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Di Gennaro F, Cotugno S, Guido G, Cavallin F, Papagni R, De Vita E, Manco Cesari G, Di Gregorio S, Giliberti V, Cassano D, Metrangolo G, Amendolara A, Francabandiera A, Fiorella M, Lobalsamo V, Brindicci G, Santoro CR, Ronga L, Lattanzio R, De Iaco G, Saracino A. Impact of a TB Team on TB Outcomes: A 2016-2024 Pre-Post Study From a Referral Center in Southern Italy. Open Forum Infect Dis 2025; 12:ofaf258. [PMID: 40376187 PMCID: PMC12079650 DOI: 10.1093/ofid/ofaf258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2025] [Accepted: 04/24/2025] [Indexed: 05/18/2025] Open
Abstract
Background Tuberculosis (TB) remains a major global public health challenge, requiring innovative management strategies to improve patient outcomes and reduce disease burden. Despite advancements in diagnostics and treatment, TB continues to cause significant morbidity and mortality worldwide, particularly among vulnerable populations such as migrants and individuals with limited healthcare access. The World Health Organization has emphasized the need for patient-centered approaches, including the establishment of TB-dedicated teams, to enhance care coordination and improve outcomes. However, real-world evidence on their effectiveness remains limited. Methods We conducted a retrospective before-after study to evaluate the impact of a structured TB-dedicated team implemented at a referral hospital in Southern Italy between 2016 and 2024. Prior to 2020, TB care was unstructured, with patients being followed by different physicians without a standardized system. Between 2021 and 2024, a dedicated TB team was established, comprising 2 infectious disease specialists, infectious disease residents, and a senior professor overseeing scientific activities. This new model introduced key interventions, including a dedicated outpatient reservation system, directly observed therapy, structured follow-up, specialist networking, systematic data collection, and targeted counseling on risk behaviors and comorbidities. Primary outcomes included treatment success rates, hospital length of stay, incidence of adverse events, and patient retention in follow-up programs. All tests were 2-sided and a P-value <.05 was considered statistically significant. Statistical analysis was carried out using R 4.4. Results A total of 269 TB patients were analyzed (117 pre- and 152 postimplementation). The introduction of the TB team was associated with a significant reduction in loss to follow-up (41.9% to 3.7%; P < .0001; odds ratio, 0.04; 95% confidence interval, .01-.12) and incomplete treatments (41.9% to 12.0; P < .0001; odds ratio, 0.13; 95% confidence interval, .06-.29). Median hospital stay decreased from 28 to 14 days (P < .0001), whereas adverse events remained comparable (32.5% vs 29.6%, P = .71). Conclusions The implementation of a TB-dedicated team significantly improved TB management by enhancing treatment adherence, reducing hospitalization, and preventing loss to follow-up. Given the public health impact of TB, structured care models should be prioritized to optimize patient outcomes and strengthen health system efficiency.
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Affiliation(s)
- Francesco Di Gennaro
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Sergio Cotugno
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Giacomo Guido
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | | | - Roberta Papagni
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Elda De Vita
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Giorgia Manco Cesari
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Stefano Di Gregorio
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Giliberti
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Domenica Cassano
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Giuliana Metrangolo
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Angela Amendolara
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Francabandiera
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Monica Fiorella
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Vittoria Lobalsamo
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Gaetano Brindicci
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Carmen Rita Santoro
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Luigi Ronga
- Microbiology and Virology Unit, University of Bari, University Hospital Policlinico, Bari, Italy
| | - Rossana Lattanzio
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppina De Iaco
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Annalisa Saracino
- Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ), Clinic of Infectious Diseases, University of Bari Aldo Moro, Bari, Italy
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Cesilia C, Rinawan FR, Santoso P, Nataprawira HM. Post-TB sequelae in adolescent pulmonary TB survivors. IJTLD OPEN 2025; 2:19-25. [PMID: 39802235 PMCID: PMC11724524 DOI: 10.5588/ijtldopen.24.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 09/13/2024] [Indexed: 01/16/2025]
Abstract
OBJECTIVE To compare the persistent clinical symptoms, chest X-ray (CXR), spirometry and echocardiography results in adolescent survivors of drug-susceptible (DS) and drug-resistant (DR) pulmonary TB (PTB). METHODS This retrospective cohort study was conducted in 52 adolescent PTB survivors. We compared persistent clinical symptoms, CXR, spirometry and echocardiography in DS-TB and DR-TB survivors. χ2 test was used to compare groups (P < 0.05 significant), logistic regression analysis was used to identify risk factors, and Many-Factor Rasch Measurement Version Facets 3.86.0 was used to assess the multi-rater agreement of CXR. RESULTS Significant differences were found in persistent clinical symptoms (higher in DS-TB survivors), CXR, and spirometry abnormalities (higher in DR-TB survivors). The echocardiography revealed a low pulmonary hypertension probability in both groups. Adolescent PTB survivors with comorbidity have 1.5 times the risk of developing pulmonary sequelae compared to non-sequelae. CONCLUSION Pulmonary sequelae in adolescent PTB survivors were documented in both DS and DR-TB. Monitoring after treatment completion was necessary for PTB survivors, especially in adolescents.
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Affiliation(s)
- C Cesilia
- Division of Respirology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr Hasan Sadikin General Hospital, Bandung, Indonesia
- Faculty of Medicine, University of Riau, Pekanbaru, Indonesia
| | - F R Rinawan
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - P Santoso
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Dr Hasan Sadikin General Hospital, Bandung, Indonesia
| | - H M Nataprawira
- Division of Respirology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr Hasan Sadikin General Hospital, Bandung, Indonesia
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3
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Charatcharoenwitthaya K, Suntrapiwat K, Wongtrakul W. The Association Between Tuberculosis and Osteoporosis: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e76397. [PMID: 39867096 PMCID: PMC11762585 DOI: 10.7759/cureus.76397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2024] [Indexed: 01/28/2025] Open
Abstract
Recent research suggests that tuberculosis (TB) may pose a potential risk factor for osteoporosis, although the available evidence remains limited. This study aimed to comprehensively assess osteoporosis risk in TB patients through systematic review and meta-analysis methodology. Two investigators independently conducted a literature search using the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica Database (EMBASE) databases up to April 2024. Eligible longitudinal cohort studies had to evaluate the impact of active or a history of TB on the risk of osteoporosis and/or osteoporotic fractures. Point estimates and standard errors from each eligible study were pooled using DerSimonian and Laird's generic inverse variance method. Of 2,062 articles (1,765 from EMBASE and 297 from MEDLINE) reviewed, three retrospective cohort studies, comprising a total of 531,624 participants (174,726 patients with TB and 356,898 participants without TB), met the eligibility criteria and were included in the meta-analysis. The pooled analysis of three studies revealed an increased risk of osteoporosis among TB patients, with a pooled hazard ratio of 1.40 (95% CI, 1.26 - 1.57; I2 = 54%). The pooled analysis indicated that populations with TB also had a higher risk of osteoporotic fractures than populations without TB, with a pooled hazard ratio of 1.65 (95% CI, 1.26 - 2.15; I2 = 71%). Our systematic review and meta-analysis demonstrated a significantly increased risk of osteoporosis and osteoporotic fractures in patients with TB.
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Affiliation(s)
| | - Kajorn Suntrapiwat
- Pulmonary Diseases and Critical Care Medicine, Buddhachinaraj Hospital, Phitsanulok, THA
| | - Wasit Wongtrakul
- Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, THA
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4
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Qin X, Qin B, Zhou C, Liu C, Chen T, Zhu J, Huang C, Wu S, He R, Wu S, Feng S, Chen J, Xue J, Wei W, Chen L, He K, Qin Z, Zhou T, Ma J, Zhan X. A Multi Center, Epidemiological Study of Bone Tuberculosis in Southwest China from 2011 to 2023. J Epidemiol Glob Health 2024; 14:1678-1692. [PMID: 39556304 PMCID: PMC11652554 DOI: 10.1007/s44197-024-00325-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 11/12/2024] [Indexed: 11/19/2024] Open
Abstract
BACKGROUND Despite continued efforts to manage and control Tuberculosis (TB) in China, it remains a major health concern. Bone tuberculosis (Bone-TB), a common form of extrapulmonary tuberculosis, still adds considerably to the global TB case load. Diagnosing Bone-TB is often difficult as its symptoms can be similar to other bone or joint diseases, which leads to delayed detection and treatment. Currently, comprehensive reports on the epidemiological aspects of Bone-TB in China are scarce. METHODS This retrospective study analyzed demographic and clinical data from 2,191 patients diagnosed with Bone-TB in Southwest China between January 2011 and September 2023.This study fully reveals the characteristics of Bone-TB in Southwest China. RESULTS The overall trend of bone tuberculosis was a slow rise. Among 2191 patients, males, farmers, aged 42-68 years, and people with HIV and diabetes are the priority groups for the prevention and treatment of Bone-TB. The majority of the infected spines (1556/2191) were located in the thoracic vertebra (759/2191) and lumbar vertebra (715/2191). Forty-nine (2.24%) patients had drug-resistant TB (DR-TB). Forty-five (2.05%) died during the treatment. The total and actual hospitalization. Costs amounted to $3,837.10 and $1,914.35 (p < 0.01). Patients with DR-TB incurred the highest costs, amounting to $4,968.37. Cervical TB, with a prevalence of 5 patients (6.10%), exhibited the highest rates of catastrophic expenditures. CONCLUSIONS From 2011 to 2023, the yearly occurrence of Bone-TB in southwestern China exhibited a rising pattern, marked by notable distinctions in terms of gender, age, and regional variations, indicating localized clustering characteristics.
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Affiliation(s)
- Xiaopeng Qin
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Boli Qin
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Chenxing Zhou
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Chong Liu
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Tianyou Chen
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Jichong Zhu
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Chengqian Huang
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Shaofeng Wu
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Rongqing He
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Songze Wu
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Sitan Feng
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Jiarui Chen
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Jiang Xue
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Wendi Wei
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Liyi Chen
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China
| | - Kechang He
- The Fourth People's Hospital of Nanning, No. 1, Lane 2, Changgang Road, Nanning, 530023, Guangxi, People's Republic of China
| | - Zhendong Qin
- The Fourth People's Hospital of Nanning, No. 1, Lane 2, Changgang Road, Nanning, 530023, Guangxi, People's Republic of China
| | - Tiejun Zhou
- The Fourth People's Hospital of Nanning, No. 1, Lane 2, Changgang Road, Nanning, 530023, Guangxi, People's Republic of China
| | - Jie Ma
- The Fourth People's Hospital of Nanning, No. 1, Lane 2, Changgang Road, Nanning, 530023, Guangxi, People's Republic of China.
| | - Xinli Zhan
- The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi, People's Republic of China.
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Hamza M, Jalil ZEH, Sattar AJA, Sohail H, Oduoye MO. Comments on: prevalence and risk factors for tuberculosis and HIV coinfections in Kenyan prison inmates. Trop Med Health 2024; 52:78. [PMID: 39482708 PMCID: PMC11528985 DOI: 10.1186/s41182-024-00650-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Accepted: 10/22/2024] [Indexed: 11/03/2024] Open
Abstract
The study by Mwatenga et al. found a tuberculosis (TB) prevalence of 10.2% and an HIV prevalence of 19.1% among inmates, with all TB cases co-infected with HIV. Education level, smoking history, and substance use are key predictors of coinfections. Although informative, its single-centred design and reliance on sputum samples may be insufficient for some patient groups, potentially compromising diagnostic accuracy. Expanding the study to include several jails and employing more diagnostic procedures may increase reliability and the ability to generalize. The report also notes the lack of debate on broader socioeconomic variables and structural barriers to healthcare in jails, which are crucial to understanding inmates' health challenges. Overcrowding, malnutrition, and a poor healthcare system are examples of environmental factors that probably contribute to the spread of tuberculosis and make managing HIV more difficult. Additionally, not enough is known about the dietary habits of prisoners and other health conditions like diabetes or mental health, which may have an impact on the course of HIV and TB. Future studies should take these extra characteristics into account to create more comprehensive approaches to controlling HIV coinfections and TB in prison populations. This will help build more effective therapies.
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Affiliation(s)
- Muhammad Hamza
- Department of Internal Medicine, Saidu Medical College, Swat, Pakistan
| | - Zil-E-Huma Jalil
- Department of Internal Medicine, Saidu Medical College, Swat, Pakistan
| | | | - Hamnah Sohail
- Department of Internal Medicine, Sahiwal Medical College, Sahiwal, Pakistan
| | - Malik Olatunde Oduoye
- Department of Research, The Medical Research Circle (MedReC), Goma, Democratic Republic of the Congo.
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Mistry D, Patil P, Beniwal SS, Penugonda R, Paila S, Deiveegan DS, Tibrewal C, Yousef Ghazal K, Anveshak, Nikhil Padakanti SS, Chauhan J, Reddy A L, Sofia Cummings KR, Reddy Molakala SS, Saini P, Abdullahi Omar M, Vandara M, Ijantkar SA. Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities. Ann Med Surg (Lond) 2024; 86:5922-5929. [PMID: 39359826 PMCID: PMC11444617 DOI: 10.1097/ms9.0000000000002446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/30/2024] [Indexed: 10/04/2024] Open
Abstract
Tuberculosis (TB) and cachexia are clinical entities that have a defined relationship, making them often found together. TB can lead to cachexia, while cachexia is a risk factor for TB. This article reviews cachexia in Tuberculosis patients in Southeast Asian and African regions by conducting a comprehensive literature search across electronic databases such as PubMed, Google Scholar, and Research Gate between 2013 and 2024 using keywords including 'Africa', 'cachexia', 'prevalence', 'implications', 'tuberculosis', and 'Southeast Asia. This article utilized only studies that satisfied the inclusion criteria, revealing knowledge gaps and untapped opportunities for cachexia in TB across Southeast Asian and African regions. Many Southeast Asian and Western Pacific patients initially receive a tuberculosis diagnosis. Sub-Saharan African countries are among the 30 high TB burden nations, according to the WHO. Food inadequacy and heightened energy expenditure can impair the immune system, leading to latent TB and subsequently, active infection. Symptoms needing attention: shortness of breath, productive cough, hyponatremia at 131 mmol/l, hypoalbuminemia at 2.1 g/dl, elevated aspartate transaminase at 75 U/l, increased lactate dehydrogenase at 654, and normocytic anemia. Comorbidities, such as kidney disease, cardiovascular disease, and asthma, can influence the nutritional status of individuals with TB. While efforts like screening, contact tracing, and utilizing gene Xpert to detect TB cases were implemented, only a few proved effective. It is essential to conduct further studies, including RCTs, in Southeast Asia and Africa to evaluate and manage cachexia in TB patients.
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Affiliation(s)
- Dhruv Mistry
- Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra
| | | | | | - Raghav Penugonda
- GSL Medical College & General Hospital, Rajamahendravaram, Jagannadhapuram Agraharam
| | - Sushmitha Paila
- All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh
| | | | - Charu Tibrewal
- Rajasthan Hospital (The Gujarat Research & Medical Institute), Shahibaug, Ahmedabad, Gujarat
| | | | - Anveshak
- Hassan Institute of Medical Sciences, Sri Chamarajendra Hospital Campus, Krishnaraja Pura, Hassan, Karnataka
| | | | | | | | | | | | - Pulkit Saini
- Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
| | | | | | - Saakshi A. Ijantkar
- Danylo Halytsky Lviv National Medical University, L’viv, L’vivs’ka Oblast, Ukraine
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Yu S, Gao Y, Lu J, Zhang G, Chen X, Zhang R, Kong W, Shang L. Clinical profiles and related factors in tuberculosis patients with positive sputum smear mycobacterium tuberculosis tests. Sci Rep 2024; 14:20376. [PMID: 39223209 PMCID: PMC11369116 DOI: 10.1038/s41598-024-71403-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024] Open
Abstract
The aim of this study was to explore the related factors linked to the development and infectivity of tuberculosis. This was achieved by comparing the clinical characteristics of patients with pulmonary tuberculosis (TB) who tested positive in smear Mycobacterium tuberculosis tests with this who tested negative in smear mycobacterium tests but positive in sputum Gene Xpert tests. We gathered clinical data of 1612 recently hospitalized patients diagnosed with pulmonary tuberculosis who tested positive either in sputum Gene-Xpert test or sputum smear Mycobacterium tuberculosis tests. The data was collected from January 1, 2018 to August 5, 2023, at Sichuan Provincial People's Hospital. We conducted separately analyzes and comparisons of the clinical characteristics between the two groups of patients, aiming to discussed the related factors influencing the development and infectivity of tuberculosis. In comparison to the GeneXpert positive group, the sputum smear positive group exhibited a higher proportion of elderly patients (aged 75-89) and individuals classified as underweight (BMI < 18.5 kg/m2). Furthermore, this group was more prone to experiencing symptoms such as weight loss, coughing and sputum production, hemoptysis, shortness of breath, and difficulty breathing. Moreover, they are also more likely to develop extrapulmonary tuberculosis, such as tuberculous meningitis, tuberculous pleurisy, and tuberculous peritonitis. These clinical features, when present, not only increase the likelihood of a positive result in sputum smear tests but also suggest a high infectivity of pulmonary tuberculosis. Elderly individuals (aged 75 to 89) who are underweight (BMI < 18.5 kg/m2), display symptom of cough, expectoration, hemoptysis and dyspnea-particularly cough and expectoration-and those with extra pulmonary tuberculosis serve as indicators of highly infectious pulmonary tuberculosis patients. These patients may present with more severe condition, carrying a higher bacteria, and being more prone to bacterial elimination. Identification of these patients is crucial, and prompt actions such as timely and rapid isolation measures, cutting off transmission routes, and early empirical treatment of tuberculosis are essential to control the development of the disease.
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Affiliation(s)
- Shiqing Yu
- Department of Radiology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, Sichuan, People's Republic of China
| | - Yan Gao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Junzhu Lu
- Department of Radiology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, Sichuan, People's Republic of China
| | - Guojin Zhang
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Xinyue Chen
- CT Collaboration, Siemens-Healthineers, Chengdu, People's Republic of China
| | - Rongping Zhang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Weifang Kong
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
| | - Lan Shang
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
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8
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Wagnew F, Gray D, Tsheten T, Kelly M, Clements ACA, Alene KA. Effectiveness of nutritional support to improve treatment adherence in patients with tuberculosis: a systematic review. Nutr Rev 2024; 82:1216-1225. [PMID: 37759339 PMCID: PMC11317773 DOI: 10.1093/nutrit/nuad120] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
CONTEXT Nutritional interventions substantially improve tuberculosis (TB) treatment outcomes and prevent complications. However, there is limited evidence about the connections between having nutritional support and TB treatment adherence. OBJECTIVE The aim of this study was to determine the effectiveness of nutritional support in improving treatment adherence among patients with TB. DATA SOURCES Databases, including PubMed, Embase (Ovid), Web of Science, and Scopus, were comprehensively reviewed to identify relevant studies reporting the impacts of nutritional support on TB treatment adherence. DATA EXTRACTION Two authors independently screened the title, abstracts, and full article texts to identify eligible studies and assess the risk of bias. Observational and interventional studies were included. DATA ANALYSIS A narrative synthesis approach was used to summarize the findings qualitatively. RESULTS From the search, 3059 publications were identified; of these, 8 studies were included in this systematic review. Three types of nutritional interventions were identified: food baskets (eg, energy, micronutrient- or macronutrient-enriched food support), nutritional advice and guidance, and incentives for buying foods. Although 5 studies reported that nutritional support significantly improved treatment adherence in patients with TB, 3 studies showed that nutritional support had no effect on TB treatment adherence. CONCLUSIONS Providing nutritional support may improve adherence to TB treatment. However, more well-powered, high-quality trials are warranted to demonstrate the effect of nutrition support on cost-effectively improving adherence to TB treatment. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42023392162.
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Affiliation(s)
- Fasil Wagnew
- National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Darren Gray
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Tsheten Tsheten
- National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Kefyalew Addis Alene
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Faculty of Health Sciences, School of Population Health, Curtin University, Bentley, Western Australia, Australia
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Sheela RM, Dhanasekar S. Analyzing risk factors of tuberculosis using type-2 interval-valued trapezoidal fuzzy numbers with Einstein aggregation operators extended to MCDM. Heliyon 2024; 10:e35997. [PMID: 39247314 PMCID: PMC11380000 DOI: 10.1016/j.heliyon.2024.e35997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/07/2024] [Accepted: 08/07/2024] [Indexed: 09/10/2024] Open
Abstract
The principal motive of this work is to evolve and initiate an extension from interval-valued fuzzy sets to type-2 interval-valued fuzzy sets (T2IVFS) related to weighted aggregation functions containing the Einstein operator. The chief reason for this extension is that the constancy of the terms can also be taken into data during the aggregation operation. The main goal of this article is to compose the aggregation operators and their characteristics such as the Type-2 interval-valued fuzzy Einstein weighted arithmetic aggregating operator (T2IVFEWA), Type-2 interval-valued fuzzy Einstein weighted geometric aggregating operator (T2IVFEWG), and the characteristics are expressed. At last, to intimate the effectiveness of the suggested approach and explicate the purpose of these operators, a hybrid multi-criteria decision-making problem (MCDM) to select the best risk factor for Tuberculosis (TB) is considered and the result is compared with the outcome of the existing operators and methods. Additionally, a sensitivity analysis was conducted to verify the robustness of the proposed decision-making process.
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Affiliation(s)
- Rani M Sheela
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Chennai, 600127, India
| | - S Dhanasekar
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Chennai, 600127, India
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Zou L, Kang W, Guo C, Du J, Chen Q, Shi Z, Tang X, Liang L, Tang P, Pan Q, Zhu Q, Yang S, Chang Z, Guo Z, Wu G, Tang S. Treatment Outcomes and Associated Influencing Factors Among Patients with Rifampicin-Resistant Tuberculosis: A Multicenter, Retrospective, Cohort Study in China. Infect Drug Resist 2024; 17:3737-3749. [PMID: 39221187 PMCID: PMC11366237 DOI: 10.2147/idr.s467971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024] Open
Abstract
Objective Rifampin-resistant tuberculosis (RR-TB) remains a serious global public health concern. We assessed treatment outcomes and associated influencing factors among RR-TB patients in China. Methods This research enrolled 1339 patients who started RR-TB treatment between May 2018 and April 2020 in China retrospectively. Data were collected from the electronic medical records. Multivariable logistic regression analysis was used to identify the influencing factors related to unfavorable outcomes. Results Of the 1339 RR-TB patients, 78.8% (1055/1339) achieved treatment success (cured or treatment completed), 5.1% (68/1339) experienced treatment failure, 1.1% (15/1339) died during treatment, 10.1% (135/1339) were lost to follow-up, and 4.9% (66/1339) were not evaluated. About 67.7% (907/1339) of patients experienced at least one adverse event (AE). The most common AE was hypohepatia (507/1339, 37.9%), followed by hyperuricemia (429/1339, 32.0%), anemia (368/1339, 27.5%), electrolyte disturbance (318/1339, 23.7%), peripheral neuritis (245/1339, 18.3%), and gastrointestinal reactions (203/1339, 15.2%). Multivariate analysis showed that age ≥60 years [adjusted odds ratio (aOR): 1.96, 95% confidence interval (CI): 1.39-2.77], national minority (aOR: 2.36, 95% CI: 1.42-3.93), smoking (aOR: 1.50, 95% CI: 1.10-2.04), cardiopathy (aOR: 2.90, 95% CI: 1.33-6.31), tumors (aOR: 9.84, 95% CI: 2.27-42.67), immunocompromise (aOR: 2.17, 95% CI: 1.21-3.91), re-treated TB (aOR: 1.46, 95% CI: 1.08-1.97), and experienced gastrointestinal reactions (aOR: 2.27, 95% CI: 1.52-3.40) were associated with unfavorable outcomes. Body mass index (BMI) ≥18.5 kg/m2, regimens containing bedaquiline and experienced adverse events (AEs) such as hypohepatia, leukopenia, peripheral neuritis, and optic neuritis were associated with favorable outcomes. Conclusion High rates of treatment success were achieved for RR-TB patients at tertiary tuberculosis hospitals in China. Age ≥60 years, national minority, smoking status, comorbidities, re-treated TB, and experienced gastrointestinal reactions were independent prognostic factors for unfavorable treatment outcomes.
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Affiliation(s)
- Liping Zou
- Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, People’s Republic of China
| | - Wanli Kang
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, People’s Republic of China
| | - Chunhui Guo
- Department of Tuberculosis, Harbin Chest Hospital, Harbin, People’s Republic of China
| | - Juan Du
- Department of Tuberculosis, Wuhan Pulmonary Hotel, Wuhan, People’s Republic of China
| | - Qing Chen
- Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, People’s Republic of China
| | - Zhengyu Shi
- Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, People’s Republic of China
| | - Xianzhen Tang
- Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, People’s Republic of China
| | - Li Liang
- Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, People’s Republic of China
| | - Peijun Tang
- Department of Tuberculosis, the Fifth People’s Hospital of Suzhou, Suzhou, People’s Republic of China
| | - Qing Pan
- Department of Respiratory and Critical Care Medicine, Anqing Municipal Hospital, Anqing, People’s Republic of China
| | - Qingdong Zhu
- Department of Tuberculosis, the Fourth People’s Hospital of Nanning, Nanning, People’s Republic of China
| | - Song Yang
- General Internal Medicine Department, Chongqing Public Health Medical Center, Chongqing, People’s Republic of China
| | - Zhanlin Chang
- Department of Surgery, the Third People’s Hospital of Tibet Autonomous Region, Lasa, People’s Republic of China
| | - Zhouli Guo
- Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, People’s Republic of China
| | - Guihui Wu
- Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, People’s Republic of China
| | - Shenjie Tang
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, People’s Republic of China
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Kassaw A, Asferie WN, Azmeraw M, Kefale D, Kerebih G, Mekonnen GB, Baye FD, Zeleke S, Beletew B, Kebede SD, Aytenew TM, Bazezew LY, Agimas MC. Incidence and predictors of tuberculosis among HIV-infected children after initiation of antiretroviral therapy in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0306651. [PMID: 38968268 PMCID: PMC11226042 DOI: 10.1371/journal.pone.0306651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Globally, Tuberculosis (TB) is the main cause of morbidity and mortality among infectious disease. TB and Human Immune Virus (HIV) are the two deadly pandemics which interconnected each other tragically, and jeopardize the lives of children; particularly in Sub-Saharan Africa. Therefore, this review was aimed to determine the aggregated national pooled incidence of tuberculosis among HIV- infected children and its predictors in Ethiopia. METHODS An electronic search engine (HINARI, PubMed, Scopus, web of science), Google scholar and free Google databases were searched to find eligible studies. Quality of the studies was checked using the Joanna Briggs Institute (JBI) quality assessment checklists for cohort studies. Heterogeneity between studies was evaluated using Cochrane Q-test and the I2 statistics. RESULT This review revealed that the pooled national incidence of tuberculosis among children with HIV after initiation of ART was 3.63% (95% CI: 2.726-4.532) per 100-person-years observations. Being Anemic, poor and fair ART adherence, advanced WHO clinical staging, missing of cotrimoxazole and isoniazid preventing therapy, low CD4 cell count, and undernutrition were significant predictors of tuberculosis incidence. CONCLUSION The study result indicated that the incidence of TB among HIV- infected children is still high. Therefore, parents/guardians should strictly follow and adjust nutritional status of their children to boost immunity, prevent undernutrition and opportunistic infections. Cotrimoxazole and isoniazid preventive therapy need to continually provide for HIV- infected children for the sake of enhancing CD4/immune cells, reduce viral load, and prevent from advanced disease stages. Furthermore, clinicians and parents strictly follow ART adherence.
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Affiliation(s)
- Amare Kassaw
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Worku Necho Asferie
- Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molla Azmeraw
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Demewoz Kefale
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Kerebih
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gebrehiwot Berie Mekonnen
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fikadie Dagnew Baye
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Shegaw Zeleke
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Biruk Beletew
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Solomon Demis Kebede
- Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Munye Aytenew
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Lakachew Yismaw Bazezew
- Department of Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Dong L, Kong S, Deng M, Zhang D. Impact of Health Education in Combination with Nutrition Support Nursing on the Nutritional Status and Quality of Life in Patients with Pulmonary Tuberculosis. J Community Health Nurs 2024; 41:203-212. [PMID: 38551201 DOI: 10.1080/07370016.2024.2329632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2024]
Abstract
This study aimed to ascertain the effects of health education combined with nutrition support nursing on the nutritional status and quality of life of patients with pulmonary tuberculosis. A clinical study was conducted. Sixty-four patients with tuberculosis were selected as the study participants and divided into control and observation groups (n = 32). Both groups received antituberculosis drugs. The control group received standard nursing care, while the observation group received health education in conjunction with nutrition support nursing. After 3 months of intervention, the total effective treatment rate and adherence were compared. Before and after the intervention, the albumin (ALB), prealbumin (PA), transferrin (TF), and hemoglobin (Hb) level, body mass index (BMI), and Short Form-36 (SF-36) scores were compared. The occurrence of adverse reactions during intervention was recorded. Following the intervention, the observation group exhibited a higher treatment total effective rate and increased levels of ALB, PA, TF, Hb, and BMI compared with the control group (p < 0.05). The observation group demonstrated a higher total adherence rate and a lower incidence of adverse reactions compared with the control group (p < 0.05); the SF-36 score of the observation group was higher than that of the control group (p < 0.05). The integration of health education and nutrition support nursing can effectively enhance the therapeutic outcomes of patients with pulmonary tuberculosis. This approach not only improves their nutritional status, treatment adherence, and quality of life, but also reduces the incidence of adverse reactions. The findings of this study lay a solid foundation for further exploration of the combined effects of health education and nutrition support nursing on pulmonary tuberculosis.
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Affiliation(s)
- Lifei Dong
- Department of Tuberculosis, Infectious Disease Hospital of Heilongjiang Province, Harbin, Heilongjiang, China
| | - Shuo Kong
- Department of Tuberculosis, Infectious Disease Hospital of Heilongjiang Province, Harbin, Heilongjiang, China
| | - Meixin Deng
- Department of Tuberculosis, Infectious Disease Hospital of Heilongjiang Province, Harbin, Heilongjiang, China
| | - Di Zhang
- Department of Tuberculosis, Infectious Disease Hospital of Heilongjiang Province, Harbin, Heilongjiang, China
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Choi H, Shin J, Jung JH, Han K, Choi W, Lee HR, Yoo JE, Yeo Y, Lee H, Shin DW. Tuberculosis and osteoporotic fracture risk: development of individualized fracture risk estimation prediction model using a nationwide cohort study. Front Public Health 2024; 12:1358010. [PMID: 38721534 PMCID: PMC11076769 DOI: 10.3389/fpubh.2024.1358010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/08/2024] [Indexed: 05/15/2024] Open
Abstract
Purpose Tuberculosis (TB) is linked to sustained inflammation even after treatment, and fracture risk is higher in TB survivors than in the general population. However, no individualized fracture risk prediction model exists for TB survivors. We aimed to estimate fracture risk, identify fracture-related factors, and develop an individualized risk prediction model for TB survivors. Methods TB survivors (n = 44,453) between 2010 and 2017 and 1:1 age- and sex-matched controls were enrolled. One year after TB diagnosis, the participants were followed-up until the date of fracture, death, or end of the study period (December 2018). Cox proportional hazard regression analyses were performed to compare the fracture risk between TB survivors and controls and to identify fracture-related factors among TB survivors. Results During median 3.4 (interquartile range, 1.6-5.3) follow-up years, the incident fracture rate was significantly higher in TB survivors than in the matched controls (19.3 vs. 14.6 per 1,000 person-years, p < 0.001). Even after adjusting for potential confounders, TB survivors had a higher risk for all fractures (adjusted hazard ratio 1.27 [95% confidence interval 1.20-1.34]), including hip (1.65 [1.39-1.96]) and vertebral (1.35 [1.25-1.46]) fractures, than matched controls. Fracture-related factors included pulmonary TB, female sex, older age, heavy alcohol consumption, reduced exercise, and a higher Charlson Comorbidity Index (p < 0.05). The individualized fracture risk model showed good discrimination (concordance statistic = 0.678). Conclusion TB survivors have a higher fracture risk than matched controls. An individualized prediction model may help prevent fractures in TB survivors, especially in high-risk groups.
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Affiliation(s)
- Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jungeun Shin
- International Healthcare Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jin-Hyung Jung
- Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Han Rim Lee
- International Healthcare Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yohwan Yeo
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine, Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
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Yerezhepov D, Gabdulkayum A, Akhmetova A, Kozhamkulov U, Rakhimova S, Kairov U, Zhunussova G, Kalendar R, Akilzhanova A. Pulmonary tuberculosis epidemiology and genetics in Kazakhstan. Front Public Health 2024; 12:1340673. [PMID: 38706548 PMCID: PMC11066200 DOI: 10.3389/fpubh.2024.1340673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/08/2024] [Indexed: 05/07/2024] Open
Abstract
Background Tuberculosis (TB) is a major public health emergency in many countries, including Kazakhstan. Despite the decline in the incidence rate and having one of the highest treatment effectiveness in the world, the incidence rate of TB remains high in Kazakhstan. Social and environmental factors along with host genetics contribute to pulmonary tuberculosis (PTB) incidence. Due to the high incidence rate of TB in Kazakhstan, our research aimed to study the epidemiology and genetics of PTB in Kazakhstan. Materials and methods 1,555 participants were recruited to the case-control study. The epidemiology data was taken during an interview. Polymorphisms of selected genes were determined by real-time PCR using pre-designed TaqMan probes. Results Epidemiological risk factors like diabetes (χ2 = 57.71, p < 0.001), unemployment (χ2 = 81.1, p < 0.001), and underweight-ranged BMI (<18.49, χ2 = 206.39, p < 0.001) were significantly associated with PTB. VDR FokI (rs2228570) and VDR BsmI (rs1544410) polymorphisms were associated with an increased risk of PTB. A/A genotype of the TLR8 gene (rs3764880) showed a significant association with an increased risk of PTB in Asians and Asian males. The G allele of the rs2278589 polymorphism of the MARCO gene increases PTB susceptibility in Asians and Asian females. VDR BsmI (rs1544410) polymorphism was significantly associated with PTB in Asian females. A significant association between VDR ApaI polymorphism and PTB susceptibility in the Caucasian population of Kazakhstan was found. Conclusion This is the first study that evaluated the epidemiology and genetics of PTB in Kazakhstan on a relatively large cohort. Social and environmental risk factors play a crucial role in TB incidence in Kazakhstan. Underweight BMI (<18.49 kg/m2), diabetes, and unemployment showed a statistically significant association with PTB in our study group. FokI (rs2228570) and BsmI (rs1544410) polymorphisms of the VDR gene can be used as possible biomarkers of PTB in Asian males. rs2278589 polymorphism of the MARCO gene may act as a potential biomarker of PTB in Kazakhs. BsmI polymorphism of the VDR gene and rs2278589 polymorphism of the MARCO gene can be used as possible biomarkers of PTB risk in Asian females as well as VDR ApaI polymorphism in Caucasians.
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Affiliation(s)
- Dauren Yerezhepov
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - Aidana Gabdulkayum
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - Ainur Akhmetova
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - Ulan Kozhamkulov
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - Saule Rakhimova
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - Ulykbek Kairov
- Laboratory of Bioinformatics and Systems Biology, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | | | - Ruslan Kalendar
- Laboratory of Bioinformatics and Systems Biology, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
| | - Ainur Akilzhanova
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana, Kazakhstan
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Kakiuchi M, Inoue T, Kobayashi H, Ebina A, Nakano G, Kakehi T, Tanaka T, Nishihara M. Sarcopenia assessed using a questionnaire can predict in-hospital mortality in older patients with pulmonary tuberculosis. Clin Nutr ESPEN 2024; 60:217-222. [PMID: 38479913 DOI: 10.1016/j.clnesp.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/08/2024] [Accepted: 02/02/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND & AIMS Pulmonary tuberculosis is a severe disease with a high mortality rate. However, whether sarcopenia is a risk factor for in-hospital mortality remains unclear. The SARC-F (five items: strength, assistance in walking, rising from a chair, climbing stairs, and falls) is a questionnaire developed to screen for sarcopenia. This study aimed to determine whether the high risk of sarcopenia, assessed using the SARC-F questionnaire, affects in-hospital mortality in older patients with pulmonary tuberculosis. METHODS This was a retrospective, observational study. We included patients with active pulmonary tuberculosis aged ≥65 years who required inpatient treatment between 30 April 2021 and 30 November 2022. We assessed sarcopenia using SARC-F, and SARC-F ≥ 4 points at admission was defined as a high risk of sarcopenia. The primary outcome was all-cause mortality during hospitalisation. We extracted information on age, sex, body mass index, comorbidities, blood and biochemical tests, modified Glasgow Prognostic Score, calf circumference, geriatric nutritional risk index, physiotherapy, and length of hospital stay from medical records. RESULTS We included 147 patients (mean age: 83.0 ± 7.8 years; males: 61.9%). Ninety-three (63.3%) patients had a high risk of developing sarcopenia. Patients with a high risk of sarcopenia were significantly older (mean: 85.0 ± 7.1 years), had a lower body mass index (median: 18.1 kg/m2, range: 16.1-20.5 kg/m2), had a higher modified Glasgow Prognostic Score (median: 2, range: 2-2), and had a lower calf circumference (mean: 26.8 ± 3.6 cm), had a lower geriatric nutritional risk index (mean: 72.2 ± 12.9) than those without high-risk sarcopenia. More patients with a high risk of sarcopenia underwent physiotherapy (93.5%) than those without high-risk sarcopenia (P < 0.01, all). Kaplan-Meier survival curves showed that patients with a high risk of sarcopenia had significantly lower overall survival than those without high-risk sarcopenia (log-rank test, P = 0.001). Logistic regression analysis for in-hospital mortality showed that a high risk of sarcopenia significantly affected in-hospital mortality (odds ratio [OR]: 6.425, 95% confidence interval [CI]: 1.399-47.299). In addition, logistic regression analysis for each item of SARC-F showed that assistance in walking (OR: 3.931, 95% CI: 1.816-9.617) and rising from a chair (OR: 2.458, 95% CI: 1.235-5.330) significantly affected in-hospital mortality. CONCLUSION A high risk of sarcopenia, as assessed using SARC-F at admission, was a risk factor for in-hospital mortality in older patients with pulmonary tuberculosis. Among the SARC-F items, assistance in walking and rising from a chair were the risk factors for in-hospital mortality.
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Affiliation(s)
- Masayoshi Kakiuchi
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398, Shimami-cho, Kita-ku, Niigata-shi, Niigata-ken, 950-3198, Japan.
| | - Hikaru Kobayashi
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Aoi Ebina
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Gen Nakano
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Tetsuya Kakehi
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Toshiaki Tanaka
- Department of Rehabilitation, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
| | - Masamitsu Nishihara
- Department of Neurosurgery, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2273, Japan
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16
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Liu L, Wang X, Luo L, Liu X, Chen J. Risk Factors of Tuberculosis Destroyed Lung in Patients with Pulmonary Tuberculosis and Structural Lung Diseases: A Retrospective Observational Study. Risk Manag Healthc Policy 2024; 17:753-762. [PMID: 38567384 PMCID: PMC10985215 DOI: 10.2147/rmhp.s448765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Tuberculosis destroyed lung constitutes a significant worldwide public health challenge, little is known about its associated risk factors and prognosis. Our study aimed to identify the risk factors of tuberculosis destroyed lung among pulmonary tuberculosis and structural lung diseases. Methods Between January 2019 and December 2021, a case-control study was conducted at the Third People's Hospital of Shenzhen in China. We collected the clinical data among patients with pulmonary tuberculosis and structural lung diseases. Cases were defined as patients with tuberculosis destroyed lung. Controls were not diagnosed with the tuberculosis destroyed lung. A binary logistic regression was performed. Results In our study, a total of 341 patients met the inclusion criteria, including 182 cases and 159 controls. We found that age ranges of 46-60 years (aOR: 4.879; 95% CI: 2.338-10.180), >60 years (aOR: 3.384; 95% CI: 1.481-7.735); history of TB treatment (aOR: 2.729; 95% CI: 1.606-4.638); malnutrition (aOR: 5.126; 95% CI: 1.359-19.335); respiratory failure (aOR: 5.080; 95% CI: 1.491-17.306); and bronchiarctia (aOR: 3.499; 95% CI: 1.330-9.209) were the independent risk factors for tuberculosis destroyed lung. Conversely, having a normal (aOR: 0.207; 95% CI: 0.116-0.371) or overweight BMI (aOR: 0.259; 95% CI: 0.090-0.747) emerged as a protective factor against tuberculosis destroyed lung. Conclusion This study indicated that tuberculosis destroyed lung is a common condition among patients with pulmonary tuberculosis and structural lung diseases. The independent risk factors for tuberculosis destroyed lung were identified as being within the age groups of 46-60 and over 60 years, having a previous history of TB treatment, malnutrition, respiratory failure, and bronchiarctia. It is essential to closely monitor patients possessing these risk factors to prevent the progression towards tuberculosis destroyed lung.
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Affiliation(s)
- Linlin Liu
- Hengyang Medical School, School of Nursing, University of South China, Hengyang, People’s Republic of China
| | - Xiufen Wang
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
| | - Li Luo
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
| | - Xuhui Liu
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
| | - Jingfang Chen
- Hengyang Medical School, School of Nursing, University of South China, Hengyang, People’s Republic of China
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
- Faculty of Medicine, Macau University of Science and Technology, Macau, People’s Republic of China
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Wang DM, Wang C, An Q, Yang Q, Liao Y. Clinical characteristic, common sites, and geographical distribution of pediatric tuberculosis patients in Southwest China. Front Pediatr 2024; 12:1327648. [PMID: 38562135 PMCID: PMC10982491 DOI: 10.3389/fped.2024.1327648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Background The data report of a large sample, dynamic epidemiology, and characteristic analysis of pediatric tuberculosis (TB) in Southwest China is not clear. Herein, we conducted descriptive dynamic epidemiology, characteristic analysis and geographical distribution study of pediatric TB inpatients in Southwest China for more than 20 years. Methods Patients with pediatric TB were recruited from October 2002 to September 2022 in Southwest of China based on etiology or clinical confirmation. Extract hospitalization medical record information for each patient. The geographical distribution chart of cases is used to display the trend of case flow segmented every 5 years. Results Among 3,024 pediatric TB patients with an average age of 9.11 ± 4.39, 17.49% (529) had pulmonary tuberculosis (PTB), 9.06% (274) had extrapulmonary tuberculosis (EPTB), and 73.45% (2,221) had combined TB. The most common form of EPTB is disseminated TB (28.98%), followed by TB lymphadenitis (20.56%), pleural TB (19.72%), and TB meningitis (19.68%). Children aged 0-4 years had a high risk of TB meningitis and a severe symptoms, while children in the elderly age group had a high risk of pleural TB. In the past 20 years, hospitalized TB pediatric cases mainly came from Sichuan, Tibet, Qinghai, Yunnan and other places. The number of patients from ethnic minorities, especially Tibetans, showed an upward trend on a yearly basis (χ2 = 401.43, P < 0.001). Conclusions Public health investment and effective management in pediatric TB should be further strengthened.
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Affiliation(s)
- Dong-Mei Wang
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Chuan Wang
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Qi An
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Qing Yang
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Yi Liao
- Department of Clinical Laboratory Medicine, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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18
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Yerezhepov D, Gabdulkayum A, Akhmetova A, Kozhamkulov UA, Rakhimova SE, Kairov UY, Zhunussova G, Kalendar RN, Akilzhanova A. Vitamin D Status, VDR, and TLR Polymorphisms and Pulmonary Tuberculosis Epidemiology in Kazakhstan. Nutrients 2024; 16:558. [PMID: 38398882 PMCID: PMC10892443 DOI: 10.3390/nu16040558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) and vitamin D deficiency remain major public health problems in Kazakhstan. Due to the high incidence of pulmonary tuberculosis in the country and based on the importance of vitamin D in the modulation of the immune response and the association of its deficiency with many health conditions, the aim of our research was to study the vitamin D status, VDR and TLR gene polymorphisms, and pulmonary tuberculosis epidemiology in Kazakhstan. METHODS A case-control study included 411 individuals diagnosed with pulmonary TB and 686 controls with no family history of pulmonary tuberculosis. Concentrations of serum vitamin D (25-(OH)D) levels were measured by electrochemiluminescence immunoassay. The gene polymorphisms were determined by real-time polymerase chain reaction (PCR) allelic discrimination assay using TaqMan probes. The association between the risk of pulmonary TB and polymorphisms was evaluated using multimodal logistic regression and assessed with the ORs, corresponding to 95% Cis, and the significance level was determined as p < 0.05. RESULTS 1097 individuals were recruited from 3 different regions of Kazakhstan. Biochemical data showed vitamin D deficiency (25-(OH)D < 20 ng/mL) was present in both groups, with the case group accounting for almost 95% and 43.7% in controls. Epidemiological data revealed that socioeconomic factors such as BMI < 25 kg/m2 (p < 0.001), employment (p < 0.001), diabetes (p < 0.001), and vitamin D deficiency (p < 0.001) were statistically different between case and control groups. Logistic regression analysis, adjusted by sex, age, BMI, residence, employment, smoking, alcohol consumption, and diabetes, showed that T/T polymorphism of the VDR gene (rs1544410, OR = 1.97, 95% CI: 1.04-3.72, p = 0.03) and A/A polymorphism of the TLR8 gene (rs3764880, OR = 2.44, 95% CI: 1.20-4.98, p = 0.01) were associated with a high risk of developing pulmonary tuberculosis. CONCLUSIONS Vitamin D deficiency remains prevalent in our study cohort and is associated with TB progression. Socioeconomic determinants such as unemployment, BMI under 25 kg/m2, and diabetes are the main risk factors for the development of pulmonary TB in our study. A/A polymorphism of TLR8 (rs3764880) and T/T polymorphism (BsmI, rs1544410) of VDR genes may act as biomarkers for pulmonary tuberculosis in the Kazakh population.
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Affiliation(s)
- Dauren Yerezhepov
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan
| | - Aidana Gabdulkayum
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan
| | - Ainur Akhmetova
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan
| | - Ulan A. Kozhamkulov
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan
| | - Saule E. Rakhimova
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan
| | - Ulykbek Y. Kairov
- Laboratory of Bioinformatics and Systems Biology, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan
| | | | - Ruslan N. Kalendar
- Institute of Biotechnology HiLIFE, University of Helsinki, P.O. Box 65, 00014 Helsinki, Finland
| | - Ainur Akilzhanova
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan
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19
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Franke MA, Emmrich JV, Ranjaharinony F, Ravololohanitra OG, Andriamasy HE, Knauss S, Muller N. A cross-sectional analysis of the effectiveness of a nutritional support programme for people with tuberculosis in Southern Madagascar using secondary data from a non-governmental organisation. Infect Dis Poverty 2024; 13:13. [PMID: 38303047 PMCID: PMC10835822 DOI: 10.1186/s40249-024-01182-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND There is a strong, bi-directional link between tuberculosis (TB) and undernutrition: TB often causes undernutrition, and undernourished people are more likely to contract TB and experience worse outcomes. Globally, several TB nutritional support programmes exist; however, evidence on their effectiveness is limited and contested. This study evaluates the effect of a nutritional support programme implemented for people with TB in the Atsimo-Andrefana region, Madagascar in 2022. Within this programme, undernourished people with TB [with a body mass index (BMI) of < 18.5 kg/m2] receive 0.6 L of vegetable oil and 6.0 kg of a soy-wheat blend per month throughout their TB treatment. METHODS We analysed secondary non-governmental organisation data collected between January and November 2022 in the Atsimo-Andrefana region, Southern Madagascar, including information on an individual's medical conditions (e.g., type of TB, treatment outcomes) and nutritional status measured prior to, during, and after completion of treatment (e.g., height, weight, mid-upper arm circumference). We conducted descriptive analyses of patient baseline characteristics and outcomes to assess the impact of the provided nutritional support on the BMI of people with TB. RESULTS A total of 1310 people with TB were included in the study [9.9% (130) children under the age of 5, 32.1% (420) children between 5 and 18 years, 58.0% (760) adults]. 55.4% of children under 5, 28.1% of children between ages 5 and 18, and 81.3% of adults were undernourished at treatment initiation. 42.3% (55/130) of children under 5 experienced severe acute malnutrition at treatment uptake. While the average BMI of adults with TB receiving food support increased over time, from 17.1 kg/m2 (interquartile range: 15.8-18.3, range: 10.3-22.5) to 17.9 kg/m2 (interquartile range: 16.6-19.1, range: 11.9-24.1), most adults remained undernourished even after completing TB treatment. CONCLUSIONS The current TB nutritional support programme falls short of sufficiently increasing the BMI of people with TB to overcome malnutrition. There is an urgent need to revise the nutritional support available for people with TB, particularly for children under 5.
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Affiliation(s)
- Mara Anna Franke
- Global Digital Health Lab at Charité Center for Global Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- London School of Hygiene and Tropical Medicine, London, UK.
- Ärzte Für Madagaskar E.V., Leipzig, Germany.
| | - Julius Valentin Emmrich
- Global Digital Health Lab at Charité Center for Global Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Ärzte Für Madagaskar E.V., Leipzig, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Harizaka Emmanuel Andriamasy
- Global Digital Health Lab at Charité Center for Global Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Doctors for Madagascar, Antananarivo, Madagascar
| | - Samuel Knauss
- Global Digital Health Lab at Charité Center for Global Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Ärzte Für Madagaskar E.V., Leipzig, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nadine Muller
- Global Digital Health Lab at Charité Center for Global Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Ärzte Für Madagaskar E.V., Leipzig, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Speciality Network: Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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20
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Morales F, Montserrat-de la Paz S, Leon MJ, Rivero-Pino F. Effects of Malnutrition on the Immune System and Infection and the Role of Nutritional Strategies Regarding Improvements in Children's Health Status: A Literature Review. Nutrients 2023; 16:1. [PMID: 38201831 PMCID: PMC10780435 DOI: 10.3390/nu16010001] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
Malnutrition refers to a person's status as under- or overnourished, and it is usually associated with an inflammation status, which can subsequently imply a different health status, as the risk of infection is increased, along with a deterioration of the immune system. Children's immune systems are generally more susceptible to problems than adults. In the situation of malnutrition, because malnourished children's immune systems are compromised, they are more likely to die. However, little is known about the underlying mechanism of altered immune functioning and how it relates to starvation. Nutritional interventions have been reported as cost-effective strategies to prevent or treat the development of malnourishment, considering the link between food intake and health, especially in children, and also the susceptibility of this population to diseases and how their health status during childhood might affect their long-term physiological growth. The ingestion of specific nutrients (e.g., vitamins or oligoelements) has been reported to contribute to the proper functioning of children's immune systems. In this review, we aim to describe the basis of malnutrition and how this is linked to the immune system, considering the role of nutrients in the modulation of the immune system and the risk of infection that can occur in these situations in children, as well as to identify nutritional interventions to improve their health.
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Affiliation(s)
- Fátima Morales
- Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, 41009 Sevilla, Spain;
- Sbarro Institute for Cancer Research and Molecular Medicine, Center of Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
| | - Sergio Montserrat-de la Paz
- Department of Medical Biochemistry, Molecular Biology, and Immunology, School of Medicine, University of Seville, Av. Sanchez Pizjuan s/n, 41009 Seville, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Hospital Universitario Virgen del Rocío, CSIC, University of Seville, 41013 Seville, Spain
| | - Maria J. Leon
- Department of Microbiology and Parasitology, School of Pharmacy, University of Seville, C. Profesor Garcia Gonzalez 2, 41012 Seville, Spain;
| | - Fernando Rivero-Pino
- Department of Medical Biochemistry, Molecular Biology, and Immunology, School of Medicine, University of Seville, Av. Sanchez Pizjuan s/n, 41009 Seville, Spain
- Instituto de Biomedicina de Sevilla, IBiS, Hospital Universitario Virgen del Rocío, CSIC, University of Seville, 41013 Seville, Spain
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