Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021

The Lancet Infectious Diseases, Год журнала: 2024, Номер 24(7), С. 698 - 725

Опубликована: Март 19, 2024

Summary

Background

Global evaluations of the progress towards WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% have not been age specific. We aimed to assess global, regional, national-level burdens trends in tuberculosis its risk factors across five separate groups, from 1990 2021, report age-specific between 2015 2020.

Methods

used Burden Diseases, Injuries, Risk Factors Study 2021 (GBD 2021) analytical framework compute estimates for 204 countries territories (1990–2021 inclusive). quantified among individuals without HIV co-infection using 22 603 site-years vital registration data, 1718 verbal autopsy 825 sample-based 680 surveillance 9 minimally invasive tissue sample (MITS) diagnoses data as inputs into Cause Death Ensemble modelling platform. Age-specific deaths were established with a population attributable fraction approach. analysed all available population-based sources, including prevalence surveys, annual case notifications, tuberculin mortality, DisMod-MR 2.1 produce internally consistent incidence, prevalence, mortality. also estimated that is independent combined effects three (smoking, alcohol use, diabetes). As secondary analysis, we examined potential impact COVID-19 pandemic by comparing expected deaths, modelled 2019 observed cause-specific data.

Findings

9·40 million (95% uncertainty interval [UI] 8·36 10·5) incident cases 1·35 (1·23 1·52) due 2021. At global level, all-age rate declined 6·26% (5·27 7·25) (the strategy evaluation period). 15 achieved 20% decrease 2020, eight which western sub-Saharan Africa. When stratified age, rates decreased 16·5% (14·8 18·4) children younger than 5 years, 16·2% (14·2 17·9) those aged 5–14 6·29% (5·05 7·70) 15–49 5·72% (4·02 7·39) 50–69 8·48% (6·74 10·4) 70 years older, 11·9% (5·77 17·0) 17 attained 35% reduction most eastern Europe (six countries) central (four countries). There was variable age: 35·3% (26·7 41·7) 29·5% (25·5 34·1) 15·2% (10·0 20·2) 7·97% (0·472 14·1) 3·29% (–5·56 9·07) older. Removing would reduced number 1·39 (1·28 1·54) 1·00 (0·703 1·23) representing 36·5% (21·5 54·8) compared 2015. 41 included our analysis 20 In 50 900 CI 49 700 52 400) ages, an 45 500 corresponding 5340 (4070 6920) fewer deaths; 39 600 (38 300 100) ages 000 657 (–713 2180) deaths.

Interpretation

Despite accelerated reducing burden past decade, world did attain first The pace decline has unequal respect older adults (ie, >50 years) having slowest progress. refine their national programmes recalibrate achieving 2035 targets, they could consider learning strategies milestones, well targeted interventions improve outcomes groups.

Funding

Bill & Melinda Gates Foundation.

Язык: Английский

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World Tuberculosis Day 2024 theme “Yes! We can end TB” can be made a reality through concerted global efforts that advance detection, diagnosis, and treatment of tuberculosis infection and disease

International Journal of Infectious Diseases, Год журнала: 2024, Номер 141, С. 106993 - 106993

Опубликована: Март 7, 2024

Every year, World Tuberculosis (TB) Day is commemorated on March 24 and targeted at raising public political awareness of TB, a preventable treatable disease. TB commemorates the day in 1882 when Professor Robert Koch announced his discovery microbial cause bacillus, Mycobacterium tuberculosis. Despite effective treatment being available for over 65 years, today causes 1.3 million deaths yearly, mostly low- middle-income countries. Drug-resistant leading death owing to antimicrobial resistant disease world growing global health security threat, with hundreds thousands people affected every year [1World Health Organization. Global tuberculosis report 2023, https://www.who.int/publications-detail-redirect/9789240083851; 2023 [accessed 27 February 2024].Google Scholar]. It this dismal situation that "Yes! We can end TB!" Organization (WHO) STOP Partnership's theme This remains same as emphasize deliver message hope those who continue be affected. Critical highlight will provision required funding enable faster uptake new WHO management recommendations finding, diagnosing, effectively treating infections all cases clinical using updated guidelines [2World consolidated tuberculosis: module 1: prevention: preventive 2020, https://www.who.int/publications-detail-redirect/9789240001503; 2020 Scholar, 3World 2: screening: systematic screening 2021, https://www.who.int/publications-detail-redirect/9789240022676; 2021 4World 3: diagnosis: rapid diagnostics detection, update https://www.who.int/publications-detail-redirect/9789240029415; 5World 4: treatment: drug-resistant https://www.who.int/publications-detail-redirect/9789240007048; Although efforts combat have saved an estimated 75 lives since 2000, COVID-19 pandemic, coupled conflicts across Europe, Africa, Middle East [6Casco N Jorge AL Palmero DJ Alffenaar JW Fox GJ et al.Global Network TB/COVID-19 Study GroupLong-term outcomes co-infection cohort.Eur Respir J. 2023; 622300925https://doi.org/10.1183/13993003.00925-2023Crossref Scopus (7) Google Scholar,7TB/COVID-19 GroupTuberculosis co-infection: description 2022; 592102538https://doi.org/10.1183/13993003.02538-2021Crossref (64) Scholar] poor socioeconomic conditions, reversed years progress was made by control eventually TB. The deteriorating economic situation, rising cost living reduction budgets national programs, has disproportionately poorest disadvantaged, very populations are most Moreover, access WHO-recommended regimens major challenge, especially countries, where 80% annual caseload occurs. United Nations General Assembly (UNGA) convened its second High-Level Meeting (HLM) fight against September 22, revisit targets established 2018-2022 during first meeting develop up 2027. Member states endorsed declaration reaffirms commitments 2030. HLM sought treat least 40 individuals worldwide from 2018 2022, addressing needs 3.5 children, providing 1.5 initiating (TPT) 30 people. 2023-2027 more ambitious These include achieving 90% patients having quality-assured diagnosis treatment, risk developing TPT, 100% social benefits packages, 22 billion US$ research, vaccine In special International Journal Infectious Diseases issue commemorate Day, we present nine reports covering several these aspects. discuss prevention issues. Prevention starts vaccines [8da Costa C Benn CS Nyirenda T Mpabalwani E Grewal HMS Ahmed R al.Perspectives development advancement vaccines.Int J Infect Dis. 2024; https://doi.org/10.1016/j.ijid.2024.106987Abstract Full Text PDF (2) There been no introduction bacille Calmette–Guerin century ago. Encouragingly, promising candidates currently evaluated phase II III trials parallel, describe immunology approaches design immune diagnostic tests [9Panda S Kearns K Cheng Arlehamn CSL. From antigens responses: shaping future detection prevention.Int https://doi.org/10.1016/j.ijid.2024.106983Abstract PubMed (1) strategies reported terms commitments, Systematic Screening Initiative, which approach technical assistance, focused screening, European Region 2030 [10Dadu A Yedilbayev Migliori GB Ahmedov Falzon D den Boon al.PASS End Europe: accelerated 2030.Int https://doi.org/10.1016/j.ijid.2024.02.023Abstract Scholar,11World Gearing towards ending regional workshop (PASS-to-EndTB), https://www.who.int/europe/news-room/events/item/2023/10/30/default-calendar/gearing-up-towards-ending-tb-in-europe–regional-workshop-on-prevention-And-systematic-screening-(pass-to-endtb); procedures TPT also discussed, focus persons moving high- low-TB endemic countries [12Petersen Al-Abri Al Jardani Memish ZA Aklillu Ntoumi F al.Screening latent migrants – status quo challenges.Int 107002Abstract highlights importance identifying infection ensuring they receive prevent re-activation (LTBI) toward disease, further transmission. addition migrants, South Korea developed highly successful program LTBI screening. intervention contributed 5.2% incidence between 2011 2016 through community workers, including daycare centers kindergarten, schools [13Go U Park M Kim UN Lee Han al.Tuberculosis care Korea: evolution policy practice.J Clin Tuberc Other Mycobact 2018; 11: 28-36https://doi.org/10.1016/j.jctube.2018.04.006Crossref (69) mainly affects lungs, it affect other organs. When pulmonary cough, sneeze, or spit, bacilli propelled spread air respiratory droplets. person close contact inhale only few mycobacteria become infected. About quarter population (around 2 people) response likely infection. Most not go some clear People showing bacteria 5-10% lifetime falling ill their whole life span. Those compromised systems, such HIV, malnutrition, diabetes, tumor necrosis factor inhibitor therapies tobacco, higher [14Cantini Niccoli L Capone Petrone Goletti D. Risk reactivation associated traditional modifying anti-rheumatic drugs non-anti-tumor biologics rheumatic disorders suggestion practice.Expert Opin Drug Saf. 2019; 18: 415-425https://doi.org/10.1080/14740338.2019.1612872Crossref (44) Scholar,15Goletti Pisapia Fusco FM Aiello Van Crevel R. Epidemiology, pathogenesis, presentation HIV diabetes.Int Lung 27: 284-290https://doi.org/10.5588/ijtld.22.0685Crossref (12) done standardized interferon-γ release assays skin [16Alonzi Repele Research infection.Expert Rev Mol Diagn. 23: 783-795https://doi.org/10.1080/14737159.2023.2240230Crossref (9) 17Kontsevaya I Cabibbe AM Cirillo DM DiNardo AR Frahm Gillespie SH al.Update tuberculosis.Clin Microbiol Infect. https://doi.org/10.1016/j.cmi.2023.07.014Abstract (11) 18Goletti Delogu G Matteelli GB. role IGRA infection, differentiating active tuberculosis, decision making therapy infection.Int 124: S12-S19https://doi.org/10.1016/j.ijid.2022.02.047Abstract (51) Scholar], one based intradermal inoculation ESAT-6 CFP-10, M. tuberculosis-specific compared included tuberculin test challenges covered here [19To KW Rui Z SS. Is antigen-based ready use alternative TST/IGRA diagnosis? narrative review.Int Abstract Finally, overview experimental non-sputum biomarkers progression Non-sputum important diagnosing extra-pulmonary unable expectorate, immunocompromised subjects sputum load low. Actiphage technology detect DNA blood described [20Rees Swift B Haldar P. State art phage technology.Int https://doi.org/10.1016/j.ijid.2024.106991Abstract useful may [21Verma BMC Handley-Hartill W JK Woltmann Rees CED al.A novel, high-sensitivity, bacteriophage-based assay identifies low-level bacteremia immunocompetent incipient 2020; 70: 933-936https://doi.org/10.1093/cid/ciz548Crossref (28) Scholar,22Kim Bowman Nazareth Verma al.PET-CT-guided characterisation progressive, preclinical association circulating household contacts Leicester, UK: prospective cohort study.Lancet Microbe. 5: e119-e130https://doi.org/10.1016/S2666-5247(23)00289-6Abstract (5) An potentially complementary progressors measuring host inflammation [23Källenius Correia-Neves Sundling C. Diagnostic markers reflecting dysregulation transition disease.Int https://doi.org/10.1016/j.ijid.2024.106984Abstract Host responses measured proteomic transcriptomic assessment increasing activation months before onset [24Tabone O Singhania Chakravarty P Branchett WJ Graham CM al.Blood transcriptomics reveal resolution tuberculosis.J Exp Med. 2021; 218e20210915https://doi.org/10.1084/jem.20210915Crossref (32) Scholar,25Scriba TJ Penn-Nicholson Shankar Hraha Thompson EG Sterling al.Sequential inflammatory processes define human disease.PLoS Pathog. 2017; 13e1006687https://doi.org/10.1371/journal.ppat.1006687Crossref (149) potential methodologies defining latency stage CD34+ cells discussed [26Martineau Chandran Palukani Garrido Mayito Reece ST al.Towards molecular https://doi.org/10.1016/j.ijid.2024.106988Abstract Scholar,27Repele Alonzi Navarra Farroni Salmi Cuzzi al.Detection peripheral mononuclear adults 106999Abstract could help better understand pathogenesis allow specific targeting require TPT. To achieve elimination, need actions: increased investments accelerate pipeline, implementation design, and/or regimens, tests, old [28Migliori Wu SJ Zenner al.Clinical standards diagnosis, 26: 190-205https://doi.org/10.5588/ijtld.21.0753Crossref identification progressing target needing therapy.

Язык: Английский

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Mycobacterium tuberculosis growth inhibition by peripheral blood mononuclear cells from household contacts is not affected by previous SARS-CoV-2 infection

Опубликована: Фев. 7, 2025

Язык: Английский

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Mycobacterium tuberculosis growth inhibition by peripheral blood mononuclear cells from household contacts is not affected by previous SARS-CoV-2 infection

Опубликована: Фев. 25, 2025

Язык: Английский

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Assessment of the impact of COVID-19 on tuberculosis care at a tertiary hospital: integrating lessons from COVID-19 learned

Frontiers in Public Health, Год журнала: 2025, Номер 13

Опубликована: Март 21, 2025

Introduction During the COVID-19 pandemic outbreak in 2020 until 2023, healthcare resources dedicated to critical diseases, including respiratory conditions like Tuberculosis (TB), were significantly impacted worldwide. The Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” (INER), a leading tertiary-level hospital Mexico City and national reference center for was designated exclusively patients during these years. Methods This report aims assess pandemic’s impact on TB care at INER propose strategies improving management by integrating lessons learned from pandemic. presumptive cases reviewed between 2016-2023, covering pre-pandemic, pandemic, post-period; number of diagnosis tests performed attending emergency areas, hospitalization, or outpatient consultation analyzed. mortality rate hospitalization also examined. Results Our analysis revealed that pre-pandemic period (2016-2019), around 1,000 patient consultations managed annually across inpatient settings, it drastically declined 2020, trend persisted through 2021 2022. Survival affected, disruption resulted decrease diagnoses increased rates among hospitalized post-pandemic period. In response challenges posed adopted innovative such as telehealth services reinforced human pathologies. These efforts enhanced diagnostic testing have strengthened hospital’s capacity patients. been pivotal reshaping system’s approach managing tertiary setting.

Язык: Английский

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Protective interplay: Mycobacterium tuberculosis diminishes SARS-CoV-2 severity through innate immune priming

Frontiers in Immunology, Год журнала: 2024, Номер 15

Опубликована: Июнь 20, 2024

At the beginning of COVID-19 pandemic those with underlying chronic lung conditions, including tuberculosis (TB), were hypothesized to be at higher risk severe disease. However, there is inconclusive clinical and preclinical data confirm specific SARS-CoV-2 poses for millions individuals infected Mycobacterium (M.tb). We others have found that compared singly mice, mice co-infected M.tb leads reduced severity alone. Consequently, a large interest in identifying molecular mechanisms responsible infection observed co-infection. To address this, we conducted comprehensive characterization co-infection model performed mechanistic vitro modeling dynamically assess how innate immune response induced by restricts viral replication. Our study has successfully identified several cytokines induce upregulation anti-viral genes epithelial cells, thereby providing protection prior challenge SARS-CoV-2. In conclusion, our offers understanding key pathways an existing bacterial effectively activity identifies candidate therapeutic targets infection.

Язык: Английский

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Suppressing Mycobacterium tuberculosis virulence and drug resistance by targeting Eis protein through computational drug discovery

Molecular Diversity, Год журнала: 2024, Номер unknown

Опубликована: Авг. 3, 2024

Язык: Английский

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Impact of Tuberculosis on Disease Severity and Viral Shedding Duration in COVID-19 Patients

Viruses, Год журнала: 2024, Номер 16(2), С. 260 - 260

Опубликована: Фев. 6, 2024

Accumulating evidence show a potential association between tuberculosis and COVID-19 disease severity. To further clarify the impact of on severity viral shedding duration, retrospective study was conducted 223 patients, including 34 with 189 without tuberculosis. Clinical information load time were collected. A higher percentage severe/critical diagnosis deaths observed in patients than those (8.8% vs. 3.2%, p = 0.142; 2.9% 1.1%, 0.393), had longer (median: 15.0 days 11.0 days; 0.0001). Having (HR 2.21, 95% CI 1.37–3.00; 0.000), being elderly age 1.02, 1.01–1.03; 0.001) diagnosed severe or critical 5.63, 2.10–15.05; independent factors associated prolonged virus SARS-CoV-2. receiving anti-tuberculosis therapy (ATT) for <2 months significantly duration ATT ≥ 4 (17.5 11.5 days, 0.012). Our results demonstrated that tend to have more worse prognosis, shedding, highlighting special attention and/or care required months.

Язык: Английский

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Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region

Deleted Journal, Год журнала: 2024, Номер 1(3), С. 103 - 110

Опубликована: Март 1, 2024

In 2022, the WHO European Region accounted for 15.1% of all incident rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB) cases. Most occurred in 18 high-priority countries eastern Europe and central Asia, many which joined an initiative led by Regional Office Europe. The aim was to introduce three, fully oral, 9-month modified shorter treatment regimens (mSTR) treat RR/MDR-TB under operational research conditions. three were: 1) bedaquiline + linezolid levofloxacin clofazimine cycloserine (BdqLzdLfxCfzCs); 2) BdqLzdLfxCfz delamanid (Dlm) children over 6 years age adults; 3) DlmLzdLfxCfz age. project aimed enhance success, facilitate mSTR implementation, promote quality care build capacity, while also contributing global knowledge on all-oral use. Between April 2020 June >2,800 patients underwent Region. This unique experience promoted further collaboration with national tuberculosis programmes, health authorities, experts donors within outside Europe, a focus implementing improving high burden region. hope encouraging others adopt this model, we have described principles initiative, its strengths weaknesses next steps.

Язык: Английский

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Augmenting Radiological Diagnostics with AI for Tuberculosis and COVID-19 Disease Detection: Deep Learning Detection of Chest Radiographs

Diagnostics, Год журнала: 2024, Номер 14(13), С. 1334 - 1334

Опубликована: Июнь 24, 2024

In this research, we introduce a network that can identify pneumonia, COVID-19, and tuberculosis using X-ray images of patients' chests. The study emphasizes tuberculosis, healthy lung conditions, discussing how advanced neural networks, like VGG16 ResNet50, improve the detection issues from images. To prepare for model's input requirements, enhanced them through data augmentation techniques training purposes. We evaluated performance by analyzing precision, recall, F1 scores across training, validation, testing datasets. results show ResNet50 model outperformed with accuracy resilience. It displayed superior ROC AUC values in both validation test scenarios. Particularly impressive were ResNet50's precision recall rates, nearing 0.99 all conditions set. On hand, also performed well during testing-detecting 0.93. Our highlights our deep learning method showcasing effectiveness over traditional approaches VGG16. This progress utilizes methods to enhance classification augmenting balancing them. positions approach as an advancement state-of-the-art applications imaging. By enhancing reliability diagnosing ailments such COVID-19 models have potential transform care treatment strategies, highlighting their role clinical diagnostics.

Язык: Английский

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