IJID regionsPub Date : 2025-03-01DOI: 10.1016/j.ijregi.2025.100600
Gahee Kim , Unyeong Go , Gyuri Park , Yujin Kim , Hyeran Jeong , Ahyoung Park , Young-Joon Park
{"title":"Latent tuberculosis infection screening program for school teachers in South Korea, 2018","authors":"Gahee Kim , Unyeong Go , Gyuri Park , Yujin Kim , Hyeran Jeong , Ahyoung Park , Young-Joon Park","doi":"10.1016/j.ijregi.2025.100600","DOIUrl":"10.1016/j.ijregi.2025.100600","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to outline the processes and identify key success factors of the 2018 latent tuberculosis (TB) infection (LTBI) screening program for high school teachers in Korea, conducted as part of a series of large-scale screening initiatives.</div></div><div><h3>Methods</h3><div>In 2018, we screened 4692 school teachers from 121 schools, and the data were recorded in the “TB-net” of the Korea Disease Control and Prevention Agency (KDCA). We analyzed the characteristics of the examinees by sex and age, in addition to the LTBI rate, and the initiation and completion rate of TB preventive treatment (TPT).</div></div><div><h3>Results</h3><div>Of the 4692 teachers screened, the LTBI prevalence was 20.0%, with rates increasing with age. Among the 938 individuals diagnosed with LTBI, 31.0% initiated TPT. Of these, 226 individuals completed treatment, yielding a treatment completion rate of 77.7%. The preferred treatment regimens were 3 months isoniazid + rifampin (3HR) (83.8%), 4 months rifampin (4R) (13.7%), and 9 months isoniazid (2.4%). Completion rates were highest among those on the 4R regimen (87.5%), followed by the 3HR regimen (77.0%).</div></div><div><h3>Conclusions</h3><div>The success of this program can be attributed to a comprehensive and well-structured process that included prior education and informed consent, screenings and treatments conducted in designated clinics and hospitals, and robust side-effect management for TPT.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100600"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645089","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}
IJID regionsPub Date : 2025-03-01DOI: 10.1016/j.ijregi.2025.100605
Meher Rizvi , Shalini Malhotra , Hiba Sami , Jyotsna Agarwal , Areena H. Siddiqui , Sheela Devi , Aruna Poojary , Bhaskar Thakuria , Isabella Princess , Aarti Gupta , Amal Al Malehi , Asfia Sultan , Ashish Jitendranath , Balvinder Mohan , Fatima Khan , Hatim El Tahir , Nainaraj Ilanchezhiyan , Mannu Jain , Maria Khan , Narendra Pal Singh , Neelam Taneja
{"title":"Klebsiella pneumoniae urinary tract infection: A multicentric study highlights significant regional variations in antimicrobial susceptibility across India","authors":"Meher Rizvi , Shalini Malhotra , Hiba Sami , Jyotsna Agarwal , Areena H. Siddiqui , Sheela Devi , Aruna Poojary , Bhaskar Thakuria , Isabella Princess , Aarti Gupta , Amal Al Malehi , Asfia Sultan , Ashish Jitendranath , Balvinder Mohan , Fatima Khan , Hatim El Tahir , Nainaraj Ilanchezhiyan , Mannu Jain , Maria Khan , Narendra Pal Singh , Neelam Taneja","doi":"10.1016/j.ijregi.2025.100605","DOIUrl":"10.1016/j.ijregi.2025.100605","url":null,"abstract":"<div><h3>Objectives</h3><div>Knowledge of local antibiotic susceptibility rates is essential to strengthen antimicrobial stewardship programs. <em>DASH to Protect Antibiotics</em> (<span><span>https://dashuti.com/</span><svg><path></path></svg></span>), promotes the dissemination of focused local antibiograms in community urinary tract infection (UTI). This study mapped the susceptibility profile of <em>Klebsiella pneumoniae</em> from 18 Indian centers.</div></div><div><h3>Methods</h3><div>The centers spanned nine Indian States and three Union Territories. Urinary <em>K. pneumoniae</em> antibiograms from the outpatient clinic were collated and analyzed. Standardization was achieved through online training. For epidemiological purposes, five centers tested fosfomycin.</div></div><div><h3>Results</h3><div>Overall, low susceptibility (<60%) was observed for the standard oral antibiotics prescribed for cystitis: co-trimoxazole, 54% (36-68%); ciprofloxacin, 52% (29-55%); amoxicillin-clavulanic acid, 46%, (35-82%); nitrofurantoin, 39% (19-78%); and cefuroxime, 30% (15-62%). The rates for third- and fourth-generation cephalosporins were 49% (45-52%) and 60% (36-76%), respectively. Extended-spectrum beta-lactamases ranged from 36-61% in India. Piperacillin-tazobactam 74% (65-87%), amikacin 76% (45-91%), and meropenem 81% (61-87%) exhibited higher activity. Fosfomycin was the most active antimicrobial, with 89% (92-97%) susceptibility. <em>K. pneumoniae</em> susceptibility was directly linked to geographic region, log gross domestic product (<em>P</em> <0.001), and humidity, and low and high temperatures (<em>P</em> <0.05).</div></div><div><h3>Conclusions</h3><div>Oral treatment options for <em>K. pneumoniae</em> cystitis are rapidly decreasing. Northern and southern India showed significant differences in antimicrobial susceptibility, highlighting the importance of local antibiograms for promoting antimicrobial stewardship. For uncomplicated cystitis, co-trimoxazole (54%) may be the empirical choice. Good susceptibility to fosfomycin was observed (89%). The empirical use of fluoroquinolones, cephalosporins, and amoxicillin-clavulanic acid has been discouraged. Piperacillin-tazobactam and aminoglycosides are carbapenem-sparing agents.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100605"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601822","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}
IJID regionsPub Date : 2025-03-01DOI: 10.1016/j.ijregi.2025.100615
Raman Swathy Vaman , George Dilu Thomas , Madhanraj Kalyanasundaram , Surabhi Soman , Mathew J. Valamparampil , Rakesh Puroshothama Bhat Susheela , Manoj V. Murhekar
{"title":"Adverse drug reactions in persons initiated on treatment for drug-resistant tuberculosis in Kerala, India: A non-concurrent cohort study","authors":"Raman Swathy Vaman , George Dilu Thomas , Madhanraj Kalyanasundaram , Surabhi Soman , Mathew J. Valamparampil , Rakesh Puroshothama Bhat Susheela , Manoj V. Murhekar","doi":"10.1016/j.ijregi.2025.100615","DOIUrl":"10.1016/j.ijregi.2025.100615","url":null,"abstract":"<div><h3>Objectives</h3><div>We conducted a study to estimate the incidence of adverse drug reactions (ADRs) in the drug-resistant tuberculosis (DR-TB) cohort in Kerala in 2020 and describe the characteristics of the reported ADRs.</div></div><div><h3>Methods</h3><div>A non-concurrent cohort study was conducted among all patients with DR-TB across 14 districts in Kerala from January 1, 2020 to December 31, 2020. We collected data on ADRs from patients, “Nikshay” web-portal, treatment cards, case sheets, and registers. We described ADRs by organ system, causality, severity, preventability, predictability, and seriousness of the reaction using standard tools.</div></div><div><h3>Results</h3><div>Of the 364 persons initiated on treatment, 304 (83.5%) had at least one of the 28 listed adverse reactions, with an incidence of 27.6 ADR per 100 person-months of treatment. Gastrointestinal disorders had the highest incidence 365 per 1046 (35%). A total of 1001 of 1046 (95.7%) ADRs were non-predictable, and 405 of 1046 (39%) were definitely preventable. A total of 83 of 304 (27.3%) patients had severe ADR, and 56 of 304 (18.4%) had serious ADR. A total of 87 of 304 (28.6%) patients with ADR required interruption of the probable offending drug, with 64 of 87 (73.6%) temporary and 23 of 87 (26.4%) permanent interruptions.</div></div><div><h3>Conclusions</h3><div>Four-fifths of all patients on therapy had at least one of the 28 listed adverse reaction and one-fifth had serious ADR. ADRs can lead to treatment interruptions. Early detection and prompt management is essential for improving treatment outcomes in patients with DR-TB.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"15 ","pages":"Article 100615"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681219","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}
IJID regionsPub Date : 2025-03-01DOI: 10.1016/j.ijregi.2025.100595
Amal Al Maani , Eskild Petersen , Ziad A. Memish
{"title":"The critical role of new tuberculosis vaccines in achieving the WHO 2035 End TB target","authors":"Amal Al Maani , Eskild Petersen , Ziad A. Memish","doi":"10.1016/j.ijregi.2025.100595","DOIUrl":"10.1016/j.ijregi.2025.100595","url":null,"abstract":"<div><div>This perspective article, in recognition of World TB Day 2025, highlights the essential role that new tuberculosis (TB) vaccines play in meeting the World Health Organization's goal of ending TB by 2035. The article does not provide a comprehensive review of all vaccine candidates but emphasizes the urgent need for novel TB vaccines, given the limitations of the bacillus Calmette-Guérin vaccine and the increasing threat of drug-resistant strains. As TB continues to be a leading cause of global morbidity and mortality, with an estimated 10.8 million new cases in 2023, it is evident that current strategies are insufficient. Although advancements in vaccine research, including candidates such as M72/AS01E, show promise, the article underscores that achieving TB elimination requires vaccines that can prevent TB infection reactivation and transmission of drug-resistant strains. Overcoming scientific, logistical, and distribution challenges, particularly, in high-burden regions, will be critical to accelerating the availability of these vaccines. The article calls for intensified global collaboration and sustained investment in research to accelerate the development of novel vaccines, which are indispensable for reaching the World Health Organization's ambitious 2035 TB elimination targets.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100595"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645088","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}
{"title":"Lessons and updates from India's National Tuberculosis Elimination Program – bold decisions and innovative ways of fast-tracking progress toward ending tuberculosis","authors":"Urvashi B. Singh , Kirankumar Rade , Raghuram Rao , Nishant Kumar , Sanjay Kumar Mattoo , Sreenivas Nair , Alimuddin Zumla , Suvanand Sahu","doi":"10.1016/j.ijregi.2025.100599","DOIUrl":"10.1016/j.ijregi.2025.100599","url":null,"abstract":"<div><div>India has the highest burden of tuberculosis (TB) globally. Strong political commitment, bold targets, and innovations have been the hallmark of the TB response. Lessons learned in India, such as understanding the diversity of TB epidemiology, approaches beyond conventional response strategies, bold decisions, and innovations, are invaluable for the global TB response. The India TB response is supported by strong political commitment cascading from the Prime Minister to local stakeholders. An initial key step was the sub-national assessment of the diverse TB burden and recognition of the public and private health care landscape. India effectively demonstrated innovative models to meaningfully engage all stakeholders, leveraging technology to bridge gaps. Community participation and social engineering movements were used to reduce stigma and address the nutritional needs of TB patients. Patient-support systems through an innovative adoption program, crowdsourced solutions, and direct benefit cash transfers were implemented to mitigate the socio-economic impact of TB. Decentralized initiatives such as the TB-Free Panchayat, district, and city schemes empowered local stakeholders and encouraged healthy sub-national competition. Advances in research and development of screening tools, rapid molecular diagnostics, real-time integrated digital surveillance systems such as Ni-kshay, and innovations such as telemedicine, call centers, direct benefit transfers, and artificial intelligence (AI)-based tools are accelerating the TB response in India.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100599"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644954","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}
{"title":"Comparison of risky sexual behavior: Evidence from Zimbabwe Population-Based HIV Impact Assessment 2020","authors":"Solomon Mukwenha , Munyaradzi Mapingure , Tafadzwa Dzinamarira , Enos Moyo , Elliot Mbunge , Rutendo Birri Makota , Tapiwa Dhiwayo , Innocent Chingombe , Amon Mpofu , Owen Mugurungi , Godfrey Musuka","doi":"10.1016/j.ijregi.2025.100607","DOIUrl":"10.1016/j.ijregi.2025.100607","url":null,"abstract":"<div><h3>Objectives</h3><div>Risky sexual behaviors are associated with the acquisition of sexually transmitted infections, including HIV/AIDS. Understanding the intricate dynamics of sexual behavior is pivotal in the relentless pursuit of curtailing the HIV epidemic. To compare risky sexual behaviors based on knowledge of HIV status and viral suppression.</div></div><div><h3>Methods</h3><div>Data from 2958 people living with HIV who participated in a Zimbabwe Population-Based HIV Impact Assessment were used to determine the association between risky sexual behaviors, awareness of HIV status, and viral load suppression.</div></div><div><h3>Results</h3><div>The number of partners in the last 12 months was associated with the first 90 of the 90-90-90, with those who were unaware of their HIV status having more partners than those who were aware, adjusted odds ratio (aOR) = 1.18, 95% (confidence interval [CI]: 1.03-1.35). Those who did not use a condom during the last sexual encounter with a non-regular partner in the last 12 months were more likely to be unaware of their status, aOR = 2.11, (95% CI: 1.28-3.50). Those who did not use a condom at their last sexual encounter were more likely to be virally unsuppressed (aOR 2.25, 95% CI: 1.78-2.85). Women were less likely to be virally unsuppressed than men.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that gaps in HIV knowledge and viral suppression are critical factors in ongoing HIV transmission. To effectively curb HIV transmission, preventive interventions should prioritize individuals who are unaware of their HIV status or those who are virally unsuppressed, addressing these gaps to reduce risky sexual behaviour and the potential for further transmission.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100607"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562010","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}
IJID regionsPub Date : 2025-03-01DOI: 10.1016/j.ijregi.2025.100603
Felix Bongomin , Ritah Nantale , Joseph Baruch Baluku , Tobius Odongo , Shamim Katusabe , Nixson Oyoo , Martin Muddu , Norman van Rhijn , David W Denning
{"title":"Baseline knowledge on chronic pulmonary aspergillosis and tuberculosis among health care workers involved in tuberculosis care in Uganda","authors":"Felix Bongomin , Ritah Nantale , Joseph Baruch Baluku , Tobius Odongo , Shamim Katusabe , Nixson Oyoo , Martin Muddu , Norman van Rhijn , David W Denning","doi":"10.1016/j.ijregi.2025.100603","DOIUrl":"10.1016/j.ijregi.2025.100603","url":null,"abstract":"<div><h3>Objectives</h3><div>Chronic pulmonary aspergillosis (CPA) often mimics pulmonary tuberculosis (PTB), leading to misdiagnosis and inappropriate management. We aimed to determine the baseline knowledge, practices, and self-rated confidence of health care workers (HCWs) regarding CPA in Uganda.</div></div><div><h3>Methods</h3><div>Between January and April 2024, we conducted a cross-sectional survey involving HCWs at four public health facilities in Uganda currently enrolling patients with current or previously treated for PTB into a cohort study aimed at establishing the incidence of CPA. Data on sociodemographic characteristics, awareness, knowledge, practices regarding CPA, PTB, and finger-prick tests for point of care testing were collected using semi-structured questionnaires. Adequate knowledge was defined as a score of ≥80%.</div></div><div><h3>Results</h3><div>A total of 110 HCWs participated, predominantly males (61, 57.5%), with a mean age of 38.8 years. Although most HCWs had heard of aspergillosis (78, 82.1%), only 23 (21.7%) demonstrated adequate knowledge about CPA. In addition, 25 (28.7%) reported encountering a patient with CPA in the past year, with 41 (47.1%) never routinely screening for CPA. Confidence in managing CPA was low among HCWs, with 29 (29.8%) expressing no confidence. Furthermore, only 22 (20.8%) had adequate knowledge about PTB. Referral hospital practice was significantly associated with higher odds of adequate CPA knowledge (adjusted odds ratio: 6.69, 95% confidence interval: 1.67-26.82, <em>P</em> = 0.007).</div></div><div><h3>Conclusions</h3><div>There are significant gaps in awareness, knowledge, and practices of HCWs in Uganda related to CPA and PTB. Strategies to enhance training, guideline dissemination, and diagnostic capacity are essential to improve the management of these respiratory conditions and reduce misdiagnosis.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100603"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601823","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}
IJID regionsPub Date : 2025-03-01DOI: 10.1016/j.ijregi.2025.100606
Isaac Osei , Baleng Mahama Wutor , Alieu Kuyateh , Ousman Barjo , Golam Sarwar , Mayowa Omotosho , Williams Oluwatosin Adefila , Yusuf Abdulsalam Olawale , Keita Modou Lamin , Ilias Hossain , Babila G. Lobga , Muhammed Wally , Morr Cham , Minteh Molfa , Rasheed Salaudeen , Grant A. Mackenzie
{"title":"Blood culture time to positivity in pediatric patients with bloodstream infection in rural Gambia","authors":"Isaac Osei , Baleng Mahama Wutor , Alieu Kuyateh , Ousman Barjo , Golam Sarwar , Mayowa Omotosho , Williams Oluwatosin Adefila , Yusuf Abdulsalam Olawale , Keita Modou Lamin , Ilias Hossain , Babila G. Lobga , Muhammed Wally , Morr Cham , Minteh Molfa , Rasheed Salaudeen , Grant A. Mackenzie","doi":"10.1016/j.ijregi.2025.100606","DOIUrl":"10.1016/j.ijregi.2025.100606","url":null,"abstract":"<div><h3>Objectives</h3><div>There is a lack of data on the time to blood culture positivity (TTP) in pediatric populations in low-income countries. We aimed to assess the host and pathogen factors associated with TTP in children aged under 5 years in rural Gambia.</div></div><div><h3>Methods</h3><div>Between September 2019 and December 2023, we collected blood cultures from children under 5 years with suspected bloodstream infections. We determined the TTP from the time of culture incubation to when bacterial growth was first detected.</div></div><div><h3>Results</h3><div>Overall, 547 invasive bacteria pathogens were evaluated. The median TTP was 19.2 hours and 70%, 76%, 89%, and 96% of cases had TTP at 24, 36, 48, and 72 hours, respectively. <em>Streptococcus pneumoniae</em> had the shortest median TTP (17.4 hours), whereas <em>Neisseria</em> species had the longest (45 hours). TTP was dependent on the pathogen and independent of age, sex, temperature, clinical outcome, nutritional status, and length of hospital stay. Gram-positive bacteria had shorter TTP than gram-negative bacteria (18.6 vs 19.6 hours, <em>P</em> < 0.01).</div></div><div><h3>Conclusions</h3><div>In rural Gambia, most blood cultures from pediatric patients would turn positive within 48 hours of incubation. A maximum of 48 hours of observation after the commencement of antibiotic therapy in hospitalized children may be sufficient for clinicians to receive feedback on blood culture results.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100606"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551914","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}