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Clinical Infectious Diseases : An... Jun 2023We compared 6 new interferon-γ release assays (IGRAs; hereafter index tests: QFT-Plus, QFT-Plus CLIA, QIAreach, Wantai TB-IGRA, Standard E TB-Feron, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
We compared 6 new interferon-γ release assays (IGRAs; hereafter index tests: QFT-Plus, QFT-Plus CLIA, QIAreach, Wantai TB-IGRA, Standard E TB-Feron, and T-SPOT.TB/T-Cell Select) with World Health Organization (WHO)-endorsed tests for tuberculosis infection (hereafter reference tests).
METHODS
Data sources (1 January 2007-18 August 2021) were Medline, Embase, Web of Science, Cochrane Database of Systematic Reviews, and manufacturers' data. Cross-sectional and cohort studies comparing the diagnostic performance of index and reference tests were selected. The primary outcomes of interest were the pooled differences in sensitivity and specificity between index and reference tests. The certainty of evidence (CoE) was summarized using the GRADE approach.
RESULTS
Eighty-seven studies were included (44 evaluated the QFT-Plus, 4 QFT-Plus CLIA, 3 QIAreach, 26 TB-IGRA, 10 TB-Feron [1 assessing the QFT-Plus], and 1 T-SPOT.TB/T-Cell Select). Compared to the QFT-GIT, QFT Plus's sensitivity was 0.1 percentage points lower (95% confidence interval [CI], -2.8 to 2.6; CoE: moderate), and its specificity 0.9 percentage points lower (95% CI, -1.0 to -.9; CoE: moderate). Compared to QFT-GIT, TB-IGRA's sensitivity was 3.0 percentage points higher (95% CI, -.2 to 6.2; CoE: very low), and its specificity 2.6 percentage points lower (95% CI, -4.2 to -1.0; CoE: low). Agreement between the QFT-Plus CLIA and QIAreach with QFT-Plus was excellent (pooled κ statistics of 0.86 [95% CI, .78 to .94; CoE: low]; and 0.96 [95% CI, .92 to 1.00; CoE: low], respectively). The pooled κ statistic comparing the TB-Feron and the QFT-Plus or QFT-GIT was 0.85 (95% CI, .79 to .92; CoE: low).
CONCLUSIONS
The QFT-Plus and the TB-IGRA have very similar sensitivity and specificity as WHO-approved IGRAs.
Topics: Humans; Interferon-gamma Release Tests; Cross-Sectional Studies; Tuberculosis; Latent Tuberculosis; Sensitivity and Specificity; Tuberculin Test; Mycobacterium tuberculosis
PubMed: 36688489
DOI: 10.1093/cid/ciad030 -
Iranian Journal of Basic Medical... Apr 2021This updated systematic review and meta-analysis follows two aims: 1) to assess antibiotic resistance in Iran from 2013 to 2020 and, 2) to assess the trend of... (Review)
Review
This updated systematic review and meta-analysis follows two aims: 1) to assess antibiotic resistance in Iran from 2013 to 2020 and, 2) to assess the trend of resistance from 1999 to 2020. Several national and international databases were systematically searched through MeSH extracted keywords to identify 41 published studies addressing drug-resistant in Iran. Meta-analysis was done based on the PRISMA protocols using Comprehensive Meta-Analysis software. The average prevalence of resistance to first- and second-line anti-TB drugs, multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) in new and previously treated tuberculosis (TB) cases in Iran during 2013-2020 were as follows: isoniazid 6.9%, rifampin 7.9%, ethambutol 5.7%, pyrazinamide 20.4%, -aminosalicylic acid 4.6%, capreomycin 1.7%, cycloserine 1.8%, ethionamide 11.3%, ofloxacin 1.5%, kanamycin 3.8%, amikacin 2.2%, MDR-TB 6.3% and XDR-TB 0.9%. Based on the presented data, resistance to first- and second-line anti-TB drugs, as well as MDR-TB, was low during 2013-2020 in Iran. Furthermore, there was a declining trend in TB drug resistance from 1999 to 2020. Hence, to maintain the current decreasing trend and to control and eliminate TB infection in Iran, continuous monitoring of resistance patterns is recommended.
PubMed: 34094023
DOI: 10.22038/IJBMS.2021.48628.11161 -
The Lancet. Microbe Oct 2023Pulmonary tuberculosis due to Mycobacterium tuberculosis can be challenging to diagnose when sputum samples cannot be obtained, which is especially problematic in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pulmonary tuberculosis due to Mycobacterium tuberculosis can be challenging to diagnose when sputum samples cannot be obtained, which is especially problematic in children and older people. We systematically appraised the performance characteristics and diagnostic accuracy of upper respiratory tract sampling for diagnosing active pulmonary tuberculosis.
METHODS
In this systematic review and meta-analysis, we searched MEDLINE, Cinahl, Web of Science, Global Health, and Global Health Archive databases for studies published between database inception and Dec 6, 2022 that reported on the accuracy of upper respiratory tract sampling for tuberculosis diagnosis compared with microbiological testing of sputum or gastric aspirate reference standard. We included studies that evaluated the accuracy of upper respiratory tract sampling (laryngeal swabs, nasopharyngeal aspirate, oral swabs, saliva, mouth wash, nasal swabs, plaque samples, and nasopharyngeal swabs) to be tested for microbiological diagnosis of tuberculous (by culture and nucleic acid amplification tests) compared with a reference standard using either sputum or gastric lavage for a microbiological test. We included cohort, case-control, cross-sectional, and randomised controlled studies that recruited participants from any community or clinical setting. We excluded post-mortem studies. We used a random-effects meta-analysis with a bivariate hierarchical model to estimate pooled sensitivity, specificity, and diagnostics odds ratio (DOR; odds of a positive test with disease relative to without), stratified by sampling method. We assessed bias using QUADAS-2 criteria. This study is registered with PROSPERO (CRD42021262392).
FINDINGS
We screened 10 159 titles for inclusion, reviewed 274 full texts, and included 71, comprising 119 test comparisons published between May 13, 1933, and Dec 19, 2022, in the systematic review (53 in the meta-analysis). For laryngeal swabs, pooled sensitivity was 57·8% (95% CI 50·5-65·0), specificity was 93·8% (88·4-96·8), and DOR was 20·7 (11·1-38·8). Nasopharyngeal aspirate sensitivity was 65·2% (52·0-76·4), specificity was 97·9% (96·0-99·0), and DOR was 91·0 (37·8-218·8). Oral swabs sensitivity was 56·7% (44·3-68·2), specificity was 91·3% (CI 81·0-96·3), and DOR was 13·8 (5·6-34·0). Substantial heterogeneity in diagnostic accuracy was found, probably due to differences in reference and index standards.
INTERPRETATION
Upper respiratory tract sampling holds promise to expand access to tuberculosis diagnosis. Exploring historical methods using modern microbiological techniques might further increase options for alternative sample types. Prospective studies are needed to optimise accuracy and utility of sampling methods in clinical practice.
FUNDING
UK Medical Research Council, Wellcome, and UK Foreign, Commonwealth and Development Office.
Topics: Child; Humans; Aged; Mycobacterium tuberculosis; Cross-Sectional Studies; Sensitivity and Specificity; Tuberculosis; Tuberculosis, Pulmonary; Respiratory System
PubMed: 37714173
DOI: 10.1016/S2666-5247(23)00190-8 -
Journal of Cellular Physiology Mar 2021Tuberculosis (TB) is referred to as a "consumption" or phthisis, which has been a fatal human disease for thousands of years. Mycobacterium tuberculosis (M. tb) might...
Tuberculosis (TB) is referred to as a "consumption" or phthisis, which has been a fatal human disease for thousands of years. Mycobacterium tuberculosis (M. tb) might have been responsible for the death of more humans than any other bacterial pathogens. Therefore, the rapid diagnosis of this bacterial infection plays a pivotal role in the timely and appropriate treatment of the patients, as well as the prevention of disease spread. More than 98% of TB cases are reported in developing countries, and due to the lack of well-equipped and specialized diagnostic laboratories, development of effective diagnostic methods based on biosensors is essential for this bacterium. In this review, original articles published in English were retrieved from multiple databases, such as PubMed, Scopus, Google Scholar, Science Direct, and Cochrane Library during January 2010-October 2019. In addition, the reference lists of the articles were also searched. Among 109 electronically searched citations, 42 articles met the inclusion criteria. The highest potential and wide usage of biosensors for the diagnosis of M. tb and its drug resistance belonged to DNA electrochemical biosensors (isoniazid and rifampin strains). Use of biosensors is expanding for the detection of resistant strains of anti-TB antibiotics with high sensitivity and accuracy, while the speed of these sensory methods is considered essential as well. Furthermore, the lowest limit of detection (0.9 fg/ml) from an electrochemical DNA biosensor was based on graphene-modified iron-oxide chitosan hybrid deposited on fluorine tin oxide for the MPT64 antigen target. According to the results, the most common methods used for M. tb detection include acid-fast staining, cultivation, and polymerase chain reaction (PCR). Although molecular techniques (e.g., PCR and real-time PCR) are rapid and sensitive, they require sophisticated laboratory and apparatuses, as well as skilled personnel and expertise in the commentary of the results. Biosensors are fast, valid, and cost-efficient diagnostic method, and the improvement of their quality is of paramount importance in resource-constrained settings.
Topics: Biosensing Techniques; DNA, Bacterial; Drug Resistance, Bacterial; Electrochemistry; Humans; Mycobacterium tuberculosis
PubMed: 32930412
DOI: 10.1002/jcp.30007 -
The Journal of Infection Dec 2020New tests are needed to overcome the limitations of existing immunodiagnostic tests for tuberculosis (TB) infection, including their inability to differentiate between... (Review)
Review
OBJECTIVES
New tests are needed to overcome the limitations of existing immunodiagnostic tests for tuberculosis (TB) infection, including their inability to differentiate between active TB and latent TB infection (LTBI). This review aimed to identify the most promising cytokine biomarkers for use as stage-specific markers of TB infection.
METHODS
A systematic review was done using electronic databases to identify studies that have investigated Mycobacterium tuberculosis (MTB)-specific cytokine responses as diagnostic tools to differentiate between LTBI and active TB.
RESULTS
The 56 studies included in this systematic review measured the MTB-specific responses of 100 cytokines, the most frequently studied of which were IFN-γ, IL-2, TNF-α, IP-10, IL-10 and IL-13. Ten studies assessed combinations of cytokines, most commonly IL-2 and IFN-γ. For most cytokines, findings were heterogenous between studies. The variation in results likely relates to differences in the study design and laboratory methods, as well as participant and environmental factors.
CONCLUSIONS
Although several cytokines show promise as stage-specific markers of TB infection, this review highlights the need for further well-designed studies, in both adult and paediatric populations, to establish which cytokine(s) will be of most use in a new generation of immunodiagnostic tests.
Topics: Adult; Antigens, Bacterial; Biomarkers; Child; Cytokines; Humans; Latent Tuberculosis; Mycobacterium tuberculosis; Tuberculosis
PubMed: 33007340
DOI: 10.1016/j.jinf.2020.09.032 -
Ethiopian Journal of Health Sciences Sep 2023Non-tuberculous mycobacteria (NTM) have been reported to cause pulmonary and extrapulmonary infections. These NTMs are often misdiagnosed as MTB due to their similar... (Review)
Review
BACKGROUND
Non-tuberculous mycobacteria (NTM) have been reported to cause pulmonary and extrapulmonary infections. These NTMs are often misdiagnosed as MTB due to their similar clinical presentations to tuberculosis, leading to inappropriate treatment and increased morbidity and mortality rates. This literature review aims to provide an overview of the prevalence, clinical manifestations, diagnosis, and management of NTM infections in Africa.
METHODS
A systematic search was performed using various electronic databases including PubMed, Scopus, and Web of Science. The search was limited to studies published in the English language from 2000 to 2021. The following keywords were used: "non-tuberculous mycobacteria", "NTM", "Africa", and "prevalence". Studies that focused solely on the Mycobacterium tuberculosis complex or those that did not report prevalence rates were excluded. Data extraction was performed on eligible studies. Overall, a total of 32 studies met the inclusion criteria and were included in this review.
RESULTS
In our literature review, we identified a total of 32 studies that reported non-tuberculosis mycobacteria (NTM) in Africa. The majority of these studies were conducted in South Africa, followed by Ethiopia and Nigeria. The most commonly isolated NTM species were Mycobacterium avium complex (MAC), Mycobacterium fortuitum, and Mycobacterium abscessus. Many of the studies reported a high prevalence of NTM infections among HIV-positive individuals. Other risk factors for NTM infection included advanced age, chronic lung disease, and previous tuberculosis infection.
CONCLUSION
In conclusion, this literature review highlights the significant burden of non-tuberculosis mycobacteria infections in Africa. The prevalence of these infections is high, and they are often misdiagnosed due to their similarity to tuberculosis. The lack of awareness and diagnostic tools for non-tuberculosis mycobacteria infections in Africa is a major concern that needs to be addressed urgently. It is crucial to improve laboratory capacity and develop appropriate diagnostic algorithms for these infections.
Topics: Humans; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Africa; Prevalence
PubMed: 38784502
DOI: 10.4314/ejhs.v33i5.21 -
Current Topics in Medicinal Chemistry 2021Today, the occurrence and recurrence of multidrug-resistant tuberculosis strains and comorbidities are the main reasons for long-term morbidity and mortality from...
BACKGROUND
Today, the occurrence and recurrence of multidrug-resistant tuberculosis strains and comorbidities are the main reasons for long-term morbidity and mortality from tuberculosis from the nasty acid-fast pathogen Mycobacterium tuberculosis. Therefore, discovering and developing well-tolerated and non-toxic antituberculosis regimens are directly needed to defend the variants strains of M. tuberculosis and, alternatively, support WHO's 'END-TB' campaign.
OBJECTIVE
Alternatively, phytochemicals from various common and medicinal plants have always been vital therapeutic agents since the primitive era. Thus, proper scientific documentation as diversity, potency, structure, drug-chemistry and overall critical analysis are essential tools to accelerate the phytochemical-based anti-TB drug development.
METHODS
In the present review, we have used some specific keywords such as 'antituberculosis phytochemicals', &; antituberculosis phytochemicals from plant source&; 'natural products against tuberculosis' in Google, PubMed, ScienceDirect sites to get more appropriate research publications. Further, based on lower minimum inhibitory concentration within fifty μ g/mL, a total of twohundred- twenty-one bioactive anti-TB phytochemicals were selected for critical drug-chemistry and structural activity relationship analyses to select most potential 'lead candidate' for anti-TB drug development.
RESULTS
Based on lower concentration, abietane, ethyl-p-methoxycinnamate, ergosterol peroxide, mono-O-methyl curcumin isoxazole, 7-methyljuglone, 12-demethylmulticaulin, 12-methyl-5- dehydroacetylhorminone, tryptanthrin, etc. are some of the potential anti-TB phytochemicals. Interestingly, existing and clinical drug pipelines for TB contain several active phytochemical pharmacophores illustrated from the structural analysis.
CONCLUSION
Therefore, updated experimental documentation and structural-cum-critical drugchemistry analysis on isolated antituberculosis phytochemicals at the primary level are more beneficial for drug developers, R&D centres, and pharmaceutical companies to accelerate anti-TB drug development using phytochemicals.
Topics: Humans; Phytochemicals; Tuberculosis
PubMed: 34225624
DOI: 10.2174/1568026621666210705170510 -
American Journal of Infection Control Jul 2022To identify the prevalence and incidence of tuberculosis in health workers. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To identify the prevalence and incidence of tuberculosis in health workers.
METHOD
Systematic literature review, according to the protocol of the Joanna Briggs Institute and report following PRISMA guidelines. Primary studies containing data on the incidence or prevalence of active or latent tuberculosis infection in health workers were considered.
RESULTS
2,310 potentially relevant studies were identified in ten databases, of which 24 were included. The prevalence of latent tuberculosis varied between 0.1% and 62.0%, and the annual incidence rate varied from 1.4% to 11.4%. A meta-analysis combining data from the studies identified the prevalence as 28% (95% CI 21-36). Occupational risk factors are related to direct contact with patients having active tuberculosis, and more years of professional experience.
CONCLUSIONS
Evidences show that tuberculosis is an important occupational problem in health care; however, there are still gaps in information about the epidemiology of tuberculosis in health workers, mainly related to the risk factors.
Topics: Health Personnel; Humans; Incidence; Latent Tuberculosis; Prevalence; Risk Factors; Tuberculosis
PubMed: 35108578
DOI: 10.1016/j.ajic.2022.01.021 -
Annals of Clinical Microbiology and... Oct 2021Mycobacterium tuberculosis (MTB) is responsible for tuberculosis; that continues to be a public health threat across the globe. Furthermore, increasing heteroresistance... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Mycobacterium tuberculosis (MTB) is responsible for tuberculosis; that continues to be a public health threat across the globe. Furthermore, increasing heteroresistance (HR)-the presence of resistant and susceptible isolates among MTB strains- has been reported from around the world. This phenomenon can lead to full resistance development and treatment failure.
METHODS
We systematically searched the relevant studies in PubMed, Scopus, and Embase (Until October 21, 2020). The study outcomes revealed the weighted pooled prevalence of antibiotic HR in MTB isolates with subgroup analysis by year, quality of study, and heteroresistance detection method.
RESULTS
A total of 38 studies which had investigated MTB isolates were included in the meta-analysis. Geographically, the highest number of studies were reported from Asia (n = 24), followed by Africa (n = 5). Nineteen studies reported HR to isoniazid, with a weighted pooled prevalence of 5% (95% CI 0-12) among 11,761 MTB isolates. Also, there is no important trend for the subgroup analysis by the study period (2001-2014 vs 2015-2017 vs 2018-2020). HR to rifampin was reported in 17 studies, with a weighted pooled prevalence of 7% (95% CI 2-14) among 3782 MTB isolates. HR to fluoroquinolone and ethambutol were reported in 12 and 4 studies, respectively, with weighted pooled prevalence of 10% and 1% among 2153 and 1509 MTB isolates, correspondingly.
CONCLUSION
Based on our analysis, HR in MTB isolates with different frequency rate is present worldwide. Thus, the selection of appropriate and reliable methods for HR detection is crucial for TB eradication.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Fluoroquinolones; Humans; Isoniazid; Mycobacterium tuberculosis; Rifampin; Tuberculosis
PubMed: 34645463
DOI: 10.1186/s12941-021-00478-z -
Current Problems in Cardiology Jul 2023A considerable epidemiological and pathogenetic overlap exists between tuberculosis (TB) and cardiovascular diseases (CVD). The objective of this study was to establish... (Meta-Analysis)
Meta-Analysis Review
A considerable epidemiological and pathogenetic overlap exists between tuberculosis (TB) and cardiovascular diseases (CVD). The objective of this study was to establish the prevalence of CVD in the TB population. A systematic literature search was performed using Scopus, PubMed, EBSCO, ProQuest, Web of Science on January 25, 2023 using the keywords: "Tuberculosis," "TB," "mycobacterium tuberculosis," and "cardiovascular disease," "CVD" and with individual terms of various CVDs. Observational Studies were included if they reported the prevalence of CVD in the presence of TB in an adult population. The Newcastle-Ottawa Scale was used for quality evaluation. Statistical analyses were performed using STATA version 17. From 10 studies involving 46715 TB patients, a combined prevalence of CVDs was found to be 11% (CI: 95%, 5-16) with significant heterogeneity across studies (I = 96.72%). This study showed a considerable prevalence of CVD among TB patients suggesting TB patients to consider cardiac examination.
Topics: Adult; Humans; Tuberculosis; Mycobacterium tuberculosis; Prevalence; Cardiovascular Diseases
PubMed: 36828041
DOI: 10.1016/j.cpcardiol.2023.101666