Serum IL-1β and IL-18 correlate with ESR and CRP in multidrug-resistant tuberculosis patients

Dear Editor： The emergence of multidrug-resistant tuberculosis （MDR-TB） is bringing new challenges. MDR-TB is caused by Mycobacterium tuberculosis （M. tuberculosis） that is resistant to isoniazid and rifampicin, with or with- out resistance to other anti-tuberculosis drugs. Approximately 450,000 people developed MDR-TB worldwide in 2012 and an estimated 170,000 people died from the disease. Bacterial burden is not strictly corre- lated with disease progression, and several hallmarks of severe tuberculosis suggest that insufficiently controlled inflammation plays an important role in pathogenesis.

Acceptance of Chemo-prophylaxis for Latent Tuberculosis Infection among High School/College Student Contacts of Tuberculosis Patients in Shanghai, China

Student contacts of tuberculosis（TB）cases are susceptible to latent tuberculosis infection（LTBI）,and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment.

Risk of Treatment Failure in Patients with Drug-susceptible Pulmonary Tuberculosis in China

The objective of this prospective study of the risks of treatment failure in patients with drug-susceptible pulmonary tuberculosis （PTB） was to provide reference data to help develop a disease control strategy. Participants were recruited in eight provinces of China from October 2008 to December 2010. A total of 1447 patients with drug-susceptible PTB and older than 15 years of age were enrolled.

Surgical treatment of spinal tuberculosis in older patients

Objective To discuss perioperative features,operative approach and surgical effects of spinal tuberculosis in older patients.Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal

DOST Model’ for DR-TB Patients, New Delhi: Perspectives of Healthcare Providers

Introduction: In India, tuberculosis continues to be a major public health problem and there is a growing concern about drug-resistant tuberculosis as most of the patients are from private sector. The National TB Elimination Programme (NTEP) in collaboration with TB Alert, India (TBAI) and Clinton Health Association of India (CHAI) had implemented a collaborative project to strengthen the network between the private practitioners and public healthcare facilities in New Delhi during 2019 and 2020. Methods: A study was conducted to understand the enablers and challenges encountered by them during the implementation of the project. This is a qualitative exploration of the “healthcare providers” on a project linking DR-TB patients in private sector with government health facilities. The process of data collection involved face-to-face in-depth interviews of healthcare providers, the Doctors mainly from private and public health facilities, the paramedical workers from general health system and paramedical from the project using an interview guide administered through a trained researcher. Results: The study findings revealed that all healthcare providers were completely aware of the DOST project in the health system, the model led to early diagnosis and initiation of quality treatment. There were no major challenges to the implementation of the project. The healthcare providers wish to have this project implemented for a longer duration. Conclusion: The perspectives of healthcare providers towards the “DOST” project were optimistic and call for re-initiating the project in the area.

Detection of Myobacterium Tuberculosis in the Samples of 122 TB Patients Using Polymerase Chain Reaction Technique

By means of polymerase chain reaction(PCR) technique,direct smear fluorescence microscopy and bacterial culture,the sputa and purulent secretion of 122 TB patients were examined to detect mycobacterium tuberculosis.

Quantifcation and correlates of tuberculosis stigma along the tuberculosis testing and treatment cascades in South Africa: a cross-sectional study

Background:South Africa has one of the world’s worst tuberculosis(TB)(520 per 100000 population)and TB-human immunodefciency virus(HIV)epidemics(~56%TB/HIV co-infected).While individual-and system-level factors infuencing progression along the TB cascade have been identifed,the impact of stigma is underexplored and underappreciated.We conducted an exploratory study to 1)describe diferences in perceived community-level TB stigma among community members,TB presumptives,and TB patients,and 2)identify factors associated with TB stigma levels among these groups.Methods:A cross sectional study was conducted in November 2017 at public health care facilities in Bufalo City Metro(BCM)and Zululand health districts,South Africa.Community members,TB presumptives,and TB patients were recruited.Data were collected on sociodemographic characteristics,TB knowledge,health and clinical history,social support,and both HIV and TB stigma.A validated scale assessing perceived community TB stigma was used.Univariate and multivariate linear regression models were used to describe diferences in perceived community TB stigma by participant type and to identify factors associated with TB stigma.Results:We enrolled 397 participants.On a scale of zero to 24,the mean stigma score for TB presumptives(14.7±4.4)was statistically higher than community members(13.6±4.8)and TB patients(13.3±5.1).Community members from Zululand(β=5.73;95%CI 2.19,9.72)had higher TB stigma compared to those from BCM.Previously having TB(β=−2.19;95%CI−4.37,0.0064)was associated with reduced TB stigma among community members.Understanding the relationship between HIV and TB disease(β=2.48;95%CI 0.020,4.94),and having low social support(β=−0.077;95%CI−0.14,0.010)were associated with increased TB stigma among TB presumptives.Among TB Patients,identifying as Black African(β=−2.90;95%CI−4.74,−1.04)and knowing the correct causes of TB(β=−2.93;95%CI−4.92,−0.94)were associated with decreased TB stigma,while understanding the relationship between HIV and TB disease(β=2.48;95%CI 1.05,3.90)and higher HIV stigma(β=0.32;95%CI 0.21,0.42)were associated with increased TB stigma.Conclusions:TB stigma interventions should be developed for TB presumptives,as stigma may increase initial-lossto-follow up.Given that stigma may be driven by numerous factors throughout the TB cascade,adaptive stigma reduction interventions may be required.

A Rarely Encountered Case: A Patient with Primary Pituitary Tuberculosis and Stroke

Dear Editor,Infections are a common cause of stroke,and tuberculosis is one of the most dangerous causes of central nervous system（CNS）diseases.For example,cerebral infarction is a relatively common and serious CNS disease associated with tuberculosis.