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Xiu L, Liu H, Xie Y, Hu Q, Li H, Chen F, Wang C, Zhang Y, Hou L, Yin K. Alternations of antibiotic resistance genes and microbial community dynamics on shared bicycles before and after pandemic lockdown. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 913:169625. [PMID: 38157892 DOI: 10.1016/j.scitotenv.2023.169625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
The prevalence of shared bicycles has raised concerns over their potential to transmit pathogens and microbes harboring antibiotic resistance genes (ARGs), which pose significant human health risks. This study investigated the impact of anthropogenic activities on the composition of ARGs and microbial communities on shared bicycles during the COVID-19 pandemic and subsequent lockdown when shared bicycle usage was altered. A total of 600 swab samples from shared bicycle surfaces were collected in Shanghai before and during COVID-19 lockdown periods. Even during lockdown, 12 out of 14 initially detected ARG subtypes persisted, indicating their tenacity in the face of reduced anthropogenic activities. These ARGs displayed significantly higher absolute and relative abundance levels before the lockdown. In addition, the percentage of potential pathogens in the total microbial abundance remained at 0.029 % during the lockdown, which was lower than the pre-lockdown percentage of 0.035 % and suggested that these risks persist within shared bicycle systems. Interestingly, although microbial abundance decreased without the consecutive use of shared bicycles during lockdown, the microbial diversity increased under the impact of restricted anthropogenic activities (p < 0.001). This emphasizes the need for continuous monitoring and research to comprehend microbial community behaviors in various environments. This study uncovered the underlying impacts of the COVID-19 lockdown on the microbial and ARG communities of shared bicycles, providing comprehensive insights into the health management of shared transportation. Although lockdown can decrease the abundance of ARGs and potential pathogens, additional interventions are needed to prevent their continued spread.
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Affiliation(s)
- Leshan Xiu
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China; State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, Shanghai Academy of Environment Sciences, Shanghai, China.
| | - Haodong Liu
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Yi Xie
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Qinqin Hu
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Huimin Li
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Fumin Chen
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Chenxi Wang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Yuqian Zhang
- Department of Surgery, Division of Surgery Research, Mayo Clinic, Rochester, MN 55905, USA; Microbiome Program, Center for Individualized Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Liyuan Hou
- Department of Civil and Environmental Engineering, Utah State University, UT 84322, USA; Utah Water Research Laboratory, 1600 Canyon Road, Logan, UT 84321, USA.
| | - Kun Yin
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China.
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Yuen CM, Brooks MB, Millones AK, Acosta D, Del Águila-Rojas E, Campos H, Farroñay S, Morales G, Ramirez-Sandoval J, Nichols TC, Jimenez J, Jenkins HE, Lecca L. Geospatial analysis of reported activity locations to identify sites for tuberculosis screening. Sci Rep 2022; 12:14094. [PMID: 35982104 PMCID: PMC9387880 DOI: 10.1038/s41598-022-18456-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Mobile screening units can help close tuberculosis case detection gaps. Placing screening units where people at high risk for undiagnosed tuberculosis preferentially spend time could make screening more resource-effective. We conducted a case–control study in Lima, Peru to identify locations where people with tuberculosis were more likely to spend time than community controls. We surveyed participants about activity locations over the past 6 months. We used density-based clustering to assess how patient and control activity locations differed, and logistic regression to compare location-based exposures. We included 109 tuberculosis patients and 79 controls. In density-based clustering analysis, the two groups had similar patterns of living locations, but their work locations clustered in distinct areas. Both groups were similarly likely to use public transit, but patients predominantly used buses and were less likely to use rapid transit (adjusted odds ratio [aOR] 0.31, 95% confidence interval [CI] 0.10–0.96) or taxis (aOR 0.42, 95% CI 0.21–0.85). Patients were more likely to have spent time in prison (aOR 11.55, 95% CI 1.48–90.13). Placing mobile screening units at bus terminals serving locations where tuberculosis patients have worked and within and around prisons could help reach people with undiagnosed tuberculosis.
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Affiliation(s)
- Courtney M Yuen
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA. .,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
| | - Meredith B Brooks
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | | | | - Tim C Nichols
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Helen E Jenkins
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Leonid Lecca
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Socios En Salud Sucursal Peru, Lima, Peru
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Zhang J, Shen X, Yang C, Chen Y, Guo J, Wang D, Zhang J, Lynn H, Hu Y, Pan Q, Zhang ZJ. Spatial analysis of tuberculosis treatment outcome in Shanghai: implications for tuberculosis control. Epidemiol Health 2022; 44:e2022045. [PMID: 35538695 DOI: 10.4178/epih.e2022045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 05/01/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Tuberculosis (TB) treatment outcome is a key indicator in the assessment of a TB control program. We aimed to identify spatial factors associated with TB treatment outcome, and to provide additional insights into TB control from a geographical perspective. Methods We collected data from the electronic TB surveillance system in Shanghai, China and included pulmonary TB patients registered for the period from January 1, 2009 to December 31, 2016. We examined the association of physical accessibility to hospitals, autoregression term and random hospital effects with treatment outcomes in logistic regression models after adjusting for demographic, clinical and treatment factors. Results Of the 53475 pulmonary TB patients, 49002 (91.6%) had a successful treatment outcome. The success rate increased from 89.3% in 2009 to 94.4% in 2016. The successful treatment outcome rate varied among hospitals from 78.6% to 97.8%, and there were 12 spatial clusters of poor treatment outcome during the 8-year study period. The best fit model incorporated the spatial factors. Both the random hospital effects and autoregression terms had significant impacts on TB treatment outcome, ranking sixth and tenth, respectively, in terms of statistical importance among 14 factors. However, number of bus stations around home is the least important variable in the model. Conclusion Spatial autocorrelation and hospital effects are associated with TB treatment outcome in Shanghai. In highly-integrated cities like Shanghai, physical accessibility is not related to treatment outcome. Governments need to pay more attention to the mobility of patients and different success rate of treatment among hospitals.
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Affiliation(s)
- Jing Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China.,Department of Population and Quantitative Health Science, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Xin Shen
- Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, China; Shanghai Institutes of Preventive Medicine, China
| | - Chongguang Yang
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, CT 06510, USA
| | - Yue Chen
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Juntao Guo
- Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, China; Shanghai Institutes of Preventive Medicine, China
| | - Decheng Wang
- Medical Science College, China Three Gorges University, Yichang, China
| | - Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Henry Lynn
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Yi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Qichao Pan
- Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, China; Shanghai Institutes of Preventive Medicine, China
| | - Zhi Jie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
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Thomas MM, Mohammadi N, Taylor JE. Investigating the association between mass transit adoption and COVID-19 infections in US metropolitan areas. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 811:152284. [PMID: 34902421 PMCID: PMC8662904 DOI: 10.1016/j.scitotenv.2021.152284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 05/26/2023]
Abstract
Urbanization introduces the threat of increased epidemic disease transmission resulting from crowding on mass transit. The coronavirus disease 2019 (COVID-19) pandemic, which has directly led to over 600,000 deaths in the US as of July 2021, triggered mass social distancing policies to be enacted as a key deterrent of widespread infections. Social distancing can be challenging in confined spaces required for transportation such as mass transit systems. Little is published regarding the degree to which mass transit system adoption effects impacted the rise of the COVID-19 pandemic in urban centers. Taking an ecological approach where areal data are the unit of observation, this national-scale study aims to measure the association between the adoption of mass transit and COVID-19 spread through confirmed cases in US metropolitan areas. National survey-based transit adoption measures are entered in negative binomial regression models to evaluate differences between areas. The model results demonstrate that mass transit adoption in US metropolitan areas was associated with the magnitude of outbreaks. Higher incidence of COVID-19 early in the pandemic was associated with survey results conveying higher transit use. Increasing weekly bus transit usage in metropolitan statistical areas by one scaled unit was associated with a 1.38 [95% CI: (1.25, 1.90)] times increase in incidence rate of COVID-19; a one scaled unit increase in weekly train transit usage was associated with an increase in incidence rate of 1.54 [95% CI: (1.42, 2.07)] times. These conclusions should inform early action practices in urban centers with busy transit systems in the event of future infectious disease outbreaks. Deeper understanding of these observed associations may also benefit modeling efforts by allowing researchers to include mathematical adjustments or better explain caveats to results when communicating with decision makers and the public in the crucial early stages of an epidemic.
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Affiliation(s)
- Michael M Thomas
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 790 Atlantic Dr NW, Atlanta, GA 30332, United States.
| | - Neda Mohammadi
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 790 Atlantic Dr NW, Atlanta, GA 30332, United States.
| | - John E Taylor
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 790 Atlantic Dr NW, Atlanta, GA 30332, United States.
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Liu Y, Tang C, Bu T, Tang D. Association of High-Speed Rail and Tuberculosis Transmission in Newly Integrated Regions: Quasi-Experimental Evidence from China. Int J Public Health 2021; 66:1604090. [PMID: 34840552 PMCID: PMC8613004 DOI: 10.3389/ijph.2021.1604090] [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: 03/20/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: The spread of tuberculosis (TB) is related to changes in the social network among the population and people’s social interactions. High-speed railway (HSR) fundamentally changed the integrated market across cities in China. This paper aims to examine the impact of HSR on TB transmission in newly integrated areas. Methods: By exploiting the opening and operation of the first HSR in Sichuan province as a quasi-natural experiment, we have collected and used the economic, social, and demographic data of 183 counties in Sichuan province from 2013 to 2016. Results: The new HSR line is associated with a 4.790 increase in newly diagnosed smear-positive TB cases per 100,000 people among newly integrated areas. On average, an additional increase of 34.178 newly diagnosed smear-positive TB cases occur every year in counties (or districts) covered by the new HSR. Conclusion: HSR development has significantly contributed to the transmission of TB. The public health system in China needs to pay more attention to the influences of new, mass public transportation.
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Affiliation(s)
- Yahong Liu
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Chengxiang Tang
- School of Public Administration, Guangzhou University, Guangzhou, China
| | - Tao Bu
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Daisheng Tang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
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Bao Y, Wang C, Xu H, Lai Y, Yan Y, Ma Y, Yu T, Wu Y. Effect of mHealth intervention for pulmonary tuberculosis self-management based on the Integrated Theory of Health Behavior Change (ITHBC): a randomized controlled trial (Preprint). JMIR Public Health Surveill 2021; 8:e34277. [PMID: 35834302 PMCID: PMC9335179 DOI: 10.2196/34277] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/26/2022] [Accepted: 04/26/2022] [Indexed: 01/18/2023] Open
Abstract
Background Improving the health self-management level of patients with tuberculosis (TB) is significant for reducing drug resistance, improving the cure rate, and controlling the prevalence of TB. Mobile health (mHealth) interventions based on behavioral science theories may be promising to achieve this goal. Objective This study aims to explore and conduct an mHealth intervention based on the Integrated Theory of Health Behavior Change (ITHBC) in patients with pulmonary TB to increase their ability of self-care management. Methods A prospective randomized controlled study was conducted from May to November 2020. A total of 114 patients who were admitted consecutively to the TB clinic of Harbin Chest Hospital, China from May 2020 to August 2020 were recruited by convenience sampling. Patients were divided into the control group and intervention group, and all received a 3-month intervention. Patients in the intervention group and the control group received routine medical and nursing care in the TB clinic, including the supervision of their medications. In addition, pharmacist-assisted mHealth (WeChat) intervention based on the ITHBC theory about TB management was provided to the intervention group. The primary outcome was self-management behavior, while the secondary outcomes were TB awareness, self-efficacy, social support, and degree of satisfaction with health education. The outcomes were measured using web-based self-designed and standard questionnaires administered at baseline and at the end point of the study. Intergroup data were assessed using the Mann-Whitney U test, whereas intragroup data were assessed with the Wilcoxon test (for paired samples). Results A total of 112 patients (59 in intervention group and 53 in control group) completed the study. After the intervention, a statistically significant increase was noted in the scores of each item of self-care management behaviors compared with the scores at the baseline (P<.001) in the intervention group. The scores of all self-care management behaviors of the control group were lower than those of all self-care management behaviors in the intervention group (all P<.05), except for the item “cover your mouth and nose when coughing or sneezing” (P=.23) and item “wash hands properly” (P=.60), which had no statistically significant difference from those in the intervention group. Compared with those at baseline, TB knowledge awareness, self-efficacy, social support, and degree of satisfaction with health education in the intervention group increased significantly (P<.001), and the intervention group had significantly higher scores than the control group (P<.001). Conclusions mHealth intervention for TB self-management based on ITHBC could deepen the understanding of patients with TB about their disease and improve their objective initiative and self-care management behaviors, which were beneficial for promoting compliance behavior and quality of prevention and control for pulmonary TB. Trial Registration Chinese Clinical Trial Registry ChiCTR2200055557; https://tinyurl.com/4ray3xnw
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Affiliation(s)
- Yuhan Bao
- Health Clinic, Changzhou Institute of Technology, Changzhou, China
| | - Chunxiang Wang
- School of Sciences, Changzhou Institute of Technology, Changzhou, China
| | - Haiping Xu
- School of Pharmaceutical Sciences, Shandong University, Jinan, China
| | - Yongjie Lai
- School of Pharmaceutical Sciences, Shandong University, Jinan, China
| | - Yupei Yan
- Department of Humanities, Arts and Media, Changzhi Medical College, Changzhi, China
| | - Yuanyuan Ma
- School of Public Health, Shandong University, Jinan, China
| | - Ting Yu
- School of Public Health, Shandong University, Jinan, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
- Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Health Culture Research Center of Shaanxi, Xi'an, China
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Laycock KM, Enane LA, Steenhoff AP. Tuberculosis in Adolescents and Young Adults: Emerging Data on TB Transmission and Prevention among Vulnerable Young People. Trop Med Infect Dis 2021; 6:148. [PMID: 34449722 PMCID: PMC8396328 DOI: 10.3390/tropicalmed6030148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 02/01/2023] Open
Abstract
Adolescents and young adults (AYA, ages 10-24 years) comprise a uniquely important but understudied population in global efforts to end tuberculosis (TB), the leading infectious cause of death by a single agent worldwide prior to the COVID-19 pandemic. While TB prevention and care strategies often overlook AYA by grouping them with either children or adults, AYA have particular physiologic, developmental, and social characteristics that require dedicated approaches. This review describes current evidence on the prevention and control of TB among AYA, including approaches to TB screening, dynamics of TB transmission among AYA, and management challenges within the context of unique developmental needs. Challenges are considered for vulnerable groups of AYA such as migrants and refugees; AYA experiencing homelessness, incarceration, or substance use; and AYA living with HIV. We outline areas for needed research and implementation strategies to address TB among AYA globally.
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Affiliation(s)
- Katherine M. Laycock
- Division of Infectious Diseases, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - Leslie A. Enane
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Andrew P. Steenhoff
- Division of Infectious Diseases, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Global Health Center, Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
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8
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Gu J, Xie XJ, Liu JX, Shui JR, Zhang HY, Feng GY, Liu XY, Li LC, Lan QW, Jin QH, Li R, Peng L, Lei CW, Zhang AY. Prevalence and transmission of antimicrobial-resistant Staphylococci and Enterococci from shared bicycles in Chengdu, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 738:139735. [PMID: 32531590 DOI: 10.1016/j.scitotenv.2020.139735] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/27/2020] [Accepted: 05/25/2020] [Indexed: 06/11/2023]
Abstract
Shared bicycles are prevailing in China but the extent to which they contribute to maintaining and transmitting pathogens and antibiotic-resistant bacteria remain largely unknown. To fill the knowledge gap, herein, swab samples (n = 963) were collected from handlebars of shared bicycles in areas of hospital, school, metro station (n = 887) and riders (n = 76) in Chengdu, China. Staphylococci (n = 241) and Enterococci (n = 69) were widely distributed across sampling locations at a frequency of 2.3%-12.9%, and 0.08%-5.5%, respectively. Bicycle or rider-borne Gram-positive bacteria were frequently resistant to clinically important antibiotics including linezolid, fosfomycin, and vancomycin, and a significant portion of these isolates (3.4%-16.6% for Staphylococci and 0.1%-13.8% for Enterococci) indicated multidrug resistance. Nineteen Staphylococcus aureus isolates were identified in this collection and 52.6% of which were considered as methicillin-resistant S. aureus. Whole genome sequencing further characterized 26 antimicrobial resistance genes (ARGs) including fosB, fusB, and lnu(G) in S. aureus and 21 ARGs including optrA in Enterococci. Leveraging a complementary approach with conventional MLST, whole genome SNP and MLST analyses, we present that genetically closely-related bacteria were found in bicycles and riders across geographical-distinct locations suggesting bacterial transmission. Further, five new ST types 5697-5701 were firstly characterized in S. aureus. ST 942 and ST 1640 are new ST types observed in E. faecalis, and E. faecium, respectively. Our results highlighted the risk of shared bicycle system in disseminating pathogens and antibiotic resistance which warrants effective disinfections.
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Affiliation(s)
- Ju Gu
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Xian-Jun Xie
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Jin-Xin Liu
- Department of Food Science and Technology, Robert Mondavi Institute for Wine and Food Science, University of California, Davis, One Shields Ave., Davis, CA 95616, United States of America
| | - Jun-Rui Shui
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Hao-Yu Zhang
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Gan-Yu Feng
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Xiao-Yu Liu
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Lin-Can Li
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Qi-Wei Lan
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Qi-Han Jin
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Rui Li
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Li Peng
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - Chang-Wei Lei
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China
| | - An-Yun Zhang
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, Sichuan, PR China.
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Tenzin C, Chansatitporn N, Dendup T, Dorji T, Lhazeen K, Tshering D, Pelzang T. Factors associated with multidrug-resistant tuberculosis (MDR-TB) in Bhutan: A nationwide case-control study. PLoS One 2020; 15:e0236250. [PMID: 32716965 PMCID: PMC7384628 DOI: 10.1371/journal.pone.0236250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 07/01/2020] [Indexed: 12/02/2022] Open
Abstract
Background Multidrug-resistant tuberculosis (MDR-TB) is a growing public health concern globally. In Bhutan, the rates of MDR-TB are high. Data on the risk factors of MDR-TB that can help inform policies are limited in Bhutan. This study aimed to determine the risk factors associated with MDR-TB. Methods A nationwide unmatched case-control study was conducted that included 79 MDR-TB cases and 118 controls. Data was collected by trained health workers through interviews using a structured questionnaire. Logistic regression analysis was performed to identify the risk factors associated with MDR-TB. Results The mean age of the participants was 32.4 and 33.7 years among the cases and the controls, respectively. In the multivariate analysis, the odds of having MDR-TB was higher among those who slept for less than 9 hours a day (AOR: 2.77, 95%CI: 1.11–6.92), frequently travelled in public transport (AOR: 2.96, 95% CI: 1.36–6.48), and had previous TB treatment (AOR: 5.90, 95%CI: 2.55–13.64). A greater number of rooms was also marginally associated with odds of having MDR-TB. Conclusions The findings suggest previous TB treatment, inadequate sleep duration, and travelling by public transport to be the risk factors associated with having MDR-TB in Bhutan. Intensification of early case detection, strengthening directly observed treatment strategy, improving treatment adherence, and increasing awareness can help control the rising MDR-TB epidemic.
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Affiliation(s)
- Chador Tenzin
- Bumthang General Hospital, Ministry of Health, Royal Government of Bhutan, Bumthang, Bhutan
- Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- * E-mail:
| | - Natkamol Chansatitporn
- Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Tashi Dendup
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Tandin Dorji
- Department of Medical Services, Ministry of Health, Royal Government of Bhutan, Kawangjangsa, Thimphu, Bhutan
| | - Karma Lhazeen
- Department of Public Health, Ministry of Health, Royal Government of Bhutan, Kawangjangsa, Thimphu, Bhutan
| | - Dorji Tshering
- Central Regional Referral Hospital, Ministry of Health, Royal Government of Bhutan, Gelephu, Bhutan
| | - Thinley Pelzang
- Phuentsholing General Hospital, Ministry of Health, Royal Government of Bhutan, Phuentsholing, Bhutan
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10
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Glasauer S, Kröger S, Haas W, Perumal N. International tuberculosis contact-tracing notifications in Germany: analysis of national data from 2010 to 2018 and implications for efficiency. BMC Infect Dis 2020; 20:267. [PMID: 32252650 PMCID: PMC7137477 DOI: 10.1186/s12879-020-04982-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/19/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND International contact-tracing (CT) following exposure during long-distance air travel is resource-intensive, whereas evidence for risk of tuberculosis (TB) transmission during international travel is weak. In this study, we systematically analyzed the information from international requests for CT received at the national level in Germany in order to evaluate the continued utility of the current approach and to identify areas for improvement. METHODS An anonymized archive of international CT notifications received by the Robert Koch Institute between 2010 and 2018 was searched for key parameters for data collection. A total of 31 parameters, such as characteristics of TB patients and their identified contacts, were extracted from each CT notification and collated into a dataset. Descriptive data analysis and trend analyses were performed to identify key characteristics of CT notifications, patients, and contacts over the years. RESULTS 192 CT notifications, each corresponding to a single TB index case, were included in the study, increasing from 12 in 2010 to 41 in 2018. The majority of notifications (N = 130, 67.7%) concerned international air travel, followed by private contact (N = 39, 20.3%) and work exposure (N = 16, 8.3%). 159 (82.8%) patients had sputum smear results available, of which 147 (92.5%) were positive. Of 119 (62.0%) patients with drug susceptibility testing results, most (N = 92, 77.3%) had pan-sensitive TB, followed by 15 (12.6%) with multi-drug resistant TB. 115 (59.9%) patients had information on infectiousness, of whom 99 (86.1%) were considered infectious during the exposure period. 7 (5.3%) patients travelled on long-distance flights despite a prior diagnosis of active TB. Of the 771 contact persons, 34 (4.4%) could not be reached for CT measures due to lack of contact information. CONCLUSION The high variability in completeness of information contained within the international CT requests emphasizes the need for international standards for reporting of CT information. With the large proportion of TB patients reported to have travelled while being infectious in our study, we feel that raising awareness among patients and health professionals to detect TB early and prevent international long-distance travel during the infectious disease phase should be a cornerstone strategy to safeguard against possible transmission during international travel.
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Affiliation(s)
- Saskia Glasauer
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Stefan Kröger
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Walter Haas
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Nita Perumal
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
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Gallego V, Berberian G, Siu H, Verbanaz S, Rodríguez-Morales AJ, Gautret P, Schlagenhauf P, Lloveras S. The 2019 Pan American games: Communicable disease risks and travel medicine advice for visitors to Peru - Recommendations from the Latin American Society for Travel Medicine (SLAMVI). Travel Med Infect Dis 2019; 30:19-24. [PMID: 31238107 DOI: 10.1016/j.tmaid.2019.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/29/2022]
Abstract
The next Pan American Games will be held in Peru in the period July-August 2019. Around 6680 participants from 41 countries are expected to take part in the event. There will be a total of 62 sport disciplines. This event poses specific challenges, given its size and the diversity of attendees. Such gatherings also have potential for the transmission of imported or endemic communicable diseases, including measles in view of the global outbreak situation, but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations taking into consideration the epidemiology and risks of the main communicable diseases at potential destinations in Peru, recommended immunizations and other preventives measures. These recommendations can be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Although Lima is malaria free, travelers visiting Peruvian high-risk areas for malaria should be assessed regarding the need for chemoprophylaxis. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing vector-borne infections. Other important recommendations for travelers should focus on preventing water- and food-borne diseases including travelers' diarrhea. This paper addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during the Pan American Games and also reviews the spectrum of endemic infections in Lima and Peru to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.
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Affiliation(s)
- Viviana Gallego
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Griselda Berberian
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Hugo Siu
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Lima, Peru
| | - Sergio Verbanaz
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Alfonso J Rodríguez-Morales
- Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, Institute for Epidemiology, Biostatistics and Prevention, Hirschengraben 84, 8001, Zürich, Switzerland
| | - Susana Lloveras
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina; Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia
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Bui DP, Oren E, Roe DJ, Brown HE, Harris RB, Knight GM, Gilman RH, Grandjean L. A Case-Control Study to Identify Community Venues Associated with Genetically-clustered, Multidrug-resistant Tuberculosis Disease in Lima, Peru. Clin Infect Dis 2019; 68:1547-1555. [PMID: 30239609 PMCID: PMC7181380 DOI: 10.1093/cid/ciy746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 08/24/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The majority of tuberculosis transmission occurs in community settings. Our primary aim in this study was to assess the association between exposure to community venues and multidrug-resistant (MDR) tuberculosis. Our secondary aim was to describe the social networks of MDR tuberculosis cases and controls. METHODS We recruited laboratory-confirmed MDR tuberculosis cases and community controls that were matched on age and sex. Whole-genome sequencing was used to identify genetically clustered cases. Venue tracing interviews (nonblinded) were conducted to enumerate community venues frequented by participants. Logistic regression was used to assess the association between MDR tuberculosis and person-time spent in community venues. A location-based social network was constructed, with respondents connected if they reported frequenting the same venue, and an exponential random graph model (ERGM) was fitted to model the network. RESULTS We enrolled 59 cases and 65 controls. Participants reported 729 unique venues. The mean number of venues reported was similar in both groups (P = .92). Person-time in healthcare venues (adjusted odds ratio [aOR] = 1.67, P = .01), schools (aOR = 1.53, P < .01), and transportation venues (aOR = 1.25, P = .03) was associated with MDR tuberculosis. Healthcare venues, markets, cinemas, and transportation venues were commonly shared among clustered cases. The ERGM indicated significant community segregation between cases and controls. Case networks were more densely connected. CONCLUSIONS Exposure to healthcare venues, schools, and transportation venues was associated with MDR tuberculosis. Intervention across the segregated network of case venues may be necessary to effectively stem transmission.
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Affiliation(s)
- David P Bui
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson
| | - Eyal Oren
- School of Public Health, San Diego State University, California
| | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson
| | - Heidi E Brown
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson
| | - Gwenan M Knight
- London School of Hygiene and Tropical Medicine, United Kingdom
| | - Robert H Gilman
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Louis Grandjean
- London School of Hygiene and Tropical Medicine, United Kingdom
- Universidad Peruana Cayetano Heredia, Lima, Peru
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Penaloza R, Navarro JI, Jolly PE, Junkins A, Seas C, Otero L. Health literacy and knowledge related to tuberculosis among outpatients at a referral hospital in Lima, Peru. Res Rep Trop Med 2019; 10:1-10. [PMID: 30881174 PMCID: PMC6400123 DOI: 10.2147/rrtm.s189201] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough or contact with a TB patient is an indication to seek formal health care. This study evaluated health literacy and TB knowledge among outpatients at Hospital Cayetano Heredia in Lima, Peru. METHODS A cross-sectional survey was performed between June and August 2017. Data on sociodemographic factors, TB knowledge, and health literacy were collected, and bivariate and multivariate logistic regressions were performed to study the associations between variables. RESULTS The analysis included 272 participants; 57.7% knew someone who had TB and 9% had TB in the past. A 2-week cough was reported as a TB symptom by 66 (24%) participants. High TB knowledge was found among 149 (54.8%) participants and high health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR=0.9; 95% CI 0.5-1.5). After controlling for sex, age, district, education, health insurance, frequency of hospital visits, and previous TB diagnosis, high TB knowledge was associated with knowing someone with TB (aOR=2.7; 95% CI 1.6-4.7) and inversely associated with being a public transport driver (aOR=0.2; 95% CI 0.05-0.9). Not living in poverty was the single factor associated with high health literacy (aOR=3.8; 95% CI 1.6-8.9). CONCLUSION Although TB knowledge was fair, 30% did not know that cough is a symptom of TB and >70% did not know being in contact with a TB patient is a risk factor for TB. Tailoring educational strategies to at-risk groups may enhance passive case detection especially among transport workers and TB contacts in Lima, Peru.
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Affiliation(s)
- Rosalina Penaloza
- University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, AL, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Charles R. Drew University, College of Medicine and Science, Los Angeles, CA, USA
| | - Joanna Itzel Navarro
- University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, AL, USA
- Graduate School of Education and Information Systems, University of California, Los Angeles, CA, USA
- Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, CA, USA
| | - Pauline E Jolly
- University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, AL, USA
| | - Anna Junkins
- University of Alabama at Birmingham, School of Public Health, Department of Epidemiology, Birmingham, AL, USA
| | - Carlos Seas
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru,
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru,
| | - Larissa Otero
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru,
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru,
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Little KM, Msandiwa R, Martinson N, Golub J, Chaisson R, Dowdy D. Yield of household contact tracing for tuberculosis in rural South Africa. BMC Infect Dis 2018; 18:299. [PMID: 29973140 PMCID: PMC6030742 DOI: 10.1186/s12879-018-3193-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 06/18/2018] [Indexed: 01/24/2023] Open
Abstract
Background Efficient and effective strategies for identifying cases of active tuberculosis (TB) in rural sub-Saharan Africa are lacking. Household contact tracing offers a potential approach to diagnose more TB cases, and to do so earlier in the disease course. Methods Adults newly diagnosed with active TB were recruited from public clinics in Vhembe District, South Africa. Study staff visited index case households and collected sputum specimens for TB testing via smear microscopy and culture. We calculated the yield and the number of households needed to screen (NHNS) to find one additional case. Predictors of new TB among household contacts were evaluated using multilevel logistic regression. Results We recruited 130 index cases and 282 household contacts. We identified 11 previously undiagnosed cases of bacteriologically-confirmed TB, giving a prevalence of 3.9% (95% CI: 2.0–6.9%) among contacts, a yield of 8.5 per 100 (95% CI: 4.2–15.1) index cases traced, and NHNS of 12 (95% CI: 7–24). The majority of new TB cases (10/11, 90.9%) were smear negative, culture positive. The presence of TB symptoms was not associated with an increased odds of active TB (aOR: 0.3, 95% CI: 0.1–1.4). Conclusions Household contacts of recently diagnosed TB patients in rural South Africa have high prevalence of TB and can be feasibly detected through contact tracing, but more sensitive tests than sputum smear are required. Symptom screening among household contacts had low sensitivity and specificity for active TB in this study.
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Affiliation(s)
- Kristen M Little
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Reginah Msandiwa
- Perinatal HIV Research Unit, Nurses Residence, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
| | - Neil Martinson
- Perinatal HIV Research Unit, Nurses Residence, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
| | - Jonathan Golub
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - David Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
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Abstract
Tuberculosis is responsible for more deaths worldwide than any other infectious disease. For anyone looking to learn more about this persistent public health threat, this conversational "frequently asked questions" style review addresses a breadth of questions. It offers a brief, somewhat opinionated, review of what is and is not known, particularly in light of how findings in the lab do or do not help inform the understanding of human tuberculosis.
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Affiliation(s)
- Kristine M Guinn
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Eric J Rubin
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Xu Z, Gao C, Ren QC, Song XF, Feng LS, Lv ZS. Recent advances of pyrazole-containing derivatives as anti-tubercular agents. Eur J Med Chem 2017; 139:429-440. [PMID: 28818767 DOI: 10.1016/j.ejmech.2017.07.059] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/23/2017] [Accepted: 07/24/2017] [Indexed: 01/18/2023]
Abstract
One-third of the world's population infected tuberculosis (TB), and more than 1 million deaths annually. The co-infection between the mainly pathogen Mycobacterium tuberculosis (MTB) and HIV, and the incidence of drug-resistant TB, multi-drug resistant TB, extensively drug-resistant TB as well as totally drug-resistant TB have further aggravated the mortality and spread of this disease. Thus, there is an urgent need to develop novel anti-TB agents against both drug-susceptible and drug-resistant TB. The wide spectrum of biological activities and successful utilization of pyrazole-containing drugs in clinic have inspired more and more attention towards this kind of heterocycles. Numerous of pyrazole-containing derivatives have been synthesized for searching new anti-TB agents, and some of them showed promising potency and may have novel mechanism of action. This review aims to outline the recent achievements in pyrazole-containing derivatives as anti-TB agents and their structure-activity relationship.
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Affiliation(s)
- Zhi Xu
- Key Laboratory of Hubei Province for Coal Conversion and New Carbon Materials, Wuhan University of Science and Technology, Hubei, PR China
| | - Chuan Gao
- WuXi AppTec (Wuhan), Hubei, PR China
| | | | - Xu-Feng Song
- Beijing University of Technology, Beijing, PR China
| | | | - Zao-Sheng Lv
- Key Laboratory of Hubei Province for Coal Conversion and New Carbon Materials, Wuhan University of Science and Technology, Hubei, PR China.
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Abstract
Transmission of tuberculosis (TB) is most effective in close contact indoor environments in various congregate settings including health care facilities, homeless shelters, correctional facilities, long-term care facilities, as well as community settings such as homes, schools, workplaces, and various modes of transportation. Outbreaks are fueled by numerous factors including the HIV epidemic, ease of global travel, unstable socio-economic and/or political situations, and lapses in response to potentially infectious patients. Organized approaches to TB control include an appropriate index of suspicion, identification and isolation of contagious patients in appropriate facilities, use of environmental controls, and personal protective equipment in accordance to national and international published guidelines. These all require tailoring to the various settings where TB is encountered using a determination of risk. Concerted efforts at the local, regional, national, and international levels at identifying patients with active disease, enforcing completion of treatment, and testing and fully treating patients with latent TB infection are paramount in reducing TB burden and continued transmission.
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Fang XH, Guan SY, Tang L, Tao FB, Zou Z, Wang JX, Kan XH, Wang QZ, Zhang ZP, Cao H, Ma DC, Pan HF. Effect of Short Message Service on Management of Pulmonary Tuberculosis Patients in Anhui Province, China: A Prospective, Randomized, Controlled Study. Med Sci Monit 2017; 23:2465-2469. [PMID: 28534476 PMCID: PMC5450853 DOI: 10.12659/msm.904957] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background To explore the significance of short message service (SMS) on the management of pulmonary tuberculosis (TB) patients in reinforcing the treatment adherence and health awareness, and provide scientific evidences for popularizing this model and formulating related polices and measures. Material/Methods Six counties (districts) were selected by stratified cluster sampling method, and randomly divided into control group and intervention group. Pulmonary TB patients eligible to the study criteria were included in the study. SMS management and regular education of core knowledge about pulmonary TB were carried out in SMS group patients. The conventional directly observed therapy (DOT) was carried out in control group. Data was collected by questionnaire method. Results A total of 350 patients were included in the study, including 160 cases in the SMS group and 190 cases in the control group. There were 270 males (77.1%) and 80 females (22.9%). The treatment completion rate in SMS group (96.25%) was significantly higher than that in the control group (86.84%) (χ2=9.52, P=0.002). Both the interrupted treatment rate and the missed dose rate in the SMS group were significantly lower than those in the control group (χ2=10.41, P=0.001; χ2=28.54, P<0.001). After a period of treatment, the reexamination rate of SMS group patients was significantly higher than that in control group (except the reexamination rate after 5 months treatment). Conclusions The management of pulmonary TB patients by SMS can effectively reinforce the completed treatment rate of pulmonary TB patients and reduce their missed dose rate and interrupted treatment rate, and further enhance their reexamination awareness. Therefore, SMS on the management of patients may be a new promising therapeutic strategy for pulmonary TB.
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Affiliation(s)
- Xue-Hui Fang
- Anhui Provincial TB Institute, Hefei, Anhui, China (mainland)
| | - Shi-Yang Guan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Li Tang
- Anhui Provincial TB Institute, Hefei, Anhui, China (mainland)
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Zheng Zou
- Anhui Provincial TB Institute, Hefei, Anhui, China (mainland)
| | - Ji-Xiang Wang
- Anhui Provincial TB Institute, Hefei, Anhui, China (mainland)
| | - Xiao-Hong Kan
- Anhui Provincial TB Institute, Hefei, Anhui, China (mainland)
| | - Quan-Zhi Wang
- Lu'an Center for Disease Control and Prevention, Lu'an, Anhui, China (mainland)
| | - Zhi-Ping Zhang
- Anqing Center for Disease Control and Prevention, Anqing, Anhui, China (mainland)
| | - Hong Cao
- Hefei Center for Disease Control and Prevention, Hefei, Anhui, China (mainland)
| | - Dong-Chun Ma
- Anhui Provincial TB Institute, Hefei, Anhui, China (mainland)
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China (mainland)
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Molton JS, Pang Y, Wang Z, Qiu B, Wu P, Rahman-Shepherd A, Ooi WT, Paton NI. Prospective single-arm interventional pilot study to assess a smartphone-based system for measuring and supporting adherence to medication. BMJ Open 2016; 6:e014194. [PMID: 27998903 PMCID: PMC5223626 DOI: 10.1136/bmjopen-2016-014194] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Suboptimal medication adherence for infectious diseases such as tuberculosis (TB) results in poor clinical outcomes and ongoing infectivity. Directly observed therapy (DOT) is now standard of care for TB treatment monitoring but has a number of limitations. We aimed to develop and evaluate a smartphone-based system to facilitate remotely observed therapy via transmission of videos rather than in-person observation. DESIGN We developed an integrated smartphone and web-based system (Mobile Interactive Supervised Therapy, MIST) to provide regular medication reminders and facilitate video recording of pill ingestion at predetermined timings each day, for upload and later review by a healthcare worker. We evaluated the system in a single arm, prospective study of adherence to a dietary supplement. Healthy volunteers were recruited through an online portal. Entry criteria included age ≥21 and owning an iOS or Android-based device. Participants took a dietary supplement pill once, twice or three-times a day for 2 months. We instructed them to video each pill taking episode using the system. OUTCOME Adherence as measured by the smartphone system and by pill count. RESULTS 42 eligible participants were recruited (median age 24; 86% students). Videos were classified as received-confirmed pill intake (3475, 82.7% of the 4200 videos expected), received-uncertain pill intake (16, <1%), received-fake pill intake (31, <1%), not received-technical issues (223, 5.3%) or not received-assumed non-adherence (455, 10.8%). Overall median estimated participant adherence by MIST was 90.0%, similar to that obtained by pill count (93.8%). There was a good relationship between participant adherence as measured by MIST and by pill count (Spearmans rs 0.66, p<0.001). CONCLUSIONS We have demonstrated the feasibility, acceptability and accuracy of a smartphone-based adherence support and monitoring system. The system has the potential to supplement and support the provision of DOT for TB and also to improve adherence in other conditions such as HIV and hepatitis C.
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Affiliation(s)
- James S Molton
- University Medicine Cluster, National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yan Pang
- University Medicine Cluster, National University Health System, Singapore, Singapore
| | - Zhuochun Wang
- School of Computing, National University of Singapore, Singapore, Singapore
| | - Boqin Qiu
- School of Computing, National University of Singapore, Singapore, Singapore
| | - Pei Wu
- School of Computing, National University of Singapore, Singapore, Singapore
| | | | - Wei Tsang Ooi
- School of Computing, National University of Singapore, Singapore, Singapore
| | - Nicholas I Paton
- University Medicine Cluster, National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Lukac D, Garaycochea O, Taype-Rondan A, Luque Bustamante L, Mujica-Vasquez A, Zamora D. [Knowledge and perception about tuberculosis among public transport workers in Lima, Peru]. Medwave 2016; 16:e6629. [PMID: 27922582 DOI: 10.5867/medwave.2016.10.6629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 10/21/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To describe the level of knowledge and perception of tuberculosis among public transport workers attending Road Safety Education courses in Lima, Peru. METHODS An observational, cross-sectional, analytic study was conducted between July and August 2014 in public transport workers attending the courses of Road Safety education. In Lima, such courses are mandatory for workers in the public transport area. An anonymous and voluntary survey was applied to obtain the following variables: sociodemographic characteristics, history of tuberculosis, tuberculosis knowledge and attitudes towards the disease. The factors associated to the risk perception of Tuberculosis infection were analysed using Poisson regression. RESULTS From 309 attendees, 216 surveys were analysed (69.9%). Of these, 88.4% were males, 3.2% had a history of tuberculosis. The most widely known symptom was cough with phlegm (44.4%), the most popular source of information was television (39.8%), and only 9.7% had any training about tuberculosis. A 41.2% of respondents believed that working in the public transport sector was an occupation with a high risk of tuberculosis infection. No significant association between risk perception of tuberculosis and sociodemographic characteristics was found. CONCLUSION A considerable lack of knowledge about tuberculosis symptoms and a low perception of risk for tuberculosis exists among public transport workers in Lima. Education strategies directed to this population need to be implemented.
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Affiliation(s)
- Danitza Lukac
- Facultad de Medicina Humana, Universidad San Martín de Porres, Lima, Perú. Address: Leonidas Yerovi 297, San Isidro, Lima, Perú.
| | | | | | | | | | - Dario Zamora
- Facultad de Medicina Humana, Universidad San Martín de Porres, Lima, Perú
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Ncayiyana JR, Bassett J, West N, Westreich D, Musenge E, Emch M, Pettifor A, Hanrahan CF, Schwartz SR, Sanne I, van Rie A. Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study. BMC Infect Dis 2016; 16:661. [PMID: 27825307 PMCID: PMC5101651 DOI: 10.1186/s12879-016-1989-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 10/28/2016] [Indexed: 01/18/2023] Open
Abstract
Background South Africa has one of the highest burdens of latent tuberculosis infection (LTBI) in high-risk populations such as young children, adolescents, household contacts of TB cases, people living with HIV, gold miners and health care workers, but little is known about the burden of LTBI in its general population. Methods Using a community-based survey with random sampling, we examined the burden of LTBI in an urban township of Johannesburg and investigated factors associated with LTBI. The outcome of LTBI was based on TST positivity, with a TST considered positive if the induration was ≥5 mm in people living with HIV or ≥10 mm in those with unknown or HIV negative status. We used bivariate and multivariable logistic regression to identify factors associated with LTBI Results The overall prevalence of LTBI was 34.3 (95 % CI 30.0, 38.8 %), the annual risk of infection among children age 0–14 years was 3.1 % (95 % CI 2.1, 5.2). LTBI was not associated with HIV status. In multivariable logistic regression analysis, LTBI was associated with age (OR = 1.03 for every year increase in age, 95 % CI = 1.01–1.05), male gender (OR = 2.70, 95 % CI = 1.55–4.70), marital status (OR = 2.00, 95 % CI = 1.31–3.54), and higher socio-economic status (OR = 2.11, 95 % CI = 1.04–4.31). Conclusions The prevalence of LTBI and the annual risk of infection with M. tuberculosis is high in urban populations, especially in men, but independent of HIV infection status. This study suggests that LTBI may be associated with higher SES, in contrast to the well-established association between TB disease and poverty.
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Affiliation(s)
- Jabulani R Ncayiyana
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. .,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa.
| | - Jean Bassett
- Witkoppen Health and Welfare Centre, 105 William Nicol Drive, Fourways, Johannesburg, 2055, South Africa
| | - Nora West
- Witkoppen Health and Welfare Centre, 105 William Nicol Drive, Fourways, Johannesburg, 2055, South Africa
| | - Daniel Westreich
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Eustasius Musenge
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa
| | - Michael Emch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Audrey Pettifor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Colleen F Hanrahan
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Sheree R Schwartz
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Ian Sanne
- Clinical HIV Research Unit, Department of Medicine, University of the Witwatersrand, Perth Road, Auckland Park, Johannesburg, 2092, South Africa
| | - Annelies van Rie
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.,Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, University Square, Wilrijk, Antwerp, 2610, Belgium
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