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Exploring the Pathways of leprosy Patients from Their Communities to a Diagnosis in the Districts of Mayuge, Yumbe and Kasese-Uganda

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Advances in Infectious Diseases 2024年第2期14卷 346-373页

作者： Rose Kengonzi Stavia Turyahabwe Samuel Orach Lisa Gerwing-Adima Ronald W. Nyote Vincent Kamara Kabugho Faith Consolata Mpambara national tuberculosis and leprosy program Ministry of Health Uganda Kampala Uganda Health Department Uganda Catholic Medical Bureau Kampala Uganda German leprosy and tuberculosis Relief Association Kampala Uganda national tuberculosis and leprosy program Kampala Uganda

Background: leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity buildi

关键词： leprosy Patient Pathway Skin Lesions Disability Discrimination Delayed Diagnosis

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Diagnosis and Management of Childhood tuberculosis: A Cross-Sectional Study of Practices in Gilgit Baltistan, Pakistan

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Journal of tuberculosis Research 2024年第2期12卷 57-72页

作者： Khalid Mahmood Razia Fatima Aashifa Yaqoob Faheem Jan Zia Samad Mahboob Ul Haq national tuberculosis Control program Islamabad Pakistan

Background: tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. tuberculosis in children remained a low public health priority with limited epidemiologic studies. Struggles for TB control in children need to be enhanced as children are providing the reservoir for future cases to develop. Objectives: The study evaluated diagnostic and treatment practices related to childhood pulmonary tuberculosis in Gilgit Baltistan (GB), Pakistan. Methods: A descriptive, cross-sectional study based on retrospective record review of childhood Pulmonary tuberculosis patients registered in the year 2020 with self-administered questionnaire. Results: Data of 557 childhood cases were collected. Most childhood cases were in age group 1 - 4 years (54%) with male predominance. More than 90% were diagnosed and treated at public sector facilities. 99% of the cases were clinically diagnosed with passive case finding. Cough was considered as a symptom of childhood tuberculosis (TB) by 94% of physicians. Other important features included failure to thrive (13%), contact with a family history of TB (15%), Malnutrition(24%) and respiratory signs (21%). 99% physicians advised chest X-ray, Complete blood count (CBC) (95%) and Erythrocytes sedimentation rate (ESR) (72%) for diagnosis and fewer physicians (2%) used sputum smear microscopy and induced sputum (0.1%). Combining data on dosage, frequency and duration for drugs, 99% of the cases were found receiving correct regimen. The treatment outcomes of the cases were cured 4 (0.8%), treatment completed 551 (99.3%) and died 2 (0.4%) with no lost to follow up. Conclusions: The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among physicians in public and private sectors of Gilgit Baltistan. Most of the cases are managed by general practitioners with no

关键词： Childhood tuberculosis Management Respiratory Signs

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Inferring Mycobacterium tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China

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Biomedical and Environmental Sciences 2024年第2期37卷 157-169页

作者： FAN Yu Feng LIU Dong Xin CHEN Yi Wang OU Xi Chao MAO Qi Zhi YANG Ting Ting WANG Xi Jiang HE Wen Cong ZHAO Bing LIU Zhen Jiang ABULIMITI Maiweilanjiang AIHEMUTI Maimaitiaili GAO Qian ZHAO Yan Lin Key Laboratory of Medical Molecular Virology(MOE/NHC/CAMS) School of Basic Medical SciencesShanghai Medical CollegeFudan UniversityShanghai 200032China national tuberculosis Reference Laboratory Chinese Center for Disease Control and PreventionBeijing 102206China Hangzhou Red Cross Hospital Hangzhou 310005ZhejiangChina Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention Urumqi 830026XinjiangChina tuberculosis Dispensary of Kashgar Prefecture Kashgar 844099XinjiangChina

Objective China is among the 30 countries with a high burden of tuberculosis(TB)worldwide,and TB remains a public health *** Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in ***,molecular epidemiological studies of Kashgar are *** A population-based retrospective study was conducted using whole-genome sequencing(WGS)to determine the characteristics of drug resistance and the transmission *** A total of 1,668 isolates collected in 2020 were classified into lineages 2(46.0%),3(27.5%),and 4(26.5%).The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid(7.4%,124/1,668),streptomycin(6.0%,100/1,668),and rifampicin(3.3%,55/1,668).The rate of rifampicin resistance was 1.8%(23/1,290)in the new cases and 9.4%(32/340)in the previously treated *** resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains,respectively:18.6%vs.8.7 or 9%,Ptuberculosis(DR-TB),78.4%(171/218)were attributed to the transmission of DR-TB *** Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

关键词： Mycobacterium tuberculosis Whole-genome sequencing(WGS) Transmission Drug resistance Xinjiang

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Is convenience really king? Comparative evaluation of catastrophic costs due to tuberculosis in the public and private healthcare sectors of Viet Nam: a longitudinal patient cost study

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贫困所致传染病(英文) 2024年第2期13卷 1-12页

作者： Nguyen Hoa Binh Quang Vo Luan Nguyen Forse Rachel Jeanette Wiemers Anja Maria Christine Huynh Huy Ba Dong Thuy Thi Thu Phan Yen Thi Hoang Creswell Jacob Dang Thi Minh Ha Nguyen Lan Huu Shedrawy Jad L?nnroth Knut Nguyen Tuan Dinh Van Dinh Luong Annerstedt Kristi Sidney Codlin Andrew James national Lung Hospital Ha Noi Viet Nam Friends for International TB Relief Ha Noi Viet Nam Department of Global Public Health WHO Collaboration Centre On Tuberculosis and Social Medicine Karolinska Institute Stockholm Sweden Stop TB Partnership Geneva Switzerland Pham Ngoc Thach Hospital Ho Chi Minh City Viet Nam

Background In Viet Nam, tuberculosis (TB) represents a devastating life-event with an exorbitant price tag, partly due to lost income from daily directly observed therapy in public sector care. Thus, persons with TB may seek care in the private sector for its flexibility, convenience, and privacy. Our study aimed to measure income changes, costs and catastrophic cost incurrence among TB-affected households in the public and private *** Between October 2020 and March 2022, we conducted 110 longitudinal patient cost interviews, among 50 patients privately treated for TB and 60 TB patients treated by the national TB program (NTP) in Ha Noi, Hai Phong and Ho Chi Minh City, Viet Nam. Using a local adaptation of the WHO TB patient cost survey tool, participants were interviewed during the intensive phase, continuation phase and post-treatment. We compared income levels, direct and indirect treatment costs, catastrophic costs using Wilcoxon rank-sum and chi-squared tests and associated risk factors between the two cohorts using multivariate *** The pre-treatment median monthly household income was significantly higher in the private sector versus NTP cohort (USD 868 vs USD 578;P=0.010). However, private sector treatment was also significantly costlier (USD 2075 vs USD 1313;P=0.005), driven by direct medical costs which were 4.6 times higher than costs reported by NTP participants (USD 754 vs USD 164;P<0.001). This resulted in no significant difference in catastrophic costs between the two cohorts (Private: 55% vs NTP: 52%;P=0.675). Factors associated with catastrophic cost included being a single-person household [adjusted odds ratio [(aOR=13.71; 95% confidence interval (CI): 1.36–138.14;P=0.026], unemployment during treatment (aOR=10.86; 95%CI: 2.64–44.60;P<0.001) and experiencing TB-related stigma (aOR=37.90; 95%CI: 1.72–831.73;P=0.021).Conclusions Persons with TB in Viet Nam face similarly high risk of catastrophic costs whether treated in the

关键词： tuberculosis Patient cost Catastrophic cost Private sector Comparative analysis Viet Nam

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Recent progresses of exosome-liposome fusions in drug delivery

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Chinese Chemical Letters 2024年第2期35卷 107-117页

作者： Lulu Zheng Bo Hu Deyao Zhao Wenjing Liu Qing Liu Yuanyu Huang Shaobo Ruan School of Life Science Advanced Research Institute of Multidisciplinary ScienceSchool of Medical TechnologyKey Laboratory of Molecular Medicine and BiotherapyKey Laboratory of Medical Molecule Science and Pharmaceutics EngineeringBeijing Institute of TechnologyBeijing 100081China Department of Radiation Oncology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000China Beijing Key Laboratory of Drug Resistance tuberculosis Research Beijing Tuberculosis and Thoracic Tumor Research Instituteand Beijing Chest HospitalCapital Medical UniversityBeijing 101149China

Exosomes are membrane-bound nanoscale extracellular vesicles,which produced by almost all *** to the excellent biocompatibility,long circulation time as well as low immunogenicity,exosomes as naturally-derived drug delivery carriers have experienced explosive growth over the past ***,issues such as insufficient loading efficiency,heterogeneous delivery efficiency,uncontrollable targeting ability,and low production limit their wide ***,the emerging exosome-liposome fusion strategy has become a potential approach to solve such ***,this review mainly focuses on the currently developed exosome-liposome fusion strategy and their application in drug delivery as well as disease *** review aims to shed light on the advantages of fusion strategy in drug delivery and provides a better understanding for more rational *** current challenge and future perspective regarding their clinical translation and application will also be discussed.

关键词： Exosome Liposome Membrane fusion Drug delivery Disease treatment

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The virulence regulator AbsR in avian pathogenic Escherichia coli has pleiotropic effects on bacterial physiology

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Journal of Integrative Agriculture 2024年第2期23卷 649-668页

作者： Dongfang Zhao Haobo Zhang Xinyang Zhang Fengwei Jiang Yijing Li Wentong Cai Ganwu Li State Key Laboratory for Animal Disease Control and Prevention Harbin Veterinary Research InstituteChinese Academy of Agricultural SciencesHarbin 150069China College of Veterinary Medicine Northeast Agricultural UniversityHarbin 150038China national Animal tuberculosis Reference Laboratory Division of Zoonoses SurveillanceChina Animal Health and Epidemiology CenterQingdao 266032China Department of Veterinary Diagnostic and Production Animal Medicine College of Veterinary MedicineIowa State UniversityAmesIowa 50011-1134the United States

Avian pathogenic Escherichia coli(APEC)belonging to extraintestinal pathogenic ***(ExPEC)can cause severe infections in extraintestinal tissues in birds and humans,such as the lungs and ***(microcin production regulation,locus A,herein renamed AbsR,a blood survival regulator),a member of the MarR(multiple antibiotic resistance regulator)transcriptional regulator family,governs the expression of capsule biosynthetic genes in human ExPEC and represents a promising druggable target for ***,a deep understanding of the AbsR regulatory mechanism as well as its regulon is *** this study,we present a systems-level analysis of the APEC AbsR regulon using ChIP-Seq(chromatin immunoprecipitation sequencing)and RNA-Seq(RNA sequencing)*** found that AbsR directly regulates 99 genes and indirectly regulates 667 ***,we showed that:1)AbsR contributes to antiphagocytotic effects by macrophages and virulence in a mouse model for systemic infection by directly activating the capsular gene cluster;2)AbsR positively impacts biofilm formation via direct regulation of the T2SS(type II secretion system)but plays a marginal role in virulence;and 3)AbsR directly upregulates the acid tolerance signaling system EvgAS to withstand acid stress but is dispensable in ExPEC ***,our data indicate that the role of AbsR in virulence gene regulation is relatively conserved in ExPEC ***,this study provides a comprehensive analysis of the AbsR regulon and regulatory mechanism,and our data suggest that AbsR likely influences virulence primarily through the control of capsule ***,we found that AbsR severely represses the expression of the type I-F CRISPR(clustered regularly interspaced short palindromic repeats)-Cas(CRISPR associated)systems,which could have implications in CRISPR biology and application.

关键词： avian pathogenic Escherichia coli(APEC) extraintestinal pathogenic Escherichia coli(ExPEC) AbsR RNA-Seq ChIP-Seq gene regulation

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Porta Hepatis Tuberculous Lymphadenopathy: Clinical and Imaging Features of 10 Cases

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Infectious Microbes & Diseases 2024年第1期6卷 29-35页

作者： Wenjuan Hu Ming Hu Jiafeng Xia Shengyue Chen Xiaomeng Li Chengmin Sheng Wanru Guo Xuewen Feng Yanwan Shangguan Bin Lu Yunzhen Shi Junke Qiu Kaijin Xu State Key Laboratory for Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineHangzhouChina Department of Cardiology the Second Affiliated Hospital of Dalian Medical UniversityDalianChina Department of Infectious Diseases Affiliated Dongyang Hospital of Wenzhou Medical UniversityDongyangChina Department of tuberculosis Intensive Care Unit Hangzhou Red Cross HospitalHangzhouChina

Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic *** offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,here,we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November *** this study,porta hepatis TL occurred predominantly in women(70%),with a mean age of 43.1 years(range,16-70 years).Among the patients,60%were initially suspected of malignancy(metastatic lymphadenopathy and lymphoma).The clinical manifestations were nonspecific,such as fever and weight loss,without overt abdominal *** patients showed high concentrations of serum C-reactive protein,erythrocyte sedimentation rate,alkaline phosphatase,γ-glutamyl transpeptidase and carbohydrate antigen *** rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the *** examination confirmed the diagnosis in 90%of patients with caseous granulo-matous inflammation and positive results of Xpert MTB/RIF,quantitative real-time PCR and/or metagenomic next-generation sequenc-ing *** patients underwent antituberculosis therapy with a median treatment duration of 13.5 months(range,1-43 months).They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after *** examination by biopsy remains the primary diagnostic method.A combination of the characteristic epidemiologic,clinical,imaging fea-tures and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.

关键词： porta hepatis tuberculous lymphadenopathy misdiagnosis tumor mimicking

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Genomic medicine in clinical practice:national genomic medicine program in Japan

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Cancer Biology & Medicine 2024年第1期21卷 4-9页

作者： Teruhiko Yoshida Yasushi Yatabe Ken Kato Genichiro Ishii Akinobu Hamada Hiroyuki Mano Kuniko Sunami Noboru Yamamoto Takashi Kohno Department of Genetic Medicine and Services National Cancer Center HospitalTokyo 104-0045Japan Department of Diagnostic Pathology National Cancer Center HospitalTokyo 104-0045Japan Clinical Research Support Offce Clinical Research Coordinating SectionBiobank Translational Research Support SectionNational Cancer Center HospitalTokyo 104-0045Japan Department of Pathology and Clinical Laboratories National Cancer Center Hospital EastChiba 277-8577Japan Division of Molecular Pharmacology National Cancer Center Research InstituteTokyo 104-0045Japan national Cancer Center Research Institute Tokyo 104-0045Japan Department of Laboratory Medicine National Cancer Center HospitalTokyo 104-0045Japan Department of Experimental Therapeutics National Cancer Center HospitalTokyo 104-0045Japan Division of Genome Biology National Cancer Center Research InstituteTokyo 104-0045Japan

Cancer statistics in Japan Cancer is the most common cause of death in Japan based on Statistics 2021~*** statistics were first gathered,infectious diseases,such as tuberculosis,and cerebrovascular disease have been the main causes of death in *** surpassed cerebrovascular disease as the main cause of death in 1981,and the number of cancer deaths has *** 38,000 people died of cancer in *** national Cancer Center(NCC)reported that the 5-year survival rate for patients with cancer was improving(62%for males and 66.9%for females)in a population-based cancer registry.

关键词： Cancer cancer death

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The Impact of COVID-19 Epidemic on tuberculosis Reports Among Students — Guizhou Province, China, 2020

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China CDC weekly 2022年第11期4卷 216-219页

作者： Yuying He Tao Li Lijie Zhang Renzhong Li Zaiping Chen Yunzhou Ruan Wei Su Jinlan Li Institute for tuberculosis Control Guizhou Center for Disease Control and PreventionGuiyangGuizhouChina national Center for tuberculosis Control and Prevention Chinese Center for Disease Control and PreventionBeijingChina Chinese Field Epidemiology Training program Chinese Center for Disease Control and PreventionBeijingChina

Summary What is already known about this topic?In 2020,the implementation of non-medical interventions during the coronavirus disease 2019(COVID-19)epidemic has created a negative impact on tuberculosis(TB)*** is unclear if the prevalence of TB among students in Guizhou Province was also *** is added by this report?Among TB cases,the proportion of student TB patients was 19.91%in the back-to-school period in 2020,which was higher than the 13.37%registered in 2017–2019,but this decreased in the COVID-19 pandemic *** time interval between symptom onset and care-seeking of the student TB patients was the shortest in the back-to-school and physical checkup *** are the implications for public health practice?TB active screening was effective for timely detection and diagnosis of TB among students,which could prevent TB outbreaks in schools.

关键词： Guizhou seeking Impact

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Treatment outcomes and adverse drug reactions among patients with drug-resistant tuberculosis receiving all-oral,long-term regimens:First record viewing report from Pakistan

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Asian Pacific Journal of Tropical Medicine 2023年第2期16卷 58-64,I0003页

作者： Hira Aslam Asad Omar Razia Fatima Usman Rasool Aashifa Yaqoob Waseem Ullah Aamir Khan Yusra Habib Khan Tauqeer Hussain Mallhi Provincial tuberculosis Control program Punjab Pakistan Cardio-metabolic Division CCL Research Laboratories Lahore PunjabPakistan Common Management Unit National Tuberculosis Control Program of PakistanIslamabadPakistan Department of Pharmacy Practice Shifa College of Pharmaceutical SciencesShifa Tameer-e-Millat UniversityIslamabadPakistan Association for Social Development IslamabadPakistan Department of Clinical Pharmacy College of PharmacyJouf UniversitySakakaAl-Jouf ProvinceSaudi Arabia

Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant ***:This retrospective study was conducted at 10 programmatic Management of Drug Resistant tuberculosis sites in Punjab province of *** receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the *** was extracted from electronic data management *** the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all *** the data was analyzed using SPSS version ***:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes *** these,384(67.9%)successfully completed their *** of 368(32%)patients who had their interim results available,all had their 6th month culture *** new medications was thought to result in serious adverse outcomes such as QT ***,this study did not record any severe adverse events among ***:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.

关键词： All-oral long-term regimens Long-term regimens Bedaquiline Linezolid Clofazimine Drug resistant tuberculosis Treatment outcomes aDSM

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