International Journal of Mycobacteriology最新文献

{"title":"Recurrent Paradoxical Reactions in Cervical Tuberculous Lymphadenitis During and after Antitubercular Therapy in an Immunocompetent Patient.","authors":"Deependra Kumar Rai, Parul Sharma, Dhruv Talwar, Sreyashi Pal, Shivam Sinha, Swati Jha","doi":"10.4103/ijmy.ijmy_55_26","DOIUrl":"10.4103/ijmy.ijmy_55_26","url":null,"abstract":"<p><p>Paradoxical reaction (PR) in lymph node tuberculosis (LNTB) is characterized by the worsening of existing lesions or the appearance of new lesions after an initial favourable response to antitubercular therapy (ATT). Although frequently reported in HIV-infected individuals, it can also occur in immunocompetent patients and may be mistaken for treatment failure or disease relapse. We report a 25-year-old immunocompetent woman with microbiologically confirmed cervical LNTB who developed recurrent lymph node enlargement during ATT and again after completing treatment. The diagnosis was established by excisional lymph node biopsy demonstrating necrotizing granulomatous inflammation, acid-fast bacilli on Ziehl-Neelsen staining, and detection of Mycobacterium tuberculosis by GeneXpert without rifampicin resistance. Despite initial clinical improvement, she experienced multiple episodes of cervical lymphadenopathy. During these episodes, smear microscopy and GeneXpert remained positive, whereas mycobacterial cultures were repeatedly negative. Following careful microbiological reassessment, the enlargements were managed conservatively without extending or modifying ATT. The lesions resolved spontaneously, and no constitutional symptoms or evidence of viable bacilli were identified. This case highlights the diagnostic challenge of distinguishing paradoxical reactions from relapse or treatment failure in LNTB. Repeated negative cultures, absence of clinical deterioration, and spontaneous resolution without therapeutic escalation supported the diagnosis of PR. Recognition of this phenomenon is essential to avoid unnecessary investigations and prolonged treatment.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"176-178"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360645","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":"Genotypic Characterization of Drug Resistance-associated Mutations in Mycobacterium tuberculosis Using Line Probe Assays in Central India.","authors":"Antisha Tiwari, Shaina Gaikwad, Vishal Dangi, Falguni Agrawal, Maneesh Singh, Jitendra Singh, Sagar Khadanga, Alkesh Khurana, Shashank Purwar, Debasis Biswas, Anand Kumar Maurya","doi":"10.4103/ijmy.ijmy_85_26","DOIUrl":"10.4103/ijmy.ijmy_85_26","url":null,"abstract":"<p><strong>Background: </strong>Drug-resistant tuberculosis (TB), especially rifampicin-resistant and multidrug-resistant TB, remains a significant public health challenge worldwide. Rapid and accurate methods for molecular diagnostics, such as first-line line probe assay (FL-LPA), are recommended by the World Health Organization for early detection of Rif and isoniazid resistance. However, limited data are available comparing resistance patterns between extrapulmonary TB (EPTB) and pulmonary TB (PTB). This study aims to compare first-line anti-tubercular drug resistance patterns and molecular mutations associated with katG, rpoB, and inhA genes between PTB and EPTB.</p><p><strong>Methods: </strong>This study was a prospective analysis of 471 Mycobacterium tuberculosis samples subjected to the FL-LPA or the genotype MTBDRplus for the detection of Rif, isoniazid, and multidrug resistance. Demographic, clinical, microbiological, and molecular resistance data were compared between PTB and EPTB isolates. Resistance-associated mutations in the rpoB , katG , and inhA genes were evaluated.</p><p><strong>Results: </strong>PTB accounted for the majority of samples (94.1%), whereas EPTB constituted 5.9%. PTB patients were more likely to be male, while EPTB patients were more likely to be female. The majority of drug resistance, or 94.1% of all resistant patterns, was found in PTB samples. The most prevalent resistance profile, especially in PTB patients, was isoniazid mono-resistance (H), which was mostly linked to the katG S315T mutation and indicated high-level isoniazid resistance. Canonical rpoB mutations in the rifampicin (Rif) resistance-determining region, such as S531 L, D516V, and H526 replacements, were the main cause of Rif resistance. In line with their paucibacillary character, EPTB cases showed decreased bacillary burden, lower smear positivity, and a narrow range of resistance-associated mutations. Both PTB and EPTB isolates had InhA promoter alterations linked to low-level isoniazid resistance.</p><p><strong>Conclusion: </strong>The study demonstrates a substantially higher burden of molecular drug resistance in PTB than in EPTB. The predominance of canonical rpoB and katG mutations highlights ongoing transmission of drug-resistant strains, emphasizing the value of FL-LPA in the routine TB diagnosis. Globally, molecular drug susceptibility testing, including extrapulmonary specimens, remains essential to guide appropriate therapy and strengthen TB control efforts under national and global elimination programs.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"104-114"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360674","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":"Performance of Molecular Diagnostics in Strengthening Tuberculosis Detection and Drug Resistance Surveillance: A Comparative Study with Conventional Methods.","authors":"Nithya S Roy, Kiran Bala, Tamanna Bordoloi, Prayas Sethi, Vivek Shankar, Anant Mohan, Urvashi B Singh","doi":"10.4103/ijmy.ijmy_79_26","DOIUrl":"10.4103/ijmy.ijmy_79_26","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a major public health challenge, with India bearing the largest global burden. Rapid molecular diagnostics such as GeneXpert Mycobacterium tuberculosis /rifampicin (MTB/RIF), Truenat MTB/MTB Plus, and first-line line probe assay (FL-LPA) have improved case detection and RIF resistance identification, but their comparative performance with conventional Ziehl-Neelsen (ZN) smear microscopy and mycobacteria growth indicator tube (MGIT) culture requires evaluation.</p><p><strong>Methods: </strong>A 16-month retrospective observational study (January 2024-April 2025) at a tertiary care hospital in New Delhi analyzed 9468 clinical specimens. Theis was to compare the diagnostic performance of molecular methods such as GeneXpert MTB/RIF, Truenat MTB/MTB Plus, and FL-LPA with ZN smear microscopy and MGIT culture for pulmonary and extrapulmonary TB, and to assess RIF resistance detection. All samples underwent ZN smear, MGIT culture, and molecular testing. Nucleic acid amplification test (NAAT)- positive samples were subjected to FL-LPA for resistance profiling.</p><p><strong>Results: </strong>Out of 9468 clinical specimens analyzed, MTB was detected in 989 (10.45%) cases. Positivity was slightly higher in pulmonary samples (11.4%) compared to extrapulmonary samples (9.5%). RIF resistance was identified in 61 (6.2%) cases, whereas 36 (3.64%) results were indeterminate, most of which occurred in specimens with very low bacillary load. ZN smear microscopy detected only 19.11% of NAAT-positive samples, and smear positivity increased significantly with increasing bacterial load ( P < 0.001). Among the 660 samples evaluated by both NAAT and MGIT culture, concordant positivity was observed in 30 cases, with overall agreement improving as bacillary load increased (overall agreement: 29.7%). FL-LPA detected RIF resistance in 9 of 44 samples tested and revealed discordance with NAAT results in several cases.</p><p><strong>Conclusion: </strong>GeneXpert MTB/RIF and Truenat MTB Plus outperform smear microscopy and MGIT in sensitivity, particularly for low-bacillary load. FL-LPA enhances resistance detection, identifying additional RIF-resistant cases missed by NAAT. Incorporating NAAT as the frontline diagnostic, complemented by LPA and culture, can strengthen TB detection and drug resistance surveillance in high-burden settings.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"161-170"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360717","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":"Clinical Characteristics and Outcomes of Gastrointestinal Tuberculosis in Saudi Arabia: A 10-year Retrospective Cohort Study.","authors":"Mohammed Alsaeed, Abdullah Alghamdi, Amal Aldawish, Mohammed Alharbi, Nabiha Bouafia, Nabih Alansari, Abdelkarim Bahloul, Naoufel Kaabia, Alaa Alibrahim, Shahad Alshehri, Esra Alsaeed, Hadi Kuriry, Ghadeer Aldoobi, Hala Muslem, Sirine Ahmad","doi":"10.4103/ijmy.ijmy_13_26","DOIUrl":"10.4103/ijmy.ijmy_13_26","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal tuberculosis (GITB) is an underrecognized form of extrapulmonary TB that often presents with nonspecific symptoms, leading to diagnostic delay and adverse outcomes. Data describing its clinical characteristics, diagnostic approaches, and outcomes in the Middle East, particularly Saudi Arabia, remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients (≥18 years) diagnosed with GITB at a tertiary care center in Saudi Arabia between January 2012 and December 2022. Diagnosis was based on microbiological confirmation, histopathological findings consistent with TB, or compatible clinical-radiological features with documented response to antituberculous therapy. Demographic characteristics, comorbidities, clinical presentation, diagnostic modalities, treatment regimens, and outcomes were analyzed descriptively, with exploratory subgroup comparisons.</p><p><strong>Results: </strong>A total of 47 patients were included; 72.3% were male, with a mean age of 59.1 years. Diabetes mellitus (42.6%) and chronic kidney disease (25.5%) were the most common comorbidities. Abdominal pain (80.9%) and weight loss (57.4%) were the most frequent presenting symptoms, with a median diagnostic delay of 60 days. Disseminated disease was identified in 36.2% of patients. Microbiological confirmation was achieved in 42.6% by acid-fast bacilli staining and 34.0% by mycobacterial culture, while molecular testing (Xpert MTB/RIF) was performed in a minority of cases. Clinical cure was achieved in 76.6% of patients, and the overall mortality was 10.6%.</p><p><strong>Conclusions: </strong>GITB in Saudi Arabia is characterized by nonspecific presentation, frequent diagnostic delay, and a high burden of chronic comorbidities, with a substantial proportion of disseminated disease. Despite generally favorable treatment outcomes, mortality remains notable. Improved utilization of molecular diagnostics and earlier recognition in high-risk populations may enhance clinical outcomes.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 1","pages":"38-44"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528585","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":"Mesenchymal Stem Cell-derived Exosomes for the Treatment of Bronchiectatic Nontuberculous Mycobacterial Pulmonary Disease.","authors":"Gaoxiang Wu, Fei He","doi":"10.4103/ijmy.ijmy_305_25","DOIUrl":"10.4103/ijmy.ijmy_305_25","url":null,"abstract":"<p><p>Nontuberculous mycobacterial pulmonary disease (NTM-PD) is a chronic and challenging infectious condition with rising global prevalence, and its bronchiectatic subtype is particularly difficult to treat with conventional regimens due to frequent adverse effects, thus necessitating novel therapeutic approaches. This report presents a 42-year-old female patient diagnosed with bronchiectatic NTM-PD, characterized by persistent cough, sputum production, and hemoptysis, which was confirmed through radiological findings and microbiological testing. Following intolerance to conventional antimicrobial therapy, the patient was treated exclusively with nebulized inhalation of human umbilical cord mesenchymal stem cell-derived exosomes (HucMSC-Exos). This intervention led to significant alleviation of respiratory symptoms, stabilization of pulmonary function, and marked improvement in immunological parameters. In conclusion, nebulized HucMSC-Exos therapy demonstrated successful outcomes in this case, improving clinical symptoms, pulmonary function, and immune status, which suggests its potential as a viable and innovative therapeutic strategy for managing this complex condition and warrants further clinical investigation.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 1","pages":"64-67"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528678","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":"Importance of Contact Tracing in the Management of Pediatric Tuberculosis in Some Diagnostic and Treatment Centers of the Centre Region of Cameroon.","authors":"Gerard Nkeunen, Myriam Elvira Fomen Tchoupa, Julie Judith Takadong Tsafack, Guy-Roger Enamba Ebanda, Marvin Echaw Nso Eyong","doi":"10.4103/ijmy.ijmy_217_25","DOIUrl":"10.4103/ijmy.ijmy_217_25","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains one of the leading causes of death among children under the age of 5 years. In some resource-limited communities, contact tracing interventions are generally used to curb this problem. We aimed to assess the effect of contact tracing interventions on the management of pediatric TB in the Centre Region of Cameroon.</p><p><strong>Methods: </strong>The study was done in 14 diagnostic and treatment centers having a mixed urban-rural population with a high burden of TB. A mixed method including assessment of pediatric TB epidemiological trends, operational data from 2019 to 2024, coupled with healthcare worker perceptions of contact tracing.</p><p><strong>Results: </strong>Overall, 119 cases of TB were reported. After contact tracing, the number of TB cases rose to 34 in 2021 but dropped in the following years. Zero household investigations and no child under 5 years of age were recorded as TB contacts in 2019-2020, respectively, 779 and 963 in 2021-2024. In 2022, there was about 4.5-fold increase in the number of children identified as TB contacts (387). About 1465 children received TB preventive treatment from 2019 to 2024. After contact tracing, this number peaked at 400 in 2022. About 96% of the personnel responded that the project improved the management of TB.</p><p><strong>Conclusions: </strong>Intensification of contact tracing activities and the decrease in TB diagnoses among children under 5 years of age strongly contributed to the prevention and control of the disease within this key population, aligning with the priorities of the World Health Organization End TB Strategy.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 1","pages":"45-53"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528726","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":"Molecular Detection of Mycobacterium leprae in Household Contacts of Leprosy Patients in Barru Regency.","authors":"Hasnawati Tahir, Mochammad Hatta, Baedah Madjid, Rizalinda Sjahril, Nadyah Haruna, Fadhilah Syamsuri","doi":"10.4103/ijmy.ijmy_5_26","DOIUrl":"10.4103/ijmy.ijmy_5_26","url":null,"abstract":"<p><strong>Background: </strong>Leprosy, caused by Mycobacterium leprae, remains a persistent public health challenge in endemic regions such as Indonesia. Despite global efforts toward elimination, hidden transmission through asymptomatic household contacts contributes to ongoing endemicity. Molecular detection methods, particularly polymerase chain reaction (PCR), have demonstrated superior sensitivity and specificity compared to conventional microscopy or clinical diagnosis.</p><p><strong>Methods: </strong>A cross-sectional molecular survey was conducted at 12 primary healthcare facilities. Nasal swab samples were obtained from 37 leprosy patients (17 undergoing multidrug therapy, 20 released from treatment (RFT), and 89 household contacts. Deoxyribonucleic acid (DNA) extraction used the Presto™ Buccal Swab Kit, followed by PCR targeting the pra gene (531 bp).</p><p><strong>Results: </strong>Out of 126 samples, M. leprae DNA was detected in 14 (9.6%) by PCR analysis. Positive amplification was observed in 3 (11.8%) of 17 patients under treatment, 6 (17.1%) of 41 household contacts of patients under treatment, 1 (5.0%) of 20 RFT patients, and 4 (8.3%) of 48 household contacts of RFT patients. These findings highlight that household contacts of both active and previously treated leprosy patients may serve as potential reservoirs for ongoing transmission.</p><p><strong>Conclusion: </strong>PCR-based molecular detection of M. leprae from nasal swabs offers a reliable tool for identifying subclinical infection and monitoring transmission dynamics in endemic settings. Integrating molecular surveillance into public health strategies can significantly enhance early diagnosis and accelerate leprosy elimination programs.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 1","pages":"26-30"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528838","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":"Leishmaniasis Masquerading as Lepromatous Leprosy: A Rare Dermatological Diagnostic Pitfall.","authors":"Madhuri Singh, Shirish S Chandanwale, Sushama Gurwale, Charusheela Rajesh Gore","doi":"10.4103/ijmy.ijmy_221_25","DOIUrl":"10.4103/ijmy.ijmy_221_25","url":null,"abstract":"<p><p>Dermal leishmaniasis, particularly postkala-azar dermal leishmaniasis (PKDL), is an uncommon entity that may closely mimic lepromatous leprosy in endemic regions. Both conditions present with chronic, symmetric nodular or plaque-like lesions, leading to frequent diagnostic confusion, especially when peripheral nerve thickening is absent. We report a 71-year-old male with a 15-year history of diffuse erythematous nodules and scaly plaques over the palms and dorsum of the feet, repeatedly managed as lepromatous leprosy without clinical improvement. The absence of peripheral nerve thickening and a negative slit-skin smear prompted further evaluation. Skin biopsy demonstrated macrophages packed with Leishmania donovani (LD) bodies, and polymerase chain reaction (PCR) targeting the ITS-1 gene confirmed LD. The patient was initiated on miltefosine 50 mg twice daily for 12 weeks (standard regimen). At 4-week follow-up, lesions showed approximately 30% flattening, and at 12 weeks, more than 60% regression was noted, without adverse effects. This rare case of a 71-year-old male with >15 years of misdiagnosis highlights that chronic diffuse nodular dermatosis without nerve involvement should prompt consideration of PKDL even in the absence of documented prior visceral leishmaniasis. Accurate diagnosis using histopathology and PCR prevents prolonged inappropriate therapy and reduces the risk of community transmission.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 1","pages":"61-63"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528716","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":"Prevalence of Bedaquiline Resistance among Drug Resistant - Tuberculosis Cases at a Tertiary Healthcare Setting in Metropolitan City of Maharashtra, India.","authors":"Shraddha Dalvi, Poulami Biswas, Shatabdi Bhagat, Nilma Hirani","doi":"10.4103/ijmy.ijmy_224_25","DOIUrl":"10.4103/ijmy.ijmy_224_25","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains the leading cause of death from a single infectious agent worldwide. Drug-resistant TB (DR-TB) poses a major challenge. Bedaquiline (BDQ) is central to multidrug resistant tuberculosis/extensively drug-resistant TB (MDR/XDR-TB) treatment, yet emerging resistance prompted this study to assess its prevalence.</p><p><strong>Methods: </strong>This prospective observational study was conducted in the TB culture and drug susceptibility testing (DST) laboratory of a tertiary care hospital over 9 months. Sputum samples from presumptive DR-TB cases were included, whereas extrapulmonary and nontuberculous mycobacteria samples were excluded from the study.</p><p><strong>Results: </strong>A total of 1190 samples were subjected to the first-line probe assay (LPA) for drug resistance detection in MTB. MDR-TB was most common, followed by mono-isoniazid and monorifampicin resistance. Of 512 DR-TB samples tested by second-line probe assay (SL-LPA), 25 yielded invalid results. Fluoroquinolone (FQ) resistance was highest (47.7%), whereas second-line injectable drug (SLID) resistance was rare (1.4%); combined FQ + SLID resistance occurred in 10.7% samples, whereas 35.4% samples were sensitive. Among 380 isolates subjected to liquid culture DST, resistance was detected to moxifloxacin (7.4%), linezolid (2.1%), and BDQ (0.78%).</p><p><strong>Conclusion: </strong>BDQ resistance is low but emerging; routine DST, rational drug use, and robust surveillance are vital to preserve BDQ efficacy and ensure effective DR-TB management.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 1","pages":"20-25"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528806","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":"Facilitators and Barriers to Implementation of Innovative Integrated Service Delivery for Tuberculosis, Community-acquired Pneumonia, and Chronic Obstructive Lung Diseases in Southern Nigeria: A Qualitative Research Protocol.","authors":"Sarah Nakalema Oshi, Edmund Ndudi Ossai, Daniel Egbule, Chinwe Chika Eze, Isaac Nwafoagu Alobu, Charles Nwafor, Ngozi Murphy-Okpala, Martin Njoku, Daniel Chukwunweolu Oshi","doi":"10.4103/ijmy.ijmy_116_25","DOIUrl":"10.4103/ijmy.ijmy_116_25","url":null,"abstract":"<p><strong>Background: </strong>This protocol describes a study in which we would determine the facilitators and barriers to implementation of innovative integrated service delivery for tuberculosis (TB), community-acquired pneumonia (CAP), and chronic obstructive pulmonary disease (COPD), in southern Nigeria.</p><p><strong>Methods: </strong>This study will adopt a cross-sectional study design using qualitative data collection methods. It will involve key informant interviews (KIIs) for program managers and health service providers, including Directly Observed Treatment Short-course focal persons, radiographers and private care providers. Focus group discussions (FGDs) will be conducted for beneficiaries of the intervention and will include persons diagnosed and treated for TB, CAP or COPD. The study will be conducted in five hard-to-reach Local Government Areas (LGAs) in two states in Southern Nigeria. The LGAs selected for the study have perennial low TB case notifications, which may be attributed to poor active case finding. A total of twenty KIIs and four FGDs will be conducted.</p><p><strong>Results: </strong>In Nigeria, funding for single-disease programs is diminishing, hence unsustainable, making it necessary to adopt more cost-efficient approaches, including integrated service delivery, especially at the primary health care level.</p><p><strong>Conclusion: </strong>The findings from this study will help in understanding the factors that influence the implementation of TB/CAP/COPD services and also inform policy/practice on the most suitable approaches to scale up the integrated service delivery for TB/CAP/COPD in Nigeria.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 1","pages":"13-19"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528650","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}