Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Rifampicin resistant Mycobacterium tuberculosis in Vietnam, 2020–2022","authors":"Hung Van Nguyen ,&nbsp;Hoa Binh Nguyen ,&nbsp;Doan Thu Ha ,&nbsp;Dinh Thi Huong ,&nbsp;Vu Ngoc Trung ,&nbsp;Khieu Thi Thuy Ngoc ,&nbsp;Tran Huyen Trang ,&nbsp;Ha Vu Thi Ngoc ,&nbsp;Tram Trinh Thi Bich ,&nbsp;Trieu Le Pham Tien ,&nbsp;Hanh Nguyen Hong ,&nbsp;Phu Phan Trieu ,&nbsp;Luong Kim Lan ,&nbsp;Kim Lan ,&nbsp;Ngo Ngoc Hue ,&nbsp;Nguyen Thi Le Huong ,&nbsp;Tran Le Thi Ngoc Thao ,&nbsp;Nguyen Le Quang ,&nbsp;Thu Do Dang Anh ,&nbsp;Nguyễn Hữu Lân ,&nbsp;Timothy M. Walker","doi":"10.1016/j.jctube.2024.100431","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100431","url":null,"abstract":"<div><h3>Objective</h3><p>We conducted a descriptive analysis of multi-drug resistant tuberculosis (MDR-TB) in Vietnam’s two largest cities, Hanoi and Ho Chi Minh city.</p></div><div><h3>Methods</h3><p>All patients with rifampicin resistant tuberculosis were recruited from Hanoi and surrounding provinces between 2020 and 2022. Additional patients were recruited from Ho Chi Minh city over the same time period. Demographic data were recorded from all patients, and samples collected, cultured, whole genome sequenced and analysed for drug resistance mutations. Genomic susceptibility predictions were made on the basis of the World Health Organization’s catalogue of mutations in <em>Mycobacterium tuberculosis</em> associated with drug resistance, version 2. Comparisons were made against phenotypic drug susceptibility test results where these were available. Multivariable logistic regression was used to assess risk factors for previous episodes of tuberculosis.</p></div><div><h3>Results</h3><p><em>233/</em>265 sequenced isolates were of sufficient quality for analysis, 146 (63 %) from Ho Chi Minh City and 87 (37 %) from Hanoi. 198 (85 %) were lineage 2, 20 (9 %) were lineage 4, and 15 (6 %) were lineage 1. 17/211 (8 %) for whom HIV status was known were infected, and 109/214 (51 %) patients had had a previous episode of tuberculosis. The main risk factor for a previous episode was HIV infection (odds ratio 5.1 (95 % confidence interval 1.3–20.0); p = 0.021). Sensitivity for predicting first-line drug resistance from whole genome sequencing data was over 90 %, with the exception of pyrazinamide (85 %). For moxifloxacin and amikacin it was 50 % or less. Among rifampicin-resistant isolates, prevalence of resistance to each non-first-line drug was &lt; 20 %.</p></div><div><h3>Conclusions</h3><p>Drug resistance among most MDR-TB strains in Vietnam’s two largest cities is confined largely to first-line drugs. Living with HIV is the main risk factor among patients with MDR-TB for having had a previous episode of tuberculosis.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100431"},"PeriodicalIF":2.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000184/pdfft?md5=024d84d480931d0c7bc9cac4c14751e0&pid=1-s2.0-S2405579424000184-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141738","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":"Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study","authors":"Divya Girishbhai Patel ,&nbsp;Tejaswini Baral ,&nbsp;Shilia Jacob Kurian ,&nbsp;Pravachana Malakapogu ,&nbsp;Kavitha Saravu ,&nbsp;Sonal Sekhar Miraj","doi":"10.1016/j.jctube.2024.100428","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100428","url":null,"abstract":"<div><h3>Background</h3><p>India has been estimated to have 14 % of malnourished population and a high TB incidence burden with a 26.9 lakh cases. Malnutrition and diabetes mellitus are major risk factors for tuberculosis infection. Malnutrition in patients with both tuberculosis and diabetes (TB-DM) population worsens the disease severity, treatment outcomes and increases morbidity and mortality risk.</p></div><div><h3>Objective</h3><p>To assess the nutritional status in patients with TB-DM compared with patients with TB and DM alone.</p></div><div><h3>Method</h3><p>Records from January 2016 to November 2020 for patients admitted to Kasturba Hospital, Manipal were assessed. Data pertaining to glycemic parameters, nutritional parameters, and other relevant laboratory parameters were extracted for assessment. The study population were divided into three groups i.e. patients with TB-DM, TB and DM. The statistical association was carried out with one-way ANOVA method, considering p &lt; 0.05 as statistically significant.</p></div><div><h3>Results</h3><p>A total of 291 patients were included, with 97 patients in each group; among those, male and female were 86.27 % and 13.73 % respectively. Cardiovascular co-morbidity was predominant in the DM (68.04 %) and TB-DM (26.8 %) group. The mean value of HbA1c (10.47 %) was found to be highest for the TB-DM group. Low levels of albumin were reported by 71.91 % of patients of the TB group, whereas 73.68 % patients in TB-DM group had vitamin D deficiency. Moreover, higher prevalence of low MCV and MCH in the TB-DM group suggest an increased risk of iron-deficiency anemia.</p></div><div><h3>Conclusion</h3><p>The findings of our study reflect the need for implementation of nutritional support in patients with TB-DM.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100428"},"PeriodicalIF":2.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000159/pdfft?md5=d50fa53c0fa5ecc912c26ce46e743e5a&pid=1-s2.0-S2405579424000159-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180432","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":"Missed opportunities for TB diagnostic testing among people living with HIV in Zimbabwe: Cross-sectional analysis of the Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) survey 2015–16","authors":"Mayuko Takamiya ,&nbsp;Kudawashe Takarinda ,&nbsp;Shrish Balachandra ,&nbsp;Godfrey Musuka ,&nbsp;Elizabeth Radin ,&nbsp;Avi Hakim ,&nbsp;Michele L. Pearson ,&nbsp;Regis Choto ,&nbsp;Charles Sandy ,&nbsp;Talent Maphosa ,&nbsp;John H. Rogers","doi":"10.1016/j.jctube.2024.100427","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100427","url":null,"abstract":"<div><h3>Background</h3><p>Using data from the Zimbabwe Population-based HIV Impact Assessment survey 2015–2016, we examined the TB care cascade and factors associated with not receiving TB diagnostic testing among adult PLHIV with TB symptoms.</p></div><div><h3>Methods</h3><p>Statistical Analysis was limited to PLHIV aged 15 years and older in HIV care. Weighted logistic regression with not receiving TB testing as outcome was adjusted for covariates with crude odd ratios (ORs) with p &lt; 0.25. All analyses accounted for multistage survey design.</p></div><div><h3>Results</h3><p>Among 3507 adult PLHIV in HIV care, 2288 (59.7 %, 95 % CI:58.1–61.3) were female and 2425 (63.6 %, 95 % CI:61.1–66.1) lived in rural areas. 1197(48.7 %, 95 % CI:46.5–51.0) reported being screened for TB symptoms at their last HIV care visit. In the previous 12 months, 639 (26.0 %, 95 % CI:23.9–28.1) reported having symptoms and of those, 239 (37.8 %, 95 % CI:33.3–42.2) received TB testing. Of PLHIV tested for TB, 36 (49.5 %, 95 % CI:35.0–63.1) were diagnosed with TB; 32 (90.3 %, 95 % CI:78.9–100) of those diagnosed with TB received treatment. Never having used IPT was associated with not receiving TB testing.</p></div><div><h3>Conclusion</h3><p>The results suggest suboptimal utilization of TB screening and diagnostic testing among PLHIV. New approaches are needed to reach opportunities missed in the HIV/TB integrated services.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100427"},"PeriodicalIF":2.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000147/pdfft?md5=2ecd95595c40db0f2b3bba2e3ab3f093&pid=1-s2.0-S2405579424000147-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140123171","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":"A health literacy analysis of online patient-directed educational materials about mycobacterium avium complex","authors":"Olabimpe Asupoto,&nbsp;Shamsuddin Anwar,&nbsp;Alysse G. Wurcel","doi":"10.1016/j.jctube.2024.100424","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100424","url":null,"abstract":"<div><h3>Introduction</h3><p>Mycobacterium avium complex (MAC) is a complex lung infection requiring multi-disciplinary approach and management. Due to limited clinician-patient interactions, clinicians may refer patients to online resources to learn about the diagnosis, prognosis, and treatment of MAC. The American Medical Association (AMA) recommends educational materials be written at a sixth-grade reading level and the National Institutes of Health (NIH) recommends that patient education materials be written at an eighth-grade reading level; however, several evaluations found these materials inaccessible due to high literacy levels. To date, there has never been a health literacy assessment of MAC patient education materials. The study aims to assess the health literacy of online patient education materials about MAC.</p></div><div><h3>Methods</h3><p>The patient education materials were evaluated for readability, actionability, understandability and clarity. Readability was assessed through the Flesch-Kincaid Grade Level Scale (FkGL), SMOG Index, Coleman Liau Index (CLI), Gunning Fog Index (GFI), and Automated Readability Index (ARI). Actionability and understandability was evaluated using the Patient Education Materials Assessment Tool (PEMAT). The Centers for Disease Control (CDC) Clear Communication Index (CCI) was used to assess clarity.</p></div><div><h3>Results</h3><p>Ten patient education resources were evaluated: CDC, Cleveland Clinic, Mayo Clinic, JAMA, American Thoracic Society (ATS), National Jewish Health, UpToDate, CHEST, WebMD, and Medline. The mean readability scores were as follows: FkGL (9.76), SMOG index (9.82), CLI (13.54), GFI (11.66), ARI (9.15). Four patient education materials were written at a sixth-grade reading level and eight patient education materials were written at an eighth-grade reading level. The majority of the materials received a passing score for understandability but failed to achieve a passing score for actionability. Cleveland Clinic, JAMA, and ATS all received a passing clarity score, indicating that they are easy to read. No patient education materials were available on UpToDate.</p></div><div><h3>Conclusion</h3><p>Most patient education materials scored poorly for actionability and clarity while scoring highly for readability and understandability. This study should serve as a guide for clinicians interested in offering online education materials to their patients. Increasing access to readable MAC educational materials should be a priority for those working at the intersection of public health, clinical care, and communications.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100424"},"PeriodicalIF":2.0,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000111/pdfft?md5=9ad6bfa87019966ca2b3c5f7c245980b&pid=1-s2.0-S2405579424000111-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052508","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":"Relapse after treatment with standardized all-oral short regimens for rifampicin-resistant tuberculosis (RR-TB): A systematic review and meta-analysis","authors":"Ahmad Reza Yosofi,&nbsp;Anita Mesic,&nbsp;Tom Decroo","doi":"10.1016/j.jctube.2024.100426","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100426","url":null,"abstract":"<div><h3>Background</h3><p>Treatment for rifampicin-resistant tuberculosis (RR-TB) has been shortened to 12 months or less, with duration depending on the regimen used and treatment response. Treatment shortening has the potential to increase the risk of relapse, with a new episode of RR-TB after cure or completion. The proportion of relapses after standardized all-oral short (12 months or less) RR-TB regimens has not yet been systematically reviewed, which is the main objective of this review.</p></div><div><h3>Methods</h3><p>This is a systematic review and <em>meta</em>-analysis. PubMed, Web of Science and Google scholar databases were systematically investigated to identify studies published between January 2018 and November 2023. Characteristics of studies, demographic data, baseline clinical condition, resistance profile, and definitions used for relapse, failure, and end-of-treatment outcomes are summarized in tables and graphs. Pooled proportions are estimated for relapse.</p></div><div><h3>Results</h3><p>A total of ten studies were included in this review and <em>meta</em>-analysis, representing 1792 participants. Seven studies were clinical trials and two were cohorts. Five studies investigated all-oral six-month regimens composed of bedaquiline, pretomanid, and linezolid (BPaL). The remaining studies assessed other standardized all-oral short regimens, with treatment duration between 6 and 12 months. Post-treatment follow-up (PTFU) duration ranged from 6 to 30 months. The pooled proportion estimate of relapse was 2·0% (95 % CI, 1·0-3·0%) for all and BPaL-based regimens. Treatment extension due to poor treatment response was poorly documented.</p></div><div><h3>Conclusion</h3><p>This review showed that the proportion of relapse in RR-TB patients treated with standardized short all-oral regimens was low. The low relapse proportion is similar to what was achieved for drug-susceptible Tuberculosis patients treated with first-line rifampicin-containing regimens. However, most data came from trial settings, and in some studies the post-treatment follow-up was short. Studies of large programmatic cohorts with longer post-treatment follow-up periods are needed to confirm the low relapse rate shown in the clinical trials.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100426"},"PeriodicalIF":2.0,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000135/pdfft?md5=c718bd5fa3c78cf83948174a2e02c497&pid=1-s2.0-S2405579424000135-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041772","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":"A teenage girl with altered mental status and paraparesis","authors":"Ryo Miyakawa ,&nbsp;Janice Louie ,&nbsp;Chris Keh ,&nbsp;Lisa Chen ,&nbsp;Babak Javid ,&nbsp;Joel D. Ernst ,&nbsp;Neela Goswami ,&nbsp;Felicia C. Chow","doi":"10.1016/j.jctube.2024.100425","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100425","url":null,"abstract":"<div><p>A teenage girl presented with fever and altered mental status. MRI showed diffuse leptomeningeal enhancement of the brain and spine. She was diagnosed by a positive cerebrospinal fluid (CSF) culture with tuberculous (TB) meningitis and was started on anti-TB medications and corticosteroids. Her mental status improved, but she was noted to have proximal weakness of the lower extremities. In the course of tapering corticosteroids at week 11 of anti-TB therapy, she became acutely confused and febrile. MRI demonstrated interval development of tuberculomas in the brain and a mass lesion in the thoracic spine causing cord compression. Given the clinical picture was suggestive of a paradoxical reaction, the dose of corticosteroids was increased. Infliximab was added when repeat MRI revealed enlargement of the mass lesion in the spine with worsening cord compression. She was successfully tapered off of corticosteroids. Over several months, the patient’s motor function recovered fully, and she returned to ambulating without assistance.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100425"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000123/pdfft?md5=8d782481dd46307859a348d9eac2d050&pid=1-s2.0-S2405579424000123-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041771","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":"Telemedicine as a tool to prevent multi-drug resistant tuberculosis in poor resource settings: Lessons from Nigeria","authors":"Kikelomo S. Olowoyo ,&nbsp;Deborah T. Esan ,&nbsp;Benedict T. Adeyanju ,&nbsp;David B. Olawade ,&nbsp;Babatunji E. Oyinloye ,&nbsp;Paul Olowoyo","doi":"10.1016/j.jctube.2024.100423","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100423","url":null,"abstract":"<div><h3>Background</h3><p>This mini review aims to provide an overview of the role of telemedicine in preventing multi-drug resistant tuberculosis (MDR-TB) in Nigeria. The specific objectives include examining the potential benefits of telemedicine, identifying the challenges associated with its implementation, and highlighting the importance of addressing infrastructure limitations and data privacy concerns.</p></div><div><h3>Methods</h3><p>This minireview is based on a comprehensive analysis of existing literature, including scholarly articles, and reports,. A systematic search was conducted using electronic databases, such as PubMed and Google Scholar, to identify relevant publications related to telemedicine and MDR-TB prevention in Nigeria. The selected articles were assessed for their relevance, and key findings were synthesized to provide an overview of the role of telemedicine in addressing the challenges of MDR-TB in Nigeria.</p></div><div><h3>Results</h3><p>The review demonstrates that telemedicine has the potential to significantly contribute to MDR-TB prevention efforts in Nigeria. The benefits of telemedicine include improved access to specialized care, enhanced patient adherence to treatment, and potential cost savings. However, challenges such as infrastructure limitations and data privacy concerns need to be addressed for successful implementation. Integrating telemedicine into the healthcare system has the potential to strengthen MDR-TB prevention, particularly in underserved areas, including within Nigeria. Specifically, the integration of telemedicine into the healthcare system can enhance access to specialized care, improve patient adherence, and potentially reduce costs associated with MDR-TB management.</p></div><div><h3>Conclusions</h3><p>Addressing infrastructure challenges, ensuring data privacy and security, and fostering trust among healthcare providers and patients are critical for successful implementation of telemedicine. Further research and policy frameworks are needed to guide the effective implementation and scale-up of telemedicine in MDR-TB prevention efforts in Nigeria.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100423"},"PeriodicalIF":2.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240557942400010X/pdfft?md5=0f76b394635a1b52bff51ba80365c579&pid=1-s2.0-S240557942400010X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975610","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":"Negative effects of undernutrition on sputum smear conversion and treatment success among retreatment cases in Uganda: A quasi-experimental study","authors":"Jonathan Izudi ,&nbsp;Francis Bajunirwe ,&nbsp;Adithya Cattamanchi","doi":"10.1016/j.jctube.2024.100422","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100422","url":null,"abstract":"<div><h3>Rationale</h3><p>The causal relationship between undernutrition and response to anti-tuberculosis (TB) treatment and TB treatment outcomes among people with retreatment TB is understudied.</p></div><div><h3>Objective</h3><p>To evaluate the effect of undernutrition on treatment success and sputum smear conversion among people with retreatment drug-susceptible TB in Kampala, Uganda.</p></div><div><h3>Methods</h3><p>We conducted a quasi-experimental study utilizing propensity score weighting among people with retreatment drug-susceptible TB aged ≥ 15 years treated between 2012 and 2022 in Kampala. The primary exposure was undernutrition assessed using the mid-upper arm circumference at the time of TB diagnosis. The primary outcome was treatment success defined as cure or treatment completion at month 6. Sputum smear conversion was the secondary outcome and was measured as a change in sputum smear status from positive to negative at months 2, 5, and 6. We estimated the causal effect of undernutrition on the outcomes using a propensity-score weighted modified Poisson regression model with robust error variance.</p></div><div><h3>Measurements and main results</h3><p>Of the 605 participants, 432 (71.4 %) were male, 215 (35.5 %) were aged 25–34 years, 427 (70.6 %) had bacteriologically confirmed pulmonary TB, 133 (22.0 %) were undernourished and 398 (65.8 %) achieved treatment success. Of participants with bacteriologically confirmed pulmonary TB, 232 (59.0 %), 327 (59.3 %), and 360 (97.6 %) achieved sputum smear conversion at months 2, 5, and 6, respectively. Undernutrition reduced treatment success (RR 0.42, 95 % CI 0.32–0.55) as well as sputum smear conversion at months 2 (RR 0.45, 95 % CI 0.42–0.49) and 5 (RR 0.46, 95 % CI 0.43–0.51) but not month 6 (RR 0.99, 95 % CI 0.97–1.02).</p></div><div><h3>Conclusion</h3><p>Undernutrition negatively impacts treatment outcomes. Therefore, nutritional assessment should be an integral component of TB care, with nutritional counseling and support offered to those undernourished to optimize their TB treatment response and outcomes.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100422"},"PeriodicalIF":2.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000093/pdfft?md5=6305974612910fb6c8e1e971e12d9101&pid=1-s2.0-S2405579424000093-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975609","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":"Cell-free DNA blood test for the diagnosis of pediatric tuberculous meningitis","authors":"Guyu Li ,&nbsp;Kendall Cannon ,&nbsp;Carlos Sisniega ,&nbsp;Jaime Fergie","doi":"10.1016/j.jctube.2024.100421","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100421","url":null,"abstract":"<div><p>Pediatric tuberculous meningitis (TBM) is a severe form of tuberculosis that may present in children. The current diagnostic methods may have a limited impact on initial clinical decision-making. We present three children with tuberculous meningitis who had Mycobacterium tuberculosis complex cell-free DNA (cfDNA) detected in their blood within three days of sampling. Our cases described here illustrate for the first time the potential role of cfDNA blood tests in the rapid diagnosis of TBM.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100421"},"PeriodicalIF":2.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000081/pdfft?md5=279f98a72aebb2c568cc29b1cdad3990&pid=1-s2.0-S2405579424000081-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139936903","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":"Assessing the utility of Truenat in extrapulmonary tuberculosis diagnosis – A NRL’s experience","authors":"Priya Rajendran ,&nbsp;Lavanya Jayabal ,&nbsp;Mythili Venkatesan ,&nbsp;Michel Prem Kumar ,&nbsp;Radhakrishnan Ramalingam ,&nbsp;P. Sivaraman ,&nbsp;Asha Fredrick ,&nbsp;Sivakumar Shanmugam","doi":"10.1016/j.jctube.2024.100420","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100420","url":null,"abstract":"<div><h3>Background</h3><p>Diagnosis of extra pulmonary TB (EPTB) remains a big challenge. While data on utility of Xpert testing in EPTB diagnosis is enormous, there is limited data on Truenat MTB testing.</p></div><div><h3>Aim</h3><p>In this study we aimed to evaluate the usefulness of Truenat in EPTB diagnosis.</p></div><div><h3>Materials and methods</h3><p>The study included patients suspected and/or treated for EPTB located from Chennai district during the year 2021–2022. All processed EPTB samples were subjected to smear microscopy, culture and Truenat MTB testing.</p></div><div><h3>Results</h3><p>Of the 195 samples tested, 38 (19.4%) samples were positive for EPTB by any one of the diagnostic methods (smear, culture, microscopy). Out of these 38, 16 (42.1 %) were positive for MTB by Truenat and negative by Culture, 12 (31.5%) were positive by culture but negative by Truenat and 8 (21%) were positive by both Truenat and/or smear and culture. The sensitivity and specificity of the test was calculated with the composite reference standard (Culture (exclusion of colonies as positives), clinical conditions, and smear) and was found to be 60% and 100% respectively.</p></div><div><h3>Conclusion</h3><p>Truenat MTB test is a cost-effective rapid molecular test that can be used only for the diagnosis of presumptive EPTB and not on follow-up samples.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100420"},"PeriodicalIF":2.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240557942400007X/pdfft?md5=d08dc2bac0289e655a408c23bfebced1&pid=1-s2.0-S240557942400007X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139985929","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}