Article
Immunology
Caroline M. Williams, Abdul K. Muhammad, Basil Sambou, Adama Bojang, Alhaji Jobe, Georgetta K. Daffeh, Olumuyiwa Owolabi, Daniel Pan, Manish Pareek, Michael R. Barer, Jayne S. Sutherland, Pranabashis Haldar
Summary: Mask sampling is a sensitive and noninvasive tool for evaluating the infectiousness of individuals in high tuberculosis (TB) burden settings. It provides better insight into community transmission and can inform public health interventions more reliably than sputum bacillary load.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Immunology
Robert Kakaire, Noah Kiwanuka, Sarah Zalwango, Juliet N. Sekandi, Trang Ho Thu Quach, Maria Eugenia Castellanos, Frederick Quinn, Christopher C. Whalen
Summary: Although households of tuberculosis cases are a key setting for tuberculosis transmission, household exposure only accounts for a small fraction of community transmission. Most first-degree social network members of TB cases do not have additional risk for infection and appear to acquire infection through exposure to infectious cases in the community.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Silvia S. Chiang, Meredith B. Brooks, Helen E. Jenkins, Dana Rubenstein, James A. Seddon, Brittney J. van de Water, Michael M. Lindeborg, Mercedes C. Becerra, Courtney M. Yuen
Summary: Household contacts of patients with drug-resistant TB have a high risk of being infected with drug-resistant M. tuberculosis strains and should receive treatment that assumes drug resistance. Drug susceptibility testing should be performed whenever possible to optimize regimen composition for better treatment outcomes.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Genetics & Heredity
Selien Oostvogels, Serej D. Ley, Tim H. Heupink, Anzaan Dippenaar, Elizabeth M. Streicher, Elise De Vos, Conor J. Meehan, Keertan Dheda, Rob Warren, Annelies Van Rie
Summary: This study investigates the distribution and transmission dynamics of extensively drug-resistant tuberculosis (XDR-TB) strains in South Africa. Through whole genome sequencing, the study identifies clustered XDR-TB strains and finds that including resistance-conferring variants in cluster definitions increases the number of small clusters. Lineage 2 strains show large clusters spread across the Western Cape Province. Residence in Cape Town is significantly associated with cluster membership. The study suggests that XDR-TB in South Africa originated from the endemic spread of multidrug-resistant and pre-XDR strains. Rapid diagnosis and treatment initiation are crucial in reducing transmission.
MICROBIAL GENOMICS
(2022)
Review
Microbiology
Afsatou Ndama Traore, Mpumelelo Casper Rikhotso, Marry Avheani Mphaphuli, Sana Mustakahmed Patel, Hafsa Ali Mahamud, Leonard Owino Kachienga, Jean-Pierre Kabue, Natasha Potgieter
Summary: This review and meta-analysis investigated the prevalence and molecular insights into isoniazid (INH) and rifampicin (RIF) resistance-conferring mutations in Mycobacterium tuberculosis isolates from South Africa. High prevalence of specific mutations, including S450L in rpoB and S315T, linked to resistance against RIF and INH respectively, were found. These findings contribute to understanding drug resistance mechanisms and provide valuable insights for targeted interventions against drug-resistant TB.
Article
Medicine, Research & Experimental
Kamakshi Prudhula Devalraju, Deepak Tripathi, Venkata Sanjeev Kumar Neela, Padmaja Paidipally, Rajesh Kumar Radhakrishnan, Karan P. Singh, Mohammad Soheb Ansari, Martin Jaeger, Romana T. Netea-Maier, Mihai G. Netea, Sunmi Park, Sheue-Yann Cheng, Vijaya Lakshmi Valluri, Ramakrishna Vankayalapati
Summary: The study found that young household contacts who exhibit decreased production of thyroid hormones are at high risk of developing active TB disease.
Article
Microbiology
Martha L. van der Walt, Karen Shean, Piet Becker, Karen H. Keddy, Joey Lancaster
Summary: The study compared treatment outcomes among MDR-TB patients receiving ethambutol, cycloserine, or terizidone as part of a standardized regimen. Results showed higher success rates and lower default rates in patients receiving cycloserine and terizidone, but higher culture conversion rates in those receiving cycloserine. Further investigation is needed to elucidate the differences observed between cycloserine and terizidone.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2021)
Article
Immunology
Amyn A. Malik, Mercedes C. Becerra, Timothy L. Lash, Lisa M. Cranmer, Saad B. Omer, Junaid Fuad, Sara Siddiqui, Farhana Amanullah, Maria Jaswal, Naseem Salahuddin, Salmaan Keshavjee, Hamidah Hussain, Neel R. Gandhi
Summary: This study investigated the occurrence of adverse events and associated risk factors during a 6-month fluoroquinolone-based preventive treatment for household contacts of drug-resistant TB patients in Karachi, Pakistan. Approximately 21% of contacts developed adverse events during treatment, with higher incidence in regimens containing ethionamide compared to ethambutol.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Davit Baliashvili, Neel R. Gandhi, Soyeon Kim, Michael Hughes, Vidya Mave, Alberto Mendoza-Ticona, Pedro Gonzales, Kim Narunsky, Poongulali Selvamuthu, Sharlaa Badal-Faesen, Caryn Upton, Linda Naini, Elizabeth Smith, Amita Gupta, Gavin Churchyard, Susan Swindells, Anneke Hesseling, N. Sarita Shah
Summary: A multinational study found that at least 10% of household contacts of patients with pulmonary multidrug- or rifampin-resistant tuberculosis are resistant to M. tuberculosis infection, regardless of exposure level. The prevalence of resistance did not significantly differ by sex, age, HIV coinfection, or comorbid conditions. Further research into the genetic or immunologic mechanisms underlying resistance could lead to new therapeutic and vaccine strategies.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Colleen F. Hanrahan, Bareng Aletta Sanny Nonyane, Limakatso Lebina, Lesego Mmolawa, Tsundzukani Siwelana, Nora S. West, Nicholas Albaugh, Neil Martinson, David W. Dowdy
Summary: This study conducted a trial of two tuberculosis contact investigation approaches (household-based and incentive-based) in South Africa and found that the incentive-based approach has similar effectiveness to the household-based approach, providing a viable alternative or complement to traditional methods.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Infectious Diseases
Joanne Harding, Corrado Bernasconi, Sarah Williams, Steffen Wildum, Masahiro Kinoshita, Takeki Uehara, Aeron C. Hurt
Summary: In a post-hoc analysis of the BLOCKSTONE study, it was found that there was a low potential for transmission of baloxavir-resistant influenza viruses from treated to untreated individuals. This could be due to reduced transmission fitness or low viral titres of the resistant viruses.
INFLUENZA AND OTHER RESPIRATORY VIRUSES
(2023)
Article
Immunology
Alexander L. Chu, Leonid W. Lecca, Roger Calderon, Carmen C. Contreras, Rosa M. Yataco, Zibiao Zhang, Mercedes C. Becerra, Megan B. Murray, Chuan-Chin Huang
Summary: This study found that the adverse effects of smoking on the transmissibility of tuberculosis are significantly reduced shortly after quitting smoking, emphasizing the importance of smoking cessation interventions in tuberculosis control.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Environmental Sciences
Michael G. Chipeta, Emmanue Fie P. A. Kumaran, Annie J. Browne, Bahar H. Kashef Hamadani, Georgina Haines-Woodhouse, Henn Sartorius, Robert C. Reiner Jr, Christian Dolecek, Simon Hay, Catrin E. Moore
Summary: This study used Bayesian geostatistical modeling to estimate household overcrowding in Africa between 2000 and 2018, showing spatial and temporal variability in overcrowding estimates. The highest overcrowding estimates were observed in the Horn of Africa region in 2018, while the lowest regional median proportion was estimated for the north of Africa region.
LANCET PLANETARY HEALTH
(2022)
Article
Immunology
Neil A. Martinson, Limakatso Lebina, Emily L. Webb, Andrew Ratsela, Ebrahim Varavia, Anthony Kinghorn, Sanjay G. Lala, Jonathan E. Golub, Zama Bosch, Kegaugetswe P. Motsomi, Peter MacPherson
Summary: Household contact tracing and intensive screening did not reduce the incidence of tuberculosis or death. Providing referral letters to household contacts is an alternative strategy.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Marian Loveday, Jennifer Hughes, Babu Sunkari, Iqbal Master, Sindisiwe Hlangu, Tarylee Reddy, Sunitha Chotoo, Nathan Green, James A. Seddon
Summary: Research in South Africa found that pregnant women receiving MDR/RR-tuberculosis treatment and their infants were affected by various factors, with some babies exposed to bedaquiline having a higher risk of low birth weight, but most of these babies gained weight and developed normally at the age of one year.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Endocrinology & Metabolism
Matthew J. Magee, Anjali Khakharia, Neel R. Gandhi, Cheryl L. Day, Hardy Kornfeld, Mary K. Rhee, Lawrence S. Phillips
Summary: Comprehensive longitudinal data indicate that latent tuberculosis infection (LTBI) is associated with increased diabetes incidence.
Article
Public, Environmental & Occupational Health
Jonathan P. Smith, Neel R. Gandhi, Benjamin J. Silk, Ted Cohen, Benjamin Lopman, Kala Raz, Kathryn Winglee, Steve Kammerer, David Benkeser, Michael R. Kramer, Andrew N. Hill
Summary: Recent evidence suggests that tuberculosis transmission may be characterized by extreme individual heterogeneity, with a few cases accounting for the majority of transmission. This study proposes a method to quantify individual heterogeneity in tuberculosis epidemiology using transmission cluster data without knowledge of individual-level transmission events. The results show that tuberculosis transmission in the United States is characterized by extensive outbreaks. This method provides a valuable tool for improving our understanding of tuberculosis epidemiology.
Article
Infectious Diseases
Sean Wasserman, James C. M. Brust, Mahmoud T. Abdelwahab, Francesca Little, Paolo Denti, Lubbe Wiesner, Neel R. Gandhi, Graeme Meintjes, Gary Maartens
Summary: This study investigated the toxicity and determinants of adverse events of linezolid in patients with rifampicin-resistant TB. A drug exposure threshold of 2.5 mg/L for linezolid toxicity was determined. The results showed that permanent discontinuation of linezolid was common, but linezolid-containing therapy led to improvement in toxicity measures on average. HIV co-infection was not independently associated with linezolid toxicity.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2022)
Article
Immunology
David W. Haas, Mahmoud Tareq Abdelwahab, Stijn W. van Beek, Paxton Baker, Gary Maartens, Yuki Bradford, Marylyn D. Ritchie, Sean Wasserman, Graeme Meintjes, Karen Beeri, Neel R. Gandhi, Elin M. Svensson, Paolo Denti, James C. M. Brust
Summary: CYP3A5*3 is associated with slower plasma bedaquiline clearance, and the different frequencies of this variation among populations may explain the faster clearance in individuals of African ancestry.
JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Public, Environmental & Occupational Health
Carly Adams, Allison Chamberlain, Yuke Wang, Mallory Hazell, Sarita Shah, David P. Holland, Fazle Khan, Neel R. Gandhi, Scott Fridkin, Jon Zelner, Benjamin A. Lopman
Summary: This study investigated the transmission of COVID-19 in long-term care facilities in Fulton County, Georgia. The distribution of vaccines resulted in a rapid decline in case counts and transmission rates. Staff cases were more infectious than resident cases, and unvaccinated resident cases were more infectious than vaccinated resident cases, although estimates were imprecise.
Article
Immunology
Nathaniel Chishinga, Sasha Smith, Neel R. Gandhi, Udodirim N. Onwubiko, Carson Telford, Juliana Prieto, Allison T. Chamberlain, Shamimul Khan, Steve Williams, Fazle Khan, N. Sarita Shah
Summary: This study found gender and racial/ethnic disparities in COVID-19 mortality and identified certain comorbidities associated with higher risk of death. These factors persisted throughout the different waves of the pandemic, despite improvements in diagnosis and treatment.
OPEN FORUM INFECTIOUS DISEASES
(2022)
Article
Immunology
Hans P. Verkerke, Gregory L. Damhorst, Daniel S. Graciaa, Kaleb McLendon, William O'Sick, Chad Robichaux, Narayanaiah Cheedarla, Sindhu Potlapalli, Shang Chuen Wu, Kristin R. Harrington, Andrew Webster, Colleen Kraft, Christina A. Rostad, Jesse J. Waggoner, Neel R. Gandhi, Jeannette Guarner, Sara C. Auld, Andrew Neish, John D. Roback, Wilbur A. Lam, N. Sarita Shah, Sean R. Stowell
Summary: In this study, we evaluated SARS-CoV-2 nucleocapsid antigenemia as a marker of acute COVID-19 and investigated outliers to gain a better understanding of the phenomenon. The findings suggest that antigenemia can serve as a biomarker for acute SARS-CoV-2 infection and may have diagnostic utility in various contexts.
JOURNAL OF INFECTIOUS DISEASES
(2022)
Review
Public, Environmental & Occupational Health
Jonathan P. Smith, Ted Cohen, David Dowdy, Sourya Shrestha, Neel R. Gandhi, Andrew N. Hill
Summary: This study systematically investigates the impact of individual heterogeneity on tuberculosis transmission and finds that a minority of cases drive the majority of ongoing transmission. By analyzing 9 studies from 8 global settings, it is observed that tuberculosis transmission is declining but individual-level heterogeneity exists in all settings. Identifying and accounting for the sources of heterogeneity can greatly contribute to mitigating tuberculosis transmission.
AMERICAN JOURNAL OF EPIDEMIOLOGY
(2023)
Article
Public, Environmental & Occupational Health
Carol Y. Liu, Sasha Smith, Allison T. Chamberlain, Neel R. Gandhi, Fazle Khan, Steve Williams, Sarita Shah
Summary: This study analyzed household clustering of COVID-19 cases in Fulton County, Georgia. The results showed that one-third of the cases occurred within households. Children were more likely to be part of household clusters compared to other age groups, and the proportion of children as the first diagnosed case increased over time.
ANNALS OF EPIDEMIOLOGY
(2022)
Article
Immunology
Davit Baliashvili, Henry M. Blumberg, David Benkeser, Russell R. Kempker, Shaun Shadaker, Francisco Averhoff, Lia Gvinjilia, Natalia Adamashvili, Matthew Magee, George Kamkamidze, Mamuka Zakalashvili, Tengiz Tsertsvadze, Lali Sharvadze, Mamuka Chincharauli, Nestan Tukvadze, Neel R. Gandhi
Summary: In this large-scale cohort study, it was found that both treated and untreated hepatitis C are associated with active tuberculosis. People with hepatitis C should be considered for TB-preventive measures, such as treatment for latent TB infection.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Immunology
Lisa M. Cranmer, Irene N. Njuguna, Sylvia M. LaCourse, Janet Figueroa, Scott Gillespie, Elizabeth Maleche-Obimbo, Vincent Otieno, Cyrus Mugo, Helen Okinyi, Sarah Benki-Nugent, Patricia B. Pavlinac, Amyn A. Malik, Neel R. Gandhi, Barbara A. Richardson, Joshua Stern, Dalton C. Wamalwa, Grace C. John-Stewart
Summary: This study evaluated the performance of tuberculosis (TB) screening criteria for children with HIV (CHIV) and found that the World Health Organization (WHO) TB symptom screen had high sensitivity but resulted in a high proportion of hospitalized CHIV who would require TB diagnostic evaluation. Other published TB screening criteria missed CHIV with confirmed TB. An optimized screening tool was developed to increase specificity while preserving sensitivity. Future multicenter studies are needed to improve TB screening for CHIV.
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
(2022)
Article
Public, Environmental & Occupational Health
Kristin R. Harrington, Meron R. Siira, Elizabeth P. Rothschild, Sharon R. Rabinovitz, Samuel Shartar, David Clark, Alexander Isakov, Allison Chamberlain, Enku Gelaye, J. Peter Cegielski, Neel R. Gandhi
Summary: This study describes how Emory University controlled a COVID-19 outbreak through case investigation and contact tracing. They identified clusters of cases and implemented timely measures to bring the surge under control. Early systematic testing and rapid contact tracing were vital in containing the spread of the virus.
PUBLIC HEALTH REPORTS
(2022)
Article
Immunology
Amyn A. Malik, Neel R. Gandhi, Olivier Marcy, Elisabetta Walters, Mathurin Tejiokem, Giang Do Chau, Saad B. Omer, Timothy L. Lash, Mercedes C. Becerra, Irene N. Njuguna, Sylvia M. LaCourse, Elizabeth Maleche-Obimbo, Dalton Wamalwa, Grace C. John-Stewart, Lisa M. Cranmer
Summary: This study aimed to evaluate the performance of monocyte-lymphocyte ratio (MLR) as a diagnostic biomarker for CHIV tuberculosis and construct a prediction score to improve specificity of diagnosis. The results showed that the prediction score had high sensitivity and specificity, enabling rapid initiation of tuberculosis treatment when microbiological testing is unavailable.
OPEN FORUM INFECTIOUS DISEASES
(2022)
Review
Health Care Sciences & Services
Susanna S. Van Wyk, Marriott Nliwasa, James A. Seddon, Graeme Hoddinott, Lario Viljoen, Emmanuel Nepolo, Gunar Guenther, Nunurai Ruswa, Hsien-Ho Lin, Stefan Niemann, Neel R. Gandhi, N. Sarita Shah, Mareli Claassens
Summary: This protocol aims to describe the available literature on case-finding for DR-TB and to describe case-finding strategies. The study will screen and analyze research related to improving DR-TB case detection to provide information for future research, policy, and practice.
JMIR RESEARCH PROTOCOLS
(2022)
Article
Medicine, Research & Experimental
Riti Sharan, Shashank R. Ganatra, Dhiraj K. Singh, Journey Cole, Taylor W. Foreman, Rajesh Thippeshappa, Charles A. Peloquin, Vinay Shivanna, Olga Gonzalez, Cheryl L. Day, Neel R. Gandhi, Edward J. Dick, Shannan Hall-Ursone, Smriti Mehra, Larry S. Schlesinger, Jyothi Rengarajan, Deepak Kaushal
Summary: This study assessed the clearance of M. tuberculosis bacteria in macaques with asymptomatic LTBI following a three-month treatment of 3HP. The results showed that most of the treated macaques did not have persistent bacterial infection or extrapulmonary spread, while the untreated macaques harbored persistent bacterial infection and experienced tuberculosis reactivation following SIV coinfection. This suggests that 3HP treatment effectively reduces tuberculosis infection and prevents reactivation of latent tuberculosis in macaques.
JOURNAL OF CLINICAL INVESTIGATION
(2022)