Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Multi-month dispensing of tuberculosis medications in sub-Saharan Africa: A feasible, person-centered care model","authors":"Jonathan Izudi ,&nbsp;Adithya Cattamanchi ,&nbsp;Francis Bajunirwe","doi":"10.1016/j.jctube.2025.100541","DOIUrl":"10.1016/j.jctube.2025.100541","url":null,"abstract":"<div><div>The treatment success rate among people with tuberculosis in sub-Saharan Africa is suboptimal despite the availability of shortened and efficacious TB regimens. Barriers such as long travel distances and frequent clinic visits for medication refills hinder access to care and compromise treatment adherence and completion. Multi-month dispensing of anti-retroviral drugs has proved successful in improving treatment adherence and viral load suppression among people living with human immunodeficiency virus. The strategy could be adapted for tuberculosis care to address treatment access and adherence barriers to optimize treatment success. In this perspective, we discuss the key considerations for the multi-month dispensing of tuberculosis drugs in sub-Saharan Africa. In particular, we highlight treatment monitoring, strengthening of logistics and supply chain systems, multi-month dispensing protocols, healthcare provider capacity building, community engagement, and monitoring and evaluation framework. We call for research, policy reforms, and pilot programs to evaluate and scale up multi-month dispensing of tuberculosis medications to end the epidemic by 2035.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100541"},"PeriodicalIF":1.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330088","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":"Medication adherence in patients with nontuberculous mycobacterial disease","authors":"Arthur Lemson ,&nbsp;Fleur Dijkhuizen ,&nbsp;Ralf Stemkens ,&nbsp;Arjan van Laarhoven ,&nbsp;Reinout van Crevel ,&nbsp;Jakko van Ingen ,&nbsp;Rob Aarnoutse ,&nbsp;Wouter Hoefsloot","doi":"10.1016/j.jctube.2025.100544","DOIUrl":"10.1016/j.jctube.2025.100544","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to measure and understand medication adherence in patients with nontuberculous mycobacterial (NTM) disease.</div></div><div><h3>Methods</h3><div>We enrolled adults with NTM disease receiving antimycobacterial treatment at Radboudumc, the Netherlands. Demographics and treatment outcomes were recorded, and medication adherence was assessed repeatedly. Adherence was measured using the Proportion of Days Covered (PDC) at 6 and 12 months, calculated from pharmacy records, and the 5-item Medication Adherence Report Scale (MARS-5). The Beliefs about Medicines Questionnaire (BMQ) explored reasons for (non)adherence.</div></div><div><h3>Results</h3><div>Sixty-one participants were enrolled, with a mean age of 63.2 (±12.9) years. Forty-one (67 %) had pulmonary, and 20 (33 %) extrapulmonary NTM disease, with <em>M. avium</em> complex being the most prevalent species (n = 38; 62 %). One or more adverse effects occurred in 56/61 (92 %) participants. A favorable response was seen in 34/49 (69 %) and 25/29 (86 %) participants at 6 and 12 months, respectively. The median PDC was 100 % (IQR, 99–100 %) at both timepoints, and the MARS-5 remained 5 out of 5 throughout treatment, indicating high adherence. Participants’ beliefs about the necessity of NTM treatment, as assessed in the BMQ, consistently outweighed concerns.</div></div><div><h3>Conclusions</h3><div>Medication adherence was high throughout the first year of NTM treatment, likely due to the perceived necessity of treatment and regular follow-up at our reference clinic.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100544"},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329916","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":"Effect of home-based pulmonary rehabilitation on ventilation dynamics and small airway dysfunction in people with post-tuberculosis lung disease","authors":"Iasmim Maria Pereira Pinto Fonseca ,&nbsp;Samantha Gomes de Alegria ,&nbsp;Jéssica Gabriela Messias Oliveira ,&nbsp;Thaís Souza Rodrigues ,&nbsp;Carolina Alves Osório da Silva Chagas ,&nbsp;Alícia Sales Carneiro ,&nbsp;Walter Costa ,&nbsp;Ana Paula Santos ,&nbsp;Thiago Thomaz Mafort ,&nbsp;Agnaldo José Lopes","doi":"10.1016/j.jctube.2025.100542","DOIUrl":"10.1016/j.jctube.2025.100542","url":null,"abstract":"<div><h3>Background</h3><div>As the world moves toward eliminating tuberculosis (TB), there is a large population of TB survivors who still face a significant burden of TB complications. However, basic pulmonary rehabilitation program (PRP) packages for this population are currently lacking. This study aimed to evaluate the effect of home-based PRP (HBPRP) on lung mechanics, exercise capacity, and quality of life (QoL) in people with PTLD (pwPTLD).</div></div><div><h3>Methods</h3><div>This is a quasi-experimental study in pwPTLD who underwent HBPRP for 3 months. Before and after HBPRP, the following assessments were performed: QoL using the St George’s Respiratory Questionnaire (SGRQ), general fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), handgrip strength (HGS), pulmonary function, and functional exercise capacity using the Glittre-ADL test (TGlittre) coupled with measurement of dynamic ventilation.</div></div><div><h3>Results</h3><div>When comparing pre- and post-HBPRP values, there was a significant increase in TGlittre time [208 (194–249) vs. 184 (153–211) seconds, <em>P</em> = 0.004] and breathing reserve [56 (34–71) vs. 58 (39–73) %, <em>P</em> = 0.032], and a reduction in end-of-test inspiratory capacity [1.4 (0.9–2.3) vs. 1.6 (1.1–2.6) L, <em>P</em> = 0.030]. Although no increase in spirometric parameters was observed, there was an improvement in small airway dysfunction (SAD) as measured by respiratory oscillometry. Improvements were observed in the Activity and Impacts domains of the SGRQ. However, no significant changes were noted in FACIT-F or HGS after HBPRP.</div></div><div><h3>Conclusions</h3><div>In pwPTLD, HBPRP improves exercise tolerance, QoL, and SAD, with no effect on general fatigue and HGS. Therefore, TB programs should ensure the availability of PRP for pwPTLD, including HBPRP.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100542"},"PeriodicalIF":1.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291594","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":"First insights into the genetic composition of M. tuberculosis population circulating in Kosovo","authors":"Alina Minias ,&nbsp;Magdalena Kuzioła ,&nbsp;Florin Ahmeti ,&nbsp;Nazmi Mehmeti ,&nbsp;Blendi Jerliu ,&nbsp;Greta Lila ,&nbsp;Albuena Miftari ,&nbsp;Xhevat Shkodra ,&nbsp;Xhevat Jakupi ,&nbsp;Zana Kacaniku ,&nbsp;Monika Kozińska ,&nbsp;Anna Zabost ,&nbsp;Marcin Słomka ,&nbsp;Dominik Strapagiel ,&nbsp;Jarosław Dziadek ,&nbsp;Ewa Augustynowicz-Kopeć ,&nbsp;Rrezarta Bajrami","doi":"10.1016/j.jctube.2025.100537","DOIUrl":"10.1016/j.jctube.2025.100537","url":null,"abstract":"<div><div>Tuberculosis incidence in Kosovo is among one of the highest in Europe at 33/100,000 citizens. While World Health Organization encourages epidemiological monitoring of tuberculosis transmission, studies regarding <em>M. tuberculosis</em> population structure in the Balkan region are limited. Here, we used spoligotyping and whole genome sequencing to describe the variation of <em>M. tuberculosis</em> strains circulating in Kosovo. We used samples isolated from patients in the period 2021/2022. We found that the vast majority of isolated strains belonged to spoligotype based Euro-American lineage, five strains belonged to East-Asian lineage, and one was <em>M. caprae</em>. We described the general characteristics of the <em>M. tuberculosis</em> population in our study and identified chains of transmission based on whole genome sequencing data of selected samples. Our data will be a reference point for subsequent studies of <em>M. tuberculosis</em> population in Kosovo.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100537"},"PeriodicalIF":1.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263370","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 CAD4TB artificial intelligence technology in TB screening programmes among the adult population in South Africa and Lesotho","authors":"Nonhlanhla Nzimande ,&nbsp;Keelin Murphy ,&nbsp;Klaus Reither ,&nbsp;Shannon Bosman ,&nbsp;Irene Ayakaka ,&nbsp;Tracy R. Glass ,&nbsp;Fiona Vanobberghen ,&nbsp;Bart K.M. Jacobs ,&nbsp;Aita Signorell ,&nbsp;Jabulani Ncayiyana","doi":"10.1016/j.jctube.2025.100540","DOIUrl":"10.1016/j.jctube.2025.100540","url":null,"abstract":"<div><h3>Summary</h3><div>There is growing evidence of the performance accuracy and potential impact of Computer-Aided Diagnosis (CAD) products in TB-burdened settings. It remains unclear, however, which factors of populations and settings can affect CAD performance. We aimed to investigate the parameters affecting the performance accuracy of the two latest versions of CAD4TB in TB screening programmes in South Africa and Lesotho.</div><div>We included participants recruited for the Lesotho National Prevalence Survey and the TB TRIAGE + ACCURACY studies, who underwent digital chest radiography and microbiological reference testing for TB. In total, 6,524 chest images were included in the analysis: 288 cases and 6,236 controls. CAD4TB versions 6 and 7 interpreted the X-ray images, and the performance of both versions was investigated. Threshold analyses were performed, as well as subgroup analyses, including age, X-ray hardware and HIV status.</div><div>CAD4TB v7 showed overall improved performance accuracy compared to v6 (p &lt; 0.01). The area under the ROC curve was 0.833 (95 % CI 0.808–0.859) for v6 and 0.865 (95 % CI 0.842–0.889) for v7. At 90 % sensitivity, v7 showed a higher specificity of 65 % compared to the 54 % achieved by v6. Both versions showed lower performance in the older age group (≥60 years) and individuals with a previous history of TB. The threshold required to achieve the same sensitivity or specificity varies notably across the two versions.</div><div>CAD4TB performed well as a TB screening tool; however, factors such as software version, age, TB history and X-ray hardware should be considered in threshold determination and performance evaluation.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100540"},"PeriodicalIF":1.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239696","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":"Dietary diversity and associated factors among people with tuberculosis in Kampala, Uganda: A cross-sectional study","authors":"Jonathan Izudi ,&nbsp;Simon Kyazze ,&nbsp;Francis Bajunirwe","doi":"10.1016/j.jctube.2025.100539","DOIUrl":"10.1016/j.jctube.2025.100539","url":null,"abstract":"<div><div>Rationale.</div><div>Dietary diversity (DD) is important in enhancing the nutritional status of people with tuberculosis (TB), but has been understudied in Uganda.</div></div><div><h3>Objective</h3><div>To investigate the frequency of adequate DD and the associated factors among people with pulmonary TB aged ≥ 18 years in Kampala, Uganda.</div></div><div><h3>Methods</h3><div>We enrolled people with pulmonary TB across five health facilities in Kampala, Uganda. The outcome variable was adequate DD, assessed using the World Food Program’s Food Consumption Score (FCS). Participants with FCS values &lt; 35 were categorized as having inadequate DD, whereas those with FCS ≥ 35 were classified as having adequate DD. Independent variables included sociodemographic, clinical, and behavioral factors. We used a Generalized Estimating Equation with a Poisson distribution, log link function, and robust standard errors, with health facility as a cluster and several variables to identify the factors associated with adequate DD. We reported adjusted risk ratios (aRR) and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Of 818 participants studied, 250 (30.6 %) had adequate DD. The factors associated with adequate DD included age ≥ 25 years old (aRR 1.12; 95 % CI: 1.04–1.22), being married (aRR 1.77; 95 % CI: 1.51–2.07), self-employed (aRR 1.22; 95 % CI: 1.09–1.36), and low socioeconomic status (aRR 1.48; 95 % CI: 1.15–1.89).</div></div><div><h3>Conclusion</h3><div>We found a low frequency of adequate DD. Persons aged ≥ 25 years, married, self-employed, and of lower socioeconomic status are more likely to have adequate DD. Findings suggest a complex interplay between socioeconomic factors and DD. Targeted interventions are needed to improve DD among people with TB across different demographic groups.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100539"},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196255","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":"Change in lung function abnormalities in patients treated for first ever pulmonary tuberculosis in Dar es Salaam, Tanzania","authors":"Reinhard Elisania Lema ,&nbsp;Grace Ambrose Shayo ,&nbsp;Zuhura Nkrumbih ,&nbsp;Tumaini Joseph Nagu","doi":"10.1016/j.jctube.2025.100538","DOIUrl":"10.1016/j.jctube.2025.100538","url":null,"abstract":"<div><h3>Objectives</h3><div>To document abnormalities in pulmonary function (PF) and associated factors in patients completing treatment for microbiologically confirmed, first-ever pulmonary tuberculosis (PTB).</div><div>From August 2020 to May 2021, we recruited 332 patients aged ≥15 years. PF was evaluated at baseline and at treatment completion. The Wilcoxon signed-rank test was used to compare median PF changes between baseline and treatment completion. A log-binomial regression model was used to determine factors associated with abnormal PF at treatment completion. Statistical significance was set at <em>p</em> ≤ 0.05.</div></div><div><h3>Results</h3><div>Abnormal PF was observed in 142 of 300 (47.3 %) patients who completed the study. Being male (RR [95 % CI] = 1.22 [1.19–2.23]), underweight (RR = 1.49 [1.13–1.95]), having lung cavitation (RR = 1.90 [1.29–2.78]), and lung fibrosis at baseline (RR = 2.16 [1.32–3.53]) were significantly associated with abnormal PF. The median (IQR) FEV₁ at treatment completion was 2.33 L (0.90–4.23 L) and FVC was 3.05 L (1.10–7.50 L), both significantly higher than FEV₁ of 2.18 L (0.20–5.70 L) and FVC of 2.82 L (0.26–7.05 L) at treatment initiation (<em>p</em> &lt; 0.05 for both).</div></div><div><h3>Conclusion</h3><div>Approximately half of the patients had abnormal PF at treatment completion. Underweight patients, males, and those with lung cavitation at treatment initiation are more likely to have abnormal PF at the end of treatment and may require special attention.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100538"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196215","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":"Operational considerations of select new treatment recommendations for drug-susceptible and drug-resistant tuberculosis","authors":"John W. Wilson ,&nbsp;Zelalem Temesgen ,&nbsp;James T. Gaensbauer","doi":"10.1016/j.jctube.2025.100536","DOIUrl":"10.1016/j.jctube.2025.100536","url":null,"abstract":"<div><div>A number of management updates recently have been published for both drug-susceptible and drug-resistant tuberculosis (TB), TB in children, and contacts of patients with drug-resistant TB. The operationalization and application of these recommendations, which reflect favorable clinical trial outcomes, may vary significantly for different patient groups and in different settings. Defining the best treatment approach for each patient requires the integration of multiple data points including organism culture growth and corresponding drug susceptibility profiles, specific TB syndrome, concurrent patient co-morbidities and available public health resources. We review several updated TB treatment recommendations and discuss applicable strengths, select limitations and corresponding precautions as they pertain to diverging patient groups, TB syndromes, and public health capacity.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100536"},"PeriodicalIF":1.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178214","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":"Characteristics of subclinical pulmonary tuberculosis compared to active pulmonary tuberculosis: A retrospective cohort study","authors":"Aiping Zhang ,&nbsp;Wenjie Wang ,&nbsp;Zijian Wang,&nbsp;Haoyu Sheng,&nbsp;Jianghua Yang","doi":"10.1016/j.jctube.2025.100535","DOIUrl":"10.1016/j.jctube.2025.100535","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about subclinical pulmonary tuberculosis (SPTB), and its diagnosis remains challenging. The aim is to analyze the results of laboratory of SPTB and improve clinical understanding and help early diagnosis.</div></div><div><h3>Method</h3><div>This retrospective cohort study was conducted in patients with pulmonary tuberculosis (TB) at a university hospital in China. 138 cases of SPTB were compared with active pulmonary tuberculosis (APTB) (140 cases) and healthy person (HC) (136 cases).</div></div><div><h3>Result</h3><div>The average age of the SPTB group (40.43 ± 19.85 years) was younger than that of the APTB group (50.01 ± 21.49 years) (p &lt; 0.05). The WBC count was elevated in both pulmonary TB groups compared to the HC group(p &lt; 0.05). CRP and CA-125 were higher in the APTB group than in SPTB and HC group (p &lt; 0.05). The CD4+ T cells counts in SPTB group was lower than that in HC group (p &lt; 0.05); although the CD4+ T cells counts in SPTB group was lower than that in APTB group, the difference was not statistically significant (p &gt; 0.05). There were statistically significant differences in CD8 + T cells counts between the three groups (p &lt; 0.05), and the CD8 + T cells counts in two pulmonary TB groups was lower than that in the HC group (p &lt; 0.05), and there was no statistically significant difference between SPTB and APTB group (p &gt; 0.05). The T-SPOT.TB value in SPTB were lower than those in the APTB group (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Patients with SPTB tend to develop the condition at a younger age and are predominantly male. Clinically, we can judge whether SPTB will develop into APTB by monitoring WBC count, CA-125, CRP, T lymphocyte count and T-SPOT.TB value level, in order to achieve the purpose of early diagnosis and treatment.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100535"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279368","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 co-occurrence with pulmonary TB, a respiratory tract infection (RTI): A cross-sectional study in a resource-limited setting","authors":"Mpho Magwalivha,&nbsp;Mpumelelo Casper Rikhotso,&nbsp;Leonard Owino Kachienga,&nbsp;Rendani Musoliwa,&nbsp;Ntshunxeko Thelma Banda,&nbsp;Maphepele Sara Mashilo,&nbsp;Thembani Tshiteme,&nbsp;Avheani Marry Mphaphuli,&nbsp;Hafsa Ali Mahamud,&nbsp;Sana Patel,&nbsp;Jean-Pierre Kabue Ngandu,&nbsp;Sana Patel,&nbsp;Natasha Potgieter,&nbsp;Afsatou Ndama Traoré","doi":"10.1016/j.jctube.2025.100534","DOIUrl":"10.1016/j.jctube.2025.100534","url":null,"abstract":"<div><h3>Background</h3><div>Bacterial co-infections significantly affect the treatment outcomes of tuberculosis (TB) patients, particularly in resource-limited settings. Misdiagnosis of TB co-infections accelerate disease progression and contribute to the development of drug resistance, leading to higher mortality and morbidity rates, especially in underserved areas. This study aimed to investigate bacterial co-infections in patients with pulmonary tuberculosis in a rural Vhembe region of Limpopo, South Africa.</div></div><div><h3>Materials and methods</h3><div>A total of 100 sputum together with 100 blood samples were collected from TB patients who were undergoing TB treatment. DNA isolates were used as templates for PCR using the Anyplex™MTB/NTMe Assay kit, and subsequently, the Allplex™ MTB/MDR/XDRe Assay kit was used for the multiple detections of <em>Mycobacterium tuberculosis</em> (MTB) and resistance to first line and second line anti-TB drugs. Co-infections were determined using the Allplex™ Bacteria(I) &amp; (II) Assay kit. HIV status of patients was determined using blood testing kits.</div></div><div><h3>Results</h3><div>Majority of study participants were male (55 %) and aged between 36 and 55 (54 %), while female were 46 % of the population. Bacterial species detected included non-tuberculous mycobacteria (NTM) in 67 % of participants, Aeromonas spp. (19 %), Vibrio spp. (2 %), and E. coli (2 %). Multidrug-resistant <em>Mycobacterium tuberculosis</em> (MTB) strains were identified in 2 % of the cohort. There was a significant association between employment status and age (p = 0.00), as well as between HIV status and age (p = 0.03). While no significant associations were found between HIV status and the presence of NTM or other bacterial co-infections (p = 0.19 and 0.21, respectively), the majority of Aeromonas spp. and NTM cases were observed among HIV-positive participants. Notably, 36 of the NTM cases occurred in individuals living with HIV.</div></div><div><h3>Conclusion</h3><div>The study findings suggest that age, socioeconomic status, and gender play a role in the development of TB, HIV, and other bacterial infections, which could further complicate treatment outcomes in patients. These factors likely contribute to increased vulnerability to co-infections, emphasizing the complex interplay between TB and HIV in these populations. Additionally, the study emphasises the importance of considering these socio-demographic factors in public health interventions to reduce the burden of TB-HIV co-infection and associated bacterial infections.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100534"},"PeriodicalIF":1.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941821","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}