IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.25.0031

A Duret, A Cardoso-Pinto, A Bhattacharyya, Ivin Jose, A Ahmadi, I Patton, A Ostrzewska, H Durkan, O M Kon, J A Seddon, E Whittaker

{"title":"Adolescents and young adults with TB in a low-incidence setting.","authors":"A Duret, A Cardoso-Pinto, A Bhattacharyya, Ivin Jose, A Ahmadi, I Patton, A Ostrzewska, H Durkan, O M Kon, J A Seddon, E Whittaker","doi":"10.5588/ijtldopen.25.0031","DOIUrl":"10.5588/ijtldopen.25.0031","url":null,"abstract":"Background: Adolescents and young adults (AYA) with TB have distinct physical and social characteristics compared to other age groups. This study describes a cohort of AYA with TB in a low TB-prevalence, high-income setting and investigates whether demographic or social factors affect management outcomes.Methods: A retrospective cohort study was conducted at a TB referral centre in North West London, including patients aged 10-24 years from 2015 to 2022. Median days from symptom onset to healthcare presentation were determined and risk factors for late presentation (>60 days) were assessed.Results: Among 158 patients (median age 20 years, IQR 17-23), 53.6% had pulmonary TB, 39.9% extrapulmonary disease, and 5.7% disseminated disease; 25.3% had cavities. Social risk factors were present in 32.3% of patients. Median delay to presentation was 45 days (IQR 14-96), with 38.7% presenting after two months. Delays were longer in patients with incarceration, drug misuse, or mental health issues, though not statistically significant. Patients with social risk factors were more likely to receive observed therapy (OR 2.65, IQR 1.27-5.64).Conclusions: AYA with TB in this setting experienced delays in healthcare presentation and a quarter had cavitary disease. Social risk factors were common but not significantly related to outcomes.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"333-338"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319152","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

Data-driven targets for reducing the global burden of TB. 减少全球结核病负担的数据驱动目标。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.25.0014

C R Horsburgh, Helen E Jenkins, L Martinez, L F White

{"title":"Data-driven targets for reducing the global burden of TB.","authors":"C R Horsburgh, Helen E Jenkins, L Martinez, L F White","doi":"10.5588/ijtldopen.25.0014","DOIUrl":"10.5588/ijtldopen.25.0014","url":null,"abstract":"Background: The proportion of persons with infectious TB that need to be cured to reduce prevalence is an important but not well characterized target for TB control.Methods: We compared infectious TB prevalence from countries with two population-based surveys since 2000, accounting for persons receiving curative treatment and those dying or undergoing natural recovery. Annual incidence was estimated as the proportion of prevalence that, when applied to each year over the interval between the two surveys, yielded the observed second survey prevalence. We then determined the relationship between the proportion of people with TB cured and the change in prevalence in each of the years covered by the surveys.Results: Achieving a decline in prevalence required curing at least 20% of those with infectious TB. None of the countries studied reached the 11% annual decline in prevalence required to yield the END TB goal of a 90% decrease in prevalence over 20 years; this would require diagnosing and curing 35-40% of people with prevalent TB each year.Conclusions: These results provide targets for achieving the goal of a 90% reduction in TB and indicate that active case finding will be required to reach these targets.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"352-358"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319155","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

Progress and challenges to TB elimination in New South Wales, Australia. 澳大利亚新南威尔士州消除结核病的进展和挑战。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.24.0596

E J Donnan, J Pett, E Ulbricht, P D Massey, V Sintchenko, B J Marais

{"title":"Progress and challenges to TB elimination in New South Wales, Australia.","authors":"E J Donnan, J Pett, E Ulbricht, P D Massey, V Sintchenko, B J Marais","doi":"10.5588/ijtldopen.24.0596","DOIUrl":"10.5588/ijtldopen.24.0596","url":null,"abstract":"In Australia, TB care and control is delivered by states and territories, with a National TB Advisory Committee to advise on national surveillance and strategy. For more than 30 years, New South Wales (NSW), Australia, has maintained TB incidence rates of <10/100,000 population, but progress toward TB elimination and 'zero local TB transmission' remains challenging. Reductions in the TB notification rate have plateaued in recent decades, mainly due to increased migration from high incidence countries. There is limited awareness of TB among the public, and a general perception of low risk, at least for Australian-born people and locally trained healthcare professionals. As in other low TB incidence settings, migrants and hard-to-reach populations are overrepresented in TB notifications. Progress in reducing TB among Australia's Aboriginal and Torres Strait Islander people has been slow, hindered by embedded disadvantage, limited healthcare access and historical mistrust. Community engagement and patient advocacy for TB is minimal. Despite excellent progress over many decades, TB elimination remains out of reach in NSW due to ongoing migration from high-incidence settings and the reality of competing health priorities. Here, we critically assess progress towards TB elimination targets and identify opportunities to further improve TB control.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"324-332"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319159","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

Trends in prevalent TB among persons enrolling for HIV care before and after 'Test and Treat' across East-Africa. 东非各国在“检测和治疗”前后参加艾滋病毒护理的人群中结核病流行趋势。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.24.0687

N Kalema, B Musick, S Babirye, L Najjemba, P Mubiri, A Kiragga, A Ddungu, C Kasozi, L O Diero, F Odhiambo, R Lyamuya, B Castelnuovo, J Musaazi, C T Yiannoutsos, K Wools-Kaloustian, A Semeere

{"title":"Trends in prevalent TB among persons enrolling for HIV care before and after 'Test and Treat' across East-Africa.","authors":"N Kalema, B Musick, S Babirye, L Najjemba, P Mubiri, A Kiragga, A Ddungu, C Kasozi, L O Diero, F Odhiambo, R Lyamuya, B Castelnuovo, J Musaazi, C T Yiannoutsos, K Wools-Kaloustian, A Semeere","doi":"10.5588/ijtldopen.24.0687","DOIUrl":"10.5588/ijtldopen.24.0687","url":null,"abstract":"Background: In 2015, WHO recommended the global adoption of the 'Test and Treat' strategy (TTS) for all persons living with HIV (PLHIV). While TTS has improved viral suppression and reduced mortality, its impact on TB in PLHIV remains unclear.Methods: We assessed TB prevalence trends 48 months before and after TTS among PLHIV aged ≥18 years enrolling at HIV primary care sites affiliated with the East Africa International Epidemiology Databases to Evaluate AIDS (EA-IeDEA) consortium. We defined prevalent TB as bacteriologically confirmed or empirically treated TB within 60 days of enrolment. We estimated monthly TB prevalence trends using Poisson (change point) model.Results: Among 125,647 PLHIV, 37% were male. The prevalence of TB was 8.9% (95% CI: 8.7-9.1) before and 6.2% (95% CI: 5.9-6.4) after TTS-adoption. Adjusted analysis showed significant downward trend in TB prevalence before TTS (adjusted Prevalence Rate Ratio, aPRR=0.989, p<0.001), which plateaued during TTS (aPRR=0.999, p=0.131). TB was more frequently present among males (aPRR: 2.09, p<0.001) and adults ≥25 years across both periods.Conclusion: This study highlights a plateau in TB prevalence decline during TTS and persistent disparities in TB by sex and age, underscoring the need for targeted interventions.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"359-365"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319160","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

Post-TB sequelae and care: a systematic review and synthesis of qualitative research. 结核后后遗症和护理：定性研究的系统回顾和综合。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.25.0084

C L Leung, D Jerene, J Meghji, M Drage, W Mbawala, S G Mpagama, C Pell, C Mulder

{"title":"Post-TB sequelae and care: a systematic review and synthesis of qualitative research.","authors":"C L Leung, D Jerene, J Meghji, M Drage, W Mbawala, S G Mpagama, C Pell, C Mulder","doi":"10.5588/ijtldopen.25.0084","DOIUrl":"10.5588/ijtldopen.25.0084","url":null,"abstract":"Background: TB has long-term health and social sequelae. The experiences of TB survivors are not well understood and there is limited evidence around gaps in care. This article aims to provide a comprehensive overview of qualitative research on post-TB sequelae and care, to identify knowledge gaps and inform future research and interventions to support person-centred care.Methods: A systematic search strategy, using two search strings incorporating post-TB and TB-related chronic respiratory disease. Searches were conducted on PubMed, Web of Science and CINAHL. Sources were screened systematically, data extracted independently and analyzed thematically.Results: Sixty-six sources were identified. After applying exclusion/inclusion criteria, 16 articles were included in a qualitative synthesis. Key themes included the physical, psychological, economic and social impacts of TB. These included threats to TB survivors' social role. People who suffer from long-term sequelae are stigmatised. Access to care is limited and tends to focus on acute respiratory disease. Policymakers indicate that the lack of data regarding the long-term impacts of TB contributed to insufficient resources being allocated.Conclusion: This systematic review underscores the post-TB physical and psychological impacts and the complexity of post-TB sequelae; it emphasizes the urgent need for evidence regarding the long-term impact of TB sequelae to improve care.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"339-345"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319157","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

High incidence of TB at a psychiatric hospital. 精神病医院肺结核发病率高。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.24.0684

X Li, X Pang, C Mu, F Zhang, C Wang, G Zhang

{"title":"High incidence of TB at a psychiatric hospital.","authors":"X Li, X Pang, C Mu, F Zhang, C Wang, G Zhang","doi":"10.5588/ijtldopen.24.0684","DOIUrl":"10.5588/ijtldopen.24.0684","url":null,"abstract":"Background: Individuals with mental illness are susceptible to TB. This study aimed to investigate a TB epidemic in a male psychiatric hospital to explore its potential for institutional spread.Methods: From April 2022 to March 2023, 19 TB cases were diagnosed in a male psychiatric hospital. Epidemiological investigations and screening of close contacts were carried out.Results: A total of 400 psychiatric patients and 160 staff members were screened for TB. The overall positive rate was 37.15%, with 43.09% among patients and 22.93% among staff. Ultimately, a total of 17 psychiatric patients (including 2 index cases, 5 active cases, and 11 confirmed cases) and 2 staff (1 active case and 1 confirmed case) were diagnosed. The overall attack rate was 3.36%, with 4.20% in patients and 1.24% in staff. Whole-genome sequencing revealed that 3 drug-resistant patients from a third Department had mutations at two loci (rpoB and rpsL) with fewer than 6 SNPs.Conclusion: Strengthening surveillance and conducting comprehensive epidemiological investigations for any occurrence of two or more TB cases is of utmost importance. Additionally, enhancing diagnostic capabilities and ensuring strict adherence to infection control protocols during patient care are essential measures to prevent TB outbreak.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"346-351"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319156","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

Mycobacterium tuberculosis in patients with hematologic malignancies in a low-risk setting. 结核分枝杆菌在血液恶性肿瘤患者的低风险设置。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.25.0155

L Mezzadri, A Tebaldi, V Ravasio, D Ripamonti

引用次数: 0

Clinical best practices for caring for people with expanded resistance to newer TB drugs. 照料对结核病新药耐药性扩大的患者的临床最佳做法。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.25.0240

T Nkomo, Z Udwadia, D Vambe, A van Rie, S S Thi, J Stillo, A Stambekova, A Sinha, M L Rich, A Reuter, J Patel, R Otto-Knapp, I Motta, A Mesic, L McKenna, S Maru, E Lessem, C Lange, N Kiria, Y Kherabi, G Günther, L Guglielmetti, T Decroo, L Chen, A Ashesh, A Abubakirov, J Furin

{"title":"Clinical best practices for caring for people with expanded resistance to newer TB drugs.","authors":"T Nkomo, Z Udwadia, D Vambe, A van Rie, S S Thi, J Stillo, A Stambekova, A Sinha, M L Rich, A Reuter, J Patel, R Otto-Knapp, I Motta, A Mesic, L McKenna, S Maru, E Lessem, C Lange, N Kiria, Y Kherabi, G Günther, L Guglielmetti, T Decroo, L Chen, A Ashesh, A Abubakirov, J Furin","doi":"10.5588/ijtldopen.25.0240","DOIUrl":"10.5588/ijtldopen.25.0240","url":null,"abstract":"Background: Strains of Mycobacterium tuberculosis with resistance to the new and repurposed drugs included in the all-oral shorter TB regimens recommended by WHO for the treatment of multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) are becoming increasingly common globally. When strains of M. tuberculosis have resistance to one or more of these drugs (bedaquiline, linezolid, third-generation fluoroquinolones, delamanid, pretomanid, or clofazimine), they are more challenging to treat.Methods: In the absence of trial data on how to care for these individuals, a group of clinical, programmatic and civil society experts came together to generate a series of best clinical practices. These practices are based on the published literature and on experience caring for individuals with these forms of TB.Results: We discuss best clinical practices in the following areas: 1) drug susceptibility testing; 2) regimen design; 3) adverse event monitoring and management; 4) special populations; 5) shared decision making and informed consent; 6) holistic packages of support; and 7) pre-approval access/compassionate use of newer TB compounds.Conclusion: While we await systematic studies of treatment approaches to generate the necessary evidence base, the clinical practices described here can be used to guide the programmatic care of people with strains of M. tuberculosis that have expanded resistance.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"315-323"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319154","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

Antenatal screening for TB disease: a systematic review and meta-analysis. 结核病产前筛查：一项系统综述和荟萃分析。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.25.0105

A J Morton, N Meagher, G Tonkin-Hill, J T Denholm, R I Zahroh, S J Dunstan

{"title":"Antenatal screening for TB disease: a systematic review and meta-analysis.","authors":"A J Morton, N Meagher, G Tonkin-Hill, J T Denholm, R I Zahroh, S J Dunstan","doi":"10.5588/ijtldopen.25.0105","DOIUrl":"10.5588/ijtldopen.25.0105","url":null,"abstract":"Objectives: TB disease during pregnancy is associated with poor maternal and neonatal outcomes, and is a leading non-obstetric cause of maternal death. However, optimal detection strategies remain uncertain. We aimed to identify the optimal screening approach for TB disease in pregnant women.Methods: We searched Ovid MEDLINE, Embase + Embase Classic, Web of Science, and CENTRAL to identify antenatal screening studies for TB disease. The yield, number needed to screen (NNS), and positive predictive value (PPV) were calculated for each method. Pooled estimates were generated using random-effects meta-analyses. Narrative synthesis was conducted to summarise secondary outcomes.Results: We included 33 studies. Pooled yield for symptom screening (SS) was 7.26 [95% CI: 0.70, 19.25] cases per 1,000 versus 5.12 [95% CI: 0.79, 12.39] for TST/IGRA. NNS was 138 [95% CI: 51.95, 1,428.57] for SS versus 1,667 [95% CI: 537.63, 1,000,000] for TST/IGRA. SS pooled PPV was 3.85% [95% CI: 1.23-7.57%], and <0.01% [95% CI: <0.01-0.05%] for TST/IGRA. Narrative synthesis indicated antenatal SS is low-cost, feasible, and acceptable but poorly implemented.Conclusion: In pregnancy, symptom screening demonstrates highest yield and lowest NNS, is low-cost, feasible and acceptable. While currently optimal, the low PPV underscores the need for TB screening tools tailored to pregnant populations.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 6","pages":"366-373"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319153","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

Prevalence and knowledge of medical students about the risks of E-cigarette use. 医学生对电子烟使用风险的患病率和知识。

IJTLD open Pub Date : 2025-06-13 eCollection Date: 2025-06-01 DOI: 10.5588/ijtldopen.24.0642

M A Souza de Castro, G F Machado, M M Zamboni, P Normando, M B Conte

引用次数: 0

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