MyMedR

Noor KM, Shephard L, Bastian I

Pathology, 2015 Apr;47(3):250-6.

PMID: 25719854 DOI: 10.1097/PAT.0000000000000232

The phenotypic methods of smear microscopy, culture and indirect drug susceptibility testing (DST) remain the 'gold standard' diagnostics for tuberculosis (TB) in 2015. However, this review demonstrates that genotypic methods are in the ascendancy. Current-generation nucleic acid amplification tests (NAATs) are important supplementary tests for the rapid direct detection of (multidrug-resistant) TB in specific clinical settings. Genotypic detection is already the preferred method of detecting rifampicin and pyrazinamide resistance. Next-generation NAATs able to detect about 10 colony forming units/mL of sputum could replace culture as the initial test for detecting TB. Whole genome sequencing could also plausibly replace phenotypic DST but much work is required in method standardisation, database development and elucidation of all resistance gene determinants. The challenge then will be to rollout these increasingly complex and expensive diagnostics in the low-income countries where TB is prevalent.

Matched MeSH terms: Tuberculosis/diagnosis*

Fulltext Tuberculosis disease diagnosis using artificial immune recognition system

Shamshirband S, Hessam S, Javidnia H, Amiribesheli M, Vahdat S, Petković D, et al.

Int J Med Sci, 2014;11(5):508-14.

PMID: 24688316 DOI: 10.7150/ijms.8249

There is a high risk of tuberculosis (TB) disease diagnosis among conventional methods.

Matched MeSH terms: Tuberculosis/diagnosis*

RAIRS2 a new expert system for diagnosing tuberculosis with real-world tournament selection mechanism inside artificial immune recognition system

Saybani MR, Shamshirband S, Golzari S, Wah TY, Saeed A, Mat Kiah ML, et al.

Med Biol Eng Comput, 2016 Mar;54(2-3):385-99.

PMID: 26081904 DOI: 10.1007/s11517-015-1323-6

Tuberculosis is a major global health problem that has been ranked as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus. Diagnosis based on cultured specimens is the reference standard; however, results take weeks to obtain. Slow and insensitive diagnostic methods hampered the global control of tuberculosis, and scientists are looking for early detection strategies, which remain the foundation of tuberculosis control. Consequently, there is a need to develop an expert system that helps medical professionals to accurately diagnose the disease. The objective of this study is to diagnose tuberculosis using a machine learning method. Artificial immune recognition system (AIRS) has been used successfully for diagnosing various diseases. However, little effort has been undertaken to improve its classification accuracy. In order to increase the classification accuracy, this study introduces a new hybrid system that incorporates real tournament selection mechanism into the AIRS. This mechanism is used to control the population size of the model and to overcome the existing selection pressure. Patient epacris reports obtained from the Pasteur laboratory in northern Iran were used as the benchmark data set. The sample consisted of 175 records, from which 114 (65 %) were positive for TB, and the remaining 61 (35 %) were negative. The classification performance was measured through tenfold cross-validation, root-mean-square error, sensitivity, and specificity. With an accuracy of 100 %, RMSE of 0, sensitivity of 100 %, and specificity of 100 %, the proposed method was able to successfully classify tuberculosis cases. In addition, the proposed method is comparable with top classifiers used in this research.

Matched MeSH terms: Tuberculosis/diagnosis*

Fulltext Tuberculous infection

Ch'ng EC, Hooi LN, Halimah Y, Syed J

Med J Malaysia, 1997 Mar;52(1):91-3.

PMID: 10968062

A female patient presenting with post-prandial epigastric pain and weight loss was diagnosed to have oesophageal tuberculosis by endoscopic biopsy. She responded well to standard anti-tuberculosis treatment.

Matched MeSH terms: Tuberculosis/diagnosis*

Fulltext Tuberculous encephalopathy in Sabah children

Ng LF

Med J Malaysia, 1985 Dec;40(4):289-93.

PMID: 3842728

A series of 18 cases of tuberculous encephalopathy (TBE) in children studied between June 1983 and October 1984 at Queen Elizabeth Hospital, Kota Kinabalu is presented. The data suggest that: the incidence is not as rare as previously thought; the occurrence of TBE is related to the absence of BCG vaccination; the presentation is often late; laboratory data, although helpful is not often confirmatory; early treatment is the key to better outcome; the clinical picture should outweigh laboratory diagnosis in the initial assessment and management.

Matched MeSH terms: Tuberculosis/diagnosis*

Effect of delay in diagnosis on the rate of tuberculosis among close contacts of tuberculosis patients

Aldhubhani AH, lzham MI, Pazilah I, Anaam MS

East Mediterr Health J, 2013 Oct;19(10):837-42.

PMID: 24313146

Few studies have explored diagnosis delay by tuberculosis (TB) patients and its effects on the rate of infection among their close contacts. A cross-sectional study of the close contacts of 505 newly diagnosed TB patients was conducted in a TB referral centre in Sana'a, Yemen from 2008 to 2010. Only the close contacts of 89 new TB patients agreed to participate and completed the tuberculin skin test (TST). Of the 239 close contacts investigated, 133 (55.6%) had a positive TST result. Index patients were classified as long or short diagnosis delay (above or below the median). There was no significant difference in the number of infected close contacts between long and short delay index patients (Mann-Whitney U-test). A larger sample size, with more incentives for patients to participate and the use of other investigative tools could provide a better picture of the pattern of TB transmission among all contacts.

Matched MeSH terms: Tuberculosis/diagnosis*

Fulltext Tuberculosis of gallbladder with candidiasis, a rare entity

Leong BD, Chan KW, Ramu P, Kumar VM, Chuah JA

Med J Malaysia, 2011 Jun;66(2):146-7.

PMID: 22106698 MyJurnal

Gallbladder tuberculosis (GT) is an extremely rare condition. This is thought to be due to the protective property of bile against the infection. Clinical and radiological diagnosis of GT is difficult. We describe a case of GT who initially presented to us with jaundice, a right hypochondrial mass and computed tomographic findings suggestive of gallbladder empyema. Diagnosis was made from histopathological examination of the resected gallbladder which revealed epitheloid granulomas with caseating necrosis and presence of Langhan's giant cells. From a literature search and to the best of our knowledge, this is the first GT to be reported in South East Asia.

Matched MeSH terms: Tuberculosis/diagnosis*

Fulltext Clinical significance of Mantoux test in Malaysian patients

Yaacob I, Ahmad Z

Med J Malaysia, 1990 Sep;45(3):231-4.

PMID: 2152084

The value of tuberculin skin testing in the diagnosis of active tuberculosis remains uncertain. Interpretation of tuberculin tests would be easier if the tuberculin test profiles in different communities were accurately known. We reviewed 468 Mantoux test reactions in patients coming to Hospital Universiti Sains Malaysia with suspected tuberculosis. Eighty six percent of patients with active tuberculosis had a positive Mantoux test. Forty two percent of the cases of positive Mantoux test did not have evidence of active tuberculosis. Most of these cases had evidence of past infection with tuberculosis. We conclude that Mantoux test is a sensitive but a non-specific test in the diagnosis of active tuberculosis.
Study site: outpatients, inpatients; Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia

Matched MeSH terms: Tuberculosis/diagnosis*

Fulltext Guinea pig inoculation versus culture in the diagnosis of tuberculosis

Cheong YM, Jegathesan M

Med J Malaysia, 1983 Dec;38(4):350.

PMID: 6443797

Matched MeSH terms: Tuberculosis/diagnosis*

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*

Diagnostic accuracy of the Xpert® MTB/RIF cycle threshold level to predict smear positivity: a meta-analysis

Lange B, Khan P, Kalmambetova G, Al-Darraji HA, Alland D, Antonenka U, et al.

Int J Tuberc Lung Dis, 2017 05 01;21(5):493-502.

PMID: 28399963 DOI: 10.5588/ijtld.16.0702

SETTING: Xpert® MTB/RIF is the most widely used molecular assay for rapid diagnosis of tuberculosis (TB). The number of polymerase chain reaction cycles after which detectable product is generated (cycle threshold value, CT) correlates with the bacillary burden.OBJECTIVE To investigate the association between Xpert CT values and smear status through a systematic review and individual-level data meta-analysis.

DESIGN: Studies on the association between CT values and smear status were included in a descriptive systematic review. Authors of studies including smear, culture and Xpert results were asked for individual-level data, and receiver operating characteristic curves were calculated.

RESULTS: Of 918 citations, 10 were included in the descriptive systematic review. Fifteen data sets from studies potentially relevant for individual-level data meta-analysis provided individual-level data (7511 samples from 4447 patients); 1212 patients had positive Xpert results for at least one respiratory sample (1859 samples overall). ROC analysis revealed an area under the curve (AUC) of 0.85 (95%CI 0.82-0.87). Cut-off CT values of 27.7 and 31.8 yielded sensitivities of 85% (95%CI 83-87) and 95% (95%CI 94-96) and specificities of 67% (95%CI 66-77) and 35% (95%CI 30-41) for smear-positive samples.

CONCLUSION: Xpert CT values and smear status were strongly associated. However, diagnostic accuracy at set cut-off CT values of 27.7 or 31.8 would not replace smear microscopy. How CT values compare with smear microscopy in predicting infectiousness remains to be seen.

Matched MeSH terms: Tuberculosis/diagnosis*

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: implications for a comprehensive approach for integrated care

Al-Darraji HA, Wong KC, Yeow DG, Fu JJ, Loeliger K, Paiji C, et al.

J Subst Abuse Treat, 2014 Feb;46(2):144-9.

PMID: 24074846 DOI: 10.1016/j.jsat.2013.08.023

People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N=196) were mostly men (95%), under 40 (median age=36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR=1.1 for every entry, p<0.05) and not being HIV-infected (AOR=6.04, p=0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.

Matched MeSH terms: Tuberculosis/diagnosis*; Latent Tuberculosis/diagnosis*

Fulltext Disseminated tuberculosis masquerading primary myelodysplastic syndrome

Shaharir SS, Tumian NR, Yu Lin AB, Abdul Wahid SF

J Infect Dev Ctries, 2013 Mar;7(3):286-8.

PMID: 23493009 DOI: 10.3855/jidc.2691

Tuberculosis is notoriously known to be a great mimicker of other diseases and may cause various haematologic abnormalities, especially with marrow involvement. A 61-year-old man who presented with right empyema and pancytopenia was diagnosed to have disseminated tuberculosis supported by the presence of caseating granuloma with Langhan's giant cells in the marrow and demonstration of acid-fast bacilli in the pleural fluid. Trilineage dysplasia from marrow aspirate was initially attributed to be reactive to the infection. A cytogenetic study was repeated after he showed poor response to a year of anti-tuberculosis treatment. The underlying primary myelodysplastic syndrome was unmasked when his cytogenetics showed trisomy 8. This case report has demonstrated the various haematological manifestations of tuberculosis and highlighted the importance of cytogenetic study in differentiating between primary and secondary myelodysplastic marrow changes.

Matched MeSH terms: Tuberculosis/diagnosis*

A prospective study of mycobacterial viability in refrigerated, unpreserved sputum batched for up to 8 weeks

Rashid Ali MR, Parameswaran U, William T, Bird E, Wilkes CS, Lee WK, et al.

Int J Tuberc Lung Dis, 2015 May;19(5):620-1.

PMID: 25868033 DOI: 10.5588/ijtld.14.0938

Matched MeSH terms: Tuberculosis/diagnosis

Fulltext Tuberculin reactivity and subsequent development of tuberculosis in a cohort of student nurses

Jeyakumar D

Med J Malaysia, 1999 Dec;54(4):492-5.

PMID: 11072468

This retrospective study documents a strong correlation between tuberculin reactivity and the subsequent development of active tuberculosis in student nurses. 12% of the 25 student nurses with tuberculin reactions above 20 mm developed tuberculosis over a period of 2 years, compared to only 0.3% of the 341 student nurses with reactions of 20 mm or less. The implications of these findings for preventive therapy are discussed.

Matched MeSH terms: Tuberculosis/diagnosis*

Fulltext In Silico identification of M. TB proteins with diagnostic potential

Calero R, Mirabal M, Bouza J, Guzmán MV, Carrillo H, López Y, et al.

BMC Immunol, 2013;14 Suppl 1:S9.

PMID: 23458073 DOI: 10.1186/1471-2172-14-S1-S9

TB, caused by Mycobacterium tuberculosis (MTB), is one of the major global infectious diseases. For the pandemic control, early diagnosis with sensitive and specific methods is fundamental. With the advent of bioinformatics' tools, the identification of several proteins involved in the pathogenesis of TB (TB) has been possible. In the present work, the MTB genome was explored to look for molecules with possible antigenic properties for their evaluation as part of new generation diagnostic kits based on the release of cytokines. Seven proteins from the MTB proteome and some of their combinations suited the computational test and the results suggested their potential use for the diagnosis of infection in the following population groups: Cuba, Mexico, Malaysia and sub-Saharan Africa. Our predictions were performed using public bioinformatics tools plus three computer programs, developed by our group, to facilitate information retrieval and processing.

Matched MeSH terms: Tuberculosis/diagnosis*

Infections in post-tsunami victims

Othman N, Ismail IH, Yip R, Zainuddin Z, Kasim SM, Isa R, et al.

Pediatr Infect Dis J, 2007 Oct;26(10):960-1.

PMID: 17901807 DOI: 10.1097/INF.0b013e3181257234

Two tsunami survivors from Banda Acheh, Sumatra, presented with pyrexia of unknown origin and a nonresolving left-sided empyema, respectively. Both children had mixed infections of tuberculosis and melioidosis; Salmonella typhi was also present in the second patient. Mixed infections are common late sequela complications in post-tsunami victims.

Matched MeSH terms: Tuberculosis/diagnosis*

Congenital Tuberculosis Complicated by Hemophagocytic Lymphohistiocytosis

Osowicki J, Wang S, McKenzie C, Marshall C, Gard J, Ke Juin W, et al.

Pediatr Infect Dis J, 2016 Jan;35(1):108-10.

PMID: 26398869 DOI: 10.1097/INF.0000000000000932

We present the case of a male infant with congenital tuberculosis in a nonendemic setting complicated by hemophagocytic lymphohistiocytosis, who was treated successfully with antituberculous therapy and corticosteroids. We review the pediatric literature concerning the unusual association of these 2 rare conditions.

Matched MeSH terms: Tuberculosis/diagnosis

Development of an immunochromatographic lateral flow dipstick for the detection of Mycobacterium tuberculosis 16 kDa antigen (Mtb-strip)

Mohd Amiruddin MN, Ang GY, Yu CY, Falero-Diaz G, Otero O, Reyes F, et al.

J Microbiol Methods, 2020 09;176:106003.

PMID: 32702386 DOI: 10.1016/j.mimet.2020.106003

Mycobacterium tuberculosis (Mtb) is a pathogenic bacterium that causes tuberculosis (TB). This contagious disease remains a severe health problem in the world. The disease is transmitted via inhalation of airborne droplets carrying Mtb from TB patients. Early detection of the disease is vital to prevent transmission of the infection to people in close contact with the patients. To date, there is a need of a simple, rapid, sensitive and specific diagnostic test for TB. Previous studies showed the potential of Mtb 16 kDa antigen (Ag16) in TB diagnosis. In this study, lateral flow immunoassay, also called simple strip immunoassay or immunochromatographic test (ICT) for detection of Ag16 was developed (Mtb-strip) and assessed as a potential rapid TB diagnosis method. A monoclonal antibody against Ag16 was optimized as the capturing and detection antibody on the Mtb-strip. Parameters affecting the performance of the Mtb-strip were also optimized before a complete prototype was developed. Analytical sensitivity showed that Mtb-strip was capable to detect as low as 125 ng of purified Ag16. The analytical sensitivity of Mtb-strip suggests its potential usefulness in different clinical applications.

Matched MeSH terms: Tuberculosis/diagnosis*

Human tuberculosis and Mycobacterium tuberculosis complex: A review on genetic diversity, pathogenesis and omics approaches in host biomarkers discovery

Kanabalan RD, Lee LJ, Lee TY, Chong PP, Hassan L, Ismail R, et al.

Microbiol Res, 2021 May;246:126674.

PMID: 33549960 DOI: 10.1016/j.micres.2020.126674

Mycobacterium tuberculosis complex (MTBC) refers to a group of mycobacteria encompassing nine members of closely related species that causes tuberculosis in animals and humans. Among the nine members, Mycobacterium tuberculosis (M. tuberculosis) remains the main causative agent for human tuberculosis that results in high mortality and morbidity globally. In general, MTBC species are low in diversity but exhibit distinctive biological differences and phenotypes among different MTBC lineages. MTBC species are likely to have evolved from a common ancestor through insertions/deletions processes resulting in species speciation with different degrees of pathogenicity. The pathogenesis of human tuberculosis is complex and remains poorly understood. It involves multi-interactions or evolutionary co-options between host factors and bacterial determinants for survival of the MTBC. Granuloma formation as a protection or survival mechanism in hosts by MTBC remains controversial. Additionally, MTBC species are capable of modulating host immune response and have adopted several mechanisms to evade from host immune attack in order to survive in humans. On the other hand, current diagnostic tools for human tuberculosis are inadequate and have several shortcomings. Numerous studies have suggested the potential of host biomarkers in early diagnosis of tuberculosis, in disease differentiation and in treatment monitoring. "Multi-omics" approaches provide holistic views to dissect the association of MTBC species with humans and offer great advantages in host biomarkers discovery. Thus, in this review, we seek to understand how the genetic variations in MTBC lead to species speciation with different pathogenicity. Furthermore, we also discuss how the host and bacterial players contribute to the pathogenesis of human tuberculosis. Lastly, we provide an overview of the journey of "omics" approaches in host biomarkers discovery in human tuberculosis and provide some interesting insights on the challenges and directions of "omics" approaches in host biomarkers innovation and clinical implementation.

Matched MeSH terms: Tuberculosis/diagnosis*

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