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Trajman A. The social drivers of tuberculosis, reconfirmed. Lancet Infect Dis 2024; 24:5-6. [PMID: 37591302 DOI: 10.1016/s1473-3099(23)00390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Anete Trajman
- Federal University of Rio de Janeiro, Rio de Janeiro 21941-617, Brazil; McGill University, Montreal, QC, Canada.
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2
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Bayly H, Mei W, Egeren D, Stoddard M, Chakravarty A, White LF. Accuracy of Inferences About the Reproductive Number and Superspreading Potential of SARS-CoV-2 with Incomplete Contact Tracing Data. Res Sq 2023:rs.3.rs-3760127. [PMID: 38234843 PMCID: PMC10793487 DOI: 10.21203/rs.3.rs-3760127/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
The basic reproductive number (R0) and superspreading potential ( k ) are key epidemiological parameters that inform our understanding of a disease's transmission. Often these values are estimated using the data obtained from contact tracing studies. Here we performed a simulation study to understand how incomplete data due to preferential contact tracing impacted the accuracy and inferences about the transmission of SARS-CoV-2. Our results indicate that as the number of positive contacts traced decreases, our estimates of R0 tend to decrease and our estimates of ktend to increase. Notably, when there are large amounts of positive contacts missed in the tracing process, we can conclude that there is no indication of superspreading even if we know there is. The results of this study highlight the need for a unified public health response to transmissible diseases.
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Affiliation(s)
| | - Winnie Mei
- University of Washington School of Public Health
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Afshari M, Dehmardeh A, Hoseini A, Moosazadeh M. Tuberculosis infection among children under six in contact with smear positive cases: A study in a hyper endemic area of Iran. J Clin Tuberc Other Mycobact Dis 2023; 30:100347. [PMID: 36713330 PMCID: PMC9874550 DOI: 10.1016/j.jctube.2023.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introduction Annually, tens of millions of children are being exposed to tuberculosisinfection. Note that children are in higher risk of getting infection and sever types of the disease, detecting the factors associated with transmission of the tuberculosis infection and disease to the exposed children is necessary for disease prevention within the community. Methods In this retrospective cohort study, 50 children under 6 who were in close contact with 25 smear-positive pulmonary tuberculosis cases in Sistan-Baloochistanprovine, Iran, were investigated. Demographic, behavioral and clinical characteristics of children and index cases were collected and tuberculosis infection and disease was assessed using the WHO guidelines. Results Of 50 children exposed to the active cases, 12 (24 %) were infected to tuberculosis but none of them had active disease. We also found significant associations of the history of diabetes mellitus in the index cases (p = 0.043) and large family size (p = 0.026) with the increased risk of infection among the exposed children. Conclusion Children under six which are in close contact with diabetic tuberculosis cases in large families are in higher risk of getting infection.
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Affiliation(s)
- Mahdi Afshari
- Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Aref Hoseini
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,Corresponding author.
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Abdollahi E, Keynan Y, Foucault P, Brophy J, Sheffield H, Moghadas SM. Evaluation of TB elimination strategies in Canadian Inuit populations: Nunavut as a case study. Infect Dis Model 2022; 7:698-708. [PMID: 36313153 PMCID: PMC9583452 DOI: 10.1016/j.idm.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/26/2022] [Indexed: 11/26/2022] Open
Abstract
Tuberculosis (TB) continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born, non-Indigenous people. Inuit Tuberculosis Elimination Framework has set the goal of reducing active TB incidence by at least 50% by 2025, aiming to eliminate it by 2030. Whether these goals are achievable with available resources and treatment regimens currently in practice has not been evaluated. We developed an agent-based model of TB transmission to evaluate timelines and milestones attainable in Nunavut, Canada by including case findings, contact-tracing and testing, treatment of latent TB infection (LTBI), and the government investment on housing infrastructure to reduce the average household size. The model was calibrated to ten years of TB incidence data, and simulated for 20 years to project program outcomes. We found that, under a range of plausible scenarios with tracing and testing of 25%–100% of frequent contacts of detected active cases, the goal of 50% reduction in annual incidence by 2025 is not achievable. If active TB cases are identified rapidly within one week of becoming symptomatic, then the annual incidence would reduce below 100 per 100,000 population, with 50% reduction being met between 2025 and 2030. Eliminating TB from Inuit populations would require high rates of contact-tracing and would extend beyond 2030. The findings indicate that time-to-identification of active TB is a critical factor determining program effectiveness, suggesting that investment in resources for rapid case detection is fundamental to controlling TB. TB elimination in Inuit populations would likely extend beyond timelines outlined in action plans. Rapid case findings combined with testing of frequent contacts are fundamental to TB control. Reducing average household size has minimal effect on rates of TB incidence.
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Abstract
Early in the COVID-19 pandemic, models predicted hundreds of thousands of additional TB deaths as a result of health service disruption. To date, empirical evidence on the effects of COVID-19 on TB outcomes has been limited. Here we summarise the evidence available at a country level, identifying broad mechanisms by which COVID-19 may modify TB burden and mitigation efforts. From the data, it is clear that there have been substantial disruptions to TB health services and an increase in vulnerability to TB. Evidence for changes in Mycobacterium tuberculosis transmission is limited, and it remains unclear how the resources required and available for the TB response have changed. To advocate for additional funding to mitigate the impact of COVID-19 on the global TB burden, and to efficiently allocate resources for the TB response, requires a significant improvement in the TB data available.
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Affiliation(s)
- C F McQuaid
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - A Vassall
- Department of Global Health Development, Faculty of Public Health and Policy, LSHTM, London, UK
| | - T Cohen
- Yale School of Public Health, Laboratory of Epidemiology and Public Health, New Haven, CT, USA
| | - K Fiekert
- KNCV Tuberculosefonds, The Hague, the Netherlands
| | - R G White
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
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Mandalakas AM, Hesseling AC, Kay A, Du Preez K, Martinez L, Ronge L, DiNardo A, Lange C, Kirchner HL. Tuberculosis prevention in children: a prospective community-based study in South Africa. Eur Respir J 2021; 57:13993003.03028-2020. [PMID: 33122339 PMCID: PMC8060782 DOI: 10.1183/13993003.03028-2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022]
Abstract
Tuberculosis (TB) preventive therapy reduces TB risk in children. However, the effectiveness of TB preventive therapy in children living in high TB burden settings is unclear. In a prospective observational community-based cohort study in Cape Town, South Africa, we assessed the effectiveness of routine TB preventive therapy in children ≤15 years of age in a high TB and HIV prevalence setting. Among 966 children (median (interquartile range) age 5.07 (2.52–8.72) years), 676 (70%) reported exposure to an adult with TB in the past 3 months and 240 out of 326 (74%) eligible children initiated isoniazid preventive therapy under programmatic guidelines. Prevalent (n=73) and incident (n=27) TB were diagnosed among 100 out of 966 (10%) children. Children who initiated isoniazid preventive therapy were 82% less likely to develop incident TB than children who did not (adjusted OR 0.18, 95% CI 0.06–0.52; p=0.0014). Risk of incident TB increased if children were <5 years of age, living with HIV, had a positive Mycobacterium tuberculosis-specific immune response or recent TB exposure. The risk of incident TB was not associated with sex or Mycobacterium bovis bacille Calmette–Guérin vaccination status. Number needed to treat (NNT) was lowest in children living with HIV (NNT=15) and children <5 years of age (NNT=19) compared with children of all ages (NNT=82). In communities with high TB prevalence, TB preventive therapy substantially reduces the risk of TB among children who are <5 years of age or living with HIV, especially those with recent TB exposure or a positive M. tuberculosis-specific immune response in the absence of disease. In high TB burden communities, preventive therapy substantially reduces risk of TB among child contacts, especially those who are <5 years of age, living with HIV, recently TB exposed or have a positive M. tuberculosis-specific immune responsehttps://bit.ly/3dKHpUc
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Affiliation(s)
- Anna M Mandalakas
- Global Tuberculosis Program, Dept of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Anneke C Hesseling
- Desmond Tutu TB Centre, Dept of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Alexander Kay
- Global Tuberculosis Program, Dept of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.,Baylor College of Medicine Children's Foundation - Eswatini, Mbabane, Swaziland
| | - Karen Du Preez
- Desmond Tutu TB Centre, Dept of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leonardo Martinez
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Lena Ronge
- Desmond Tutu TB Centre, Dept of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Andrew DiNardo
- Global Tuberculosis Program, Dept of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Christoph Lange
- German Center for Infection Research (DZIF) Clinical Tuberculosis Center, Research Center Borstel, Borstel, Germany.,Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany.,Dept of Medicine, Karolinska Institute, Stockholm, Sweden
| | - H Lester Kirchner
- Global Tuberculosis Program, Dept of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.,Dept of Population Health Sciences, Geisinger, Danville, PA, USA
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Campbell JR, Bastos ML. No time to waste: preventing tuberculosis in children. Lancet 2020; 395:924-926. [PMID: 32199475 DOI: 10.1016/s0140-6736(20)30532-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Jonathon R Campbell
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC H3A 1A2, Canada; McGill International TB Centre, Montreal, QC, Canada.
| | - Mayara L Bastos
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC H3A 1A2, Canada; McGill International TB Centre, Montreal, QC, Canada; Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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dos Santos VM. Pulmonary tuberculosis in young people. Russ Open Med J 2019. [DOI: 10.15275/rusomj.2019.0413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Tuberculosis is a global health problem and the main cause of death in the whole world. Young individuals are significantly affected in the low- and medium income countries. The children are more often infected by close contact with familiar adults at home, and lung tuberculosis with cavities plays a major role in environmental contamination. Their primary infection may evolve to primary tuberculosis without specific manifestations. The diagnostic challenges may be solved by higher clinical suspicion index associated with complementary investigation tools including tuberculin skin test and chest X-rays. These comments aim to enhance the awareness of lung tuberculosis at younger ages.
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