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  1. Fulltext Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis
    Nathavitharana RR, Bond P, Dramowski A, Kotze K, Lederer P, Oxley I, et al.
    Presse Med, 2017 Mar;46(2 Pt 2):e53-e62.
    PMID: 28256382 DOI: 10.1016/j.lpm.2017.01.014
    Healthcare workers (HCWs) play a central role in global tuberculosis (TB) elimination efforts but their contributions are undermined by occupational TB. HCWs have higher rates of latent and active TB than the general population due to persistent occupational TB exposure, particularly in settings where there is a high prevalence of undiagnosed TB in healthcare facilities and TB infection control (TB-IC) programmes are absent or poorly implemented. Occupational health programmes in high TB burden settings are often weak or non-existent and thus data that record the extent of the increased risk of occupational TB globally are scarce. HCWs represent a limited resource in high TB burden settings and occupational TB can lead to workforce attrition. Stigma plays a role in delayed diagnosis, poor treatment outcomes and impaired well-being in HCWs who develop TB. Ensuring the prioritization and implementation of TB-IC interventions and occupational health programmes, which include robust monitoring and evaluation, is critical to reduce nosocomial TB transmission to patients and HCWs. The provision of preventive therapy for HCWs with latent TB infection (LTBI) can also prevent progression to active TB. Unlike other patient groups, HCWs are in a unique position to serve as agents of change to raise awareness, advocate for necessary resource allocation and implement TB-IC interventions, with appropriate support from dedicated TB-IC officers at the facility and national TB programme level. Students and community health workers (CHWs) must be engaged and involved in these efforts. Nosocomial TB transmission is an urgent public health problem and adopting rights-based approaches can be helpful. However, these efforts cannot succeed without increased political will, supportive legal frameworks and financial investments to support HCWs in efforts to decrease TB transmission.
    Matched MeSH terms: Latent Tuberculosis/epidemiology
  2. Fulltext Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management
    Park DI, Hisamatsu T, Chen M, Ng SC, Ooi CJ, Wei SC, et al.
    Intest Res, 2018 Jan;16(1):17-25.
    PMID: 29422794 DOI: 10.5217/ir.2018.16.1.17
    Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.
    Matched MeSH terms: Latent Tuberculosis
  3. Fulltext Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment
    Park DI, Hisamatsu T, Chen M, Ng SC, Ooi CJ, Wei SC, et al.
    Intest Res, 2018 Jan;16(1):4-16.
    PMID: 29422793 DOI: 10.5217/ir.2018.16.1.4
    Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommendaduring anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.
    Matched MeSH terms: Latent Tuberculosis
  4. Fulltext Tuberculosis and biologics - a glimpse of Sabah rheumatology patients
    Le Low, Darman Shah N. S., Mohd Noh M., Y. Y. Chong
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):66-66.
    MyJurnal
    Introduction: Biologic patients are at increased risk of tuberculosis (TB) infection, especially in TB prevalent areas like Sabah. We present three cases of rheumatology patients who developed tuberculosis infection while on bi-ologics. Case description: Case1: 47 year old lady with active rheumatoid arthritis despite being on four disease modifying antirheumatic drugs (DMARDS) was given subcutaneous Etanercept after prescreening with mantoux test and interferon gamma release assay (IGRA). Due to poor response, she was switched to Tofacitinib with a repeat pre-screening done except IGRA. Three months after biologics, she developed pulmonary tuberculosis and Tofacitinib was stopped. Case2: 50 year old male with seropositive rheumatoid arthritis and seroconverted hepatitis B. He was worked up for biologic treatment after failing multiple DMARDS; mantoux was 10mm, IGRA not done. He was start-ed on subcutaneous Etanercept for disabling arthritis while being treated for latent TB but developed TB Lymphadeni-tis on his third month of biologic therapy which was withheld thereafter. Case3:48 year old teacher with seropositive rheumatoid arthritis and old pulmonary TB, had intolerance to methotrexate, was initiated on three DMARDS but symptoms remained uncontrolled. Prescreening with IGRA was negative and Adalimumab commenced. Following two years of biologic, she developed reactivation of TB. Rituximab was commenced a year after for persistent active arthritis but withheld due to dermatitis. Conclusion: All patients had mantoux test done routinely but not IGRA due to its cost and limited availability. A follow up study to analyze the effectiveness of IGRA versus Mantoux in detecting latent TB in such patients would be beneficial.
    Matched MeSH terms: Latent Tuberculosis
  5. Generation of a T cell receptor (TCR)-like single domain antibody (sDAb) against a Mycobacterium Tuberculosis (Mtb) heat shock protein (HSP) 16kDa antigen presented by Human Leukocyte Antigen (HLA)-A*02
    Dass SA, Norazmi MN, Dominguez AA, Miguel MESGS, Tye GJ
    Mol Immunol, 2018 09;101:189-196.
    PMID: 30007228 DOI: 10.1016/j.molimm.2018.07.001
    The discovery of heat shock protein 16 kDa antigen protein has deepen the understanding of latent tuberculosis since it was found to be primarily expressed by Mycobacterium tuberculosis during latent phase leading to the rapid optimization and development in terms of diagnosis and therapeutics. Recently, T cell receptor-like antibody has been explored extensively targeting various diseases due to its dual functionality (T cell receptor and antibody). In this study, a TCR-like domain antibody (A2/Ab) with the binding capacity to Mtb heat shock protein (HSP) 16 kDa antigen presented by major histocompatible complex (MHC) HLA-A*02 was successfully generated via biopanning against human domain antibody library. The generated antibody (A2/Ab) exhibited strong functionality and binding capacity against the target assuring the findings of this study to be beneficial for the development of latent tuberculosis diagnosis and immunotherapeutics in future.
    Matched MeSH terms: Latent Tuberculosis
  6. Fulltext Prevalence and risk factors of latent tuberculosis infection among health care workers in Malaysia
    Rafiza S, Rampal KG, Tahir A
    BMC Infect Dis, 2011;11:19.
    PMID: 21244645 DOI: 10.1186/1471-2334-11-19
    BACKGROUND: Health care workers are exposed to patients with tuberculosis and are at risk of nosocomial infection. The aim of this study was to determine the prevalence and factors associated with latent tuberculosis infection among health care workers in Malaysia and also to evaluate the agreement between Quantiferon TB Gold in tube test with Tuberculin Skin Test.
    METHODS: A cross sectional study was conducted at four randomly selected hospitals in the Klang Valley from December 2008 to May 2009. Self administered questionnaire was used to obtain information on health care workers and possible risk factors. The response rate for this study was 90.8% with 954 respondents completed the questionnaire and were tested with Quantiferon TB Gold in tube for latent tuberculosis infection. Agreement between Quantiferon TB Gold in tube and Tuberculin Skin Test was assessed among 95 health care workers who consented to undergo both tests.
    RESULTS: The overall prevalence of latent tuberculosis infection among health care workers was 10.6% (CI: 8.6%; 12.6%). Factors significantly associated with latent tuberculosis infection were aged 35 years and older [9.49 (CI: 2.22; 40.50)], history of living in the same house with close family members or friends who had active tuberculosis [8.69 (CI: 3.00; 25.18)], worked as a nurse [4.65 (CI: 1.10; 19.65)] and being male [3.70 (CI: 1.36; 10.02)]. Agreement between Quantiferon TB Gold in tube test and tuberculin skin test at cut-off points of 10 mm and 15 mm was 50.5% and 82.1% respectively. However, Kappa-agreement was poor for both cut-off points.
    CONCLUSION: The prevalence of latent tuberculosis infection in Malaysia was relatively low for an intermediate TB burden country. We could not comment on the occupational risk of latent tuberculosis infection among health care worker compared to the general population as there were no prevalence data available for latent tuberculosis infection in the general population. Kappa agreement between Quantiferon TB gold in-tube and tuberculin skin test was poor.
    Matched MeSH terms: Latent Tuberculosis/diagnosis; Latent Tuberculosis/epidemiology*; Latent Tuberculosis/transmission*
  7. Fulltext A review of tuberculosis research in Malaysia
    Swarna Nantha Y
    Med J Malaysia, 2014 Aug;69 Suppl A:88-102.
    PMID: 25417956 MyJurnal
    One hundred seventy four articles related to tuberculosis were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. One hundred fifty three articles were selected and reviewed on the basis of clinical relevance and future research implications. Topics related to epidemiology, clinical presentation, detection methods and treatment were well researched. However, limited information was available on screening and behavioural interventions. The younger population were more vulnerable to tuberculosis infection and had higher prevalence of risk factors that reactivate tuberculosis infection. Screening of tuberculosis was conducted primarily on healthcare workers, tuberculosis contacts, prisoners and foreign workers. Data on the clinical presentation of pulmonary and extrapulmonary tuberculosis was comprehensive. There was a general focus on related risk factors such as HIV and diabetes mellitus. A great degree of information was available on the treatment and various detection methods to identify tuberculosis. The efficacy and the practicality of investigative methods was analysed in this review. In conclusion, the direction of research should be aimed at novel preventive and control measures of tuberculosis. There should be emphasis on the screening of high risk groups (other than HIV) within the population namely diabetic patients, smokers and immunosuppressed individuals. The design of health policies should be guided by information gathered from research evaluation of communitybased behavioural interventions.
    Matched MeSH terms: Latent Tuberculosis
  8. Fulltext Influence of diabetes mellitus and risk factors in activating latent tuberculosis infection: a case for targeted screening in Malaysia
    Swarna Nantha Y
    Med J Malaysia, 2012 Oct;67(5):467-72.
    PMID: 23770860 MyJurnal
    A review of the epidemiology of tuberculosis, its contributing risk factors (excluding HIV) and the role of screening latent tuberculosis infection in Malaysia was done. Despite the global and domestic decrease in prevalence rates of tuberculosis in the past decade, there is an alarming increase in the trend of non communicable diseases in the country. High prevalence rates of major risk factors leading to reactivation of tuberculosis were seen within the population, with diabetes mellitus being in the forefront. The rising numbers in the ageing population of Malaysia poses a further threat of re-emergence of tuberculosis in the years to come. Economically, screening of diabetic patients with comorbidities for latent tuberculosis infection (LTBI) using two major techniques, namely tuberculin sensitivity (TST) and Interferon gamma release assay tests (IGRA) could be a viable option. The role of future research in the detection of LTBI in the Malaysian setting might be necessary to gauge the disease reservoir before implementing prophylactic measures for high risk groups involved.
    Matched MeSH terms: Latent Tuberculosis*
  9. Fulltext Knowledge and practice among nurses on management of tuberculosis in a teaching hospital
    Hng, S.H., Siti Nabihah, S., Siti Nabilah, S.
    Medicine & Health, 2018;13(1):153-164.
    MyJurnal
    Tuberculosis (TB) has become a worldwide public concern with 10.4 million new cases reported in 2015 and 1.4 million deaths. More importantly, an increase in trend in TB incidence among healthcare workers has become a major concern. Therefore, the present study was conducted to explore the knowledge and practice towards TB and the factors associated with it among nurses in a teaching hospital. The present study used cross-sectional design and stratified sampling method. A total of 275 nurses in a teaching hospital participated in this study. The knowledge and practice on management of TB was measured using a structured questionnaire. Majority of the respondents had good knowledge and practice on management of TB represented by 70.2% and 63.3%, respectively. However, knowledge gap (1.8%) and practice gap (0.4%) were identified in method of sputum collection. Work place setting was the only demographic factor found significantly associated with level of knowledge and practice (p=0.028). Level of knowledge and practice on management of TB identified among nurses was not associated with many socio-demographic factors. Nurses as frontline healthcare workers are at high risk of being exposed due to frequent contact with various patients especially those who are undiagnosed and TB suspect patients. Hence, implementation of TB Infection Control (TBIC) measures is important to minimize the risk of infection and cross-infection within hospital.
    Matched MeSH terms: Latent Tuberculosis
  10. Evidence and potential risk factors of tuberculosis among captive Asian elephants and wildlife staff in Peninsular Malaysia
    Yakubu Y, Ong BL, Zakaria Z, Hassan L, Mutalib AR, Ngeow YF, et al.
    Prev Vet Med, 2016 Mar 1;125:147-53.
    PMID: 26775804 DOI: 10.1016/j.prevetmed.2016.01.008
    Elephant tuberculosis (TB) caused by Mycobacterium tuberculosis is an important re-emerging zoonosis with considerable conservation and public health risk. We conducted prospective cohort and cross-sectional studies in elephants and wildlife staff respectively in order to identify potential risk factors associated with TB in captive Asian elephants and their handlers in Peninsular Malaysia. Sixty elephants in six different facilities were screened for TB longitudinally using the ElephantTB STAT-PAK and DPP VetTB assays from February 2012 to May 2014, and 149 wildlife staff were examined for tuberculosis infection using the QuantiFERON-TB Gold In-tube (QFT) assay from January to April, 2012. Information on potential risk factors associated with infection in both elephants and staff were collected using questionnaires and facility records. The overall seroprevalence of TB amongst the elephants was 23.3% (95% CI: 13.8-36.3) and the risk of seroconversion was significantly higher among elephants with assigned mahouts [p=0.022, OR=4.9 (95% CI: 1.3-18.2)]. The percentage of QFT responders among wildlife staff was 24.8% (95% CI: 18.3-32.7) and the risk of infection was observed to be significantly associated with being a zoo employee [p=0.018, OR=2.7 (95% CI: 1.2-6.3)] or elephant handler [p=0.035, OR=4.1 (95% CI: 1.1-15.5)]. These findings revealed a potential risk of TB infection in captive elephants and handlers in Malaysia, and emphasize the need for TB screening of newly acquired elephants, isolating sero-positive elephants and performing further diagnostic tests to determine their infection status, and screening elephant handlers for TB, pre- and post-employment.
    Matched MeSH terms: Latent Tuberculosis
  11. Fulltext Close contact investigation of TB in high-burden, low- and middle-income countries
    Pang YK
    Malays Fam Physician, 2014;9(2):11-17.
    PMID: 25893066 MyJurnal
    Tuberculosis (TB) remains a very common disease in most of the low- and middle-income countries. As a result of high disease burden, TB control measures in these countries are usually concentrated on intensifying active disease case-finding and early treatment of infectious TB. On the contrary, in countries with low disease burden, the focus is on contact investigation to identify latently infected individuals and prophylactically treating them to prevent disease reactivation and transmission. These two strategies are deemed important for the effective TB control. Nonetheless, WHO cautions that targeted contact investigation and latent TB infection (LTBI) treatment should only be undertaken by countries that have the operational capacity/ resources and have achieved ≥ 85% treatment success rate of active TB. The screening of LTBI is further challenged by the lack of a “gold standard” test to identify and validate individuals with this condition. Tuberculin skin test (TST) is still the preferred investigation as it is cheap, widely available and validated in many trials. The sensitivity and specificity of the newer test—interferon gamma release assay (IGRA) for LTBI screening has been encouraging in low prevalence countries. However, the evidence supporting such usage remains uncertain in high burden settings. Diagnosis of LTBI should adhere to the strict criteria outlined in the guidelines to avoid misdiagnosing active TB as LTBI. The treatment of the latter involved only one or two anti-TB drugs. It has been demonstrated that in the properly conducted contact screening and LTBI treatment, chances of the emergence of multi-drug-resistant TB is very low.
    Matched MeSH terms: Latent Tuberculosis
  12. Fulltext Chromosomal rearrangements and protein globularity changes in Mycobacterium tuberculosis isolates from cerebrospinal fluid
    Saw SH, Tan JL, Chan XY, Chan KG, Ngeow YF
    PeerJ, 2016;4:e2484.
    PMID: 27688977 DOI: 10.7717/peerj.2484
    BACKGROUND: Meningitis is a major cause of mortality in tuberculosis (TB). It is not clear what factors promote central nervous system invasion and pathology but it has been reported that certain strains of Mycobacterium tuberculosis (Mtb) might have genetic traits associated with neurotropism.

    METHODS: In this study, we generated whole genome sequences of eight clinical strains of Mtb that were isolated from the cerebrospinal fluid (CSF) of patients presenting with tuberculous meningitis (TBM) in Malaysia, and compared them to the genomes of H37Rv and other respiratory Mtb genomes either downloaded from public databases or extracted from local sputum isolates. We aimed to find genomic features that might be distinctly different between CSF-derived and respiratory Mtb.

    RESULTS: Genome-wide comparisons revealed rearrangements (translocations, inversions, insertions and deletions) and non-synonymous SNPs in our CSF-derived strains that were not observed in the respiratory Mtb genomes used for comparison. These rearranged segments were rich in genes for PE (proline-glutamate)/PPE (proline-proline-glutamate), transcriptional and membrane proteins. Similarly, most of the ns SNPs common in CSF strains were noted in genes encoding PE/PPE proteins. Protein globularity differences were observed among mycobacteria from CSF and respiratory sources and in proteins previously reported to be associated with TB meningitis. Transcription factors and other transcription regulators featured prominently in these proteins. Homologs of proteins associated with Streptococcus pneumoniae meningitis and Neisseria meningitidis virulence were identified in neuropathogenic as well as respiratory mycobacterial spp. examined in this study.

    DISCUSSION: The occurrence of in silico genetic differences in CSF-derived but not respiratory Mtb suggests their possible involvement in the pathogenesis of TBM. However, overall findings in this comparative analysis support the postulation that TB meningeal infection is more likely to be related to the expression of multiple virulence factors on interaction with host defences than to CNS tropism associated with specific genetic traits.

    Matched MeSH terms: Latent Tuberculosis
  13. Fulltext Prevalence and Factors Associated with Tuberculosis Treatment Success among TB/HIV Co-Infection in North-East Malaysia
    Jalal TMT, Abdullah S, Wahab FA, Dir S, Naing NN
    Malays J Med Sci, 2017 Dec;24(6):75-82.
    PMID: 29379389 DOI: 10.21315/mjms2017.24.6.9
    Background: One of the six strategies developed by WHO, in order to stop Tuberculosis (TB) is addressing TB/HIV high-risk groups. This study aimed to determine the prevalence of successful TB treatment and factors associated with TB treatment success among TB/HIV co-infection patients in North-East Malaysia.
    Methods: A cross-sectional study was carried out in the a-year period from 2003 to 2012 by reviewing TB/HIV records in all hospitals and health clinics. The outcome of interest was treatment success as defined by Ministry of Health (MOH) when the patients was cured or completed TB treatment.
    Results: Out of 1510 total TB/HIV co-infection cases, 27.9% (95% CI: 25.2, 30.6) of the patients were having treatment success. A majority of TB/HIV co-infection cases were male (91.1%). Fifty-eight percent the patients were drug addicts and 6% were having positive tuberculin tests. The multiple logistic regression revealed that male (OR: 0.39, 95% CI: 0.22, 0.71) and positive tuberculin test result (OR: 2.61, 95% CI: 1.63, 4.19) were significantly associated with the treatment success of TB/HIV co-infection patients. Other factors such as age, comorbid, sputum smear and x-ray findings were not significantly factors in this study.
    Conclusion: Female patients and those with negative tuberculin test should be emphasised for successful tuberculosis treatment.
    Matched MeSH terms: Latent Tuberculosis
  14. Fulltext A rare case of Tuberculous Prostatitis
    Nurul Yaqeen Esa, Mohammad Hanafiah, Marymol Koshy, Hilmi Abdullah, Ahmad Izuanuddin Ismail, Mohamed Fauzi Abdul Rani
    Journal of Clinical and Health Sciences, 2016;1:33-36.
    Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.
    Matched MeSH terms: Latent Tuberculosis
  15. Fulltext A rare case of Tuberculous Prostatitis
    Nurul Yaqeen Esa, Mohammad Hanafiah, Marymol Koshy, Hilmi Abdullah, Ahmad Izuanuddin Ismail, Mohamed Fauzi Abdul Rani
    Journal of Clinical and Health Sciences, 2016;1(2):33-36.
    MyJurnal
    Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.
    Matched MeSH terms: Latent Tuberculosis
  16. Fulltext Diagnosis and management of latent tuberculosis infection in Asia: Review of current status and challenges
    Paton NI, Borand L, Benedicto J, Kyi MM, Mahmud AM, Norazmi MN, et al.
    Int J Infect Dis, 2019 Oct;87:21-29.
    PMID: 31301458 DOI: 10.1016/j.ijid.2019.07.004
    Asia has the highest burden of tuberculosis (TB) and latent TB infection (LTBI) in the world. Optimizing the diagnosis and treatment of LTBI is one of the key strategies for achieving the WHO 'End TB' targets. We report the discussions from the Asia Latent TubERculosis (ALTER) expert panel meeting held in 2018 in Singapore. In this meeting, a group of 13 TB experts from Bangladesh, Cambodia, Hong Kong, India, Indonesia, Malaysia, Myanmar, the Philippines, Singapore, Taiwan, Thailand and Vietnam convened to review the literature, discuss the barriers and propose strategies to improve the management of LTBI in Asia. Strategies for the optimization of risk group prioritization, diagnosis, treatment, and research of LTBI are reported. The perspectives presented herein, may help national programs and professional societies of the respective countries enhance the adoption of the WHO guidelines, scale-up the implementation of national guidelines based on the regional needs, and provide optimal guidance to clinicians for the programmatic management of LTBI.
    Matched MeSH terms: Latent Tuberculosis/diagnosis*; Latent Tuberculosis/drug therapy*; Latent Tuberculosis/epidemiology
  17. Fulltext Role of Mantoux test in the diagnosis of tuberculosis
    Loh KY
    Malays Fam Physician, 2011;6(2):85-86.
    PMID: 25606232 MyJurnal
    Mantoux test is a sensitive but non-specific in the diagnosis of active tuberculosis. The positive cut-off of 10 mm in a person without BCG and 15 mm with previous BCG is appropriate. The interpretation of Mantoux needs to be correlated to the patient’s clinical context. Mantoux test may have a role in assisting extrapulmonary tuberculosis and latent tuberculosis in children.
    Matched MeSH terms: Latent Tuberculosis
  18. Genomic plasticity between human and mycobacterial DNA: A review
    Danjuma L, Ling MP, Hamat RA, Higuchi A, Alarfaj AA, Marlina, et al.
    Tuberculosis (Edinb), 2017 12;107:38-47.
    PMID: 29050770 DOI: 10.1016/j.tube.2017.03.006
    Mycobacterium tuberculosis has a remarkable ability of long-term persistence despite vigorous host immunity and prolonged therapy. The bacteria persist in secure niches such as the mesenchymal stem cells in the bone marrow and reactivate the disease, leading to therapeutic failure. Many bacterial cells can remain latent within a diseased tissue so that their genetic material can be incorporated into the genetic material of the host tissue. This incorporated genetic material reproduces in a manner similar to that of cellular DNA. After the cell division, the incorporated gene is reproduced normally and distributed proportionately between the two progeny. This inherent adoption of long-term persistence and incorporating the bacterial genetic material into that of the host tissue remains and is considered imperative for microbial advancement and chemotherapeutic resistance; moreover, new evidence indicates that the bacteria might pass on genetic material to the host DNA sequence. Several studies focused on the survival mechanism of M. tuberculosis in the host immune system with the aim of helping the efforts to discover new drugs and vaccines against tuberculosis. This review explored the mechanisms through which this bacterium affects the expression of human genes. The first part of the review summarizes the current knowledge about the interactions between microbes and host microenvironment, with special reference to the M. tuberculosis neglected persistence in immune cells and stem cells. Then, we focused on how bacteria can affect human genes and their expression. Furthermore, we analyzed the literature base on the process of cell death during tuberculosis infection, giving particular emphasis to gene methylation as an inherited process in the neutralization of possibly injurious gene components in the genome. The final section discusses recent advances related to the M. tuberculosis interaction with host epigenetic circuitry.
    Matched MeSH terms: Latent Tuberculosis/drug therapy; Latent Tuberculosis/genetics*; Latent Tuberculosis/immunology; Latent Tuberculosis/microbiology*
  19. Fulltext Understanding the tuberculosis disease progression and future directions of research in tuberculosis: a mini review
    Siti, H.N., Syarifah-Noratiqah, S.B., Zulfarina, M.S., Isa, N.M., Kamisah, Y.
    Medicine & Health, 2018;13(1):20-28.
    MyJurnal
    Eradication of tuberculosis seems to be a long way off especially with the growing of drug resistance tuberculosis and HIV co-infection tuberculosis. The gaps in our knowledge and the limited sensitive and specific biomarkers especially for latent tuberculosis infection make it defensive. The fate of tuberculosis treatment ranged from cured to failure and there are many risk factors involved apart from the immune state and age. Therefore, this review focuses on the understanding of tuberculosis disease progression and the associated risk factors of the events in the disease progression. This article also highlights the diagnostic and predictive marker that may predict the disease progression. In addition, this review highlights the potential use of rifabutin in tuberculosis treatment regimen. It is hoped that this review could give an overview on future directions of research in tuberculosis.
    Matched MeSH terms: Latent Tuberculosis
  20. Fulltext Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective
    Tan L, Kamarulzaman A
    Biomed Imaging Interv J, 2006 Jan;2(1):e3.
    PMID: 21614220 MyJurnal DOI: 10.2349/biij.2.1.e3
    Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.
    Matched MeSH terms: Latent Tuberculosis
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