Comparing transmission reconstruction models with Mycobacterium tuberculosis whole genome sequence data

Pathogen genomic epidemiology is now routinely used worldwide to interrogate infectious disease dynamics. Multiple computational tools that reconstruct transmission networks by coupling genomic data with epidemiological modelling have been developed. The resulting inferences are often used to inform outbreak investigations, yet to date, the performance of these transmission reconstruction tools has not been compared specifically for tuberculosis, a disease process with complex epidemiology that includes variable latency periods and within-host heterogeneity. Here, we carried out a systematic comparison of seven publicly available transmission reconstruction tools, evaluating their accuracy in predicting transmission events in both simulated and real-world Mycobacterium tuberculosis outbreaks. No tool was able to fully resolve transmission networks, though both the single-tree and multi-tree input implementations of TransPhylo identified the most epidemiologically supported transmission events and the fewest false positive links. We observed a high degree of variability in the transmission networks inferred by each approach. Our findings may inform the choice of tools in future tuberculosis transmission analyses and underscore the need for caution when interpreting transmission networks produced using probabilistic approaches.

Literature Review : Gambaran Pengetahuan dan Sikap Pada Pasien Tuberkulosis

Tuberculosis is the second leading cause of death from infectious diseases in the world. Mycobacterium tuberculosis transmission is influenced by knowledge and attitude factors. A lack of knowledge about tuberculosis will make a bad attitude impact on the success of treatment. This study aims to portray the knowledge and attitudes among tuberculosis patients. This literature review study highlighted five articles obtained from article searches through PubMed and Google Scholar according to inclusion and exclusion criteria with the STROBE as critical appraisal instrumen. Most of the tuberculosis patients of the male were 524 respondents (62%), most of them worked 696 respondents (96.7%), and most of them had basic education 283 respondents (39.66%). In the context of knowledge, most of the respondents (57%) have good knowledge (527 responden). Meanwhile, in terms of attitude, 548 respondents (59.2%) have positive attitudes. The attitude was related to knowledge. The higher the knowledge possessed will to the a good attitude. Ners should give health education to tuberculosis patients to increase their understanding of tuberculosis. As a result, a positive attitud may show in tuberculosis patientsKeywords : Knowledge; Attitude; Tuberculosis AbstrakTuberkulosis merupakan penyebab kedua kematian dari penyakit infeksi di dunia. Penularan Mycrobakterium Tuberculosis dipengaruhi oleh faktor pengetahuan dan sikap. Kurangnya pengetahuan mengenai penyakit tuberkulosis akan menjadikan suatu sikap yang tidak baik sehingga dapat berdampak pada keberhasilan pengobatan. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan dan sikap pada pasien tuberkolosis. Penelitian ini menggunakan metode penelitian melalui literature riview deskriptif dengan pengambilan data 5 artikel yang di dapat dari pencarian artikel melalui PubMed dan Google Scholar sesuai kriteria inklusi dan eksklusi dengan instrumen critical appraisal strobe. Sebagian besar pasien tuberkulosis dengan jenis kelamin laki-laki sebanyak 524 responden (62%), sebagian besar bekerja 696 responden (96,7%), dan sebagian besar berpendidikan dasar 283 responden (39,66%). Pengetahuan responden sebagian besar 527 responden (57%) memiliki pengetahuan baik,dan sebagian besar 548 responden (59,2%) memiliki sikap positif. Sikap mempengaruhi pengetahuan yang dimilikinya. Semakin tinggi pengetahuan yang dimiliki akan memberikan kontribusi terhadap terbentuknya sikap yang baik. Perawat senantiasa memebrikan edikusi kepada pada pasien tuberculosis untuk meningkatkan pengetahuan pasien tuberkulosisagar muncul sikap positif pada pasien tuberkulosis.Kata kunci: Pengetahuan; Sikap; Tuberkulosis

Association of High-Speed Rail and Tuberculosis Transmission in Newly Integrated Regions: Quasi-Experimental Evidence from China

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.

FAST tuberculosis transmission control strategy speeds the start of tuberculosis treatment at a general hospital in Lima, Peru

Objective: To evaluate the effect of the FAST (Find cases Actively, Separate safely, Treat effectively) strategy on time to tuberculosis diagnosis and treatment for patients at a general hospital in a tuberculosis-endemic setting. Design: Prospective cohort study with historical controls. Participants: Patients diagnosed with pulmonary tuberculosis during hospitalization at Hospital Nacional Hipolito Unanue in Lima, Peru. Methods: The FAST strategy was implemented from July 24, 2016, to December 31, 2019. We compared the proportion of patients with drug susceptibility testing and tuberculosis treatment during FAST to the 6-month period prior to FAST. Times to diagnosis and tuberculosis treatment were also compared using Kaplan-Meier plots and Cox regressions. Results: We analyzed 75 patients diagnosed with pulmonary tuberculosis through FAST. The historical cohort comprised 76 patients. More FAST patients underwent drug susceptibility testing (98.7% vs 57.8%; OR, 53.8; P < .001), which led to the diagnosis of drug-resistant tuberculosis in 18 (24.3%) of 74 of the prospective cohort and 4 (9%) of 44 of the historical cohort (OR, 3.2; P = .03). Overall, 55 FAST patients (73.3%) started tuberculosis treatment during hospitalization compared to 39 (51.3%) controls (OR, 2.44; P = .012). FAST reduced the time from hospital admission to the start of TB treatment (HR, 2.11; 95% CI, 1.39–3.21; P < .001). Conclusions: Using the FAST strategy improved the diagnosis of drug-resistant tuberculosis and the likelihood and speed of starting treatment among patients with pulmonary tuberculosis at a general hospital in a tuberculosis-endemic setting. In these settings, the FAST strategy should be considered to reduce tuberculosis transmission while simultaneously improving the quality of care.

Age and sex distribution of Mycobacterium tuberculosis infection and rifampicin resistance in Myanmar as detected by Xpert MTB/RIF

Background Detection of tuberculosis disease (TB) and timely identification of Mycobacterium tuberculosis (Mtb) strains that are resistant to treatment are key to halting tuberculosis transmission, improving treatment outcomes, and reducing mortality. Methods We used 332,657 Xpert MTB/RIF assay results, captured as part of the Myanmar Data Utilization Project, to characterize Mtb test positivity and rifampicin resistance by both age and sex, and to evaluate risk factors associated with rifampicin resistance. Results Overall, 70% of individuals diagnosed with TB were males. Test positivity was higher among males (47%) compared to females (39%). The highest positivity by age occurred among individuals aged 16–20, with test positivity for females (65%) higher than for males (57%). Although a greater absolute number of males were rifampicin resistant, a greater proportion of females (11.4%) were rifampicin resistant as compared to males (9.3%). In the multivariate model, history of previous treatment, age less than 30, testing in the Yangon region, and female sex were significantly positively associated with rifampicin resistance after adjusting for HIV status and year test was performed. Conclusions Our results indicate that young adults were more likely to test positive for TB and be identified as rifampicin resistant compared to older adults.