IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0301

A Ghodousi, I Iannucci, F Saluzzo, J Dreisbach, S Mirold-Mei, M Hoelscher, D M Cirillo

{"title":"Low-level BTZ-043 resistance in Mycobacterium tuberculosis and cross-resistance to bedaquiline and clofazimine.","authors":"A Ghodousi, I Iannucci, F Saluzzo, J Dreisbach, S Mirold-Mei, M Hoelscher, D M Cirillo","doi":"10.5588/ijtldopen.25.0301","DOIUrl":"10.5588/ijtldopen.25.0301","url":null,"abstract":"Background: Multidrug- and extensively drug-resistant strains of Mycobacterium tuberculosis complex (MTBC) remain a significant global health challenge. This study investigates resistance mechanisms to BTZ-043, a novel decaprenylphosphoryl-β-D-ribose 2'-epimerase (DprE1) inhibitor, and its potential cross-resistance with bedaquiline (BDQ) and clofazimine (CFZ).Methods: BTZ-043-resistant mutants were generated in M. tuberculosis H37Rv by serial exposure to escalating drug concentrations. Minimum inhibitory concentrations (MICs) for BTZ-043 were determined for 130 wild-type strains, including 60 H37Rv independent cultures and 70 diverse clinical isolates, plus 33 non-wild-type clinical strains with known BDQ susceptibility. MICs were correlated with whole-genome sequencing (WGS) data to identify genetic factors underlying resistance.Results: The MIC distribution for clinical MTBC strains was similar to the reference strain, with a mode of 0.002 μg/mL. WGS of resistant mutants revealed mutations in dprE1 and Rv0678. Rv0678 and dprE1 mutations resulted in 4- to 8-fold and >1,000-fold increase in MIC compared with the reference mode, respectively. Sequential clinical strains from BDQ-treated patients showed increased MICs and Rv0678 mutations, indicating low-level cross-resistance. However, Rv0678 mutations in BDQ-susceptible strains did not affect BTZ-043 MICs.Conclusion: Rv0678 mutations confer low-level cross-resistance to BTZ-043, BDQ, and CFZ, with variable effects on susceptibility. These findings highlight the complexity of resistance mechanisms and the need for ongoing surveillance and early resistance assessments in drug development.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 10","pages":"604-609"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294973","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}

引用次数: 0

Diagnostic accuracy of a commercial AI digital stethoscope for diagnosis of TB. 商用人工智能数字听诊器诊断结核病的准确性。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0360

H Cox, Y Rani, L Nakiyingi, K A Francia, Y Xie, C Hoang, N Hapeela, G P Romero, E Nasinghe, N Van Hung, S Kim, A Penn-Nicholson, S E Dorman

{"title":"Diagnostic accuracy of a commercial AI digital stethoscope for diagnosis of TB.","authors":"H Cox, Y Rani, L Nakiyingi, K A Francia, Y Xie, C Hoang, N Hapeela, G P Romero, E Nasinghe, N Van Hung, S Kim, A Penn-Nicholson, S E Dorman","doi":"10.5588/ijtldopen.25.0360","DOIUrl":"10.5588/ijtldopen.25.0360","url":null,"abstract":"Background: Improved TB screening requires non-invasive, low-cost, and rapid diagnostics. Digital stethoscopes utilising machine-learning approaches to analyse respiratory sounds have potential.Methods: We assessed accuracy of a commercial digital stethoscope for TB diagnosis among TB symptomatic participants. The microbiological reference standard (MRS) was sputum TB-positive on either liquid culture, solid culture, or Xpert MTB/RIF Ultra. Adults were enrolled from South Africa, Uganda, Vietnam, and Peru, with pre-defined sampling of 60 MRS-positive and 180 MRS-negative participants over two stages. Respiratory sounds from six auscultation positions on the participant's torso were analysed. The manufacturer (blinded to MRS status) provided participant scores and a test-positivity cut-off.Results: Among 240 participants, 135 (56%) were female, 62 (26%) living with HIV, 35 (15%) current smokers, and 31 (13%) previously treated for TB. Estimates of sensitivity and specificity, adjusted for country-stratified sampling, were 77% (95% confidence interval [CI]: 65-85) and 50% (95% CI: 43-57), respectively. Sensitivity was lower among people living with HIV and those with sputum smear-negative TB and varied by country. Testing took 5 min per participant (median, interquartile range 4-6).Conclusion: These early data suggest that further refinement of this test is warranted. The device is simple to use, is inexpensive, and can be used offline.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 10","pages":"610-615"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294905","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}

引用次数: 0

Management of latent TB infection: a national survey of French physicians. 潜伏性结核感染的管理：法国医师的一项全国性调查。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0368

N Dournon, Y Tandjaoui-Lambiotte, C M Kilu, P T Phan, P Fraisse, F-X Blanc, O Launay, O Epaulard, C Andrejak, P Loubet, A Dinh

引用次数: 0

AI-CAD enhances pulmonary TB detection and yield in active case finding. AI-CAD提高了肺结核的检出率和主动病例发现率。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0088

A Frederick, R Kubendiran, T Neelagandan, K K Shankar, A Ojha, R Pant, S Pardeshi, T Gupte, A Kharat

{"title":"AI-CAD enhances pulmonary TB detection and yield in active case finding.","authors":"A Frederick, R Kubendiran, T Neelagandan, K K Shankar, A Ojha, R Pant, S Pardeshi, T Gupte, A Kharat","doi":"10.5588/ijtldopen.25.0088","DOIUrl":"10.5588/ijtldopen.25.0088","url":null,"abstract":"Background: India accounts for 27% of global TB incidence and bears the highest TB burden worldwide. This study evaluates the performance of an AI-assisted computer-aided detection (AI-CAD) solution in a community-based, active case-finding TB screening programme conducted in Tamil Nadu, India. It also provides a comparative analysis of AI-assisted screening and conventional screening methods.Methods: Community-based TB screening was carried out using mobile diagnostic units equipped with digital X-ray machines. The performance of the AI-CAD solution was evaluated by calculating area under the receiver operating characteristic (AUROC) curve, sensitivity, and specificity. Additionally, data from five districts that used conventional screening methods were analysed for comparative analysis against AI-assisted screening.Results: AI-CAD exceeded the World Health Organization (WHO)-recommended minimum target product profile (TPP) with a sensitivity of 0.93 (95% confidence interval [CI]: 0.88, 0.97) and a specificity of 0.83 (95% CI: 0.82, 0.83). AI interpretation was significantly associated with positive TB diagnosis (odds ratio: 58.95, P < 0.0001). AI-assisted screening led to a 2.09-fold increase in TB diagnoses (P < 0.05) and a 2.86-fold higher sputum positivity rate (P < 0.05) compared with the conventional screening approach.Conclusion: The AI-CAD met and exceeded the WHO's minimal TPP for TB detection. The higher sputum-positive yield reinforces AI-CAD's potential in large-scale TB screening programmes.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 10","pages":"577-582"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294909","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}

引用次数: 0

The effect of pollutant exposure on cough in progressive pulmonary fibrosis. 污染物暴露对进行性肺纤维化患者咳嗽的影响。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0427

H Vander Linden, U Zanini, M Kalluri, J Cole, P Boulanger, M Feist, G Ferrara

引用次数: 0

Personnel time requirements for mobile chest X-ray screening for TB. 结核病流动胸部x线筛查的人员时间要求。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0254

T S Johnson, J Kakeeto, D Isooba, S Birabwa, J Magezi, W Kamya, R Okura, I Naluyima, A Nalutaaya, P J Kitonsa, E A Kendall, A Katamba, D W Dowdy

{"title":"Personnel time requirements for mobile chest X-ray screening for TB.","authors":"T S Johnson, J Kakeeto, D Isooba, S Birabwa, J Magezi, W Kamya, R Okura, I Naluyima, A Nalutaaya, P J Kitonsa, E A Kendall, A Katamba, D W Dowdy","doi":"10.5588/ijtldopen.25.0254","DOIUrl":"10.5588/ijtldopen.25.0254","url":null,"abstract":"Background: Community-based active case finding (ACF) using chest X-ray (CXR) is effective for early TB detection, but implementation is limited by high resource demands.Methods: We assessed human resource needs for two ACF strategies - community-based and facility-adjacent - using mobile CXR with computer-aided detection during a cluster randomised crossover trial in peri-urban Uganda. Tuberculin skin testing (TST) was offered, with referral to preventive therapy for those with positive TST but negative TB evaluation. We conducted time-and-motion observations of three- and four-member screening teams over 90 days (July 2023-April 2024). We estimated staff time per key screening outcome, including time per positive Xpert result and per positive TST reading.Results: Given an average yield of 6.9 cases per 1,000 individuals screened, three-member (four-member) screening teams collectively spent 65.0 (80.2) person-hours per positive Xpert result, or 26.7 (32.9) person-hours per positive TST read. Staff performed a diverse range of activities, of which the most time-consuming were initial intake (community-based: 2.0 h/day, 23% of time; facility-adjacent: 2.7 h/day, 31% of time) and participant counselling (1.6 h/day, 18%; 2.0 h/day, 22%).Conclusion: TB ACF requires substantial human resources for implementation. National TB Programs should carefully consider personnel requirements when planning and scaling these programmes.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 10","pages":"563-569"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294918","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}

引用次数: 0

Central nervous system TB: a retrospective review of management. 中枢神经系统结核：治疗的回顾性回顾。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0371

V Grey, G Eather

引用次数: 0

The effect of smart pillboxes on TB stigma among adults in a cluster-randomised TB treatment trial. 在一项聚类随机结核治疗试验中，智能药箱对成人结核病耻感的影响。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0113

L Jennings, N Maraba, R Mukora, P Hippner, K Velen, C Orrell, S Charalambous, K Fielding

{"title":"The effect of smart pillboxes on TB stigma among adults in a cluster-randomised TB treatment trial.","authors":"L Jennings, N Maraba, R Mukora, P Hippner, K Velen, C Orrell, S Charalambous, K Fielding","doi":"10.5588/ijtldopen.25.0113","DOIUrl":"10.5588/ijtldopen.25.0113","url":null,"abstract":"Background: TB stigma has been shown to result in delayed health-seeking behaviours and treatment initiation. Few studies have quantitatively described stigma during treatment. As part of the TB Mate trial, we summarise TB stigma at treatment start and the effect of the intervention on stigma in follow-up.Methods: In the TB Mate trial, we conducted a cluster-randomised trial in 18 primary health care facilities from three provinces in South Africa to evaluate the use of alarmed electronic pillboxes in drug-sensitive TB on treatment adherence. We administered a questionnaire, measuring five TB stigma domains, at baseline, 6 months, and 18 months. We conducted a sub-analysis of these stigma data.Results: Overall, 2,469/2,657 adults with TB enrolled had a baseline stigma questionnaire. At baseline, reporting experience of stigma or internalised stigma was low (≤3%), whereas disclosure of TB status outside of the household was common (42.3%; 1,045/2,469). Prevalence of experiencing stigma remained low at the end of treatment. Disclosure increased at 6 months in the intervention (40%-64%) and standard of care arms (44.7%-56%), though was similar by arm (adjusted prevalence ratio 2.55 [95% confidence interval: 0.50-12.90]).Conclusion: The overall prevalence of TB stigma, in domains other than disclosure, in our study population was low. There was no evidence that stigma increased with use of an alarmed smart pillbox.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 10","pages":"583-589"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294937","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}

引用次数: 0

Acceptability of 100-mg moxifloxacin in children with rifampicin-resistant TB in three high-burden countries. 在三个高负担国家，100mg莫西沙星对患有利福平耐药结核病的儿童的可接受性。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0365

N Suryavanshi, H R Draper, G Dhumal, S Bagchi, N T Castillo-Carandang, A Marthinus, A M A Cheong, A Kinikar, M Paradkar, A Gupta, J D R Ocampo, M V G Frias, D J O Casalme, A Hesseling, A J Garcia-Prats, M Palmer, G Hoddinott, L Viljoen

{"title":"Acceptability of 100-mg moxifloxacin in children with rifampicin-resistant TB in three high-burden countries.","authors":"N Suryavanshi, H R Draper, G Dhumal, S Bagchi, N T Castillo-Carandang, A Marthinus, A M A Cheong, A Kinikar, M Paradkar, A Gupta, J D R Ocampo, M V G Frias, D J O Casalme, A Hesseling, A J Garcia-Prats, M Palmer, G Hoddinott, L Viljoen","doi":"10.5588/ijtldopen.25.0365","DOIUrl":"10.5588/ijtldopen.25.0365","url":null,"abstract":"Background: Routinely, a 400-mg tablet of moxifloxacin is used in children with rifampicin-resistant TB (RR-TB), but it has very poor acceptability. We describe the acceptability of a 100-mg dispersible moxifloxacin among children and their caregivers in South Africa, India, and the Philippines.Methods: This study is nested in a pharmacokinetics, safety, and acceptability trial of new formulations of clofazimine and moxifloxacin in children with RR-TB. Quantitative and qualitative data were collected at four time points over 24 weeks and were analysed descriptively and thematically.Findings: Median age of participants (n = 36) was 4.9 years. Children and caregivers from all three countries preferred the dispersible 100-mg moxifloxacin to the routine 400-mg tablet due to the relative ease of administration. The 100-mg formulation was unpalatably bitter. Children who were able to swallow the 100-mg formulation preferred to do so. The smaller size of the 100-mg tablets enhanced their ease of preparation and acceptability, although some older participants experienced the increase in the number of tablets (compared with single 400-mg tablet) as a burden.Conclusion: The 100-mg moxifloxacin dispersible formulation is preferred over 400-mg. Overall, moxifloxacin palatability remains sub-optimal, and there is a need to further improve the acceptability of RR-TB treatments for children.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 10","pages":"597-603"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294933","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}

引用次数: 0

Towards TB elimination in Malawi: a 5-year analysis of key indicators for TB control using surveillance data. 马拉维实现消除结核病：利用监测数据对结核病控制关键指标的5年分析。

IJTLD open Pub Date : 2025-10-10 eCollection Date: 2025-10-01 DOI: 10.5588/ijtldopen.25.0316

H H Twabi, T C Msosa, M Mukoka, I Mwaluka, B Girma, T Sikwese, J Mpunga, T Mwenyenkulu, D Chimatiro, K Mbendera, J Simbeye, M Nliwasa

{"title":"Towards TB elimination in Malawi: a 5-year analysis of key indicators for TB control using surveillance data.","authors":"H H Twabi, T C Msosa, M Mukoka, I Mwaluka, B Girma, T Sikwese, J Mpunga, T Mwenyenkulu, D Chimatiro, K Mbendera, J Simbeye, M Nliwasa","doi":"10.5588/ijtldopen.25.0316","DOIUrl":"10.5588/ijtldopen.25.0316","url":null,"abstract":"Background: Malawi's TB Control Programme emphasises data-driven approaches for monitoring TB control efforts, but programmatic indicators have never been systematically evaluated. This study evaluates the performance of Malawi's TB Control Programme, providing insights into national trends, geographical distributions, and programmatic gaps in TB care.Methods: Aggregate TB data collected through Malawi's District Health Information System from 2018 to 2022 were analysed cross-sectionally. We analysed trends in TB incidence and case notification rates (CNRs), calculated performance indicators, and assessed district-level variations using time-series plots and statistical comparisons. Population estimates were derived from the 2018 census and adjusted for annual growth.Findings: Malawi reported 18,025 new persons with TB in 2022. From 2005 to 2018, TB incidence and CNRs declined by 68.6% and 54.5%, respectively. The highest CNRs were recorded among men aged 35-64 years. Treatment success rates improved overall, reaching 89.2% in 2022, though disparities persisted for HIV-positive patients and those treated at tertiary facilities.Conclusion: Challenges remain in Malawi's TB control efforts, particularly in addressing case detection gaps in high-burden districts and improving outcomes for vulnerable populations. Strengthening active case finding, enhancing diagnostic capacity, and addressing socio-economic determinants of health are essential for sustaining progress and achieving END-TB Strategy goals.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 10","pages":"590-596"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294966","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}

引用次数: 0

IJTLD open最新文献