Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"COVID-19 policies and tuberculosis services in private health sectors of India, Indonesia, and Nigeria","authors":"Nathaly Aguilera Vasquez ,&nbsp;Charity Oga-Omenka ,&nbsp;Vijayashree Yellappa ,&nbsp;Bony Wiem Lestari ,&nbsp;Angelina Sassi ,&nbsp;Surbhi Sheokand ,&nbsp;Bolanle Olusola-Faleye ,&nbsp;Lavanya Huria ,&nbsp;Laura Jane Brubacher ,&nbsp;Elaine Baruwa ,&nbsp;Bachti Alisjahbana ,&nbsp;Madhukar Pai","doi":"10.1016/j.jctube.2024.100503","DOIUrl":"10.1016/j.jctube.2024.100503","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic created unprecedented challenges in the field of global health. Nigeria, Indonesia and India are three high tuberculosis (TB) burden countries with large private health sectors. Both TB and the private health sector faced challenges in these countries because of COVID-19. This study aimed to compare the COVID-19 control measures and policies in the provision of TB care services and gain insights from policymakers on how the pandemic affected the provision of TB services in the private healthcare sector, how each country adapted, and identify lessons learned for health system preparedness.</div></div><div><h3>Methods</h3><div>Qualitative, in-depth interviews were conducted among a purposive sample of 11 national and sub-national policymakers in each country. Thematic content analysis was conducted on the data collected using an adapted WHO Health Equity Policy Framework.</div></div><div><h3>Results</h3><div>Results revealed three policy dimensions under costs, access, and quality. Under healthcare costs, policymakers highlighted resource allocation and diversion of TB resources to COVID response, and increased operational costs for private provider. Under healthcare access, key themes included reduced TB case detection due to fear of COVID-19, disrupted diagnostic services, and adaptations such as extended medicine supplies and tele-consultations. Under healthcare quality, themes included compromised TB diagnostic accuracy due to similar respiratory symptoms with COVID-19, and strain on laboratory infrastructure due to competing demands from both diseases. Policymakers across the three countries pointed to the need for strengthening private–public partnerships (PPP) for healthcare service delivery and continued private sector investment to facilitate the continuity of TB care within a pandemic context.</div></div><div><h3>Conclusion</h3><div>The results of this study provide an overview of the impact of the pandemic from the perspective of private facilities and policymakers in Nigeria, Indonesia and India, which can inform future policy and ways forward in strengthening PPP for healthcare service delivery in high TB burden countries.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"38 ","pages":"Article 100503"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932869","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":"Corrigendum to “Tuberculosis screening for patients on biologic Medications: A Single-Center experience and Society guideline Review, Monroe County, New York, 2018–2021” [J. Clin. Tuberc. Other Mycobact. Dis. 36 (2024) 100460]","authors":"Tetsuro Maeda ,&nbsp;Margaret Connolly ,&nbsp;Kelly Thevenet-Morrison ,&nbsp;Paul Levy ,&nbsp;Mark Utell ,&nbsp;Sonal Munsiff ,&nbsp;Daniel Croft","doi":"10.1016/j.jctube.2024.100491","DOIUrl":"10.1016/j.jctube.2024.100491","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"38 ","pages":"Article 100491"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153633","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":"Challenges in achieving the guideline-recommended amikacin level for Mycobacterium avium complex pulmonary disease","authors":"Takuya Akutsu ,&nbsp;Kazuya Tone ,&nbsp;Airi Hasegawa ,&nbsp;Takaaki Kitayama ,&nbsp;Shunsuke Inaki ,&nbsp;Mina Gochi ,&nbsp;Masamichi Takagi ,&nbsp;Jun Araya","doi":"10.1016/j.jctube.2025.100514","DOIUrl":"10.1016/j.jctube.2025.100514","url":null,"abstract":"<div><h3>Background</h3><div>The addition of aminoglycosides to a macrolide-based regimen is recommended for refractory <em>Mycobacterium avium</em> complex pulmonary disease (MAC-PD). For intravenous amikacin (AMK) administration three times a week, the ATS/ERS/ESCMID/IDSA guidelines recommend targeting a peak serum concentration of 65–80 µg/mL. However, the feasibility of achieving the guideline-recommended AMK concentration remains unclear.</div></div><div><h3>Methods</h3><div>From 2018 to 2022, we retrospectively analyzed patients with refractory MAC-PD treated with AMK thrice weekly for ≥3 months combined with an oral regimen of ≥2 drugs, including macrolides. The peak serum concentration and therapeutic effects of AMK were evaluated.</div></div><div><h3>Results</h3><div>The median age of the 9 patients was 70 years (range: 50–79 years; 2 men and 7 women). The causative organism was <em>M. avium</em> in all cases. All cases demonstrated susceptibility to AMK, which was administered at a median dose of 700 mg/day (15.8 mg/kg/day) for a median duration of 6 months. One patient experienced hearing loss, which led to AMK discontinuation at 4 months. The median AMK peak concentration was 47.1 μg/mL, with a tendency to be higher in the clinical efficacy group compared to the nonefficacy group. None of patient, except one, achieved the target AMK peak concentration.</div></div><div><h3>Conclusions</h3><div>In this preliminary study, the guideline-recommended AMK concentration for MAC-PD was not achieved in the majority of patients. Due to the small sample size and retrospective design, robust conclusions regarding the association between AMK concentrations and clinical outcomes could not be drawn. Prospective randomized controlled trials are required to better define the optimal AMK concentration for efficacy and safety.</div></div><div><h3>Trial registration</h3><div>Not applicable.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100514"},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403160","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":"Maximizing tuberculosis services through private provider engagement – A case study from Pakistan","authors":"Aamna Rashid ,&nbsp;Surbhi Sheokand ,&nbsp;Razia Fatima ,&nbsp;Hammad Habib ,&nbsp;Adeel Tahir ,&nbsp;Asim Saleem ,&nbsp;Poshan Thapa ,&nbsp;Petra Heitkamp","doi":"10.1016/j.jctube.2024.100506","DOIUrl":"10.1016/j.jctube.2024.100506","url":null,"abstract":"<div><div>Pakistan is the fourth highest contributor to the globally estimated 3.7 million tuberculosis (TB) cases. Due to the subpar condition of public sector facilities in Pakistan, the private sector remains the preferred choice, with over 90% of people accessing it for TB care. Aligning with the World Health Organization’s (WHO) patient-centered approach, the private provider engagement program led by Mercy Corps (MC) and supported by the Global Fund has been actively engaging the private sector for over a decade in strengthening Pakistan’s TB services through innovative interventions. Their public–private mix (PPM) strategies like, involving General Practitioners (GPs), large private hospitals, pharmacies, specimen transportation and mobile outreach chest camps, take an integrated approach (Fig. 1) to ensure treatment adherence, completion, and contact screening in reaching the last mile. In this paper, we present MC’s contributions as a case study to elaborate on the crucial role of private provider engagement in improving overall TB care, increasing TB notifications, and addressing the urgent need to identify people with undiagnosed TB.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100506"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349744","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":"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}