IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0050

J Boffa, D Vambe, C Khosa, B José, N Ndjeka, T Nkomo, A W Kay, A M Mandalakas, L Mvusi, S V Omar, S Thi, K Velen, S Charalambous, M X Rangaka

{"title":"TB elimination in Southern Africa: overview and critical reflection.","authors":"J Boffa, D Vambe, C Khosa, B José, N Ndjeka, T Nkomo, A W Kay, A M Mandalakas, L Mvusi, S V Omar, S Thi, K Velen, S Charalambous, M X Rangaka","doi":"10.5588/ijtldopen.25.0050","DOIUrl":"10.5588/ijtldopen.25.0050","url":null,"abstract":"Despite significant progress, TB remains a major public health challenge in Southern Africa. We highlight the key initiatives in Eswatini, Mozambique and South Africa, which have implemented various interventions, including systematic TB screening, TB preventive treatment, targeted next-generation sequencing, targeted universal testing, and shorter drug-resistant and paediatric TB regimens. We also identify the key challenges, such as inconsistent drug access, increasing drug resistance and limited healthcare capacity, which continue to affect progress. Health systems must also balance TB care with broader healthcare priorities, and the integration of TB care into existing services requires further investment in outreach, treatment support and training. Identifying and treating missing people with TB, diagnosing TB in children, and improving treatment adherence remain critical areas requiring enhanced support and resources. While new diagnostic tools and treatments offer promise, their high costs and labour demands present barriers to routine implementation. Successful TB elimination will depend on simple, low-cost prevention, testing and treatment options, tailored to each country's specific needs. All of which will require sustained political commitment, innovation and strategic investments in health system strengthening and community-based care.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 7","pages":"381-387"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629285","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

Non-tuberculous mycobacterial disease in a high TB/HIV burden setting. 结核/艾滋病毒高负担地区的非结核分枝杆菌病。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0205

S Janssen, Z Ismail, T Lovelock, S Hugo, M van Schalkwyk, A Parker, B W Allwood, C F N Koegelenberg, J van Ingen, A van Laarhoven, T Mabuka, H Prozesky, J Taljaard

引用次数: 0

A longitudinal analysis of the economic cost of all phases of TB care in a low incidence setting. 对低发病率环境下结核病治疗各阶段经济成本的纵向分析。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0076

L C Ramsay, S K Brode, E Rea, K Barrett, A Hernandez, N Iragorri, K Liu, L Macdonald, B Sander

{"title":"A longitudinal analysis of the economic cost of all phases of TB care in a low incidence setting.","authors":"L C Ramsay, S K Brode, E Rea, K Barrett, A Hernandez, N Iragorri, K Liu, L Macdonald, B Sander","doi":"10.5588/ijtldopen.25.0076","DOIUrl":"10.5588/ijtldopen.25.0076","url":null,"abstract":"Background: Our objective was to estimate the attributable health care costs associated with TB in Ontario, Canada.Methods: We conducted an incidence-based matched cohort study among individuals diagnosed with TB between April 1, 2002 to December 31, 2016. We matched exposed individuals 1:2 to unexposed individuals using hard and propensity score matching. Using phase-of-care costing, we calculated the mean attributable costs of TB, standardized to 10-day cost, for seven phases of illness: pre-diagnosis, initial treatment, continuation phase, remainder year 1, year 2, post-TB, and prior-to-death. We estimated survival-adjusted attributable mean 1-, 2-, and 5-year costs.Results: We matched 6,456 individuals with TB to 12,443 individuals without TB. Mean (95% CI) attributable 10-day costs was highest in the pre-death phase at $2,656 ($2,207, $3,104), followed by the initial treatment phase at $1,693 ($1,608, $1,778). Hospitalization costs were the largest cost component in each phase. The mean attributable 1-, 2-, and 5-year survival-adjusted costs were $25,586, $30,178, and $33,370, respectively.Conclusion: Individuals with TB have higher health care costs over their lifetime (from pre-diagnosis until death) than individuals without TB.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 7","pages":"404-411"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629279","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

Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease. 广泛非结核性分枝杆菌肺病的早期手术干预。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0127

T-F Kuo, M-R Lee, H-L Huang, K-C Chen, M-W Lin, S-W Kuo, P-M Huang, H-H Chen, J-Y Wang, J-S Chen

{"title":"Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease.","authors":"T-F Kuo, M-R Lee, H-L Huang, K-C Chen, M-W Lin, S-W Kuo, P-M Huang, H-H Chen, J-Y Wang, J-S Chen","doi":"10.5588/ijtldopen.25.0127","DOIUrl":"10.5588/ijtldopen.25.0127","url":null,"abstract":"Background: Adjuvant lung resection surgery benefits selected patients with nontuberculous mycobacterial pulmonary disease (NTM-PD); however, optimal timing remains controversial. This study evaluated surgical outcomes and prognostic factors, with a focus on the timing of surgical intervention.Methods: This study included 41 patients with NTM-PD who underwent adjuvant lung resection surgery between January 2000 and August 2022. Data on patient characteristics, surgical procedures and postoperative outcomes were analyzed. The primary outcome, defined as freedom from unfavorable outcomes (mortality, failure to achieve sputum culture conversion, or microbiological recurrence), was estimated using the Kaplan-Meier method, with prognostic factors analyzed by Cox regression model.Results: Extensive disease was observed in 35 (85%) patients. The median preoperative antibiotic duration was 3.2 months. Twenty-two (54%) patients received lobectomies, whereas 15 (37%) received wedge resections. Thirty-four (83%) achieved sputum culture conversion. The probability of being free from unfavorable outcomes within two years was 80%. Independent favorable prognostic factors included body mass index ≥ 18.5 kg/m2 (p=0.007) and early surgical intervention (preoperative antibiotic duration < 3 months, p=0.039). Additionally, early surgical intervention correlated with shorter operation time (p=0.03).Conclusions: Early surgical intervention, irrespective of the surgical approach, appeared feasible and potentially beneficial even in patients with extensive NTM-PD.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 7","pages":"412-419"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629282","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

Willingness to accept new TB vaccines among adults, adolescents and their caregivers in a high TB burden setting. 在结核病高负担环境中，成人、青少年及其照顾者是否愿意接受新的结核病疫苗。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0177

K N Nelson, L M Cranmer, L Vasudevan, A Lima, S Acacio, A García-Basteiro

引用次数: 0

Conflation of prediction and causality in the TB literature. 结核病文献中预测与因果关系的合并。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0142

M L Romo, L Barcellini, M F Franke, P Y Khan

{"title":"Conflation of prediction and causality in the TB literature.","authors":"M L Romo, L Barcellini, M F Franke, P Y Khan","doi":"10.5588/ijtldopen.25.0142","DOIUrl":"10.5588/ijtldopen.25.0142","url":null,"abstract":"Background: Observational data can answer both predictive and etiologic research questions; however, the model-building approach and interpretation of results differ based on the research goal (i.e., prediction versus causal inference). Conflation occurs when aspects of the methodology and/or interpretation that are unique to prediction or etiology are combined or confused, potentially leading to biased results and erroneous conclusions.Methods: We conducted a rapid review using MEDLINE (2018-2023) of a subset of the observational TB literature: cohort studies among people with drug-resistant TB that considered HIV status an exposure of interest and reported on TB treatment outcomes. For each article, we assessed the research question, statistical approach, presentation of results, and discussion and interpretation of results.Results: Among the 40 articles included, 32 (80%) had evidence of conflation. The most common specific types of conflation were recommending or proposing interventions to modify exposures in a predictive study and having a causal interpretation of predictors, with both types frequently co-occurring.Conclusion: Conflation between prediction and etiology was common, highlighting the importance of increasing awareness about it and its potential consequences. We propose simple steps on how TB and lung health researchers can avoid conflation, beginning with clearly defining the research question.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 7","pages":"388-396"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629280","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 lung function, quality of life, and radiographic findings in children. 儿童结核后肺功能、生活质量和影像学表现。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.24.0675

G L Becker, H Kisembo, Y Sato, L H Wendt, H Aanyu-Tukamuhebwa, R Nantanda, J B Jackson, R J Blount, E Wobudeya

{"title":"Post-TB lung function, quality of life, and radiographic findings in children.","authors":"G L Becker, H Kisembo, Y Sato, L H Wendt, H Aanyu-Tukamuhebwa, R Nantanda, J B Jackson, R J Blount, E Wobudeya","doi":"10.5588/ijtldopen.24.0675","DOIUrl":"10.5588/ijtldopen.24.0675","url":null,"abstract":"Background: The long-term effects of pulmonary TB (PTB) on pediatric lung health are poorly understood. Our objective was to assess predictors of lung function and describe health-related quality of life (QoL) and chest radiograph findings in children following PTB treatment in Kampala, Uganda.Methods: We performed a cross-sectional study of children aged 6-16 years who completed PTB treatment within the last five years compared to household controls with no history of active TB. Children underwent chest radiograph, St. George's Respiratory Questionnaire, and spirometry. Mixed-effects regression models were performed to assess predictors of lung function impairment.Results: We enrolled 73 children with prior TB and 49 controls. In univariate mixed-effects regression models, prior TB was associated with lower FEV1 and FVC Z-scores (p<0.05). In multivariate models, BMI-for-age Z-score predicted FVC-Z-score (p<0.001). Fibrosis and pleural thickening were common radiographic abnormalities among children with prior TB. Median SGRQ total score was higher among children with prior TB (p<0.001).Conclusion: Children with prior TB showed reduced lung function and QoL compared to household controls. Our findings support the need for routine clinical follow-up after TB treatment.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 7","pages":"427-433"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629284","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 Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0174

B Tsogt, J T Denholm, N Dambaa, T Sambuu, N Tsegeen, G Munkhjargal, A Chuluunbaatar, G Dorj, G Sukhbaatar, O Adilaa, D Dalai, O Batmunkh, Z Khukhkhuukhen, B Ulziikhutag, Kh Jargalsaikhan, N Moyo, S M Graham

{"title":"TB-related stigma is widely prevalent among people with TB and carers in Mongolia.","authors":"B Tsogt, J T Denholm, N Dambaa, T Sambuu, N Tsegeen, G Munkhjargal, A Chuluunbaatar, G Dorj, G Sukhbaatar, O Adilaa, D Dalai, O Batmunkh, Z Khukhkhuukhen, B Ulziikhutag, Kh Jargalsaikhan, N Moyo, S M Graham","doi":"10.5588/ijtldopen.25.0174","DOIUrl":"10.5588/ijtldopen.25.0174","url":null,"abstract":"Background: In Mongolia, estimated TB incidence is high, but treatment coverage is low. Stigma is a likely barrier to access but has not previously been evaluated.Methods: We conducted a national TB stigma assessment in Mongolia in 2021-2022 to evaluate prevalence and impact of TB-related stigma. All survey participants had face-to-face interviews conducted by trained community staff members using semi-structured questionnaires tailored to study participants.Results: Study participants included 460 people with TB, 90 family members, 83 community members and 115 healthcare workers (HCWs). Overall, 53% of participants reported experiencing stigma with HCWs reporting highest prevalence (72%). Stigma was most commonly experienced in healthcare settings, particularly during initial diagnosis and treatment initiation. Urban slum residence was associated with higher stigma among patients while older age was associated with lower scores. Female respondents reported stigma significantly more commonly overall. Family members and community members commonly reported secondary stigma with concerns about infection and social isolation being prevalent.Conclusion: TB-related stigma is highly prevalent across Mongolia. There is an urgent need for comprehensive stigma-reduction strategies that extend beyond PWTB and their families to also include HCWs and broader community.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 7","pages":"420-426"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629286","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 RISK6 assay in childhood pulmonary TB. RISK6检测对儿童肺结核诊断的准确性。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.24.0603

S Pouzol, M K M Uddin, A Islam, T Alam, M S Jabin, S Banu, J Hoffmann

{"title":"Diagnostic accuracy of RISK6 assay in childhood pulmonary TB.","authors":"S Pouzol, M K M Uddin, A Islam, T Alam, M S Jabin, S Banu, J Hoffmann","doi":"10.5588/ijtldopen.24.0603","DOIUrl":"10.5588/ijtldopen.24.0603","url":null,"abstract":"Background: The WHO recently updated the target product profile (TPP) for TB identification at the peripheral level to guide test development.Methods: We conducted a prospective diagnostic accuracy study among outpatients under 15 years old with presumed pulmonary TB at the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) Dhaka Hospital. We evaluated the accuracy of the RISK6 assay and performed a cost-per-TB case identification analysis.Results: Of 365 enrolled children, 68 had microbiologically confirmed TB, 94 had unconfirmed TB and 203 were unlikely to have TB. RISK6 did not meet the TPP for TB diagnosis in children but in presumptive pulmonary TB individuals ≤ 12 months, the assay outperformed (32/42) both the Mantoux test (7/42) and chest X-ray (11/42) in correctly referring individuals for confirmatory testing. RISK6, alone or in combination with Mantoux test, was the most cost-effective strategy for identifying and confirming TB, with a cost as low as $US132.00 in children > 12 months.Conclusion: Although RISK6 did not meet the WHO TPP for TB diagnosis, it shows promise as a triage test, especially for children ≤ 12 months, and could serve as a decision-support tool in integrated treatment algorithms recommended by the WHO.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"2 7","pages":"397-403"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629281","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

Underutilisation of GeneXpert devices for TB diagnosis: a missed opportunity. 未充分利用GeneXpert设备进行结核病诊断：一个错失的机会。

IJTLD open Pub Date : 2025-07-09 eCollection Date: 2025-07-01 DOI: 10.5588/ijtldopen.25.0143

J Dörfler, O G Ravololohanitra, T Decroo, M A Franke, J Emmrich, G I Pasteur, E A Harizaka, N Muller

引用次数: 0

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