Tuberculosis preventive treatment in eight SEAR countries - Current practices, implementation challenges and operations research priorities.

Objectives: Countries in the South East Asian region face similar challenges in control of infectious diseases. There is limited access to experiences and learnings of neighboring countries. The Indian Council - of Medical Research (ICMR) has established a Regional Enabler for the South-East Asia Research Collaboration for Health (RESEARCH) Platform for South East Asian Region (SEAR) countries to address the above issues.

Comparing cross-sectional and longitudinal approaches to tuberculosis patient cost surveys using Nepalese data.

The World Health Organization has supported the development of national tuberculosis (TB) patient cost surveys to quantify the socio-economic impact of TB in high-burden countries. However, methodological differences in the study design (e.g.

Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study.

Background: The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.

Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra: a cost-effectiveness analysis.

Background: The World Health Organization (WHO) recommends the diagnosis of tuberculosis (TB) using molecular tests, such as Xpert MTB/RIF (MTB/RIF) or Xpert Ultra (Ultra). These tests are expensive and resource-consuming, and cost-effective approaches are needed for greater coverage.

Methods: We evaluated the cost-effectiveness of pooling sputum samples for TB testing by using a fixed amount of 1,000 MTB/RIF or Ultra cartridges.

Pooling sputum for Xpert MTB/RIF and Xpert Ultra testing during the Covid-19 pandemic in Lao People's Democratic Republic.

The global Covid-19 pandemic has limited access to molecular TB diagnostics and National Programmes are struggling to maintain essential services. The pooling method (testing several samples together) could reduce the number of cartridges and staff time needed for TB diagnosis but has not been tested within the pandemic. We conducted two independent cross-sectional surveys.

Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People's Democratic Republic.

The COVID-19 pandemic created the need for large-scale testing of populations. However, most laboratories do not have sufficient testing capacity for mass screening. We evaluated pooled testing of samples, as a strategy to increase testing capacity in Lao PDR.

Detection of Mutations in in Clinical Isolates from Nepal in Association with Pyrazinamide Resistance.

Without the proper information on pyrazinamide (PZA) susceptibility of Mycobacterium tuberculosis (MTB), PZA is inappropriately recommended for the treatment of both susceptible and multidrug-resistant tuberculosis (MDR-TB) in Nepal. This study aimed to collect information regarding PZA susceptibility in MTB isolates from Nepal by analyzing pncA and its upstream regulatory region (URR). A total of 211 MTB isolates were included in this study.

Sputum Smear Non-conversion at the End of Intensive Phase of Tuberculosis Treatment at a Tertiary Center: A Descriptive Cross-sectional study.

Introduction: Sputum non-conversion is smear positive tuberculosis despite anti-tubercular therapy. Various factors may lead to sputum non-conversion including resistance to anti-tubercular drugs, age, gender, disease severity, non-compliance, drugs unavailability etc. Little is known and studied about the contribution of these individual factors.

Pooled testing of sputum with Xpert MTB/RIF and Xpert Ultra during tuberculosis active case finding campaigns in Lao People's Democratic Republic.

Introduction: Active case finding (ACF) of individuals with tuberculosis (TB) is a key intervention to find the 30% of people missed every year. However, ACF requires screening large numbers of individuals who have a low probability of positive results, typically <5%, which makes using the recommended molecular tests expensive.

Methods: We conducted two ACF surveys (in 2020 and 2021) in high TB burden areas of Lao PDR.

Comparative genomic analyses of multi-drug resistant Mycobacterium tuberculosis from Nepal and other geographical locations.

Nepal exhibits a tuberculosis (TB) incidence rate that is comparable to neighbouring high TB incidence countries. In addition, it records >500 cases of multi-drug resistant (MDR) TB each year. The objective of this study was to perform whole-genome bioinformatic analysis on MDR-TB isolates from Nepal (n = 19) to identify the specific mutations underlying their phenotypic resistance.

Genome Sequences of Two Mycobacterium tuberculosis Isolates from Asian Elephants in Nepal.

This report describes the genome sequences of two Mycobacterium tuberculosis isolates, S1 and S3, recovered from Asian elephants in Nepal. These genome sequences will enhance our understanding of the genomic epidemiology of Mycobacterium tuberculosis in Asian elephants.

Knowledge, Attitude, and Practices on Drug-Resistant Tuberculosis Infection Control in Nepal: A Cross-Sectional Study.

Drug-resistant tuberculosis (DR-TB) transmission is an important problem, particularly in low-income settings. This study is aimed at assessing the knowledge, attitude, and practices of DR-TB infection control among the healthcare workers under the National Tuberculosis Control Program in Nepal. In this cross-sectional study, we studied the healthcare workers from all the 11 functioning DR-TB treatment centers across Nepal in March 2018.

Prevalence and risk factors of depression in patients with drug-resistant tuberculosis in Nepal: A cross-sectional study.

Background: Patients with drug-resistant tuberculosis (DR TB) have a protracted course of illness and the available treatment has a low success rate. These factors combined with the associated stigma and financial implications put the patients with DR TB at an increased risk of depression. The psychiatric side effects of anti-tuberculosis drugs further aggravate the problem.

Rifampicin-resistant by GeneXpert MTB/RIF and Associated Factors Among Presumptive Pulmonary Tuberculosis Patients in Nepal.

Background: Mycobacterium tuberculosis(MTB) remains a major public health problem worldwide, and emergence of drug-resistant TB has become a significant obstacle to effective TB control. However, the rate of MTB and rifampicin resistant-MTB (RR-MTB) in the Nepalese setting has not been studied extensively. Therefore, the present study aims to assess the rate of MTB and RR-MTB and further determine the factors associated with it.

A country-wide evaluation of infection control for tuberculosis in health-care facilities in Armenia.

Introduction: Infection control at health facilities is an important part of TB control programmes. To assess the implementation of tuberculosis infection control (TB IC) measures and barriers hindering their implementation in TB health care facilities (HCFs) in Armenia; to report the feasibility of using the WHO recommended checklist.

Methodology: A cross-sectional survey using WHO TB-IC checklist and direct observations was conducted between January and May 2018.

Quality of care provided to tuberculosis patients in Armenia: How satisfied are the patients?

Introduction: Adherence to tuberculosis (TB) treatment as an important determinant for the successful cure of patients can be increased by focusing on patient satisfaction. The objective of this study was to evaluate patient satisfaction with TB services, different aspects of patient satisfaction, and demographic, health and treatment characteristics associated with satisfaction.

Methodology: Overall 505 randomly selected TB patients that received treatment during 2014-2015 in Armenia underwent a cross-sectional telephone survey.

Change in TB diagnostic profile after introduction of GeneXpert MTB/RIF assay in National TB Program of Armenia, 2013-2017.

Introduction: In 2013, the National Tuberculosis (TB) Program of Armenia introduced GeneXpert MTB/RIF (Xpert) assay to address World Health Organization (WHO) target of 80% (2020) of notified new and relapse TB cases to be tested with WHO recommended rapid diagnostic methods. This study aimed to assess the change in laboratory diagnostic profile of Mycobacterium tuberculosis after introduction of the Xpert assay from 2013 to 2017.

Methodology: Retrospective cohort analysis of all presumptive TB patients' records retrieved from the National Reference Laboratory database was performed.

Tuberculosis care services in Armenia: What has changed since the 2014 reform?

Introduction: In efforts to reach the 2020 Tuberculosis targets, the WHO advocates for an outpatient, people-centered model of TB care. To this end, the TB care system in Armenia underwent structural and financing reforms in 2014. Financing mechanism for inpatient TB facilities was changed from a fee per bed/day to a mixed type of financing that includes fixed and variable costs eliminating incentives for unnecessary and extended hospitalizations.

Mind the gap: Improving the performance of the reference laboratory to end-tuberculosis in Armenia.

Introduction: A one of the step towards achieving TB related targets is to ensure early and quality diagnosis of TB in national laboratories. WHO recommends that all national reference laboratories in TB burden countries strive to reach accreditation by 2025, based on ISO15189:2012 quality management system standard. To identify gaps, progress and evaluated the evolution in implementation QMS we performed a formal assessment of the national TB reference laboratory of Armenia, as well as estimates the specific quality indicators of NRL activity.

Draft Genome Sequence of an Isolate of Extensively Drug-Resistant Mycobacterium tuberculosis from Nepal.

Extensively drug-resistant (XDR) has become a challenge to the treatment of tuberculosis (TB) in several countries, including Nepal. Here, we report for the first time the draft genome sequence of an isolate of XDR-TB collected in Nepal and describe single-nucleotide variations associated with its extensively drug-resistant phenotype.

Tuberculosis among migrants in Bishkek, the capital of the Kyrgyz Republic.

Twenty-two first-line, two second-line and one tertiary health facility in Bishkek, the capital of Kyrgyzstan. Among migrants, a marginalised population at risk for acquiring and transmitting tuberculosis (TB), we determined the proportion with TB among all registered TB cases. For those registered at primary-level facilities, we then reported on their demographic and clinical profiles and TB treatment outcomes.

Tuberculosis treatment and Smoking, Armenia, 2014-2016.

Introduction: Tuberculosis and tobacco prove to be increasingly apparent world problems. Armenia is a developing country which is facing issues related to the high rates of tobacco consumption. Moreover, it is among the list of high multi-drug resistant (MDR) Tuberculosis TB burden countries.