1976 research outputs found
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A profile on the Truenat assays for the detection of pulmonary tuberculosis and rifampicin resistance
No full textEarly diagnosis and treatment initiation are essential to prevent ongoing tuberculosis (TB) transmission and reduce the disease burden. Smear microscopy, which is widely used test for diagnosis, has limited sensitivity and does not detect rifampicin resistance. Truenat is a portable, battery-operated, chip-based test that can be placed in peripheral laboratories, serving as a point-of-care test. It also detects rifampicin resistance, which is crucial in the management of TB
Plasma biomarkers CRP, iFABP, and zonulin as predictors of tuberculosis progression in household contacts of pulmonary TB patients
No full textIdentifying host biomarkers associated with progression from Mycobacterium tuberculosis infection to active tuberculosis (TB) could support early risk stratification in household contacts (HHCs). This exploratory study evaluated baseline plasma immune biomarkers in HHCs of pulmonary TB (PTB) patients to assess their association with subsequent disease development
Immunological Analysis of Different Treatment Strategies for Multisystem Inflammatory Syndrome in Children (MIS-C)
Full text linkMIS-C is an uncommon but devastating ill�ness that occurs mainly in children after exposure to SARS�COV-2 [1]. Early diagnosis, rapid treatment with supportive care, anti-inflammatory medications, and/or immunosup�pressants & immunomodulators with a multidisciplinary approach is essential for effective management of this con�dition. However, the optimal therapeutic strategy remains
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High-dose isoniazid for TB with low-to-moderate isoniazid resistance after 1 week of treatment
Full text linkTo evaluate the effect of high-dose isoniazid in patients with isoniazid-resistant TB by its bactericidal
activity after 1 or more weeks of treatment.Using the rapid direct method of phenotypic drug susceptibility testing, we screened persons with positive sputum microscopy results and genotypic drug resistance for isoniazid resistance.Those with no growth at a critical concentration of 2.0 mg/L were invited to participate in a trial of high-dose isoniazid monotherapy lasting 6 days. After 3 days of no treatment, patients received isoniazid 15 mg/kg and were followed with serial quantitative sputum cultures from Days 0 to
Comparing cost-effectiveness of short-course regimens for drug-resistant tuberculosis treatment in India
Full text linkShort-course regimens are currently explored to improve multidrug-resistant tuberculosis effects, reduce costs, as well as enhance patient adherence. Currently, we are determining the most cost-effective shorter regimen out of seven short-course regimens (6–9 months) to treat drug-resistant tuberculosis (DR-TB) compared to the current standard of care (SoC) 9- to 11-month regimen
Cost-effectiveness of BPaL/BPaLM as compared to mixed standard of care bedaquiline containing regimen for MDR/RR-TB
No full textCurrent options for treating tuberculosis (TB) that is resistant to rifampicin (RR-TB) are limited and available regimens are often lengthy and poorly tolerated. However, following recent evidence from the TB PRACTECAL trial, countries are considering programmatic adoption of six-month, all-oral treatment regimen such as bedaquiline, pretomanid, linezolid (BPaL) and BPaL with moxifloxacin (BPaLM). We conducted an economic evaluation to assess whether the introduction of BPaL/BPaLM regimen under National Tuberculosis Elimination Programme (NTEP) for the treatment of multi-drug resistant (MDR)/RR-TB is a cost-effective strategy. The idea was to estimate the incremental cost incurred from BPaL/BPaLM regimen in comparison with the current mix of standard of care (SoC) regime
Detection of Drug Susceptibility and Drug Interactions in Mycobacterium tuberculosis using Resazurin Microtiter and Checkerboard Assay
No full textThe emergence of multidrug-resistant tuberculosis (MDR-TB) necessitates rapid and accurate drug susceptibility testing (DST) methods to guide effective treatment. This study introduces a methodology combining the resazurin microtiter assay (REMA) and checkerboard assay to determine minimum inhibitory concentration (MIC) and evaluate drug-drug interactions of anti-tuberculosis drugs against Mycobacterium tuberculosis. The REMA, adapted to a 96-well format, leverages the reduction of resazurin dye by metabolically active M. tuberculosis as a visual indicator of drug susceptibility. Varying concentrations of anti-TB drugs are tested against M. tuberculosis isolates, and color changes are observed to determine the MIC. Subsequently, a checkerboard assay is employed to assess potential synergistic, additive, or antagonistic effects between drug combinations. This simple and inexpensive method yields results within seven days, offering a significant advantage over traditional DST methods. This method provides valuable insights into the DST of M. tuberculosis isolates and facilitates the identification of promising drug combinations for improved treatment outcomes against MDR-TB
An Application for Spatial Frailty Models: An Exploration with Data on Fungal Sepsis in Neonates
Full text linkGlobally, neonatal fungal sepsis (NFS) is a leading cause of neonatal mortality, particularly among vulnerable opulations in neonatal intensive care units (NICU). The use of spatial frailty models with a Bayesian approach to identify hotspots
and risk factors for neonatal deaths due to fungal sepsis has not been explored before. Methods: A cohort of 80 neonates admitted to the NICU at a Government Hospital in
Tamil Nadu, India and diagnosed with fungal sepsis through blood cultures between 2018–2020 was considered for this study. Bayesian spatial frailty models using parametric
distributions, such as Log-logistic, Log-normal, and Weibull proportional hazard (PH) models, were employed to identify associated risk factors for NFS deaths and hotspot areas using the R version 4.1.3 software and QGIS version 3.26 (Quantum Geographic Information System). Results: The spatial parametric frailty models were found to be good
models for analyzing NFS data. Abnormal levels of activated thromboplastin carried a significantly higher risk of death in neonates across all PH models (Log-logistic, Hazard
Ratio (HR), 95% Credible Interval (CI): 22.12, (5.40, 208.08); Log-normal: 20.87, (5.29, 123.23); Weibull: 18.49, (5.60, 93.41). The presence of hemorrhage also carried a risk of death for the Log-normal (1.65, (1.05, 2.75)) and Weibull models (1.75, (1.07, 3.12)). Villivakkam,
Tiruvallur, and Poonamallee blocks were identified as high-risk areas. Conclusions: The spatial parametric frailty models proved their effectiveness in identifying these risk factors and quantifying their association with mortality. The findings from this study underline the importance of the early detection and management of risk factors to improve survival outcomes in neonates with fungal sepsis
Truenat MTB assays for pulmonary tuberculosis and rifampicin resistance in adults and adolescents (Review)
Full text linkAccurate and rapid diagnosis is crucial for ending the tuberculosis epidemic. Truenat assays are World Health Organization (WHO)-recommended rapid molecular diagnostic tests that detect Mycobacterium tuberculosis complex and rifampicin resistance
Optimizing Pyrazinamide Use: A Low‑Hanging Fruit in Improving Outcomes with Tuberculous Meningitis? Narrative Review
Full text linkTuberculous meningitis (TBM) disables more than a third of its sufferers. Recent research has focused on optimizing the antitubercular regimen, mainly by increasing the dosage of
rifampicin. However, pyrazinamide, with higher penetration into the central nervous system, is generally overlooked. We discuss the potential clinical impact of using pyrazinamide throughout antitubercular therapy in TBM, in contrast
to only the intensive phase. This approach may improve the treatment outcomes and reduce disability in TBM. We summarize the available data regarding this approach from in vitro studies, clinical cohorts, toxicity data, and baseline
resistance rates. Additionally, we discuss the two ongoing clinical trials evaluating this approach