IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0625

Y Hamada, R Mukora, R Pelusa, T Ntshiqa, J Shedrawy, K Velen, I Abubakar, S Charalambous, S Walker, M X Rangaka

{"title":"Costs and cost-effectiveness of integrated screening for non-communicable diseases in TB contacts.","authors":"Y Hamada, R Mukora, R Pelusa, T Ntshiqa, J Shedrawy, K Velen, I Abubakar, S Charalambous, S Walker, M X Rangaka","doi":"10.5588/ijtldopen.24.0625","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0625","url":null,"abstract":"Background: Integrating non-communicable disease (NCD) screening into TB household contact investigations may identify undiagnosed NCDs and reduce the burden of both conditions. However, evidence on the costs and cost-effectiveness of this approach is limited.Method: We conducted a cross-sectional study in South Africa to assess patient and provider costs for NCD screening (hypertension, diabetes, chronic kidney disease, dyslipidaemia). Incremental costs per NCD case identified were calculated. Using a decision tree model, we estimated incremental costs per disability-adjusted life year (DALY) averted over 10 years from a healthcare perspective, with cardiovascular disease (CVD) risk estimated using the WHO prediction model.Results: The incremental cost was USD72.3 per contact screened and USD334.0 per NCD case identified. Integrated screening reduced mean 10-year CVD risk from 5.7% to 2.7% among contacts with NCDs. The incremental cost-effectiveness ratio (ICER) was USD27,043.6 per DALY averted, exceeding South Africa's threshold of USD3,708. Management of identified NCDs, mainly drug costs, comprised over 80% of total incremental costs. The ICER decreased in populations with a high risk for NCDs.Conclusion: Integrated NCD screening was not cost-effective, mainly due to subsequent care costs. Prioritising individuals at high risk for NCDs can improve cost-effectiveness.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 3","pages":"160-165"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653258","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 risk of rifampicin-resistant TB after drug-susceptible TB treatment. 药物敏感结核治疗后出现利福平耐药结核的风险。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0552

A N Shapiro, H Moultrie, K R Jacobson, J Bor, P da Silva, L Scott, H E Jenkins

引用次数: 0

An open-label cluster-randomised trial on TB preventive therapy for children. 一项关于儿童结核病预防治疗的开放标签集群随机试验。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0467

G Lemvik, L Larsson, F Rudolf, J E Vejrum, M Sodemann, V F Gomes, C Wejse

{"title":"An open-label cluster-randomised trial on TB preventive therapy for children.","authors":"G Lemvik, L Larsson, F Rudolf, J E Vejrum, M Sodemann, V F Gomes, C Wejse","doi":"10.5588/ijtldopen.24.0467","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0467","url":null,"abstract":"Background: In a study on 9 months of isoniazid preventive therapy (IPT) in children in Guinea-Bissau, 76% of children exposed to TB at home completed 6 months of IPT. We aimed to test whether 4 months of rifampicin and isoniazid (RH) would improve adherence compared to 9 months of isoniazid (INH).Methods: We conducted an open-label cluster-randomised superiority study in children aged <15 years living with a TB case. Children were randomised by house to receive 4 months of RH or 9 months of INH. RH was given as a fixed-combination pill. The primary outcome was adherence, defined as taking >80% of prescribed dosages per month, assessed by pill count. Our aim was 3 months of RH or 6 months of INH.Results: A total of 752 children from 223 houses were included, 354 in the INH group and 398 in the RH group. Overall, 57% of the children took >80% of the prescribed pills. In the INH group, 68% completed 6 months of therapy, while 61% of the RH group completed 3 months (OR 1.32, 95% CI 0.90-1.95). The main reason for non-adherence in both groups was travel or relocation, accounting for 50% of missed doses.Conclusion: The shorter preventive therapy of 4 months of RH did not improve adherence in children in Guinea-Bissau. Travelling was the primary reason for non-adherence.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 3","pages":"120-128"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653253","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

Concurrent pulmonary TB and histoplasmosis in an HIV-negative patient with Evans Syndrome. 埃文斯综合征hiv阴性患者并发肺结核和组织胞浆菌病。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0607

T-W Kao, M-T Tsai, S-C Pan, C-C Shu, W-Y Liao, J-S Jerng

引用次数: 0

Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB. 儿童结核病的非痰分诊和确证性诊断试验。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0484

A Drane, A Molkenthin, M Gassama, S Pouzol, P Vanhems, J Hoffmann

{"title":"Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB.","authors":"A Drane, A Molkenthin, M Gassama, S Pouzol, P Vanhems, J Hoffmann","doi":"10.5588/ijtldopen.24.0484","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0484","url":null,"abstract":"Background: Non-sputum-based triage and confirmatory tests are essential for early TB detection and timely treatment in children.Methods: A mini-review was conducted from January 2022 to May 2024, evaluating five studies on non-sputum-based assays for childhood TB diagnosis. Both Microbiological and Clinical Reference Standards were used to assess diagnostic accuracy and triage potential.Results: Among the confirmatory tests, only the gastric aspiration test with cartridge-based nucleic acid amplification tests (CBNAAT) met the WHO Target Product Profile criteria. However, this method remains invasive and is not suitable for point-of-care testing. Urine testing by gas chromatography-mass spectrometry (GC/MS) or C-ELISA (BJ76/A194) demonstrated high performance but lacked point-of-care applicability in resource-limited settings. Stool testing with CBNAAT is a viable alternative with high specificity but low sensitivity. For triage, urine lipoarabinomannan tests and blood MTB-HR tests show promise based on specificity, practicality, cost, and turnaround time.Conclusion: This review highlights the performance of non-sputum-based assays for childhood TB and their potential as triage tools. While some other innovations show promise for the triage and/or diagnosis of TB in adults, further studies are needed to evaluate the performance of these tests in pediatric populations.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 3","pages":"153-159"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652496","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

Urgent request for pretomanid label expansion to align with WHO guidelines and improve treatment accessibility and efficacy. 紧急要求扩大普雷托马尼标签，以符合世卫组织指南并改善治疗可及性和疗效。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.25.0152

L Kuksa, C Andrejak, B Haecker, G Bothamley, A Calcagno, D M Cirillo, R Duarte, R Fatima, G Ferlazzo, L Guglielmetti, G Günther, C Hewison, C R Horsburgh, T Jäger, Y Kalancha, R Otto-Knapp, K Kranzer, T Lillebaek, G Marks, K Middelkoop, I Motta, V Rabinova, P Sommerfeld, P Tattevin, C Lange

引用次数: 0

Acceptability of a 250 mg levofloxacin formulation in children receiving TB preventive treatment. 250mg左氧氟沙星制剂在接受结核病预防治疗的儿童中的可接受性。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0569

S E Purchase, J Brigden, J A Seddon, N A Martinson, L Fairlie, S Staples, A Poswa, T Duong, H S Schaaf, A C Hesseling

{"title":"Acceptability of a 250 mg levofloxacin formulation in children receiving TB preventive treatment.","authors":"S E Purchase, J Brigden, J A Seddon, N A Martinson, L Fairlie, S Staples, A Poswa, T Duong, H S Schaaf, A C Hesseling","doi":"10.5588/ijtldopen.24.0569","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0569","url":null,"abstract":"Background: Recent evidence indicates that levofloxacin (LFX) is effective in preventing TB in individuals exposed to multidrug-resistant TB (MDR-TB). Despite the need for pediatric formulations, the 250 mg adult LFX formulation is affordable and widely used for TB treatment and prevention in children.Methods: TB-CHAMP (Tuberculosis Child Multidrug-resistant Preventive Therapy ISRCTN92634082) was a trial of MDR-TB preventive treatment, comparing levofloxacin to placebo in children with MDR-TB exposure. Acceptability questionnaires were administered to caregivers at six timepoints during the 24-week treatment phase. Likert scales were used to grade 6 domains of acceptability, and a composite acceptability (CA) outcome was generated. Factors associated with acceptability were assessed using modified Poisson regression models to estimate risk ratios (RRs).Results: Overall, 922 children were randomised, 453 to LFX and 469 to placebo. By Week 8, 25.1% of children on LFX had poor CA versus 6.2% receiving placebo (Weeks 0-24: RR 3.43, 95% CI 2.69-4.37). Acceptability in the LFX arm improved from 36.8% poor CA at baseline to 12.9% at Week 24. Only 11.7% of children swallowing tablets whole/halved had poor CA outcomes at Week 8, compared to 34.4% swallowing crushed/softened tablets.Conclusion: LFX 250 mg tablets have reasonable acceptability and could be used as an alternative to dispersible formulations, especially in children able to swallow tablets.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 3","pages":"129-136"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653252","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

Investigating low uptake of tuberculin skin testing when integrated with active case-finding for TB. 调查结核菌素皮肤试验与结核病主动病例发现相结合时的低吸收率。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0667

T S Johnson, A Nalutaaya, P Biché, K Ndyabayunga, R Okura, I Mugabi, D Nantale, V Nakiiza, P J Kitonsa, E A Kendall, A Katamba, D W Dowdy

引用次数: 0

Treatment outcomes of pulmonary TB in adults in Indonesia. 印度尼西亚成人肺结核的治疗结果。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0482

R I Sugiyono, A M Naysilla, N H Susanto, D Handayani, E Burhan, A Karuniawati, T Kusmiati, B H Wibisono, B S Riyanto, I G K Sajinadiyasa, I Djaharuddin, B Y M Sinaga, R D Dewantara, M Karyana, H Kosasih, C J Liang, R Ridzon, A T Neal, R Y Chen

{"title":"Treatment outcomes of pulmonary TB in adults in Indonesia.","authors":"R I Sugiyono, A M Naysilla, N H Susanto, D Handayani, E Burhan, A Karuniawati, T Kusmiati, B H Wibisono, B S Riyanto, I G K Sajinadiyasa, I Djaharuddin, B Y M Sinaga, R D Dewantara, M Karyana, H Kosasih, C J Liang, R Ridzon, A T Neal, R Y Chen","doi":"10.5588/ijtldopen.24.0482","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0482","url":null,"abstract":"Background: Achieving the goal of Ending TB requires a treatment success rate of ≥90%, a challenging target for Indonesia. To understand outcomes and associated factors for unfavourable outcomes, we analysed prospective multicentre study data from 2017 to 2020 involving drug-susceptible TB (DS-TB) and multidrug-resistant TB (MDR-TB) treatment adult patients.Methods: This study focused on bacteriologically confirmed participants based on Xpert MTB/RIF or culture results. We analysed participants with available treatment outcomes - cured, completed, failed, dead, and lost to follow-up (LTFU) - excluding withdrawn or transferred. Univariable and multivariable logistic regression analyses identified factors associated with unfavourable outcomes.Results: Among 328 bacteriologically confirmed participants with available outcomes, the overall treatment success was 72.3% (DS-TB: 81.6% and MDR-TB: 60.1%). Unfavourable outcomes were 27.7%, with 3.6% failures, 9.5% deaths, and 14.6% LTFUs. Associated factors for unfavourable outcomes included age ≥50 years (aOR 2.54, 95% CI 1.11-5.95; P = 0.029); being underweight (aOR 1.93, 95% CI 1.05-3.61; P = 0.037); having baseline acid-fast bacilli smear of scanty/+1 (aOR 3.77, 95% CI 1.41-11.65; P = 0.013) or +2/+3 (aOR 3.34, 95% CI 1.31-9.83; P = 0.017); and being treated with MDR-TB regimen (aOR 2.03, 95% CI 1.05-3.96; P = 0.036).Conclusion: Strategies to improve outcomes include tailored care for older adults, nutritional support, treatment monitoring, and enhanced MDR-TB management.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 3","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653004","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

Anthropometric growth trajectories of children presenting with presumptive pulmonary TB. 假定肺结核患儿的人体测量生长轨迹。

IJTLD open Pub Date : 2025-03-12 eCollection Date: 2025-03-01 DOI: 10.5588/ijtldopen.24.0489

M V de Geus, M van Niekerk, C McKenzie, I Dewandel, J Zenhausern, E Wijstma, R Dunbar, H Rabie, A C Hesseling, V W Jongen, M M van der Zalm

{"title":"Anthropometric growth trajectories of children presenting with presumptive pulmonary TB.","authors":"M V de Geus, M van Niekerk, C McKenzie, I Dewandel, J Zenhausern, E Wijstma, R Dunbar, H Rabie, A C Hesseling, V W Jongen, M M van der Zalm","doi":"10.5588/ijtldopen.24.0489","DOIUrl":"10.5588/ijtldopen.24.0489","url":null,"abstract":"Background: This study assessed growth trajectories in children presenting with presumptive pulmonary TB (PTB).Methods: This sub-study of the Umoya TB diagnostic study was conducted in South Africa from November 2017 until November 2021. Children (0-13 years) with presumptive PTB were recruited from and followed up for 12 months. Anthropometric measurements of children with TB, symptomatic controls (TB excluded), and healthy controls were taken at baseline and follow-up (2, 8, 16, 24 and 52 weeks). Changes in weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ) and body mass index for age (BAZ) over time were assessed using multivariable mixed-effect linear regression adjusted for confounders.Results: Of the 372 children included in the analyses (median age: 2 years, IQR 1-4), 153 children had TB, 168 were symptomatic and 51 were healthy controls. Median WAZ was similar between groups; however, more children with TB were underweight than symptomatic and healthy controls. WAZ increased over time for children with TB. Median HAZ of children with TB (-1.34, IQR -2.17 to -0.21) was lower compared to symptomatic (-1.06, IQR -1.90 to -0.10) and healthy controls (-0.74, IQR -1.26 to -0.03; P = 0.0037). There was no significant change over time for HAZ.Conclusion: To improve the long-term outcomes of TB and other illnesses, the overall nutrition of children needs to be improved.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 3","pages":"137-144"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653254","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

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