Tropical Diseases, Travel Medicine and Vaccines最新文献

{"title":"\"Universal test and treat\" program reduced TB incidence by 75% among a cohort of adults taking antiretroviral therapy (ART) in Gurage zone, South Ethiopia.","authors":"Tadele Girum, Fedila Yasin, Samuel Dessu, Bereket Zeleke, Mulugeta Geremew","doi":"10.1186/s40794-020-00113-3","DOIUrl":"10.1186/s40794-020-00113-3","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains the leading cause of morbidity and mortality in peoples living with HIV and at least 25% of deaths are attributed to TB. Many countries implement the Universal Test and Treat (UTT) program for HIV, which is believed to reduce the incidence of TB. However, there are limited studies that evaluate the impact of UTT on TB incidence. Therefore, by recruiting a cohort of ART users in the \"UTT\" and \"differed treatment\" programs, we aim to measure the effect of the UTT program on TB incidence.</p><p><strong>Objective: </strong>To measure the effect of \"UTT\" program on TB incidence among a cohort of adults taking antiretroviral therapy (ART) in Gurage Zone, South Ethiopia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted through record review over 5 years (2014-2019) in public health facilities in Gurage Zone. Three hundred eighty-four records were randomly selected and reviewed using a standardized structured checklist. Data was entered using Epi Info™ Version 7 and analyzed by STATA. A generalized linear model with binomial link function was fitted to measure the adjusted incidence density/incidence rate ratio and to identify predictors of incidence difference between the two programs.</p><p><strong>Results: </strong>During the follow up period, 39 incident TB cases were identified with an overall incidence rate of 4.79/100 person-year (PY). TB incidence was significantly lower in the UTT cohort (IR = 2.10/100 PY) in comparison to the differed program cohort (IR = 6.23/100 PY). The adjusted incidence rate ratio (AIRR) of TB among patients enrolled in the UTT program was; 0.25 (95% CI = 0.08-0.70). Thus, there was a reduction of TB incidence by 75% in the UTT program compared to differed program. In addition, IPT (isoniazid preventive therapy) use (AIRR = 0.35 (95% CI = 0.22-0.48)), WHO Stage I and II (AIRR = 0.70 (95% CI = 0.61-0.94)) and higher base line CD4 count (AIRR = 0.96 (95% CI = .94-0.99)) significantly reduced the incidence of TB. However, treatment failure increase the incidence (AIRR = 5.8 (95% CI = 1.93-8.46)).</p><p><strong>Conclusion: </strong>TB incidence was significantly reduced by 75% after UTT. Therefore, intervention to further reduce the incidence has to focus on strengthening UTT program and IPT.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"12"},"PeriodicalIF":3.1,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38326254","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}

{"title":"Utilization of isoniazid prophylaxis therapy and its associated factors among HIV positive clients taking antiretroviral therapy at Fre Semaetat primary hospital, Hawzien districts, Tigrai, Northern Ethiopia.","authors":"Haftom Legese,&nbsp;Hagos Degefa,&nbsp;Aderajew Gebrewahd,&nbsp;Haftay Gebremedhin","doi":"10.1186/s40794-020-00106-2","DOIUrl":"https://doi.org/10.1186/s40794-020-00106-2","url":null,"abstract":"<p><strong>Background: </strong>Isoniazid prophylaxis therapy is a significant public health intervention to prevent the progression of latent tuberculosis to active tuberculosis disease among people living with HIV. Those with HIV are at high risk to develop active Tuberculosis from latent Tuberculosis than those without HIV. Even though there is strong evidence supporting Isoniazid Prophylaxis therapy for Tuberculosis prevention, there is limited information about the implementation of isoniazid prophylaxis therapy in Ethiopia as well as in the study area.</p><p><strong>Objective: </strong>To determine the effects of Isoniazid Prophylaxis therapy and its associated factors among HIV positive clients taking antiretroviral therapy at Fre Semaetat primary Hospital, Hawzien districts, Tigray, northern Ethiopia.</p><p><strong>Method: </strong>Institutional based cross-sectional study design was conducted from April to August 2019 among HIV positive clients who came to Fre Semaetat primary Hospital. Data related to socio-demographic characteristics and associated risk factors were taken from 372 HIV positive clients who were selected by a simple random sampling method. Data was coded and cleaned by using SPSS version 23.0 for the final analysis.</p><p><strong>Results: </strong>A total of 372 HIV positive clients taking antiretroviral therapy were included in the study. Of those, the overall prevalence that took and completed their Isoniazid Prophylaxis therapy for 6 months was found to be 231(62.1%). From those who completed Isoniazid Prophylaxis therapy (IPT), 13(3.5%) was developed active Tuberculosis (TB) incidence. Gender, co-trimexazol Prophylaxis therapy users, HIV positive clients who took Anti-pain and married clients were the predictor among statistically significant variables of Isoniazid Prophylaxis therapy.</p><p><strong>Conclusions: </strong>Isoniazid Prophylaxis therapy utilization found to below. Therefore, health education and counseling of patients who are in their first 2 months of therapy should be strengthened further. Prophylaxis should be given by service providers, medication side effects should be addressed rapidly.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"11"},"PeriodicalIF":3.1,"publicationDate":"2020-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40794-020-00106-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38068395","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}

{"title":"Tetravalent dengue DNA vaccine is not immunogenic when delivered by retrograde infusion into salivary glands.","authors":"Guy El Helou,&nbsp;Todd A Ponzio,&nbsp;Joseph F Goodman,&nbsp;Maria Blevins,&nbsp;David L Caudell,&nbsp;Kanakatte S Raviprakash,&nbsp;Daniel Ewing,&nbsp;Maya Williams,&nbsp;Kevin R Porter,&nbsp;John W Sanders","doi":"10.1186/s40794-020-00111-5","DOIUrl":"https://doi.org/10.1186/s40794-020-00111-5","url":null,"abstract":"<p><strong>Introduction and background: </strong>A tetravalent DNA vaccine for Dengue virus is under development but has not yet achieved optimal immunogenicity. Salivary glands vaccination has been reported efficacious in rodents and dogs. We report on a pilot study testing the salivary gland as a platform for a Dengue DNA vaccine in a non-human primate model.</p><p><strong>Materials and methods: </strong>Four cynomolgus macaques were used in this study. Each macaque was pre-medicated with atropine and sedated with ketamine. Stensen's duct papilla was cannulated with a P10 polyethylene tube, linked to a 500ul syringe. On the first two infusions, all macaques were infused with 300ul of TVDV mixed with 2 mg of zinc. For the 3rd infusion, to increase transfection into salivary tissue, two animals received 100uL TVDV mixed with 400uL polyethylenimine 1μg/ml (PEI) and the other two animals received 500uL TVDV with zinc. Antibody titers were assessed 4 weeks following the second and third infusion.</p><p><strong>Results and conclusions: </strong>SGRI through Stensen's duct is a well-tolerated, simple and easy to reproduce procedure. TVDV infused into macaques salivary glands elicited a significantly weaker antibody response than with different delivery methods.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"10"},"PeriodicalIF":3.1,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40794-020-00111-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38027557","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}

{"title":"Opportunities and challenges in providing health care for International Retirement Migrants: a qualitative case study of Canadians travelling to Yuma, Arizona.","authors":"John Pickering,&nbsp;Valorie A Crooks,&nbsp;Jeremy Snyder,&nbsp;Trudie Milner","doi":"10.1186/s40794-020-00110-6","DOIUrl":"https://doi.org/10.1186/s40794-020-00110-6","url":null,"abstract":"<p><strong>Background: </strong>Increasing numbers of older individuals opt to spend extended time abroad each year for lifestyle, health, and financial reasons. This practice is known as international retirement migration, and it is particularly popular among retirees in Global North countries such as Canada. Despite the popularity of international retirement migration, very little is known about how and why health care is accessed while abroad, nor the opportunities and challenges posed for destination hospitals. In this article we focus on addressing the latter knowledge gap.</p><p><strong>Methods: </strong>This qualitative case study is focused on the only hospital in Yuma, Arizona - a popular destination for Canadian retirement migrants in the United States. We conducted focus groups with workers at this hospital to explore their experiences of treating this transnational patient group. Twenty-seven people participated in three, 90-min focus groups: twelve nurses, six physicians, and nine administrators. Thematic analysis of the focus group transcripts was conducted using a triangulated approach.</p><p><strong>Results: </strong>Participants identified three care environments: practice, transnational, and community. Each environment presents specific opportunities and challenges pertaining to treating Canadian retirement migrants. Important opportunities include the creation of a strong and diverse seasonal workforce in the hospital, new transnational paths of communication and information sharing for physicians and health administrators, and informal care networks that support formal health care services within and beyond the hospital. These opportunities are balanced out by billing, practical, administrative, and lifestyle-related challenges which add complexity to treating this group of transnational patients.</p><p><strong>Conclusion: </strong>Canadians represent a significant group of patients treated in Yuma, Arizona. This is contrary to long-standing, existing research that depicts older Canadians as being reluctant to access care while in the United States. Significant overlaps exist between the opportunities and challenges in the practice, transnational and community environments. More research is needed to better understand if these findings are similar to other destinations popular with Canadian international retirement migrants or if they are unique to Yuma, Arizona.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"9"},"PeriodicalIF":3.1,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40794-020-00110-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38029549","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}

{"title":"Temperature integrity and exposure of vaccines to suboptimal temperatures in cold chain devices at different levels in three states of India.","authors":"Manoja Kumar Das, Narendra Kumar Arora, Thomas Mathew, Bhadresh Vyas, Salam Kabita Devi, Abhishek Yadav","doi":"10.1186/s40794-020-00109-z","DOIUrl":"10.1186/s40794-020-00109-z","url":null,"abstract":"<p><strong>Objective: </strong>To document the temperature integrity at the vaccine storage devices at various levels in three states of India.</p><p><strong>Methods: </strong>A total of 213 health facilities including 196 facilities (district and sub-district levels) from 27 select districts and 17 division or state level vaccine stores in three states were included. At these facilities, temperature in 223 vaccine storage devices was recorded for at least 7 consecutive days using electronic temperature datalogger.</p><p><strong>Results: </strong>During the observation period, overall the vaccines were exposed to temperature < 0 °C for 14.8% of the storage time with 8.6, 6.7 and 18% at state/division, district and sub-district vaccine stores, respectively. The vaccines were also exposed to temperature > 8 °C for 6.6% of the storage time including 1.3, 13 and 5.1% at state/division, district and sub-district vaccine stores, respectively. Continuous episodes of temperature deviation for 45 min or longer to < 0 °C and > 8 °C was observed in 7.2 and 6.4% of the observation period, respectively. These temperature deviations were not captured by the routine temperature monitoring practice.</p><p><strong>Conclusion: </strong>The vaccines were exposed to freezing temperature for a considerable period at all level stores, which was more than the exposure to higher temperature. To ensure vaccine potency and immunogenicity, stringent temperature integrity maintenance is needed at all levels.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"8"},"PeriodicalIF":2.4,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38029548","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}

{"title":"Risk perception of health problems among travelers visiting a travel clinic in Bangkok, Thailand.","authors":"Thanyapat Hiranrusme,&nbsp;Watcharapong Piyaphanee,&nbsp;Jaranit Kaewkungwal,&nbsp;Udomsak Silachamroon,&nbsp;Wattana Leowattana,&nbsp;Lapakorn Chatapat,&nbsp;Wasin Matsee","doi":"10.1186/s40794-020-00108-0","DOIUrl":"https://doi.org/10.1186/s40794-020-00108-0","url":null,"abstract":"<p><strong>Background: </strong>Effective pre-travel consultations cannot be achieved only through individual risk assessment and advice on vaccinations and chemoprophylaxis. Travelers' perceptions of the risk of health problems represent another key factor in successful risk communication and co-operation with pre-travel advice. The objective of this study was to determine perception of travel-related health risks among Thais and westerners visiting the Thai Travel Clinic for consultation before visiting developing countries.</p><p><strong>Methods: </strong>A novel pictorial scale questionnaire-based study was conducted with both Thai and western travelers who visited the Thai Travel Clinic for pre-travel consultation. All participants were approached before and after completing the consultation, and were asked about their demographic data and perceptions of travel-related health risk. The perceptions of risk before and after consultation were compared using the McNemar test, and were also compared with the actual estimated risk.</p><p><strong>Results: </strong>During May to November 2019, 594 travelers (330 Thais and 264 Westerners) were enrolled and completed the pictorial scale questionnaires. Most Thai travelers visited Africa/South America (63%), and 20% had previously received counseling. Westerners were mostly backpackers (37.5%), traveling for > 30 days (71.6%), while 43.6% had previously received counseling. Overall, the westerners (<i>n</i> = 264) changed their risk perceptions slightly after counseling in contrast with the Thais. The change in perception of most health problems was observed statistically significant (<i>p</i>-value < 0.05) after receiving pre-travel consultation among both groups of travelers. Risk perception among western travelers after consultation compared with estimated actual risk showed accurate risk perception toward most of health problems especially in travelers who had previously received counseling in ones' home countries.</p><p><strong>Conclusions: </strong>Risk perception of health problems plays an important role in successful risk communication and their response to pre-travel advices. Differences in risk perceptions were evident between the two groups. Therefore, this highlight the importance of obtaining pre-travel advice in one's home country before travelling. Raised awareness of the risks should be emphasized during consultations for underestimated health risks, especially for rabid animal exposure and sexually transmitted diseases.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"7"},"PeriodicalIF":3.1,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40794-020-00108-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37993028","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}

{"title":"Battling COVID-19: using old weapons for a new enemy.","authors":"Rohit Kumar, Nitin Gupta, Parul Kodan, Ankit Mittal, Manish Soneja, Naveet Wig","doi":"10.1186/s40794-020-00107-1","DOIUrl":"10.1186/s40794-020-00107-1","url":null,"abstract":"<p><p>Coronavirus disease-19 (COVID-19) has reached pandemic proportions. Most of the drugs that are being tried for the treatment have not been evaluated in any randomized controlled trials. The purpose of this review was to summarize the in-vitro and in-vivo efficacy of these drugs on Severe Acute Respiratory Syndrome (SARS-CoV-2) and related viruses (SARS and Middle East Respiratory Syndrome) and evaluate their potential for re-purposing them in the management of COVID-19.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"6"},"PeriodicalIF":3.1,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37974899","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}

{"title":"First sequence of influenza D virus identified in poultry farm bioaerosols in Sarawak, Malaysia.","authors":"Emily S Bailey,&nbsp;Jane K Fieldhouse,&nbsp;Natalie A Alarja,&nbsp;David D Chen,&nbsp;Maria E Kovalik,&nbsp;Juliana N Zemke,&nbsp;Jessica Y Choi,&nbsp;Laura K Borkenhagen,&nbsp;Teck-Hock Toh,&nbsp;Jeffrey Soon Yit Lee,&nbsp;Kuek-Sen Chong,&nbsp;Gregory C Gray","doi":"10.1186/s40794-020-0105-9","DOIUrl":"https://doi.org/10.1186/s40794-020-0105-9","url":null,"abstract":"<p><p>In 2018, our team collected aerosols samples from five poultry farms in Malaysia. Influenza D virus was detected in 14% of samples. One sample had an 86.3% identity score similar to NCBI accession number MH785020.1. This is the first molecular sequence of influenza D virus detected in Southeast Asia from a bioaerosol sample. Our findings indicate that further study of role of IDV in poultry is necessary.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"5"},"PeriodicalIF":3.1,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40794-020-0105-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37752544","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}

{"title":"Essential in-vitro laboratory diagnostic services provision in accordance with the WHO standards in Guragae zone primary health care unit level, South Ethiopia.","authors":"Teha Shumbej,&nbsp;Sofia Menu,&nbsp;Teklemichael Gebru,&nbsp;Tadele Girum,&nbsp;Fitsum Bekele,&nbsp;Absra Solomon,&nbsp;Dereje Mesfin,&nbsp;Abdulewhab Jemal","doi":"10.1186/s40794-020-0104-x","DOIUrl":"https://doi.org/10.1186/s40794-020-0104-x","url":null,"abstract":"<p><strong>Introduction: </strong>Laboratory services are crucial parts of the health system having a great contribution to disease prevention and management. The importance of accurate and reliable laboratory test results is less recognized in developing countries like Ethiopia where most medical decisions are based on clinical judgment. It is time for countries like Ethiopia to not only increase health care coverage but also improve access to essential diagnostic tests. Hence, this proposed study aims to assess essential in-vitro laboratory service provision in accordance with the WHO standards in Guragae Zone primary health care unit level, South Ethiopia.</p><p><strong>Methods: </strong>Health institution-based cross-sectional study was carried out. 30% randomly selected primary health care units were recruited. Each facility was visited with a WHO checklist by a trained data collector to assess the availability of essential diagnostics service provision. The proportion of available in-vitro diagnostics services was calculated. Results were presented as percentages in tables and figures.</p><p><strong>Result: </strong>Twenty-one primary health care facilities located in Guragae Zone were assessed between May and July 2019. All surveyed facilities had major gaps in essential test availability. Among essential diagnostic tests listed with WHO like C-reactive protein, lipid profile, Amylase and Lipase, TroponinT/I, hepatitis B e-antigen, IgM-specific antibodies to hepatitis B core antigen, Glucose-6-phosphate dehydrogenase activity, and anti-HIV/p24 rapid test were not provided in any facilities. However, essential diagnostic services like urine dipstick testing, random blood sugar, smear microscopy, and few serological tests were provided at all primary health care units. All surveyed facilities had limited major laboratory equipment and consumables.</p><p><strong>Conclusion and recommendation: </strong>The present study shows limited access to essential laboratory tests at the primary health care level. Hence, the responsible body should invest to make essential tests accessible at the primary care unit level within the framework of universal health coverage in the study area. The fact that access to essential diagnostic tests is the first key step in improving quality of care; such study has its own efforts to enable the implementation of essential diagnostic lists, and improve access to diagnostics in the country.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"4"},"PeriodicalIF":3.1,"publicationDate":"2020-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40794-020-0104-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37728372","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}

{"title":"Testing for <i>Mycobacterium tuberculosis</i> infection using the QuantiFERON-TB GOLD assay in patients with comorbid conditions in a tertiary care endemic setting.","authors":"Kiran Iqbal Masood, Bushra Jamil, Alnoor Akber, Maheen Hassan, Muniba Islam, Zahra Hasan","doi":"10.1186/s40794-020-0102-z","DOIUrl":"10.1186/s40794-020-0102-z","url":null,"abstract":"<p><strong>Introduction: </strong>There were 10 million new cases of tuberculosis (TB) in 2017. To eliminate TB, it is necessary to diagnose active TB and latent tuberculosis infection (LTBI). Diagnosis of paucibacillary disease and in extrapulmonary TB (EPTB) remains challenging; low mycobacterial load can be missed by microbiological or molecular based confirmation; EPTB, can be misdiagnosed due to absence of site specific specimens for testing. Interferon gamma release assays (IGRA) use T cell-based Interferon-gamma (IFN-γ) to identify infection with <i>M. tuberculosis</i> (MTB) but cannot discriminate between active and LTBI. We investigated how IGRA was being used in a high burden low resource setting.</p><p><strong>Methods: </strong>We conducted a retrospective review of 149 consecutive cases received for QuantiFERON-TB Gold In-Tube Assay (QFT-GIT) testing in routine clinical service.</p><p><strong>Results: </strong>Fifty-six cases were QFT-GIT positive and 93 were QFT-GIT negative. Thirty-six per cent of QFT-GIT tested cases had active TB. Of QFT-GIT positive cases, 59% patients had active TB; 10 with pulmonary and 23 with extra-pulmonary TB. The remaining 41% QFT-positive cases were LTBI. Of the QFT-GIT negative cases, 22% had active TB. Co-morbid conditions were present in 37% of QFT-GIT positive and 60% of QFT-GIT negative cases.</p><p><strong>Conclusions: </strong>Our study shows that IGRA is being used as an adjunct test for active TB in this population. It highlights the complexity of interpreting QFT-GIT results particularly for QFT-GIT negative cases when ruling out MTB infection.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":"6 ","pages":"3"},"PeriodicalIF":2.4,"publicationDate":"2020-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37677938","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}