Tuberculosis, HIV, and viral hepatitis diagnostics in eastern Europe and central Asia: high time for integrated and people-centred services

Dara, Masoud; Ehsani, Soudeh; Mozalevskis, Antons; Vovc, Elena; Simões, Daniel; Avellón, Ana; Barbarà, Jordi Casabona i; Chokoshvili, Otar; Felker, Irina; Hoffner, Sven; Kalmambetova, Gulmira; Noroc, Ecatarina; Shubladze, Natalia; Skrahina, Alena; Tahirli, Rasim; Tsertsvadze, Tengiz; Drobniewski, Francis

doi:10.1016/s1473-3099(19)30524-9

Cited by 18 publications

(18 citation statements)

References 39 publications

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“…function separately. As TB/HIV coinfection affect the most vulnerable groups more severely, further efforts shall be made to provide integrated testing and treatment [9]. Davtyan et al, presenting the rather high mortality of TB/HIV coinfected individuals as well as high lost to follow-up of migrants remind us once more of the importance of the need for specific interventions for the key population [10].…”

Section: Smentioning

confidence: 99%

“Nothing for or about us, without us”, focus on key populations to end tuberculosis and its coinfection

Dara

Avanesova²,

Aslanyan

2020

J Infect Dev Ctries

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Section: Smentioning

confidence: 99%

“Nothing for or about us, without us”, focus on key populations to end tuberculosis and its coinfection

Dara

Avanesova²,

Aslanyan

2020

J Infect Dev Ctries

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“…Reducing morbidity and mortality from HIV-associated TB requires strong collaborative activities between TB and HIV programmes and services at all levels with integrated peoplecentred models of care [6,7]. The WHO issued policy guidelines on three distinct objectives of collaboration: establishing and strengthening mechanisms for integrated delivery of TB and HIV services; reducing the burden of TB among people living with HIV (PLHIV) and initiating early ART; and reducing the burden of HIV among people with presumptive TB (i.e., people with signs and symptoms of TB but not bacteriologically confirmed) by offering regular HIV testing [8].…”

Section: Introductionmentioning

confidence: 99%

“…Legido-Quigley et al described models of collaborative TB and HIV service delivery with increasing levels of integration [9]. Some countries in the Region have reported on successful collaboration and integration of TB and HIV services [7,10,11]. However, it is not known what models and levels of integration are applied in the majority of the Region's countries and territories and how the prevention and care services for the two diseases collaborate.…”

Section: Introductionmentioning

confidence: 99%

Collaborative tuberculosis/HIV activities in the European Region

Vries

Berg

Dam³

et al. 2020

ERJ Open Res

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IntroductionAn estimated 12% of tuberculosis (TB) patients are coinfected with HIV in the World Health Organisation European Region (Region). Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with integrated people-centred models of care.MethodsWe collected information on the current models of integration of TB and HIV services in the Region via a comprehensive survey among the TB and HIV National Focal Points, and identified challenges and opportunities.ResultsForty-seven of 55 countries (85%) responded. HIV testing in all TB patients and screening for active TB in all people living with HIV (PLHIV) was recommended in 40 (85%) and 34 (72%) respectively. Thirty countries (64%) recommended latent TB infection (LTBI) screening in all PLHIV, while 13 (28%) had a selective approach and 4 countries (9%) did not recommend LTBI screening. In most countries testing for HIV and screening for active TB and LTBI was done by the specialist that is treating the patient, i.e. TB patients were tested for HIV by a TB specialist in 42 countries (89%) and PLHIV were screened for active TB by an HIV specialist in 34 countries (72%).ConclusionTB and HIV care are well integrated in policies of especially high TB and high HIV burden countries. Implementation though needs to be improved. Continuous monitoring of HIV and TB services integration enables assessing the quality of HIV/TB care and to identify where further improvements are needed.

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“…Tuberculosis (TB) is a global health disease caused by infection with Mycobacterium tuberculosis (MTB), despite its advanced developments in diagnosis and therapy [1]. In 2018, 10.0 million people were diagnosed with tuberculosis worldwide.…”

Section: Introductionmentioning

confidence: 99%

Mean Platelet Volume (MPV): New diagnostic indices for co-morbidity of Tuberculosis and Diabetes Mellitus

xu¹,

qu²,

Wang³

et al. 2020

Preprint

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Background: Tuberculosis (TB) and type 2 diabetes mellitus (DM) are global health diseases with high morbidity and mortality. Few studies have focused on platelet indices in TB-DM coinfection patients. The objective of this work was to analyze the platelet indices in TB, DM and TB-DM patients to assess the predictive value of the platelet index for the risk of these diseases.Methods: In total, 246 patients admitted to our hospital were distributed into three groups (113 TB, 59 DM and 74 TB+DM). A total of 133 individuals were also recruited as healthy controls (HC). Platelet indices, namely, platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW), were compared among the four groups, and the relationship with inflammatory markers was explored by using statistical software.Results: Our study discovered that MPV and PCT were significantly downregulated in TB+DM patients (9.95±1.25 fL, 0.20±0.05%, P<0.0001, P=0.0121, separately) compared with DM individuals (10.92±1.17 fL, 0.22±0.04%). Moreover, the changes in MPV were significantly higher in TB+DM patients (9.95±1.25 fL, P=0.0041) than in TB patients (9.42±1.01 fL). No differences were found in PLT and PDW among the four groups (P>0.05). The sensitivity and specificity of MPV in the differential diagnosis of DM patients vs TB+DM patients were 64.9% and 66.1% (P<0.0001), respectively, and the sensitivity and specificity of MPV between TB patients and TB+DM patients was 60.8% and 66.4%, respectively (P=0.003). MPV improved the diagnosis sensitivity when it was combined with clinical parameters, such as fasting blood glucose in DM and Mycobacterium tuberculosis culture result in TB (76.3% vs 64.9%, 72.6% vs 60.8%, P<0.0001, P=0.001, respectively). In addition, the sensitivity and specificity of PCT in the differential diagnosis of DM patients vs TB+DM patients were 69.5% and 59.4%, respectively (P=0.008). PCT improved the diagnosis sensitivity when combined with fasting blood glucose in DM (72.9% vs 64.9%, P=0.004). In addition, MPV was linked to CRP (C-reactive protein) [Ed1] and ESR (erythrocyte sedimentation rate) in the TB+DM patients (r = 0.3203, P =0.0054, r = 0.2504, P=0.0307) but PCT was not (r = 0.1905, r = 0.008675, P>0.05, respectively).Conclusions: Our research shows that MPV and PCT might be good clinical laboratory markers to distinguish TB+DM patients from TB or DM individuals, thus providing support for earlier clinical diagnosis, prevention, and therapy.When defining abbreviations and acronyms, please be consistent in whether it is the abbreviated or spelled-out form that appears in parentheses. Some journals request a specific style, so please review the journal's guidelines.

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Tuberculosis, HIV, and viral hepatitis diagnostics in eastern Europe and central Asia: high time for integrated and people-centred services

Cited by 18 publications

References 39 publications

“Nothing for or about us, without us”, focus on key populations to end tuberculosis and its coinfection

“Nothing for or about us, without us”, focus on key populations to end tuberculosis and its coinfection

Collaborative tuberculosis/HIV activities in the European Region

Mean Platelet Volume (MPV): New diagnostic indices for co-morbidity of Tuberculosis and Diabetes Mellitus

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