Search Results (132)

Objectives: Private sector engagement has been shown to improve tuberculosis diagnosis and treatment outcomes in Asia and Africa, but systematic reviews in 2015 and 2017 identified only two reports from Latin America. We conducted a systematic review to identify descriptions of private sector engagement interventions for tuberculosis in Latin America. Methods: We systematically searched for reports on private sector engagement for tuberculosis services in Spanish- and Portuguese-speaking countries of the Western Hemisphere. On 1 November 2024, we searched PubMed, Embase, LILACS, and SciELO, with terms related to tuberculosis, the private sector, and eligible countries. We double-reviewed abstracts and full-text articles and classified private sector engagement mechanisms according to an established framework. Results: We identified seven documents describing five distinct interventions for private sector engagement in 10 countries. The most common engagement mechanism was technical support to increase awareness, knowledge, or capacity in the private sector. Intervention goals included promoting collaboration, ensuring adherence to national guidelines, increasing referrals to the public sector, and reducing tuberculosis drug sales in private pharmacies. Three impact evaluations found evidence of improved referral to the public sector. Conclusions: We found few reports of private sector engagement interventions for tuberculosis in Latin America, suggesting missed opportunities for collaborations to expand and improve tuberculosis service delivery. A lack of impact assessments suggests a dearth of evidence on the best models for private sector engagement to advance tuberculosis elimination in the Latin American region. Full article

Tuberculosis (TB) is a global health challenge, particularly in the Central African Republic (CAR), which is classified as a high TB burden country. In the CAR, factors like poverty, limited healthcare access, high HIV prevalence, malnutrition, inadequate sanitation, low measles vaccination coverage, and conflict-driven crowded living conditions elevate TB risk. Improved AI-driven surveillance is hypothesized to address under-reporting and underdiagnosis. Therefore, we created an epidemiological digital representation of TB in Bangui by employing passive data collection, spatial analysis using a 100 × 100 m grid, and mapping TB treatment services. Our approach included estimating undiagnosed TB cases through the integration of TB incidence, notification rates, and diagnostic data. High-resolution predictions are achieved by subdividing the area into smaller units while considering influencing variables within the Bayesian model. By designating moderate and high-risk hotspots, the model highlighted the potential for precise resource allocation in TB control. The strength of our model lies in its adaptability to overcome challenges, although this may have been to the detriment of precision in some areas. Research is envisioned to evaluate the model’s accuracy, and future research should consider exploring the integration of multidrug-resistant TB within the model. Full article

One area of study within machine learning and artificial intelligence (AI) seeks to create computer programs with intelligence that can mimic human focal processes in order to produce results. This technique includes data collection, effective data usage system development, conclusion illustration, and arrangements. Analysis algorithms that are learning to mimic human cognitive activities are the most widespread application of AI. Artificial intelligence (AI) studies have proliferated, and the field is quickly beginning to understand its potential impact on medical services and investigation. This review delves deeper into the pros and cons of AI across the healthcare and pharmaceutical research industries. Research and review articles published throughout the last few years were selected from PubMed, Google Scholar, and Science Direct, using search terms like ‘artificial intelligence’, ‘drug discovery’, ‘pharmacy research’, ‘clinical trial’, etc. This article provides a comprehensive overview of how artificial intelligence (AI) is being used to diagnose diseases, treat patients digitally, find new drugs, and predict when outbreaks or pandemics may occur. In artificial intelligence, neural networks and deep learning are some of the most popular tools; in clinical research, Bayesian non-parametric approaches hold promise for better results, while smartphones and the processing of natural languages are employed in recognizing patients and trial monitoring. Seasonal flu, Ebola, Zika, COVID-19, tuberculosis, and outbreak predictions were made using deep computation and artificial intelligence. The academic world is hopeful that AI development will lead to more efficient and less expensive medical and pharmaceutical investigations and better public services. Full article

The study was conducted in all regions of Ethiopia, except Tigray. It describes types of Tuberculosis (TB) based on gender, age, region, HIV status, and geographic setting in Ethiopia. It is a cross-sectional study that utilized the Ministry of Health’s District Health Information System-based reporting to analyze all types of TB from July 2022 to March 2024. In total, 290,450 TB cases were detected: 42.6% (123,871) were female, 9.4% (27,160) were children (under 15 years of age), and 14.5% (42,228) were adolescents (10–19 years of age). About 48% (20,185) of adolescent TB cases were bacteriologically confirmed, of which 47.5% were females. Compared to children <5 years, the male-to-female ratio is 26% higher among older children (5–9 years of age) (Adjusted Odds Ratio (AOR): 1.26, 95% Confidence Interval (CI): 0.51–2.01)) and 53% higher among adolescents (AOR: 1.53, 95% CI 0.87–2.18). In short, about half of TB cases are infectious among older children and young adolescents of the female gender in Ethiopia. TB among these age categories may be addressed through the integration of TB services with reproductive health services and youth-friendly and pediatric clinics. Full article

Tuberculosis (TB) is a leading cause of death from a single infectious agent in humans. The morbidity and mortality due to TB are further worsened by co-existing health conditions and the emergence of drug-resistant (DR-TB) cases. The WHO has declared TB as a global emergency and endorsed global efforts to improve diagnosis, and treatment while reducing the catastrophic cost in an EndTB strategy in 2013, with a vision to create a TB-free world. In the past decade, molecular diagnostic tools, such as nucleic acid amplification technologies (NAATs), have replaced the conventional smear microscopy of TB, thus offering better bacteriological confirmation and case detection along with drug resistance in pulmonary and extrapulmonary samples. Follow-on testing using a more advanced targeted next-generation sequencing (tNGS) system has improved the diagnosis of cases resistant to first- and second-line anti-TB drugs, including newer ones. TB treatment has been improved with the introduction of newer drugs including an all-oral regimen for DR-TB, thereby improving patient compliance. Improved TB prevention is achieved through the broadening of BCG vaccination as well as preventive therapy for asymptomatic, latent TB (LTBI) cases, which, otherwise, can reactivate to symptomatic disease. However, the recent goal of the WHO’s EndTB-2035 strategy has been met with significant challenges in the areas of implementing improved diagnosis and treatment modalities in resource-limited TB endemic countries. The complexity of global TB management is confounded by malnutrition, comorbidities with other infectious and non-infectious diseases, and the socio-economic landscape of vulnerable populations. Political commitment to universal health coverage (UHC), including service coverage and reduction in catastrophic cost, are some of the essential components that need to be addressed to achieve the EndTB strategy. In this perspective, we have highlighted the intricacies of global TB management and summarized some of the key challenges that may keep the WHO’s EndTB-2035 strategy on the fence. Full article

Background/Objectives: Brazil has a high incidence of new tuberculosis cases influenced by socioeconomic factors. Inadequate housing, limited access to health services, and insufficient food increase vulnerability to the disease. This study aimed to identify sociodemographic, nutritional, and anthropometric factors associated with active pulmonary tuberculosis. Methods: This case–control study was conducted at the tuberculosis (TB) Referral Hospital in São Luís, Maranhão, Brazil, from 2022 to 2024. It included 65 patients with active pulmonary TB and 73 comparison individuals. Sociodemographic and nutritional data were collected using an adapted semi-quantitative questionnaire with 77 items, based on the validated ELSA-BRASIL questionnaire for adults, to assess the consumption of calcium, phosphorus, iron, zinc, vitamin B3, vitamin B6, vitamin C, vitamin E, and vitamin D. The Brazilian Food Insecurity Scale (EBIA) was used to analyze food and nutrition security or insecurity. Body Mass Index (BMI) was calculated based on weight and height measurements. Results: The TB patients were predominantly men (73.8%), of mixed ancestry (69.4%), with low education levels (73.4%), and had a mean age of 39 years. Furthermore, 26.2% of the patients were underweight, and 64% experienced some degree of food and nutrition insecurity. The variables education level, vitamin D, and BMI were associated with the outcome in the final model. Conclusions: The study identified a high prevalence of food insecurity and vitamin E deficiency in individuals with active tuberculosis, in addition to associating low educational levels, inadequate vitamin D intake, and overweight with a higher risk of TB. Although it has limitations, such as the cross-sectional design and sample size, the results highlight the importance of these determinants and point to the need for longitudinal research to confirm and expand the evidence. Full article

Background: Little is known about mental health among tuberculosis (TB) patients in Thailand. This study aimed to identify factors associated with mental health problems in TB patients in urban Thailand. Methods: This cross-sectional study collected data from 210 TB patients receiving treatment at two tertiary care hospitals in the Bangkok Metropolitan Region of Thailand using consecutive sampling. The General Health Questionnaire (GHQ-12) and the Patient Health Questionnaire (PHQ-9) were used to assess mental health problems and probable depression, respectively. Results: Among TB patients, 34.3% had mental health problems (95% CI: 27.8–40.8), and 23.8% had depression (95% CI: 18.0–29.6). The final model from logistic regression with forward selection identified factors significantly associated with mental health problems, including high family support (OR = 0.45; 95% CI: 0.24–0.83) and perceived stigma: low (OR = 2.77; 95% CI: 1.16–6.60), moderate (OR = 3.56; 95% CI: 1.66–7.65), and high (OR = 3.56; 95% CI: 1.31–9.67) versus no stigma. Depression was associated with income ≥10,000 baht (OR = 0.43; 95% CI: 0.21–0.87), alcohol consumption (OR = 2.90; 95% CI: 1.27–6.64), and high social support from healthcare providers (OR = 0.44; 95% CI: 0.22–0.87). Conclusion: This study highlights the need to integrate mental health services into the TB care program to address the TB challenge in Thailand. Policies such as routine mental health screening and psychological counseling alongside treatment, as well as expanded social support and stigma reduction interventions, should be implemented to reduce the risk of mental health issues, particularly depression, and improve treatment outcomes among Thai TB patients. Full article

The equity of medical services is crucial for the quality of life of a population and the sustainable development of cities. Current research on optimizing the maximal equity of medical facilities has the following limitations: (1) In the accessibility calculation models for multiple transportation modes, the impact of factors such as public transport transfers and travel distance on the choice of transportation mode is often overlooked. (2) Existing spatial equity indicators are mostly derived from the overall study area, failing to fully consider the differences in population distribution and development gaps within different development zones inside the region. This study proposes a novel Incorporating Multiple Transportation Two-Step Floating Catchment Area (IMT-2SFCA) and a Hierarchical Theil-based Maximal Accessibility Equality model (HT-MAE) to optimize the equity of access to tuberculosis medical institutions in Wuhan. The findings reveal that, compared to single-mode transportation accessibility models, the multimodal accessibility model integrates the characteristics of four transportation modes, providing a more realistic reflection of residents’ access to medical services. The optimization results show a significant improvement in the equity of access to medical services across Wuhan and among different economic development zones, although the equity indicators in non-central urban areas have declined. The results of this study provide a theoretical basis and practical insights for alleviating the inequality of access to medical services across different urban layers. Full article

Inadequate access to timely diagnosis and linkage to treatment are major barriers to tuberculosis (TB) care. New point-of-care diagnostics that do not rely solely on sputum samples are needed to make up for lost time, bringing TB testing closer to service recipients and addressing current sputum sampling limitations. Urine-based TB lipoarabinomannan tests and tongue dorsum swabs have demonstrated potential as alternatives to sputum-based molecular testing. We conducted a study to ascertain the perceived value of these non-sputum-based TB tests among stakeholders from the TB community, including TB service recipients and healthcare providers, in India, South Africa, and Viet Nam. Our results showed that there was a high degree of enthusiasm among various end-users for both novel sample types. It is important to generate both qualitative and quantitative evidence to support optimal uptake and implementation of these potential new sample types for TB testing. Full article

Tuberculosis preventive therapy (TPT) for people living with HIV (PLHIV) has been recommended by Indonesia’s National TB Program since 2014 but has seen limited implementation. This study describes TB screening and TPT initiation from 2019 to 2022 among eight healthcare facilities supported by the Zero TB Yogyakarta (ZTB) project. ZTB assigned a dedicated nurse to assist with active TB screening among PLHIV and recommended the immediate initiation of TPT as an innovation implemented. Data were obtained from the national HIV program reporting system, routinely reported by ART clinics from 2019 to 2022. We conducted a descriptive analysis, comparing the pre-intervention and intervention periods. During the intervention, there was a significant increase in PLHIV visits to healthcare facilities where TPT eligibility was assessed. At health centers, TB screening coverage for PLHIV decreased toward the end of the baseline period but recovered during the intervention. The number of PLHIV starting TPT also rose during the intervention. While the direct impact of ZTB is difficult to measure, the changes observed indicate progress in integrating TB/HIV services and enhancing TB prevention among PLHIV. Ongoing support, training, and supervision of healthcare facilities are crucial for improving TB screening and TPT provision. Full article

Justicia adhatoda, also known as Adulsa or Vasaka, is a notable member of the family Acanthaceae, with a broad geographic distribution across varied climatic conditions, and is known for its extensive medicinal properties for treating respiratory disorders, tuberculosis, malaria, and dysentery. It possesses several pharmacological activities, including anti-bacterial, anti-fungal, and anti-cancerous ones. In addition to discussing its morphology, phytochemistry, and pharmacological aspects, the present review also focuses on its several unexplored facets, such as pollination mechanism, cytology, molecular and genetic aspects, conservation, and ecological attributes. The literature survey indicates that, despite its medicinal value, J. adhatoda is also a strong invader in various ecosystems, suppressing associated species and cause vegetation homogenization. It also provides several ecosystem services, including soil stabilization, ecological restoration, and phytoremediation by removing contaminants such as chromium and mercury from wastewater. Additionally, its leaves increase the nitrogen content in compost, promote the proliferation of earthworms, and help suppress plant diseases. This highlights its potential for sustainable land management and integrated disease control. The urgency of this research is underscored by the significant gap in the literature regarding the ecological interactions of J. adhatoda, particularly its allelopathic effects on other plant species. The findings underscore the need for sustainable utilization and conservation strategies, emphasizing the dual importance of J. adhatoda as a medicinal resource and an ecological disruptor. Full article

Timor Leste is one of the top countries in Asia with a high incidence rate of pulmonary tuberculosis (TB). The success of TB treatment necessitated a more profound comprehension of adherence as a multifaceted behavioral issue, along with identifying the barriers that hinder and the factors that promote patient adherence. This study aimed to assess the rate of pulmonary TB medication adherence and identify its predictors among adults in Metinaro and Becora, Dili, Timor-Leste. A descriptive analytical cross-sectional study was conducted, and new patients with pulmonary TB aged 18 years and above were selected using a proportional sampling method. Quantitative data were collected from 398 patients with pulmonary tuberculosis. The medication adherence results were as follows: 73.6% low adherence, 18.3% moderate adherence, and only 8.1% high adherence. The study identified significant predictors of medication adherence, such as health service factors (OR = 14.024, 95% CI: 5.42–35.54, p = 0.001). Patients who perceived a high quality in the health service were 14 times more likely to exhibit higher medication adherence. Regarding individual behaviors, patients who consumed alcohol or occasionally engaged in physical exercise were significantly less likely to exhibit higher medication adherence (OR = 0.17, 95% CI: 0.091–0.312, p = 0.001). Similarly, patients experiencing high levels of stigma were less likely to achieve strong adherence (OR = 0.146, 95% CI: 0.058–0.326, p = 0.001).Both health service quality and individual factors, such as lifestyle behaviors and social stigma, were statistically significant predictors ofTB medication adherence. Enhancing the healthcare infrastructure, implementing multisectoral strategies for behavior change, and reducing stigma are crucial. Additionally, mobile health technologies, like SMS reminders and telehealth, might support real-time adherence improvements. Full article

The integration of mental health (MH) services into tuberculosis (TB) and HIV care remains a significant challenge in South Africa’s Free State province. This study seeks to understand the perspectives of public health programme managers on the barriers to such integration and to identify potential strategies to overcome these challenges. Data were collected between February and October 2021 using qualitative methods including four individual semi-structured interviews and two focus group discussions with a total of 15 managers responsible for the MH, primary healthcare, TB, and HIV programmes. Thematic data analysis was guided by an adapted version of the World Health Organization’s “building blocks” framework encompassing “service delivery”, “workforce”, “health information”, “essential medicines”, “financing”, and “leadership/governance”. Additionally, the analysis underscored the crucial role of “people”, acknowledging their significant contributions as both caregivers and recipients of care. Managers highlighted significant concerns regarding the insufficient integration of MH services, identifying structural barriers such as inadequate MH management structures and staff training, as well as social barriers, notably stigma and a lack of family treatment adherence support. Conversely, they recognised strong management structures, integrated screening, and social interventions, including family involvement, as key facilitators of successful MH integration. The findings emphasise the need for a whole-system approach that addresses all building blocks while prioritising the role of “people” in overcoming challenges with integrating MH services into TB and HIV care. Full article

Tuberculosis (TB) is a serious infectious disease accounting for a significant number of deaths due to the infectious nature of the disease on the global platform. Migrant workers need special attention as these population groups live in substandard and crowded environmental conditions with poor ventilation, which play a crucial role in augmenting the risk of acquisition of infection. The global vision to ensure the delivery of effective TB control-related services for migrant workers has been influenced by a wide range of barriers. This issue is further complicated by the limited knowledge of migrant workers about tuberculosis, their rights, the kind of services available in healthcare facilities, and the ways to prevent the acquisition and transmission of infectious disease. By acknowledging the role of predisposing factors and the potential barriers that impact accessing timely healthcare services, it can be seen that the need of the hour is to plan and implement a comprehensive package of services for the benefit of migrant workers. Full article

Like many countries, Ukraine faces challenges with diagnosing tuberculosis (TB) in children due to the paucibacillary nature of the disease and difficulty obtaining respiratory samples. To improve diagnostic efficiency, stool testing is being integrated into routine pediatric TB services. This started with a pilot introduction at 12 regional TB facilities, where stool was collected for children with a preliminary diagnosis of TB, based on clinical and/or radiological or laboratory findings, in addition to routine testing. For 168 children, a stool test was conducted between November 2021 and September 2022, with samples submitted in all 12 pilot regions. For 132 children, other samples were available in addition to stool. Mycobacterium tuberculosis (MTB) was bacteriologically confirmed in 37 children (in stool for 18 children). For 7 of the 18 children with MTB in stool, stool was the only sample in which MTB was detected. Rifampicin resistance was detected in seven children (in stool for three). This noninvasive TB diagnostic sample is especially beneficial for young children who cannot produce sputum. Early detection of TB and its drug-resistant strains in children will allow medical workers to provide safer and more effective treatment and save more lives. Based on the pilot implementation, Ukraine’s national TB program began implementing stool testing throughout the country. Full article