Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Building a virtual community of practice – The evolution of the TBPPM learning network, India chapter","authors":"Vijayashree Yellappa ,&nbsp;Kusum Moray ,&nbsp;Petra Heitkamp ,&nbsp;Joel Shyam Klinton","doi":"10.1016/j.jctube.2024.100419","DOIUrl":"10.1016/j.jctube.2024.100419","url":null,"abstract":"<div><p>India's National Tuberculosis (TB) Elimination Program strategically involves private providers to achieve its 2025 goal of ending TB. The government's patient-provider support agency scheme (PPSA) aims to expand the Public-Private Mix (PPM) strategy using domestic resources, though challenges persist in cross-learning and documentation. The TB Public Private Mix Learning Network (TBPPM-LN) launched its India chapter in 2021, connecting PPM stakeholders virtually. With 600 + members, TBPPM-India, acting as a digital Community of Practice, is pivotal in fostering a learning culture, leading knowledge-sharing initiatives, and disseminating TBPPM field innovations, contributing significantly to India's intensified efforts against TB.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100419"},"PeriodicalIF":2.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000068/pdfft?md5=5600461b152f31a15404474ab7bde936&pid=1-s2.0-S2405579424000068-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139889531","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":"TB-free Ebeye: Results from integrated TB and noncommunicable disease case finding in Ebeye, Marshall Islands","authors":"Richard J. Brostrom ,&nbsp;Angela Largen ,&nbsp;Joaquin N. Nasa ,&nbsp;Glorine Jeadrik ,&nbsp;Seiji Yamada ,&nbsp;Subhash Yadav ,&nbsp;Eunyoung Ko ,&nbsp;Jon V. Warkentin ,&nbsp;Terence L. Chorba","doi":"10.1016/j.jctube.2024.100418","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100418","url":null,"abstract":"<div><h3>Background</h3><p>Tuberculosis (TB) incidence rates in the Republic of the Marshall Islands are among the highest in the world, 480/100,000 in 2017. In response, the Health Ministry completed islandwide screening in Ebeye Island in 2017.</p></div><div><h3>Methods</h3><p>Participants were interviewed to obtain TB history, exposures, and symptoms. TB assessment included chest radiography with sputum collection for GeneXpert® MTB-RIF if indicated. TB diagnosis was made by consensus of visiting TB experts. Participants were also screened for Hansen’s disease (HD) and diabetes mellitus (DM). For persons aged ≥21 years, blood pressure, cholesterol, and blood glucose were assessed.</p></div><div><h3>Results</h3><p>A total of 5,166 persons (90.0 % of target population) completed screening leading to the identification of 39 new cases of TB (755/100,000) and 14 persons with HD (270/100,000). DM was detected in 1,096 persons (27 %), including in 351 persons not previously diagnosed. The rate of hypertension was 61 % and of hypercholesterolemia was 15 %. New or prevalent TB diagnosis was associated with newly diagnosed or history of DM (aOR 4.68, 2.15–10.20).</p></div><div><h3>Conclusions</h3><p>In Ebeye, an integrated TB screening campaign found TB, HD, DM, and hypertension. TB and DM were strongly associated.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100418"},"PeriodicalIF":2.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000056/pdfft?md5=17b59b45e142a2a0272dc3ec8235b4bf&pid=1-s2.0-S2405579424000056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139694146","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":"Assessment of osteoporosis knowledge and its determinants among tuberculosis patients in tertiary care hospital Malaysia: A prospective study","authors":"Zohra Bhatti ,&nbsp;Madeeha Laghari ,&nbsp;Amer Hayat Khan ,&nbsp;Bandeh Ali Talpur ,&nbsp;Syed Azhar Syed Sulaiman","doi":"10.1016/j.jctube.2024.100416","DOIUrl":"10.1016/j.jctube.2024.100416","url":null,"abstract":"<div><h3>Objective</h3><p>Osteoporosis self-care knowledge is essential to encourage the patient’s contribution towards controlling the disease. Osteoporosis incidence with various infectious diseases prompts us to conduct a study on osteoporosis knowledge among Tuberculosis (TB) patients. This study aimed to assess osteoporosis-related knowledge and its influencing factors among TB patients.</p></div><div><h3>Methods</h3><p>A prospective cross-sectional study was conducted in the TB clinic of Hospital Pulau Pinang, Malaysia, and an osteoporosis knowledge test (OKT), a structured questionnaire, was used to collect data. TB patients aged 18 years and above with compromised bone health were included in the present study. Overall knowledge scores were dichotomized, calculating the mean score, descriptive statistics, and multivariate regression analysis was used to determine the influence of risk factors on knowledge scores.</p></div><div><h3>Results</h3><p>Of 337 patients, 129(38.28 %) had good osteoporosis knowledge and 208(61.72 %) had poor knowledge. Among them, 231(68.54 %) were males, and 106(31.45 %) were females, with a mean age of 46.5 ± 17.1 years. The mean ± SD of OKT total score was 10.5 ± 2.0. The mean ± SD of the exercise knowledge score was 5.3 ± 3.4, while the nutrition knowledge score was 5.0 ± 3.2. Male gender (OR 3.86, 95 % CI 1.98–7.53), low-income level (OR 1.92, 95 % CI 1.12–3.30), rural residents (OR 2.49, 95 % CI 1.46–4.27) and participants with no formal education (OR 4.34, 95 % CI 1.11–16.84) or ≤12 years of education (OR 3.63, 95 % CI 1.52–8.65) were significantly responsible for poor OKT score.</p></div><div><h3>Conclusion</h3><p>The results indicated that most TB patients had a poor perception of osteoporosis. More extensive strategies should be developed to enhance the campaign of awareness programs among TB patients to improve preventive measures of osteoporosis, such as calcium intake and exercise.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100416"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000032/pdfft?md5=5619d4c482ad57a93e782cb51915def7&pid=1-s2.0-S2405579424000032-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636367","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":"Global research trends in central nervous system tuberculosis — A bibliometric analysis","authors":"Aaradhya Pant ,&nbsp;Farrokh Farrokhi ,&nbsp;Purnima Gyawali ,&nbsp;Kalkidan Yekuno ,&nbsp;Om Shah ,&nbsp;Shreejana Singh ,&nbsp;Mohan Raj Sharma","doi":"10.1016/j.jctube.2024.100414","DOIUrl":"10.1016/j.jctube.2024.100414","url":null,"abstract":"<div><h3>Background</h3><p>Central Nervous System Tuberculosis (CNS-TB) is a serious public health concern causing significant morbidity and mortality, especially in high TB burden countries. Despite the expanding research landscape of CNS-TB, there is no comprehensive map of this field. This work aims to (1) obtain a current and comprehensive overview of the CNS-TB research landscape, (2) investigate the intellectual and social structure of CNS-TB publications, and (3) detect geographical discrepancies in scientific production, highlighting regions requiring increased research focus.</p></div><div><h3>Methods</h3><p>We conducted a bibliometric analysis on CNS-TB literature indexed in Web of Science from 2000 to 2022, evaluating 2130 articles. The dataset was analyzed in R for descriptive statistics. We used R-bibliometrix and VOSViewer for data visualization.</p></div><div><h3>Findings</h3><p>Publication output grew annually at an average rate of 6·88%, driven primarily by India and China. International collaborations comprised 16·44% of total publications but contributed to 11 of the 15 top-cited papers. Additionally, we identified discrepancies of CNS-TB research in many low- and middleincome countries relative to their TB incidence.</p></div><div><h3>Interpretation</h3><p>Our findings reveal a growing interest in CNS-TB research from China and India, countries with rapidly developing economies, high TB burdens, and a recent increase in research funding. Furthermore, we found that international collaborations are correlated with high impact and accessibility of CNS-TB research. Finally, we identified disparities in CNS-TB research in specific countries, particularly in many low- and middle-income countries, emphasizing the need for increased research focus in these regions.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100414"},"PeriodicalIF":2.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000019/pdfft?md5=6059c2270e54fac9fe2ad56eaac1a651&pid=1-s2.0-S2405579424000019-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139457111","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":"Clinical and microbiological predictors of healing in Buruli ulcer disease","authors":"Bernadette Agbavor ,&nbsp;Abigail Agbanyo ,&nbsp;Aloysius Dzigbordi Loglo ,&nbsp;Philemon Boasiako Antwi ,&nbsp;Nancy Ackam ,&nbsp;Jonathan Adjei ,&nbsp;Venus Frimpong ,&nbsp;Kwadwo Boampong ,&nbsp;Michael Frimpong ,&nbsp;Matthew Glover Addo ,&nbsp;Mark Wansbrough-Jones ,&nbsp;Yaw Ampem Amoako ,&nbsp;Richard Odame Phillips","doi":"10.1016/j.jctube.2024.100415","DOIUrl":"10.1016/j.jctube.2024.100415","url":null,"abstract":"<div><h3>Introduction</h3><p>Wound measurements are relevant in monitoring the rate of healing (RoH) and may predict time to healing. Predicting the time to healing can help improve the management of Buruli ulcer. We examine three methods for the determination of RoH and their use as predictors of time to healing.</p></div><div><h3>Methods</h3><p>Lesion measurements of Buruli ulcer patients treated from 2007 to 2022 were obtained with acetate sheet tracings (2D) or Aranz software (3D) fortnightly. RoH was determined using the absolute area, percentage area reduction and linear methods at 4 weeks post onset of antibiotic treatment. Predicted time to healing was compared to the actual healing time. Baseline characteristics were assessed for associations with healing.</p></div><div><h3>Results</h3><p>All three methods for calculating the RoH significantly distinguished between fast and slow healers (p &lt; 0.0001). The predicted healing time using the linear method was comparable to the actual healing time for fast healers (p = 0.34). The RoH was influenced by the form of lesion, with plaques [OR 2.19 5 %CI (1.2–3.6), p = 0.009], and oedemas [OR 8.5; 95 %CI (1.9––36.9), p = 0.004] being associated with delayed healing. The proportion of patients with paradoxical reactions 16 % vs 3 %, p &lt; 0.0001), higher baseline bacterial load (75/104;72 % vs 21/47;45 %, p = 0.001) and delayed clearance of viable organisms (71/104;68 % vs 9/47;19 %, p &lt; 0.0001) was higher in the slow healers than the fast healers.</p></div><div><h3>Conclusion</h3><p>Predicted healing rates were comparatively lower for slow healers than fast healers. Baseline characteristics associated with healing can be explored for an improved disease management plan to reduce patient and caregiver anxiety.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100415"},"PeriodicalIF":2.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000020/pdfft?md5=00040d2c702677cf27c2597927813f9c&pid=1-s2.0-S2405579424000020-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394392","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":"Clinical manifestation and long-term follow-up of presumed ocular tuberculosis in China","authors":"Jing Xie ,&nbsp;Ya Qu ,&nbsp;Zhuyun Qian ,&nbsp;Xiaohong Meng ,&nbsp;Jun Lin ,&nbsp;Yong Liu ,&nbsp;Zhengqin Yin ,&nbsp;Yong Tao ,&nbsp;Shiying Li","doi":"10.1016/j.jctube.2023.100413","DOIUrl":"https://doi.org/10.1016/j.jctube.2023.100413","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to report the clinical manifestations of presumed ocular tuberculosis (OTB) and the treatment response after anti-tuberculosis therapy (ATT) in a Chinese population.</p></div><div><h3>Methods</h3><p>Clinical data, including general characteristics, ocular lesions, visual acuity at baseline, and final follow-up of patients with presumed OTB from 2006 to 2022 in two eye clinics in China, were retrospectively analyzed.</p></div><div><h3>Results</h3><p>The study included 84 eyes of 52 patients. The following ocular manifestations were observed: anterior uveitis (4.8%), posterior uveitis (34.5%), panuveitis (11.9%), retinal vasculitis (40.5%) and optic neuropathy (8.3%). After ATT, the vision improved by varying degrees in 48 eyes (57.1%), remained stable in 34 eyes (40.5%) and decreased in 2 eyes (2.4%).</p></div><div><h3>Conclusions</h3><p>OTB is likely to be misdiagnosed as other infectious uveitis and optic neuropathy. Clinical features must be interpreted in conjunction with topical and general laboratory findings and in collaboration with other subspecialties to make a final diagnosis.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100413"},"PeriodicalIF":2.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579423000694/pdfft?md5=8c583080a555bbdb6bbf17204e3a53e8&pid=1-s2.0-S2405579423000694-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100684","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":"Biosensors; nanomaterial-based methods in diagnosing of Mycobacterium tuberculosis","authors":"Ahmad Mobed ,&nbsp;Mohammad Darvishi ,&nbsp;Fereshteh Kohansal ,&nbsp;Fatemeh Moradi Dehfooli ,&nbsp;Iraj Alipourfard ,&nbsp;Amir Tahavvori ,&nbsp;Farhood Ghazi","doi":"10.1016/j.jctube.2023.100412","DOIUrl":"https://doi.org/10.1016/j.jctube.2023.100412","url":null,"abstract":"<div><p>Diagnosis of <em>Mycobacterium tuberculosis (Mtb)</em> before the progression of pulmonary infection can be very effective in its early treatment. The Mtb grows so slowly that it takes about 6–8 weeks to be diagnosed even using sensitive cell culture methods. The main opponent in tuberculosis (TB) and nontuberculous mycobacterial (NTM) epidemiology, like in all contagious diseases, is to pinpoint the source of infection and reveal its transmission and dispersion ways in the environment. It is crucial to be able to distinguish and monitor specific <em>mycobacterium</em> strains in order to do this. In food analysis, clinical diagnosis, environmental monitoring, and bioprocess, biosensing technologies have been improved to manage and detect Mtb. Biosensors are progressively being considered pioneering tools for point-of-care diagnostics in Mtb discoveries. In this review, we present an epitome of recent developments of biosensing technologies for <em>M. tuberculosis</em> detection, which are categorized on the basis of types of electrochemical, Fluorescent, Photo-thermal, Lateral Flow, Magneto-resistive, Laser, Plasmonic, and Optic biosensors.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100412"},"PeriodicalIF":2.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579423000682/pdfft?md5=0cfa010bb38eac8f0cd2e040ea4fbb79&pid=1-s2.0-S2405579423000682-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100683","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":"Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia","authors":"Getu Balay ,&nbsp;Kedir Abdella ,&nbsp;Wakjira Kebede ,&nbsp;Mulualem Tadesse ,&nbsp;Zegeye Bonsa ,&nbsp;Mekidim Mekonnen ,&nbsp;Misikir Amare ,&nbsp;Gemeda Abebe","doi":"10.1016/j.jctube.2023.100411","DOIUrl":"https://doi.org/10.1016/j.jctube.2023.100411","url":null,"abstract":"<div><h3>Objective</h3><p>Pyrazinamide (PZA) susceptibility testing is important to develop evidence-based algorithms for case management. We aimed to assess the prevalence of PZA-resistance and its impact on treatment outcomes in previously treated tuberculosis (TB) cases in southwestern Oromia, Ethiopia.</p></div><div><h3>Methods</h3><p>A Phenotypic Drug Susceptibility Testing (DST) of PZA with BACTEC MGIT 960 was conducted at the Mycobacteriology Research Center of Jimma University (MRC-JU) from June to November 2021 on sixty-six <em>Mycobacterium tuberculosis</em> complex (MTBC) isolates from previously treated TB cases. SPSS software package version 21 was used. The differences in the proportion of PZA resistance between the groups were compared using the chi squared test. Logistic regression was used to identify the association between PZA resistance and treatment outcomes.</p></div><div><h3>Results</h3><p>Among 66 MTBC isolates (49 rifampicin-resistant and 17 rifampicin-sensitive) included in this study, 31.8 % were resistant to PZA. The proportion of PZA resistance was almost three times higher in previously treated TB cases with rifampicin resistance than in rifampicin-sensitive patients (38.8 % vs. 11.8 %, p = 0.039). An unfavorable treatment outcome was documented for 23 % (15/65) of the participants. Patients with PZA resistance were almost four times more likely to have an unfavorable treatment outcome than patients with PZA sensitive (aOR 4.2, 95 % CI: 1.13–15.3).</p></div><div><h3>Conclusions</h3><p>The prevalence of PZA resistance was high compared to the pooled PZA resistance estimated worldwide. The majority of TB cases with PZA resistance had an unfavorable treatment outcome. PZA susceptibility testing should be included in the multidrug-resistant TB diagnostic algorithm to improve management of these patients.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100411"},"PeriodicalIF":2.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579423000670/pdfft?md5=f919f633176ab4843ad14f8b0b692453&pid=1-s2.0-S2405579423000670-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100685","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":"Discordance between genotypic and phenotypic methods for the detection of rifampicin and isoniazid resistant Mycobacterium tuberculosis and the correlation with patient treatment outcomes","authors":"Zegeye Bonsa ,&nbsp;Mulualem Tadesse ,&nbsp;Getu Balay ,&nbsp;Wakjira Kebede ,&nbsp;Gemeda Abebe","doi":"10.1016/j.jctube.2023.100410","DOIUrl":"10.1016/j.jctube.2023.100410","url":null,"abstract":"<div><h3>Background</h3><p>Accurate drug susceptibility testing (DST) of <em>Mycobacterium tuberculosis</em> (MTB) is essential for proper patient management. We investigated discordance between genotypic (Xpert MTB/RIF and MTBDR<em>plus</em>) and phenotypic (MGIT 960) methods for the detection of rifampicin (RIF) and isoniazid (INH) resistant MTB and its correlation with patient treatment outcomes in Jimma, Southwest Oromia, Ethiopia.</p></div><div><h3>Methods</h3><p>A retrospective study was conducted on 57 stored MTB isolates with known Xpert RIF resistance status (45 RIF resistant and 12 RIF susceptible) at Jimma University Mycobacteriology Research Center from November 2, 2021, to December 28, 2022. We did MTBDR<em>plus</em> and phenotypic DST (using the Mycobacterial Growth Indicator Tube (MGIT) system). The Xpert and MTBDR<em>plus</em> results were compared using phenotypic DST as a reference standard method. The treatment outcome was determined as per national guideline. The discordance between the genotypic and phenotypic DST was calculated using GraphPad software.</p></div><div><h3>Results</h3><p>Among the 57 MTB isolates, six (10.5 %) had discordant results between the two DST methods. Xpert yielded five discordant results for RIF when compared with phenotypic DST (kappa coefficient (κ) = 0.76, 95 % confidence interval 0.56–0.96). The MTBDR<em>plus</em> compared with phenotypic DST gave three discordant results for RIF (κ = 0.86, 95 % confidence interval 0.71–1.00) and three for INH (κ = 0.86, 95 % confidence interval 0.70–1.00). Compared with Xpert, MTBDR<em>plus</em> yielded lower discordance with phenotypic DST for RIF. Out of six patients with discordant results, three had unfavorable outcomes while the other three were cured. Of the three patients with unfavorable outcomes, only one patient has received an inappropriate treatment regimen. There was no correlation between unfavorable outcomes and incorrect treatment regimens due to discordant results (Χ² = 0.404; P = 0.525).</p></div><div><h3>Conclusions</h3><p>Discordance between genotypic and phenotypic DST for RIF or INH occurred in 10.5 % of isolates. Only one patient with discordant results has received an inappropriate treatment regimen, resulting in an unfavorable outcome. The impact of parallel use of rapid molecular assay with phenotypic DST on patient treatment outcomes requires further study.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100410"},"PeriodicalIF":2.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579423000669/pdfft?md5=db358b2031b6edeef48254d201de6ff8&pid=1-s2.0-S2405579423000669-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139021798","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":"Implementation bottlenecks of real time medication monitoring (evriMED) for improving adherence to anti-TB drugs among people with tuberculosis in Kilimanjaro, Tanzania","authors":"Rehema Anenmose Maro ,&nbsp;Alan Mtenga ,&nbsp;Benson Mtesha ,&nbsp;Krisanta Wilhelm ,&nbsp;Naomi Lekashingo ,&nbsp;Marion Sumari-de Boer ,&nbsp;Kennedy Ngowi","doi":"10.1016/j.jctube.2023.100409","DOIUrl":"10.1016/j.jctube.2023.100409","url":null,"abstract":"<div><h3>Introduction</h3><p>Digital Adherence Tools (DATs), which include real-time medication monitoring and Short Message Service (SMS) reminders, have been reported to improve medication adherence among people with Tuberculosis (TB). Recently, in limited resource settings, DATs have been described as a promising tool to monitor patients’ medication behaviour. We aimed to determine implementation bottlenecks of real-time medication monitoring using the evriMED device.</p></div><div><h3>Method</h3><p>We conducted a research study using a mixed-methods approach, involving both people with TB s and directly observed treatment (DOT) providers who participated in the REMIND-TB trial and utilized the evriMED devices. EvriMED is a medication dispenser with internet connectivity that can send real-time SMS reminders. To gather data, we extracted reports from the Wisepill dashboard, specifically the client status report. This report documented the activity status of all devices, including communication and battery status. Additionally, we conducted in-depth interviews with people with TB and TB care providers who were involved in implementing the Remind TB trial in the Kilimanjaro region. These interviews were guided by the MIDI (Measurement Instrument for Determinants of Innovation), which helps identify the factors influencing the implementation of innovations such as evriMED.</p></div><div><h3>Results</h3><p>Out of the initial 281 participants who were given devices, 245 completed the 6-month follow-up period. The findings indicate that at month 6, most of the devices (49%) reported battery-related challenges. Additionally, forty devices (14%) had reported more than one incidence of losing communication. Through interviews with participants, we observed that evriMED was perceived as user-friendly, and the people with TB reported high satisfaction as the device facilitated improved medication intake. TB care providers also said that evriMED was a relevant tool to be used by the people with TB. However, during the in-depth interview certain implementation bottlenecks were identified, including network issues, limited training, and low technology knowledge among TB care providers, who found the procedure of using the evriMED to be time-consuming.</p></div><div><h3>Conclusion</h3><p>Implementation of evriMED was perceived as user-friendly and highly satisfactory by people with TB. Certain implementation bottlenecks were identified as potential barriers to the use of devices. These bottlenecks include network issues, limited training, battery-related challenges and low technological knowledge among TB care providers, which may have contributed to communication loss. Further research may be needed to address these limitations and develop effective strategies to facilitate the successful implementation of evriMED as a tool for improving medication intake among people with TB.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"34 ","pages":"Article 100409"},"PeriodicalIF":2.0,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579423000657/pdfft?md5=8a6e58513649b2811484d3d610aee588&pid=1-s2.0-S2405579423000657-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621327","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}