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Tuberculosis (TB) Prevention and Care: A Global Public Health Issue

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Infectious Disease Epidemiology".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 11122

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Dr. Juan F. Vesga

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Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Interests: infectious disease dynamics; emerging infectious diseases; the population impact of interventions

Special Issue Information

Dear Colleagues,

Recent years have seen a considerable elevation of the elimination of tuberculosis (TB) in the global health agenda. This change in gears was activated by the release of the End TB strategy in 2014 and finally paved its way as a global resolution during a United Nations high-level meeting in 2018. Ending TB under this renewed vision should be attainable in the coming years if countries around the world commit to expand their efforts against TB beyond the basic requirements for epidemic control. This means strengthening every step of the TB cascade of care and moving upstream to promote the prevention of TB. On the latter, it is widely recognised that TB elimination cannot be achieved without preventive interventions being used at scale, but despite promising recent developments, a licenced efficacious vaccine against tuberculosis is not yet available. For this reason, currently, the principal approach to prevention is through TB preventive therapy (TPT). Exciting new developments such as the WHO’s recently updated guidance for treating drug-resistant TB are important steps towards achieving the global goals. Despite this, challenges remain and expand beyond the drug- and vaccine-development realm, with important operational, behavioural, social, and health-system-related issues around TB care still requiring urgent attention.

With this timely Special Issue on TB prevention and care, we call for original papers that point at understanding those challenges from a multidimensional perspective, assess and quantify the role of existing and novel tools to reduce TB incidence, explore social and behavioural aspects around TB prevention, and research the role of health systems in ending TB. Specifically, our call is open for papers on, but not limited to, the following topics:

Epidemiological studies assessing the role of TB preventive tools;
Mathematical modelling exploring End TB scenarios and deployment of novel tools in TB care;
Assessment and estimation on the impact of novel TB vaccines;
Transversal aspects affecting TB burden (e.g., sustainable development goals, climate, infrastructure);
TB policy and decision making around TB prevention;
Qualitative research around barriers and interventions for TB prevention;
Health systems and access to care;
Operational research around TB care services;
Case studies on TB prevention and care.

Dr. Juan F. Vesga
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

TB
MDR-TB
elimination
new drugs
vaccines
diagnostics
prevention
LTBI
cost-effectiveness
capacity building
public private partnership
monitoring and evaluation
operational research
COVID-19
policy

Published Papers (6 papers)

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Research

21 pages, 386 KiB

Open AccessArticle

A Study on the Health-Related Issues and Behavior of Vietnamese Migrants Living in Japan: Developing Risk Communication in the Tuberculosis Response

by Sangnim Lee, Nhan Huu Thanh Nguyen, Shori Takaoka, An Dang Do, Yoshihisa Shirayama, Quy Pham Nguyen, Yusuke Akutsu, Jin Takasaki and Akihiro Ohkado

Int. J. Environ. Res. Public Health 2023, 20(12), 6150; https://doi.org/10.3390/ijerph20126150 - 16 Jun 2023

Viewed by 2299

Abstract

Ensuring a healthy lifestyle for the increasing number of Vietnamese migrants living in Japan is a key public health issue, including infectious disease responses such as tuberculosis (TB). To develop risk communication in relation to the TB response, this study aimed to explore the health issues and health-related behaviors of Vietnamese migrants living in Japan using a mixed method. A survey was conducted on Vietnam-born migrants, aged 18 years and over, in Tokyo. The survey consisted of questions on the following components: (1) demographics; (2) health-related issues and behavior; and (3) health-seeking behavior, information, and communication. A total 165 participants participated in the survey. The majority of the participants were young adults. 13% of the participants responded that they were concerned about their health. Moreover, 22% and 7% of the participants reported weight loss and respiratory symptoms, respectively. 44% of the participants answered they had no one to consult about their health in Japan when they needed it, and 58% answered they had no awareness of any Vietnamese-language health consultation services. Logistic regression analysis revealed that people who contact family members living in Vietnam or overseas using social networking services (SNSs) when they needed to consult someone about their health (adjusted odds ratio (AOR) = 6.09, 95% confidence interval (CI) 1.52–24.43) were more likely to present with one or more of the typical TB symptoms, compared to those who did not consult someone in this manner. Current smokers (OR = 3.08, 95% CI 1.15–8.23) were more likely to have health problems compared to non-smokers. The key informant interviews revealed that individual factors, the health system, and socio-environmental factors may hinder Vietnamese migrants’ health-seeking and health-information-seeking behaviors in Japan. TB risk communication approaches for migrants need to be developed considering their health-related behaviors while addressing their health needs. Full article

(This article belongs to the Special Issue Tuberculosis (TB) Prevention and Care: A Global Public Health Issue)

16 pages, 855 KiB

Open AccessArticle

Tuberculosis in Prisons: Importance of Considering the Clustering in the Analysis of Cross-Sectional Studies

by Diana Marín, Yoav Keynan, Shrikant I. Bangdiwala, Lucelly López and Zulma Vanessa Rueda

Int. J. Environ. Res. Public Health 2023, 20(7), 5423; https://doi.org/10.3390/ijerph20075423 - 06 Apr 2023

Viewed by 1769

Abstract

The level of clustering and the adjustment by cluster-robust standard errors have yet to be widely considered and reported in cross-sectional studies of tuberculosis (TB) in prisons. In two cross-sectional studies of people deprived of liberty (PDL) in Medellin, we evaluated the impact of adjustment versus failure to adjust by clustering on prevalence ratio (PR) and 95% confidence interval (CI). We used log-binomial regression, Poisson regression, generalized estimating equations (GEE), and mixed-effects regression models. We used cluster-robust standard errors and bias-corrected standard errors. The odds ratio (OR) was 20% higher than the PR when the TB prevalence was >10% in at least one of the exposure factors. When there are three levels of clusters (city, prison, and courtyard), the cluster that had the strongest effect was the courtyard, and the 95% CI estimated with GEE and mixed-effect models were narrower than those estimated with Poisson and binomial models. Exposure factors lost their significance when we used bias-corrected standard errors due to the smaller number of clusters. Tuberculosis transmission dynamics in prisons dictate a strong cluster effect that needs to be considered and adjusted for. The omission of cluster structure and bias-corrected by the small number of clusters can lead to wrong inferences. Full article

(This article belongs to the Special Issue Tuberculosis (TB) Prevention and Care: A Global Public Health Issue)

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14 pages, 702 KiB

Open AccessArticle

Catastrophic Costs among Tuberculosis-Affected Households in Egypt: Magnitude, Cost Drivers, and Coping Strategies

by Ramy Mohamed Ghazy, Malik Sallam, Rasha Ashmawy, Amira Mohamed Elzorkany, Omar Ahmed Reyad, Noha Alaa Hamdy, Heba Khedr and Rasha Ali Mosallam

Int. J. Environ. Res. Public Health 2023, 20(3), 2640; https://doi.org/10.3390/ijerph20032640 - 01 Feb 2023

Cited by 2 | Viewed by 1891

Abstract

Despite national programs covering the cost of treatment for tuberculosis (TB) in many countries, TB patients still face substantial costs. The end TB strategy, set by the World Health Organization (WHO), calls for “zero” TB households to be affected by catastrophic payments by 2025. This study aimed to measure the catastrophic healthcare payments among TB patients in Egypt, to determine its cost drivers and determinants and to describe the coping strategies. The study utilized an Arabic-validated version of the TB cost tool developed by the WHO for estimating catastrophic healthcare expenditure using the cluster-based sample survey with stratification in seven administrative regions in Alexandria. TB payments were considered catastrophic if the total cost exceeded 20% of the household’s annual income. A total of 276 patients were interviewed: 76.4% were males, 50.0% were in the age group 18–35, and 8.3% had multidrug-resistant TB. Using the human capital approach, 17.0% of households encountered catastrophic costs compared to 59.1% when using the output approach. The cost calculation was carried out using the Egyptian pound converted to the United States dollars based on 2021 currency values. Total TB cost was United States dollars (USD) 280.28 ± 29.9 with a total direct cost of USD 103 ± 10.9 and a total indirect cost of USD 194.15 ± 25.5. The direct medical cost was the main cost driver in the pre-diagnosis period (USD 150.23 ± 26.89 pre diagnosis compared to USD 77.25 ± 9.91 post diagnosis, p = 0.013). The indirect costs (costs due to lost productivity) were the main cost driver in the post-diagnosis period (USD 4.68 ± 1.18 pre diagnosis compared to USD 192.84 ± 25.32 post diagnosis, p < 0.001). The households drew on multiple financial strategies to cope with TB costs where 66.7% borrowed and 25.4% sold household property. About two-thirds lost their jobs and another two-thirds lowered their food intake. Being female, delay in diagnosis and being in the intensive phase were significant predictors of catastrophic payment. Catastrophic costs were high among TB households in Alexandria and showed wide variation according to the method used for indirect cost estimation. The main cost driver before diagnosis was the direct medical costs, while it was the indirect costs, post diagnosis. Full article

(This article belongs to the Special Issue Tuberculosis (TB) Prevention and Care: A Global Public Health Issue)

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15 pages, 828 KiB

Open AccessArticle

Characteristics and Treatment Outcomes among Migrants with Pulmonary Tuberculosis: A Retrospective Cohort Study in Japan, 2009–2018

by Sangnim Lee, Myo Nyein Aung, Lisa Kawatsu, Kazuhiro Uchimura, Reiko Miyahara, Jin Takasaki, Akihiro Ohkado and Motoyuki Yuasa

Int. J. Environ. Res. Public Health 2022, 19(19), 12598; https://doi.org/10.3390/ijerph191912598 - 02 Oct 2022

Cited by 1 | Viewed by 1722

Abstract

This study aimed to describe characteristics and treatment outcomes of overseas-born pulmonary tuberculosis (PTB) patients in Japan, and identify the factors associated with “treatment non-success”. We conducted a retrospective analysis of overseas-born patients with drug-susceptible PTB using cohort data of PTB cases newly registered in the Japan tuberculosis (TB) surveillance system between 2009 and 2018. Overall, 9151 overseas-born PTB cases were included in this study, and 70.3% were aged 34 years old or younger. “Students of high school and higher” (28.6%) and “regular workers other than service related sectors” (28.5%) accounted for over half of the study population, and they have continued to increase. Overall, the treatment success rate was 67.1%. Transferred-out constituted the largest proportion (14.8%) among the treatment non-success rate (32.9%). Multiple logistic regression analysis revealed patients whose health insurance type was “others and unknown”, including the uninsured (adjusted OR (AOR) = 3.43: 95% Confidence Intervals (CI) 2.57–4.58), those diagnosed as TB within “one year” (AOR = 2.61, 95% CI 1.97–3.46) and “1–5 years” (AOR = 2.44, 95% CI 1.88–3.17) of arrival in Japan, and males (AOR = 1.34, 95% CI 1.16–1.54), which were the main factors associated with treatment non-success. These findings imply that Japan needs to develop TB control activities considering the increasing trends of overseas-born PTB patients, the majority of whom are young and highly mobile. There is a need to pay greater attention to overseas-born PTB patients diagnosed within a short duration after entering Japan, who may be socially and economically disadvantaged for their treatment completion. Full article

(This article belongs to the Special Issue Tuberculosis (TB) Prevention and Care: A Global Public Health Issue)

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10 pages, 656 KiB

Open AccessArticle

Latent Tuberculosis Infection in Haematopoietic Stem Cell Transplant Recipients: A Retrospective Italian Cohort Study in Tor Vergata University Hospital, Rome

by Mirko Compagno, Assunta Navarra, Laura Campogiani, Luigi Coppola, Benedetta Rossi, Marco Iannetta, Vincenzo Malagnino, Saverio G. Parisi, Benedetta Mariotti, Raffaella Cerretti, William Arcese, Delia Goletti, Massimo Andreoni and Loredana Sarmati

Int. J. Environ. Res. Public Health 2022, 19(17), 10693; https://doi.org/10.3390/ijerph191710693 - 27 Aug 2022

Cited by 1 | Viewed by 1408

Abstract

The results of tuberculosis (TB) screening and reactivation in a cohort of 323 adult patients undergoing haematopoietic stem cell transplantation (HSCT) from 2015 to 2019 at the University Hospital of Tor Vergata, Rome, Italy, were reported. A total of 260 patients, 59 (18.3%) autologous and 264 (81.7%) allogeneic transplants, underwent Interferon Release (IFN)-γ (IGRA) test screening: 228 (87.7%) were negative, 11 (4.2%) indeterminate and 21 (8.1%) positive. Most of the IGRA-positive patients were of Italian origin (95.2%) and significantly older than the IGRA-negative (p < 0.001); 22 (8.5%) patients underwent a second IGRA during the first year after transplantation, and 1 tested positive for IGRA. Significantly lower monocyte (p = 0.044) and lymphocyte counts (p = 0.009) were detected in IGRA negative and IGRA indeterminate patients, respectively. All latent TB patients underwent isoniazid prophylaxis, and none of them progressed to active TB over a median follow-up period of 63.4 months. A significant decline in TB screening practices was shown from 2015 to 2019, and approximately 19% of patients were not screened. In conclusion, 8.1% of our HSCT population had LTBI, all received INH treatment, and no reactivation of TB was observed during the follow-up period. In addition, 19% escaped screening and 8% of these came from countries with a medium TB burden, therefore at higher risk of possible development of TB. Full article

(This article belongs to the Special Issue Tuberculosis (TB) Prevention and Care: A Global Public Health Issue)

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16 pages, 2893 KiB

Open AccessArticle

Demographic Control Measure Implications of Tuberculosis Infection for Migrant Workers across Taiwan Regions

by Szu-Chieh Chen, Tzu-Yun Wang, Hsin-Chieh Tsai, Chi-Yun Chen, Tien-Hsuan Lu, Yi-Jun Lin, Shu-Han You, Ying-Fei Yang and Chung-Min Liao

Int. J. Environ. Res. Public Health 2022, 19(16), 9899; https://doi.org/10.3390/ijerph19169899 - 11 Aug 2022

Cited by 1 | Viewed by 1225

Abstract

A sharp increase in migrant workers has raised concerns for TB epidemics, yet optimal TB control strategies remain unclear in Taiwan regions. This study assessed intervention efforts on reducing tuberculosis (TB) infection among migrant workers. We performed large-scale data analyses and used them to develop a control-based migrant worker-associated susceptible–latently infected–infectious–recovered (SLTR) model. We used the SLTR model to assess potential intervention strategies such as social distancing, early screening, and directly observed treatment, short-course (DOTS) for TB transmission among migrant workers and locals in three major hotspot cities from 2018 to 2023. We showed that social distancing was the best single strategy, while the best dual measure was social distancing coupled with early screening. However, the effectiveness of the triple strategy was marginally (1–3%) better than that of the dual measure. Our study provides a mechanistic framework to facilitate understanding of TB transmission dynamics between locals and migrant workers and to recommend better prevention strategies in anticipation of achieving WHO’s milestones by the next decade. Our work has implications for migrant worker-associated TB infection prevention on a global scale and provides a knowledge base for exploring how outcomes can be best implemented by alternative control measure approaches. Full article

(This article belongs to the Special Issue Tuberculosis (TB) Prevention and Care: A Global Public Health Issue)

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Tuberculosis (TB) Prevention and Care: A Global Public Health Issue

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