241 results match your criteria: "Centre de compétence tuberculose[Affiliation]"

Predictive Markers of Incident Tuberculosis in Close Contacts in Brazil and India.

J Infect Dis

January 2025

Programa de Pós-graduação em Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.

There are insufficient predictors of progression to tuberculosis among contacts. A case-control study within RePORT-Brazil matched 20 QuantiFERON-positive progressors and 40 non-progressors by sex, age, and exposure duration. Twenty-nine cytokines were measured by Luminex in QuantiFERON-TB Gold Plus supernatants collected at baseline and evaluated using machine learning for tuberculosis prediction.

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Background: Tuberculosis vaccine trials using disease as the primary endpoint are large, time consuming, and expensive. An earlier immunological measure of the protection against disease would accelerate tuberculosis vaccine development. We aimed to assess whether the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine for prevention of Mycobacterium tuberculosis infection was consistent with that for prevention of tuberculosis disease.

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Context: Tuberculosis (TB) diagnosis in children remains challenging due to the paucibacillary nature of specimens and the difficulty in obtaining suitable samples. The use of alternative samples like nasopharyngeal aspirate (NPA) and stools, alongside Xpert MTB/RIF testing, offers promising improvements.

Objective: This study aimed to assess the diagnostic performance of the Xpert MTB/RIF test on NPA and stool samples for detecting intrathoracic TB in children from Madagascar, Cameroon, and Ivory Coast.

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Introduction: The TriAD study will assess the Xpert MTB/XDR (Xpert XDR; Cepheid) assay to detect tuberculosis (TB) drug resistance in sputum testing positive for TB to rapidly triage and treat patients with a short all-oral treatment regimen.

Methods And Analysis: In this study, approximately 4800 Xpert MTB/RIF or Ultra MTB-positive patients (irrespective of rifampicin (RIF) resistance (RR) status) from several clinical sites across South Africa, Nigeria and Ethiopia will be enrolled over 18-24 months and followed-up for approximately 6 months post-TB treatment completion. Participants will be enrolled into one of two cohorts based on Xpert MTB/RIF and Xpert XDR results: () positive participants with RR in Cohort 1 (n=880) and positive RIF susceptible TB patients with isoniazid mono-resistance irrespective of presence of resistance to fluoroquinolones, second-line injectable drugs or ethionamide in Cohort 2 (n=400).

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Article Synopsis
  • Tuberculosis (TB) is facing a significant challenge due to drug resistance, with Cameroon reporting a 1.4% prevalence of drug-resistant TB among new cases and 8.3% among those being retreated in 2022.
  • A study analyzed data from 2013 to 2022 in Cameroon, examining the trends, risk factors, and treatment outcomes related to drug-resistant TB, finding a total of 567 reported cases.
  • The study reported a high database quality (93.7%) and highlighted concerning treatment outcomes, including an 11.9% refusal rate and a 14.8% case fatality rate, with male gender and HIV-positive status identified as significant risk factors for poor treatment outcomes.
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Accuracy of Xpert and alternative sampling methods to diagnose childhood pulmonary tuberculosis, a prospective cohort study.

Clin Microbiol Infect

November 2024

Unité d'Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar.

Article Synopsis
  • The study aimed to assess the effectiveness (sensitivity and specificity) of various diagnostic tests for childhood pulmonary tuberculosis (CPTB) using latent class analysis, given the lack of definitive reference standards.
  • Conducted in the Ivory Coast, Madagascar, and Cameroon with 1,165 children suspected of having CPTB, multiple tests were evaluated, including smear microscopy, culture, and Xpert on different sample types.
  • Results indicated that while smear microscopy was very specific, it had low sensitivity across all sample types; Xpert showed better sensitivity, particularly in gastric and nasopharyngeal aspirates, suggesting a potentially effective diagnostic strategy for CPTB.
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Implementation of digital chest radiography for childhood tuberculosis diagnosis at district hospital level in six high tuberculosis burden and resources limited countries.

Trop Med Int Health

November 2024

Translational Research on HIV and Endemic and Emerging Infectious Diseases (TransVIHMI), University of Montpellier, National Institute for Health and Medical Research (INSERM), French National Research Institute for Sustainable Development (IRD), Montpellier, France.

Objectives: Chest x-ray (CXR) plays an important role in childhood tuberculosis (TB) diagnosis, but access to quality CXR remains a major challenge in resource-limited settings. Digital CXR (d-CXR) can solve some image quality issues and facilitate their transfer for quality control. We assess the implementation of introducing d-CXR in 12 district hospitals (DHs) in 2021-2022 across Cambodia, Cameroon, Ivory Coast, Mozambique, Sierra Leone and Uganda as part of the TB-speed decentralisation study on childhood TB diagnosis.

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Background: Genetic polymorphisms have been associated with risk of antituberculosis treatment toxicity. We characterized associations with adverse events and treatment failure/recurrence among adults treated for tuberculosis in Brazil.

Methods: Participants were followed in Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil.

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Article Synopsis
  • The study analyzed the prevalence of co-infections with parasites in newly diagnosed pulmonary tuberculosis (TB) patients compared to non-TB participants in Bobo-Dioulasso from 2019 to 2021, finding a higher frequency of parasitic infections in the TB group (69.5% vs. 55.7%).
  • Protozoal infections, especially by Entamoeba spp. and Cryptosporidium spp., were significantly more prevalent in TB+ patients, indicating a strong link between TB and certain types of parasites.
  • Factors such as illiteracy, smoking, and inadequate hygiene practices (like not washing hands after defecation) were identified as potential contributors to parasite infections, suggesting a need for improved health
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MARVEL-minimising the emergence and dissemination of HIV-1 drug resistance in Portuguese-speaking African Countries (PALOP): low-cost portable NGS platform for HIV-1 surveillance in Africa.

BMC Infect Dis

August 2024

Global Health and Tropical Medicine, Associate Laboratory in Translation and Innovation Towards Global Health, GHTM, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Rua da Junqueira 100, Lisboa, 1349-008, Portugal.

Article Synopsis
  • - The study addresses the ongoing challenge of HIV-1 infections in Africa, highlighting the rise of drug-resistance mutations (DRMs) due to inadequate testing and treatment adherence, necessitating improved surveillance methods.
  • - Researchers aim to develop a cost-effective third-generation sequencing protocol to monitor HIV-1 in Portuguese-speaking African Countries, involving a multicentric study with approximately 600 newly diagnosed patients.
  • - By implementing this low-cost surveillance method, the study hopes to enhance drug resistance monitoring, understand the spread of resistant strains, and build research capacities in Africa, ultimately improving the fight against HIV infection.
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[Pre-extensively and extensively drug-resistant tuberculosis, in Libreville, Gabon].

Rev Mal Respir

October 2024

Programme national de lutte contre la tuberculose (PNLT), Libreville, Gabon.

Introduction: Very few studies have been devoted to extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis (TB) in Gabon.

Aim: The aim of the present study is to present the epidemiology of pre-XDR and XDR TB and the evolution over time of patients with multidrug-resistant TB.

Methods: This retrospective study covered the activities from 2019 to 2022 of the Nkembo anti-tuberculosis center.

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There has been a dramatic increase in the identification of non-canonical translation and a significant expansion of the protein-coding genome. Among the strategies used to identify unannotated small Open Reading Frames (smORFs) that encode microproteins, Ribosome profiling (Ribo-Seq) is the gold standard for the annotation of novel coding sequences by reporting on smORF translation. In Ribo-Seq, ribosome-protected footprints (RPFs) that map to multiple genomic sites are removed since they cannot be unambiguously assigned to a specific genomic location.

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Background: Adherence to anti-tuberculosis treatment (ATT) in Brazil remains a challenge in achieving the goals set by the World Health Organization (WHO). Patients who are lost to follow-up during treatment pose a significant public health problem. This study aimed to investigate the factors associated with unfavorable ATT outcomes among those undergoing retreatment in Brazil.

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Strengthening Multidrug-Resistant Tuberculosis Epidemiological Surveillance in Rio de Janeiro: a multidimensional analysis.

Rev Soc Bras Med Trop

July 2024

Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil.

This study aimed to reinforce the importance of the epidemiological surveillance of multidrug-resistant tuberculosis (MDR-TB) in Rio de Janeiro State (RJ). Here, we reviewed seven articles we published between 2018 and 2022. This study had two phases.

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Phylogenomic and genomic analysis reveals unique and shared genetic signatures of complex species.

Microb Genom

July 2024

Laboratório de Biologia Molecular Aplicada a Micobactérias, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.

Species belonging to the complex (MKC) are frequently isolated from humans and the environment and can cause serious diseases. The most common MKC infections are caused by the species (), leading to tuberculosis-like disease. However, a broad spectrum of virulence, antimicrobial resistance and pathogenicity of these non-tuberculous mycobacteria (NTM) are observed across the MKC.

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Background: Chest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence countries.

Methods: Within the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features.

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The provision of tuberculosis preventive treatment is one of the critical interventions to reduce tuberculosis incidence and ultimately eliminate the disease, yet we still miss appropriate tools for an impactful intervention and treatment coverage remains low. We used recent data, epidemiological estimates, and research findings to analyze the challenges of each step of the cascade of tuberculosis prevention that currently delay the strategy implementation. We addressed research gaps and implementation bottlenecks that withhold key actions in tuberculosis case finding, testing for tuberculosis infection, provision of preventive treatment with safer, shorter regimens and supporting people to complete their treatment.

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Genetic Characterization and Population Structure of Drug-Resistant Isolated from Brazilian Patients Using Whole-Genome Sequencing.

Antibiotics (Basel)

May 2024

Laboratório de Biologia Molecular Aplicado à Micobactérias, Fundação Oswaldo Cruz (FIOCRUZ), Instituto Oswaldo Cruz (IOC), Rio de Janeiro 21040-360, RJ, Brazil.

Article Synopsis
  • - The study focused on analyzing the genetic diversity of Mycobacterium tuberculosis (Mtb) isolates from drug-resistant tuberculosis patients in Brazil, finding a high prevalence of multidrug-resistant cases at 54.8% and pre-extensively drug-resistant cases at 9.2%.
  • - Researchers utilized whole-genome sequencing (WGS) to scrutinize 298 Mtb isolates, identifying the most common sub-lineage as 4.3 and uncovering 20 new mutations linked to drug resistance, with significant ongoing transmission among patients noted through genomic clustering.
  • - The in-house WGS pipeline outperformed online tools in predicting drug resistance, revealing key associations between certain genotypes and severe disease outcomes, which enhances the understanding of
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Setting: Côte d'Ivoire is a country with a high incidence of TB. The control of TB infection is focused on high-risk patients but has limited implementation.

Objective: Cost-benefit analysis of TB infection (TBI) screening of household contacts in Côte d'Ivoire to evaluate economic implications of the implementation of interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST).

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Diagnosis of M. tuberculosis (Mtb) infection in close contacts is critical for TB control. Smoking is a risk factor for Mtb infection and TB disease but its effect on longitudinal interferon-gamma release assay (IGRA) results remains unknown.

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Transcriptomic Signatures of Progression to Tuberculosis Disease Among Close Contacts in Brazil.

J Infect Dis

December 2024

South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.

Background: Approximately 5% of people infected with Mycobacterium tuberculosis progress to tuberculosis (TB) disease without preventive therapy. There is a need for a prognostic test to identify those at highest risk of incident TB so that therapy can be targeted. We evaluated host blood transcriptomic signatures for progression to TB disease.

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Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study.

Rev Saude Publica

April 2024

Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil.

Objective: To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators.

Methods: An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years.

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