How the corona pandemic affects the global fight against tuberculosis and how to react

The emergence of the acute pandemic by SARS-CoV-2 is a setback for the fight against chronic pandemics like tuberculosis (TB), malaria, and HIV/AIDS. In fact, after more than a decade of decreasing fatality numbers, 2020 saw a re-increase in the number of people dying from TB. After COVID-19, TB was the infectious disease with the second-highest fatality rate caused by a single pathogen, with 1.6 million deaths in 2021. It is expected by the WHO that the pandemic years to come and even after the pandemic will continue this trend. More efforts are needed to support TB control structures as an integral part of the strengthening measures of the general health care system

Perceived challenges to public health in Central and Eastern Europe: a qualitative analysis

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.AbstractBackgroundThere is a major gradient in burden of disease between Central and Eastern Europe compared to Western Europe. Many of the underlying causes and risk factors are amenable to public health interventions. The purpose of the study was to explore perceptions of public health experts from Central and Eastern European countries on public health challenges in their countries.MethodsWe invited 179 public health experts from Central and Eastern European countries to a 2-day workshop in Berlin, Germany. A total of 25 public health experts from 14 countries participated in May 2008. The workshop was structured into 8 sessions of 1.5 hours each, with the topic areas covering coronary heart disease, stroke, prevention, obesity, alcohol, tobacco, tuberculosis, and HIV/AIDS. The workshop was recorded and the proceedings transcribed verbatim. The transcripts were entered into atlas.ti for content analysis and coded according to the session headings. After analysis of the content of each session discussion, a re-coding of the discussions took place based on the themes that emerged from the analysis.ResultsThemes discussed recurred across disease entities and sessions. Major themes were the relationship between clinical medicine and public health, the need for public health funding, and the problems of proving the effectiveness of disease prevention. Areas for action identified included the need to engage with the public, to create a better scientific basis for public health interventions, to identify “best practices” of disease prevention, and to implement registries/surveillance instruments. The need for improved data collection was seen throughout all areas discussed, as was the need to harmonize data across countries.ConclusionsTo reduce the burden of disease across Europe, closer collaboration of countries across Europe seems important in order to learn from each other. A more credible scientific basis for effective public health interventions is urgently needed. The monitoring of health trends is crucial to evaluate the impact of public health programmes.Peer Reviewe

Critical Role of Methylglyoxal and AGE in Mycobacteria-Induced Macrophage Apoptosis and Activation

Apoptosis and activation of macrophages play an important role in the host response to mycobacterial infection involving TNF-α as a critical autocrine mediator. The underlying mechanisms are still ill-defined. Here, we demonstrate elevated levels of methylglyoxal (MG), a small and reactive molecule that is usually a physiological product of various metabolic pathways, and advanced glycation end products (AGE) during mycobacterial infection of macrophages, leading to apoptosis and activation of macrophages. Moreover, we demonstrate abundant AGE in pulmonary lesions of tuberculosis (TB) patients. Global gene expression profiling of MG-treated macrophages revealed a diverse spectrum of functions induced by MG, including apoptosis and immune response. Our results not only provide first evidence for the involvement of MG and AGE in TB, but also form a basis for novel intervention strategies against infectious diseases in which MG and AGE play critical roles

Anomalous Nernst effect and three-dimensional temperature gradients in magnetic tunnel junctions

Understanding nanoscale temperature gradients in magnetic materials and how it affects their properties can help widen their potential applications. The authors analyze the anomalous Nernst effect in magnetic tunnel junctions and report how temperature gradients influence the thermomagnetic properties in three dimensions

Loss of Receptor on Tuberculin-Reactive T-Cells Marks Active Pulmonary Tuberculosis

BACKGROUND: Tuberculin-specific T-cell responses have low diagnostic specificity in BCG vaccinated populations. While subunit-antigen (e.g. ESAT-6, CFP-10) based tests are useful for diagnosing latent tuberculosis infection, there is no reliable immunological test for active pulmonary tuberculosis. Notably, all existing immunological tuberculosis-tests are based on T-cell response size, whereas the diagnostic potential of T-cell response quality has never been explored. This includes surface marker expression and functionality of mycobacterial antigen specific T-cells. METHODOLOGY/PRINCIPAL FINDINGS: Flow-cytometry was used to examine over-night antigen-stimulated T-cells from tuberculosis patients and controls. Tuberculin and/or the relatively M. tuberculosis specific ESAT-6 protein were used as stimulants. A set of classic surface markers of T-cell naive/memory differentiation was selected and IFN-gamma production was used to identify T-cells recognizing these antigens. The percentage of tuberculin-specific T-helper-cells lacking the surface receptor CD27, a state associated with advanced differentiation, varied considerably between individuals (from less than 5% to more than 95%). Healthy BCG vaccinated individuals had significantly fewer CD27-negative tuberculin-reactive CD4 T-cells than patients with smear and/or culture positive pulmonary tuberculosis, discriminating these groups with high sensitivity and specificity, whereas individuals with latent tuberculosis infection exhibited levels in between. CONCLUSIONS/SIGNIFICANCE: Smear and/or culture positive pulmonary tuberculosis can be diagnosed by a rapid and reliable immunological test based on the distribution of CD27 expression on peripheral blood tuberculin specific T-cells. This test works very well even in a BCG vaccinated population. It is simple and will be of great utility in situations where sputum specimens are difficult to obtain or sputum-smear is negative. It will also help avoid unnecessary hospitalization and patient isolation

Charakterisierung der Tuberkulosesituation in der Russischen Föderation : Analyse der epidemiologischen Lage und der Probleme in der Tuberkulosekontrolle auf föderaler Ebene und in der Autonomen Republik Tuva

Ulrichs T. Charakterisierung der Tuberkulosesituation in der Russischen Föderation : Analyse der epidemiologischen Lage und der Probleme in der Tuberkulosekontrolle auf föderaler Ebene und in der Autonomen Republik Tuva. Bielefeld (Germany): Bielefeld University; 2009.Russia and the other successor states of the former Soviet Union suffer from high numbers in tuberculosis prevalences and incidences, the problem of tuberculosis spread is aggravated by rising rates of multidrug resistance. Information for this thesis was gathered by literature research and by analysis of tuberculosis surveillance data from the Russian Federation as well as from one high burden region, the Autonomous Republic of Tuva. The thesis highlights the main reasons for the current tuberculosis problem and for difficulties to efficiently implement DOTS. Russia's tuberculosis control system is based on active case finding. Microbiological analysis and standardized drug regimens still need to be improved. Therapy failure often results in prolonged treatment. The thesis puts forward arguments for a more flexible discussion of efficient ways of tuberculosis control in Russia. The special situation in Russia with high rates of multidrug resistant tuberculosis requires an adapted implementation of DOTS and of the WHO recommendations for tuberculosis control.Die vorliegende Arbeit beschäftigt sich mit der Situation der Tuberkulosekontrolle in Russland und zeigt am Beispiel der Autonomen Republik Tuva auf, welche Probleme eine effiziente Tuberkulosekontrolle erschweren. Dabei wurden Daten aus den Jahren 2006 und 2007 aus verschiedenen russischen Quellen mit denen verglichen, die offiziell an die WHO gemeldet wurden. Darüber hinaus konnten aktuelle Daten aus Tuva mit Hilfe einer prospektiven epidemiologischen Studie gewonnen und in die Gesamtanalyse einbezogen werden. Hintergrund: Die Tuberkulosekontrolle in den Nachfolgestaaten der ehemaligen Sowjetunion steht gegenwärtig vor besonderen Problemen. Steigende Tuberkulosezahlen und Raten multiresistenter (MDR-)Erreger fallen zusammen mit einer zunehmenden Durchseuchung mit HIV/AIDS. Die Einführung des DOTS-Systems (directly observed therapy - short course) der WHO stieß wegen der überkommenen Kontrollstrukturen auf Widerstände. Fragestellung: Lässt sich aus den vorhandenen Daten ein aktuelles Bild der Tuberkulosekontrolle erstellen? Dabei sollten auch die vorhandenen Regelungen und Programme offizieller Tuberkulosekontrollinstitutionen berücksichtigt und kritisch beurteilt werden. Eignet sich die Autonome Republik Tuva als Beispielregion, um die Probleme der Tuberkulosekontrolle aufzuzeigen und Lösungsmöglichkeiten zu entwickeln? Methoden: Zur Beantwortung dieser Fragen wurden ein systematischer Literaturreview sowie eine Analyse der offiziellen Dokumente zur Tuberkulosekontrolle in Russland vorgenommen. Darüber hinaus wurden Informationen in den verantwortlichen gesundheitspolitischen Institutionen eingeholt. In Tuva wurde eine prospektive Studie zur Tuberkulosesituation durchgeführt. Ergebnisse und Diskussion: Nach einem Anstieg in den 90er Jahren haben sich die Tuberkulosezahlen auf einem hohen Niveau stabilisiert. Der hohe Quotient aus Prävalenz und Inzidenz deutet auf lange Krankheits- und Behandlungszeiten hin. Neben steigenden MDR-Raten treten vermehrt schwere Verlaufsformen auf. Defizite in den Kontrollprogrammen umfassen neben Mangel an qualifiziertem Personal und Ausstattung auch fehlende politische Unterstützung und unzureichende Diagnostik und Therapie. Die Autonome Republik Tuva leidet unter besonders hohen Tuberkulosezahlen. Eine höhere genetische Suszeptibilität ist dafür weniger die Ursache als vielmehr eine Konzentrierung von Problemen in der Tuberkulosekontrolle. Es wird eine Angleichung der Übertragungswahrscheinlichkeit zwischen den Geschlechtern und den verschiedenen Ethnien beobachtet. Fehlende mikrobiologische Kontrolle führt häufig zu radiologisch-klinischen Fehldiagnosen. Active case finding ist sehr verbreitet und führt zu kürzerer Behandlungsdauer und weniger schweren Verlaufsformen als bei passive case finding. BCG-(Re-)Vakzinierung ist sehr weit verbreitet und von teils erheblichen Nebenwirkungen begleitet. Auf der Grundlage dieser Ergebnisse wurden Empfehlungen an das tuvinische Gesundheitsministerium formuliert. Sie beinhalten eine (zumindest vorläufige) Beibehaltung des active case finding, einen Bestätigungstest für radiologisch-klinische Diagnosen durch Mikrobiologie oder IFN-gamma-basierte Tests, eine Stärkung der mikrobiologischen Diagnostik als Grundlage für Therapieentscheidungen, Surveillance und Monitoring und Umgebungsuntersuchungen und eine Beibehaltung der BCG-Impfung bei Kindern, aber eine Einstellung der (Re-)Vakzinierung Erwachsener

Data on the descriptive overview and the quality assessment details of 12 qualitative research papers

This data article presents the supplementary material for the review paper “Role of acceptability barriers in delayed diagnosis of Tuberculosis: Literature review from high burden countries” (Barnabishvili et al., in press) [1]. General overview of 12 qualitative papers, including the details about authors, years of publication, data source locations, study objectives, overview of methods, study population characteristics, as well as the details of intervention and the outcome parameters of the papers are summarized in the first two tables included to the article. Quality assessment process of the methodological strength of 12 papers and the results of the critical appraisal are further described and summarized in the second part of the article. Keywords: Acceptability of Health Care, Access to Health Care, Drug-resistant tuberculosis, High M/XDR-TB burden countries, Quality assessment of qualitative studies, Critical appraisal of qualitative studie

Oral Health Status of Healthcare Workers in Ilembula/Tanzania during the COVID-19 Condition.

The challenge of reduced dental treatment and education infrastructure in the Tanzanian highlands affects the oral health situation of both the general population and local healthcare workers. The aim of this study was to investigate the oral health status of healthcare workers at Ilembula Lutheran Hospital (ILH), Tanzania, during the COVID-19 pandemic. In total, 134 healthcare workers (62 women, 72 men; mean age 36.48 ± 9.56 years, range 19-59 years; median age 35.00 years) participated in this cross-sectional study, conducted from 12 February to 27 February. A dental examiner trained in oral health screening performed the oral health data collection. Data collection was performed by probability sampling using the Ilembula Data Collection Form-Oral Health (IDCF-Oral Health) questionnaire distributed in paper form. Ethical approval was obtained from the National Institute for Medical Research/Tanzania. The decayed, missing, and filled teeth (DMF/T) index proposed by the World Health Organization (WHO) was used with the associated caries measurement method and the simplified oral hygiene index (OHI-S). Details regarding edentulism, nutritional habits, and socio-economic factors were collected. Statistical analysis was performed using linear regression (α = 0.05). The average DMF-T index was 3.33 ± 0.82, with age, gender, meal frequency, and soft drink consumption significantly influencing the index. No evidence of dental plaque was detected in 43.3% of the participants. Of the participants, 32.8% required prosthetic treatment (Kennedy Class III), while 16.4% needed it for acute malocclusions. Oral hygiene products were used in 97% of cases. A total of 35.8% of the participants had an OHI-S score of up to 1.0, with (p < 0.001) age and (p < 0.001) sex having a significant influence on the index. The current oral health situation of healthcare workers at ILH shows a moderate need for restorative and prosthetic treatment in rural Tanzania. Despite the COVID-19 pandemic, there was no change in the need for dental treatment, which may be explained by the generally restricted access to dental healthcare in the investigated region. The development of an interdisciplinary oral health prophylaxis system could help to reduce the need for future treatments