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Cost effectiveness analysis of expanding tuberculosis preventive therapy to household contacts aged 5–14 years in the Philippines 菲律宾将结核病预防治疗扩大到5-14岁家庭接触者的成本效益分析
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-03-19 DOI: 10.1016/j.jctube.2025.100519
Ghassan Ilaiwy , Jessica Keim-Malpass , Romella Tuppal , Alexander F. Ritua , Flordeliza R. Bassiag , Tania A. Thomas

Background

Children aged 5–14 years who are household contacts (HHCs) of index people with active TB disease (PWTB) have limited coverage for TB preventive therapy (TPT) due to variable uptake of the national guideline recommendations in the Philippines. We conducted a cost-effectiveness analysis evaluating the expansion of TB infection (TBI) testing and treatment among pediatric (5–14 years) HHCs of index PWTB in the Philippines to assist the National TB program in choosing the most cost-effective testing and treatment strategy for TBI among HHCs of index PWTB.

Methods

Using a Markov state transition model, eligible HHCs age 5–14 years are screened for TBI with either the tuberculin skin test (TST) or interferon gamma release assay (IGRA). Those who test positive are then simulated to receive one of the following TPT strategies: 6 months of daily isoniazid (6H), 3 months of weekly isoniazid and rifapentine (3HP), 3 months of daily isoniazid plus rifampicin (3HR) and the current practice of no testing or treatment for TBI (NTT). The analysis assesses the projected cost and quality-adjusted life years (QALY) gained for every strategy from the perspective of the Philippines public healthcare system over a time horizon of 20 years. The total cost and gain in QALYs are presented as an incremental cost-effectiveness ratio (ICER) comparing cost per QALY gained for each strategy over NTT.

Results

Our model estimates that expanding TPT coverage to HHCs aged 5–14 years would be cost-effective with incremental cost-effectiveness ratios (ICERs) ranging from 1,024 $/QALY gained when using TST and 6H (Uncertainty range: 497–––2,334) to 2,293 $/QALY gained when IGRA and 3HR are used (Uncertainty range: 1,140 – 5,203). These findings were robust to sensitivity analyses over a wide range of parameter values.

Conclusion

Expanding TPT coverage to HHCs aged 5–14 years is cost-effective when using TST and 6H closely followed by a strategy combining TST and 3HP.
背景:由于菲律宾国家指南建议的接受程度不一,5-14岁儿童作为活动性结核病(PWTB)患者的家庭接触者(HHCs)对结核病预防治疗(TPT)的覆盖率有限。我们进行了一项成本-效果分析,评估了菲律宾儿童(5-14岁)乙型肝炎病毒感染(TBI)检测和治疗的扩展情况,以帮助国家结核病规划在乙型肝炎病毒感染儿童中选择最具成本效益的TBI检测和治疗策略。方法采用马尔可夫状态转移模型,通过结核菌素皮肤试验(TST)或干扰素释放试验(IGRA)筛选5-14岁符合条件的HHCs。测试呈阳性的患者接受以下TPT策略之一:6个月每日异烟肼(6H), 3个月每周异烟肼和利福喷丁(3HP), 3个月每日异烟肼加利福平(3HR)和目前不测试或治疗TBI (NTT)的做法。该分析评估了从菲律宾公共医疗保健系统的角度来看,在20年的时间范围内,每种策略的预计成本和质量调整生命年(QALY)。QALY的总成本和收益表示为增量成本效益比(ICER),比较NTT上每种策略获得的每个QALY的成本。结果我们的模型估计,将TPT覆盖范围扩大到5-14岁的HHCs将具有成本效益,其增量成本效益比(ICERs)范围从使用TST和6H时获得的1,024美元/QALY(不确定性范围:497 - 2,334)到使用IGRA和3HR时获得的2,293美元/QALY(不确定性范围:1,140 - 5,203)。这些发现对于在大范围参数值的敏感性分析是稳健的。结论将TST和6H结合使用,再结合TST和3HP,扩大TPT覆盖范围至5-14岁的HHCs具有成本效益。
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引用次数: 0
Diagnostic accuracy study of STANDARD TB-Feron FIA and STANDARD TB-Feron ELISA tests for tuberculosis infection diagnosis in Eastern European setting 标准结核-铁离子FIA和标准结核-铁离子ELISA试验诊断东欧地区结核感染的准确性研究
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-03-14 DOI: 10.1016/j.jctube.2025.100518
Valeriu Crudu , Dumitru Chesov , Alexandru Codreanu , Nadejda Turcanu , Nelly Ciobanu , Liuba Nepoliuc , Doina Rusu

Introduction

Tuberculosis infection (TBI) is diagnosed based on a positive immune response to M. tuberculosis antigens. This study aimed to evaluate both the qualitative and quantitative performance of two novel IGRA-based tests, the STANDARD E TB-Feron ELISA (TB-Feron-ELISA) and the STANDARD F TB-Feron FIA (IFN-γ) (TB-Feron-FIA), and compare their results to those of QuantiFERON-TB Gold Plus (QuantiFERON).

Methods

At Chiril Draganiuc Phthisiopneumology Institute in the Republic of Moldova, we prospectively enrolled three cohorts of adults: healthy individuals with no known close contact with TB, patients with active tuberculosis (TB), and individuals with a history of TB. The active TB and past TB cohorts were used to assess the tests’ sensitivity, while the healthy group was used to evaluate specificity. Both qualitative and quantitative results from the TB-Feron ELISA and TB-Feron FIA were compared with those of QuantiFERON.

Results

The TB-Feron-FIA demonstrated a sensitivity of 80.58 % (95 %CI: 71.90–87.06) in the active TB cohort and 82.93 % (95 %CI: 68.74–91.47) in the past TB cohort, with a specificity of 85.19 % (95 % CI: 73.40–92.30). The TB-Feron-ELISA showed a sensitivity of 80.58 % (95 %CI: 71.90–87.06) in the active TB cohort and 78.57 % (95 %CI: 64.06–88.29) in the past TB cohort, with a specificity of 85.19 % (95 %CI: 73.40–92.30). The agreement coefficient (κ) with QuantiFERON was 0.766 (95 %CI: 0.689–0.843) for TB-Feron-FIA and 0.809 (95 %CI: 0.739–0.880) for TB-Feron-ELISA.

Conclusions

Both the TB-Feron-ELISA and TB-Feron-FIA demonstrated good diagnostic accuracy for identifying individuals with TBI, comparable to the performance of QuantiFERON.
结核感染(TBI)的诊断是基于对结核分枝杆菌抗原的阳性免疫反应。本研究旨在评估两种基于igra的新型检测方法——STANDARD E TB-Feron ELISA (TB-Feron-ELISA)和STANDARD F TB-Feron FIA (IFN-γ) (TB-Feron-FIA)的定性和定量性能,并将其结果与QuantiFERON- tb Gold Plus (QuantiFERON)的结果进行比较。方法在摩尔多瓦共和国的Chiril Draganiuc肺病学研究所,我们前瞻性地招募了3组成年人:未与结核病有过密切接触的健康个体、活动性结核病患者和有结核病史的个体。活动性结核病和既往结核病队列用于评估试验的敏感性,而健康组用于评估特异性。将TB-Feron ELISA和TB-Feron FIA的定性和定量结果与QuantiFERON进行比较。结果TB- feron - fia在活动性结核队列中的敏感性为80.58% (95% CI: 71.90 ~ 87.06),在既往结核队列中的敏感性为82.93% (95% CI: 68.74 ~ 91.47),特异性为85.19% (95% CI: 73.40 ~ 92.30)。TB- feron - elisa在活动性结核队列中灵敏度为80.58% (95% CI: 71.90 ~ 87.06),在既往结核队列中灵敏度为78.57% (95% CI: 64.06 ~ 88.29),特异性为85.19% (95% CI: 73.40 ~ 92.30)。TB-Feron-FIA与QuantiFERON的一致系数(κ)为0.766 (95% CI: 0.689 ~ 0.843), TB-Feron-ELISA与QuantiFERON的一致系数(κ)为0.809 (95% CI: 0.739 ~ 0.880)。结论TB-Feron-ELISA和TB-Feron-FIA对TBI患者的诊断准确性与QuantiFERON相当。
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引用次数: 0
Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study 血液化学标志作为肺结核严重程度的标志:一项多中心横断面研究
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-03-13 DOI: 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.
背景:确定可获得且可靠的结核病严重程度生物标志物对于改善患者管理至关重要。这项研究评估血液学结果作为结核病严重程度的潜在指标在一个大型多中心意大利队列。方法本回顾性、多中心、横断面研究分析了意大利10个中心(2018-2023)577例结核病患者的血液学参数(血红蛋白、白细胞、炎症指标、肝肾功能、蛋白尿)。严重结核病的定义至少有两个标准:TIMIKA评分;60、痰转化时间>;21天,还是需要补氧。统计分析包括受试者工作特征曲线(AUC)评估、校准曲线和临床应用。结果30.3%的患者为重症,60.2%为非重症,9.5%为不确定。预测严重结核病的血液学变量的AUC值在0.51到0.56之间。贫血和CRP升高的敏感性分别为0.71和0.74。使用连续或分类血液学变量的模型的auc分别为0.61和0.65,在30 - 60%的阈值范围内显示出较差的校准和有限的临床效用。结论血液学标志物虽然快速、经济,但对结核病严重程度的鉴别能力有限。需要进一步的研究来建立可靠的预测模型,整合额外的临床和分子数据。
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引用次数: 0
Machine learning analysis for predicting acid-fast bacilli results in tuberculosis sputum tests: Comment 机器学习分析预测抗酸杆菌结核痰试验结果:评论
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-03-07 DOI: 10.1016/j.jctube.2025.100516
Hinpetch Daungsupawong , Viroj Wiwanitkit
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引用次数: 0
Adverse drug reactions and contributing factors in patients with drug-resistant tuberculosis: A 7-year retrospective cohort study in Addis Ababa, Ethiopia 耐药结核病患者的药物不良反应及其影响因素:埃塞俄比亚亚的斯亚贝巴的一项7年回顾性队列研究
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-03-05 DOI: 10.1016/j.jctube.2025.100515
Bisrat Solomon , Yimtubezinash Woldeamanuel , Tigest Ajeme , Mbazi Senkoro , Tsegahun Manyazewal
<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
背景耐药性结核病对全球公共卫生构成重大威胁,药物不良反应使治疗复杂化并导致死亡。在埃塞俄比亚,尽管许多耐药结核病患者正在接受治疗,但对药物不良反应及其诱因的研究仍然有限。本研究旨在评估埃塞俄比亚亚的斯亚贝巴耐药结核病治疗患者的药物不良反应发生率和诱因。方法对2017年至2023年期间在两个主要耐药结核病治疗点(圣彼得专科医院和ALERT综合专科医院)接受随访的耐药结核病患者进行了一项基于设施的回顾性队列研究。对患者整个治疗期间的记录进行了审查。从患者的病历和登记簿中摘录了有关药物不良反应诊断、实验室检查结果、临床观察结果、二线治疗方案类型、耐药结核病的类型和性质、是否患有人类免疫缺陷病毒、高血压、糖尿病、慢性阻塞性肺病和哮喘等合并症以及社会人口学特征等信息。采用世界卫生组织-乌普萨拉监测中心(WHO-UMC)系统对药物不良反应进行标准化因果关系评估。采用多变量 Cox 回归分析来确定与药物不良反应相关的因素。使用 Kaplan-Meier (KM) 曲线评估了预测变量之间的存活率。结果共纳入了 292 名耐药结核病患者。在总计 2294 个月的随访期间,药物不良反应的总发生率为每百人月 8.10 例(95 % CI:7.02-9.36)。最常报告的药物不良反应是胃肠道不适(31.9%),其次是周围神经病变(21.9%)和关节痛(17.5%)。与药物不良反应相关的因素包括住院(AHR = 1.53,95 % CI:1.10-2.13)、基线贫血(AHR = 1.58,95 % CI:1.16-2.17)、25-49 岁年龄组(AHR = 1.53,95 % CI:1.05-2.21)以及年龄大于或等于 50 岁(AHR = 1.87,95 % CI:1.19-2.93)。结论 在这项涉及耐药性结核病患者的研究中,一半以上的参与者至少遇到过一次药物不良反应。在耐多药结核病治疗过程中,患者入院、基线贫血和年龄较大被认为是与药物不良反应相关的主要因素。应特别重视这些易感人群,以便及早预测、及时处理,并制定适当的治疗方案,有效解决药物不良反应问题。
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引用次数: 0
Tuberculosis and drug resistance in a region of Southern Italy among native and foreign-born populations: A twelve-year province-based study 意大利南部一个地区本地和外国出生人口中的结核病和耐药性:一项为期12年的省级研究
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jctube.2025.100512
Salvatore Rotundo , Salvatore Nisticò , Helen Linda Morrone , Luigia Gallo , Saveria Dodaro , Carmelo Papola , Pasquale Minchella , Giovanni Matera , Francesca Greco , Luigi Principe , Lorenzo Antonio Surace , Francesco Lucia , Francesca Serapide , Alessandro Russo , Carlo Torti , Enrico Maria Trecarichi , the Calabria TB group
Tuberculosis (TB) remains a significant global health challenge, with the World Health Organization (WHO) aiming for a 95% reduction in TB deaths by 2030. Disparities in TB detection persist, particularly regarding gender, immigration status, and resistance patterns. In Calabria, Italy—a key entry point for migrants from high-TB-incidence regions—TB poses a notable public health risk. This multicenter, retrospective study examines newly diagnosed TB cases in Calabria from 2012 to 2023, focusing on rifampicin-resistant TB (RR-TB).
During this period, 800 TB cases were diagnosed, with 270 (33.7 %) in native-born Italians and 530 (66.2 %) in foreign-born individuals, showing significant differences in age (p < 0.001) and gender (p = 0.013). Among 685 patients of this cohort with available HIV status, 24 (3.5 %) were people living with HIV (PLWH), primarily from Africa, and diagnosed at higher rates of RR-TB (p < 0.001). TB cases varied by province, correlating with specific birthplaces. A total of 27 (3.4 %) RR-TB cases were identified, with heightened resistance to multiple drugs. Among these strains, 20 (74.1 %) were isoniazid-resistant (MDR-TB).
This study underscores the need for comprehensive TB control strategies, especially regarding co-infection with HIV and the emergence of drug-resistant strains, emphasizing the importance of early detection and tailored management in Southern Italy.
结核病仍然是一项重大的全球卫生挑战,世界卫生组织(世卫组织)的目标是到2030年将结核病死亡人数减少95%。结核病检测方面的差异仍然存在,特别是在性别、移民身份和耐药性模式方面。在意大利卡拉布里亚,结核病是结核病高发地区移民的关键入境点,结核病构成了显著的公共卫生风险。这项多中心回顾性研究调查了2012年至2023年卡拉布里亚新诊断的结核病病例,重点是利福平耐药结核病(RR-TB)。在此期间,诊断出800例结核病病例,其中270例(33.7%)为意大利本土出生的人,530例(66.2%)为外国出生的人,显示出年龄上的显着差异(p <;0.001)和性别(p = 0.013)。在该队列的685例可获得艾滋病毒感染的患者中,24例(3.5%)是艾滋病毒感染者(PLWH),主要来自非洲,诊断为RR-TB的比例较高(p <;0.001)。结核病病例因省而异,与具体的出生地有关。共发现27例(3.4%)耐药结核病例,对多种药物的耐药性增强。其中20株(74.1%)耐异烟肼(MDR-TB)。这项研究强调了制定综合结核病控制战略的必要性,特别是在艾滋病毒合并感染和耐药菌株出现方面,强调了在意大利南部早期发现和量身定制管理的重要性。
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引用次数: 0
Perforating ENL: A variant of type 2 lepra reaction 穿孔ENL: 2型lepra反应的一种变体。
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jctube.2024.100507
Bhakti Sarda , Bhushan Madke , Vikrant Saoji , Ambika Kondalkar
Lepra reactions are acute episodic inflammatory reactions that occur during illness due to abrupt changes in the body’s immunological response against Mycobacterium leprae. These are of two types, type 1 and type 2. Type 2 reaction is also called Erythema Nodosum Leprosum (ENL).
The common skin lesion in ENL is a red, tender, raised lesion. Subcutaneous nodules can also appear. The skin lesions may present as vesicles, pustules, or bulla. They can also develop ulcers and become necrotic. Some patients may experience skin lesions that resemble those seen in erythema multiforme. A rare desquamative rash may occur, which needs to be differentiated from a drug-related rash. Healing lesions may leave scars that may become inflamed during ENL flare-ups. In rare instances, there may be no skin lesions suggesting ENL.
Reactive perforating type of erythema nodosum leprosum (ENL) is a rare type 2 lepra reaction occurrence, observed in lepromatous leprosy and borderline lepromatous cases. It is linked with the involvement of several organs, so if diagnosis and treatment are delayed, it can result in complications and a grim prognosis.
麻风反应是指在患病期间,由于机体对麻风分枝杆菌的免疫反应突然发生变化而出现的急性发作性炎症反应。这些反应分为两种类型,即 1 型和 2 型。2 型反应也称为结节性红斑(ENL)。ENL常见的皮损为红色、触痛、隆起的皮损。皮下也会出现结节。皮损可表现为水泡、脓疱或鼓包。皮损还可能出现溃疡和坏死。有些患者的皮损可能与多形性红斑相似。可能会出现罕见的脱屑性皮疹,这需要与药物相关皮疹相鉴别。皮损愈合后可能会留下疤痕,在 ENL 复发时可能会发炎。在极少数情况下,可能没有皮损提示 ENL。反应性穿孔型结节性麻风红斑(ENL)是一种罕见的2型麻风反应,可见于麻风病和边缘麻风病例。它与多个器官受累有关,因此如果延误诊断和治疗,可能会导致并发症和严重的预后。
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引用次数: 0
Discordance of 3rd and 4th generation QuantiFERON-TB Gold assays by pregnancy stages in India 第三代和第四代QuantiFERON-TB金测定在印度妊娠阶段的不一致。
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jctube.2024.100504
Vandana Kulkarni , Mallika Alexander , Ramesh Bhosale , Divyashri Jain , Prasad Deshpande , Emily Shira Gitlin , Arthi Vaidyanathan , Andrea Chalem , Shilpa Naik , Nikhil Gupte , Neelu Nawani , Amita Gupta , Jyoti Mathad

Background

Pregnancy and HIV affect CD4+ T lymphocytes and impact performance of QuantiFERON-TB Gold (QFT). We compared the results of QFT with QuantiFERON-TB Gold Plus (QFT-Plus), which also measures CD8+ responses to TB antigens, during pregnancy and postpartum.

Methods

We screened 516 pregnant women for TB infection (TBI) with IGRA. From 165 IGRA + pregnant women, QFT vs QFT-Plus results were compared at delivery and postpartum. Longitudinal changes in QFT-Plus were assessed in 74 pregnant women who received QFT-Plus testing at pregnancy, delivery, and postpartum.

Results

Through cross-sectional analysis of the IGRA + cohort, QFT-Plus showed higher positivity than QFT (80 % vs 65 %, p = 0.04) at delivery but no difference postpartum. Among 35 women with HIV, QFT-Plus returned more positive results than QFT at delivery and postpartum (76 % vs 47 %, p = 0.08; 90 % vs 80 %, p = 0.54), though not statistically significant. Longitudinally, QFT-Plus positivity by TB1 or TB2 was highest antepartum vs. delivery and postpartum (74 % vs. 58 % vs. 62 %; p = 0.09) and performed better than TB1 alone (100 % vs 90 %, p = 0.04) in women without HIV but not in women with HIV.

Conclusions

Performance of QFT-Plus was consistent across pregnancy, including at delivery when QFT positivity is lower. QFT-Plus may enhance antenatal TBI detection among pregnant women.
背景:妊娠和HIV影响CD4+ T淋巴细胞,影响QuantiFERON-TB Gold (QFT)的性能。我们将QFT的结果与QuantiFERON-TB Gold Plus (QFT-Plus)的结果进行了比较,QFT-Plus也测量了CD8+在怀孕和产后对TB抗原的反应。方法:采用IGRA对516例孕妇进行TB感染筛查。在165名IGRA阳性孕妇中,比较了QFT和QFT- plus在分娩和产后的结果。对74名在怀孕、分娩和产后接受QFT-Plus检测的孕妇进行QFT-Plus的纵向变化评估。结果:通过IGRA +队列的横断面分析,分娩时QFT- plus的阳性率高于QFT (80% vs 65%, p = 0.04),但产后无差异。在35名感染艾滋病毒的妇女中,QFT- plus在分娩和产后的阳性结果比QFT更多(76%比47%,p = 0.08;90% vs 80%, p = 0.54),但没有统计学意义。纵向上,TB1或TB2的QFT-Plus阳性在产前、分娩和产后最高(74%、58%、62%;p = 0.09),并且在未感染艾滋病毒的妇女中优于单独使用TB1 (100% vs 90%, p = 0.04),而在感染艾滋病毒的妇女中则不然。结论:QFT- plus的表现在整个怀孕期间是一致的,包括在分娩时,QFT阳性较低。QFT-Plus可能提高孕妇产前TBI的检测。
{"title":"Discordance of 3rd and 4th generation QuantiFERON-TB Gold assays by pregnancy stages in India","authors":"Vandana Kulkarni ,&nbsp;Mallika Alexander ,&nbsp;Ramesh Bhosale ,&nbsp;Divyashri Jain ,&nbsp;Prasad Deshpande ,&nbsp;Emily Shira Gitlin ,&nbsp;Arthi Vaidyanathan ,&nbsp;Andrea Chalem ,&nbsp;Shilpa Naik ,&nbsp;Nikhil Gupte ,&nbsp;Neelu Nawani ,&nbsp;Amita Gupta ,&nbsp;Jyoti Mathad","doi":"10.1016/j.jctube.2024.100504","DOIUrl":"10.1016/j.jctube.2024.100504","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy and HIV affect CD4+ T lymphocytes and impact performance of QuantiFERON-TB Gold (QFT). We compared the results of QFT with QuantiFERON-TB Gold Plus (QFT-Plus), which also measures CD8+ responses to TB antigens, during pregnancy and postpartum.</div></div><div><h3>Methods</h3><div>We screened 516 pregnant women for TB infection (TBI) with IGRA. From 165 IGRA + pregnant women, QFT vs QFT-Plus results were compared at delivery and postpartum. Longitudinal changes in QFT-Plus were assessed in 74 pregnant women who received QFT-Plus testing at pregnancy, delivery, and postpartum.</div></div><div><h3>Results</h3><div>Through cross-sectional analysis of the IGRA + cohort, QFT-Plus showed higher positivity than QFT (80 % vs 65 %, p = 0.04) at delivery but no difference postpartum. Among 35 women with HIV, QFT-Plus returned more positive results than QFT at delivery and postpartum (76 % vs 47 %, p = 0.08; 90 % vs 80 %, p = 0.54), though not statistically significant. Longitudinally, QFT-Plus positivity by TB1 or TB2 was highest antepartum vs. delivery and postpartum (74 % vs. 58 % vs. 62 %; p = 0.09) and performed better than TB1 alone (100 % vs 90 %, p = 0.04) in women without HIV but not in women with HIV.</div></div><div><h3>Conclusions</h3><div>Performance of QFT-Plus was consistent across pregnancy, including at delivery when QFT positivity is lower. QFT-Plus may enhance antenatal TBI detection among pregnant women.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"38 ","pages":"Article 100504"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932870","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}
引用次数: 0
Buruli ulcer: Current landscape, challenges, and future directions 布鲁里溃疡:现状、挑战和未来方向
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jctube.2024.100490
Rie R. Yotsu , Richard O. Phillips
{"title":"Buruli ulcer: Current landscape, challenges, and future directions","authors":"Rie R. Yotsu ,&nbsp;Richard O. Phillips","doi":"10.1016/j.jctube.2024.100490","DOIUrl":"10.1016/j.jctube.2024.100490","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"38 ","pages":"Article 100490"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153641","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}
引用次数: 0
Corrigendum to “Patient perceptions of video directly observed therapy for tuberculosis: a systematic review” [J. Clin. Tuberc. Other Mycobact. Dis 35 (2024) 100406] “结核病患者对视频直接观察治疗的看法:一项系统综述”[J]。中国。Tuberc。其他Mycobact。Dis 35 (2024) 100406]
IF 1.9 Q3 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jctube.2024.100484
Angela Mak , Rumia Owaisi , Leah Goldschmidt , Ilo-Katryn Maimets , Amrita Daftary
{"title":"Corrigendum to “Patient perceptions of video directly observed therapy for tuberculosis: a systematic review” [J. Clin. Tuberc. Other Mycobact. Dis 35 (2024) 100406]","authors":"Angela Mak ,&nbsp;Rumia Owaisi ,&nbsp;Leah Goldschmidt ,&nbsp;Ilo-Katryn Maimets ,&nbsp;Amrita Daftary","doi":"10.1016/j.jctube.2024.100484","DOIUrl":"10.1016/j.jctube.2024.100484","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"38 ","pages":"Article 100484"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153638","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}
引用次数: 0
期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
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