IJID regions最新文献

{"title":"Epidemiology and clinicodemographic features of microbiologically confirmed and presumptive extrapulmonary tuberculosis in Ethiopia: a multicenter study","authors":"Hilina Mollalign ,&nbsp;Shewki Moga ,&nbsp;Dawit Chala ,&nbsp;Muluwok Getahun ,&nbsp;Habteyes Hailu Tola ,&nbsp;Dereje Beyene","doi":"10.1016/j.ijregi.2025.100765","DOIUrl":"10.1016/j.ijregi.2025.100765","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the magnitude and factors associated with extrapulmonary tuberculosis (EPTB) and examine differences in clinicodemographic features compared to presumptive EPTB.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted between August 2022 and October 2023 to enroll 542 participants from eleven public hospitals. Microbiologic confirmations of EPTB were made using Xpert MTB/RIF-Ultra and TB culture. Clinicodemographic variables were described using frequency and compared using chi-square and regression statistics.</div></div><div><h3>Result</h3><div>The prevalence of culture-confirmed EPTB was 34.9% (95% confidence interval [CI]: 30.9-39.0). The mean platelet count distribution was higher among microbiologically confirmed EPTB (<em>P</em> &lt;0.001), whereas leukocytosis and erythrocytopenia were significantly associated with presumptive EPTB (<em>P</em> &lt;0.001), without differences in the mean hemoglobin concentration (<em>P</em> &gt;0.05). However, the area under the curve (AUC) of hematological indices poorly distinguished presumptive and confirmed EPTB (AUC = 0.533-0.645). Previous TB treatment history (adjusted odds ratio [AOR] = 3.7, 95% CI: 1.9-6.9) and HIV coinfection (AOR = 3.1, 95% CI: 1.3-7.3) were predictors of microbiologically confirmed EPTB. Alcohol use (AOR = 1.7, 95% CI: 1.1-2.6), hospitalization (AOR = 2.5, 95% CI: 1.6-3.8), and any treatment nonadherence history (AOR = 1.9, 95% CI: 1.2-2.9) were significantly associated with presumptive EPTB.</div></div><div><h3>Conclusions</h3><div>The prevalence of EPTB in Ethiopia remains high. Most clinical features of presumptive and confirmed EPTB overlap, while there are slight differences in sociodemographic characteristics.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100765"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268994","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}

{"title":"Letter to the Editor: elevating fingernail hygiene in parasitic disease prevention — implications from Hajipour and Valizadeh’s study","authors":"Nathkapach Kaewpitoon Rattanapitoon ,&nbsp;Chutharat Thanchonnang ,&nbsp;Schawanya Kaewpitoon Rattanapitoon","doi":"10.1016/j.ijregi.2025.100762","DOIUrl":"10.1016/j.ijregi.2025.100762","url":null,"abstract":"<div><div>The recent study by Hajipour and Valizadeh reveals a high prevalence of intestinal parasitic infections in fingernail debris across occupational and demographic groups in Iran. In this letter, we contextualize their findings with global evidence, highlighting the significance of fingernails as hidden reservoirs of parasitic transmission. We propose the integration of fingernail hygiene—specifically, nail trimming and handwashing—into public health interventions, particularly, in endemic and underserved communities. Emphasizing the One Health approach, we underscore the potential of this low-cost strategy in controlling human and zoonotic parasitic infections.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100762"},"PeriodicalIF":1.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267912","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}

{"title":"Case-based surveillance of bacterial meningitis following MenAfrivac™ introduction at Sourô Sanou University Hospital, Bobo-Dioulasso, Burkina Faso, 2011-2021","authors":"Zoungrana Jacques ,&nbsp;Kabore D. Odilon ,&nbsp;Tonde Issa ,&nbsp;Ouattara Cheick Ahmed ,&nbsp;Kiodima M.S. Odette ,&nbsp;Muhigwa Merci ,&nbsp;Diallo Ismael ,&nbsp;Sawadogo Yacouba ,&nbsp;Poda Armel ,&nbsp;Ouedraogo Abdoul-Salam","doi":"10.1016/j.ijregi.2025.100764","DOIUrl":"10.1016/j.ijregi.2025.100764","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the distribution of <em>Neisseria meningitidis</em> serogroups in bacterial meningitis cases diagnosed by polymerase chain reaction at the Sourô Sanou University Hospital, Bobo-Dioulasso, from 2011 to 2021.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional study was conducted using retrospective data from cerebrospinal fluid samples collected in Bobo-Dioulasso and surrounding districts and analyzed at the National Reference Laboratory for bacterial meningitis.</div></div><div><h3>Results</h3><div>Among 3823 suspected cases, 3341 samples underwent polymerase chain reaction, confirming 1186 cases (35.5%). The highest number of samples was recorded in 2012 (32.9%), mainly from Dafra district (20.2%). <em>Streptococcus pneumoniae</em> was the leading pathogen (51.9%), followed by <em>N. meningitidis</em> (46.1%) and <em>Haemophilus influenzae</em> type b (1.9%). Most <em>N. meningitidis</em> cases (69.5%) occurred in 2012, declining thereafter, with no cases by 2021. Serogroup W predominated (69.7%), while serogroups A and B were absent.</div></div><div><h3>Conclusions</h3><div>The results emphasize the need to strengthen epidemiological surveillance and adapt vaccination strategies to achieve meningitis elimination in Africa.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100764"},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268992","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}

{"title":"Differences found in patient profiles and incidence trends between migrants and native-born tuberculosis patients in Ireland: A cross-sectional analysis of national surveillance data, 2011-2021","authors":"Sarah Jackson ,&nbsp;Zubair Kabir ,&nbsp;Catherine Comiskey","doi":"10.1016/j.ijregi.2025.100763","DOIUrl":"10.1016/j.ijregi.2025.100763","url":null,"abstract":"<div><h3>Objectives</h3><div>Tuberculosis (TB) remains a global public health threat that was responsible for 1.3 million deaths in 2022 alone. Although Ireland is a low TB incidence country, with crude incidence rates (CIRs) in the Irish-born below six per 100,000 population since 2011, CIRs in the foreign-born population are up to 13 times higher. This study aims to inform TB prevention and care by analyzing the differences in the epidemiology of TB in native-born and foreign-born populations in Ireland.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis of all TB notifications reported to the Irish TB Surveillance System from 2011-2021 was performed. Temporal trends in CIRs were analyzed using negative-binomial regression. Independent variables selected with a <em>P</em>-value of &lt;0.25 in univariable analysis were investigated in a multivariable logistic regression model comparing TB patient characteristics between migrants and Irish-born.</div></div><div><h3>Results</h3><div>Of the 3364 TB patients, 48% were among migrants. Compared with Irish-born, migrants with TB were younger, had higher odds of living with HIV (odds ratio [OR] 3.8, confidence interval [CI] 1.99-7.73), extrapulmonary disease (OR 3.14, CI 2.09-4.79), infection with drug-resistant strains (OR 2.30, CI 1.37-4.01), and residence in congregate residential settings (OR 2.00, CI 1.34-3.05) with lower odds linkage to outbreaks (OR 0.16, CI 0.09-0.28). Recently arrived migrants with TB had higher proportions of international protection applicants and refugees, pulmonary disease, and people living with HIV. Between 2011 and 2021, a significantly declining temporal trend was present for migrants (incidence rate ratio [IRR] 0.96, CI 0.95-0.98), Irish-born (IRR 0.89; CI 0.86-0.92), and total TB patients (IRR 0.95, CI 0.94-0.96). Between 2017 and 2021, a significantly declining temporal trend was still present in Irish-born (IRR 0.76, CI 0.69-0.83) and total patients (IRR 0.91, CI 0.88-0.95), but the trend was no longer significant among migrants with TB (IRR 0.96, CI 0.91-1.01).</div></div><div><h3>Conclusions</h3><div>A heightened awareness of extrapulmonary TB within health systems is needed, given the high levels observed among migrants with TB. The pace of TB decline among migrants is no longer significantly declining in the final years of this study period, making TB elimination targets more difficult to achieve. Differences in the epidemiology of TB reported by this study can be used to inform and enhance future TB service provision and promote migrant health.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100763"},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268960","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}

{"title":"Real-world evidence on long COVID-19 in Greece: A multicenter, cross-sectional study (LONCOV2)","authors":"Garyphallia Poulakou ,&nbsp;Vasileios Michailidis ,&nbsp;Athina Gogali ,&nbsp;Stylianos Boutlas ,&nbsp;Melina Kavousanaki ,&nbsp;Paschalina Giouleka ,&nbsp;Alexandros Stefanidis ,&nbsp;Panagiota Styliara ,&nbsp;Paschalis Steiropoulos ,&nbsp;Argyris Tzouvelekis","doi":"10.1016/j.ijregi.2025.100761","DOIUrl":"10.1016/j.ijregi.2025.100761","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to provide real-world data on the clinical presentation and management of long COVID in Greece.</div></div><div><h3>Methods</h3><div>This non-interventional, nationwide, multicenter, cross-sectional study included adults with a history of symptomatic SARS-CoV-2 infection who presented with suspected long-term COVID-19 manifestations ≥4 weeks after acute infection.</div></div><div><h3>Results</h3><div>Among 1011 patients (mean ± SD age: 55.95 ± 15.74 years; 56.18% female; 5.04% hospitalized) enrolled between December 2022 and May 2023, the most affected Medical Dictionary for Regulatory Activities (MedDRA) System Organ Class (SOC) was General disorders and administration site conditions (75.67%), with fatigue/malaise as the predominant symptom (69.93%). This was followed by Respiratory, thoracic, and mediastinal disorders (60.34%), with cough (50.64%) and dyspnea (24.83%) as leading symptoms. Social circumstances, specifically impairments in daily living activities (44.21%), Nervous system disorders (40.26%), mainly headache (23.24%), and Musculoskeletal and connective tissue disorders (27.70%), mainly myalgia (24.63%), were also prominent. The majority (74.38%) had been vaccinated prior to infection, with vaccination shown to be protective against nervous and musculoskeletal symptoms. Females were more prone to systemic, psychiatric, nervous, and musculoskeletal symptoms and impairments in daily activities, but less prone to respiratory symptoms.</div></div><div><h3>Conclusions</h3><div>Multisystem long-term COVID-19 complications were observed, underscoring the importance of multidisciplinary management of this complex, multifaceted condition.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100761"},"PeriodicalIF":1.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268990","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}

{"title":"A case of chronic bilharzia endocervicitis, mimicking cervix dysplasia, in sub-Saharan Africa","authors":"Yacouba Cissoko ,&nbsp;Amavi Essenam Akakpo Alle ,&nbsp;Mamadou Sima ,&nbsp;Aliou Bina Diarra ,&nbsp;Ezéchiel Djokdelna Gandaye ,&nbsp;Sounkalo Dao","doi":"10.1016/j.ijregi.2025.100759","DOIUrl":"10.1016/j.ijregi.2025.100759","url":null,"abstract":"<div><div>Female genital schistosomiasis (FGS), a neglected parasitic genital infection, is a major public health problem for reproductive health in areas where schistosomiasis is endemic. The diagnosis is challenging while mimicking other cervical pathologies. We report here a case of chronic bilharzia cervicitis diagnosed through anatomical pathology examination and successfully treated with praziquantel after the patient underwent several treatments for conditions that were confused with FGS.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100759"},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268961","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}

{"title":"Bacterial prevalence and inflammatory changes in positive blood culture in community-acquired neonatal sepsis in Jordan","authors":"Abedulrhman S. Abdelfattah ,&nbsp;Hamzeh Al-Momani ,&nbsp;Ala'a Al-ma'aiteh ,&nbsp;Tamara Kufoof ,&nbsp;Amjad Tarawneh ,&nbsp;Ahmad Alhroob ,&nbsp;Hossam AlNoaimi ,&nbsp;Hussein Abu Qaoud ,&nbsp;Yazan Alshra’ah ,&nbsp;Yara Alhazaimeh ,&nbsp;Rahaf Alshorman ,&nbsp;Mohammad AlMshagba ,&nbsp;Omar Alkhaldi ,&nbsp;Ruba Alfuqaha ,&nbsp;Mohamadrasoul Alrashaideh","doi":"10.1016/j.ijregi.2025.100756","DOIUrl":"10.1016/j.ijregi.2025.100756","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify the most common causative microorganisms of community-acquired neonatal sepsis and assess the diagnostic performance of C-reactive protein (CRP) and complete blood count as predictors for neonatal sepsis.</div></div><div><h3>Methods</h3><div>This retrospective study examined 359 community-acquired septic neonates in Jordan from 2016 to 2022. Blood cultures, complete blood count, and CRP levels were collected.</div></div><div><h3>Results</h3><div>Among 359 neonates with community-acquired sepsis, the mean age at presentation was 8.8 days; 61.6% were male, and 55.4% were full-term. Fever (54.6%) and respiratory distress (28.4%) were the most frequent presenting symptoms. Gram-positive and Gram-negative organisms were nearly equal (50.4% vs 49.6%), with <em>Escherichia coli</em> (17%) and <em>Streptococcus viridans</em> (16.4%) being the most common isolates. Mortality occurred in 11.1% of cases. Diagnostic analysis showed variable utility of inflammatory markers. CRP demonstrated limited discrimination with an area under the curve (AUC) of 0.64, moderate sensitivity (67.4%) and specificity (60.1%). White blood cell abnormalities showed weaker accuracy with AUC values of 0.54 for leukocytosis and 0.43 for leukopenia, with fair specificity (54.5%) but low sensitivity (39.8%). Neutrophil count abnormalities provided better diagnostic utility with AUC values of 0.63 for neutropenia and 0.57 for neutrophilia, yielding moderate sensitivity (64.1%) and specificity (51.1%). Thrombocytopenia (AUC 0.46) and thrombocytosis (AUC 0.41) demonstrated the lowest diagnostic performance, with low sensitivity and moderate specificity being 28.2% and 61.2%, respectively.</div></div><div><h3>Conclusions</h3><div>Early diagnosis and testing for inflammatory markers are essential for detecting community-acquired neonatal sepsis. However, because each test has limited sensitivity and specificity, combining these markers is necessary to improve diagnostic accuracy.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100756"},"PeriodicalIF":1.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221675","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}

{"title":"Ten-year trend and geographic analysis of the incidence of dengue in Taiwan","authors":"Ching-En Jason Chou ,&nbsp;Yi-Hsuan Lee ,&nbsp;Wen-Ching Lin ,&nbsp;Shao-Yi Cheng ,&nbsp;Kuo-Chin Huang ,&nbsp;Chia-Wen Lu","doi":"10.1016/j.ijregi.2025.100754","DOIUrl":"10.1016/j.ijregi.2025.100754","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine a decade of dengue data in Taiwan, focusing on high-risk groups, the influence of imported cases on local outbreaks, and the role of the climate in disease spread.</div></div><div><h3>Methods</h3><div>A descriptive study was carried out utilizing the statistical databases of the Taiwan Centers for Disease Control. The incidence of dengue was analyzed by age, sex, and administrative area. Chi-square tests and <em>t</em>-tests were employed to test differences across subgroups. Geographic information system was used to compare the spatial distribution of dengue incidence.</div></div><div><h3>Results</h3><div>The highest incidence was observed in individuals aged ≥70 years. Comparison of the 2015 and 2023 outbreaks showed a significant surge in dengue incidence in Yunlin County, the first county north of the Tropic of Cancer. Furthermore, no indigenous cases were observed in 2021, the year marked with the longest period of COVID-19 border control in Taiwan.</div></div><div><h3>Conclusions</h3><div>Taiwan should target older age groups and enhance the border control to mitigate dengue outbreaks. Subtropical areas should learn from experienced regions and implement strict preventive strategies against climate change.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100754"},"PeriodicalIF":1.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268991","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}

{"title":"Diverse respiratory viruses detected among hospitalized patients with pneumonia in Sri Lanka and Vietnam","authors":"Phuong Thu Phan ,&nbsp;Gaya Wijayaratne ,&nbsp;Champica K. Bodinayake ,&nbsp;Judith U. Oguzie ,&nbsp;Thang Nguyen-Tien ,&nbsp;Lyudmyla V. Marushchak ,&nbsp;Jessica Rodriguez ,&nbsp;Claudia M. Trujillo-Vargas ,&nbsp;Ismaila Shittu ,&nbsp;Nga Thanh Pham ,&nbsp;Sen Thi Le ,&nbsp;Ajith Nagahawatte ,&nbsp;Phuong Thai Truong ,&nbsp;Ruvini Kurukulasooriya ,&nbsp;Armstrong Obale ,&nbsp;Emily R. Robie ,&nbsp;Emily S. Bailey ,&nbsp;Bradly P. Nicholson ,&nbsp;Christopher W. Woods ,&nbsp;Gayani L. Tillekeratne ,&nbsp;Gregory C. Gray","doi":"10.1016/j.ijregi.2025.100757","DOIUrl":"10.1016/j.ijregi.2025.100757","url":null,"abstract":"<div><h3>Objectives</h3><div>We conducted surveillance for novel respiratory viruses among patients hospitalized with pneumonia in Sri Lanka and Vietnam.</div></div><div><h3>Methods</h3><div>We enrolled patients from January 2020 to July 2022 at one major hospital each in Sri Lanka and Vietnam. The participants’ nasopharyngeal swabs were studied with assays for previously recognized viruses as well as for assays for novel viruses.</div></div><div><h3>Results</h3><div>A total of 401 hospitalized patients were enrolled, 204 from Sri Lanka and 197 from Vietnam. Laboratory analyses detected a number of previously recognized viruses, including influenza A/(H1N1)pdm09, human respiratory syncytial virus B, human respirovirus 3, rhinovirus A59, enteroviruses, and a human mastadenovirus C. Although an assortment of common human coronaviruses was characterized, 18 (43.9%) of 41 coronavirus-positive samples from Vietnam had evidence of the newly described canine-like coronavirus, CCoV-HuPn-2018 (previously only detected in Malaysia and Haiti).</div></div><div><h3>Conclusions</h3><div>The detection of a novel, possibly emerging virus, CCoV-HuPn-2018, in multiple patients in Vietnam, demonstrates the value of such periodic novel virus surveillance, especially in regions at risk for viral emergence.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100757"},"PeriodicalIF":1.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267915","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}

{"title":"Mortality hazards after treatment completion of pulmonary tuberculosis in a tertiary hospital in Uganda","authors":"Felix Bongomin ,&nbsp;Martha Namusobya ,&nbsp;Ritah Nantale ,&nbsp;Daniel S. Ebbs ,&nbsp;Charles Batte ,&nbsp;Norman van Rhijn ,&nbsp;Joseph Baruch Baluku ,&nbsp;David W. Denning","doi":"10.1016/j.ijregi.2025.100758","DOIUrl":"10.1016/j.ijregi.2025.100758","url":null,"abstract":"<div><h3>Objectives</h3><div>Treated pulmonary tuberculosis (PTB) is associated with long-term complications that contribute to substantial morbidity and mortality. We estimated the incidence and predictors of post-PTB mortality and evaluated whether chronic pulmonary aspergillosis (CPA) independently increases the risk of death.</div></div><div><h3>Methods</h3><div>Between July 1, 2020 and June 30, 2021, we enrolled 162 individuals with treated drug-susceptible PTB who had persistent respiratory symptoms and screened them for CPA using a symptom checklist, chest x-ray, <em>Aspergillus</em> immunoglobulin G-immunoglobulin M point-of-care test, and sputum culture. Between November and December 2024, we followed up all participants via phone calls to determine their vital status. On chest X-ray, PTB was classified as minimal, moderate, and far advanced disease based on involvement of one, two, or more zones, respectively, and coupled to unilateral or bilateral lung disease. Cox proportional hazards regression was used to identify independent predictors of mortality.</div></div><div><h3>Results</h3><div>Thirty-seven (22.8%) participants were lost to follow-up. The median follow-up duration was 3.8 years (interquartile range 3.6-3.9). Of the 125 participants with vital status, their mean age was 33.5 years (±11.7). At baseline, 46 (36.8%) had far advanced PTB, 64 (51.2%) had pulmonary fibrosis, 15 (12.0%) had a history of previous TB, and 34 (27.2%) were living with HIV. Coinfection with PTB and CPA was identified in 31 participants at baseline (24.8%). The median St. George’s respiratory questionnaire score was 50.9 (interquartile range 40.9-63.3), and 32.0% (n = 40) had scores above 60, indicating poor health-related quality of life. Overall mortality was 8.8% (95% confidence interval [CI] 4.4-15.2%), with a mortality rate of 24.3 deaths per 1000 person-years of follow-up. Mortality rates were comparable among participants with and without CPA-PTB coinfection. Independent predictors of mortality included a St. George’s respiratory questionnaire score &gt;60 (adjusted hazard ratio = 2.01; 95% CI 1.49-2.72; <em>P</em> &lt;0.001) and HIV infection (adjusted hazard ratio = 3.04; 95% CI 1.46-6.34; <em>P</em> = 0.029).</div></div><div><h3>Conclusions</h3><div>Post-PTB mortality remains high, with poor health-related quality of life and HIV co-infection emerging as significant independent predictors of death. Integrating long-term follow-up, respiratory rehabilitation, and fungal diagnostics into post-TB care pathways is essential to improve outcomes and reduce preventable mortality.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"17 ","pages":"Article 100758"},"PeriodicalIF":1.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267916","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}