Monaldi Archives for Chest Disease最新文献

{"title":"Compression-only or standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized controlled trials.","authors":"Arshbeer Singh Sandhu, Muhammad Arslan Arif Maan, Ogechukwu Obi, Oliver Hervir, Mark Abdelnour, Nayan Gandhi, Mansoureh Fatahi, Abuelgasim Mohamed, Ratan Pal Yadav, Jassim Zaheen Shah, Muhammad Ehsan, Wajeeh Ur Rehman","doi":"10.4081/monaldi.2025.3362","DOIUrl":"10.4081/monaldi.2025.3362","url":null,"abstract":"<p><p>This meta-analysis aims to compare chest compression-only cardiopulmonary resuscitation (CO-CPR) with standard CPR (sCPR), which includes mouth-to-mouth ventilation, as potential strategies for managing out-of-hospital cardiac arrest (OHCA). We systematically searched various databases and registries such as MEDLINE, Embase, The Cochrane Library, and Clinicaltrials.gov to retrieve relevant studies. We used the revised Cochrane \"Risk of Bias\" tool for randomized trials (RoB 2.0) to assess the risk of bias in included studies. Revman 5.4 was used to pool dichotomous outcomes under a random-effects model. A total of 4 randomized controlled trials were included in our meta-analysis. Our results indicate that CO-CPR was associated with a significantly increased survival to hospital discharge compared to sCPR [relative risk (RR) 1.22, 95% confidence interval (CI): 1.01 to 1.46] with minimal heterogeneity (I2=0%). No significant difference was observed between the two groups regarding 1-day survival (RR 1.07, 95% CI: 0.94 to 1.23), survival to hospital admission with a good neurological outcome (cerebral performance category 1 or 2) (RR 1.10, 95% CI: 0.80 to 1.51), return of spontaneous circulation (RR 1.05, 95% CI: 0.95 to 1.17), and survival to hospital admission (RR 1.08, 95% CI: 0.93 to 1.25). This meta-analysis found that chest CO-CPR significantly improves survival to hospital discharge compared to sCPR for managing OHCA, while yielding comparable results for other resuscitation outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the clinical profile of community-acquired pneumonia: a cross-sectional study in northeast India.","authors":"Annu Gupta, K G Lynrah, Monaliza Lyngdoh, Iadarilang Tiewsoh, Baphiralyn Wankhar, Debashis Priyadarshan Sahoo, Bhupen Barman, Mohammad Jamil, Gwenette Andrea War","doi":"10.4081/monaldi.2025.3549","DOIUrl":"10.4081/monaldi.2025.3549","url":null,"abstract":"<p><p>Community-acquired pneumonia (CAP) continues to pose a significant public health burden in India, particularly in the northeastern region, where data on microbial etiology and resistance patterns remain scarce. This cross-sectional observational analytical study, conducted over one year at a tertiary care center in northeast India, analyzed 117 adult patients with clinico-radiologically confirmed CAP to elucidate their clinical, epidemiological, and microbiological profiles. The cohort was predominantly male (76.9%), with a mean age of 52 years, and the most affected age group was 31-40 years. Hypertension and chronic obstructive pulmonary disease were the most common comorbidities. Cough, breathlessness, and fever were the leading symptoms. Sputum cultures were positive in 42.7% of cases, with a striking predominance of gram-negative organisms (94%), especially Klebsiella pneumoniae and Pseudomonas species. Alarmingly, high resistance rates were observed for widely used antibiotics such as ceftriaxone and cefuroxime, while meropenem, amikacin, and ertapenem retained high sensitivity. These findings emphasize the critical need for tailored, region-specific empirical treatment strategies in light of emerging antibiotic resistance trends in CAP.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-18 cytokine gene polymorphism 137G/C (rs187238) and susceptibility to tuberculosis in north India.","authors":"Karan Gupta, Vibha Uppal, Pranav Ish, Shubham Singh Chauhan, Sibasish Patro, Neeraj Kumar Gupta","doi":"10.4081/monaldi.2025.3545","DOIUrl":"10.4081/monaldi.2025.3545","url":null,"abstract":"<p><p>Tuberculosis (TB) regained its position globally as the leading cause of mortality from a single infectious agent after being surpassed by COVID-19 for 3 years consecutively. Host genetic factors, particularly cytokine gene polymorphisms, play a significant role in influencing susceptibility to TB. Interleukin-18 (IL18) is a proinflammatory cytokine involved in immune regulation against Mycobacterium tuberculosis. This study aimed to evaluate the association of IL18 gene polymorphism (rs187238) with susceptibility to TB and its effect on serum IL18 levels in a north Indian population. A case-control study was conducted with 100 newly diagnosed TB patients (pulmonary and extrapulmonary) and 100 age- and gender-matched healthy controls. Serum IL18 levels were measured using sandwich enzyme-linked immunosorbent assay, and the IL18 gene polymorphism at rs187238 was analyzed by polymerase chain reaction-restriction fragment length polymorphism. The association between IL18 polymorphism, TB susceptibility, and serum IL18 levels was statistically evaluated. Mean serum IL18 levels were significantly elevated in TB patients (400.42±149.58 pg/mL) compared to controls (96.05±40.67 pg/mL; p<0.01). The distribution of IL18 genotypes showed that individuals with GC/CC genotypes had a significantly lower risk of developing TB compared to the GG genotype [odds ratio (OR)=0.31; 95% confidence interval (CI)=0.20-0.88; p=0.0167]. Additionally, the C allele conferred a protective effect against TB (OR=0.33; 95% CI=0.22-0.51; p<0.0001). Serum IL18 concentrations varied significantly with genotype, with the highest levels observed in CC genotype carriers in both cases and controls (p<0.01). Thus, our study suggests that IL18 polymorphism at rs187238 significantly influences susceptibility to TB in the north Indian population. The C allele and GC/CC genotypes appear to confer a protective effect, possibly through modulation of IL18 serum levels. IL18 rs187238 polymorphism may serve as an independent predictive marker for TB risk, though larger studies are recommended for validation.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of chest ultrasound and intrapleural fibrinolytics with gentamicin following failed pleurodesis.","authors":"Aldo Pezzuto, Ferdinando Cozzolino, Giosuè Amoroso, Evohe Adone, Elisa Desideri, Alberto Ricci","doi":"10.4081/monaldi.2025.3224","DOIUrl":"10.4081/monaldi.2025.3224","url":null,"abstract":"<p><p>This is a case of a 65-year-old male patient who presented to our institution due to worsening dyspnea and respiratory failure development. The patient was admitted due to dyspnea at rest and chest pain. He had a recent medical history of lung cancer with malignant pleural effusion. The patient had already undergone pleural talc poudrage by thoracoscopy, which had not been effective. Indeed, the patient was found to have residual septate pleural effusion on ultrasound examination. A placement of transthoracic pleural drainage followed by intrapleural instillation of urokinase (100,000 units) and gentamicin (80 mg) was performed within 30 days of chemical pleurodesis, achieving re-expansion of the lung by preventing recurrence of the effusion and leading to rapid clinical improvement. The novelty of the present case concerns the effectiveness of a combined treatment of fibrinolytic and intrapleural antibiotic through a pleural drainage after failure of chemical pleurodesis.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a novel ultrasound sign in the management of malignant pleural effusions: a prospective observational trial.","authors":"Pradeep Bajad, Naveen Dutt, Nishant Chauhan, Avinash Babu, Aditi Joshi, Amartya Chakraborti, Rishabh Kochar, Saumya Shishir","doi":"10.4081/monaldi.2025.3263","DOIUrl":"10.4081/monaldi.2025.3263","url":null,"abstract":"<p><p>The management of malignant pleural effusion (MPE) is influenced by the lung's ability to re-expand following fluid drainage. Lung entrapment can complicate this process and may be predicted using pleural manometry. Recently, a novel lung ultrasound (LUS) marker-the sinusoidal sign-has emerged as a potential tool to differentiate between expandable and entrapped lung prior to thoracentesis. A prospective observational study was conducted to evaluate the role of pre-drainage LUS in identifying entrapped lung and compare its diagnostic accuracy with pleural manometry. A total of 30 patients with MPE were enrolled. Prior to thoracentesis, targeted ipsilateral LUS was performed at the level of the atelectatic lung. M-mode displacement <1 mm was considered indicative of an absent sinusoidal sign. Simultaneously, pleural manometry was conducted during thoracentesis to measure pressure changes and calculate pleural elastance. Lung expandability was determined based on pleural elastance and post-thoracentesis imaging findings (computed tomography thorax). A pleural elastance >13.6 cm H2O/L was considered diagnostic of lung entrapment. A pleural elastance cut-off of 13.6 cm H2O/L demonstrated 100% sensitivity, 93% specificity, a 100% positive predictive value, and 84.2% negative predictive value. The absence of the sinusoidal sign on LUS had a sensitivity of 78.6% and specificity of 100% in identifying entrapped lung. Both absent sinusoidal sign on pre-drainage LUS and elevated pleural elastance (>13.6 cm H2O/L) during thoracentesis are reliable indicators of lung entrapment in MPE. LUS may serve as a useful, non-invasive bedside tool for early identification of nonexpandable lung.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of inhaled corticosteroids/formoterol in relieving acute asthma as compared to traditional salbutamol in children 6 to 11 years old on maintenance and reliever therapy step 3 and above as per the Global Initiative for Asthma guideline.","authors":"Danish Abdul Aziz, Werdah Viquar","doi":"10.4081/monaldi.2025.3355","DOIUrl":"10.4081/monaldi.2025.3355","url":null,"abstract":"<p><p>The recent Global Initiative for Asthma (GINA) guidelines offer two reliever therapy options for patients on step 3 and above: the more popularly used short-acting β-agonists (SABA) and the newly introduced inhaled corticosteroids (ICS)-formoterol combination. Our aim was to assess the effectiveness of the ICS/formoterol combination in comparison to the traditional SABA offered to patients aged 6-11 years old following step 3 and above of the GINA guidelines. A retrospective study was conducted at a tertiary care facility in Karachi, Pakistan. The study involved children aged 6-11 years old who were admitted with an asthma exacerbation and were subsequently discharged on step 3 and above as per the GINA guidelines for 3 months. The patients were then categorized into two groups depending on the type of reliever used (ICS/formoterol or salbutamol). There were 80 pediatric patients enrolled in our study. The emergency room visits with asthma exacerbation in 3 months following discharge were significantly lower in the ICS/formoterol reliever group (1.27±0.83) than in the salbutamol reliever group (1.93±1.36) (p=0.01). Mean admissions with asthma in 6 months post-discharge were significantly higher in the salbutamol group (2.18±0.82) as compared to the ICS/formoterol group (1.24±0.83). Moreover, the number of patients requiring step-up control within 3 months of discharge was also significantly lower in the ICS/formoterol group, with 2 patients, than in the salbutamol group, with 10 patients (p=0.02). The forced expiratory volume in 1 second value 3 months after discharge was significantly greater in the ICS/formoterol group (91.27±8.32) than in the salbutamol group (84.58±10.44) (p=0.02). Through our analysis, we were able to highlight the superiority of ICS/formoterol as a reliever compared to SABA for moderate asthma.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of unsuccessful treatment outcome of pulmonary tuberculosis under the National Tuberculosis Elimination Program in Mohali district, India.","authors":"Aditi Gupta, Vidhu Mittal, Navdeep Singh, Anuradha Nadda","doi":"10.4081/monaldi.2025.3363","DOIUrl":"10.4081/monaldi.2025.3363","url":null,"abstract":"<p><p>Tuberculosis is a global healthcare concern, being the leading infectious cause of mortality by a single infectious agent. India bears the highest burden of tuberculosis. Disease outcome is an important indicator for the successful implementation of the National Program. Risk factors associated with unsuccessful outcomes must be identified, and differential care must be provided to those with risk factors. The study included all pulmonary tuberculosis patients registered from 1st October 2022 to 30th September 2023 at the Directly Observed Therapy Short Course Center, Dr. BR Ambedkar State Institute of Medical Sciences, Mohali, who received treatment. Data were collected from the Nikshay portal retrospectively. Out of 1103, 575 (52.13%) patients were declared cured, whereas 452 (40.97%) were declared treatment completed. A total of 19 (1.72%) pulmonary tuberculosis patients died during treatment, and 57 (5.16%) were declared failures. Advanced age [adjusted odds ratio (AOR) 4.028, 95% confidence interval (CI): 1.368-4.610, p=0.003], people living with HIV (AOR 0.185, 95% CI: 0.031-1.082, p=0.05) and male gender (crude OR 1.611, 95% CI: 0.371-1.006, p=0.050) were associated with poor outcomes. Diabetes, retreatment, microbiological confirmation, and low body mass index were not statistically significant in the study. Age above 45 years, male sex, and HIV co-infection are determinants for unsuccessful treatment outcomes in patients with pulmonary tuberculosis.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes and factors associated with unfavorable outcomes among drug-resistant tuberculosis patients treated with a bedaquiline-based oral regimen.","authors":"Oki Nugraha Putra, Julaeha Julaeha, Nurhayati Nurhayati, Telly Purnamasari, Nurul Damayanti, Dewi Ramdani, Ahmad Erlan, Paisal Paisal, Rini Sasanti Handayani, Nur Indah","doi":"10.4081/monaldi.2026.3928","DOIUrl":"https://doi.org/10.4081/monaldi.2026.3928","url":null,"abstract":"<p><p>The treatment success rate for drug-resistant tuberculosis (DR-TB) in Indonesia remains below the national target. Identifying factors associated with unfavorable treatment outcomes is essential to inform more targeted interventions. This retrospective study analyzed medical records of patients with DR-TB who received treatment at Surabaya Haji Hospital between 2020 and 2024. Demographic, clinical, behavioral, and treatment-related variables were evaluated in relation to unfavorable treatment outcomes, defined as a composite outcome of death, treatment failure, or loss to follow-up. Bivariate and binary logistic regression analyses were performed to estimate crude odds ratios and adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs). A total of 90 eligible patients were included in the analysis. Overall, 52 patients (57.8%) achieved a favorable treatment outcome (cure), whereas 38 (42.2%) experienced unfavorable treatment outcomes, including loss to follow-up (42.1%), death (34.2%), and treatment failure (23.7%). In the bivariable analysis, only a history of previous TB treatment was significantly associated with unfavorable treatment outcomes. After adjustment for diabetes mellitus and BCG vaccination history, previous TB treatment remained an independent predictor of unfavorable treatment outcomes (aOR = 11.47; 95% CI: 4.19-31.41; p<0.001). These findings indicate that patients with a history of previous TB treatment are at substantially greater risk of unfavorable treatment outcomes and underscore the need for closer monitoring and more comprehensive management strategies to improve treatment success.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing patterns of antimicrobial therapy in respiratory tract infections at a tertiary care teaching hospital: a prospective study.","authors":"Mandati Santhosh Reddy, Vaishnavi Jotiba Gurav, Jyoti A Hanamgond, Anasuya Vannur, Alika V Martins, Pradnya Rajmane","doi":"10.4081/monaldi.2026.4118","DOIUrl":"https://doi.org/10.4081/monaldi.2026.4118","url":null,"abstract":"<p><p>Respiratory tract infections (RTIs) are among the most common causes of hospital admissions and antibiotic use worldwide, and inappropriate antimicrobial prescribing in such cases significantly contributes to the growing problem of antimicrobial resistance, particularly in tertiary care settings. This prospective observational study was conducted in the Departments of General Medicine and Respiratory Medicine at a tertiary care teaching hospital from March to May 2026 and included 113 adult inpatients (≥18 years) diagnosed with upper or lower RTIs and receiving at least one antimicrobial agent. Data were collected from case records and analyzed using WHO prescribing indicators along with descriptive statistics. The average number of antibiotics prescribed per patient was 1.7. Injectable formulations were predominantly used, accounting for 88% of prescriptions, while oral therapy constituted only 12%. Generic prescribing was observed in 72% of cases, and the mean duration of antimicrobial therapy was 6.2 days. Upper RTIs were the most common diagnosis (42.48%), followed by community-acquired pneumonia (26.55%). Ceftriaxone emerged as the most frequently prescribed antibiotic, used as monotherapy in 26.5% of patients and in combination with azithromycin in 19.5% of cases. A high proportion of prescriptions involved broad-spectrum \"Watch\" category antibiotics, including piperacillin-tazobactam and meropenem, whereas the use of \"Access\" antibiotics was relatively limited. Intravenous-to-oral switch therapy was also found to be underutilized. Overall, the study highlights a strong reliance on broad-spectrum and injectable antibiotics in the management of RTIs, with suboptimal utilization of Access-category agents. Although prescribing practices were broadly consistent with guideline recommendations for more severe infections, the excessive use of Watch and Reserve antibiotics indicates a need for stronger antimicrobial stewardship interventions. Enhancing culture-guided therapy, promoting intravenous-to-oral switch strategies, encouraging generic prescribing, and strengthening institutional antimicrobial stewardship programs are essential measures to optimize antibiotic use and help curb antimicrobial resistance in tertiary care settings.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic, behavioral, and life-course risk factors for tuberculosis in older Indian adults: evidence from a nationally representative survey.","authors":"Saurav Basu, Shubhanjali Roy, Puja Samanta, Suneela Garg","doi":"10.4081/monaldi.2026.3825","DOIUrl":"https://doi.org/10.4081/monaldi.2026.3825","url":null,"abstract":"<p><p>While tuberculosis (TB) propagation is multifactorial, the intersection of biological vulnerability (undernutrition) and cumulative life-course adversities is increasingly recognized as a crucial modifiable determinant. This study aimed to identify the independent biological, socioeconomic, behavioral, and life-course determinants of self-reported TB prevalence among middle-aged and older adults in India. We conducted a cross-sectional analysis using Wave 1 of the Longitudinal Ageing Study in India (LASI, 2017-18). The analytical sample included 59,910 adults aged 45 years and above with non-missing data on TB status and body mass index. The outcome was a self-reported TB diagnosis within the preceding 2 years. Survey-weighted logistic regression was used to examine factors associated with self-reported TB. Firth bias-reduced logistic regression was performed as a sensitivity analysis because of the low prevalence of self-reported TB. Overall, 550 participants (0.92%) reported TB within the preceding two years. Undernutrition was more common among participants with self-reported TB than among those without TB. In adjusted survey-weighted models, undernutrition, history of being bedridden for 1 month or more during childhood, multimorbidity, and residence in the Western region were independently associated with higher odds of self-reported TB. The findings were broadly consistent in the Firth bias-reduced sensitivity analysis. TB prevalence in older Indian adults is independently driven by undernourishment and the cumulative impact of early-life disease/deprivation, alongside the burden of multimorbidity. These findings underscore the need for the National TB Elimination Program to strengthen nutritional support and integrate TB prevention with comprehensive geriatric care and robust pediatric health investments to reduce adult vulnerability.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}