Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Factors associated with tuberculosis drug resistance among presumptive multidrug resistance tuberculosis patients identified in a DRTB surveillance study in western Kenya","authors":"Albert Okumu ,&nbsp;James Orwa ,&nbsp;Ruth Sitati ,&nbsp;Isaiah Omondi ,&nbsp;Ben Odhiambo ,&nbsp;Jeremiah Ogoro ,&nbsp;George Oballa ,&nbsp;Benjamin Ochieng ,&nbsp;Steve Wandiga ,&nbsp;Collins Ouma","doi":"10.1016/j.jctube.2024.100466","DOIUrl":"10.1016/j.jctube.2024.100466","url":null,"abstract":"<div><p>Multidrug-resistant tuberculosis (MDR-TB) is caused by <em>M. tuberculosis</em> (<em>Mtb</em>) with resistance to the first-line anti-TB medicines isoniazid (INH) and rifampicin (RIF). In Western Kenya, there is reported low prevalence of drug resistant strains among HIV tuberculosis patients, creating a need to determine factors associated with drug resistance patterns among presumptive MDR-TB patients. To determine factors associated with drug resistance patterns among presumptive MDR-TB patients in western Kenya. Three hundred and ninety (3<!--> <!-->9<!--> <!-->0) sputum sample isolates from among presumptive multidrug TB patients, were analyzed for TB drug resistance as per Ministry of Health (MoH) TB program diagnostic algorithm. Frequency and percentages were used to summarize categorical data while median and interquartile range (IQR) were used for continuous data. Multivariable logistic regression was carried out to identify factors associated with TB drug resistance. Out of 390 participants enrolled, 302/390 (77.4 %) were males, with a median age of 34 years. The HIV-infected were 118/390 (30.3 %). Samples included 322 (82.6 %) from presumptive patients, while 68/390 (17.4 %) were either lost to follow-up patients, failures to first-line treatment or newly diagnosed cases. A total of 64/390 (16.4 %) of the isolates had at least some form of drug resistance. Out of 390, 14/390 (3.6 %) had MDR, 12 (3.1 %) were RIF mono-resistance, 34 (8.7 %) had INH, while 4 (1 %) had ethambutol resistance. The category of previously treated patients (those who received or are currently on TB treatment) had a 70 % reduced likelihood of resistance (aOR: 0.30; 95 % CI: 0.13–0.70). In contrast, older age was associated with an increased likelihood of resistance to INH and RIF, with an adjusted odds ratio of 1.04 per year (95 % CI: 1.00–1.08). Prompt MDR-TB diagnosis is essential for appropriate patient care, management, and disease prevention and control. We recommend active surveillance on drug resistant TB in these regions to detect drug resistance patterns for rapid disease management.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100466"},"PeriodicalIF":1.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000536/pdfft?md5=7b2b02de9f953b8195ed23b9e43f47c3&pid=1-s2.0-S2405579424000536-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952249","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":"Antimicrobial resistance profile and prevalence of Mycobacterium tuberculosis complex in Western Iran using spoligotyping method","authors":"Soroush Borji ,&nbsp;Sara Kooti ,&nbsp;Rashid Ramazanzadeh ,&nbsp;Sepide Kadivarian ,&nbsp;Sara Atashi ,&nbsp;Parviz Mohajeri","doi":"10.1016/j.jctube.2024.100467","DOIUrl":"10.1016/j.jctube.2024.100467","url":null,"abstract":"<div><p>Tuberculosis (TB) is a chronic infectious disease with multiple manifestations and gradual progression that remains a major health problem and a leading cause of death worldwide. In recent years, a number of DNA fingerprinting techniques have been developed to identify strains of the <em>Mycobacterium tuberculosis</em> (MTB) complex. Spoligotyping is one of the first PCR-based genotyping methods. Information on the number and identification of common strains among MTB complex samples in clinical samples from Kermanshah city is needed to develop more effective therapeutic strategies.</p><p>This is a descriptive cross-sectional study of 41 sample patients with TB referred to Kermanshah Tuberculosis Centre between December 2021 and June 2022, including sputum, aspiration, urine, etc. First, the susceptibility of the developed bacteria to culture media was compared with that of isoniazid using the proportional method, and rifampin was determined according to the standard protocol. Demographic data of patients referred to the Centre for the Control of Lung Diseases were also recorded.</p><p>In the next step, spoligotyping was carried out using the standard method and each strain pattern was recorded as an OCTAL code and compared with the information available at the World Bank on spoligotyping and its strains. Forty-one patients with pulmonary TB were tested using spoligotyping. Four MTB strains were identified, including H4, CAS, T1 and H1.</p><p>The H4 strain also had the highest frequency with 16 samples (39%) among the MTB complex strains isolated using spoligotyping.</p><p>The highest frequency of strains isolated using spoligotyping was associated with the H4 strain. It can be concluded that spoligotyping is very cost effective, simple, repeatable and highly sensitive.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100467"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000548/pdfft?md5=76f39348ba153eeab2f14e31eca9d413&pid=1-s2.0-S2405579424000548-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848859","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":"Bacterial diversity in Buruli ulcer lesions in Ghana","authors":"Nancy Ackam ,&nbsp;Abigail Opoku-Boadi ,&nbsp;Bernadette Agbavor ,&nbsp;Jonathan Kofi Adjei ,&nbsp;Abigail Agbanyo ,&nbsp;Michael Ntiamoah Oppong ,&nbsp;Charity Wiafe-Akenten ,&nbsp;Augustina Sylverken ,&nbsp;Kwasi Obiri-Danso ,&nbsp;Mark Wansbrough-Jones ,&nbsp;Yaw Ampem Amoako ,&nbsp;Richard Odame Phillips","doi":"10.1016/j.jctube.2024.100468","DOIUrl":"10.1016/j.jctube.2024.100468","url":null,"abstract":"<div><h3>Background</h3><p>Previous studies have demonstrated secondary microbial infection of Buruli ulcer (BUD) lesions before, during and after treatment. However, there is limited data on the bacterial diversity across treatment and their influence on clinical outcome. The present study aimed to investigate the relationship between bacterial diversity within BUD lesions and clinical outcome in affected individuals.</p></div><div><h3>Methods</h3><p>We investigated the bacterial diversity within lesions of individuals with PCR confirmed BUD from 5 endemic districts within central Ghana. Samples were collected longitudinally from lesions over treatment period. Microbiological analyses including isolation of bacteria, and species identification were performed using the VITEK 2 compact.</p></div><div><h3>Results</h3><p>Out of 36 participants included, 80.5 % presented with ulcers on the lower limbs. Higher bacterial diversity was observed in ulcers compared to other clinical forms of BUD. There was a significant association between bacterial diversity and clinical outcome (<em>p</em> = 0.002). ESBL producing bacteria and MRSA were isolated in slow healing BUD lesions.</p></div><div><h3>Conclusion</h3><p>Higher diversity of secondary organisms colonizing BUD lesions may have an impact on clinical outcome in affected individuals. There is the need for the development of treatment guidelines for simultaneous management of <em>M. ulcerans</em> and other potential pathogens within lesions to improve clinical outcome.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100468"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240557942400055X/pdfft?md5=55e34dc847bb56aeef7a8458bb39dbc9&pid=1-s2.0-S240557942400055X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959361","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":"Pilot use of a mycolactone-specific lateral flow assay for Buruli ulcer: A case report from Japan","authors":"Yasuhisa Sakakibara ,&nbsp;Michio Konishi ,&nbsp;Teruo Ueno ,&nbsp;Chiaki Murase ,&nbsp;Yuji Miyamoto ,&nbsp;Manabu Ato ,&nbsp;Dziedzom K. de Souza ,&nbsp;Marco Biamonte ,&nbsp;Gerd Pluschke ,&nbsp;Rie R. Yotsu","doi":"10.1016/j.jctube.2024.100469","DOIUrl":"10.1016/j.jctube.2024.100469","url":null,"abstract":"<div><p>Buruli ulcer, caused by <em>Mycobacterium (M.) ulcerans</em>, is a neglected tropical disease (NTD) characterized by necrosis of the cutaneous tissue, predominantly affecting the limbs. The pathogenesis of this disease is mainly attributed to mycolactone, a lipid toxin produced by <em>M. ulcerans</em>. Here, we report the case of a 7-year-old Japanese girl who presented with worsening ulceration on her left forearm, extending to the elbow, following antimicrobial treatment. To evaluate disease progression, we used a mycolactone-specific lateral flow assay. The test yielded positive results in the advancing necrotic area, aiding in determining the extent of necessary debridement. After undergoing two debridement surgeries and receiving 38 weeks of antimicrobial treatment followed by skin grafting, the patient achieved cure. Timely diagnosis is imperative in avoiding prolonged treatment, highlighting the importance of readily available diagnostic point-of-care tests for Buruli ulcer. Moreover, detection of mycolactone not only can serve as a diagnostic tool for Buruli ulcer but also enables prediction of lesion spread and assessment of cure.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100469"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000561/pdfft?md5=8c6a83841749ef713e3d49c6bfbae732&pid=1-s2.0-S2405579424000561-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851544","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":"Experiences in the introduction of bedaquiline pretomanid linezolid for drug-resistant tuberculosis in Kyrgyzstan","authors":"B. Myrzaliev ,&nbsp;M. Ahmatov ,&nbsp;A. Duishekeeva ,&nbsp;A. Kulzhabaeva ,&nbsp;A. Kadyrov ,&nbsp;A. Toktogonova ,&nbsp;G. Abdulaeva ,&nbsp;D.F. Wares ,&nbsp;V. Mirtskhulava ,&nbsp;M. Mbenga ,&nbsp;A. Slyzkyi ,&nbsp;S. Foraida ,&nbsp;M. Diachenko ,&nbsp;S. Juneja ,&nbsp;G. Turdumambetova ,&nbsp;A. Musaeva ,&nbsp;A. Gebhard","doi":"10.1016/j.jctube.2024.100472","DOIUrl":"10.1016/j.jctube.2024.100472","url":null,"abstract":"<div><h3>Settings</h3><p>In Kyrgyzstan, drug-resistant tuberculosis poses a significant challenge. Recognizing the potential of the BPaL regimen, the World Health Organization recommended its use for selected drug-resistant TB cases under operational research conditions in 2020.</p></div><div><h3>Objective</h3><p>This report presents experiences and results from the BPaL operational research under the LIFT-TB project in Kyrgyzstan.</p></div><div><h3>Design</h3><p>Prospective cohort study.</p></div><div><h3>Results</h3><p>From August 2021 to June 2022, 50 patients were enrolled, achieving an 84 % treatment success rate. Although adverse events affected 11 patients (34.3 %), primarily linked to linezolid use (39 [78 %] patients started on 1200 mg linezolid daily), no unexpected adverse events occurred, and management was appropriate. The operational research emphasized proper patient inclusion, highlighting the crucial roles of psychological counselling support and active drug safety monitoring.</p></div><div><h3>Conclusion</h3><p>With insights gained, Kyrgyzstan is now nationwide implementing the BPaLM/BPaL regimens for a broader drug-resistant TB patient group. The experiences, successes, and lessons from the BPaL operational research, along with the programmatic introduction, offer valuable guidance for global drug-resistant TB control strategies. This initiative becomes a resource for countries with similar drug-resistant TB burdens, promoting a collaborative global approach to address drug-resistant TB challenges.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100472"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000597/pdfft?md5=4bbcce0a1369d915d702521507e820cd&pid=1-s2.0-S2405579424000597-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852004","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":"Costs of non-multidrug-resistant pulmonary tuberculosis and of preventive treatment in Germany – An update","authors":"Roland Diel ,&nbsp;Albert Nienhaus","doi":"10.1016/j.jctube.2024.100473","DOIUrl":"10.1016/j.jctube.2024.100473","url":null,"abstract":"<div><h3>Background</h3><p>Only 4076 new cases of tuberculosis (TB) were reported in Germany in 2022; of those 184 were multidrug-resistant TB (MDR-/RR-TB).</p></div><div><h3>Methods</h3><p>Based on the current therapy guidelines of the German Central Committee against Tuberculosis and most recent renumeration data of the Statutory Health Insurances (SHI), this study estimates the mean in- and outpatient costs per adult infectious pulmonary non-MDR-TB patient, together with costs arising from Rifampicin (RIF)-based short-course options of tuberculosis preventive treatment (TPT) of their close contacts.</p></div><div><h3>Results</h3><p>From the insurance perspective, the mean inpatient cost (rounded) per adult case was 6138 EUR (SD±2810 EUR) for standard therapy; the cost of primary outpatient treatment only amounted to 1930 EUR and the cost of outpatient treatment post-hospital to 1093 EUR. The mean weighted cost was 6377 EUR (SD±2357 EUR), a drop of 27 % vs. 2019. This is mainly due to a decrease in hospitalizations of 5.6 %, and, given hospital treatment, by a 95 EUR decrease in the per-day reimbursement rate for TB patients who are hospitalized for at least 14 days. In contrast, the mean costs of TPT per person were 466 EUR (RIF solely over 4 months) and 423 EUR (RIF combined with Isoniazid over 3 months).</p></div><div><h3>Conclusion</h3><p>While costs for active non-MDR-TB treatment in Germany have clearly decreased thanks to increased engagement on the part of the private practice sector and lower reimbursement rates in hospital, the comparatively high costs of short-course TPT have surprisingly significant economic impact. This negative development can be countered through diligent selection of close contacts persons of infectious TB cases before using IGRA testing to detect latent TB, to minimize the number of those persons who are tested falsely determined to be at risk and needlessly undergo TPT.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100473"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000603/pdfft?md5=fa2f2be838585436e9ba77beff664486&pid=1-s2.0-S2405579424000603-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959362","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 and treatment outcome of infected patients with pulmonary Mycobacterium kansasii: A systematic review","authors":"Fatemeh Andalibi ,&nbsp;Narjess Bostanghadiri ,&nbsp;Nour Amirmozafari ,&nbsp;Gholamreza Irajian ,&nbsp;Shiva Mirkalantari","doi":"10.1016/j.jctube.2024.100463","DOIUrl":"10.1016/j.jctube.2024.100463","url":null,"abstract":"<div><h3>Background</h3><p><em>Mycobacterium kansasii</em> (<em>M. kansasii</em>) is a non-tuberculosis bacterium with a highly prevalent that is transferred by aerosols from water and soil resources to the respiratory system. <em>M. kansasii</em> is one of the main species responsible for NTM pulmonary disease.</p></div><div><h3>Methods</h3><p>Web of Science, Scopus, and PubMed databases were systematically explored. Relevant articles from 1971 to November 2023 were reviewed. “The inclusion criteria” included patients with <em>M. kansasii</em> infection, treatment follow-up, and treatment outcomes. “The exclusion criteria” were clinical samples from animals, environmental samples, and other laboratory investigations.</p></div><div><h3>Results</h3><p>40 studies, including 1201 patients, were obtained through database search. Using the therapeutic regimens used in different studies, the therapy course for patients with <em>M. kansasii</em> infection ranged from 1 week to 118 months. In this study, the antibiotics prescribed in different treatment regimens for <em>M. kansasii</em> pulmonary infection were as follows: Rifampin, Ethambutol, Isoniazid, Clarithromycin, Streptomycin, and Pyrazinamide. Antibiotic combinations of three or four medicines, including rifampin, ethambutol, and isoniazid with or without streptomycin or pyrazinamide had the most therapeutic effect.</p></div><div><h3>Conclusion</h3><p>The initial treatment involves rifampin, ethambutol, isoniazid, and pyridoxine, per the guidelines from the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA). Understanding the treatment plan and its outcomes is crucial for managing and determining the most effective therapy approach.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100463"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000500/pdfft?md5=372c114e41416f06143989227f90c4e5&pid=1-s2.0-S2405579424000500-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709260","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":"Pharmacology of emerging drugs for the treatment of multi-drug resistant tuberculosis","authors":"Tanner M. Johnson,&nbsp;Christina G. Rivera,&nbsp;Grace Lee,&nbsp;John D. Zeuli","doi":"10.1016/j.jctube.2024.100470","DOIUrl":"10.1016/j.jctube.2024.100470","url":null,"abstract":"<div><p><em>Mycobacterium tuberculosis</em> (TB) remains the leading cause of infection-related mortality worldwide. Drug resistance, need for multiple antimycobacterial agents, prolonged treatment courses, and medication-related side effects are complicating factors to TB cure. The introduction of treatment regimens containing the novel agents bedaquiline, pretomanid, and linezolid, with or without moxifloxacin (BPaL-M or BPaL, respectively) have substantially reduced TB-related morbidity and mortality and are associated with favorable rates of treatment completion and cure. This review summarizes key information on the pharmacology and treatment principles for moxifloxacin, bedaquiline, delamanid, pretomanid, linezolid, and tedizolid in the treatment of multi-drug resistant TB, with recommendations provided to address and attenuate common adverse effects during treatment.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100470"},"PeriodicalIF":1.9,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000573/pdfft?md5=b9fc4b67cffb682f04449f860d0857f1&pid=1-s2.0-S2405579424000573-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844075","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":"Molecular epidemiology of Mycobacterium tuberculosis in Ecuador: Recent advances and future challenges","authors":"Bernardo Castro-Rodriguez ,&nbsp;Greta Franco-Sotomayor ,&nbsp;Solón Alberto Orlando ,&nbsp;Miguel Ángel Garcia-Bereguiain","doi":"10.1016/j.jctube.2024.100465","DOIUrl":"10.1016/j.jctube.2024.100465","url":null,"abstract":"<div><p>Tuberculosis (TB) is one of the three leading causes of death from a single infectious agent, <em>Mycobacterium tuberculosis</em> (MTB), together with COVID-19 and HIV/AIDS. This disease places a heavy burden on countries with low socio-economic development and aggravates existing inequalities. For the year 2021, estimations for Ecuador were 8500 TB cases, of which 370 were associated to multiple drug resistance (TB-MDR), and 1160 deaths. In the same year, Ecuador notified 5973 total cases, 401 of them were TB-MDR, pointing out an under diagnosis problem. The few molecular epidemiology studies available conclude that L4 is the most prevalent MTB lineage in Ecuador (with LAM as the main L4 sublineage), but L2-Beijing family is also present at low prevalence. Nevertheless, with less than 1 % MTB isolates genetically characterized by either MIRU-VNTR, spolygotyping or WGS to date, molecular epidemiology research must me improved to assist the TB surveillance and control program in Ecuador.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100465"},"PeriodicalIF":1.9,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000524/pdfft?md5=523e158b4dc2231d00ccc23469b658a7&pid=1-s2.0-S2405579424000524-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844086","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":"Investigating the efficacy of integrating video-directly observed therapy (VDOT) in the treatment of tuberculosis (TB): A statewide analysis from Florida","authors":"Aneesha Raj ,&nbsp;Nabiha S. Khakoo ,&nbsp;Alex A. Ashkin ,&nbsp;Mary T. Green ,&nbsp;Rene R. Tresgallo","doi":"10.1016/j.jctube.2024.100471","DOIUrl":"10.1016/j.jctube.2024.100471","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine if integrating VDOT into TB therapy demonstrated non-inferiority to direct observation, and if VDOT utilization increased across Florida after the onset of Covid-19.</p></div><div><h3>Methods</h3><p>A statewide programmatic review was conducted of all patients in Florida who initiated tuberculosis treatment between January 2018 – December 2018 and January 2020 – December 2021, as documented by the Florida Department of Health.</p></div><div><h3>Results</h3><p>1361 patients received treatment within the analysis timeframe. Therapy completion was 97.2% in those utilizing VDOT compared to 92.3% utilizing only DOT (<em>p=&lt;.001</em>). Average duration of therapy was 220.5 days in the DOT-only cohort compared to 211.1 days with VDOT integration (<em>p=.027</em>). A 176.35% increase in VDOT utilization was seen across Florida during Covid-19.</p></div><div><h3>Conclusions</h3><p>This is the first and largest state-wide study evaluating the efficacy of integrating VDOT into TB therapy, finding statistically significant improvements in completion and duration of therapy. Despite increased VDOT utilization since the onset of Covid-19, we suspect that multiple barriers may be hindering further integration. VDOT should be recommended as a cost effective, non-inferior alternative to DOT in monitoring the treatment of tuberculosis.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100471"},"PeriodicalIF":1.9,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000585/pdfft?md5=53a81a011b7f7bc2a5244b626b2d383d&pid=1-s2.0-S2405579424000585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847457","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}