Encuestas telefónicas para el estudio de costos catastróficos por tuberculosis en Colombia: una herramienta innovadora / Telephone surveys for the study of catastrophic costs due to tuberculosis in Colombia: a novel tool / Pesquisas telefônicas para um estudo de custos catastróficos da tuberculose na Colômbia: uma ferramenta inovadora

[RESUMEN]. El estudio de costos catastróficos que experimentan las personas afectadas por tuberculosis realizado en Colombia durante la pandemia de COVID-19 trajo consigo la oportunidad de implementar encuestas telefónicas como medio para la recopilación de información. Lo anterior se constituye como una innovación metodológica en los estándares establecidos por la Organización Mundial de la Salud (OMS) que, para este tipo de estudios, suelen tener base en el empleo de encuestas cara a cara con los pacientes que acuden a las instalaciones de salud. El diseño del estudio, sus objetivos y metodología fueron adaptados del manual práctico para la realización de encuestas de costos de la tuberculosis de la OMS. Se seleccionaron 1 065 personas afectadas por tuberculosis como participantes del estudio, a quienes se les administró de manera telefónica el cuestionario estándar adaptado al contexto colombiano. Fue posible obtener datos estructurados sobre los costos directos e indirectos que enfrentan los pacientes con tuberculosis y sus familias; de manera general, se observó que todas las variables de recopilación alcanzaron una completitud mayor a 80%, con un tiempo promedio de encuesta de 40 minutos y una tasa de rechazo de 8%. La metodología de encuestas telefónicas desarrollada para determinar la línea base del estudio de costos catastróficos en Colombia resultó innovadora por el formato telefónico, que mantiene los estándares de información requerida para permitir estimaciones comparables a nivel internacional, y es un medio útil en la generación de resultados estandarizados en eventos en los cuales existe limitación para la realización de encuestas cara a cara.

[ABSTRACT]. The study of catastrophic costs incurred by people affected by tuberculosis (TB), conducted in Colombia during the COVID-19 pandemic, provided the opportunity to implement telephone surveys for data collection. This constitutes a methodological innovation regarding the standards established by the World Health Organization (WHO) which, for this type of study, usually rely on face-to-face surveys of patients attending health facilities. The study design, objectives, and methodology were adapted from the WHO publication Tuberculosis patient cost surveys: a handbook. A total of 1065 people affected by tuberculosis were selected as study participants and, by telephone, were administered a standard questionnaire adapted to the Colombian context. This allowed the collection of structured data on the direct and indirect costs faced by TB patients and their families. Greater than 80% completeness was achieved for all variables of interest, with an average survey duration of 40 minutes and a rejection rate of 8%. The described survey method to determine the baseline for further study of catastrophic costs in Colombia was novel because of its telephone-based format, which adheres to the information standards required to allow internationally comparable estimates. It is a useful means of generating standardized results in contexts in which the ability to conduct face-to-face surveys is limited.

[RESUMO]. O estudo dos custos catastróficos incorridos pelas pessoas afetadas pela tuberculose realizado na Colômbia durante a pandemia de COVID-19 representou uma oportunidade de implementar pesquisas telefônicas como forma de coleta de dados. Constitui-se uma inovação metodológica dos padrões estabelecidos pela Organização Mundial da Saúde (OMS), que, para esse tipo de estudo, geralmente se baseiam no uso de pesquisas presenciais com os pacientes que frequentam estabelecimentos de saúde. O delineamento, os objetivos e a metodologia do estudo foram adaptados do manual prático da OMS para a realização de pesquisas de custos da tuberculose. Um total de 1065 pessoas afetadas pela tuberculose foram selecionadas para participar do estudo. O questionário padrão, adaptado ao contexto colombiano, foi aplicado pelo telefone. Foi possível obter dados estruturados sobre os custos diretos e indiretos enfrentados pelos pacientes com tuberculose e suas famílias. Em geral, observou-se que todas as variáveis de coleta atingiram uma completude de mais de 80%, com um tempo médio de pesquisa de 40 minutos e uma taxa de recusa de 8%. A metodologia de pesquisa telefônica desenvolvida para determinar a linha de base do estudo de custos catastróficos na Colômbia foi inovadora devido ao formato telefônico, que mantém os padrões de informação necessários para permitir estimativas comparáveis internacionalmente e é uma forma útil de gerar resultados padronizados em circunstâncias em que há limitações para a realização de pesquisas presenciais.

Facilitators and barriers to adolescent participation in a TB clinical trial.

The inclusion of adolescents in TB drug trials is essential for the development of safe, child-friendly regimens for the prevention and treatment of TB. TB Trials Consortium Study 31/AIDS Clinical Trials Group A5349 (S31/A5349) enrolled adolescents as young as 12 years old. We assessed investigator and coordinator described facilitators and barriers to adolescent recruitment, enrollment, and retention.Interviews were conducted with six investigators from sites that enrolled adolescent participants and six investigators from non-enrolling sites. Additionally, two focus groups were conducted with study coordinators from enrolling sites and two focus groups with non-enrolling sites. Discussions were transcribed, analyzed, summarized, and summaries were reviewed by Community Research Advisors Group members and research group representatives for content validity.Investigators and coordinators attributed the successful enrollment of adolescents to the establishment and cultivation of external partnerships, flexibility to accommodate adolescents' schedules, staff engagement, recruitment from multiple locations, dedicated recruitment staff working onsite to access potential participants, creation of youth-friendly environments, and effective communications. Non-enrolling sites were mainly hindered by regulations. Suggestions for improvement in future trials focused on study planning and site preparations.Proactive partnerships and collaboration with institutions serving adolescents helped identify and reduce barriers to their inclusion in this trial..

Research of Russian physicians' opinions on tuberculosis pharmacogenetics.

BACKGROUND: There is currently no widespread implementation of pharmacogenetic testing (PGx) methods in the practice of phthisiology service. OBJECTIVE: The aim of this study is to determine how informed and prepared phthisiologists, residents, and postgraduate students of the Russian Medical Academy of Continuing Professional Education (RMACPE, Moscow) use PGx techniques in their work to improve treatment safety, predict the occurrence of adverse reactions (ADRs), and personalize therapy. METHODS: A survey was conducted among phthisiologists (n = 314) living in different regions of the Russian Federation and studying at RMACPE, such as residents and post-graduate students (n = 185). The survey was developed on the Testograf.ru web platform and had 25 questions for physicians and 22 for residents and post-graduate students. RESULTS: More than 50% of respondents are ready to use PGx in clinical practice and thus are aware of the method's possibilities. At the same time only a small part of participants were aware of the pharmgkb.org resource. The absence of PGx in clinical guidelines and treatment standards, according to 50.95% of phthisiologists and 55.13% of students of RMACPE, the absence of large-scale randomized clinical trials, according to 37.26% of phthisiologists and 43.33% of students, and the lack of physician knowledge on PGx, according to 41.08% of phthisiologists and 57.83% of students, are all factors that prevent the implementation of PGx in Russia. CONCLUSION: According to the survey, the overwhelming majority of participants recognize the importance of PGx and are willing to use the method in practice. However, there is a low level of awareness among all respondents about the possibilities of PGx and the pharmgkb.org resource. The implementation of this service could significantly increase patient compliance, lower ADRs, and enhance anti-tuberculosis (TB) therapy quality.

Emerging trends, collaboration, and impact of global scientific production on tuberculosis and human immunodeficiency virus coinfection: A bibliometric study.

Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) coinfection represents a serious public health problem that requires new approaches for its prevention and comprehensive management. Therefore, the aim of this study was to analyze the bibliometric profile of the worldwide scientific production on TB and HIV coinfection. Methods: Bibliometric study that retrieved publications indexed in Scopus, from the design of a search strategy based on Medical Subject Heading terms and logical operators. The sample consisted of 219 articles, whose metadata were analyzed with SciVal, VOSviewer, and RStudio. Results: Between 2017 and 2018, there was a notorious interest in the interrelationship between HIV and TB, as well as in the role of Mycobacterium tuberculosis in the context of acquired immunodeficiency syndrome. The United States and South Africa clustered the most publications. On the other hand, the most productive authors have a US Institution affiliation, Brust James CM and Gandhi Neel R had seven publications. The categories of "Infectious Diseases" and "Microbiology (medical)" accumulated 94 and 35 publications. In addition, the most productive journals were PLOS One and the International Journal of TB and Lung Disease, while clinical infectious diseases had the best CiteScore 2021 (17.3). Conclusions: Scientific production has been mainly disseminated in high-impact journals, with a slight increase in recent years. The United States is the leading and most influential country, followed by South Africa; in addition, Brust James CM, an American National, is recognized as the most productive.

Trends, collaboration, and visibility of global scientific production on birth complications in pregnant women with tuberculosis: A scientometric study.

Background: The increase in the number of pregnant women with tuberculosis is an important factor that should be analyzed at present. Thus, It is important to evaluate the bibliometric characteristics of the scientific production indexed in Scopus on complications of pregnancy and childbirth in pregnant women with tuberculosis. Methods: A cross-sectional bibliometric study was carried out analyzing the publications of journals indexed in Scopus between January 2016 and May 2022. A search strategy was developed using MESH terms and Boolean operators. The SciVal program (Elsevier) was used for bibliometric analysis of the information in the documents. Results: Of the 287 publications analyzed, 13 were in the International Journal of Tuberculosis and Lung Disease and BJOG: An International Journal of Obstetrics and Gynaecology presented 11.9 citations per publication. Gupta Amita, from the United States, presented the most published papers; however, Myer London, from South Africa, had the highest impact, with 17.8 citations per publication. Johns Hopkins University was the institution with the highest number of publications (34). 51.9% of the publications were in journals in the Q1 quartile while 41.8% were international collaborations. Conclusions: In each year analyzed, scientific production was similar, with the highest proportion of publications in journals located in the Q1 and Q2 quartile. The institutions with the highest production were from the United States and South Africa. Therefore, there is a need to promote collaborative production in countries with greater presence of this disease.

Norma técnica de salud para el cuidado integral de la persona afectada por tuberculosis, familia y comunidad (NTS N° 200-MINSA/DGIESP-2023) / Technical health standard for the comprehensive care of the person affected by tuberculosis, family and community (NTS N° 200-MINSA/DGIESP-2023)

La presente publicación describe los criterios clínicos y programáticos, así como los procedimientos técnicos de las intervenciones sanitarias en el cuidado integral por curso de vida de la prevención y control de la tuberculosis en la población afectada o con factores de riesgo. Asimismo, incorpora importantes avances e innovaciones para la prevención y control de la tuberculosis, basadas en las recomendaciones brindadas por los organismos internacionales de salud y evidencias científicas, aplicadas a la realidad nacional. Así, incluye la introducción de metodología molecular en el diagnóstico de esta enfermedad, el uso de nuevos medicamentos para la terapia preventiva, esquemas totalmente orales y acortados para el tratamiento de la tuberculosis resistente, un mayor involucramiento de los actores comunitarios en la prevención y la detección de la tuberculosis, así como su participación activa en las diversas intervenciones estratégicas

The development of the national tuberculosis research priority in Indonesia: A comprehensive mixed-method approach.

Ranked second in global tuberculosis (TB) incidence, Indonesia has developed a National Strategy for TB Prevention and Control 2020-2024 to accelerate the TB elimination program. Research and innovation are key pillars to support the program and need to be prioritised. This study aimed to develop updated national TB research priorities in Indonesia. This study was a mixed-methods study consisting of an open survey, a published literature survey, and Delphi survey. The open survey invited all related TB stakeholders to answer (a) the main barriers of the TB program and (b) the need for studies to support TB elimination. The published literature survey retrieved scientific articles published in national and international journals between 2015 and 2020 to identify gaps between published research and the current national strategy for TB control. The online survey and literature survey informed a panel of TB experts in a two-phase Delphi Survey to select the top 10 priority research topics. We identified 322 articles and analysed 1143 open survey responses. Through two-phases Delphi surveys, top ten research categories were listed: early TB detection; diagnosis and treatment of DR-TB; contact investigation; case detection and treatment of child TB; TB preventive therapy; government policy; laboratory for drug-sensitive- and drug-resistant-TB diagnosis; treatment adherence; diagnostic tool development; and community empowerment. This study also found the gap between stakeholders' interests and the importance of translating research into policy and practice. TB research priorities have been identified through the involvement of various stakeholders. The combination of an online survey, a published literature survey, and a Delphi survey was a rigorous methodology and was fit to build a systematic consensus about the priority of TB research.

Mycobacterial Death and Resurrection: paradigm shifts in disease understanding.

This article examines two medical journal research articles on tuberculosis, one published in 1938 and the other in 2014. The two articles, which use animal models to understand aspects of tuberculosis mycobacteria survival in the lungs, rely on markedly different research and biotechnological techniques, reach somewhat opposite conclusions, and reflect different paradigms of tuberculosis pathogenesis: the 1938 article (indirectly invoking Koch's postulates) was written before the paradigm of so-called "latent" and "reactivation" tuberculosis became widely adopted, while the 2014 article (indirectly invoking the molecular equivalents to Koch's postulates) works within that paradigm but implicitly questions it. Despite this, both articles exhibit fascinating similarities in terms of how their authors tackled their research questions, formulated their results, and framed their research methodologies. These similarities reflect both the reliance on tenets of the scientific method but also the value of paradigms of disease causation. Using tuberculosis as an example, this article concludes with remarks about how disease paradigms evolve and can stimulate research that leads to advances in disease understanding.

Scientometric analysis of the world scientific production on tuberculosis associated with COVID-19.

Background: Nowadays, tuberculosis and COVID-19 are the principal infections around the world. This study aimed to determine the global scientific production on COVID-19 associated to tuberculosis during the period 2019-2020. Methods: For the collection of metadata on COVID-19 associated to tuberculosis, the Scopus database was used, considering the period 2019-2020, with the last day of update being September 13, 2021. The main authors, countries, institutions, journal metrics, and documents were extracted. The Scival tool was used for the scientometric analysis of the data. Results: A total of 464 papers were retrieved where it was found that universities in South Africa, the United States, and England led the world's scientific production. The International Journal of Tuberculosis and Lung Disease was the journal with the highest production and The Lancet Global Health was the journal with the most citations per publication. On the other hand, most papers were published in Q1 journals, with infectious diseases within the area of medicine being the most addressed. Conclusion: South African universities lead the world in scientific output. Most of the research on this topic has been published in Q1 journals, with collaboration being largely national. Further analysis is needed in the aftermath of the pandemic.

Screening and testing for latent tuberculosis infection among patients who are immunocompromised.

ABSTRACT: It is critical to detect latent tuberculosis infection through screening and testing individuals at high risk of progression to active tuberculosis, including patients who are immunocompromised. NPs should be familiar with available testing for accurate diagnosis in order to expedite treatment.

Prioridades Nacionales de Investigación en Tuberculosis en el Perú 2022-2025 / National Research Priorities in Tuberculosis in Peru 2022-2025

El documento contiene los objetivos estratégicos en cuanto a las prioridades nacionales de Investigación en Tuberculosis en el Perú del 2022 al 2025.