Background:Quick diagnosis of smear-negative pulmonary tuberculosis(TB)and extra-pulmonary TB are urgently needed in clinical diagnosis.Our research aims to investigate the usefulness of the interferon-γrelease assay...Background:Quick diagnosis of smear-negative pulmonary tuberculosis(TB)and extra-pulmonary TB are urgently needed in clinical diagnosis.Our research aims to investigate the usefulness of the interferon-γrelease assay(IGRA)for the diagnosis of smear-negative pulmonary and extra-pulmonary TB.Methods:We performed TB antibody and TB-IGRA tests on 389 pulmonary TB patients(including 120 smear-positive pulmonary TB patients and 269 smear-negative pulmonary TB patients),113 extra-pulmonary TB patients,81 patients with other pulmonary diseases and 100 healthy controls.Blood samples for the TB-Ab test and the TB-IGRA were collected,processed,and interpreted according to the manufacturer’s protocol.Results:The detection ratio of smear-positive pulmonary TB patients and smear-negative pulmonary TB patients were 90.8%(109 of 120)and 89.6%(241 of 269),respectively.There was no statistically significant difference of its performance between these two sample sets(P>0.05).The detection ratio of positive TB patients and extra-pulmonary TB patients were 90.0%(350 of 389)and 87.6%(99 of 113),respectively,which was not significantly different(P>0.05).Conclusions:In this work,the total detection ratio using TB-IGRA was 89.4%,therefore TB-IGRA has diagnostic values in smear-negative pulmonary TB and extra-pulmonary TB diagnosis.展开更多
<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:&...<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Due to the limitations of diagnosis by Xpert MTB/RIF assay, WHO suggests Loop</span><b><span style="font-family:Verdana;">—</span></b><span style="font-family:Verdana;">Mediated Isothermal Amplification (TB-LAMP) instead of sputum-smear microscopy for pulmonary TB diagnosis in patients. Dr. Thongchai Kaewphinit <i></span><i><span style="font-family:Verdana;">et al</span></i><span style="font-family:Verdana;"></i></span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> invented a fast TB detection kit called TB d-tect (LAMP-LFD assay). There was no clinical trial to estimate the performance of TB d-tect. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study was aimed to find the performance of LFD assay and Xpert MTB/RIF ultra for pulmonary TB. </span><b><span style="font-family:Verdana;">Material</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> A cross-sectional study was conducted. Suggestive pulmonary TB patients were enrolled from June 2020-28 February 2021.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Respiratory specimen</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> were collected from each patient and sent for AFB smear, LAMP-LFD assay, Xpert MTB/RIF ultra and culture TB. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> 139 patients with suspected pulmonary TB were enrolled.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">51% of patients were diagnosed with pulmonary tuberculosis. Based on culture TB as a gold standard, the sensitivity and specificity of LAMP-LFD assay were 85.4% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">70.8% - 94.4%) and 87.8% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">79.6 - 93.5), respectively. The sensitivity and specificity of Xpert MTB/RIF ultra were 95.1% (95% CI: 83.5% - 99.4%) and 74.5% (95% CI: 64.7 - 82.8), respectively. According to ROC curve, it was found that the areas under the curve of LAMP-LFD assay and Xpert MTB/RIF ultra were 0.866 and 0.848, respectively (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.546). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The diagnostic sensitivity and specificity of LAMP-LFD assay appeared to be comparable to those of Xpert MTB/RIF ultra. LAMP-LFD assay could be used in resource limiting laboratory.展开更多
Objectives: To examine demographics, clinical correlates, sputum AFB (acid fast bacilli) smear grading DOTS (Directly Observed Therapy Short Course) uptake, and drug resistance in a cohort of newly-diagnosed, smear po...Objectives: To examine demographics, clinical correlates, sputum AFB (acid fast bacilli) smear grading DOTS (Directly Observed Therapy Short Course) uptake, and drug resistance in a cohort of newly-diagnosed, smear positive pulmonary tuberculosis (TB) patients with respect to HIV status at baseline, and compare smear conversion rates, side effects and mortality after two months. Design: A prospective study among 54 HIV positive and 41 HIV negative pulmonary TB patients. Data were collected via face-to-face interviews, review of medical records, and lab tests. Results: HIVTB co-infected patients, though more symptomatic at baseline, showed more improvement in their symptoms compared to HIV-uninfected TB patients at follow-up. The HIV co-infected group had more prevalent perceived side effects, and sputum smear positivity was marginally higher compared to the HIV negative group at follow-up. Mortality was higher among the HIV-infected group. Both groups had high rates of resistance to first-line anti-tubercular drugs, particularly isoniazid. There was no significant difference in the drug resistance patterns between the groups. Conclusions: Prompt initiation and provision of daily regimens of ATT (Anti-Tubercular treatment) along with ART (Anti-Retroviral treatment) via ART centers is urgently needed in India. As resistance to ART and/or ATT is directly linked to medication non-adherence, the use of counseling, regular reinforcement, early detection and appropriate intervention strategies to tackle this complex issue could help prevent premature mortality and development of resistance in HIV-TB co-infected patients. The high rate of isoniazid resistance might preclude its use in India as prophylaxis for latent TB in HIV infected persons as per the World Health Organization (WHO) guideline.展开更多
Objectives:To evaluate the value of Xpert MTB/RIF in the diagnosis of pulmonary tuberculosis(PTB)in general hospitals,which are usually where patients first visit.Materials and methods:Presumptive PTB patients,based o...Objectives:To evaluate the value of Xpert MTB/RIF in the diagnosis of pulmonary tuberculosis(PTB)in general hospitals,which are usually where patients first visit.Materials and methods:Presumptive PTB patients,based on imaging results,in a general hospital in China,were enrolled from August 2015 to April 2017.The sensitivity and specificity of four tuberculosis(TB)detection methods,including sputum smear,Xpert MTB/RIF,T-SPOT.TB and TB-DNA were studied.To predict the effectiveness of the methods,different combinations were assessed using the receiver operating characteristic(ROC)curve.Results:283 PTB suspect patients were enrolled,81 of which were diagnosed as TB infections based on the golden standard.The TB detection rate for sputum smear was 11.7%(33/283).The respective sensitivity and specificity of Xpert MTB/RIF were 87.8%(71/81)and 99.5%(201/202).For the smear negative TB patients,the sensitivity of Xpert MTB/RIF was 79.2%(38/48).Combined with several methods,the Xpert MTB/RIF assay had the highest area under curve(AUC)value(0.913).Conclusions:Xpert MTB/RIF showed tremendous promise for early,rapid and accurate diagnosis of TB.Multicentre evaluation and adoption of Xpert MTB/RIF in general hospitals in China should be embraced and promoted in order to establish an effective TB identification system.展开更多
Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α...Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α gene polymorphism with pulmonary tuberculosis （TB） among patients with coal worker＇s pneumoconiosis （CWP）. Methods A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-α gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism （PCR-RFLP）. Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher＇s exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplieative model with combined OR. All data were analyzed using SAS version 8.2 software. Results No significant difference in frequency of the TNF-α-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls （2,2=5.44, P=-0.07）. But difference in frequency of the TNF-α-308 A allele was identified between them （2,2-5.14, P=0.02）. No significant difference in frequencies of the TNF-α-238 genotype and allele （P=0.23 and P=0.09, respectively） was found between cases and controls either, with combined （GG and AA） OR of 3.96 （95% confidence interval of 1.30-12.09） at the -308 locus of the TNF-α gene, as compared to combination of the TNF-α-238 GG and TNF-α-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-α-238 GG and TNF-α-308 GA genotypes was 1.98 （95% CI of 1.06-3.71） for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-a-308 GG genotype and body mass index （OR=4.92）, as well as an interaction between the TNF-α-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-α-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated. Conclusions TNF-α-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-α-238 A allele was otherwise.展开更多
Introduction:We explored risk factors for latent tuberculosis infection(LTBI)and developed a risk prediction model using machine learning algorithms.Methods:Patients with active pulmonary TB in months 3 to 6 of anti-T...Introduction:We explored risk factors for latent tuberculosis infection(LTBI)and developed a risk prediction model using machine learning algorithms.Methods:Patients with active pulmonary TB in months 3 to 6 of anti-TB treatment in Henan Province,China,July–September 2024 were selected as index cases.Close contacts identified through epidemiological investigation underwent tuberculinpurified protein derivative testing to determine LTBI status.Face-to-face questionnaires were conducted to collect epidemiological data.The dataset was divided into training and testing sets(6:4),using a fixed random seed.Five models—logistic regression(LR),decision tree(DT),random forest(RF),support vector machines(SVM),and multilayer perceptron(MLP)—were trained and evaluated using the mean squared error(MSE)and coefficient of determination.The test set was subjected to external validation.Receiver operating characteristic curve analysis,area under the curve(AUC),and F1-scores were used to quantify predictive performance.Results:Among 795 close contacts,LTBI prevalence was 401(50.5%).By MSE,models ranked:SVM(0.121),RF(0.165),DT(0.197),LR(0.229),and MLP(0.233).SVM identified five key predictors:contact type of index case,key population classification,residential area,frequency of participation in group activities,and etiological results.Internal validation showed strong performance(AUC=0.921,F1=0.858),whereas external validation showed moderate performance(AUC=0.752,F1=0.694).Conclusion:The SVM model incorporating contact type of index case,key population classification,residential area,frequency of group activity participation,and etiological results demonstrated robust predictive value for LTBI risk.This model shows promise for the targeted screening and management of high-risk populations.展开更多
Background: Tuberculosis is endemic in Sudan and has witnessed a major surge amid the country’s continuous conflict. The goal of this study is to analyze the epidemiological aspects of tuberculosis in Western Sudan f...Background: Tuberculosis is endemic in Sudan and has witnessed a major surge amid the country’s continuous conflict. The goal of this study is to analyze the epidemiological aspects of tuberculosis in Western Sudan from 2023 to 2024, during the Sudan War. Methodology: This is a retrospective descriptive study that was carried out at El-Obeid Teaching Hospital in North Kordofan State, Sudan, during August and September 2024. All information on tuberculosis patients diagnosed between 15 April 2023, and 15 April 2024, was obtained from the hospital. Results: The results showed that 71% of the 751 tuberculosis patients had pulmonary tuberculosis, while 29% had extrapulmonary tuberculosis. Among the 533 patients with pulmonary tuberculosis, 74.3% were male and 62% were female. Among the 218 patients with extrapulmonary tuberculosis, 19% were males and 37.9% were females. The predominant age group for pulmonary tuberculosis was 19 - 25 years, followed by ≥46 and 26 - 35 years, with incidence rates of 25.3%, 25%, and 24.6%, respectively. Extrapulmonary tuberculosis was most prevalent in those aged ≥ 46 years, followed by those aged ≤ 18 years and 26 - 35 years, representing 38%, 18.3%, and 16%, respectively. Conclusion: Tuberculosis is prevalent in western Sudan and has seen a significant rise during the region’s conflict. Tuberculosis predominantly impacts individuals in their younger years. The heightened operations of conventional gold mining, coupled with the escalating urban air pollution, have markedly influenced the elevated epidemiological rates of the disease in Sudan. A significant number of individuals receive diagnoses and treatment at a delayed stage, potentially facilitating the propagation of infection.展开更多
Introduction:Tuberculosis(TB)remains a major public health challenge in China,which ranks fourth among the 30 high-burden countries worldwide.Individuals with asymptomatic Pulmonary TB(aPTB)may act as“silent transmit...Introduction:Tuberculosis(TB)remains a major public health challenge in China,which ranks fourth among the 30 high-burden countries worldwide.Individuals with asymptomatic Pulmonary TB(aPTB)may act as“silent transmitters”,contributing to undetected community transmission and hindering progress toward the End-TB goals.This study examined the epidemiological characteristics of patients with aPTB in China from 2021 to 2024 to inform targeted control strategies.Methods:Data were obtained from the China Information System for Disease Control and Prevention for the period 2021-2024 and included TB cases with complete symptom records.aPTB was defined as cases without recorded cough symptoms,whereas symptomatic TB was defined as cases with recorded cough symptoms.Descriptive statistical analyses compared the demographic,clinical,and healthcare-seeking characteristics of patients with aPTB and symptomatic TB.Results:Among 973,299 PTB cases with complete symptom records,16.66%were classified as aPTB.This proportion remained relatively stable throughout the study period,with a slight peak observed in 2022.Higher proportions of aPTB were observed among individuals aged 55-64 years(17.07%),65-74 years(15.51%),and 15-24 years(14.03%),and among farmers and herders(50.87%).A mild seasonal trend was observed.Geographically,high-incidence areas were concentrated in western and southwestern China.Conclusions:aPTB constitutes a substantial component of the total TB burden in China.Strengthening active case detection in high-risk populations,optimizing medical resources in western China,and integrating aPTB control programs into national prevention and control plans for TB to mitigate hidden transmissions and advance national End-TB objectives.展开更多
Introduction:Drug-resistant tuberculosis(TB)poses a significant threat to public health.This study aimed to analyze the drug resistance patterns of Mycobacterium tuberculosis(MTB)and its risk factors in 10 districts o...Introduction:Drug-resistant tuberculosis(TB)poses a significant threat to public health.This study aimed to analyze the drug resistance patterns of Mycobacterium tuberculosis(MTB)and its risk factors in 10 districts of Hunan Province from 2018‒2025.The study provides a reference for formulating strategies to prevent and control drug-resistant TB.Methods:Isolates were collected from patients with pulmonary TB between January 2018 and December 2025 at 10 surveillance sites in Hunan Province.Drug resistance profiles were determined for two anti-TB drugs,rifampicin(RIF)and isoniazid(INH).Statistical analyses of epidemiological characteristics and risk factors for drug resistance were performed.Results:Among the 25,978 MTB isolates tested,1,320(5.08%)strains were resistant to one or more anti-TB drugs.The prevalence of rifampicin-resistant(RR)and multidrug-resistant(MDR)TB was 553(2.13%)and 310(1.19%),respectively.Univariate analysis revealed that sex,age,occupation,patient source,prior treatment history,comorbidities,residential district,and time of diagnosis were significantly associated with overall TB drug resistance(all P<0.05).RR-TB was significantly associated with all variables except occupation(all P<0.05).Multivariate logistic regression revealed the following independent predictors of drug resistance:male sex,retreatment status,age 25-44 years,diabetes mellitus,and residence in Lengshuitan.Conclusion:The results demonstrated the factors that indicated a significant risk of MDR-TB.Therefore,intensifying MDR-TB surveillance to develop treatment and monitoring guidelines is urgently needed.展开更多
基金This work was supported by Grants from the National Natural Sciences Foundation of China(81271893)the Natural Science Foundation of Zhejiang Province(LY12H19002)+2 种基金Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents,the Scientific Research Foundation of the Education Department of Zhejiang Province(Y201534356)the Natural Science Foundation of Zhejiang Medical College(2014B01)Visiting Engineer Program of the Education Department of Zhejiang Province(FG2014011).
文摘Background:Quick diagnosis of smear-negative pulmonary tuberculosis(TB)and extra-pulmonary TB are urgently needed in clinical diagnosis.Our research aims to investigate the usefulness of the interferon-γrelease assay(IGRA)for the diagnosis of smear-negative pulmonary and extra-pulmonary TB.Methods:We performed TB antibody and TB-IGRA tests on 389 pulmonary TB patients(including 120 smear-positive pulmonary TB patients and 269 smear-negative pulmonary TB patients),113 extra-pulmonary TB patients,81 patients with other pulmonary diseases and 100 healthy controls.Blood samples for the TB-Ab test and the TB-IGRA were collected,processed,and interpreted according to the manufacturer’s protocol.Results:The detection ratio of smear-positive pulmonary TB patients and smear-negative pulmonary TB patients were 90.8%(109 of 120)and 89.6%(241 of 269),respectively.There was no statistically significant difference of its performance between these two sample sets(P>0.05).The detection ratio of positive TB patients and extra-pulmonary TB patients were 90.0%(350 of 389)and 87.6%(99 of 113),respectively,which was not significantly different(P>0.05).Conclusions:In this work,the total detection ratio using TB-IGRA was 89.4%,therefore TB-IGRA has diagnostic values in smear-negative pulmonary TB and extra-pulmonary TB diagnosis.
文摘<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Background: </span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Due to the limitations of diagnosis by Xpert MTB/RIF assay, WHO suggests Loop</span><b><span style="font-family:Verdana;">—</span></b><span style="font-family:Verdana;">Mediated Isothermal Amplification (TB-LAMP) instead of sputum-smear microscopy for pulmonary TB diagnosis in patients. Dr. Thongchai Kaewphinit <i></span><i><span style="font-family:Verdana;">et al</span></i><span style="font-family:Verdana;"></i></span><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> invented a fast TB detection kit called TB d-tect (LAMP-LFD assay). There was no clinical trial to estimate the performance of TB d-tect. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study was aimed to find the performance of LFD assay and Xpert MTB/RIF ultra for pulmonary TB. </span><b><span style="font-family:Verdana;">Material</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">methods:</span></b><span style="font-family:Verdana;"> A cross-sectional study was conducted. Suggestive pulmonary TB patients were enrolled from June 2020-28 February 2021.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Respiratory specimen</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> were collected from each patient and sent for AFB smear, LAMP-LFD assay, Xpert MTB/RIF ultra and culture TB. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> 139 patients with suspected pulmonary TB were enrolled.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">51% of patients were diagnosed with pulmonary tuberculosis. Based on culture TB as a gold standard, the sensitivity and specificity of LAMP-LFD assay were 85.4% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">70.8% - 94.4%) and 87.8% (95% CI:</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">79.6 - 93.5), respectively. The sensitivity and specificity of Xpert MTB/RIF ultra were 95.1% (95% CI: 83.5% - 99.4%) and 74.5% (95% CI: 64.7 - 82.8), respectively. According to ROC curve, it was found that the areas under the curve of LAMP-LFD assay and Xpert MTB/RIF ultra were 0.866 and 0.848, respectively (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> = 0.546). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The diagnostic sensitivity and specificity of LAMP-LFD assay appeared to be comparable to those of Xpert MTB/RIF ultra. LAMP-LFD assay could be used in resource limiting laboratory.
文摘Objectives: To examine demographics, clinical correlates, sputum AFB (acid fast bacilli) smear grading DOTS (Directly Observed Therapy Short Course) uptake, and drug resistance in a cohort of newly-diagnosed, smear positive pulmonary tuberculosis (TB) patients with respect to HIV status at baseline, and compare smear conversion rates, side effects and mortality after two months. Design: A prospective study among 54 HIV positive and 41 HIV negative pulmonary TB patients. Data were collected via face-to-face interviews, review of medical records, and lab tests. Results: HIVTB co-infected patients, though more symptomatic at baseline, showed more improvement in their symptoms compared to HIV-uninfected TB patients at follow-up. The HIV co-infected group had more prevalent perceived side effects, and sputum smear positivity was marginally higher compared to the HIV negative group at follow-up. Mortality was higher among the HIV-infected group. Both groups had high rates of resistance to first-line anti-tubercular drugs, particularly isoniazid. There was no significant difference in the drug resistance patterns between the groups. Conclusions: Prompt initiation and provision of daily regimens of ATT (Anti-Tubercular treatment) along with ART (Anti-Retroviral treatment) via ART centers is urgently needed in India. As resistance to ART and/or ATT is directly linked to medication non-adherence, the use of counseling, regular reinforcement, early detection and appropriate intervention strategies to tackle this complex issue could help prevent premature mortality and development of resistance in HIV-TB co-infected patients. The high rate of isoniazid resistance might preclude its use in India as prophylaxis for latent TB in HIV infected persons as per the World Health Organization (WHO) guideline.
文摘Objectives:To evaluate the value of Xpert MTB/RIF in the diagnosis of pulmonary tuberculosis(PTB)in general hospitals,which are usually where patients first visit.Materials and methods:Presumptive PTB patients,based on imaging results,in a general hospital in China,were enrolled from August 2015 to April 2017.The sensitivity and specificity of four tuberculosis(TB)detection methods,including sputum smear,Xpert MTB/RIF,T-SPOT.TB and TB-DNA were studied.To predict the effectiveness of the methods,different combinations were assessed using the receiver operating characteristic(ROC)curve.Results:283 PTB suspect patients were enrolled,81 of which were diagnosed as TB infections based on the golden standard.The TB detection rate for sputum smear was 11.7%(33/283).The respective sensitivity and specificity of Xpert MTB/RIF were 87.8%(71/81)and 99.5%(201/202).For the smear negative TB patients,the sensitivity of Xpert MTB/RIF was 79.2%(38/48).Combined with several methods,the Xpert MTB/RIF assay had the highest area under curve(AUC)value(0.913).Conclusions:Xpert MTB/RIF showed tremendous promise for early,rapid and accurate diagnosis of TB.Multicentre evaluation and adoption of Xpert MTB/RIF in general hospitals in China should be embraced and promoted in order to establish an effective TB identification system.
基金supported by grants from China National Programs for Science and Technology Development (Grant No. 2003BA712A11-24)Scientific Research Fund of North China Coal Medical College (Grant No. 2005-14)
文摘Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α gene polymorphism with pulmonary tuberculosis （TB） among patients with coal worker＇s pneumoconiosis （CWP）. Methods A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-α gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism （PCR-RFLP）. Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher＇s exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplieative model with combined OR. All data were analyzed using SAS version 8.2 software. Results No significant difference in frequency of the TNF-α-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls （2,2=5.44, P=-0.07）. But difference in frequency of the TNF-α-308 A allele was identified between them （2,2-5.14, P=0.02）. No significant difference in frequencies of the TNF-α-238 genotype and allele （P=0.23 and P=0.09, respectively） was found between cases and controls either, with combined （GG and AA） OR of 3.96 （95% confidence interval of 1.30-12.09） at the -308 locus of the TNF-α gene, as compared to combination of the TNF-α-238 GG and TNF-α-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-α-238 GG and TNF-α-308 GA genotypes was 1.98 （95% CI of 1.06-3.71） for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-a-308 GG genotype and body mass index （OR=4.92）, as well as an interaction between the TNF-α-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-α-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated. Conclusions TNF-α-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-α-238 A allele was otherwise.
基金Supported by grants from Henan Provincial Science and Technology Development Program(Grant No.242102311109).
文摘Introduction:We explored risk factors for latent tuberculosis infection(LTBI)and developed a risk prediction model using machine learning algorithms.Methods:Patients with active pulmonary TB in months 3 to 6 of anti-TB treatment in Henan Province,China,July–September 2024 were selected as index cases.Close contacts identified through epidemiological investigation underwent tuberculinpurified protein derivative testing to determine LTBI status.Face-to-face questionnaires were conducted to collect epidemiological data.The dataset was divided into training and testing sets(6:4),using a fixed random seed.Five models—logistic regression(LR),decision tree(DT),random forest(RF),support vector machines(SVM),and multilayer perceptron(MLP)—were trained and evaluated using the mean squared error(MSE)and coefficient of determination.The test set was subjected to external validation.Receiver operating characteristic curve analysis,area under the curve(AUC),and F1-scores were used to quantify predictive performance.Results:Among 795 close contacts,LTBI prevalence was 401(50.5%).By MSE,models ranked:SVM(0.121),RF(0.165),DT(0.197),LR(0.229),and MLP(0.233).SVM identified five key predictors:contact type of index case,key population classification,residential area,frequency of participation in group activities,and etiological results.Internal validation showed strong performance(AUC=0.921,F1=0.858),whereas external validation showed moderate performance(AUC=0.752,F1=0.694).Conclusion:The SVM model incorporating contact type of index case,key population classification,residential area,frequency of group activity participation,and etiological results demonstrated robust predictive value for LTBI risk.This model shows promise for the targeted screening and management of high-risk populations.
文摘Background: Tuberculosis is endemic in Sudan and has witnessed a major surge amid the country’s continuous conflict. The goal of this study is to analyze the epidemiological aspects of tuberculosis in Western Sudan from 2023 to 2024, during the Sudan War. Methodology: This is a retrospective descriptive study that was carried out at El-Obeid Teaching Hospital in North Kordofan State, Sudan, during August and September 2024. All information on tuberculosis patients diagnosed between 15 April 2023, and 15 April 2024, was obtained from the hospital. Results: The results showed that 71% of the 751 tuberculosis patients had pulmonary tuberculosis, while 29% had extrapulmonary tuberculosis. Among the 533 patients with pulmonary tuberculosis, 74.3% were male and 62% were female. Among the 218 patients with extrapulmonary tuberculosis, 19% were males and 37.9% were females. The predominant age group for pulmonary tuberculosis was 19 - 25 years, followed by ≥46 and 26 - 35 years, with incidence rates of 25.3%, 25%, and 24.6%, respectively. Extrapulmonary tuberculosis was most prevalent in those aged ≥ 46 years, followed by those aged ≤ 18 years and 26 - 35 years, representing 38%, 18.3%, and 16%, respectively. Conclusion: Tuberculosis is prevalent in western Sudan and has seen a significant rise during the region’s conflict. Tuberculosis predominantly impacts individuals in their younger years. The heightened operations of conventional gold mining, coupled with the escalating urban air pollution, have markedly influenced the elevated epidemiological rates of the disease in Sudan. A significant number of individuals receive diagnoses and treatment at a delayed stage, potentially facilitating the propagation of infection.
基金Supported by the National Key R&D Program(Reference numbers:2024YFC2311204 and 2024YFC2310905)the Prevention and Control of Emerging and Major Infectious Diseases-National Science and Technology Major Project(Reference number:2025ZD01901000).
文摘Introduction:Tuberculosis(TB)remains a major public health challenge in China,which ranks fourth among the 30 high-burden countries worldwide.Individuals with asymptomatic Pulmonary TB(aPTB)may act as“silent transmitters”,contributing to undetected community transmission and hindering progress toward the End-TB goals.This study examined the epidemiological characteristics of patients with aPTB in China from 2021 to 2024 to inform targeted control strategies.Methods:Data were obtained from the China Information System for Disease Control and Prevention for the period 2021-2024 and included TB cases with complete symptom records.aPTB was defined as cases without recorded cough symptoms,whereas symptomatic TB was defined as cases with recorded cough symptoms.Descriptive statistical analyses compared the demographic,clinical,and healthcare-seeking characteristics of patients with aPTB and symptomatic TB.Results:Among 973,299 PTB cases with complete symptom records,16.66%were classified as aPTB.This proportion remained relatively stable throughout the study period,with a slight peak observed in 2022.Higher proportions of aPTB were observed among individuals aged 55-64 years(17.07%),65-74 years(15.51%),and 15-24 years(14.03%),and among farmers and herders(50.87%).A mild seasonal trend was observed.Geographically,high-incidence areas were concentrated in western and southwestern China.Conclusions:aPTB constitutes a substantial component of the total TB burden in China.Strengthening active case detection in high-risk populations,optimizing medical resources in western China,and integrating aPTB control programs into national prevention and control plans for TB to mitigate hidden transmissions and advance national End-TB objectives.
基金Supported by Major Scientific Research Project for High-Level Talents in Health in Hunan Province(R2023098):Research on the Mechanism of Drug Resistance Mutations and Evolutionary Transmission Characteristics of Mycobacterium tuberculosis in Hunan Province.
文摘Introduction:Drug-resistant tuberculosis(TB)poses a significant threat to public health.This study aimed to analyze the drug resistance patterns of Mycobacterium tuberculosis(MTB)and its risk factors in 10 districts of Hunan Province from 2018‒2025.The study provides a reference for formulating strategies to prevent and control drug-resistant TB.Methods:Isolates were collected from patients with pulmonary TB between January 2018 and December 2025 at 10 surveillance sites in Hunan Province.Drug resistance profiles were determined for two anti-TB drugs,rifampicin(RIF)and isoniazid(INH).Statistical analyses of epidemiological characteristics and risk factors for drug resistance were performed.Results:Among the 25,978 MTB isolates tested,1,320(5.08%)strains were resistant to one or more anti-TB drugs.The prevalence of rifampicin-resistant(RR)and multidrug-resistant(MDR)TB was 553(2.13%)and 310(1.19%),respectively.Univariate analysis revealed that sex,age,occupation,patient source,prior treatment history,comorbidities,residential district,and time of diagnosis were significantly associated with overall TB drug resistance(all P<0.05).RR-TB was significantly associated with all variables except occupation(all P<0.05).Multivariate logistic regression revealed the following independent predictors of drug resistance:male sex,retreatment status,age 25-44 years,diabetes mellitus,and residence in Lengshuitan.Conclusion:The results demonstrated the factors that indicated a significant risk of MDR-TB.Therefore,intensifying MDR-TB surveillance to develop treatment and monitoring guidelines is urgently needed.
