Knowledge, attitude, and preventive practices of leptospirosis affected populations in South Andaman, India: A cross-sectional study

Introduction: Leptospirosis is the most common reoccurring zoonosis worldwide. Climatic conditions in tropical and subtropical regions are optimal for Leptospira survival. The pathogen thrives in flood-prone slum settlements of underprivileged areas where waste, open sewers, and standing water are present. Methods: A descriptive cross-sectional study using universal sampling methodology was conducted to determine associationsbetween sociodemographic variables and knowledge, attitudes, and practices of leptospirosis-infected individuals compared with a control group from the South Andaman population. Results: Eight hundred and one (388 cases and 413 controls) subjects were included in the study. Overall, 61.5% of the participants were male, while the main occupation of 43.94% of the subjects was farming or agricultural work. Multilogistic regression assessing the likelihood of good knowledge about leptospirosis showed that leptospirosis-positive subjects were more likely to have good knowledge (adjusted odds ratio [AOR]: 3.5 [95% CI: 2.59–4.97], p < 0.001), better attitude (AOR: 97.30 [95% CI: 41.72–226.9], p < 0.001] than leptospirosis-negative subjects, male population groups were also more likely to have a good attitude (AOR: 3.03 [95% CI: 1.94–4.73], p < 0.001), and those whose main occupation is farming were more likely to have a good attitude (AOR: 3.59 [95% CI: 2.31–5.56], p < 0.001). The leptospirosis seropositive group was more likely to have good practices (AOR: 5.80 [95% CI: 3.58–8.73], p < 0.001), rural residents were 88% less likely to have good practice levels than urban residents (AR: 0.12 [95% CI: 0.07–0.20], p < 0.01). Conclusion: The infected group had better knowledge than the control group. The integration of knowledge and attitudes to maintain good practices, along with the provision of an adequate sanitation system, waste disposal system, and availability of essential personal protective equipment is necessary for disease control in these islands

MicroRNAs as diagnostic biomarkers for Tuberculosis: A systematic review and meta- analysis

BACKGROUND: The early diagnosis of tuberculosis using novel non-sputum-based biomarkers is of high priority in the End TB strategy. MicroRNAs (miRNAs) are significant regulators of TB pathogenesis and their differential expression pattern among healthy, latent, and active TB population has revealed their potentiality as biomarkers in recent studies. Thus, we systematically reviewed and performed a meta-analysis on the role of host miRNAs in TB diagnosis. We also reviewed the involvement of miRNAs in the immune response to Mycobacterium tuberculosis (Mtb). METHODS: Pubmed, Ovid and Cochrane databases were searched to retrieve published literature from 2000 to 2020 using predefined keywords. We screened relevant studies based on inclusion and exclusion criteria and the included studies were assessed for their quality using STARD guidelines and QUADAS-2 tool. Funnel plots were constructed to assess the publication bias. The heterogeneity of studies and overall pooled results of sensitivity, specificity and DOR were determined using forest plots. RESULTS: We retrieved a total of 447 studies collectively from all the databases, out of which 21 studies were included for qualitative analysis. In these studies, miR-29, miR-31, miR-125b, miR146a and miR-155 were consistently reported. The overall sensitivity, specificity and DOR of these miRNAs were found to be 87.9% (81.7-92.2), 81.2% (74.5-86.5) and 43.1(20.3-91.3) respectively. Among these, miR-31 had the maximum diagnostic accuracy, with a sensitivity of 96% (89.7-98.5), specificity of 89% (81.2-93.8) and DOR of 345.9 (90.2-1326.3), meeting the minimal target product profile (TPP) for TB diagnostics. CONCLUSION: miRNAs can thus be exploited as potential biomarkers for rapid detection of tuberculosis as evident from their diagnostic performance. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021226559 PROSPERO (CRD42021226559)

Long-term Survival of Treated Tuberculosis Patients in Comparison to a General Population In South India: A Matched Cohort Study

Objectives: This study aimed to measure the mortality rate, potential years of life lost, and excess general mortality among individuals treated for pulmonary tuberculosis (TB) in a TB endemic country. Methods: A retrospective analysis was conducted on a population-based cohort study of 4022 TB patients and 12,243 gender-matched and age-matched controls from prevalence surveys conducted between 2000 and 2004 in the Thiruvallur district of Tamil Nadu, South India. Results: The mortality rate among TB patients was 59/1000 person-years. The excess standardized mortality ratio was 2.3 (95% CI: 1.7–3.1). The rate of potential years of life lost was 6.15/1000 (95% CI: 5.97–6.33) in the TB cohort compared to the general population of 1.52/1000 (95% CI: 1.46–1.60). Individuals aged >50 years, those underweight (<40 kg), with treatment failures, or lost to follow-up had higher mortality rates when compared with the rest of the TB cohort. The risk of death was significantly higher in the TB cohort until the end of the fourth year when compared with later years. Conclusion: Mortality in the TB cohort was 2.3 times higher than in the age-matched general population. Most deaths occurred in the first year after completing treatment. Post-treatment follow-ups and interventions for reducing comorbid conditions are necessary to prevent deaths

Isolation and comparative genomics of Mycobacterium tuberculosis isolates from cattle and their attendants in South India

Funder: UK Medical Research Council, grant Reference number (MR/N501864/1)Abstract: The major human pathogen Mycobacterium tuberculosis is rarely reported to cause disease in other animals. Cases in livestock are thought to occur through contact with infected handlers, but previous studies evaluating putative livestock-human transmission used typing techniques with limited resolution. Here, we undertook cross-sectional surveillance for tuberculosis in 271 livestock handlers and 167 cattle on three farms in Chennai, India and defined the relatedness of cultured isolates using whole genome sequencing. Humans and livestock were screened for active mycobacterial infection, and opportunistic post-mortem examination was performed on comparative intradermal test-positive cattle that died. Four cattle and 6 handlers on two farms were culture-positive for M. tuberculosis; M. bovis was not isolated. All 10 isolates (one from each case) belonged to Lineage 1. Pairwise genome comparisons of single nucleotide polymorphism (SNP) differences ranged from 1 to 600 SNPs, but 3 isolate pairs were less than 5 SNPs different. Two pairs were from handlers and the third pair were from two cattle on the same farm. The minimum pairwise SNP difference between a cattle and human isolate was >250 SNPs. Our study confirms the presence of M. tuberculosis infection in cattle in India, sequencing of which characterised relatedness between human and cattle-derived isolates