to delayed diagnosis and treatment. Here, we report a case of disseminated TB with bone marrow involvement, characterized by unexplained fever, pancytopenia, liver dysfunction, and associated hemophagocytosis.
Case presentation
A 37-year-old woman with a history of diabetes, hypertension, and end-stage renal disease presented with unexplained fever, pancytopenia, and liver dysfunction. A diagnosis of disseminated TB with bone marrow involvement associated with HLH was established based on findings of bone marrow aspiration and biopsy, along with transjugular liver biopsy. Three months after anti-TB treatment, she developed a paradoxical upgrading reaction, for which she was treated with steroids for 5 weeks. The patient was successfully treated with anti-TB drugs and steroids. However, the pancytopenia persisted. A bone marrow biopsy was performed 14 months after the diagnosis. Nonetheless, there was no evidence of TB or any hematological abnormalities. Through our literature review, we summarized diagnostic findings, treatment, and clinical outcomes for 42 patients diagnosed with bone marrow tuberculosis with or without HLH.
Conclusions
The diagnosis and treatment of disseminated TB-associated HLH are challenging. Early recognition, use of all available diagnostic approaches, and individualized treatment are crucial for improving patient outcomes.
{"title":"Diagnostic and therapeutic challenges in disseminated tuberculosis with bone marrow involvement and hemophagocytic lymphohistiocytosis: A case report and literature review","authors":"Seulki Kim , A Reum Kim , Seungjin Lim , Su Jin Lee , Moonsuk Bae","doi":"10.1016/j.jctube.2025.100550","DOIUrl":"10.1016/j.jctube.2025.100550","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB)-associated hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal condition characterized by a hyperinflammatory response. Bone marrow TB poses unique diagnostic and therapeutic challenges, often leading to delayed diagnosis and treatment. Here, we report a case of disseminated TB with bone marrow involvement, characterized by unexplained fever, pancytopenia, liver dysfunction, and associated hemophagocytosis.</div></div><div><h3>Case presentation</h3><div>A 37-year-old woman with a history of diabetes, hypertension, and end-stage renal disease presented with unexplained fever, pancytopenia, and liver dysfunction. A diagnosis of disseminated TB with bone marrow involvement associated with HLH was established based on findings of bone marrow aspiration and biopsy, along with transjugular liver biopsy. Three months after anti-TB treatment, she developed a paradoxical upgrading reaction, for which she was treated with steroids for 5 weeks. The patient was successfully treated with anti-TB drugs and steroids. However, the pancytopenia persisted. A bone marrow biopsy was performed 14 months after the diagnosis. Nonetheless, there was no evidence of TB or any hematological abnormalities. Through our literature review, we summarized diagnostic findings, treatment, and clinical outcomes for 42 patients diagnosed with bone marrow tuberculosis with or without HLH.</div></div><div><h3>Conclusions</h3><div>The diagnosis and treatment of disseminated TB-associated HLH are challenging. Early recognition, use of all available diagnostic approaches, and individualized treatment are crucial for improving patient outcomes.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100550"},"PeriodicalIF":1.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to identify the factors influencing Multidrug-Resistant Pulmonary Tuberculosis (MDR-TB) in Northeast Thailand.
Methods
A case-control study was conducted by reviewing medical record and collecting primary data using a structured questionnaire. The study population comprised the case group of patients with MDR-TB and the control group consisted of other pulmonary tuberculosis patients aged 18 years and over with ratio 1 case: 3 controls. The factors influencing MDR-TB in the Northeast of Thailand were identified by multivariable analysis.
Results
The results revealed that the majority of the cases and controls were males (73.79 % and 59.87 %, respectively) with mean ages of 50.50 years and 56.30 years. Cases had more moderate self-care behaviors (40.78 %) compared with controls (17.15 %). Nearly half (48.54 %) of the cases had a limited level of health literacy. Multivariable analysis demonstrated that education level (Adjusted Odd Ratio (AOR) = 1.12; 95 % CI = 1.14–1.96, p = 0.04), average monthly family income (AOR = 1.78; 95 % CI = 1.19–2.97, p = 0.01), number of windows (AOR = 2.03; 95 % CI = 1.34–3.91, p = 0.001), being diagnosed with tuberculosis two or more times (AOR = 4.63; 95 % CI = 2.51–12.35, p < 0.001), poor attitude towards tuberculosis illness (AOR = 1.32; 95 % CI = 1.05–2.48, p = 0.03), mild to moderate self-care behavior levels (AOR = 1.47; 95 % CI = 1.14–3.05, p < 0.001), and inadequate to problematic levels of health literacy (AOR = 2.11; 95 % CI = 1.36–3.63, p < 0.001) were significant determinants of MDR-TB.
Conclusions
This study concluded that education level, monthly family income, number of windows, recurrence of TB diagnosis, attitude towards TB illness, self-care behavior level and limited health literacy level were risk factors of MDR-TB. Inadequate health literacy was particularly associated with a high risk of developing MDR-TB. In order to increase treatment success rates, the results from this study should be used to improve targeted interventions and health education strategies.
本研究旨在确定泰国东北部地区耐多药肺结核(MDR-TB)的影响因素。方法采用病例对照研究方法,查阅病案资料,采用结构化问卷收集原始资料。研究人群包括耐多药结核病患者病例组和其他18岁及以上肺结核患者的对照组,1例:3例对照。通过多变量分析确定泰国东北部耐多药结核病的影响因素。结果本组病例以男性居多,分别为73.79%和59.87%,平均年龄为50.50岁和56.30岁。患者有较多的中度自我护理行为(40.78%),对照组为17.15%。近一半(48.54%)的病例卫生知识水平有限。多变量分析表明,受教育程度(调整奇数比(AOR) = 1.12;95% CI = 1.14-1.96, p = 0.04),家庭月平均收入(AOR = 1.78;95%可信区间-2.97 = 1.19,p = 0.01), windows(优势比= 2.03;95% CI = 1.34-3.91, p = 0.001),两次或两次以上被诊断为结核病(AOR = 4.63;95% CI = 2.51-12.35, p <;0.001),对结核病的态度差(AOR = 1.32;95% CI = 1.05-2.48, p = 0.03),轻至中度自我照顾行为水平(AOR = 1.47;95% CI = 1.14-3.05, p <;0.001),健康素养水平不足(AOR = 2.11;95% CI = 1.36-3.63, p <;0.001)是耐多药结核病的重要决定因素。结论受教育程度、家庭月收入、窗口数、结核病诊断复发率、结核病态度、自我保健行为水平和有限健康素养水平是耐多药结核病的危险因素。卫生知识普及不足与发生耐多药结核病的高风险特别相关。为了提高治疗成功率,本研究的结果应用于改进有针对性的干预措施和健康教育策略。
{"title":"Factors influencing the risk of developing multidrug-resistant pulmonary tuberculosis in Northeast Thailand","authors":"Nion Leeka , Wongsa Laohasiriwong , Roshan Kumar Mahato , Kittiporn Amprarat , Seksan Chaisuksant","doi":"10.1016/j.jctube.2025.100549","DOIUrl":"10.1016/j.jctube.2025.100549","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to identify the factors influencing Multidrug-Resistant Pulmonary Tuberculosis (MDR-TB) in Northeast Thailand.</div></div><div><h3>Methods</h3><div>A case-control study was conducted by reviewing medical record and collecting primary data using a structured questionnaire. The study population comprised the case group of patients with MDR-TB and the control group consisted of other pulmonary tuberculosis patients aged 18 years and over with ratio 1 case: 3 controls. The factors influencing MDR-TB in the Northeast of Thailand were identified by multivariable analysis.</div></div><div><h3>Results</h3><div>The results revealed that the majority of the cases and controls were males (73.79 % and 59.87 %, respectively) with mean ages of 50.50 years and 56.30 years. Cases had more moderate self-care behaviors (40.78 %) compared with controls (17.15 %). Nearly half (48.54 %) of the cases had a limited level of health literacy. Multivariable analysis demonstrated that education level (Adjusted Odd Ratio (AOR) = 1.12; 95 % CI = 1.14–1.96, p = 0.04), average monthly family income (AOR = 1.78; 95 % CI = 1.19–2.97, p = 0.01), number of windows (AOR = 2.03; 95 % CI = 1.34–3.91, p = 0.001), being diagnosed with tuberculosis two or more times (AOR = 4.63; 95 % CI = 2.51–12.35, p < 0.001), poor attitude towards tuberculosis illness (AOR = 1.32; 95 % CI = 1.05–2.48, p = 0.03), mild to moderate self-care behavior levels (AOR = 1.47; 95 % CI = 1.14–3.05, p < 0.001), and inadequate to problematic levels of health literacy (AOR = 2.11; 95 % CI = 1.36–3.63, p < 0.001) were significant determinants of MDR-TB.</div></div><div><h3>Conclusions</h3><div>This study concluded that education level, monthly family income, number of windows, recurrence of TB diagnosis, attitude towards TB illness, self-care behavior level and limited health literacy level were risk factors of MDR-TB. Inadequate health literacy was particularly associated with a high risk of developing MDR-TB. In order to increase treatment success rates, the results from this study should be used to improve targeted interventions and health education strategies.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100549"},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-26DOI: 10.1016/j.jctube.2025.100547
Bhakti Chavhan, Lajwanti Lalwani
Background
Post-treated pulmonary tuberculosis (PTB) frequently leads to long-term impairments in lung function, endurance, and mental well-being. Pulmonary rehabilitation (PR) programs aim to restore functional capacity but may not sufficiently address psychological distress. Mindful meditation, when integrated with PR, may offer enhanced recovery by addressing both physical and emotional deficits [1,2].
Methods
We plan to conduct this study at a single hospital, where 51 people who recently completed TB treatment will be invited to participate. Each person will be randomly placed into one of two groups. One group will follow a regular rehab program, while the other will follow the same program with added daily meditation sessions. The rehab will last for four weeks. We’ll check each person’s walking ability and quality of life [5,6], and also note changes in their breathing, oxygen levels, and vital signs [7].
Expected Results: People who do both meditation and rehab are likely to feel and function better than those who only do rehab. We hope this combined approach gives more balanced physical and mental recovery [1,2].
Conclusion
If adding meditation works well, it could become part of rehab for others recovering from TB. This might help patients feel more energetic and positive after their illness [3,4].
{"title":"Efficacy of mindful meditation in adjunct to a pulmonary rehabilitation program in improving functional capacity and quality of life in post-treated pulmonary tuberculosis patients: A randomized controlled trial (Study Protocol)","authors":"Bhakti Chavhan, Lajwanti Lalwani","doi":"10.1016/j.jctube.2025.100547","DOIUrl":"10.1016/j.jctube.2025.100547","url":null,"abstract":"<div><h3>Background</h3><div>Post-treated pulmonary tuberculosis (PTB) frequently leads to long-term impairments in lung function, endurance, and mental well-being. Pulmonary rehabilitation (PR) programs aim to restore functional capacity but may not sufficiently address psychological distress. Mindful meditation, when integrated with PR, may offer enhanced recovery by addressing both physical and emotional deficits [1,2].</div></div><div><h3>Methods</h3><div>We plan to conduct this study at a single hospital, where 51 people who recently completed TB treatment will be invited to participate. Each person will be randomly placed into one of two groups. One group will follow a regular rehab program, while the other will follow the same program with added daily meditation sessions. The rehab will last for four weeks. We’ll check each person’s walking ability and quality of life [5,6], and also note changes in their breathing, oxygen levels, and vital signs [7].</div><div>Expected Results: People who do both meditation and rehab are likely to feel and function better than those who only do rehab. We hope this combined approach gives more balanced physical and mental recovery [<span><span>1</span></span>,<span><span>2</span></span>].</div></div><div><h3>Conclusion</h3><div>If adding meditation works well, it could become part of rehab for others recovering from TB. This might help patients feel more energetic and positive after their illness [<span><span>3</span></span>,<span><span>4</span></span>].</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100547"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-26DOI: 10.1016/j.jctube.2025.100546
Frouke A. Procee , Jizzo R. Bosdriesz , Frank G.J. Cobelens , Maria Prins , Sabine M. Hermans , Anton E. Kunst
Background
Extrapulmonary tuberculosis (EPTB) poses significant diagnostic and therapeutic challenges in low-incidence settings like the Netherlands. Despite declining overall tuberculosis (TB) incidence, the proportion of EPTB has risen, especially among migrant populations. This study examines sociodemographic, migration-related, and clinical factors associated with EPTB from 1993 to 2022 to inform TB diagnostics and care.
Methods
A retrospective quantitative analysis of 34,048 TB patients reported to the Netherlands Tuberculosis Registry (1993–2022) was conducted. Logistic regression was used to identify associations with EPTB. Temporal trends in EPTB and pulmonary TB (PTB) were evaluated, including stratification by age, country of birth, and duration of residency.
Results
Over the study period, the proportion of EPTB rose from 37 % to 50 %. EPTB was more common in women (adjusted odds ratio (aOR) 1.53; 95 % CI 1.45–1.62) and children under 14 years (aOR 2.83; 95 % CI 2.46–3.24). Foreign-born individuals, particularly from India, Somalia, Eritrea, Ethiopia and Pakistan, had higher odds of EPTB compared to Dutch-born individuals (aOR range: 2.33–3.86). EPTB was also associated with HIV infection (aOR 1.73; 95 % CI 1.43–2.11) but inversely related to social risk factors like homelessness and problem substance use. TB was notably frequently diagnosed among individuals residing in the Netherlands for over 10 years, more often EPTB than PTB.
Conclusion
The rising proportion of EPTB underscores the need for targeted interventions, particularly for high-risk groups such as women, children and migrants. Enhanced screening, early detection, and preventive strategies, especially for tuberculosis infection (TBI) are critical to reducing EPTB morbidity and mortality.
背景:在荷兰等低发病率地区,肺痨(EPTB)的诊断和治疗面临重大挑战。尽管结核病的总发病率有所下降,但EPTB的比例却有所上升,尤其是在移民人群中。本研究调查了1993年至2022年与EPTB相关的社会人口统计学、移民相关和临床因素,为结核病诊断和治疗提供信息。方法对荷兰结核病登记处1993-2022年报告的34048例结核病患者进行回顾性定量分析。使用逻辑回归来确定与EPTB的关联。对EPTB和肺结核(PTB)的时间趋势进行了评估,包括年龄、出生国家和居住时间的分层。结果在研究期间,EPTB的比例从37%上升到50%。EPTB在女性中更为常见(调整优势比(aOR) 1.53;95% CI 1.45-1.62)和14岁以下儿童(aOR 2.83;95% ci 2.46-3.24)。外国出生的人,特别是来自印度、索马里、厄立特里亚、埃塞俄比亚和巴基斯坦的人,与荷兰出生的人相比,患EPTB的几率更高(aOR范围:2.33-3.86)。EPTB还与HIV感染相关(aOR 1.73;95% CI 1.43-2.11),但与无家可归和问题物质使用等社会风险因素呈负相关。结核病在荷兰居住10年以上的人群中被诊断出来的频率很高,EPTB比PTB更常见。结论EPTB比例的上升强调了有针对性干预的必要性,特别是对妇女、儿童和移民等高危人群。加强筛查、早期发现和预防策略,特别是结核病感染(TBI),对于降低EPTB发病率和死亡率至关重要。
{"title":"Extrapulmonary tuberculosis in The Netherlands, an epidemiologic overview, 1993–2022","authors":"Frouke A. Procee , Jizzo R. Bosdriesz , Frank G.J. Cobelens , Maria Prins , Sabine M. Hermans , Anton E. Kunst","doi":"10.1016/j.jctube.2025.100546","DOIUrl":"10.1016/j.jctube.2025.100546","url":null,"abstract":"<div><h3>Background</h3><div>Extrapulmonary tuberculosis (EPTB) poses significant diagnostic and therapeutic challenges in low-incidence settings like the Netherlands. Despite declining overall tuberculosis (TB) incidence, the proportion of EPTB has risen, especially among migrant populations. This study examines sociodemographic, migration-related, and clinical factors associated with EPTB from 1993 to 2022 to inform TB diagnostics and care.</div></div><div><h3>Methods</h3><div>A retrospective quantitative analysis of 34,048 TB patients reported to the Netherlands Tuberculosis Registry (1993–2022) was conducted. Logistic regression was used to identify associations with EPTB. Temporal trends in EPTB and pulmonary TB (PTB) were evaluated, including stratification by age, country of birth, and duration of residency.</div></div><div><h3>Results</h3><div>Over the study period, the proportion of EPTB rose from 37 % to 50 %. EPTB was more common in women (adjusted odds ratio (aOR) 1.53; 95 % CI 1.45–1.62) and children under 14 years (aOR 2.83; 95 % CI 2.46–3.24). Foreign-born individuals, particularly from India, Somalia, Eritrea, Ethiopia and Pakistan, had higher odds of EPTB compared to Dutch-born individuals (aOR range: 2.33–3.86). EPTB was also associated with HIV infection (aOR 1.73; 95 % CI 1.43–2.11) but inversely related to social risk factors like homelessness and problem substance use. TB was notably frequently diagnosed among individuals residing in the Netherlands for over 10 years, more often EPTB than PTB.</div></div><div><h3>Conclusion</h3><div>The rising proportion of EPTB underscores the need for targeted interventions, particularly for high-risk groups such as women, children and migrants. Enhanced screening, early detection, and preventive strategies, especially for tuberculosis infection (TBI) are critical to reducing EPTB morbidity and mortality.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100546"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-20DOI: 10.1016/j.jctube.2025.100541
Jonathan Izudi , Adithya Cattamanchi , Francis Bajunirwe
The treatment success rate among people with tuberculosis in sub-Saharan Africa is suboptimal despite the availability of shortened and efficacious TB regimens. Barriers such as long travel distances and frequent clinic visits for medication refills hinder access to care and compromise treatment adherence and completion. Multi-month dispensing of anti-retroviral drugs has proved successful in improving treatment adherence and viral load suppression among people living with human immunodeficiency virus. The strategy could be adapted for tuberculosis care to address treatment access and adherence barriers to optimize treatment success. In this perspective, we discuss the key considerations for the multi-month dispensing of tuberculosis drugs in sub-Saharan Africa. In particular, we highlight treatment monitoring, strengthening of logistics and supply chain systems, multi-month dispensing protocols, healthcare provider capacity building, community engagement, and monitoring and evaluation framework. We call for research, policy reforms, and pilot programs to evaluate and scale up multi-month dispensing of tuberculosis medications to end the epidemic by 2035.
{"title":"Multi-month dispensing of tuberculosis medications in sub-Saharan Africa: A feasible, person-centered care model","authors":"Jonathan Izudi , Adithya Cattamanchi , Francis Bajunirwe","doi":"10.1016/j.jctube.2025.100541","DOIUrl":"10.1016/j.jctube.2025.100541","url":null,"abstract":"<div><div>The treatment success rate among people with tuberculosis in sub-Saharan Africa is suboptimal despite the availability of shortened and efficacious TB regimens. Barriers such as long travel distances and frequent clinic visits for medication refills hinder access to care and compromise treatment adherence and completion. Multi-month dispensing of anti-retroviral drugs has proved successful in improving treatment adherence and viral load suppression among people living with human immunodeficiency virus. The strategy could be adapted for tuberculosis care to address treatment access and adherence barriers to optimize treatment success. In this perspective, we discuss the key considerations for the multi-month dispensing of tuberculosis drugs in sub-Saharan Africa. In particular, we highlight treatment monitoring, strengthening of logistics and supply chain systems, multi-month dispensing protocols, healthcare provider capacity building, community engagement, and monitoring and evaluation framework. We call for research, policy reforms, and pilot programs to evaluate and scale up multi-month dispensing of tuberculosis medications to end the epidemic by 2035.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100541"},"PeriodicalIF":1.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-18DOI: 10.1016/j.jctube.2025.100544
Arthur Lemson , Fleur Dijkhuizen , Ralf Stemkens , Arjan van Laarhoven , Reinout van Crevel , Jakko van Ingen , Rob Aarnoutse , Wouter Hoefsloot
Objectives
We aimed to measure and understand medication adherence in patients with nontuberculous mycobacterial (NTM) disease.
Methods
We enrolled adults with NTM disease receiving antimycobacterial treatment at Radboudumc, the Netherlands. Demographics and treatment outcomes were recorded, and medication adherence was assessed repeatedly. Adherence was measured using the Proportion of Days Covered (PDC) at 6 and 12 months, calculated from pharmacy records, and the 5-item Medication Adherence Report Scale (MARS-5). The Beliefs about Medicines Questionnaire (BMQ) explored reasons for (non)adherence.
Results
Sixty-one participants were enrolled, with a mean age of 63.2 (±12.9) years. Forty-one (67 %) had pulmonary, and 20 (33 %) extrapulmonary NTM disease, with M. avium complex being the most prevalent species (n = 38; 62 %). One or more adverse effects occurred in 56/61 (92 %) participants. A favorable response was seen in 34/49 (69 %) and 25/29 (86 %) participants at 6 and 12 months, respectively. The median PDC was 100 % (IQR, 99–100 %) at both timepoints, and the MARS-5 remained 5 out of 5 throughout treatment, indicating high adherence. Participants’ beliefs about the necessity of NTM treatment, as assessed in the BMQ, consistently outweighed concerns.
Conclusions
Medication adherence was high throughout the first year of NTM treatment, likely due to the perceived necessity of treatment and regular follow-up at our reference clinic.
{"title":"Medication adherence in patients with nontuberculous mycobacterial disease","authors":"Arthur Lemson , Fleur Dijkhuizen , Ralf Stemkens , Arjan van Laarhoven , Reinout van Crevel , Jakko van Ingen , Rob Aarnoutse , Wouter Hoefsloot","doi":"10.1016/j.jctube.2025.100544","DOIUrl":"10.1016/j.jctube.2025.100544","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to measure and understand medication adherence in patients with nontuberculous mycobacterial (NTM) disease.</div></div><div><h3>Methods</h3><div>We enrolled adults with NTM disease receiving antimycobacterial treatment at Radboudumc, the Netherlands. Demographics and treatment outcomes were recorded, and medication adherence was assessed repeatedly. Adherence was measured using the Proportion of Days Covered (PDC) at 6 and 12 months, calculated from pharmacy records, and the 5-item Medication Adherence Report Scale (MARS-5). The Beliefs about Medicines Questionnaire (BMQ) explored reasons for (non)adherence.</div></div><div><h3>Results</h3><div>Sixty-one participants were enrolled, with a mean age of 63.2 (±12.9) years. Forty-one (67 %) had pulmonary, and 20 (33 %) extrapulmonary NTM disease, with <em>M. avium</em> complex being the most prevalent species (n = 38; 62 %). One or more adverse effects occurred in 56/61 (92 %) participants. A favorable response was seen in 34/49 (69 %) and 25/29 (86 %) participants at 6 and 12 months, respectively. The median PDC was 100 % (IQR, 99–100 %) at both timepoints, and the MARS-5 remained 5 out of 5 throughout treatment, indicating high adherence. Participants’ beliefs about the necessity of NTM treatment, as assessed in the BMQ, consistently outweighed concerns.</div></div><div><h3>Conclusions</h3><div>Medication adherence was high throughout the first year of NTM treatment, likely due to the perceived necessity of treatment and regular follow-up at our reference clinic.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100544"},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-18DOI: 10.1016/j.jctube.2025.100545
Jiangbo Li , Mei Ye , Haiyue Wang , Aidibai Ainiwaier , Ayididar Jumahan , Feng Sun
Chronic obstructive pulmonary disease (COPD) and tuberculosis pose significant public health challenges, particularly in tuberculosis-endemic developing regions where their co-prevalence may exacerbate the disease burden of chronic airflow obstruction. This study aimed to investigate the impact of stable pulmonary tuberculosis on inflammatory status, coagulation function, and pulmonary function in COPD patients during acute exacerbations.We conducted a retrospective analysis of 68 COPD patients with acute exacerbation and stable pulmonary tuberculosis (observation group) admitted between December 2019 and December 2023. Using propensity score matching based on age and gender, we selected 68 COPD patients without stable pulmonary tuberculosis as the control group. Comparative analysis of laboratory tests and pulmonary function parameters revealed that the observation group had significantly elevated levels of erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), lymphocyte count, platelet count (PLT), and D-dimer, along with significantly reduced pulmonary function parameters including forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) and forced expiratory flow between 25 %-75 % of vital capacity (FEF25-FEF75) (all P < 0.05). Correlation analysis demonstrated positive associations between ESR/IL-6 levels and D-dimer, PLT, and fibrin(ogen) degradation product (FDP) levels (P < 0.05).Binary logistic regression analysis of 14 significantly different variables identified IL-6 (OR = 1.056), ESR (OR = 1.022), PLT (OR = 1.005), D-Dimer (OR = 1.002), FEV1/FVC (OR = 0.962), FEF50 (OR = 0.534), and FEF75 (OR = 0.089) as independent factors associated with acute exacerbation in COPD patients with stable pulmonary tuberculosis (all P < 0.05). Our findings indicate that elevated IL-6, ESR, PLT, and D-Dimer levels coupled with decreased FEV1/FVC, FEF50, and FEF75 levels represent distinctive clinical characteristics of these patients.This study demonstrates that COPD patients with stable pulmonary tuberculosis exhibit enhanced inflammatory responses, prothrombotic tendencies, and more severe pulmonary function impairment, providing a scientific basis for developing individualized treatment strategies for this patient population.
{"title":"The exacerbating effects of stable pulmonary tuberculosis on the deterioration of inflammatory response, coagulation function, and pulmonary function in COPD: A propensity score-matched retrospective study","authors":"Jiangbo Li , Mei Ye , Haiyue Wang , Aidibai Ainiwaier , Ayididar Jumahan , Feng Sun","doi":"10.1016/j.jctube.2025.100545","DOIUrl":"10.1016/j.jctube.2025.100545","url":null,"abstract":"<div><div>Chronic obstructive pulmonary disease (COPD) and tuberculosis pose significant public health challenges, particularly in tuberculosis-endemic developing regions where their co-prevalence may exacerbate the disease burden of chronic airflow obstruction. This study aimed to investigate the impact of stable pulmonary tuberculosis on inflammatory status, coagulation function, and pulmonary function in COPD patients during acute exacerbations.We conducted a retrospective analysis of 68 COPD patients with acute exacerbation and stable pulmonary tuberculosis (observation group) admitted between December 2019 and December 2023. Using propensity score matching based on age and gender, we selected 68 COPD patients without stable pulmonary tuberculosis as the control group. Comparative analysis of laboratory tests and pulmonary function parameters revealed that the observation group had significantly elevated levels of erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), lymphocyte count, platelet count (PLT), and D-dimer, along with significantly reduced pulmonary function parameters including forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) and forced expiratory flow between 25 %-75 % of vital capacity (FEF25-FEF75) (all P < 0.05). Correlation analysis demonstrated positive associations between ESR/IL-6 levels and D-dimer, PLT, and fibrin(ogen) degradation product (FDP) levels (P < 0.05).Binary logistic regression analysis of 14 significantly different variables identified IL-6 (OR = 1.056), ESR (OR = 1.022), PLT (OR = 1.005), D-Dimer (OR = 1.002), FEV1/FVC (OR = 0.962), FEF50 (OR = 0.534), and FEF75 (OR = 0.089) as independent factors associated with acute exacerbation in COPD patients with stable pulmonary tuberculosis (all P < 0.05). Our findings indicate that elevated IL-6, ESR, PLT, and D-Dimer levels coupled with decreased FEV1/FVC, FEF50, and FEF75 levels represent distinctive clinical characteristics of these patients.This study demonstrates that COPD patients with stable pulmonary tuberculosis exhibit enhanced inflammatory responses, prothrombotic tendencies, and more severe pulmonary function impairment, providing a scientific basis for developing individualized treatment strategies for this patient population.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100545"},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-14DOI: 10.1016/j.jctube.2025.100542
Iasmim Maria Pereira Pinto Fonseca , Samantha Gomes de Alegria , Jéssica Gabriela Messias Oliveira , Thaís Souza Rodrigues , Carolina Alves Osório da Silva Chagas , Alícia Sales Carneiro , Walter Costa , Ana Paula Santos , Thiago Thomaz Mafort , Agnaldo José Lopes
Background
As the world moves toward eliminating tuberculosis (TB), there is a large population of TB survivors who still face a significant burden of TB complications. However, basic pulmonary rehabilitation program (PRP) packages for this population are currently lacking. This study aimed to evaluate the effect of home-based PRP (HBPRP) on lung mechanics, exercise capacity, and quality of life (QoL) in people with PTLD (pwPTLD).
Methods
This is a quasi-experimental study in pwPTLD who underwent HBPRP for 3 months. Before and after HBPRP, the following assessments were performed: QoL using the St George’s Respiratory Questionnaire (SGRQ), general fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), handgrip strength (HGS), pulmonary function, and functional exercise capacity using the Glittre-ADL test (TGlittre) coupled with measurement of dynamic ventilation.
Results
When comparing pre- and post-HBPRP values, there was a significant increase in TGlittre time [208 (194–249) vs. 184 (153–211) seconds, P = 0.004] and breathing reserve [56 (34–71) vs. 58 (39–73) %, P = 0.032], and a reduction in end-of-test inspiratory capacity [1.4 (0.9–2.3) vs. 1.6 (1.1–2.6) L, P = 0.030]. Although no increase in spirometric parameters was observed, there was an improvement in small airway dysfunction (SAD) as measured by respiratory oscillometry. Improvements were observed in the Activity and Impacts domains of the SGRQ. However, no significant changes were noted in FACIT-F or HGS after HBPRP.
Conclusions
In pwPTLD, HBPRP improves exercise tolerance, QoL, and SAD, with no effect on general fatigue and HGS. Therefore, TB programs should ensure the availability of PRP for pwPTLD, including HBPRP.
{"title":"Effect of home-based pulmonary rehabilitation on ventilation dynamics and small airway dysfunction in people with post-tuberculosis lung disease","authors":"Iasmim Maria Pereira Pinto Fonseca , Samantha Gomes de Alegria , Jéssica Gabriela Messias Oliveira , Thaís Souza Rodrigues , Carolina Alves Osório da Silva Chagas , Alícia Sales Carneiro , Walter Costa , Ana Paula Santos , Thiago Thomaz Mafort , Agnaldo José Lopes","doi":"10.1016/j.jctube.2025.100542","DOIUrl":"10.1016/j.jctube.2025.100542","url":null,"abstract":"<div><h3>Background</h3><div>As the world moves toward eliminating tuberculosis (TB), there is a large population of TB survivors who still face a significant burden of TB complications. However, basic pulmonary rehabilitation program (PRP) packages for this population are currently lacking. This study aimed to evaluate the effect of home-based PRP (HBPRP) on lung mechanics, exercise capacity, and quality of life (QoL) in people with PTLD (pwPTLD).</div></div><div><h3>Methods</h3><div>This is a quasi-experimental study in pwPTLD who underwent HBPRP for 3 months. Before and after HBPRP, the following assessments were performed: QoL using the St George’s Respiratory Questionnaire (SGRQ), general fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), handgrip strength (HGS), pulmonary function, and functional exercise capacity using the Glittre-ADL test (TGlittre) coupled with measurement of dynamic ventilation.</div></div><div><h3>Results</h3><div>When comparing pre- and post-HBPRP values, there was a significant increase in TGlittre time [208 (194–249) vs. 184 (153–211) seconds, <em>P</em> = 0.004] and breathing reserve [56 (34–71) vs. 58 (39–73) %, <em>P</em> = 0.032], and a reduction in end-of-test inspiratory capacity [1.4 (0.9–2.3) vs. 1.6 (1.1–2.6) L, <em>P</em> = 0.030]. Although no increase in spirometric parameters was observed, there was an improvement in small airway dysfunction (SAD) as measured by respiratory oscillometry. Improvements were observed in the Activity and Impacts domains of the SGRQ. However, no significant changes were noted in FACIT-F or HGS after HBPRP.</div></div><div><h3>Conclusions</h3><div>In pwPTLD, HBPRP improves exercise tolerance, QoL, and SAD, with no effect on general fatigue and HGS. Therefore, TB programs should ensure the availability of PRP for pwPTLD, including HBPRP.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100542"},"PeriodicalIF":1.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}