IJTLD open最新文献_第3页

Effectiveness and safety of a shortened oral regimen for rifampicin- or multidrug-resistant TB. 缩短口服方案治疗利福平或耐多药结核病的有效性和安全性。

IJTLD open Pub Date : 2026-03-13 eCollection Date: 2026-03-01 DOI: 10.5588/ijtldopen.25.0553

E Herrera-Flores, E Shen, D Vargas-Vasquez, F Llanos-Tejada, Z Ruiz-Vargas, J Cornejo-García, D Vela-Trejo, Z M Puyen-Guerra, M C Rojas, D M Guerra, M L Romo, J Jimenez, E Osso, L Trevisi, A LaHood, M L Rich, K J Seung, C D Mitnick, M F Franke, L Lecca, V Alarcon-Guizado

{"title":"Effectiveness and safety of a shortened oral regimen for rifampicin- or multidrug-resistant TB.","authors":"E Herrera-Flores, E Shen, D Vargas-Vasquez, F Llanos-Tejada, Z Ruiz-Vargas, J Cornejo-García, D Vela-Trejo, Z M Puyen-Guerra, M C Rojas, D M Guerra, M L Romo, J Jimenez, E Osso, L Trevisi, A LaHood, M L Rich, K J Seung, C D Mitnick, M F Franke, L Lecca, V Alarcon-Guizado","doi":"10.5588/ijtldopen.25.0553","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0553","url":null,"abstract":"Background: Multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) poses significant challenges to patients, providers, and programmes. We evaluated a 9-month, 5-drug all-oral regimen implemented under operational conditions in Peru.Methods: Between February and September 2023, we enrolled 50 adults with confirmed pulmonary MDR/RR-TB in a prospective observational study conducted within Peru's National Tuberculosis Programme. The regimen consisted of bedaquiline, linezolid, levofloxacin, clofazimine, and delamanid, administered for 9 months and potentially extended to 12 months. We describe the frequency of clinically relevant adverse events of special interest, sputum culture conversion, end-of-treatment outcomes, and changes in dyspnoea and quality of life.Results: Of 50 participants, 24 (48%) were women, and median age was 28.5 years (interquartile range [IQR]: 23-59 years); 38 (76%) had cavitary disease, and 29 (58%) had bilateral disease. Adverse events were infrequent and manageable; only one case of linezolid-associated myelosuppression led to permanent drug discontinuation. Of 33 participants with positive sputum culture, 100% experienced culture conversion (median: 39 days, IQR: 31-61). Favourable end-of-treatment outcomes were observed in 40 (85.1%) (95% confidence interval: 72.3%-92.6%). Quality-of-life and dyspnoea scores improved significantly in those with treatment success.Conclusion: This 9-month oral regimen was effective and safe and improved patient-reported outcomes. These results support broader adoption in national TB programmes across Latin America and beyond.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 3","pages":"144-150"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477939","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

Ultrasound dynamics during treatment of pulmonary and extra-pulmonary TB. 肺结核和肺外结核治疗期间的超声动力学。

IJTLD open Pub Date : 2026-03-13 eCollection Date: 2026-03-01 DOI: 10.5588/ijtldopen.25.0608

S F Weber, F Tobian, M Gaeddert, R Wolf, K Manten, D Shankar, B Thangakunam, B Isaac, A K Dutta, N Wetzstein, M J G T Vehreschild, I Suárez, J Rybniker, P Wolf, F Herth, S Bélard, D J Christopher, C M Denkinger

{"title":"Ultrasound dynamics during treatment of pulmonary and extra-pulmonary TB.","authors":"S F Weber, F Tobian, M Gaeddert, R Wolf, K Manten, D Shankar, B Thangakunam, B Isaac, A K Dutta, N Wetzstein, M J G T Vehreschild, I Suárez, J Rybniker, P Wolf, F Herth, S Bélard, D J Christopher, C M Denkinger","doi":"10.5588/ijtldopen.25.0608","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0608","url":null,"abstract":"Background: Point-of-care ultrasound (POCUS) offers an accessible tool for TB screening, particularly in resource-limited settings. Data on the longitudinal dynamics of sonographic pulmonary (PTB) and extra-pulmonary TB (EPTB) findings during anti-TB treatment (ATT) for potential therapy monitoring remain limited.Methods: This secondary analysis of a prospective, multi-centre accuracy study of adults with presumed TB at one Indian and three German referral hospitals followed up participants undergoing ATT. Participants underwent lung (LUS) and extra-pulmonary ultrasound for pleural effusions, lymphadenopathy (peripheral, abdominal, internal mammary), ascites, and peritoneal pathology, before and during ATT. LUS findings were calculated as a score and compared between time-points.Results: 71 participants were enrolled from January 2022 to July 2023; most had pulmonary pathology (n = 68) or pleural effusion (n = 33). Median LUS scores declined consistently to 86% after 2-3 months of ATT compared to baseline. After 6-8 months, median LUS score was 47%, suggesting persistence of pathology. Pleural effusion showed improvements after 2-3 months in 30%, and peripheral lymphadenopathy persisted in 33% even after ATT completion.Conclusion: Sonographic findings in TB typically resolved with ATT but resolution may be incomplete even after 6 months. This study provides evidence supporting the potential role of ultrasound monitoring for the response of TB to ATT.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 3","pages":"169-176"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477548","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

Lateral-flow urine lipoarabinomannan for TB diagnosis in children. 侧流尿脂阿拉伯糖甘露聚糖对儿童结核诊断的价值。

IJTLD open Pub Date : 2026-03-13 eCollection Date: 2026-03-01 DOI: 10.5588/ijtldopen.25.0401

R Mahajan, L F Nyikayo, Y B Peter Ajack, B T Chol, M Sangma, J Ayor, M J Sagrado, A E Llosa, L Moretó-Planas

{"title":"Lateral-flow urine lipoarabinomannan for TB diagnosis in children.","authors":"R Mahajan, L F Nyikayo, Y B Peter Ajack, B T Chol, M Sangma, J Ayor, M J Sagrado, A E Llosa, L Moretó-Planas","doi":"10.5588/ijtldopen.25.0401","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0401","url":null,"abstract":"Background: Diagnosing childhood TB is challenging due to nonspecific symptoms and difficulty obtaining sputum samples. This study evaluated the urine-based Alere Determine™ TB-LAM Ag test (AlereLAM) in a high-burden TB, HIV, and malnutrition setting.Methods: Médecins Sans Frontières conducted a cross-sectional study in Malakal, South Sudan (October 2021-November 2023). Children (6 months-15 years) with presumptive TB received clinical and laboratory tests, including Xpert-Ultra and AlereLAM, regardless of HIV status. TB was classified as confirmed (Xpert-Ultra positive), unconfirmed (clinical), or unlikely.Results: Of the 276 children (median age: 44 months), 53.3% (147/276) were female, 64.9% (179/276) were severely malnourished, and 9.4% (26/276) were children living with HIV. TB was confirmed in 10.5% (29/276), unconfirmed in 50.7% (140/276), and unlikely in 38.8% (169/276). Overall, AlereLAM positivity was 17.8% (49/276), with higher positivity in confirmed TB (27.6%; 8/29) than unconfirmed (20.0%; 28/140) and unlikely TB (12.1%; 13/107). Using confirmed plus unconfirmed TB as positive and unlikely TB as negative reference standard, sensitivity was 21.3% (95% confidence interval [CI]: 15.4-28.3), specificity 87.9% (95% CI: 80.1-93.4), positive predictive value (PPV) 73.5% (95% CI: 58.9-85.1), and negative predictive value 41.4% (95% CI: 34.9-48.1).Conclusion: AlereLAM's high specificity and PPV support ruling in TB in resource-limited settings, but low sensitivity highlights the need for additional diagnostic tests.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 3","pages":"157-162"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477937","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

From Thomas Mann to John Green, how authors and books shape our understanding of TB. 从托马斯·曼到约翰·格林，作者和书籍如何塑造我们对结核病的理解。

IJTLD open Pub Date : 2026-03-13 eCollection Date: 2026-03-01 DOI: 10.5588/ijtldopen.25.0806

M Pai

引用次数: 0

Sustained outcomes 3 years after all-oral 9-month regimen for rifampicin-resistant TB. 利福平耐药结核病全口服9个月方案后3年的持续结果。

IJTLD open Pub Date : 2026-02-11 eCollection Date: 2026-02-01 DOI: 10.5588/ijtldopen.25.0494

T M P Nguyen, T H M Le, C S C Merle, L Guglielmetti, N L Nguyen, V L Dinh, B H Nguyen, T T T Hoang, V N Nguyen, S Callens, T Decroo

引用次数: 0

Pharmacokinetic modelling as a tool to assess TB treatment adherence: application to the REMEMBER study. 药代动力学建模作为评估结核病治疗依从性的工具：在记忆研究中的应用。

IJTLD open Pub Date : 2026-02-11 eCollection Date: 2026-02-01 DOI: 10.5588/ijtldopen.25.0467

N Abdelgawad, M Chirehwa, H McIlleron, C Kanyama, N Mwelase, A Naidoo, J Kumwenda, M Nyirenda, W P Samaneka, J R Lama, L Mohapi, V Mave, V G Veloso, J Valencia, A Gupta, M C Hosseinipour, K Scarsi, P Denti

{"title":"Pharmacokinetic modelling as a tool to assess TB treatment adherence: application to the REMEMBER study.","authors":"N Abdelgawad, M Chirehwa, H McIlleron, C Kanyama, N Mwelase, A Naidoo, J Kumwenda, M Nyirenda, W P Samaneka, J R Lama, L Mohapi, V Mave, V G Veloso, J Valencia, A Gupta, M C Hosseinipour, K Scarsi, P Denti","doi":"10.5588/ijtldopen.25.0467","DOIUrl":"10.5588/ijtldopen.25.0467","url":null,"abstract":"Background: The REMEMBER (A5274) study found that the four-drug TB preventive regimen did not reduce mortality compared to isoniazid-only, raising adherence concerns. Using drug measurements and pharmacometrics, we assessed adherence in the four-drug arm by comparing participants who developed TB (cases) to those who did not (controls).Methods: Using a 1:4 matched case-control design, we analysed stored blood samples at weeks 2, 4, and 8 since treatment start. Rifampicin and pyrazinamide were measured, and adherence was assessed using two thresholds: i) lower limit of quantification (LLOQ) and ii) personalised thresholds derived from pharmacokinetic simulations. Population pharmacokinetic models and Monte Carlo simulations were used to predict individualised thresholds assuming 100% adherence. Conditional logistic regression compared non-adherence between cases and controls.Results: Among 28 cases and 112 controls, the proportion of samples <LLOQ was 52% (cases) versus 45% (controls) for rifampicin and 20% (cases) versus 14% (controls) for pyrazinamide. Non-adherence was significantly higher in cases compared to controls for two pyrazinamide metrics: the week 4 LLOQ (P = 0.050) and the week 2 2.5th percentile personalised threshold (P = 0.023).Conclusion: Poor adherence may have contributed to TB incidence in REMEMBER. While not definitive, personalised thresholds from model-based simulations remain useful for adherence assessment.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 2","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477915","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

Linkage to TB and HIV care for persons who smoke illicit drugs: a prospective cohort study. 非法吸毒者与结核病和艾滋病毒护理的联系：一项前瞻性队列研究。

IJTLD open Pub Date : 2026-02-11 eCollection Date: 2026-02-01 DOI: 10.5588/ijtldopen.25.0515

S Thomson, V Overbeck, D Theron, B Botha, S Malatesta, T C Bouton, N Niemand Wolhuter, F Ratangee, J I Campbell, N Cesare, S Kulkarni Goodwin, C S Meade, C R Horsburgh, L F White, B Myers, R M Warren, T Carney, K R Jacobson

{"title":"Linkage to TB and HIV care for persons who smoke illicit drugs: a prospective cohort study.","authors":"S Thomson, V Overbeck, D Theron, B Botha, S Malatesta, T C Bouton, N Niemand Wolhuter, F Ratangee, J I Campbell, N Cesare, S Kulkarni Goodwin, C S Meade, C R Horsburgh, L F White, B Myers, R M Warren, T Carney, K R Jacobson","doi":"10.5588/ijtldopen.25.0515","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0515","url":null,"abstract":"Background: Linking people diagnosed with TB and HIV into care is critical. However, many barriers exist to care linkage, especially for people who use drugs (PWUD).Objectives: Characterise differences in TB and HIV care linkage among PWUD in a high-TB/HIV-burden setting.Design: We analysed HIV and TB linkage to care among PWUD who were diagnosed with HIV and/or TB in a prospective study in Worcester, South Africa. We compared care cascades between participants diagnosed with HIV, TB, or both.Results: Among 750 participants screened in the community for HIV and TB, we diagnosed and referred 81 individuals with newly diagnosed (N = 39) or previously diagnosed but untreated (N = 42) HIV, as well as 64 individuals with newly diagnosed TB; 11 of these individuals had HIV/TB co-infection. Linkage was higher for TB care (78%) than HIV care (57% for previously diagnosed and 42% for newly diagnosed). 56% of participants with TB had a favourable treatment outcome, whereas only 23% of people with HIV were retained on antiretroviral therapy 6 months after referral.Conclusion: While many PWUD successfully linked to TB and HIV care, disparities exist between the two cascades in this setting. Systems improvements are needed to facilitate linkage and retention for high-risk populations.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 2","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477956","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

Factors affecting the integration of tobacco cessation services for TB patients. 影响结核病患者综合戒烟服务的因素。

IJTLD open Pub Date : 2026-02-11 eCollection Date: 2026-02-01 DOI: 10.5588/ijtldopen.25.0587

B Loabile, D Ahmed, O Nteba, B Tsima, B Kgwaadira, S Schriger, M Mosepele, F K Barg, R A Schnoll, R Gross

{"title":"Factors affecting the integration of tobacco cessation services for TB patients.","authors":"B Loabile, D Ahmed, O Nteba, B Tsima, B Kgwaadira, S Schriger, M Mosepele, F K Barg, R A Schnoll, R Gross","doi":"10.5588/ijtldopen.25.0587","DOIUrl":"10.5588/ijtldopen.25.0587","url":null,"abstract":"Background: Tobacco smoking remains a serious health threat, especially for patients with TB and HIV. Cessation services may be apt for integration into TB and HIV clinics, particularly in lower- and middle-income countries, where these services often have robust structures. We aimed to identify barriers and facilitators to the integration of smoking cessation within health care services for people with HIV on TB treatment in Botswana.Methods: Using the Consolidated Framework for Implementation Research 2.0, we conducted a convergent parallel mixed-methods study collecting demographic data on current TB patients and semi-structured interviews with patients and providers.Results: We identified four key themes on programme implementation: 1) Tobacco knowledge is necessary but insufficient to facilitate smoking cessation; 2) Providers lack skill to provide cessation services and are apprehensive about interactions with TB patients; 3) An intervention would be desirable but will require additional infrastructure and cannot exclude other non-TB populations; and 4) Leveraging non-governmental implementation partners would be an asset but may also impede programme longevity.Conclusion: Novel approaches are needed to overcome key barriers to the integration of smoking cessation treatments for this important subgroup of smokers, including developing a comprehensive tobacco treatment programme that can extend beyond education and provide critical skills for providers.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 2","pages":"84-90"},"PeriodicalIF":0.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477965","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 avium complex (MAC) elimination slopes from sputum are potential treatment response biomarkers in patients with HIV and pulmonary MAC. 痰液中鸟分枝杆菌复合体（MAC）的消除斜率是HIV和肺部MAC患者潜在的治疗反应生物标志物。

IJTLD open Pub Date : 2026-02-11 eCollection Date: 2026-02-01 DOI: 10.5588/ijtldopen.25.0313

J G Pasipanodya, L Nqwata, J Schmitz, S Srivastava, C N Wanjalla, R S Wallis, K E Dooley

{"title":"Mycobacterium avium complex (MAC) elimination slopes from sputum are potential treatment response biomarkers in patients with HIV and pulmonary MAC.","authors":"J G Pasipanodya, L Nqwata, J Schmitz, S Srivastava, C N Wanjalla, R S Wallis, K E Dooley","doi":"10.5588/ijtldopen.25.0313","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0313","url":null,"abstract":"Background: Lack of quantitative and reproducible treatment response biomarkers is slowing the development of better therapy regimens for pulmonary Mycobacterium avium complex (P-MAC) disease. We hypothesised that steeper bacterial elimination rate slopes (BERSs) would be associated with faster mycobacterial cure and more favourable outcomes.Methods: We retrospectively compared serial sputum culture (SSC) trajectories and outcomes of 29 P-MAC patients, of whom 26/29 (90%) had concurrent HIV infection, treated with guideline-based therapy (GBT) versus non-GBT regimens at a tertiary hospital in Gauteng province of South Africa between 2013 and 2017. We used 'current value' parameterisation of joint models with BERSs as longitudinal biomarkers for the composite outcomes of time-to-death or therapy failure.Results: Overall, initial bacterial burden and BERS trajectories were heterogeneous. BERSs ranged from -0.034 to 0.013 log10 CFU/mL per day. BERSs were significantly steeper in the 18 (62%) censored survivors, with median (interquartile range) -0.011 (-0.021, -0.008), versus 0.002 (-0.008, 0.003) in 11 (38%) non-survivors or therapy failure. In multivariate analyses, one log10 CFU/mL/day decline was associated with an 88% reduction in the hazard for death or therapy failure (95% confidence intervals, 0.04, 0.34).Conclusion: BERSs from sputum are potential P-MAC treatment response biomarkers, which should be evaluated further in larger prospective studies of people with and without HIV.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 2","pages":"97-104"},"PeriodicalIF":0.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477881","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 role of the UNITE4TB Young Investigators Group in empowering early career researchers through mentorship, capacity building, and innovation. UNITE4TB青年研究小组在通过指导、能力建设和创新赋予早期职业研究人员权力方面的作用。

IJTLD open Pub Date : 2026-02-11 eCollection Date: 2026-02-01 DOI: 10.5588/ijtldopen.25.0651

A Vasiliu, F Saluzzo, J A Schildkraut, R Villar-Hernandez, J P Ramos, M Vieira, G Thwaites, D M Cirillo, C Lange, R Duarte

引用次数: 0