<i>Aim</i>. We aimed to investigate the demographic and clinical factors associated with TB mortality in patients managed at a tertiary TB referral center. <i>Methods</i>. We conducted a retrospective review of the medical records of 1,933 TB patients seen between January 2017 and December 2020 at the Korle-Bu Teaching Hospital (KBTH) Chest Department in Accra, Ghana. TB mortality was defined as any TB patient who died for any reason during the course of treatment. Multivariable logistic regression was used to estimate adjusted odds ratios with 95% confidence intervals for factors associated with TB mortality. <i>Results</i>. A total of 1,933 patients with TB were registered at the chest clinic over the study period. Males accounted for 1,227 (63.5%), and majority of participants were between 24 and 64 years old. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) cases accounted for 51% and 48.4% of the total TB cases, respectively. A significant proportion (69%) of the patients managed for TB had no bacteriological confirmation of the disease. About 34% of tested TB patients were HIV positive. Mortality among patients was 33.6%. In a multivariable regression model, patients with HIV positive status had over 3-fold increased risk of mortality, compared to those with HIV negative status. TB patients diagnosed empirically had an increased risk of death compared to those with a confirmed diagnosis. <i>Conclusion</i>. The proportion of clinically diagnosed TB was high among the patients seen at the chest clinic. Mortality was high among the patients with HIV/TB coinfection as well as in patients with empirical TB diagnosis.

Jane S. Afriyie-Mensah

Robert Aryee

Francisca Zigah

Ernest Amaning-Kwarteng

Marie Nancy Séraphin

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

<i>Introduction</i>. Prisoners in Sub-Saharan Africa (SSA) are at a high risk of tuberculosis (TB) infection due to overcrowding and poor ventilation. Consequently, TB is a leading cause of morbidity and mortality in prison, and many inmates face a number of barriers to TB control and had limited information in the region. Thus, the aim of this systematic review and meta-analysis was to estimate the overall pooled prevalence of pulmonary TB and predictors among prison inmates in SSA. <i>Methods</i>. From 2006 to 2019, a systematic review and meta-analysis was conducted using various databases, including PubMed, Embase, Web of Science, and Scopus. The data were extracted in Microsoft Excel using a standardized data extraction format, and the analysis was carried out with STATA version 14. To detect heterogeneity across studies, the <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.04979992pt" id="M1" height="11.6412pt" version="1.1" viewBox="-0.0498162 -11.5914 10.6309 11.6412" width="10.6309pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-74" d="M405 650H141L135 622C222 616 230 610 215 535L133 116C118 41 113 33 29 28L23 0H289L295 28C209 33 205 40 219 116L298 535C312 609 317 616 399 622L405 650Z"/></g><g transform="matrix(.0091,0,0,-0.0091,5.567,-5.741)"><path id="g50-51" d="M414 144C384 79 371 75 317 75H135L276 221C367 316 408 376 408 465C408 570 327 635 237 635C179 635 131 609 100 575L42 494L67 471C94 510 138 565 205 565C277 565 321 517 321 435C321 348 258 270 195 195C146 137 88 81 33 26V0H411C423 44 433 88 446 135L414 144Z"/></g></svg> and the Cochrane <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.150701pt" id="M2" height="10.7866pt" version="1.1" viewBox="-0.0498162 -8.6359 9.52083 10.7866" width="9.52083pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-82" d="M699 368C699 549 574 666 407 666C186 666 23 488 23 277C23 113 129 -3 288 -13L307 -26C431 -111 501 -139 533 -147C559 -154 613 -163 658 -164L666 -141C597 -111 507 -66 430 -11L416 -1C580 42 699 190 699 368ZM601 371C601 227 518 54 381 22L354 40L278 24C175 47 120 145 120 269C120 451 235 631 398 631C540 631 601 521 601 371Z"/></g></svg> test statistics were computed. To determine the overall prevalence of TB and predictors among prison populations, a random effect meta-analysis model was used. <i>Results</i>. Of the 3,479 retrieved articles, 37studies comprising 72,844 inmates met the inclusion criteria. The pooled prevalence of pulmonary TB among prison inmates in SSA was 7.74% (95% CI: 6.46-8.47). In the subgroup analysis, the highest prevalence was found in the Democratic Republic Congo (DRC) (19.72%) followed by Zambia (11.68%) and then Ethiopia (9.22%). TB/HIV coinfection (OR 4.99 (95% CI: 2.60-9.58)), Body mass index (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="35.012pt" style="vertical-align:-0.6370001pt" id="M3" height="9.16198pt" version="1.1" viewBox="-0.0498162 -8.52498 35.012 9.16198"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-67" d="M372 352C427 368 507 407 507 502C507 548 486 592 451 616C420 638 376 650 301 650H44V622C124 616 128 610 128 527V123C128 40 122 34 36 28V0H257C336 0 402 12 453 40C512 72 548 124 548 191C548 291 471 335 372 350V352ZM213 362V558C213 591 216 602 226 608C235 614 258 618 282 618C377 618 415 558 415 490C415 406 369 362 260 362H213ZM213 328H258C380 328 450 283 450 181C450 76 377 35 296 34C231 34 213 53 213 125V328Z"/></g><g transform="matrix(.013,0,0,-0.013,7.644,0)"><path id="g190-78" d="M861 0V28C774 35 771 41 768 147L759 509C756 612 762 614 851 622V650H681L449 149L221 650H57V622C148 613 153 609 144 479L130 271C123 166 117 123 111 88C104 46 85 34 26 28V0H259V28C192 35 169 42 167 90C166 130 166 173 170 256L185 541H187L411 7H431L675 555H679L683 147C683 41 680 35 598 28V0H861Z"/></g><g transform="matrix(.013,0,0,-0.013,19.227,0)"><path id="g190-74" d="M303 0V28C221 34 213 39 213 125V525C213 610 221 616 303 622V650H38V622C120 616 128 610 128 525V125C128 40 120 34 38 28V0H303Z"/></g><g transform="matrix(.013,0,0,-0.013,27.381,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.893pt" style="vertical-align:-0.6370001pt" height="9.16198pt" version="1.1" viewBox="38.594183799999996 -8.52498 21.893 9.16198"><g transform="matrix(.013,0,0,-0.013,38.644,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,44.884,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g><g transform="matrix(.013,0,0,-0.013,51.124,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,54.088,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g></svg>)</span></span> (OR 3.62 (95% CI: 2.65-6.49)), incarceration (OR 4.52 (95% CI: 2.31-5.68)), and previous TB exposure (OR 2.43 (95% CI: 1.61-3.56)) had higher odds of pulmonary TB among inmates. <i>Conclusion</i>. The prevalence of pulmonary TB among SSA prison inmates was found to be high as compared to total population. TB/HIV coinfection, BMI, incarceration duration, and TB exposure were all predictors with pulmonary tuberculosis in prison inmates. As a result, emphasizing early screening for prisoners at risk of pulmonary TB is an important point to achieving global TB commitments in resource-limited settings.

Habtamu Belew Mera

Fasil Wagnew

Yibeltal Akelew

Zigale Hibstu

Sileshi Berihun

Workineh Tamir

Simegn Alemu

Yonas Lamore

Bewket Mesganaw

Adane Adugna

Tefsa Birlew Tsegaye

Prevalence and Predictors of Pulmonary Tuberculosis among Prison Inmates in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

<i>Introduction</i>. Tuberculosis is a bacterial disease caused by the <i>Mycobacterium tuberculosis</i>. Regardless of many efforts made to control tuberculosis, the disease remains to be a major public health problem. Nonadherence to antituberculosis treatment poses a challenge to the disease treatment as it potentially increases the risk of drug resistance, mortality, relapse, and extended infectiousness. The North Shewa Zone had a poor performed on TB control status, so this study assessed the prevalence of antituberculosis drug nonadherence and its associated factors at governmental health institutions in Debre Berhan town, North Shewa Zone, Ethiopia, 2020. <i>Methods</i>. An institution-based cross-sectional study design was employed. A total of 180 tuberculosis patients were included in the study. The data was entered using EpiData version 3.1 and exported to SPSS version 20.0 for statistical analysis. Bivariable and multivariable logistic regression analyses were computed to determine factor associated with antituberculosis drug nonadherence. <i>Result</i>. Study finding shows that 26.0% respondents were nonadherent to their antituberculosis treatment. Respondents who were married were less likely to be nonadherent than who were single (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M1" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><path id="g190-80" d="M381 665C170 665 44 498 44 318C44 125 188 -15 369 -15C552 -15 703 117 703 333C703 534 550 665 381 665ZM359 629C491 629 601 517 601 306C601 114 502 21 390 21C249 21 146 158 146 346S248 629 359 629Z"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><path id="g190-83" d="M631 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172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z"/></g></svg>;</span></span> <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="46.699pt" style="vertical-align:-0.4673605pt" id="M2" height="9.2207pt" version="1.1" viewBox="-0.0498162 -8.75334 46.699 9.2207"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-58" d="M244 635C114 635 38 519 38 422C38 317 111 240 217 240C236 240 255 244 277 256L345 292C311 140 203 39 59 15L64 -15C89 -15 150 -5 204 17C339 72 440 202 440 386C440 521 368 635 244 635ZM228 602C326 602 352 479 352 390C352 370 351 347 348 324C327 308 293 296 258 296C174 296 124 369 124 458C124 517 152 602 228 602Z"/></g><g transform="matrix(.013,0,0,-0.013,6.241,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g><g transform="matrix(.013,0,0,-0.013,12.482,0)"><path id="g121-35" d="M594 629L561 652L159 -9L190 -32L594 629ZM194 635C92 635 49 534 49 453C49 374 92 272 193 272C295 272 338 374 338 454S295 635 194 635ZM193 605C257 605 265 504 265 453C265 405 257 302 194 302C133 302 122 403 122 454S133 605 193 605ZM567 351C465 351 421 250 421 169C421 90 465 -12 566 -12S710 90 710 170S667 351 567 351ZM566 322C628 322 637 221 637 169C637 121 628 18 567 18S494 119 494 170C494 223 506 322 566 322Z"/></g><g transform="matrix(.013,0,0,-0.013,22.31,0)"><path id="g190-68" d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z"/></g><g transform="matrix(.013,0,0,-0.013,30.954,0)"><path id="g190-74" d="M303 0V28C221 34 213 39 213 125V525C213 610 221 616 303 622V650H38V622C120 616 128 610 128 525V125C128 40 120 34 38 28V0H303Z"/></g><g transform="matrix(.013,0,0,-0.013,39.068,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.239pt" style="vertical-align:-0.4673605pt" height="9.2207pt" version="1.1" viewBox="50.2811838 -8.75334 28.239 9.2207"><g transform="matrix(.013,0,0,-0.013,50.331,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,56.571,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,59.535,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,65.775,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 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Respondents who have primary and secondary education were less likely to be nonadherent than those who had no formal education (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M3" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.157pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 28.157 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,62.964,0)"><use xlink:href="#g113-52"/></g></svg>;</span></span> <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="46.699pt" style="vertical-align:-0.4673605pt" id="M4" height="9.2207pt" version="1.1" viewBox="-0.0498162 -8.75334 46.699 9.2207"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-58"/></g><g transform="matrix(.013,0,0,-0.013,6.241,0)"><use xlink:href="#g113-54"/></g><g transform="matrix(.013,0,0,-0.013,12.482,0)"><use xlink:href="#g121-35"/></g><g transform="matrix(.013,0,0,-0.013,22.31,0)"><use xlink:href="#g190-68"/></g><g transform="matrix(.013,0,0,-0.013,30.954,0)"><use xlink:href="#g190-74"/></g><g transform="matrix(.013,0,0,-0.013,39.068,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.239pt" style="vertical-align:-0.4673605pt" height="9.2207pt" version="1.1" viewBox="50.2811838 -8.75334 28.239 9.2207"><g transform="matrix(.013,0,0,-0.013,50.331,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,56.571,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,59.535,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,65.775,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,72.015,0)"><use xlink:href="#g113-49"/></g></svg>,</span></span> 0.976). Respondents who experienced drug side effects were two times more likely to be nonadherent than those who did not experience drug side effects (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M5" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.157pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 28.157 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-56"/></g><g transform="matrix(.013,0,0,-0.013,62.966,0)"><use xlink:href="#g113-58"/></g></svg>;</span></span> <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="46.699pt" style="vertical-align:-0.4673605pt" id="M6" height="9.2207pt" version="1.1" viewBox="-0.0498162 -8.75334 46.699 9.2207"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-58"/></g><g transform="matrix(.013,0,0,-0.013,6.241,0)"><use xlink:href="#g113-54"/></g><g transform="matrix(.013,0,0,-0.013,12.482,0)"><use xlink:href="#g121-35"/></g><g transform="matrix(.013,0,0,-0.013,22.31,0)"><use xlink:href="#g190-68"/></g><g transform="matrix(.013,0,0,-0.013,30.954,0)"><use xlink:href="#g190-74"/></g><g transform="matrix(.013,0,0,-0.013,39.068,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.239pt" style="vertical-align:-0.4673605pt" height="9.2207pt" version="1.1" viewBox="50.2811838 -8.75334 28.239 9.2207"><g transform="matrix(.013,0,0,-0.013,50.331,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,56.571,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,59.535,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,65.775,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,72.015,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g></svg>,</span></span> 5.615). In addition, respondents who do not screen for HIV were four times more likely to be nonadherent than their counterparts (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M7" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.157pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 28.157 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z"/></g><g transform="matrix(.013,0,0,-0.013,47.52,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.484,0)"><path id="g113-55" d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,62.964,0)"><use xlink:href="#g113-49"/></g></svg>;</span></span> <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="46.699pt" style="vertical-align:-0.4673605pt" id="M8" height="9.2207pt" version="1.1" viewBox="-0.0498162 -8.75334 46.699 9.2207"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-58"/></g><g transform="matrix(.013,0,0,-0.013,6.241,0)"><use xlink:href="#g113-54"/></g><g transform="matrix(.013,0,0,-0.013,12.482,0)"><use xlink:href="#g121-35"/></g><g transform="matrix(.013,0,0,-0.013,22.31,0)"><use xlink:href="#g190-68"/></g><g transform="matrix(.013,0,0,-0.013,30.954,0)"><use xlink:href="#g190-74"/></g><g transform="matrix(.013,0,0,-0.013,39.068,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="34.503pt" style="vertical-align:-0.4673605pt" height="9.2207pt" version="1.1" viewBox="50.2811838 -8.75334 34.503 9.2207"><g transform="matrix(.013,0,0,-0.013,50.331,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,56.571,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,62.811,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,65.775,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,72.015,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,78.256,0)"><use xlink:href="#g113-54"/></g></svg>,</span></span> 18.802). <i>Conclusion</i>. The antituberculosis drug nonadherence is high. Marital status, educational status, drug side effects, HIV screening status of the patients, and availability of medication were the variables that influence drug nonadherence. There is a need to strengthen awareness creation and improve quality of the TB treatment services and anti-TB drug availability.

Tomas Getahun

Hailemikael Debebe

Helen Getahun

Yonas Abebe

Kidist Assefa

Mizan Habtemichael

Antituberculosis Drug Nonadherence and Its Associated Factors: Evidence from Debre Berhan Town, North Shewa Zone, Ethiopia

<i>Introduction</i>. Tuberculosis (TB) was one of the top causes of ill health and the leading cause of deaths worldwide until the coronavirus (COVID-19) pandemic. Hence, this study is aimed at assessing the prevalence of sputum smear-positive TB and associated factors among TB-suspected patients attending in Gedeo Zone health facilities, Southern Ethiopia. <i>Methods</i>. A facility-based cross-sectional study was conducted among 220 TB-suspected patients in Gedeo Zone health facilities from July 01 to Sep 30, 2021. Patients were grouped as smear positive if one sputum out of two was positive or two sputum smears became positive. Various descriptive statistics were computed using the SPSS-25, and factors to smear positivity were identified by multivariable logistic regression analysis. Odds ratio at 95% CI and <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.42943pt" id="M1" height="10.2124pt" version="1.1" viewBox="-0.0498162 -6.78297 7.83752 10.2124" width="7.83752pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g></svg> values < 0.05 were considered as indicators of statistical association. <i>Results</i>. The overall prevalence of smear-positive TB in Gedeo Zone health facilities was 18.2%, which is significantly high, and the MTB detection rate of GeneXpert was 29.5%. Contact with a TB patient, cigarette smoking, and previously treatment for TB were factors significantly associated with smear-positive TB. <i>Conclusion</i>. The prevalence rate of smear-positive PTB in the study area was 18.2% and 29.5% by direct sputum AFB and sputum GeneXpert, respectively. As a result, we recommend intervention on the identified associated risk factors and further studies to ascertain risk factors and their magnitude at the community level.

Bahru Mantefardo

Gizaw Sisay

Ephrem Awlachew

Assessment of Smear-Positive Pulmonary Tuberculosis and Associated Factors among Patients Visiting Health Facilities of Gedeo Zone, Southern Ethiopia: A Cross-Sectional Study

<i>Background</i>. Drug-resistant tuberculosis (TB) epidemic in high-TB-incidence countries, particularly Ethiopia, remains a significant challenge. As a result, we investigated the drug resistance, common gene mutation, and molecular characterization of mycobacterial isolates from patients with suspected tuberculous lymphadenitis (TBLN). <i>Methodology</i>. A cross-sectional study of 218 FNA samples from TBLN patients inoculated on Lowenstein-Jensen media was carried out. The culture isolates were identified as MTB by polymerase chain reaction (PCR) and the difference-9 (RD9) test region. In addition, the GenoType MTBDR<i>plus</i> assay tested the first and second-line MTB drugs, and the spoligotyping strain-dependent polymorphism test was determined. <i>Results</i>. Among the 50 culture-positive isolates, 14% (7/50) had drug resistance caused by a gene mutation. Out of these, 4 (8%) isolates were mono-resistant to isoniazid drug, which is caused by a gene mutation in <i>katG</i> in the region of interrogated at codon 315 in the amino acid sequence of S315T1, and 3 (6%) isolates were resistant to both rifampicin and isoniazid drugs. The mutation was observed for <i>katG</i> (at codon 315 with a change in the sequence of amino acid S315T) and <i>rpoB</i> (at codon 530–533 with a change in the sequence of amino acid S531L (S450L)) genes. The most prevalent spoligotypes were orphan and SIT53 strains. <i>Conclusion</i>. The predominance of INH mono-resistance poses a critical risk for the potential development of MDR-TB, as INH mono-resistance is a typical pathway to the occurrence of MDR-TB. The orphan and SIT53 (T) strains were the most common in the study area, and a drug-resistant strain caused by a common gene mutation could indicate the transmission of clonal-resistant strains in the community.

Gebeyehu Assefa

Kassu Desta

Shambel Araya

Selfu Girma

Elena Hailu

Adane Mihret

Tsegaye Hailu

Melaku Tilahun

Getu Diriba

Biniyam Dagne

Abay Atnafu

Nigatu Endalafer

Adugna Abera

Shiferaw Bekele

Yordanos Mengistu

Kidist Bobosha

Abraham Aseffa

Drug Resistance in Tuberculous Lymphadenitis: Molecular Characterization

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<p><em>Tuberculosis Research and Treatment</em> publishes original research articles and&nbsp;review articles related to all aspects of tuberculosis, from the immunological basis of disease to translational and clinical research.</p>


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Tuberculosis Research and Treatment - Table of contents 2023

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Tuberculosis Research and Treatment publishes original research articles and review articles related to all aspects of tuberculosis, from the immunological basis of disease to translational and clinical research.

Tuberculosis Research and Treatment