Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Impact of financial support on treatment outcomes of multidrug-resistant tuberculosis: A population-based, retrospective cohort study in Shanghai, China","authors":"Yong Chen ,&nbsp;Xin Shen ,&nbsp;Yi Zhang ,&nbsp;Zheyuan Wu ,&nbsp;Biao Xu ,&nbsp;Jing Chen ,&nbsp;Wei Sha ,&nbsp;Xiaoxia Liu ,&nbsp;Chenxi Ning","doi":"10.1016/j.jctube.2024.100500","DOIUrl":"10.1016/j.jctube.2024.100500","url":null,"abstract":"<div><h3>Background</h3><div>To date, the prolonged treatment duration and expensive second-line anti-tuberculosis drugs (SLDs) for multidrug-resistant tuberculosis (MDR-TB) can impose a significant financial burden, which may negatively impact treatment outcomes. This study examines the effect of a subsidy policy on treatment outcomes of MDR-TB patient..</div></div><div><h3>Methods</h3><div>We collected demographic and drug resistance data of all registered MDR-TB patients between April 2011 and December 2019 in Shanghai, China. Documentation of financial support received was routinely maintained until December 2021. We employed multivariate logistic regression to assess the association between financial support and treatment outcomes, estimating odds ratios (ORs) and their corresponding 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Of the 865 patients, 70.6% (611/865) achieved treatment success. The median amount compensated under the subsidy policy was 2359 United States dollar (USD), with an interquartile range from 1116 to 5652 USD. A positive association was found between benefiting from the subsidy policy and higher rate of treatment success, with an adjusted OR of 2.95 (95% CI, 2.03–4.28). Among the 641 patients covered by the policy, the adjusted OR comparing those with higher versus lower reimbursement was 1.74 (95% CI, 1.16–2.61).</div></div><div><h3>Conclusions</h3><div>Financial support policies for MDR-TB patients demonstrate a positive influence on treatment outcomes.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100500"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756816","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":"Determining the relationship between stigmatization and social support in tuberculosis patients","authors":"Hatice Polat ,&nbsp;Gulcan Bahcecioglu Turan ,&nbsp;Mehtap Tan","doi":"10.1016/j.jctube.2024.100502","DOIUrl":"10.1016/j.jctube.2024.100502","url":null,"abstract":"<div><h3>Background &amp; Aim</h3><div>It is aimed to analyze the relationship between stigmatization levels and social support perceptions of tuberculosis patients.</div></div><div><h3>Methods &amp; Materials</h3><div>Research data are collected using socio-demographic information form, Stigmatization Scale in Patients with Tuberculosis and Multidimensional Social Support Scale.</div></div><div><h3>Results</h3><div>85.5 % of the patients have said that there are no other tuberculosis patients in their families. 83.9 % of the patients have stated that they did not tell anyone that they had tuberculosis. The results of the study show that patients with tuberculosis faced stigmatization, that their score from the scale is at a moderate level [mean:88.0 ± 10.33], and they got a moderate score [mean:54.19 ± 14.07] on the social support perception scale. It is determined that there is a negative relationship between social support perception and stigmatization. It is determined that tuberculosis patients experienced medium level of stigmatization. It is determined that their social support perception is at a medium level.</div></div><div><h3>Conclusion</h3><div>Stigmatization level is found to be significantly higher in individuals whose support from family, friends and a significant other in their life decreased. In order to reduce stigmatization in patients with tuberculosis, it may be recommended to increase the awareness of the society about the disease.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100502"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744791","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":"Analysis of the c.1135G > A, c.1993A > G, c.2059T > C TAP2 gene variants and their relationship with latent tuberculosis infection in Mexico","authors":"Gerardo Cazarez-Navarro ,&nbsp;Ivan Hernández-Cañaveral ,&nbsp;Ana Gabriela Colima-Fausto ,&nbsp;Jaime Palomares-Marín ,&nbsp;Karel Licona-Lasteros ,&nbsp;Ana Laura Pereira-Suarez ,&nbsp;Sergio Yair Rodríguez-Preciado","doi":"10.1016/j.jctube.2024.100501","DOIUrl":"10.1016/j.jctube.2024.100501","url":null,"abstract":"<div><div>Tuberculosis (TB) is a worldwide public health problem with 10.6 million people falling ill and 1.5 million deaths every year. Latent tuberculosis infection (LTBI) is a condition in which an individual has been infected with <em>Mycobacterium tuberculosis</em> (<em>Mtb</em>) but does not show clinical signs and symptoms. The transporter associated with antigen processing (TAP2) protein plays a fundamental role in the immune response promoting the clearance of intracellular pathogens, such as <em>Mtb</em>. Our study aimed to determine the association between c.1135G &gt; A (rs1800454), c.1993A &gt; G (rs241447) and c.2059 T &gt; C (rs241448) <em>TAP2</em> gene variants with LTBI susceptibility. In this case-control study, 180 individuals (90 were LTBI-positive and 90 were controls) from shelters were analyzed. Genotyping of the polymorphisms was performed using the Applied Biosystems Step One Thermal Cycler Real-Time PCR allelic discrimination technology. The haplotypic analyses were performed with the Arlequin 3.5 software. The G allele (OR = 1.732, CI = 1.125–2.667, <em>p</em> = 0.012) and AG genotype of the c.1993A &gt; G variant (<em>p</em>=&lt;0.001) were associated with susceptibility to LTBI (<em>p</em>=&lt;0.001), as well as the GAT, AAT, AAC, AGT haplotypes (<em>p</em>=&lt;0.001). The c.1135G &gt; A and c.2059 T &gt; C variants were not associated with LTBI risk.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100501"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756815","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":"Culturing stool specimens has no added value in diagnosing pulmonary tuberculosis","authors":"Dorte Bek Folkvardsen ,&nbsp;Victor Naestholt Dahl ,&nbsp;Christian Wejse ,&nbsp;Erik Svensson ,&nbsp;Troels Lillebaek","doi":"10.1016/j.jctube.2024.100498","DOIUrl":"10.1016/j.jctube.2024.100498","url":null,"abstract":"<div><div>Patients with pulmonary tuberculosis (PTB) may face challenges in providing sputum specimens for diagnosis. Mycobacterium tuberculosis (Mtb) is potentially present in the stool due to swallowed sputum. Therefore easy-to-obtain stool could be used as an alternative to sputum sampling. However, the evidence for using stool specimens for PTB diagnosis is sparse, especially in resource-rich settings.</div><div>In this study, spanning two years, the results of 562 stool specimens were evaluated alongside those of respiratory specimens sent to the International Reference Laboratory of Mycobacteriology in Denmark.</div><div>Despite the potential advantages of stool culture, only five out of 19 patients with PTB had Mtb culture-positive stool, all of whom also had positive respiratory specimens. Conversely, relying solely on stool specimens could lead to missed diagnoses of PTB.</div><div>While stool analysis may offer additional value in specific settings or populations, such as those unable to produce sputum, this study discourages its general use for PTB testing in resource-rich, TB low-incidence settings like Denmark. Instead, we advocate for prospective trials in specific subpopulations to elucidate the role of stool as a complementary diagnostic tool for PTB. The study underscores the importance of tailoring diagnostic approaches based on the setting and patient characteristics.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100498"},"PeriodicalIF":1.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720140","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":"Treatment success and mortality among people with multi-drug resistant and rifampicin resistant-tuberculosis on bedaquiline-based regimen at three referral hospitals in Uganda: A retrospective analysis","authors":"Lodiong Jackson Dumo Lodiong ,&nbsp;Jonathan Izudi ,&nbsp;Boniface Amanee Elias Lumori","doi":"10.1016/j.jctube.2024.100499","DOIUrl":"10.1016/j.jctube.2024.100499","url":null,"abstract":"<div><h3>Introduction</h3><div>In Uganda, people with multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) have been treated with a bedaquiline-based regimen since 2020. Still, their treatment outcomes have not been rigorously studied. We describe the treatment outcomes of people with MDR/RR-TB treated with a bedaquiline-based regimen and analyze the factors associated with their treatment success at three referral hospitals in Uganda.</div></div><div><h3>Method and materials</h3><div>We retrospectively reviewed medical records for people with MDR/RR-TB treated with a bedaquiline-based regimen between January 2020 and December 2021 at 3 referral hospitals. Treatment success was defined as cure or treatment completion on a binary scale at the end of the MDR/RR-TB treatment. Factors independently associated with treatment success were analyzed using the modified Poisson regression analysis with robust standard errors, reported as risk ratio (RR) and 95% confidence interval (CI). Analyses were performed at a 5% level of statistical significance.</div></div><div><h3>Results</h3><div>Of 71 participants aged ≥ 15 years, 13 (18.3 %) completed treatment, 46 (64.8) were cured, 8 (11.3) died, and 4 were lost to follow-up. Overall, 59 (83.1) were successfully treated. Current alcohol consumption (adjusted RR [aRR] 0. 78, 95 % CI 0.60–0. 99) and high aspartate aminotransferase levels (aRR 0.77, 95 % CI 0.60–0.98) were associated with a lower treatment success.</div></div><div><h3>Conclusion</h3><div>The treatment success among people with MDR/RR-TB on a bedaquiline-based regimen was relatively high. High AST levels and alcohol consumption are associated with a lower treatment success. There is a need to strengthen psychosocial support regarding the harmful effects of alcohol consumption and its interaction with drugs, including routine monitoring of liver function to enhance the TB treatment success.</div><div>Our study is the first to describe treatment success among people with MDR/RR-TB in three large hospitals in Uganda, this provides a good picture of treatment success among people with MDR/RR-TB on bedaquiline-based regimens in the country. The weaknesses are the smaller sample size, we analyzed data spanning a relatively shorter period, and alcohol use was measured by self-reporting, this might have underestimated its association with treatment success.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100499"},"PeriodicalIF":1.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699558","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":"Dissecting regional variability in Pyrazinamide prescribing practices for tuberculosis treatment in Japan","authors":"Nobuaki Kobayashi,&nbsp;Hiromi Matsumoto,&nbsp;Takeshi Kaneko","doi":"10.1016/j.jctube.2024.100497","DOIUrl":"10.1016/j.jctube.2024.100497","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate regional variations in pyrazinamide (PZA) prescribing across Japan’s 47 prefectures and associated influential factors.</div></div><div><h3>Methods</h3><div>This study utilized the Standardized Claim Ratio (SCR) for PZA from Japan’s National Database of Health Insurance Claims in 2018. Pearson’s correlation coefficients assessed relationships between SCR and tuberculosis (TB) incidence, patient characteristics (age, liver disease), and healthcare resources (specialists, TB beds). Multiple regression analysis identified independent predictors of SCR.</div></div><div><h3>Results</h3><div>Median SCR for PZA was 90.0 (range 40.2–187.1), with a 3-fold difference between top and bottom prefectures. In univariate analysis, SCR correlated positively with TB incidence (r = 0.42), respiratory/infectious disease/TB specialists, and negatively with elderly TB patients (r = -0.33) and liver disease per TB case. Multiple regression revealed higher SCR associated with higher TB incidence (β = 0.44, p &lt; 0.001), lower elderly patients (β = -0.33, p = 0.005), and more respiratory specialists (β = 0.41, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Regional PZA prescription patterns are multifaceted, significantly influenced by TB prevalence, elderly patient ratios, and the availability of respiratory specialists. To enhance PZA prescribing conformity and TB management, fostering respiratory expertise across Japan is imperative.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100497"},"PeriodicalIF":1.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699559","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":"Efficacy of nutritional support in combination with standard Buruli ulcer treatment: A case study in Côte d’Ivoire","authors":"Yao Didier Koffi ,&nbsp;Paul Aboa Koffi ,&nbsp;Evans Ehouman ,&nbsp;Saint-Pierre Kouadio ,&nbsp;Mamadou Kaloga","doi":"10.1016/j.jctube.2024.100496","DOIUrl":"10.1016/j.jctube.2024.100496","url":null,"abstract":"<div><h3>Background</h3><div>Buruli ulcer (BU) is an infectious skin disease caused by <em>Mycobacterium ulcerans</em>. It primarily affects disadvantaged rural populations and mainly impacts children who are chronically malnourished being especially vulnerable. In Côte d’Ivoire, the estimated prevalence of BU in children is 30 %. Malnutrition may further deteriorate the nutritional status of these individuals. This study aimed to compare the healing time of BU patients treated with the standard protocol (SP) of 8 weeks of rifampicin and clarithromycin combined with wound care versus those treated with the standard protocol plus nutritional support using Skin Renewal Medicine-1 (SPSRM-1) (UNHWA Medical Centre, Seoul, Republic of Korea). Additionally, the study measured the effects of SRM-1 on the patients’ nutritional status.</div></div><div><h3>Method</h3><div>This was a prospective, randomized, single-blind paired interventional study conducted in BU-endemic health districts of Côte d’Ivoire. This 12-month study had two arms: the standard protocol versus the test treatment (SPSRM-1). SRM-1 is a cereal-based nutraceutical composed of 60 % cereal, 25 % vegetable, and 15 % plant concentrate. Patients included in the study had uncomplicated category I and II ulcerations without comorbidities. Nutritional status including haemoglobin, albumin levels, and body mass index (BMI) was evaluated from enrolment to the end of the study, alongside ulcer healing rates.</div></div><div><h3>Results</h3><div>Sixty BU wound patients were enrolled: 30 in the control group and 30 in the test group, with a mean age of 22 years. Of the patients, 28.3 % were malnourished, and 42 % had hypoalbuminemia. At the primary endpoint, 6 patients (20.0 %) in the SPSRM1 and 5 patients (16.7 %) in the SP group achieved complete epithelialization, with a reduction rate of 0.7 % per day in the SPSRM1 group compared to 0.3 % per day in the SP group. Patients who received SRM-1 had a higher BMI than those who did not, with a mean difference of 1.72 kg/m² favouring the test group. Haemoglobin and albumin levels also showed improvement at the secondary endpoint compared to the control group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the potential benefit of adding nutritional support to improve BU treatment outcomes, by shortening the healing time of ulcerations. However, further studies with larger sample sizes are necessary to confirm these findings.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100496"},"PeriodicalIF":1.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658473","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":"Computational investigation of the global prevalence of multidrug resistant Mycobacterium leprae: A systematic review and meta-analysis","authors":"Hamidreza Zivarifar ,&nbsp;Forough Ahrari ,&nbsp;Mohsen Karbalaei","doi":"10.1016/j.jctube.2024.100495","DOIUrl":"10.1016/j.jctube.2024.100495","url":null,"abstract":"<div><h3>Background</h3><div>Leprosy is a chronic infectious disease caused by <em>Mycobacterium leprae</em> (<em>M. leprae</em>) However, the emergence of drug-resistant strains of this bacterium, especially multidrug-resistant (MDR) strains, is a serious concern. This study aimed to evaluate the global prevalence of MDR <em>M. leprae</em> and its implications.</div></div><div><h3>Methods</h3><div>Using PRISMA guidelines, we systematically reviewed ISI Web of Science, MEDLINE, and EMBASE up to August 2023 to assess the prevalence of MDR <em>M. leprae</em>. We included human clinical trials on MDR <em>M. leprae</em>, as well as excluded reviews, animal studies, and unavailable full texts. Data was analyzed using Comprehensive Meta-Analysis software, and publication bias was addressed using Egger’s, Begg’s tests, and the trim-fill method.</div></div><div><h3>Results</h3><div>Overall, 861 articles were initially identified, of which 28 met the methodological criteria for inclusion in the quantitative synthesis. Statistically, the combined prevalence of drug resistant <em>M. leprae</em> was approximated at 11.7 % (95 % CI: 7.7–17.3; <em>I²</em>: 90.79; <em>p</em> value = 0.01). Specific drug resistance rates included 7.4 % to dapsone and 5.1 % to rifampin, among others. The global rate for MDR <em>M. leprae</em> was measured at 2.2 % (95 % CI: 1.2–3.9; <em>I²</em>: 82.68; <em>p</em> value = 0.01). Factors such as bacterial density and the lepromatous phase were associated with elevated DR <em>M. leprae</em> risk (OR: 2.69; 95 % CI: 1.35–2.48). A systematic assessment of publication bias indicated a minimal impact on the general results.</div></div><div><h3>Conclusions</h3><div>The increasing prevalence of MDR <em>M. leprae</em> globally requires urgent and strategic interventions to prevent further spread, which in turn is effective in treating leprosy patients.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100495"},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658471","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":"Pulmonary tuberculosis related diffuse cystic lung disease with recurrent pneumothorax mimicking pulmonary lymphangioleomyomatosis in Ethiopia: A review and case report","authors":"Haba Churako ,&nbsp;Melese Tesema ,&nbsp;Lijalem Tema ,&nbsp;Tsion Ababiya ,&nbsp;Desalegn Wodajo ,&nbsp;Teshome Hadaro ,&nbsp;Amanuel Tateso ,&nbsp;Eyosiyas Anjajo ,&nbsp;Temesgen Sidamo ,&nbsp;Abenezer Bekele","doi":"10.1016/j.jctube.2024.100494","DOIUrl":"10.1016/j.jctube.2024.100494","url":null,"abstract":"<div><div>Millions of individuals worldwide are afflicted by the fatal infectious disease tuberculosis, which accounts for thousands of avoidable deaths. The literature has provided a good description of the clinical manifestation and radiologic features of pulmonary tuberculosis. However, the parenchymal complication of pulmonary tuberculosis presenting as cystic lung disease, has not been widely documented in the literature and is one of the incredibly uncommon causes of diffuse cystic lung disease. It is very uncommon to have a patient with possible pulmonary lymphangioleomyomatosis to be superinfected with bacteriologically confirmed tuberculosis.</div><div>This report describes a young female patient who was admitted to the hospital, had repeated chest tube insertions and drainage of recurrent spontaneous pneumothoraxes secondary to likely diffuse cystic lung disease related to pulmonary tuberculosis. First, it was thought that the most likely diagnosis was pulmonary lymphangioleomyomatosis. The patient ultimately diagnosed with diffuse cystic lung disease associated with pulmonary tuberculosis as the most likely cause of her clinical presentation considering the high index of suspicion and her sputum gene xpert results. For drug-susceptible tuberculosis, the patient was finally started on anti-tuberculosis medication. She had both clinical and radiological improvement after completion of her anti tuberculosis treatment.</div><div>Thus, it is reasonable to conclude that tuberculosis may contribute to diffuse cystic lung disease (DCLD) in tuberculosis endemic settings such as Ethiopia, and that appropriate diagnostic efforts should be undertaken to make the diagnosis. A high index of clinical suspicion is crucial to prevent delays in the diagnosis of diffuse cystic lung disease associated with pulmonary tuberculosis.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100494"},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699677","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":"Endogenous reactivation cases identified by whole genome sequencing of Mycobacterium tuberculosis: Exploration of possible causes in Latvian tuberculosis patients","authors":"Anda Viksna ,&nbsp;Darja Sadovska ,&nbsp;Vija Riekstina ,&nbsp;Anda Nodieva ,&nbsp;Ilva Pole ,&nbsp;Renate Ranka ,&nbsp;Iveta Ozere","doi":"10.1016/j.jctube.2024.100493","DOIUrl":"10.1016/j.jctube.2024.100493","url":null,"abstract":"<div><h3>Background</h3><div>The recurrence of tuberculosis (TB) continues to place a significant burden on patients and TB programs worldwide. Repeated TB episodes can develop either due to endogenous reactivation of previously treated TB or exogenous reinfection with a distinct strain of <em>Mycobacterium tuberculosis</em> (Mtb). Determining the precise cause of the recurrent TB episodes and identifying reasons for endogenous reactivation of previously successfully treated patients is crucial for introducing effective TB control measures.</div></div><div><h3>Methods</h3><div>Here, we aimed to provide a retrospective individual analysis of the clinical data of pulmonary TB patients with assumed endogenous infection reactivation based on WGS results to identify the reasons for reactivation. Patient medical files were reviewed to describe the provoking factors for endogenous reactivation.</div></div><div><h3>Results</h3><div>In total, 25 patients with assumed endogenous TB reactivation were included in the study group, and 30 patients with one TB episode during the study period were included in the control group. There were no statistically significant differences identified between studied patient groups in patients age (t₍₅₃₎ = −1.53, p = 0.13), body mass index (t₍₅₃₎ = 0.82, p = 0.42), area of residency (χ²_(1;55) = 0.015, p = 0.9), employment status (χ²_{(1;55) =} 0.076, p = 0.78) and presence of comorbidities (χ²_(1;55) = 3.67, p = 0.78). Study group patients had statistically significantly more frequently positive sputum smear microscopy results (χ²_(1;55) = 8.72, p = 0.0031), longer time to sputum smear (t₍₃₁₎ = −2.2, p = 0.036) and sputum culture conversion (W ₍₅₅₎ = 198.5, p = 0.0029). Smoking was statistically significantly (χ²_(1;55) = 5.77, p = 0.016) more frequently represented among study group patients. The median treatment duration for drug susceptible TB was 6 months in both in the control group (IQR 6–6) and among study group patients (IQR 6–7.75). The median treatment duration for multidrug-resistant TB was 20 months (IQR 17–23) in the control group and 19 months (IQR 16–19) in the study group patients.</div></div><div><h3>Conclusion</h3><div>Positive SSM for acid-fast bacteria, delayed time to sputum smear and sputum culture conversion, smoking, and incomplete therapy in the study group patients with multidrug-resistant TB should be considered as potential reasons for reactivation in recurrent TB patient group in our study.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100493"},"PeriodicalIF":1.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573228","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}