scholarly journals High tuberculosis incidence among people living with diabetes in Indonesia

Author(s):  
Susan M McAllister ◽  
Raspati C Koesoemadinata ◽  
Prayudi Santoso ◽  
Nanny N M Soetedjo ◽  
Abdul Kamil ◽  
...  

Abstract Background Data regarding the incidence of tuberculosis (TB) among people living with diabetes (PLWD) in TB-endemic settings are scarce. We examined TB incidence among PLWD in Indonesia who had previously been screened for latent TB infection (LTBI) and TB disease. Methods PLWD (≥18 y of age) in an urban setting were examined a mean 3.4 y after they had been screened for active TB and LTBI. Data on subsequent TB diagnosis were collected by interview and with chest X-ray, sputum smear and Mycobacterium tuberculosis culture. TB incidence rates were stratified for baseline LTBI status, as determined by the QuantiFERON interferon-gamma release assay (IGRA). Results Of 590 PLWD, 101 had died and 163 could not be contacted or refused. Among the 326 who were re-examined, 6 (1.8%; 95% confidence interval [CI] 0.7 to 4.0) reported being diagnosed already and a further 5 were diagnosed with active TB (1.5%; 95% CI 0.50 to 3.5). The TB incidence rate was 9.85 (95% CI 4.03 to 15.68) per 1000 person-years. TB incidence was higher among PLWD with baseline LTBI (17.13; 95% CI 5.25 to 29.00/1000 person-years) compared with those without LTBI (4.79; 95% CI −0.63 to 10.21), with an incidence rate ratio of 3.57 (95% CI 0.86 to 20.92; p=0.054). Conclusions PLWD with LTBI in Indonesia and similar settings are likely to benefit from TB preventive therapy.

2020 ◽  
Vol 12 (1) ◽  
pp. 19-26
Author(s):  
Stefani Candra Firmanti ◽  
Rina Triasih ◽  
Tri Wibawa ◽  
Sofia Mubarika Haryana

BACKGROUND: The diagnosis of tuberculosis (TB) in children is challenging by the absence of a practical gold standard. Interferon (IFN)-ginducible protein 10 (IP-10) is a chemokine that may serve as the leading candidate marker in child TB diagnosis. The aim of this study is to assess the diagnostic value of IP-10 in the diagnosis of TB in children.METHODS: We recruited eligible symptomatic and asymptomatic children aged <15 years actively by contact investigation and passively from inpatient and outpatient clinics in two hospitals, in Yogyakarta, Indonesia. We conducted clinical examination and chest X-ray in all eligible children. Sputum smear and the rapid molecular TB test were performed in children with TB symptoms. All participants underwent blood sampling for IFN-g Release Assay and IP-10 test.RESULTS: A total of 79 children were recruited to this study. Twelve children were with TB disease, 16 with latent TB infection (LTBI), 40 were TB-exposed only and 11 were non-TB. Children with evidence of TB infection either with TB disease or LTBI had higher levels of antigen-stimulated IP-10 compared to non-infected children, both TB exposed only and non-TB (p=0.000). A cut-off 408.74 pg/mL for antigen-stimulated IP-10 showed high diagnostic accuracy for diagnosis of TB infection (AUC: 0.97, 95% CI: 0.92-1.00, sensitivity: 92.3%, and specificity: 91.9%). However, the stimulated levels of IP-10 between children with TB disease and LTBI were not significantly different (p=0.268).CONCLUSION: IP-10 performed well to diagnose TB infection in children. However, it cannot be used to differentiate TB infection from TB disease.KEYWORDS: IFN-g, IP-10, latent TB, active TB, children


2007 ◽  
Vol 136 (9) ◽  
pp. 1179-1187 ◽  
Author(s):  
K. OKADA ◽  
T. E. MAO ◽  
T. MORI ◽  
T. MIURA ◽  
T. SUGIYAMA ◽  
...  

SUMMARYNewly developed interferon-gamma release assays have become commercially available to detect tuberculosis (TB) infection in adults. However, little is known about their performance in children. We compared test results between the QuantiFERON-TB® Gold test (QFT) and tuberculin skin test (TST) in young children living with pulmonary TB patients in Cambodia. Of 195 children tested with both QFT and TST, the TST-positive rate of 24% was significantly higher than the QFT-positive rate of 17%. The agreement between the test results was considerable (κ-coefficient 0·63). Positive rates increased from 6% to 32% for QFT and from 15% to 43% for TST, according to the sputum smear grades of the index cases. The presence of Bacille Calmette-Guérin (BCG) scars did not significantly affect the results of TST or QFT in a logistic regression analysis. In conclusion, QFT can be a substitute for TST in detecting latent TB infection in childhood contacts aged ⩽5 years, especially in those who may have a false-positive TST due to BCG vaccination or non-tuberculous mycobacterial infection.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sivaporn Gatechompol ◽  
Weerakit Harnpariphan ◽  
Ruamthip Supanan ◽  
Gompol Suwanpimolkul ◽  
Jiratchaya Sophonphan ◽  
...  

Abstract Background Prisons are considered as major reservoirs for tuberculosis. Preventive therapy for latent TB infection (LTBI) is an adjunctive strategy to control TB. However, LTBI data in Thai prisoners is limited. This study assessed the prevalence of LTBI and feasibility of isoniazid preventive therapy (IPT). Methods A cross-sectional study was conducted among prisoners in Klong Prem Central Prison, Bangkok. Participants were screened for active TB by questionnaire and chest X-ray. LTBI was evaluated by Tuberculin skin test (TST) and QuantiFERON-TB Gold Plus (QFTP) among subgroup. Participants with positive TST or QFTP were considered to have LTBI. Participants with LTBI were offered IPT. Results From August 2018–November 2019, 1002 participants were analyzed. All participants were male with a median age of 38 (IQR 32–50) years. LTBI identified by either TST/QFTP was present in 466 (46.5%) participants. TST was positive in 359 (36%) participants. In the subgroup of 294 participants who had both TST and QFTP results, 181/294 (61.6%) tested positive by QFTP. Agreement between TST and QFTP was 55.1% (Kappa = 0.17). The risk factors associated with LTBI were previous incarceration (aOR 1.53, 95%CI, 1.16–2.01, p = 0.002), history of prior active TB (aOR 3.02, 95%CI, 1.74–5.24, p < 0.001) and duration of incarceration ≥10 years (aOR 1.86, 95%CI, 1.24–2.79, p = 0.003). Majority of LTBI participants (82%) agreed to take IPT. Three hundred and 56 (93%) participants completed treatment whereas 27 (7%) participants discontinued IPT due to the side effects of INH. Conclusion This is the first study to evaluate the prevalence of LTBI and feasibility of IPT among Thai prisoners. LTBI prevalence in male prisoners in Thailand is high. LTBI screening and treatment should be implemented together with other preventive components.


2019 ◽  
Vol 23 (9) ◽  
pp. 989-995 ◽  
Author(s):  
H-C. Zhang ◽  
Q-L. Ruan ◽  
J. Wu ◽  
S. Zhang ◽  
S-L. Yu ◽  
...  

BACKGROUND: Screening tuberculosis (TB) contacts is a priority for TB control; however, it remains inadequate in most regions of China.OBJECTIVE: To investigate the progression of latent TB infection (LTBI) using the interferon-gamma release assay (IGRA) in contacts of active TB patients.DESIGN: This longitudinal prospective observational study included 159 household contacts aged ≥14 years without preventive treatment who were followed up for 6 years to compare their conversion and reversion rates using the T-SPOT®.TB IGRA to diagnose LTBI.RESULTS: Among the 159 household contacts, LTBI positivity was 47.5%. Age was independently associated with LTBI (OR 3.6, 95%CI 1.81–7.14; P = 0.00). T-SPOT.TB conversion rates were respectively 29.4% and 18.8% at 3- and 6-year follow-up. The reversion rates were 9.4% of contacts during the 3-year follow-up period, which increased to 38.2% at the 6-year follow-up. A decreasing trend in spot-forming cells on T-SPOT.TB was observed in most patients at the 6-year follow-up.CONCLUSION: LTBI prevalence among household contacts was relatively high, particularly in elderly patients. Furthermore, serial IGRA testing was highly dynamic; however, this overall trend gradually decreased over time, even if preventive therapy was not prescribed.


2020 ◽  
Author(s):  
Francisca Srioetami Tanoerahar ◽  
Indri Rooslamiati ◽  
Natalie Kipuw ◽  
Hadiyanto ◽  
Soegianto Ali ◽  
...  

Abstract IntroductionActive tuberculosis (TB) patient is a potential source of Mycobacterium tuberculosis transmission in an overcrowded and poor area. Family members living in the same house may have been infected or latent tuberculosis infection (LTBI) may develop. The aim of the study was to explore LTBI among newborns and their family members living in an overcrowded area in Jakarta, Indonesia. MethodsA prospective analytical study was conducted among newborns from October 2016 to March 2017. Interferon gamma release assay (IGRA) was examined before BCG vaccination and after 12 weeks. In parallel, TB active case finding was performed among family members of the newborns.ResultsOf 135 newborns, only 117 (86.7%) came for BCG vaccination. Of 346 family members screened, 8 (2.3%) were detected as untreated active pulmonary TB, confirmed by positive sputum and/or MTB culture. Family members living in the same house with active TB individuals (p=0.011, OR 2.69) as well as being males (p = 0.025; OR 1.68) had a significant higher risk of having a positive IGRA. ConclusionsUntreated pulmonary TB infection in overcrowded areas infects the surrounding neighbors, resulting in latent TB infection. An active program for detecting pulmonary TB cases and preventive measures need to be taken seriously to contain the potential spreading of the infection.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S486-S487
Author(s):  
Samantha Kaplan ◽  
Daniel Matemo ◽  
Jerphason O Mecha ◽  
John Kinuthia ◽  
Grace John-Stewart ◽  
...  

Abstract Background Pregnancy and HIV-associated immunologic changes may affect latent TB infection (LTBI) interferon-gamma release assay (IGRA) QuantiFERON TB Gold Plus (QFT-Plus) diagnostic performance. Methods In this ongoing study, HIV-infected and -uninfected women 20–34 weeks gestation without TB in the past year are enrolled from antenatal clinics in western Kenya and tested with QFT-Plus. Mean quantitative IFN- γ responses to mitogen, and M. tuberculosis antigens (TB1 [primarily CD4+] and TB2 [addition of CD8+ response]) were compared using two-sample t-tests. Proportions for categorical variables were compared using univariate logistic regression. Results Among 306 women (HIV+ 127 [41.5%], HIV− 179 [58.5%]) enrolled between January 2018 and March 2019, median maternal and gestational age were 25 years (IQR 21–28) and 28 weeks (IQR 24–32), respectively. Among HIV-infected women at enrollment, 99.2% were on ART, median CD4 count was 440 cells/mm3 (IQR 235–703), 37.5% were virally suppressed, and 60.6% reported having received isoniazid preventive therapy (IPT). Overall, 95 (31.1%) women were QFT-Plus positive (HIV+ 38 [29.9%], HIV− 57 [31.8%], OR 0.90, 95% CI 0.54–1.48, P = 0.671); 190 (62.1%) were negative (HIV+ 81 [63.8%], HIV− 109 [60.9%]), and 21 had indeterminate results (HIV+ 8 [6.3%], HIV− 13 [7.3%], OR 0.83, 95% CI 0.33–2.09, P = 0.690). Mean response to mitogen was similar between HIV-infected and -uninfected women (6.0 vs. 6.1 IU/mL, P = 0.663]. Among QFT-Plus positive women, HIV+ women had significantly lower TB1 responses than HIV− women (HIV+ 2.7 vs. 4.2 IU/mL, P = 0.035). Mean TB2 responses had a similar pattern, but did not reach statistical significance (HIV+ 3.1 vs. 4.3 IU/mL, P = 0.107). Both TB1 and TB2 were positive for 82 women (86.3%), 4 women were only TB1 positive (4.2%), and 8 women were only TB2 positive (8.4%). Conclusion Among pregnant women, HIV-infection was not associated with increased prevalence of QFT+ responses. However, among QFT-positive women, TB1 responses were lower in HIV-positive women with a similar trend observed for TB2 responses. These findings suggest that HIV-associated immunologic changes may influence QFT test performance. Disclosures All authors: No reported disclosures.


Respiration ◽  
2021 ◽  
pp. 369-373
Author(s):  
Jean-Pierre Zellweger ◽  
Ariane Zellweger-Landry ◽  
Jean-Marie Egger ◽  
Annette Koller-Doser ◽  
Axel Jeremias Schmidt

Background: Asylum seekers in Switzerland have to register in federal asylum centres (FACs) before formal permission to enter the country. Some of them may have active tuberculosis (TB), exposing fellow refugees and employees. Objectives: The aim of this study was to assess the risk of TB infection among employees of Swiss FACs. Methods: Between 2010 and 2018, a free interferon-gamma release assay (IGRA) was offered to all employees of 8 FACs, at employment and at yearly intervals. We defined latent TB infection as IGRA conversion from negative to positive. IGRA-positive employees were referred to a medical centre for further clinical follow-up. Results: 1,427 tests were performed among 737 employees (54.6% male). 403 (55%) persons were tested only once; 330 (44.5%) were tested several times; for 4 (0.5%) persons, the number of IGRA tests is unknown. Twenty employees (2.7%) had a positive IGRA at baseline, 2 (0.6%) converted from negative to positive during follow-up, resulting in an incidence of 22/10,000 person-years. We observed no case of active TB among employees. Conclusions: The prevalence of latent TB among employees to Swiss FACs and the risk of acquiring TB infection through work-related exposure are low. Yearly IGRA controls in the absence of documented TB exposure seem unnecessary.


Author(s):  
Yuanyuan Zhou ◽  
Huan Xiong ◽  
Rong Chen ◽  
Lixia Wan ◽  
Ying Kong ◽  
...  

Tuberculosis (TB) is the leading infectious cause of mortality worldwide. However, the diagnosis of TB, especially extrapulmonary TB (EPTB) diagnosis from lesion tissues, remains a challenge. Nucleic acid aptamers are analogous to antibodies and have advantages of easier modification, high specificity, and affinity. Mannose-capped lipoarabinomannan (ManLAM) is a unique surface lipoglycan component or constantly released from mycobacterium tuberculosis (M.tb) cell wall, which makes it a perfect candidate biomarker for TB diagnosis. Our present study aims to establish M.tb ManLAM aptamer-based immunohistochemistry (IHC) method for TB diagnosis. We performed TB diagnosis using 263 formalin-fixed paraffin-embedded tissue samples including 213 TB samples (pulmonary TB (PTB) and EPTB), and 8 samples from latent TB infection (LTBI) high risk subjects, and 42 samples from other non-TB patients with ManLAM aptamer-based IHC and routine laboratory TB diagnostic methods parallelly. The sensitivity and specificity of the ManLAM aptamer-based IHC were 86.38% and 92.86%, with much higher sensitivity than those of mycobacterial culture (9.66%) and acid-fast staining (AFS) (43.01%) and comparability to Interferon-gamma Release Assay (IGRA) (84.38%) and GeneXpert (79.31%). High agreement between ManLAM based-IHC and IGRA or GeneXpert for TB diagnosis were observed. Furthermore, ManLAM aptamer-based IHC combination with other routine TB laboratory diagnostic methods significantly increased the sensitivity up to 88.64%–97.92%. As our knowledge, this is the first report about aptamer-based IHC for disease diagnosis. Thus, ManLAM aptamer-based IHC has potentials for TB diagnosis, including PTB, and EPTB, and assists the diagnosis of LTBI with high effectiveness, feasibility, and easy production.


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