BACKGROUND:There is limited data about the performance of QuantiFERON-TB Gold (QFT-G) test in detecting latent tuberculosis infection (LTBI) in our region. We intended to determine the performance of QFT-G compared to conventional tuberculin skin test (TST) in detecting LTBI in HIV-positive individuals in Iran.METHODS:This study was conducted in a HIV clinic in Tehran, Iran in April 2007. A total of 50 consecutive HIV-positive patients, not currently affected with active tuberculosis (TB), were recruited; 43 (86%) were male. The mean age was 38 ± 7.2 years (21–53). All had history of Bacillus Calmette Guerin (BCG) vaccination. A TST with purified protein derivative (PPD) and whole-blood interferon-gamma release assay (IGRA) in reaction to ESAT-6 and CFP-10 antigens was performed and measured by enzyme-linked immuno-sorbent assay (ELISA). The agreement between TST and QFT-G results were analyzed using Kappa test.RESULTS:A total of 36 (72%) patients had negative and 14 (28%) revealed positive TST. For QFT-G, 20 (40%) tested positive, 19 (38%) tested negative, and the results in 11 cases (22%) were indeterminate. A total of 14 (28%) patients had a CD4 count of <200. Of the 14, TST + group, 12 had QFT-G +, only one case TST+/QFT-G-, and QFT-G was indeterminate in one TST positive case. Of the 36 patients with negative TST tests, 8 (22%) had positive GFT-G and 10 (28%) yielded indeterminate results. There was no association between a positive TST and receiving highly active anti-retroviral therapy (HAART) or absolute CD4 counts. Similarly, the association between QFT-G results and receiving HAART or CD4 counts was not significant (P = 0.06). Although TST results were not significantly different in patients with CD4 < 200 vs. CD4 >200 (P = 0.295), association between QFT-G results and CD4 cutoff of 200 reached statistical significance (P = 0.027). Agreement Kappa coefficient between TST and QFT-G was 0.54 (Kappa = 0.54, 95% CI = 38.4-69.6,P < 0.001).CONCLUSION:Detecting LTBI in HIV-positive individuals showed moderate agreement between QFT-G and LTBI in our study. Interestingly, our findings revealed that nontuberculous mycobacteria and prior BCG vaccination have minimal influence on TST results in HIV patients in Iran.

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Introduction: Sexually transmitted infections (STIs) incidence, as most common acute diseases in the world, has been increasing. We investigated knowledge, attitude, and practice (KAP) of healthcare staff, including physicians and healthcare providers, such as health professionals and midwifes. Material and methods:In this cross sectional study, self-made questionnaire was applied. Data collection was performed between September and November 2019. Participants were selected using stratified random sampling method, and 226 healthcare staff were included in the study. Mann-Whitney and Kruskal-Wallis tests were used to compare median and interquartile range (IQR) score of KAP among participants. KAPs were classified into poor, moderate, and desirable. Data were analyzed in SPSS version 21.Results: Total median (interquartile range) score of KAP was 14 (4), 29 (8), 30 (9), respectively. Knowledge score of health professionals were low (52%), midwives and physicians scored average (74% and 75%, respectively). Most health professionals, midwives, and physicians scored moderate on attitudes (61%, 78%, and 80%, respectively). The results indicated that 60% of midwives performed well, with 46% of health professionals and 45% of physicians having mediocre performance. Conclusions:In this study, health professionals performed well, but their level of knowledge was low. This means that they perform well according to their duties, but did not have enough knowledge. Therefore, they need more training to improve the quality of their services.

In this study, PCR-RFLP analysis (PRA) of the gene encoding 65-kD heat shock protein (hsp65) was used for identification of 70 clinical NTM isolates obtained from two mycobacteriology laboratories in Malaysia. Approximately one third of the isolates were identified as M. fortuitum. A total of 24.3% and 10% of the isolates were identified as M. abscessus and M. avium complex respectively. Other isolates identified were M. kansasii, M. marinum, M. simiae, M. parascrofulaceum, M. szulgai, and M. gordonae. Six clinical isolates were untypable by this approach. Sequence analysis of the 439-bp region of the hsp65 gene and a 564-bp region of the 16S rRNA gene revealed high degrees (97%-100%) of sequence similarity of these isolates with ''M. insubricum'', M. terrae, M. senegalense/M. conceptionense and M. houstonense in the public sequence databases. This study reported the identification of mycobacteria species which are considered rare or new to this region. As NTM are found widely in the environment, the clinical significance of the isolates in this study is yet to be determined.