bluuebunny/crossref_metadata_2025_split huggingface dataset:
KOTA CILEGON IMPLEMENTASI PROGRAM PEMBERDAYAAN SOSIAL DALAM REHABILITAS RUMAH TIDAK LAYAK HUNI DI KOTA CILEGON
Authors: Kausar Ronald Al , Yulianti Rina , Stiawati Titi 
Published: December 2021

Pengentasan angka kemiskinan menjadi perhatian dan fokus Pemerintah Daerah Kota Cilegon sebagai upaya implementasi fungsi pemerintahan dalam hal pelayanan, pemberdayaan dan pembangunan kepada masyarakat. Melihat tingkat kemiskinan dalam hal adanya rumah tidak layak huni di Kota Cilegon. Tentu saja, pemerintah daerah melakukan upaya untuk mengatasinya dengan mengeluarkan suatu kebijakan yang tertuang dalam bentuk program. Teori yang digunakan dalam penelitian ini yaitu implementasi kebijakan yang dikemukakan oleh Hill dan Hupe yang terdiri dari tiga aspek dalam mengelola implementasi kebijakan yaitu mengelola proses kebijakan, mengelola hubungan antar organisasi dan mengelola hubungan internal dan eksternal. Metode penelitian yang digunakan adalah metode deskriptif dengan pendekatan kualitatif. Penentuan informan dengan menggunakan teknik purposif. Berdasarkan hasil penelitian, program rehabilitasi rumah tidak layak huni di Kota Cilegon belum sepenuhnya berjalan secara maksimal dalam tataran realisasi pengerjaan pembangunan. Program bantuan yang ditujukan untuk masyarakat miskin dengan memberikan bantuan keuangan dalam bentuk stimulan yang bersifat swadaya, dimana masyarakat dituntut untuk membangun secara swadaya berdasarkan prakarsa masyarakat atau pemerintah dengan pendekatan berbasis pemberdayaan masyarakat, sehingga terwujudnya harapan dan kesejahteraan masyarakat.
Incidence of Adverse Drug Events among Patients on Second Line Anti-Tuberculosis Regimen in the Littoral Region of Cameroon
Authors: Mbuh Teyim Pride , Meriki Henry D. , Thumamo Pokam Benjamin D. , Adeline Wandji , Enoka Francaise , Ghislain Tchualack , Mbacham Wilfred F. , Ane-Anyangwe Irene 
Published: December 2021

Background:
An adverse drug event (ADE) is an injury resulting from medical intervention associated with a drug. This study assesses the incidence of ADEs among participants on second-line drugs for tuberculosis (TB) in Cameroon.

Methods:
This was a longitudinal observational study including 65 participants and carried out from January 2017 to December 2017. Markers of ADEs were obtained from creatinine, transaminase audiogram, and clinical data. Multivariate analysis was used to determine the association between predictors and ADEs.

Results:
Forty-eight (73.8%) of the 65 participants developed 72 ADEs. Fifty-four (75%), 11 (15.3%), and 7 (9.7%) of the 72 ADEs were classified as Grades 1, 2, and 3, respectively. Gastrointestinal disorders were most common (35 [46.6%]) followed by auditory injuries (16 [22.2%]), hepatotoxicity (11 [15.3%]), neurological disorders (6 [8.3%]), and kidney disorders (4 [5.6%]). The follow-up duration of this study was 11,250-person day (PDY). The incidence rate for ADEs was 4.3/1000 PDY and that for gastrointestinal disorders, auditory injuries, hepatotoxicity, neurological disorders, and kidney disorders was 3.1, 1.4, 1.0, 0.5, and 0.2 (/1000PDY), respectively. Kanamycin (65 [90.3%]), isoniazid (4 [5.6%]), and ethambutol (3 [4.2%]) were incriminated with ADEs. Most (29 [60.4%]) of the ADEs occurred during the first 2 months of drug initiation. There was an association between poor treatment outcome and ADEs (P = 0.04, odds ratio = 1.20, 95% confidence of interval = 0.21–6.80].

Conclusions:
The incidence of ADEs is associated with several factors and most of them occurred during the intensive phase of treatment. Kanamycin was the most associated drug linked to ADEs requiring its replacement with a less toxic one.
Pharmacodynamic Biomarkers for Quantifying the Mycobacterial Effect of High Doses of Rifampin in Patients with Rifampin-Susceptible Pulmonary Tuberculosis
Authors: Said Bibie N , Heysell Scott K , Yimer Getnet , Aarnoutse Rob E. , Kibiki Gibson S , Mpagama Stellah , Mbelele Peter M 
Published: December 2021

Background:
Suboptimal drug exposure in patients with drug-susceptible tuberculosis (DS-TB) can drive treatment failure. Pharmacodynamics (PD) biomarkers such as the plasma TB drug-activity (TDA) assay may guide dose finding studies and predict microbiological outcomes differently than conventional indices.

Methods:
A study was nested from phase 2b randomized double-blind controlled trial of Tanzanian patients who received a 600 mg, 900 mg, or 1200 mg with a standard dose for DS-TB. Serum at 6 weeks collected over 24-h at 2-h intervals was collected for rifampin area under the concentration–time curve relative to minimum inhibitory concentration (AUC0-24/MIC) or peak concentration and MIC (Cmax/MIC). TDA was the ratio of time-to-positive growth of the patient's Mycobacterium tuberculosis isolates with and without coculture of patient's plasma collected at Cmax. Spearman's rank correlation (r) between PD parameters and culture convention on both liquid and solid culture media.

Results:
Among 10 patients, 600 mg (3), 900 mg (3), and 1200 mg (4) of rifampin dosages. The mean ± standard deviation (SD) of AUC0-24/MIC for patients on 600 mg was 168 ± 159 mg·h/L, on 900 mg was 169 ± 166 mg·h/L, and on 1200 mg was 308 ± 238 mg·h/L. The mean-TDA (SD) was 2.56 (±0.75), 1.5 (±0.59), and 2.29 (±1.08) for patients on 600 mg, 900 mg, and 1200 mg rifampin doses, respectively. Higher TDA values correlated with faster time to culture convention on both liquid (r = −0.55, P = 0.099) and solid media (r = −0.65, P = 0.04).

Conclusions:
TDA and rifampin AUC0-24/MIC did not trend as expected with rifampin dose, but TDA better predicted the time to sputum culture conversion. TDA may provide additional discrimination in predicting treatment response for some regimens distinct from plasma exposure relative to MIC or mg/kg dose.
Exploring the Role of Bacillus Calmette–Guerin Vaccination in Protection against COVID-19
Authors: Chauhan Anil , Singh Manvi , Agarwal Amit , Jaiswal Nishant , Lakshmi PVM , Singh Meenu 
Published: December 2021

Background:In recent studies, it has been established that countries having Bacillus Calmette-Guerin (BCG) vaccination programs reported less COVID-19 cases and deaths per population Preliminary studies suggest that BCG vaccination could upregulate the vaccine-induced immunity against SARS-CoV-2. Hence, the recent study was aimed to determine the association of BCG vaccine with the development of COVID-19 in health care workers.Methods:The participants included in the study were healthcare workers (doctors, paramedics, and other supporting staff) working in the high and low-risk zones of COVID-19 in the hospital. The Graph Pad statistical analysis tool was used to determine the association of preliminary BCG vaccination with their COVID-19 status.Results:A total of 200 health care workers working in different departments of the hospital were enrolled in the study. The relative risk of COVID-19 positivity in BCG vaccinated versus unvaccinated was 0.79 (0.50–1.25). There was also a significant negative correlation between two groups. The relative risk of COVID-19 positivity in those with a BCG scar was 0.63 (0.44–0.92). The relative risk of COVID-19 infection in those with a history of tuberculosis was 1.08 (0.56–2.09).Conclusion:The present study did not support the beneficial effect of BCG vaccine in protection against the development of COVID-19 disease.
Five-Year Trend Analysis of Tuberculosis in Bahir Dar, Northwest Ethiopia, 2015–2019
Authors: Mengesha Dagmawi , Manyazewal Tsegahun , Woldeamanuel Yimtubezinash 
Published: December 2021

Background:
Tuberculosis (TB) remains a major cause of morbidity and mortality in Ethiopia despite the increased availability of effective treatments. Trend analysis of issues and priorities affecting TB programs across different regions of the country is critical to ensure equitable and sustainable TB outcomes. We aimed to analyze the trends of TB in Bahir Dar, Northwest Ethiopia, over 5 years from 2015 to 2019.

Methods:
An institution-based, retrospective cross-sectional study was conducted in Bahir Dar, the capital city of the Amhara Region in Ethiopia. Five-year data and records of individual TB cases were reviewed from all public and private health-care facilities and health bureaus in Bahir Dar. Using a standard checklist adapted from the World Health Organization, data were abstracted relevant to sociodemographic characteristics of the patients, year and type of TB infection, and HIV status. SPSS version 20 software was used for data analysis.

Results:
Data of 4275 patients with TB were identified, of which 929 (21.7%) were smear-positive pulmonary TB, 1195 (28%) were smear-negative pulmonary TB, and 2151 (50.3%) were extrapulmonary TB patients. TB was more prevalent in the age group 15–34 years (51.2%), and females (55.5%). In the years from 2015 to 2019, the prevalence of all forms of TB was 922 (21.6%), 812 (19.0%), 843 (19.7%), 876 (20.5%), and 822 (19.2%), respectively, demonstrating a decreasing trend though inconsistent. The variables sex (adjusted odds ratio [AOR]: 1.734, 95% confidence interval [CI] [1.390–2.187]), HIV co-infection (AOR: 1.875, 95% CI [1.553–2.265]), and age <15 years (AOR: 1.372, 95% CI [1.121–1.680]) showed a significant association with TB infection.

Conclusions:
The prevalence of TB in Bahir Dar, Northwest Ethiopia, demonstrated a decreasing trend over the years from 2015 to 2019 but with inconsistencies. HIV co-infection significantly increased the risk of developing TB, and productive age groups and females were at the greater prevalence of TB, highlighting the importance of strengthening sustainable TB care and prevention interventions toward these groups of people.
Prediction of Tuberculosis Cases Based on Sociodemographic and Environmental Factors in Gombak, Selangor, Malaysia
Authors: Mohidem Nur Adibah , Osman Malina , Muharam Farrah Melissa , Elias Saliza Mohd , Shaharudin Rafiza , Hashim Zailina 
Published: December 2021

Background:
Early prediction of tuberculosis (TB) cases is very crucial for its prevention and control. This study aims to predict the number of TB cases in Gombak based on sociodemographic and environmental factors.

Methods:
The sociodemographic data of 3325 TB cases from January 2013 to December 2017 in Gombak district were collected from the MyTB web and TB Information System database. Environmental data were obtained from the Department of Environment, Malaysia; Department of Irrigation and Drainage, Malaysia; and Malaysian Metrological Department from July 2012 to December 2017. Multiple linear regression (MLR) and artificial neural network (ANN) were used to develop the prediction model of TB cases. The models that used sociodemographic variables as the input datasets were referred as MLR1 and ANN1, whereas environmental variables were represented as MLR2 and ANN2 and both sociodemographic and environmental variables together were indicated as MLR3 and ANN3.

Results:
The ANN was found to be superior to MLR with higher adjusted coefficient of determination (R
2) values in predicting TB cases; the ranges were from 0.35 to 0.47 compared to 0.07 to 0.14, respectively. The best TB prediction model, that is, ANN3 was derived from nationality, residency, income status, CO, NO2, SO2, PM10, rainfall, temperature, and atmospheric pressure, with the highest adjusted R
2 value of 0.47, errors below 6, and accuracies above 96%.

Conclusions:
It is envisaged that the application of the ANN algorithm based on both sociodemographic and environmental factors may enable a more accurate modeling for predicting TB cases.
The Burden of Mycobacteria Species among Children from Postvaccination Abscess in Southern India
Authors: Kavitha Kannaiyan , Ragunathan Latha , Elantheriyan Paramasivam , Gopalakrishnan Kuppusamy , Gopala Kumaraswamy Ajay , Balamurugan Indrajith Devandra , Navya Ragunadha Reddy , Marcella Sherin Samuel , Venkatachalam Gobichettipalayam Kanniappan 
Published: December 2021

Background:
From the time vaccines were introduced, their impact has been beyond measurable. Mycobacteria are pathogens increasingly isolated from postvaccination abscess. Identification of these pathogens plays a very crucial role in the management of these babies. We aimed to determine Mycobacterial spp occurrence from vaccination abscess, draw local antibiogram, and guide management of babies with vaccination abscess.

Methods:
Babies with postvaccination abscess from 2016 to 2020 were included. Pus collected during incision and drainage was processed as per the standard guidelines. Mycobacterium isolates were identified by conventional methods, and all samples were confirmed by polymerase chain reaction. All babies underwent incision and drainage, and all were started with amoxicillin and clavulanic acid and changed later as per the sensitivity report.

Results:

Mycobacterium abscessus was isolated from 17% (12) pus samples from 71 postdiphtheria pertussis and tetanus vaccination, and Mycobacterium bovis was isolated from 83.3% (10) babies with post-Bacillus Calmette–Guérin vaccination. The mean interval between injection and abscess formation was 32.75 days in case of M. abscessus, whereas it was 50.4 days in case of M. bovis. All the M. abscessus were sensitive to linezolid, amikacin, and clarithromycin, whereas no treatment except incision and drainage was required for M. bovis.

Conclusion:
There is an increased incidence of Mycobacterial spp infection in postvaccination abscess. All babies with M abscessus responded well with combination antibiotic therapy plus drainage of abscesses, whereas M. bovis was treated by incision and drainage, and no further antibiotics were given.
Evaluation of Radiological Sequelae after Treatment Completion in New Cases of Pulmonary and Pleural Tuberculosis
Authors: Tandon Rajeev , Agarwal Anoushka , Nirala Pradeep , Sinha Ansha 
Published: December 2021

Background:The objective of this study was to evaluate the residual parenchymal and pleural lesions on chest X-ray posttherapy in new tuberculosis (TB) cases.Methods:This prospective study was done from January 2018 to December 2020, which involved the evaluation of medical records of 60 pulmonary or pleural TB patients who underwent successful treatment. Chest X-rays of the patients at the start and end of treatment were studied as per the guidelines by Revised National Tuberculosis Control Program. The primary outcome measures were residual chest X-ray lesions after the complete treatment of new cases of TB. Secondary outcomes measures were significant factors affecting the chest X-ray clearance.Results:Chest X-ray showed clearing in 48.33% of cases. Residual chest X-ray findings were present in 31 cases which mainly included fibrosis in 23.33% and pleural thickening in 20%. None of the clinical and demographic characters and biochemical parameters showed significant association with chest X-ray clearance (P> 0.05). Sputum microscopy was done in 45 cases of which 25 (41.66%) were positive for acid-fast bacilli. Sputum positivity showed no significant correlation with chest X-ray clearance (odds ratio [OR]: 0.734, confidence interval [CI]: 0.224–2.411,P= 0.592). Compared to nonstandardized regimen, standardized regimen showed no significant correlation with chest X-ray clearance (OR: 0.664; CI: 0.233–1.892,P= 0.426).Conclusion:Residual radiological sequelae were seen in more than half of the study subjects who were successfully treated for TB (51.67%). Demographic, clinical characteristics, sputum positivity, and treatment regimen showed no significant association with chest X-ray clearance.
The espD Full Gene as a Potential Biomarker in Active Pulmonary Tuberculosis
Authors: Mertaniasih Ni Made , Surya Suameitria Dewi Desak Nyoman , Soedarsono Soedarsono , Kurniati Anita , Rohman Ali , Nuha Zakiyathun , Matsumoto Sohkichi 
Published: December 2021

Background:
Pulmonary tuberculosis (PTB) is still a major health problem worldwide. The espD has a potential to be a new biomarker because it is important for the espA, espC, and ESX-1 protein secretion system that are actively expressed in active multiplication of Mycobacterium tuberculosis complex.

Methods:
A total of 55 sputum samples and 41 culture isolates from newly diagnosed PTB patients at Dr. Soetomo Academic Hospital were collected from September 2016 to April 2019. The tested samples using polymerase chain reaction targeted 555 bp of espD gene and sequencing. Clone Manager Version 6 and NCBI BLAST were used to align the gene sequence against wild-type M. tuberculosis. The prediction of T-cell epitope in espD gene was detected by GENETYX. The three-dimensional (3D) structure of espD was modeled by SWISS-MODEL and I-TASSER and was visualized with PyMOL.

Results:
From 55 sputum samples, 43 (78.18%) showed positive results, and all culture isolates showed positive results. In addition, all sequenced samples showed 100% homolog with M. tuberculosis H37Rv gene without detected variant or mutation. There were four T-cell epitopes that could be obtained. The 3D model had a I-TASSER confidence score of 3.91 with estimated RMSD of approximately 14.5 Å. The structure consists of a main fold of a three-stranded antiparallel β-sheet and a long α-helix surrounded by several minor secondary structures.

Conclusions:
This study provides a brief information about the sequence, epitope prediction, and 3D structure of EspD protein from M. tuberculosis strains in Indonesia.
H65 Fusion Protein Fails to Improve the Protection of a Rationally Attenuated Live Vaccine Candidate against Bovine Tuberculosis in a Mouse Model of Tuberculosis
Authors: García Elizabeth A. , Blanco Federico C. , Bigi Fabiana 
Published: December 2021

Background:
The fusion protein H65, composed of Mycobacterium tuberculosis (TB) ESX-secreted antigens, has improved the bacillus Calmette–Guerin-induced immune protection in a mouse model of bovine TB when formulated in the liposomal adjuvant CAF01. In this study, we aimed to evaluate the protective efficacy of an attenuated Mycobacterium bovis strain – a mutant in mce2 and phoP genes – combined with H65+CAF01 immunization. We evaluated the protection of MbΔmce2-phoP alone or combined with H65+CAF01 against M. bovis challenge in mice.

Methods:
Groups of BALBc mice were inoculated with the vaccine candidates or phosphate buffered saline (PBS), and 6 weeks after the last immunization, the animals were aerogenically challenged with virulent M. bovis. Bacterial load in organs was counted after 45 days of the challenge. One-way analysis of variance and Bonferroni's posttest were used for statistical analysis.

Results:
All vaccinated mice showed reduced bacterial loads in lungs compared to unvaccinated animals. However, the protection level was similar between vaccinated groups.

Conclusions:
The MbΔmce2-phoP strain combined with three doses of H65+CAF01 induced equivalent protection than the MbΔmce2-phoP strain alone. Thus, the use of combined vaccination strategies requires a careful analysis of the potential interactions of each of their components with the host's immune system.
Laboratory Diagnosis of Leprosy
Authors: Ule Belotti Naiara Cristina , Tonelli Nardi Susilene Maria , Arco Paschoal Vânia Del , Martins Montanha Janaína Olher , Paro Pedro Heloisa da , Gazetta Claudia Eli 
Published: December 2021

Background:
The diagnosis of leprosy is based on the characteristic signs and symptoms of the disease, subsidized by laboratory tests. When positive, the bacilloscopy closes the diagnosis for leprosy. Phenolic glycolipid-I, or PGL-I, is a molecule in the bacillus cell wall that confers a greater immune response. The ML Flow test is an immunochromatographic test for the detection of anti-PGL-I IgM in human blood or serum.

Methods:
A prospective study with data collection and biological materials in patients with suspected leprosy from August 2020 to May 2021. For microscopy, intradermal smears were stained with Auramine O, and after reading under a fluorescence microscope, reviewed by Ziehl–Neelsen. The ML flow test was performed according to the Bührer-Sékula protocol. To assess the agreement between the methods, the Kappa index was estimated.

Results:
Of the 94 suspected leprosy patients, 31 (32.9%) were diagnosed with leprosy. There was moderate agreement between the results of the ML Flow and Auramine O tests (Kappa = 0.58) and substantial agreement between the ML Flow and Ziehl–Neelsen microscopy (Kappa = 0.72). In paucibacillary cases, serology was positive in 100% of patients.

Conclusions:
This study concluded that the Ziehl–Neelsen technique remains the best option for standard leprosy staining, and the ML flow test is more positive among the three techniques evaluated and can be an effective tool in the early diagnosis of leprosy cases.
Impact of Early Chest Radiography on Delay in Pulmonary Tuberculosis Case Notification in Ethiopia
Authors: Mohammed Hussen , Oljira Lemessa , Roba Kedir Teji , Ngadaya Esther , Tesfaye Dagmawit , Manyazewal Tsegahun , Yimer Getnet 
Published: December 2021

Background:
One-third of tuberculosis (TB) cases are missed each year and delays in the diagnosis of TB are hampering the whole cascade of care. Early chest X-ray (CXR) in patients with cough irrespective of duration may reduce TB diagnostic and treatment delays and increase the number of TB patients put into TB care. We aimed to evaluate the impact of CXR on delay in the diagnosis of pulmonary tuberculosis (PTB) among people with cough of any duration.

Methods:
A facility-based cross-sectional study was conducted in four selected health facilities from two regions and two city administrations of Ethiopia. Patients who sought health care were screened for cough of any duration, and those with cough underwent CXR for PTB and their sputum specimens were tested for microbiological confirmation. Delays were followed up and calculated using median and inter-quartile range (IQR) to summarize (first onset of cough to first facility visit, ≥15 days), diagnosis delay (first facility visit to date of PTB diagnosis, >7 days), and total delay (first onset of cough to date of PTB diagnosis, >21 days). Kruskal–Wallis and Mann–Witney tests were used to compare the delays among independent variables.

Results:
A total of 309 PTB cases were consecutively diagnosed of 1853 presumptive TB cases recruited in the study that were identified from 2647 people who reported cough of any duration. The median (IQR) of patient delay, diagnosis delay, and the total delay was 30 (16–44), 1 (0–3), and 31 (19–48) days, respectively. Patients' delay contributed a great role in the total delay, 201/209 (96.2%). Median diagnosis delay was higher among those that visited health center, diagnosed at a facility that had no Xpert mycobacterium tuberculosis (MTB)/RIF assay, radiologist, or CXR (P < 0.05). Factors associated with patients delay were history of previous TB treatment (adjusted prevalence ratio [aPR] = 0.79, 95% confidence interval [CI]: 0.63–0.99) and history of weight loss (aPR = 1.12; 95% CI: 1.0–1.25). Early CXR screening for cough of <2 weeks duration significantly reduced the patients' delay and thus the total delay, but not diagnostic delay alone.

Conclusion:
Early screening using CXR minimized delays in the diagnosis of PTB among people with cough of any duration. Patients' delay was largest and contributed great role in the delay of TB cases. Screening by cough of any duration and/or CXR among people seeking healthcare along with ensuring the availability of Xpert MTB/RIF assay and skilled human power at primary healthcare facilities are important to reduce patient and diagnostic delays of PTB in Ethiopia.