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Vyklyuk Y, Semianiv I, Nevinskyi D, Todoriko L, Boyko N. Applying geospatial multi-agent system to model various aspects of tuberculosis transmission. New Microbes New Infect 2024; 59:101417. [PMID: 38737327 PMCID: PMC11088189 DOI: 10.1016/j.nmni.2024.101417] [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: 01/13/2024] [Revised: 04/05/2024] [Accepted: 04/25/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction The paper presents epidemiological process modeling, with a focus on tuberculosis utilizing multi-agent system. Material and methods This study involves the development of an algorithm that harnesses the potential of artificial intelligence to create a geospatial model that highlights the different pathways of TB transmission. The modeling process itself is characterized by a series of key stages, including initialization of the city, calibration of health parameters, simulation of the working day, propagation of the spread of infection, the evolution of disease trajectories, rigorous statistical calculations and transition to the following day. A comprehensive description of the course of active tuberculosis is presented, following the official hypothesis recommended by the World Health Organization. A comprehensive simulation, illustrating the propagation of tuberculosis in an entirely healthy environment devoid of any preventive or therapeutic measures, is presented. To ascertain the adequacy of the model and its sensitivity to the principal parameters governing the course of tuberculosis, a series of experiments were meticulously conducted, employing three distinct approximations, namely: the basic model, the model incorporating mortality factors, and the comprehensive model, encompassing all relevant aspects. Conclusions The model's results exhibit stability and lack of significant fluctuations. The statistical values obtained for infected, latent, and recovered individuals align well with known medical data, confirming the model's adequacy.
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Affiliation(s)
- Yaroslav Vyklyuk
- Lviv Polytechnic National University, The Department of Artificial Intelligence, Lviv, Ukraine
| | - Ihor Semianiv
- Bukovinian State Medical University, The Department of Pathobiology and Pulmonology, Chernivtsi, Ukraine
| | - Denys Nevinskyi
- Lviv Polytechnic National University, The Department of Electronics and Information Technology, Lviv, Ukraine
| | - Lilia Todoriko
- Bukovinian State Medical University, The Department of Pathobiology and Pulmonology, Chernivtsi, Ukraine
| | - Nataliya Boyko
- Lviv Polytechnic National University, The Department of Artificial Intelligence, Lviv, Ukraine
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Dadu A, Yedilbayev A, Migliori GB, Ahmedov S, Falzon D, den Boon S, Kanchar A, Matteelli A. PASS to End TB in Europe: Accelerated efforts on prevention and systematic screening to end tuberculosis in the WHO European Region by 2030. Int J Infect Dis 2024; 141S:106980. [PMID: 38403111 DOI: 10.1016/j.ijid.2024.02.023] [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: 01/17/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVES Outline the objectives, methods, and initial stages of the Prevention and Systematic Screening (PASS) initiative, a complimentary element of the innovative new approach of technical assistance mechanisms of WHO and its partners to countries aligned to the Regional TB Action Plan to End TB in the European Region by 2030. DESIGN To provide an objective and critical overview of the existing landscape on TB epidemic in the WHO European Region (the European Region) and ii) identify the strategic significance of proactive measures aimed at approaching TB pre-elimination in the Region. RESULTS Interventions primarily include systematic screening for TB disease and treatment for TB infection (TBI). CONCLUSIONS PASS to End TB is an exemplary initiative of how technical and funding partners are joining hands to support national health programmes to work towards global commitments to curb major public health challenges like TB.
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Affiliation(s)
- Andrei Dadu
- World Health Organization, Regional Office for Europe, European Tuberculosis Programme, Copenhagen, Denmark
| | - Askar Yedilbayev
- World Health Organization, Regional Office for Europe, European Tuberculosis Programme, Copenhagen, Denmark
| | - Giovanni Battista Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy.
| | - Sevim Ahmedov
- The United States Agency of International Development (USAID), Bureau of Global Health, TB Division, Washington, DC, USA
| | - Dennis Falzon
- World Health Organization, Global Tuberculosis Programme, Geneva, Switzerland
| | - Saskia den Boon
- World Health Organization, Global Tuberculosis Programme, Geneva, Switzerland
| | - Avinash Kanchar
- World Health Organization, Global Tuberculosis Programme, Geneva, Switzerland
| | - Alberto Matteelli
- Department of Clinical and Experimental Sciences (DSCS), WHO Collaborating Centre on Tuberculosis Prevention, Institute for Infectious and Tropical Diseases, University of Brescia, Brescia, Italy
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Pedersen OS, Butova T, Kapustnyk V, Miasoiedov V, Kuzhko M, Hryshchuk L, Kornaha S, Borovok N, Raznatovska O, Fedorec A, Bogomolov A, Tkhorovskiy M, Akymenko O, Klymenko I, Kulykova O, Karpenko Z, Shapoval T, Chursina N, Kondratyuk N, Parkhomenko O, Sazonenko I, Ostrovskyy M, Makoida I, Markovtsiy L, Skryp V, Lubenko V, Hrankina N, Bondarenko L, Hlynenko V, Dahl VN, Butov D. Treatment outcomes and risk factors for an unsuccessful outcome among patients with highly drug-resistant tuberculosis in Ukraine. Clin Microbiol Infect 2024; 30:360-367. [PMID: 38065363 DOI: 10.1016/j.cmi.2023.12.001] [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: 10/23/2023] [Revised: 11/28/2023] [Accepted: 12/02/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To describe demographics, clinical features, and treatment outcomes of patients with highly drug-resistant tuberculosis (TB) in Ukraine, and to evaluate risk factors for an unsuccessful outcome. METHODS Data from patients with multi-, pre-extensively, or extensively drug-resistant TB were collected prospectively from TB dispensaries in 15 out of 24 Ukrainian oblasts (regions) from 2020 to 2021. Treatment outcomes were evaluated using WHO definitions. Risk factors for an unsuccessful outcome were identified using a multivariable logistic regression model. RESULTS Among 1748 patients, the overall proportion of successful outcomes was 58% (95% confidence interval [95% CI] 56-60) (n = 1015/1748), ranging from 65% (95% CI: 62-69) (n = 531/814) for multidrug-resistant TB to 54% (95% CI: 49-58) (n = 301/563) for pre-extensively drug-resistant TB and 49% (95% CI: 44-55) (n = 183/371) for extensively drug-resistant TB. Results were similar across oblasts, with few exceptions. The strongest risk factors for an unsuccessful outcome were extensively drug-resistant TB (adjusted OR [aOR] 3.23; 95% CI: 1.88-5.53), total serum protein below 62 g/L in adults and below 57 g/L for children and adolescents (aOR 2.79; 95% CI: 1.93-4.04), psychiatric illness (aOR 2.79; 95% CI: 1.46-5.33), age at TB diagnosis >65 years (aOR 2.50; 95% CI: 1.42-4.42), and alcohol misuse (aOR 2.48; 95% CI: 1.89-3.26). DISCUSSION The overall proportion of successful outcomes among Ukrainians treated for highly drug-resistant TB was 58%, notably better compared with previous years, but still low for extensively drug-resistant TB. Risk factors for unsuccessful outcomes highlight that addressing socioeconomic factors in TB management is crucial. Efforts in maintaining TB dispensaries during and following the ongoing war are highly warranted.
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Affiliation(s)
- Ole Skouvig Pedersen
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Tetiana Butova
- Outpatient Department, Merefa Central District Hospital, Merefa, Ukraine
| | | | | | - Mykhailo Kuzhko
- Department of Chemoresistant Tuberculosis, National Institute of Phthisiology and Pulmonology named after F. G. Yanovskyi NAMS of Ukraine, Kiev, Ukraine
| | - Leonid Hryshchuk
- Department of Internal Medicine Propedeutics and Phthisiology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Svitlana Kornaha
- Department of Internal Medicine Propedeutics and Phthisiology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Natalia Borovok
- Medical Department No. 3, Regional Anti-tuberculosis Dispensary No 1 in Kharkiv, Kharkiv, Ukraine
| | - Olena Raznatovska
- Phthisiology and Pulmonology, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
| | - Andrii Fedorec
- The Pulmonary Tuberculosis Department No. 2, Zaporizhzhia Regional Phthisiology and Pulmonology Clinical Treatment and Diagnostic Center, Zaporizhzhia, Ukraine
| | - Artemii Bogomolov
- Phthisiology, Clinical Immunology and Allergology, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Mykhaylo Tkhorovskiy
- Phthisiology, Clinical Immunology and Allergology, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Oleksandra Akymenko
- Medical Department No. 3, Regional Anti-tuberculosis Dispensary No 1 in Kharkiv, Kharkiv, Ukraine
| | | | - Olena Kulykova
- Outpatient Department, Regional Clinical Tuberculosis Dispensary, Kramatorsk, Ukraine
| | - Zhanna Karpenko
- Phthisiatry Center, Chernihiv Regional Hospital, Chernihiv, Ukraine
| | - Tetiana Shapoval
- Phthisiatry Center, Chernihiv Regional Hospital, Chernihiv, Ukraine
| | | | - Natalia Kondratyuk
- Bacteriological Laboratory, Volyn Regional Phthisiopulmonological Center, Lutsk, Ukraine
| | - Olha Parkhomenko
- Mykolaiv Regional Phthisio-pulmonological Medical Center, Mykolaiv, Ukraine
| | - Inna Sazonenko
- Phthisiology, Mykolaiv Regional Phthisiology and Pulmonology Medical Center, Mykolaiv, Ukraine
| | - Mykola Ostrovskyy
- Phthisiology and Pulmonology Rate of Occupational Diseases, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Iryna Makoida
- Phthisiology and Pulmonology Rate of Occupational Diseases, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | | | - Vasyl Skryp
- Center of Pulmonary Diseases, Uzhhorod, Ukraine
| | - Victoriya Lubenko
- Information and Analytical Department, Phthisiopulmonology Center, Kyiv, Ukraine
| | - Nataliia Hrankina
- Infectious Diseases and Phthisiology, Krivoy Rig Tuberculosis Dispensary, Dnipro, Ukraine
| | - Leonid Bondarenko
- Administration, Sumy Regional Clinical Anti-tuberculosis Dispensary, Sumy, Ukraine
| | - Valentyna Hlynenko
- Outpatient Department, Sumy Regional Clinical Anti-tuberculosis Dispensary, Sumy, Ukraine
| | - Victor Næstholt Dahl
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; Center for Global Health, Aarhus University (GloHAU), Aarhus, Denmark; International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.
| | - Dmytro Butov
- Infectious Diseases and Phthisiology, Kharkiv National Medical University, Kharkiv, Ukraine
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Haldar P, Ahyow L, Dedicoat M. Responding to the tuberculosis risk of forced mass migration from Ukraine: a complex challenge with no single solution. Thorax 2023; 79:5-6. [PMID: 37758459 DOI: 10.1136/thorax-2023-220502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Pranabashis Haldar
- Respiratory Sciences and NIHR Respiratory BRC, University of Leicester, Leicester, UK
| | - Lauren Ahyow
- Tuberculosis Unit, UK Health Security Agency, London, UK
| | - Martin Dedicoat
- Tuberculosis Unit, UK Health Security Agency, London, UK
- Infectious Diseases, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Wilczek NA, Brzyska A, Bogucka J, Sielwanowska WE, Żybowska M, Piecewicz-Szczęsna H, Smoleń A. The Impact of the War in Ukraine on the Epidemiological Situation of Tuberculosis in Europe. J Clin Med 2023; 12:6554. [PMID: 37892699 PMCID: PMC10607046 DOI: 10.3390/jcm12206554] [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: 09/15/2023] [Revised: 09/22/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Ukraine is at the forefront of one of the largest outbreaks of tuberculosis (TB) in Europe, including multidrug-resistant tuberculosis. Due to the ongoing armed conflict in this area, there is a significant number of refugees from Ukraine to other European countries. The aim of the study is to emphasize the essence of the problem of the increased incidence of tuberculosis, taking into account the impact of the armed conflict in Ukraine, resulting in the intensification of migration movements. A descriptive epidemiological method was used as the research method. The material was collected by analyzing source statistical data from WHO and statistical yearbooks of selected European countries. Particularly, Ukrainian refugees in Poland, Germany, the Czech Republic, and Slovakia are at higher risk of contracting tuberculosis due to factors like migration stress, poor nutrition, and comorbidities. Epidemiological data from these countries show a rise in tuberculosis cases among foreigners, emphasizing the need for European specialists to be more vigilant in this unique situation, focusing on refugees and other vulnerable populations. More research and collaborative efforts are essential to closely monitor and prevent the severe outcomes of tuberculosis transmission.
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Affiliation(s)
- Natalia Anna Wilczek
- The Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, 20-081 Lublin, Poland; (A.B.); (J.B.); (W.E.S.); (M.Ż.); (H.P.-S.); (A.S.)
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Hauer B, Kröger S, Haas W, Brodhun B. Tuberculosis in times of war and crisis: Epidemiological trends and characteristics of patients born in Ukraine, Germany, 2022. Euro Surveill 2023; 28:2300284. [PMID: 37318760 PMCID: PMC10318937 DOI: 10.2807/1560-7917.es.2023.28.24.2300284] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/16/2023] Open
Abstract
The Russian invasion of Ukraine in 2022 caused a large migration to other European countries, including Germany. This movement impacted the TB epidemiology, as Ukraine has a higher prevalence of TB and multidrug-resistant TB rates compared to Germany. Our descriptive analysis of TB surveillance data reveals important information to improve TB care in people displaced from Ukraine. We observed an expected increase in the number of TB patients born in Ukraine, which is, however, so far below WHO/Europe estimates.
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Affiliation(s)
- Barbara Hauer
- Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Stefan Kröger
- Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Walter Haas
- Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Bonita Brodhun
- Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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