Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Exosomal microRNAs associated with tuberculosis among people living with human immunodeficiency virus","authors":"Yujiao Jin,&nbsp;Yuan Liu,&nbsp;Wenyan Yu,&nbsp;Yan Zhang,&nbsp;Kenv Pan,&nbsp;Miaochan Wang,&nbsp;Aifang Xu","doi":"10.1016/j.jctube.2024.100453","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100453","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the diagnostic value of selected exosomal miRNAs for Tuberculosis (TB) among people living with human immunodeficiency virus (PLHIV).</p></div><div><h3>Methods</h3><p>A total of 43 adult HIV patients, including 20 diagnosed with TB and 23 controls, were enrolled. The levels of six exosomal miRNAs (miR-20a, miR-20b, miR-26a, miR-106a, miR-191, and miR-486) were measured using qRT-PCR.</p></div><div><h3>Results</h3><p>The levels of these six exosomal miRNAs (miR-20a, miR-20b, miR-26a, miR-106a, miR-191, and miR-486) were significantly higher in the plasma of TB patients compared to controls among PLHIV. The Receiver Operating Characteristic (ROC) curve of these six miRNAs showed a fair performance in distinguishing TB patients from controls, with Area Under Curve (AUC) values of 0.78 (95 %CI 0.63–0.93), 0.81 (95 %CI 0.67–0.95), 0.77 (95 %CI 0.61–0.93), 0.84 (95 %CI 0.70–0.98), 0.82 (95 %CI 0.68–0.95) and 0.79 (95 %CI 0.65–0.93), respectively. These miRNAs showed higher AUC values for extrapulmonary tuberculosis compared to pulmonary tuberculosis. An analysis of subgroups was performed based on CD4 + T cell count (＜200 and ≥ 200 cells·µL⁻¹). In the high CD4 count group, all these six exosomal miRNAs appeared to have higher AUC values compared to the low CD4 count group.</p></div><div><h3>Conclusions</h3><p>These six exosomal miRNAs could serve as potential biomarkers for diagnosing TB among PLHIV.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100453"},"PeriodicalIF":2.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000408/pdfft?md5=80a636858ebad9760cc675c5c2671012&pid=1-s2.0-S2405579424000408-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239429","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":"Effects of diabetes mellitus on retreatment of Tuberculosis: A multi-centered case-control study from Bangladesh","authors":"Mohammad Afsarul Habib ,&nbsp;Kaniz Afrin ,&nbsp;Syeda Sumaiya Efa ,&nbsp;Md. Delwar Hossain ,&nbsp;Md. Rafiqul Islam ,&nbsp;Md. Mahbubur Rahman ,&nbsp;Nasreen Islam ,&nbsp;Farhana Afroz ,&nbsp;Muhammad Abdur Rahim ,&nbsp;Mohammad Delwar Hossain","doi":"10.1016/j.jctube.2024.100450","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100450","url":null,"abstract":"<div><h3>Objectives</h3><p>Several studies suggested that diabetes mellitus (DM) worsens the tuberculosis (TB) treatment outcome. But information regarding the association of DM with retreatment of TB is very scarce in Bangladesh. Present study aimed to assess the effects of DM on retreatment of TB.</p></div><div><h3>Methods</h3><p>This case-control study was conducted among 254 patients (127 cases and 127 controls) from January 2022 – December 2022. Patients were recruited by purposive sampling from 92 centers of the Diabetic Association of Bangladesh (BADAS). Data were collected by face-to-face interview and record reviewing with the help of semi-structured questionnaire and checklist respectively. Quality of data was maintained in all stages of the study. Data were analyzed by using IBM SPSS software. Informed written consent was taken from each patient prior to the study. Ethical issues were maintained strictly.</p></div><div><h3>Results</h3><p>Present study matched the age and sex of cases and controls. The study revealed that majority of case (89.0) and controls (97.6) were married. Among cases 78.0 % had DM and among controls 64.6 % had DM. Among diabetic patients, 78.8 % cases‘ and 64.6 % controls‘ HbA1C level was not within normal range. The study found that, the number of episodes of previous TB (AOR = 3.088, ρ = 0.019), presence of DM (AOR = 2.817, ρ = 0.012) and uncontrolled HbA1C level (AOR = 2.500, ρ = 0.028) were independently associated with retreatment of TB.</p></div><div><h3>Conclusion</h3><p>The study found that presence of DM, uncontrolled HbA1C level and multiple episodes of previous TB were the risk factors for retreatment of TB. So, a separate guideline for treatment of TB-DM patients should be established to prevent retreatment cases.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100450"},"PeriodicalIF":2.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000378/pdfft?md5=d5fcd8dd22efad05dd5b27a3b820b4ea&pid=1-s2.0-S2405579424000378-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140901995","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":"Effects of non-tuberculous mycobacteria on BCG vaccine efficacy: A narrative review","authors":"Fatemeh Ghasemi ,&nbsp;Jalil Kardan-Yamchi ,&nbsp;Mohsen Heidary ,&nbsp;Morteza Karami-Zarandi ,&nbsp;Sousan Akrami ,&nbsp;Abbas Maleki ,&nbsp;Saeed Khoshnood ,&nbsp;Hossein Kazemian","doi":"10.1016/j.jctube.2024.100451","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100451","url":null,"abstract":"<div><p>The <em>Mycobacterium tuberculosis</em> bacterial pathogen is responsible for the ongoing global tuberculosis (TB) epidemic. Bacille Calmette-Guérin (BCG), the only currently approved TB vaccine, is successful in preventing disseminated disease in newborns. However, it has a variable efficacy against pulmonary TB in adults. This protective effect of the vaccine varies greatly among different populations and geographical areas, which the increased exposure of particular populations to non-tuberculous mycobacteria (NTM) is considered as one of the reasons for this issue. Numerous studies have shown that exposure to NTM species causes the host immune system to be improperly primed. It has also been suggested that NTM species may be blamed for reduction in BCG vaccine effectiveness against <em>M. tuberculosis</em>. The increased exposure of certain populations to NTM has diverse effects on BCG efficacy. Moreover, the exposure to NTM can induce opposite effects on BCG efficacy depending on the NTM exposure route and survivability. A detailed understanding of the impact of NTM exposure on the efficacy of the BCG vaccine is essential for ongoing efforts to develop new TB vaccines as it may ultimately be a crucial success factor. The aim of this study was to review the findings of the studies focusing on the effects of NTM on BCG vaccine efficacy in animal models.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100451"},"PeriodicalIF":2.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240557942400038X/pdfft?md5=95ff864368404bc7ec92ab4a599a3a80&pid=1-s2.0-S240557942400038X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893825","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":"Multidrug-resistant tuberculosis in children: A practical update on epidemiology, diagnosis, treatment and prevention","authors":"James T. Gaensbauer ,&nbsp;Nabaneeta Dash ,&nbsp;Sanjay Verma ,&nbsp;DJ Hall ,&nbsp;Felice C. Adler-Shohet ,&nbsp;Guyu Li ,&nbsp;Grace Lee ,&nbsp;Laura Dinnes ,&nbsp;Kristen Wendorf","doi":"10.1016/j.jctube.2024.100449","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100449","url":null,"abstract":"<div><p>Pediatric multidrug-resistant tuberculosis (MDR-TB) remains a significant global problem, and there are numerous barriers preventing children with MDR-TB from being identified, confirmed with microbiologic tests, and treated with a safe, practical, and effective regimen. However, several recent advances in diagnostics and treatment regimens have the promise to improve outcomes for children with MDR-TB. We introduce this review with two cases that exemplify both the challenges in management of MDR-TB in children, but also the potential to achieve a positive outcome. More than 30,000 cases of MDR-TB per year are believed to occur in children but less than 5% are confirmed microbiologically, contributing to poorer outcomes and excess mortality. Rapid molecular-based testing that provides information on rifampin susceptibility is increasingly globally available and recommended for all children suspected of TB disease--but remains limited by challenges obtaining appropriate samples and the paucibacillary nature of most pediatric TB. More complex assays allowing better characterization of drug-resistant isolates are emerging. For children diagnosed with MDR-TB, treatment regimens have traditionally been long and utilize multiple drugs associated with significant side effects, particularly injectable agents. Several new or repurposed drugs including bedaquiline, delamanid, clofazimine and linezolid now allow most treatment regimens to be shorter and all-oral. Yet data to support short, all-oral, novel regimens for young children containing pretomanid remain insufficient at present, and there is a compelling need to conduct pediatric trials of promising therapeutics and MDR-TB treatment regimens.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100449"},"PeriodicalIF":2.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000366/pdfft?md5=e9c7ad8a2942fc818d05c2b37c9216ac&pid=1-s2.0-S2405579424000366-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842866","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":"Patient navigator’s role in latent tuberculosis infection at a New York City Health Department Chest Clinic","authors":"E. Barroso ,&nbsp;T. Mark ,&nbsp;R. Acevedo ,&nbsp;S. Rao ,&nbsp;H.T. Jordan ,&nbsp;J. Burzynski ,&nbsp;W. Remegio ,&nbsp;E. Ea ,&nbsp;L. Compas","doi":"10.1016/j.jctube.2024.100446","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100446","url":null,"abstract":"<div><h3>Background</h3><p>Philippines is one of the top ten countries of birth among individuals with tuberculosis in New York City (NYC). The NYC Health Department (HD) screened Filipino-born New Yorkers for latent TB infection (LTBI), but few of those tested positive completed evaluation and treatment.</p></div><div><h3>Objective</h3><p>To increase the proportion of Filipinos with a positive QuantiFeron-TB Gold Plus (QFT-Plus) complete LTBI evaluation and treatment.</p></div><div><h3>Methods</h3><p>Nine community-based LTBI screening events were conducted during September-December 2021. Patients with positive QFT-Plus results were offered no-cost LTBI evaluation and treatment at HD Chest Clinic. The HD engaged culturally- and linguistically-competent Filipino patient navigators (PN) to facilitate LTBI evaluation and treatment.</p></div><div><h3>Results</h3><p>Of 77 Filipinos screened, 17 (22%) tested positive. Fourteen (82%) were evaluated for LTBI; eight of the 14 (57%) completed LTBI treatment.</p></div><div><h3>Conclusions</h3><p>Pairing patients with culturally- and linguistically- competent Filipino PNs contributed to an increase in the proportion of Filipinos with a positive QFT-Plus who completed LTBI evaluation and treatment. TB prevention programs may wish to consider PNs in LTBI patient care.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100446"},"PeriodicalIF":2.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000330/pdfft?md5=b2cd2d1a6045247ccd8e276d952eb701&pid=1-s2.0-S2405579424000330-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140816016","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":"Rifampicin resistant Mycobacterium tuberculosis in Vietnam: Comment","authors":"Hineptch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.jctube.2024.100445","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100445","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100445"},"PeriodicalIF":2.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000329/pdfft?md5=3687fee11d971811e5bbd846392b9d21&pid=1-s2.0-S2405579424000329-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140807273","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":"Is there a role for lung or bronchial biopsies for the diagnosis of mycobacterial pulmonary disease in patients with bronchiectasis?","authors":"Rottem Kuint,&nbsp;Avraham Abutbul,&nbsp;Zvi G. Fridlender,&nbsp;Uri Laxer,&nbsp;Neville Berkman","doi":"10.1016/j.jctube.2024.100447","DOIUrl":"10.1016/j.jctube.2024.100447","url":null,"abstract":"<div><h3>Background</h3><p>Workup of bronchiectasis patients mandates microbiological characterization often being sought via Bronchoscopy. However, whether to perform bronchial or lung biopsies, is unknown, especially for the diagnosis of NTM pulmonary disease. We aimed to assess the current practice and yield of the different bronchoscopic procedures in this setting.</p></div><div><h3>Methods</h3><p>Data from an adult cohort with bronchiectasis referred for bronchoscopy for microbiologic sampling was reviewed, including demographics, etiology, imaging and results of the different bronchoscopic procedures performed.</p></div><div><h3>Results</h3><p>127 subjects were analyzed (mean age 61, 56% female). BAL culture was positive in 44%. Frequent pathogens were Hemophilus Influenza (20%), pseudomonas aeruginosa (8%) and Staphylococcus aureus (7%). NTM and tuberculosis were found in 6% and 1.5% respectively. BAL cytology was sent in 125 procedures, EBB was performed in 51 patients (40%) and TBLB in 38 patients (30%). BAL cytology and both EBB and TBB (including tissue cultures) had no benefit over BAL with respect to microbiological diagnosis, including identification of mycobacterial disease.</p></div><div><h3>Conclusions</h3><p>In adult subjects with Non-CF bronchiectasis requiring bronchoscopy for microbiological characterization, BAL cytology and lung tissue biopsies were frequently performed but were of minimal additional benefit over BAL culture (including for mycobacterial pulmonary disease), and are most likely futile.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100447"},"PeriodicalIF":2.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000342/pdfft?md5=4dc40298beb68948ab5ff8a501bff92b&pid=1-s2.0-S2405579424000342-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777336","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":"Role of therapeutic drug monitoring in the treatment of multi-drug resistant tuberculosis","authors":"Nicole F. Maranchick ,&nbsp;Charles A. Peloquin","doi":"10.1016/j.jctube.2024.100444","DOIUrl":"10.1016/j.jctube.2024.100444","url":null,"abstract":"<div><p>Tuberculosis (TB) is a leading cause of mortality worldwide, and resistance to anti-tuberculosis drugs is a challenge to effective treatment. Multi-drug resistant TB (MDR-TB) can be difficult to treat, requiring long durations of therapy and the use of second line drugs, increasing a patient’s risk for toxicities and treatment failure. Given the challenges treating MDR-TB, clinicians can improve the likelihood of successful outcomes by utilizing therapeutic drug monitoring (TDM). TDM is a clinical technique that utilizes measured drug concentrations from the patient to adjust therapy, increasing likelihood of therapeutic drug concentrations while minimizing the risk of toxic drug concentrations. This review paper provides an overview of the TDM process, pharmacokinetic parameters for MDR-TB drugs, and recommendations for dose adjustments following TDM.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100444"},"PeriodicalIF":2.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000317/pdfft?md5=a40b0f0606a53d97971c397a53c0d7a0&pid=1-s2.0-S2405579424000317-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774199","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 of an integrated control programme for neglected tropical diseases of the skin in Ghana: The essential role of the laboratory","authors":"Abigail Agbanyo ,&nbsp;Bernadette Agbavor ,&nbsp;Solomon Gyabaah ,&nbsp;Michael Ntiamoah Oppong ,&nbsp;Olivia Dornu ,&nbsp;Philemon Boasiako Antwi ,&nbsp;Aloysius Dzigbordi Loglo ,&nbsp;Kabiru Mohammed Abass ,&nbsp;George Amofa ,&nbsp;Nana Konama Kotey ,&nbsp;Benedict Quao ,&nbsp;Michael Frimpong ,&nbsp;Kingsley Asiedu ,&nbsp;Yaw Ampem Amoako ,&nbsp;Richard Odame Phillips","doi":"10.1016/j.jctube.2024.100442","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100442","url":null,"abstract":"<div><h3>Introduction</h3><p>In this study, we report on findings from approaches used, the outcomes and the lessons learnt from the laboratory support provided for integrated control of skin NTDs including Buruli ulcer (BU), and yaws in seven selected districts in Ghana.</p></div><div><h3>Methods</h3><p>Actions implemented from July 2018 to October 2022 included; training district-level health workers on specimen collection, storage, and transport to laboratories, integrated case searches, continual monitoring and supervision for trained health workers, laboratory confirmation of BU and yaws samples and providing results of the analysed samples to guide decision making. Descriptive analysis of data was performed.</p></div><div><h3>Results</h3><p>A total of 18,683 (including suspected BU 976; suspected yaws 10,995) individuals were screened for BU and yaws. Of 976 suspected BU cases, 16.8% [median (IQR) age 24 (12.0–37.8) years] were confirmed positive by IS2404 PCR; BU mostly presented as ulcers (78.7%); category I (37.2%) and category II (36%). 480 individuals (4.4%) had DPP positive yaws. Multiplex PCR analysis of 75 selected DPP positive cases identified; 7 DPP positive yaws cases as <em>Treponema pallidum</em>, 28 as <em>Haemophilus ducreyi</em> and 7 as <em>Treponema pallidum/Haemophilus ducreyi</em> coinfection. Laboratory results were sent to the districts within a median (IQR) of 5 (3 – 9) days.</p></div><div><h3>Conclusion</h3><p>The implementation of integrated diagnostic confirmation for skin NTDs is feasible with provision of timely results within a week. Multiplex diagnostic tools differentiated <em>Treponema pallidum</em> and <em>Haemophilus ducreyi</em>. There is a need to sustain active case search activities, enhance health worker training, and improve laboratory confirmation of cases as part of the overall strategy for the integrated control of skin neglected tropical diseases.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"35 ","pages":"Article 100442"},"PeriodicalIF":2.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000299/pdfft?md5=0ff774fb1b1988c3cbdb019b7263ae88&pid=1-s2.0-S2405579424000299-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140622553","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":"Pediatric tuberculosis in Mexico: A retrospective analysis of 100 patients","authors":"Enrique G. Villarreal ,&nbsp;Emilia Ramos-Barrera ,&nbsp;Ricardo J. Estrada-Mendizabal ,&nbsp;Pablo D. Treviño-Valdez ,&nbsp;Oscar Tamez-Rivera","doi":"10.1016/j.jctube.2024.100441","DOIUrl":"https://doi.org/10.1016/j.jctube.2024.100441","url":null,"abstract":"<div><h3>Background</h3><p>Analyzing the epidemiology and clinical manifestations of pediatric tuberculosis in endemic regions is crucial to meet the goal of ending tuberculosis. The objective was to assess the various clinical scenarios of tuberculosis in a large pediatric cohort in Mexico.</p></div><div><h3>Methods</h3><p>This retrospective study from a pediatric referral center in Mexico included patients diagnosed with tuberculosis from 2012 to 2021. We analyzed clinical data and diagnostic study results, including demographic characteristics, underlying medical conditions, BCG vaccination, clinical presentation, imaging findings, microbiologic data, treatment, and clinical outcomes. Basic descriptive statistics and Chi-squared analysis were performed to summarize the metadata of pediatric patients with different clinical presentations of tuberculosis and evaluate their association with mortality, respectively.</p></div><div><h3>Results</h3><p>A total of 100 patients were included with a mean age of 7.76 years ± 1.49 years. The most prevalent clinical presentation was pulmonary tuberculosis (<em>n =</em> 51). Only 51 patients were immunized with Bacillus Calmette–Guérin vaccine. The most commons symptoms were fever, cough and weight loss. Among patients with meningeal tuberculosis (<em>n =</em> 14), the most common clinical signs were seizures, fever, and vomiting. Cure was achieved in 52 patients, 12 patients died, and 36 continue in treatment. Clinical presentation of tuberculosis (p-value = 0.009) and immunodeficiency (p-value = 0.015) were significantly associated with mortality.</p></div><div><h3>Conclusions</h3><p>Increasing the visibility of tuberculosis is imperative to end this disease. We report relevant clinical data of a large pediatric tuberculosis cohort, stratified by the different forms of disease. A high index of suspicion of tuberculosis is required for a timely diagnosis and treatment initiation, particularly among immunocompromised individuals, in whom mortality is higher.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"36 ","pages":"Article 100441"},"PeriodicalIF":2.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000287/pdfft?md5=5675a3c048c7387372a7024e71f79aeb&pid=1-s2.0-S2405579424000287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140644834","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}