Pub Date : 2025-08-01Epub 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":"2025-08-01","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 : 2025-08-01Epub 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":"2025-08-01","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 : 2025-08-01Epub Date: 2025-05-10DOI: 10.1016/j.jctube.2025.100534
Mpho Magwalivha, Mpumelelo Casper Rikhotso, Leonard Owino Kachienga, Rendani Musoliwa, Ntshunxeko Thelma Banda, Maphepele Sara Mashilo, Thembani Tshiteme, Avheani Marry Mphaphuli, Hafsa Ali Mahamud, Sana Patel, Jean-Pierre Kabue Ngandu, Sana Patel, Natasha Potgieter, Afsatou Ndama Traoré
Background
Bacterial co-infections significantly affect the treatment outcomes of tuberculosis (TB) patients, particularly in resource-limited settings. Misdiagnosis of TB co-infections accelerate disease progression and contribute to the development of drug resistance, leading to higher mortality and morbidity rates, especially in underserved areas. This study aimed to investigate bacterial co-infections in patients with pulmonary tuberculosis in a rural Vhembe region of Limpopo, South Africa.
Materials and methods
A total of 100 sputum together with 100 blood samples were collected from TB patients who were undergoing TB treatment. DNA isolates were used as templates for PCR using the Anyplex™MTB/NTMe Assay kit, and subsequently, the Allplex™ MTB/MDR/XDRe Assay kit was used for the multiple detections of Mycobacterium tuberculosis (MTB) and resistance to first line and second line anti-TB drugs. Co-infections were determined using the Allplex™ Bacteria(I) & (II) Assay kit. HIV status of patients was determined using blood testing kits.
Results
Majority of study participants were male (55 %) and aged between 36 and 55 (54 %), while female were 46 % of the population. Bacterial species detected included non-tuberculous mycobacteria (NTM) in 67 % of participants, Aeromonas spp. (19 %), Vibrio spp. (2 %), and E. coli (2 %). Multidrug-resistant Mycobacterium tuberculosis (MTB) strains were identified in 2 % of the cohort. There was a significant association between employment status and age (p = 0.00), as well as between HIV status and age (p = 0.03). While no significant associations were found between HIV status and the presence of NTM or other bacterial co-infections (p = 0.19 and 0.21, respectively), the majority of Aeromonas spp. and NTM cases were observed among HIV-positive participants. Notably, 36 of the NTM cases occurred in individuals living with HIV.
Conclusion
The study findings suggest that age, socioeconomic status, and gender play a role in the development of TB, HIV, and other bacterial infections, which could further complicate treatment outcomes in patients. These factors likely contribute to increased vulnerability to co-infections, emphasizing the complex interplay between TB and HIV in these populations. Additionally, the study emphasises the importance of considering these socio-demographic factors in public health interventions to reduce the burden of TB-HIV co-infection and associated bacterial infections.
{"title":"Bacterial co-occurrence with pulmonary TB, a respiratory tract infection (RTI): A cross-sectional study in a resource-limited setting","authors":"Mpho Magwalivha, Mpumelelo Casper Rikhotso, Leonard Owino Kachienga, Rendani Musoliwa, Ntshunxeko Thelma Banda, Maphepele Sara Mashilo, Thembani Tshiteme, Avheani Marry Mphaphuli, Hafsa Ali Mahamud, Sana Patel, Jean-Pierre Kabue Ngandu, Sana Patel, Natasha Potgieter, Afsatou Ndama Traoré","doi":"10.1016/j.jctube.2025.100534","DOIUrl":"10.1016/j.jctube.2025.100534","url":null,"abstract":"<div><h3>Background</h3><div>Bacterial co-infections significantly affect the treatment outcomes of tuberculosis (TB) patients, particularly in resource-limited settings. Misdiagnosis of TB co-infections accelerate disease progression and contribute to the development of drug resistance, leading to higher mortality and morbidity rates, especially in underserved areas. This study aimed to investigate bacterial co-infections in patients with pulmonary tuberculosis in a rural Vhembe region of Limpopo, South Africa.</div></div><div><h3>Materials and methods</h3><div>A total of 100 sputum together with 100 blood samples were collected from TB patients who were undergoing TB treatment. DNA isolates were used as templates for PCR using the Anyplex™MTB/NTMe Assay kit, and subsequently, the Allplex™ MTB/MDR/XDRe Assay kit was used for the multiple detections of <em>Mycobacterium tuberculosis</em> (MTB) and resistance to first line and second line anti-TB drugs. Co-infections were determined using the Allplex™ Bacteria(I) & (II) Assay kit. HIV status of patients was determined using blood testing kits.</div></div><div><h3>Results</h3><div>Majority of study participants were male (55 %) and aged between 36 and 55 (54 %), while female were 46 % of the population. Bacterial species detected included non-tuberculous mycobacteria (NTM) in 67 % of participants, Aeromonas spp. (19 %), Vibrio spp. (2 %), and E. coli (2 %). Multidrug-resistant <em>Mycobacterium tuberculosis</em> (MTB) strains were identified in 2 % of the cohort. There was a significant association between employment status and age (p = 0.00), as well as between HIV status and age (p = 0.03). While no significant associations were found between HIV status and the presence of NTM or other bacterial co-infections (p = 0.19 and 0.21, respectively), the majority of Aeromonas spp. and NTM cases were observed among HIV-positive participants. Notably, 36 of the NTM cases occurred in individuals living with HIV.</div></div><div><h3>Conclusion</h3><div>The study findings suggest that age, socioeconomic status, and gender play a role in the development of TB, HIV, and other bacterial infections, which could further complicate treatment outcomes in patients. These factors likely contribute to increased vulnerability to co-infections, emphasizing the complex interplay between TB and HIV in these populations. Additionally, the study emphasises the importance of considering these socio-demographic factors in public health interventions to reduce the burden of TB-HIV co-infection and associated bacterial infections.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100534"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941821","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}
There is growing evidence of the performance accuracy and potential impact of Computer-Aided Diagnosis (CAD) products in TB-burdened settings. It remains unclear, however, which factors of populations and settings can affect CAD performance. We aimed to investigate the parameters affecting the performance accuracy of the two latest versions of CAD4TB in TB screening programmes in South Africa and Lesotho.
We included participants recruited for the Lesotho National Prevalence Survey and the TB TRIAGE + ACCURACY studies, who underwent digital chest radiography and microbiological reference testing for TB. In total, 6,524 chest images were included in the analysis: 288 cases and 6,236 controls. CAD4TB versions 6 and 7 interpreted the X-ray images, and the performance of both versions was investigated. Threshold analyses were performed, as well as subgroup analyses, including age, X-ray hardware and HIV status.
CAD4TB v7 showed overall improved performance accuracy compared to v6 (p < 0.01). The area under the ROC curve was 0.833 (95 % CI 0.808–0.859) for v6 and 0.865 (95 % CI 0.842–0.889) for v7. At 90 % sensitivity, v7 showed a higher specificity of 65 % compared to the 54 % achieved by v6. Both versions showed lower performance in the older age group (≥60 years) and individuals with a previous history of TB. The threshold required to achieve the same sensitivity or specificity varies notably across the two versions.
CAD4TB performed well as a TB screening tool; however, factors such as software version, age, TB history and X-ray hardware should be considered in threshold determination and performance evaluation.
越来越多的证据表明，在结核病负担严重的环境中，计算机辅助诊断（CAD）产品的性能准确性和潜在影响。然而，目前尚不清楚人群和环境的哪些因素会影响CAD的性能。我们的目的是研究影响南非和莱索托结核病筛查项目中两种最新版本CAD4TB性能准确性的参数。我们纳入了莱索托国家患病率调查和结核病TRIAGE +准确性研究招募的参与者，他们接受了数字化胸片检查和结核病微生物参考检测。总共有6524张胸部图像被纳入分析：288例病例和6236例对照。CAD4TB版本6和7解释了x射线图像，并研究了这两个版本的性能。进行阈值分析，以及亚组分析，包括年龄，x射线硬件和HIV状态。与v6相比，CAD4TB v7的总体性能精度有所提高(p <；0.01)。v6的ROC曲线下面积为0.833 (95% CI 0.808-0.859)， v7的ROC曲线下面积为0.865 （95% CI 0.842-0.889）。在90%的灵敏度下，v7的特异性为65%，而v6的特异性为54%。这两种版本在老年组（≥60岁）和有结核病病史的个体中表现较差。在两个版本中，达到相同灵敏度或特异性所需的阈值显著不同。CAD4TB作为结核病筛查工具表现良好；然而，在阈值确定和性能评估中，应考虑软件版本、年龄、结核病病史和x射线硬件等因素。
{"title":"Performance of CAD4TB artificial intelligence technology in TB screening programmes among the adult population in South Africa and Lesotho","authors":"Nonhlanhla Nzimande , Keelin Murphy , Klaus Reither , Shannon Bosman , Irene Ayakaka , Tracy R. Glass , Fiona Vanobberghen , Bart K.M. Jacobs , Aita Signorell , Jabulani Ncayiyana","doi":"10.1016/j.jctube.2025.100540","DOIUrl":"10.1016/j.jctube.2025.100540","url":null,"abstract":"<div><h3>Summary</h3><div>There is growing evidence of the performance accuracy and potential impact of Computer-Aided Diagnosis (CAD) products in TB-burdened settings. It remains unclear, however, which factors of populations and settings can affect CAD performance. We aimed to investigate the parameters affecting the performance accuracy of the two latest versions of CAD4TB in TB screening programmes in South Africa and Lesotho.</div><div>We included participants recruited for the Lesotho National Prevalence Survey and the TB TRIAGE + ACCURACY studies, who underwent digital chest radiography and microbiological reference testing for TB. In total, 6,524 chest images were included in the analysis: 288 cases and 6,236 controls. CAD4TB versions 6 and 7 interpreted the X-ray images, and the performance of both versions was investigated. Threshold analyses were performed, as well as subgroup analyses, including age, X-ray hardware and HIV status.</div><div>CAD4TB v7 showed overall improved performance accuracy compared to v6 (p < 0.01). The area under the ROC curve was 0.833 (95 % CI 0.808–0.859) for v6 and 0.865 (95 % CI 0.842–0.889) for v7. At 90 % sensitivity, v7 showed a higher specificity of 65 % compared to the 54 % achieved by v6. Both versions showed lower performance in the older age group (≥60 years) and individuals with a previous history of TB. The threshold required to achieve the same sensitivity or specificity varies notably across the two versions.</div><div>CAD4TB performed well as a TB screening tool; however, factors such as software version, age, TB history and X-ray hardware should be considered in threshold determination and performance evaluation.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100540"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239696","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 : 2025-08-01Epub Date: 2025-04-27DOI: 10.1016/j.jctube.2025.100530
Siddartha Guru, David Ingram
Mycobacterium shimoidei is a rare non-tuberculous mycobacterium (NTM) which causes pneumonia. Since its discovery in 1975, less than 50 cases have been published and this would be only the fourth case in the US. We present a case of Mycobacterium shimoidei in a 72-year-old male with symptoms of cough, dyspnea, and weight loss with cavitary lung lesion on imaging. Sputum cultures grew Mycobacterium shimoidei in two separate collections, and the patient was treated with oral azithromycin, ethambutol, and rifabutin empirically. Though due to medication side effects rifabutin was stopped and other antibiotics were attempted based on susceptibilities but he was unable to tolerate any of them. Thus, only a two-drug regimen including ethambutol and azithromycin was used, on which he improved clinically and cavitary lung lesions decreased in size. In addition, we did a literature review and compiled 41 previously published cases of Mycobacterium shimoidei.
{"title":"Mycobacterium shimoidei cavitary pneumonia: A rare case report, literature review","authors":"Siddartha Guru, David Ingram","doi":"10.1016/j.jctube.2025.100530","DOIUrl":"10.1016/j.jctube.2025.100530","url":null,"abstract":"<div><div><em>Mycobacterium shimoidei</em> is a rare non-tuberculous mycobacterium (NTM) which causes pneumonia. Since its discovery in 1975, less than 50 cases have been published and this would be only the fourth case in the US. We present a case of <em>Mycobacterium shimoidei</em> in a 72-year-old male with symptoms of cough, dyspnea, and weight loss with cavitary lung lesion on imaging. Sputum cultures grew <em>Mycobacterium shimoidei</em> in two separate collections, and the patient was treated with oral azithromycin, ethambutol, and rifabutin empirically. Though due to medication side effects rifabutin was stopped and other antibiotics were attempted based on susceptibilities but he was unable to tolerate any of them. Thus, only a two-drug regimen including ethambutol and azithromycin was used, on which he improved clinically and cavitary lung lesions decreased in size. In addition, we did a literature review and compiled 41 previously published cases of <em>Mycobacterium shimoidei.</em></div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100530"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882887","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 : 2025-08-01Epub Date: 2025-07-14DOI: 10.1016/j.jctube.2025.100552
Senjuti Kabir , Sabrina Choudhury , Mohammad Khaja Mafij Uddin , M.D. Fahim Ather , Syed Mohammad Mazidur Rahman , Pronab Kumar Modak , Mohammad Samsuddoha Sarker Shanchay , Tanjina Rahman , Shahriar Ahmed , Sayera Banu
Background
Performance of OMNIgene.SPUTUM (OM-S) for transporting sputum was evaluated.
Methods
This exploratory study was conducted during January-December 2019 at four near and one distant healthcare-facilities of Dhaka. Smear-positive pulmonary TB patients’ sputa were collected, divided into ‘OM-S untreated’ and ‘OM-S treated’ portions, and transported to testing laboratory, Dhaka, on same-day from near-sites, and through courier from distant-site for smear-microscopy, culture, and Xpert MTB/RIF (Xpert) testing. Subset of ‘OM-S treated’ sample was tested with Xpert without centrifugation. Test results of all portions were compared in between.
Results
Total 444 participants were enrolled (near-sites:198, distant-site: 246). All test results were comparable in both portions for near-sites. For distant-site, smear-microscopy’s positivity was reduced by 4.1 % in ‘OM-S treated’, Xpert showed 100 % concordance in both portions, and culture was higher in ‘OM-S treated’ than ‘OM-S untreated’ (92.3 % vs 89.4 %; p = 0.288). Primary contamination rate in ‘OM-S treated’ was lower than ‘OM-S untreated’ (2.0 % vs 9.8 %; p < 0.05). For all sites, median (IQR) time-to-culture positivity was 35 (28, 42) days in both portions. Xpert positivity was 99 % concordant in ‘OM-S treated’ regardless of centrifugation.
Conclusions
OM-S is safe for sputum transportation. OM-S mixed sputum can be tested with Xpert and culture. Further studies can validate findings and assess cost-effectiveness.
OMNIgene的背景性能。痰液（OM-S）用于痰液运输。方法本探索性研究于2019年1月至12月在达卡的四家近距离医疗机构和一家远距离医疗机构进行。收集痰液阳性肺结核患者的痰液，将其分为“未经OM-S治疗”和“OM-S治疗”两部分，并于当天从近地点和从远地点通过快递运送到达卡检测实验室，进行涂片显微镜、培养和Xpert MTB/RIF （Xpert）检测。“OM-S处理”样品的子集在不离心的情况下用Xpert进行测试。比较各部分的试验结果。结果共纳入受试者444例（近点198例，远点246例）。所有的测试结果在近地点的两个部分具有可比性。对于远处部位，“OM-S处理”的涂片显微镜阳性降低了4.1%，Xpert在两个部分显示100%的一致性，“OM-S处理”的培养高于“OM-S未处理”(92.3% vs 89.4%；p = 0.288)。“OM-S处理”组的初级污染率低于“OM-S未处理”组(2.0% vs 9.8%；p & lt;0.05)。对于所有站点，两个部分的中位（IQR）培养阳性时间为35（28,42）天。无论离心与否，“OM-S处理”的专家阳性结果一致性为99%。结论som - s用于痰液运输是安全的。OM-S混合痰液可以用Xpert法和培养法检测。进一步的研究可以验证研究结果并评估成本效益。
{"title":"OMNIgene.SPUTUM for transporting sputum in ambient temperature for tuberculosis testing: Bangladesh experience","authors":"Senjuti Kabir , Sabrina Choudhury , Mohammad Khaja Mafij Uddin , M.D. Fahim Ather , Syed Mohammad Mazidur Rahman , Pronab Kumar Modak , Mohammad Samsuddoha Sarker Shanchay , Tanjina Rahman , Shahriar Ahmed , Sayera Banu","doi":"10.1016/j.jctube.2025.100552","DOIUrl":"10.1016/j.jctube.2025.100552","url":null,"abstract":"<div><h3>Background</h3><div>Performance of OMNIgene.SPUTUM (OM-S) for transporting sputum was evaluated.</div></div><div><h3>Methods</h3><div>This exploratory study was conducted during January-December 2019 at four near and one distant healthcare-facilities of Dhaka. Smear-positive pulmonary TB patients’ sputa were collected, divided into ‘OM-S untreated’ and ‘OM-S treated’ portions, and transported to testing laboratory, Dhaka, on same-day from near-sites, and through courier from distant-site for smear-microscopy, culture, and Xpert MTB/RIF (Xpert) testing. Subset of ‘OM-S treated’ sample was tested with Xpert without centrifugation. Test results of all portions were compared in between.</div></div><div><h3>Results</h3><div>Total 444 participants were enrolled (near-sites:198, distant-site: 246). All test results were comparable in both portions for near-sites. For distant-site, smear-microscopy’s positivity was reduced by 4.1 % in ‘OM-S treated’, Xpert showed 100 % concordance in both portions, and culture was higher in ‘OM-S treated’ than ‘OM-S untreated’ (92.3 % vs 89.4 %; p = 0.288). Primary contamination rate in ‘OM-S treated’ was lower than ‘OM-S untreated’ (2.0 % vs 9.8 %; p < 0.05). For all sites, median (IQR) time-to-culture positivity was 35 (28, 42) days in both portions. Xpert positivity was 99 % concordant in ‘OM-S treated’ regardless of centrifugation.</div></div><div><h3>Conclusions</h3><div>OM-S is safe for sputum transportation. OM-S mixed sputum can be tested with Xpert and culture. Further studies can validate findings and assess cost-effectiveness.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100552"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634174","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 : 2025-08-01Epub Date: 2025-06-17DOI: 10.1016/j.jctube.2025.100543
Kristen A. Wendorf , Lisa Armitige
{"title":"Improving tuberculosis infection treatment completion among pregnant and postpartum women","authors":"Kristen A. Wendorf , Lisa Armitige","doi":"10.1016/j.jctube.2025.100543","DOIUrl":"10.1016/j.jctube.2025.100543","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100543"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757867","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 : 2025-08-01Epub 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":"2025-08-01","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 : 2025-05-01Epub Date: 2025-03-13DOI: 10.1016/j.jctube.2025.100517
Francesco Di Gennaro , Giacomo Guido , Sergio Cotugno , Francesco Cavallin , Mariantonietta Pisaturo , Lorenzo Onorato , Federica Zimmerhofer , Luca Pipitò , Giuseppina De Iaco , Giuseppe Bruno , Massimo Fasano , Agostina Pontarelli , Annarita Botta , Tiziana Iacovazzi , Rossana Lattanzio , Virginia Di Bari , Gianfranco Panico , Raffaella Libertone , Caterina Monari , Alessia Musto , Annalisa Saracino
Background
Identifying accessible and reliable biomarkers for tuberculosis (TB) severity is crucial for improving patient management. This study evaluates hematological findings as potential indicators of TB severity in a large multicenter Italian cohort.
Methods
This retrospective, multicenter, cross-sectional study analyzed hematological parameters (hemoglobin, white blood cells, inflammatory indices, hepatorenal function, albuminuria) in 577 TB patients from 10 Italian centers (2018–2023). Severe TB was defined by at least two criteria: TIMIKA score > 60, sputum conversion time > 21 days, or need for oxygen supplementation. Statistical analyses included receiver operating characteristic curve (AUC) evaluation, calibration curves, and clinical utility.
Results
Of the patients, 30.3 % were classified as severe, 60.2 % as non-severe, and 9.5 % as uncertain. AUC values for predicting severe TB ranged from 0.51 to 0.56 across hematological variables. Anemia and elevated CRP demonstrated sensitivities of 0.71 and 0.74, respectively. Models using continuous or categorical hematological variables achieved AUCs of 0.61 and 0.65, showing poor calibration and limited clinical utility in the 30–60 % threshold range.
Conclusions
Hematological markers, while rapid and cost-effective, demonstrated limited discriminative ability for TB severity. Further studies are required to develop reliable predictive models, integrating additional clinical and molecular data.
{"title":"Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study","authors":"Francesco Di Gennaro , Giacomo Guido , Sergio Cotugno , Francesco Cavallin , Mariantonietta Pisaturo , Lorenzo Onorato , Federica Zimmerhofer , Luca Pipitò , Giuseppina De Iaco , Giuseppe Bruno , Massimo Fasano , Agostina Pontarelli , Annarita Botta , Tiziana Iacovazzi , Rossana Lattanzio , Virginia Di Bari , Gianfranco Panico , Raffaella Libertone , Caterina Monari , Alessia Musto , Annalisa Saracino","doi":"10.1016/j.jctube.2025.100517","DOIUrl":"10.1016/j.jctube.2025.100517","url":null,"abstract":"<div><h3>Background</h3><div>Identifying accessible and reliable biomarkers for tuberculosis (TB) severity is crucial for improving patient management. This study evaluates hematological findings as potential indicators of TB severity in a large multicenter Italian cohort.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter, cross-sectional study analyzed hematological parameters (hemoglobin, white blood cells, inflammatory indices, hepatorenal function, albuminuria) in 577 TB patients from 10 Italian centers (2018–2023). Severe TB was defined by at least two criteria: TIMIKA score > 60, sputum conversion time > 21 days, or need for oxygen supplementation. Statistical analyses included receiver operating characteristic curve (AUC) evaluation, calibration curves, and clinical utility.</div></div><div><h3>Results</h3><div>Of the patients, 30.3 % were classified as severe, 60.2 % as non-severe, and 9.5 % as uncertain. AUC values for predicting severe TB ranged from 0.51 to 0.56 across hematological variables. Anemia and elevated CRP demonstrated sensitivities of 0.71 and 0.74, respectively. Models using continuous or categorical hematological variables achieved AUCs of 0.61 and 0.65, showing poor calibration and limited clinical utility in the 30–60 % threshold range.</div></div><div><h3>Conclusions</h3><div>Hematological markers, while rapid and cost-effective, demonstrated limited discriminative ability for TB severity. Further studies are required to develop reliable predictive models, integrating additional clinical and molecular data.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100517"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><div>Drug-resistant tuberculosis poses a major global public health threat, with adverse drug reactions complicating treatment and contributing to mortality. In Ethiopia, although many patients with drug-resistant tuberculosis are receiving treatment, studies on adverse drug reactions and their contributing factors remain limited. This study aimed to assess the incidence of adverse drug reactions and contributing factors in patients on drug-resistant tuberculosis treatment in Addis Ababa, Ethiopia.</div></div><div><h3>Methods</h3><div>A facility-based, retrospective cohort study was conducted on patients with drug-resistant tuberculosis who were followed up in two major drug-resistant tuberculosis treatment sites, St. Peter’s Specialized Hospital and the ALERT Comprehensive Specialized Hospital, in the years of 2017 to 2023. Records of the patients were reviewed throughout their treatment time. Information on any adverse drug reaction diagnosis, laboratory findings, clinical observations, type of second-line regimen, type and nature of the drug-resistant tuberculosis, presence of comorbidities such as Human Immune deficiency Virus, hypertension, diabetes mellitus, chronic obstructive pulmonary diseases, and asthma, and sociodemographic characteristics were abstracted from patients’ charts and registries. The World Health Organization − Uppsala Monitoring Center (WHO-UMC) system was employed for standardized causality assessment of adverse drug reactions. Multivariate Cox regression analysis was employed to identify factors associated with adverse drug reactions. Survival among predictor variables was assessed using Kaplan-Meier (KM) curves. Adjusted hazard ratios (AHR) with their corresponding 95 % confidence intervals (CI) were estimated, and statistical significance was declared for a p-value < 0.05.</div></div><div><h3>Result</h3><div>A total of 292 patients with drug-resistant tuberculosis were included. The overall incidence of adverse drug reaction was 8.10 per 100 person-month (PM) (95 % CI: 7.02–9.36) during a total follow-up time of 2294 months. The most frequently reported adverse drug reactions were gastrointestinal disturbance (31.9 %), followed by peripheral neuropathy (21.9 %), and arthralgia (17.5 %). Factors associated with adverse drug reactions were hospitalization (AHR = 1.53, 95 % CI: 1.10–2. 13), baseline anemia (AHR = 1.58, 95 % CI: 1.16–2.17), the age group of 25–49 years (AHR = 1.53, 95 % CI: 1.05–2.21), and age greater than or equal to 50 years (AHR = 1.87, 95 % CI: 1.19–2.93). Good treatment outcome was observed in 76 % of cases.</div></div><div><h3>Conclusion</h3><div>In this study involving patients with drug resistant tuberculosis, over half of the participants encountered at least one adverse drug reactions. Patient admission, baseline anemia, and older age were identified as major factors associated with adverse drug reaction during multidrug resistant tuberculosis treatment. Particular em
{"title":"Adverse drug reactions and contributing factors in patients with drug-resistant tuberculosis: A 7-year retrospective cohort study in Addis Ababa, Ethiopia","authors":"Bisrat Solomon , Yimtubezinash Woldeamanuel , Tigest Ajeme , Mbazi Senkoro , Tsegahun Manyazewal","doi":"10.1016/j.jctube.2025.100515","DOIUrl":"10.1016/j.jctube.2025.100515","url":null,"abstract":"<div><h3>Background</h3><div>Drug-resistant tuberculosis poses a major global public health threat, with adverse drug reactions complicating treatment and contributing to mortality. In Ethiopia, although many patients with drug-resistant tuberculosis are receiving treatment, studies on adverse drug reactions and their contributing factors remain limited. This study aimed to assess the incidence of adverse drug reactions and contributing factors in patients on drug-resistant tuberculosis treatment in Addis Ababa, Ethiopia.</div></div><div><h3>Methods</h3><div>A facility-based, retrospective cohort study was conducted on patients with drug-resistant tuberculosis who were followed up in two major drug-resistant tuberculosis treatment sites, St. Peter’s Specialized Hospital and the ALERT Comprehensive Specialized Hospital, in the years of 2017 to 2023. Records of the patients were reviewed throughout their treatment time. Information on any adverse drug reaction diagnosis, laboratory findings, clinical observations, type of second-line regimen, type and nature of the drug-resistant tuberculosis, presence of comorbidities such as Human Immune deficiency Virus, hypertension, diabetes mellitus, chronic obstructive pulmonary diseases, and asthma, and sociodemographic characteristics were abstracted from patients’ charts and registries. The World Health Organization − Uppsala Monitoring Center (WHO-UMC) system was employed for standardized causality assessment of adverse drug reactions. Multivariate Cox regression analysis was employed to identify factors associated with adverse drug reactions. Survival among predictor variables was assessed using Kaplan-Meier (KM) curves. Adjusted hazard ratios (AHR) with their corresponding 95 % confidence intervals (CI) were estimated, and statistical significance was declared for a p-value < 0.05.</div></div><div><h3>Result</h3><div>A total of 292 patients with drug-resistant tuberculosis were included. The overall incidence of adverse drug reaction was 8.10 per 100 person-month (PM) (95 % CI: 7.02–9.36) during a total follow-up time of 2294 months. The most frequently reported adverse drug reactions were gastrointestinal disturbance (31.9 %), followed by peripheral neuropathy (21.9 %), and arthralgia (17.5 %). Factors associated with adverse drug reactions were hospitalization (AHR = 1.53, 95 % CI: 1.10–2. 13), baseline anemia (AHR = 1.58, 95 % CI: 1.16–2.17), the age group of 25–49 years (AHR = 1.53, 95 % CI: 1.05–2.21), and age greater than or equal to 50 years (AHR = 1.87, 95 % CI: 1.19–2.93). Good treatment outcome was observed in 76 % of cases.</div></div><div><h3>Conclusion</h3><div>In this study involving patients with drug resistant tuberculosis, over half of the participants encountered at least one adverse drug reactions. Patient admission, baseline anemia, and older age were identified as major factors associated with adverse drug reaction during multidrug resistant tuberculosis treatment. Particular em","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100515"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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