IJTLD open最新文献_第6页

Impact of bedaquiline resistance probability on treatment decision for rifampicin-resistant TB. 贝达喹啉耐药概率对耐利福平肺结核治疗决策的影响。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0362

T P H Trang, R Kessels, T Decroo, A Van Rie

{"title":"Impact of bedaquiline resistance probability on treatment decision for rifampicin-resistant TB.","authors":"T P H Trang, R Kessels, T Decroo, A Van Rie","doi":"10.5588/ijtldopen.24.0362","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0362","url":null,"abstract":"Background: Accurate diagnosis of bedaquiline (BDQ) resistance remains challenging. A Bayesian approach expresses this uncertainty as a probability of BDQ resistance (prBDQR) with a 95% credible interval. We investigated how prBDQR information influences BDQ prescribing decisions.Method: We performed a discrete choice experiment with 55 international rifampicin-resistant tuberculosis physicians. We employed mixed-effects multinomial logistic regression to quantify the effect of prBDQR, patient attributes, and contextual factors on the decision to continue BDQ or not when sequencing results become available.Results: PrBDQR was the most influential factor for BDQ decision-making, three times greater than treatment response. Each percentage point increase in prBDQR resulted in 8.2% lower odds (OR 0.92, 95% CI 0.90-0.93) of continuing BDQ as a fully effective drug and 5.0% lower odds (OR 0.95, 95% CI 0.94-0.96) of continuing it but not counting it as an effective drug. The most favourable patient profile for prescribing BDQ as a fully effective drug was a patient receiving the BPaLM regimen (BDQ, pretomanid, linezolid and moxifloxacin) with low prBDQR, good 1-month treatment response, fluoroquinolone-susceptible TB, and no prior BDQ treatment. Physicians with higher discomfort with uncertainty and more years of experience with BDQ were more inclined to stop BDQ.Conclusion: Given the uncertainty of genotype-phenotype associations, physicians valued prBDQR for BDQ decision-making in rifampicin-resistant TB treatment.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"1 9","pages":"384-390"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306124","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

Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan. 乌兹别克斯坦卡拉卡尔帕克斯坦的二线耐药结核病及相关风险因素。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0351

S Moe, I Azamat, S Allamuratova, M Oluya, A Khristusev, M L Rekart, K Mamitova, G Bidwell, C Gomez-Restrepo, B Kalmuratov, Z Tigay, N Parpieva, K Safaev, N Sitali, D Gomez, A Mikhail, A Sinha

{"title":"Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan.","authors":"S Moe, I Azamat, S Allamuratova, M Oluya, A Khristusev, M L Rekart, K Mamitova, G Bidwell, C Gomez-Restrepo, B Kalmuratov, Z Tigay, N Parpieva, K Safaev, N Sitali, D Gomez, A Mikhail, A Sinha","doi":"10.5588/ijtldopen.24.0351","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0351","url":null,"abstract":"Background: Drug-resistant TB (DR-TB) remains a major public health threat. In 2022, Uzbekistan reported 2,117 cases of DR-TB, with 69% tested for fluoroquinolone resistance. Limited information is available on the prevalence of resistance to bedaquiline, linezolid, and fluoroquinolone, which are key components of the all-oral treatment regimen for rifampicin-resistant TB in Uzbekistan.Methods: A retrospective study was conducted using extensive programmatic data from 2019 to 2023 in Uzbekistan. We assessed second-line drug-resistant TB (SLDR-TB) rates using phenotypic drug susceptibility testing (pDST). Demographic and clinical characteristics associated with SLDR-TB were analysed using multivariable logistic regression models based on the Allen-Cady approach.Results: In total, 2,405 patients with TB who had undergone pDST were included (median age 40 years, 47% female). The overall SLDR-TB resistance rate was 24% (95% CI 22-26). Prevalence of resistance to bedaquiline, linezolid, moxifloxacin, levofloxacin, and amikacin were respectively 3.1%, 0.8%, 15%, 13%, and 12%. Risk factors for SLDR-TB were resistance to rifampicin and/or isoniazid, exposure to clofazimine, retreatment status, contact with drug-susceptible TB case or DR-TB case, and diabetes.Conclusions: The high prevalence of SLDR-TB is of major concern, emphasising the need for baseline pDST in RR-TB treatment. Identified risk factors can aid early detection of at-risk individuals and inform clinical practice.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"1 9","pages":"391-397"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306128","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

Impact of race-neutral global reference equations on spirometry interpretation in healthy children in The Gambia. 种族中立的全球参考方程对冈比亚健康儿童肺活量测定解释的影响。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0224

E Nkereuwem, V F Edem, O Owolabi, M Genekah, S A Owusu, E D McCollum, B Kampmann, T Togun

引用次数: 0

Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023. 2018-2023年世卫组织东地中海地区耐药结核病方案管理进展情况。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0348

K Bennani, M van den Boom, M G ElMedrek, Y Hutin

{"title":"Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023.","authors":"K Bennani, M van den Boom, M G ElMedrek, Y Hutin","doi":"10.5588/ijtldopen.24.0348","DOIUrl":"10.5588/ijtldopen.24.0348","url":null,"abstract":"Background: Since 2012, WHO has supported countries in scaling up programmatic management of drug-resistant tuberculosis (PMDT). We assessed progress and challenges to formulate recommendations for improvement.Methods: We reviewed the regional Green Light Committee (rGLC)mission reports and analysed data to describe the progression of programme indicators.Results: The proportion of TB patients initially tested using Xpert MTB/RIF rose from 5% in 2017 to 54% in 2022. Testing for rifampicin-resistant TB (RR-TB) increased from 4% in 2015 to 68% in 2022 among new patients and from 17% in 2015 to 94% in 2022 among those previously treated. Consequently, in 2021-2022, the number of multidrug-resistant (MDR)/RR-TB patients diagnosed increased by 29% and 84% of them were treated, accounting for 22% of estimated cases. By 2023, fourteen countries had implemented all-oral regimens, with three initiating the 6-month bedaquiline, pretomanid, linezolid, and moxifloxacin regimen (BPaL(M)). MDR/RR-TB treatment success increased from 64% in 2017 to 73% in 2020.Conclusions: Eastern Mediterranean Region countries progressed in PMDT using Xpert MTB/RIF, increased diagnosis and treatment of MDR/RR-TB patients using all-oral regimens, and improved treatment success. They must now enhance diagnostic capacity using WHO-recommended diagnostics, decentralise services while integrating them into primary health care, and prioritise the BPaL(M) regimen.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"1 9","pages":"398-403"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306127","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

Cartridge-based sequencing for bedaquiline resistance detection from sputum. 从痰中检测贝达喹啉耐药性的盒式测序法。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0124

J D Limberis, R J Nagel, D Block, R E Colman, A Nalyvayko, Z Howard, S Dewell, S Chakravorty, J Z Metcalfe

引用次数: 0

One step further: improving paediatric TB diagnosis through user-centred research approaches. 更进一步：通过以用户为中心的研究方法改进儿科结核病诊断。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0389

F W Basile, E M Bijker, M Sekadde, S E Dorman, J J Ellner, N Engel, M Ruhwald, R Song

引用次数: 0

Three months of weekly rifapentine plus isoniazid for TB prevention among people with HIV. 为预防艾滋病病毒感染者感染结核病，每周服用利福喷丁加异烟肼三个月。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.23.0609

R Borse, B Randive, S Mattoo, P Malik, H Solanki, A Gupta, R E Chaisson, V Mave, N Suryavanshi

{"title":"Three months of weekly rifapentine plus isoniazid for TB prevention among people with HIV.","authors":"R Borse, B Randive, S Mattoo, P Malik, H Solanki, A Gupta, R E Chaisson, V Mave, N Suryavanshi","doi":"10.5588/ijtldopen.23.0609","DOIUrl":"10.5588/ijtldopen.23.0609","url":null,"abstract":"Background: Evidence on implementation of three months of weekly isoniazid (H, INH) and rifapentine (P, RPT) (3HP) as a TB preventive therapy (TPT) for at-risk groups in Indian programmatic conditions is limited.Methods: A prospective demonstration study assessing scale-up, safety, and effectiveness of 3HP TPT among people living with HIV (PLHIV) in Indian programmatic settings was conducted.Results: Of 656 screened PLHIV, 502 (77%) received 3HP. Of these, 20 (4%) discontinued TPT due to toxicity,17 (3.8%) lost to follow-up, one (0.2%) had breakthrough rifampicin-sensitive TB, and 464 (92%) completed 3 HP TPT. Of 288 (57%) overall adverse events (AEs), 46 (9%) had Grade 2 or above AEs. The median time to AE was 14 days (IQR 7-42). Serious adverse events (SAEs) were reported in 9 (2%) participants; of these, 7 (78%) were not related to 3HP. No TB episodes occurred during the 1-year follow-up period.Conclusion: 3HP TPT completion rate of 92%, with few adverse events leading to 3HP discontinuation, providing evidence of the scalability and safety of 3HP TPT among PLHIV in Indian health program settings.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"1 9","pages":"404-409"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306130","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 intersection of TB and health financing: defining needs and opportunities. 结核病与卫生筹资的交集：确定需求与机遇。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0324

W A Wells, S Waseem, S Scheening

引用次数: 0

A pilot program to improve TB care with primary and specialty care coordination in TB public health clinic. 在结核病公共卫生诊所开展一项试点计划，通过协调初级和专科护理，改善结核病护理。

IJTLD open Pub Date : 2024-09-01 DOI: 10.5588/ijtldopen.24.0302

P Jadhav, G Boudoin, R Miles, S Seymour, J Parham, A Wolfe, J Ali

引用次数: 0

Yield of TB screening in prisons in Tajikistan. 塔吉克斯坦监狱结核病筛查的成果。

IJTLD open Pub Date : 2024-08-01 DOI: 10.5588/ijtldopen.24.0272

S Moe, M Asozoda, A Aung, Z Dusmatova, F Akintore, E Nshimiyimana, A Zavqibekov, N Sitali, W K Mulanda, T Cullip, A Sinha

{"title":"Yield of TB screening in prisons in Tajikistan.","authors":"S Moe, M Asozoda, A Aung, Z Dusmatova, F Akintore, E Nshimiyimana, A Zavqibekov, N Sitali, W K Mulanda, T Cullip, A Sinha","doi":"10.5588/ijtldopen.24.0272","DOIUrl":"10.5588/ijtldopen.24.0272","url":null,"abstract":"Background: The rate of TB in prison institutions is estimated to be 23 times higher than in the general population. Limited documentation exists regarding TB screening in Tajikistan's prisons. This study aims to report findings from a TB screening conducted in prison facilities in Tajikistan.Methods: A systematic TB screening was conducted between July 2022 and September 2023, following a locally adapted algorithm based on WHO recommendations. The screening yield was calculated as the proportion of confirmed TB cases, with categorical variables compared using a χ2 test.Results: A total of 7,223 screenings were conducted, identifying 31 TB cases, including 17 drug-susceptible TB cases, eight drug-resistant TB cases, and six clinically diagnosed cases. The overall screening yield was 0.43%. Notably, the screening yield was 3.4% among individuals with at least one TB symptom and 0.03% among those without TB symptoms (P < 0.001).Conclusion: The identified rate of TB in these prisons is five times higher than in the general population. Symptomatic individuals had a higher likelihood of TB diagnosis, and using chest X-rays significantly improved screening yield. We recommend increasing the capacity for chest X-ray testing to enhance TB prevention and control within prison settings.","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"1 8","pages":"344-348"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11308400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918597","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