BACKGROUND: This study aimed to estimate the number of bacteriologically confirmed pulmonary TB (BC-PTB) cases expected to be detected and the number needed to screen (NNS) to detect one BC-PTB case by the Japan Pre-entry Tuberculosis Screening (JPETS) programme. METHODS: This descriptive study estimated the number of cases with BC-PTB to be detected and the NNS required to detect one case using the JPETS programme, based on national TB prevalence survey data from the six JPETS target Asian countries and immigration statistics in Japan. RESULTS: Among JPETS applicants, the estimated total number of BC-PTB cases diagnosed per year was 1,997 (95% confidence interval [CI]: 1,910–2,086) when adjusted for sex and 1,323 (95% CI: 1,253–1,396) when adjusted for age group. The estimated NNS to identify one BC-PTB case was 227 cases (95% CI: 217–237) when adjusted for sex and 319 cases (95% CI: 302–337) when adjusted for age. CONCLUSION: The JPETS is projected to identify approximately 1,300 BC-PTB cases per year across six Asian countries. When selecting countries for JPETS, consideration of both the number of TB cases in Japan and the TB prevalence in target countries may enhance screening effectiveness.
BACKGROUND: Multimorbidity (i.e., the co-existence of two or more long-term health conditions [LTCs]) is increasing in high-TB-burden countries. Few studies have estimated the prevalence of multimorbidity in patients with TB, and none in TB–HIV. This retrospective cohort study used HIV clinic data from the Infectious Diseases Institute in Kampala, Uganda, to determine the prevalence and patterns of multimorbidity in patients with TB–HIV at the time of TB diagnosis, and its effect on TB treatment outcomes. METHODS: Adults living with HIV and diagnosed with TB between 1 January 2014 and 14 November 2024 were included. Clinical, laboratory, and prescription records were used to categorise LTCs. The prevalence and patterns of multimorbidity were examined and their effect on WHO-defined TB treatment outcomes was assessed using regression models. RESULTS: Among 993 included patients, 76.1% (95% confidence interval: 73.4%–78.8%) had multimorbidity and 34.3% (31.4%–37.4%) had three or more LTCs. Anaemia (52.1%) and undernutrition (34.3%) were most prevalent. Multimorbidity was associated with a 3.70% (−0.35%–7.74%, P = 0.07) absolute increase in the adjusted risk of an unsuccessful treatment outcome. CONCLUSION: Multimorbidity was highly prevalent at TB diagnosis in this cohort of people with TB–HIV, highlighting the complexity of care required alongside prescription of anti-TB therapy.
OBJECTIVES: To assess the concordance between TB prevention practices and treatment adherence and identify determinants of a combined prevention and adherence behaviour. METHODS: A cross-sectional study was conducted among 147 TB patients attending seven urban primary health centres in Malang, Indonesia (January to June 2025). Prevention behaviours and treatment adherence were assessed using structured questionnaire Agreement between prevention practices and adherence was analysed using weighted Cohen kappa and Gwet AC. Determinants of the combined behavioural categories were identified using multinomial logistic regression. RESULTS: High prevention behaviour and high treatment adherence was observed in 52% and 57%. Agreement between these two behaviours was moderate. Results showed 34% of patients consistently had high prevention and adherence behaviour, 53% showed moderate behaviour, and 13% showed low behaviour. Moderate combined behaviour was associated with gender and TB knowledge. High combined behaviour was significantly associated with higher education, greater income, stronger family functioning, more positive attitudes, and higher TB knowledge. CONCLUSION: Routine educational programmes are needed for patients and their families during the intensive phase of treatment, along with individualised family assistance through personalised education sessions when patients visit primary health centres to collect their medications.
BACKGROUND: The WHO European Region has the highest rates of drug-resistant TB globally. Therefore, we studied the availability of genotypic and phenotypic drug susceptibility testing (DST), including targeted next-generation sequencing and whole genome sequencing, for first- and second-line drugs. METHOD: In 2024, the results of an online survey completed by national and supranational reference laboratories (or equivalent) of 53 countries, territories, and areas of the WHO European Region were reviewed. The availability of DST was analysed using three denominators: 1) the number of countries, territories, and areas for all drugs; 2) the estimated 2024 TB incidence for first-line drugs, including fluoroquinolones; and 3) the estimated 2024 rifampicin-resistant TB incidence for the remaining drugs. RESULTS: The most important gap in the availability of DST was for pretomanid, the most recently approved anti-TB drug: phenotypic DST was only available for 4% of the estimated incident cases of rifampicin-resistant TB in countries where pretomanid is approved or used programmatically. This contrasted with an availability of phenotypic DST of >98% for bedaquiline, delamanid, and linezolid. CONCLUSION: The delay between the introduction of novel drugs and the availability of robust DST services should be minimised to avoid intrinsic and selected resistance to novel drugs going unnoticed.
