Recent Innovations in Diagnosis and Treatment of Pediatric Tuberculosis

Gaensbauer, James; Broadhurst, Richard

doi:10.1007/s11908-019-0662-0

Cited by 12 publications

(12 citation statements)

References 51 publications

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“…19 O IGRA poderá ser mais benéfico no contexto de TB latente. 22 Neste estudo, a positividade do IGRA-Quantiferon e do T-SPOT foi inferior a outros descritos na literatura, mas não foram realizados em todos os doentes, o que poderá condicionar os resultados. 22 As formas de doença extrapulmonar apresentam uma maior complexidade e exigem uma forte suspeição clínica para o diagnóstico.…”

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Tuberculose em Idade Pediátrica: Experiência de 12 Anos num Centro Terciário de Referência em Portugal

et al. 2022

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Introduction: The diagnosis of tuberculosis in children is a challenge namely because extrapulmonary tuberculosis and severe disease are more frequent in this age group. The aim of this study was to evaluate and reflect about severe tuberculosis in pediatric age, in a metropolitan area of Lisbon.Material and Methods: Descriptive study about patients under 18 years of age admitted with tuberculosis disease in a tertiary pediatric hospital, from 2008 to 2019 (12 years).Results: We report 145 patients, average of 12 cases/year, with an increase in the last three years. Median age of 12.9 years, 42.8% born in Portuguese-speaking African countries and 20% had a chronic disease. The diagnosis was pulmonary tuberculosis in 52.4% (n = 76) and extrapulmonary tuberculosis in 47.6%: lymphatic (n = 26), skeletal (n = 15), miliary (n = 8), meningeal (n = 7), peritoneal/ intestinal (n = 6), pleural (n = 4), renal (n = 1), cutaneous (n = 1), thoracic wall (n = 1) and salivary glands (n = 1). The tuberculin test was positive in 78/99 (78.8%) and Interferon Gamma Release Assay in 61/90 (67.8%). In 20.7% (n = 30) acid-fast bacilli were identified in gastric aspirate/sputum and the agent was identified in 59.3% (n = 86). Tuberculosis was resistant in 11% (n = 16). Patients with extrapulmonary tuberculosis were younger (p = 0.006) and had more prolonged therapy (p < 0.001). Therapy-related complications occurred in 11% (n = 16). One patient died (with terminal cancer).Conclusion: This study highlights the need for screening of tuberculosis in children from endemic countries, patients with immunosuppression and chronic disease.

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Section: Discussionunclassified

Tuberculose em Idade Pediátrica: Experiência de 12 Anos num Centro Terciário de Referência em Portugal

et al. 2022

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“…At present, TB poses a global threat for both developing and developed countries [ 17 , 18 ], the innate immune response representing one of the most critical determinants associated with the outcome of EPTB infection [ 19 ]. In this study, the xCell score of monocytes and platelets is significantly higher, while that of lymphocytes is lower in the EPTB group in dataset GSE83456.…”

Section: Discussionmentioning

confidence: 99%

Immune status changing helps diagnose osteoarticular tuberculosis

Liang

Chen

et al. 2021

PLoS ONE

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Objective This study is aimed to develop a new nomogram for the clinical diagnosis of osteoarticular tuberculosis (TB). Methods xCell score estimation to obtained the immune cell type abundance scores. We downloaded the expression profile of GSE83456 from GEO and proceed xCell score estimation. The routine blood examinations of 326 patients were collected for further validation. We analyzed univariate and multivariate logistic regression to identified independent predicted factor for developing the nomogram. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curves. The correlation of ESR with lymphocytes, monocytes, and ML ratio was performed and visualized in osteoarticular TB patients. Results Compared with the healthy control group in the dataset GSE83456, the xCell score of basophils, monocytes, neutrophils, and platelets was higher, while lymphoid was lower in the EPTB group. The clinical data showed that the cell count of monocytes were much higher, while the cell counts of lymphocytes were lower in the osteoarticular TB group. AUCs of the nomogram was 0.798 for the dataset GSE83456, and 0.737 for the clinical data. We identified the ML ratio, BMI, and ESR as the independent predictive factors for osteoarticular TB diagnosis and constructed a nomogram for the clinical diagnosis of osteoarticular TB. AUCs of this nomogram was 0.843. Conclusions We demonstrated a significant change between the ML ratio of the EPTB and non-TB patients. Moreover, we constructed a nomogram for the clinical diagnosis of the osteoarticular TB diagnosis, which works satisfactorily.

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“…Moreover, such advanced tests are not available in all countries, especially economically weak countries, with a substantial disease burden. Also, in children, the conventional sputum test is difficult due to the lack of ability to produce proper sputum samples ( Gaensbauer and Broadhurst, 2019 ). Thus, special attention must be paid to developing specialized and highly accurate diagnostics for pediatric TB.…”

Section: Pediatric Tb Treatment: a Neglected Aspect Of Tbmentioning

confidence: 99%

Tuberculosis: Past, present and future of the treatment and drug discovery research

Bendre

Peters

Kumar

2021

Current Research in Pharmacology and Drug Discovery

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Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis . Despite decades of research driving advancements in drug development and discovery against TB, it still leads among the causes of deaths due to infectious diseases. We are yet to develop an effective treatment course or a vaccine that could help us eradicate TB. Some key issues being prolonged treatment courses, inadequate drug intake, and the high dropout rate of patients during the treatment course. Hence, we require drugs that could accelerate the elimination of bacteria, shortening the treatment duration. It is high time we evaluate the probable lacunas in research holding us back in coming up with a treatment regime and/or a vaccine that would help control TB spread. Years of dedicated and focused research provide us with a lead molecule that goes through several tests, trials, and modifications to transform into a ‘drug’. The transformation from lead molecule to ‘drug’ is governed by several factors determining its success or failure. In the present review, we have discussed drugs that are part of the currently approved treatment regimen, their limitations, vaccine candidates under trials, and current issues in research that need to be addressed. While we are waiting for the path-breaking treatment for TB, these factors should be considered during the ongoing quest for novel yet effective anti-tubercular. If these issues are addressed, we could hope to develop a more effective treatment that would cure multi/extremely drug-resistant TB and help us meet the WHO's targets for controlling the global TB pandemic within the prescribed timeline.

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Recent Innovations in Diagnosis and Treatment of Pediatric Tuberculosis

Cited by 12 publications

References 51 publications

Tuberculose em Idade Pediátrica: Experiência de 12 Anos num Centro Terciário de Referência em Portugal

Tuberculose em Idade Pediátrica: Experiência de 12 Anos num Centro Terciário de Referência em Portugal

Immune status changing helps diagnose osteoarticular tuberculosis

Tuberculosis: Past, present and future of the treatment and drug discovery research

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