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  1. AU="Ezhumalai, Komala"
  2. AU="Bala, Jecintha J"

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  1. Article ; Online: Undernourished Household Contacts Are at Increased Risk of Tuberculosis (TB) Disease, but not TB Infection- a Multicenter Prospective Cohort Analysis.

    Sinha, Pranay / Ezhumalai, Komala / Du, Xinyi / Ponnuraja, Chinnaiyan / Dauphinais, Madolyn Rose / Gupte, Nikhil / Sarkar, Sonali / Gupta, Amita / Gaikwad, Sanjay / Thangakunam, Balamugesh / Paradkar, Mandar / Christopher, Devasahayam J / Mave, Vidya / Viswanathan, Vijay / Ellner, Jerrold J / Kornfeld, Hardy / Horsburgh, C R / Padmapriyadarsini, Chandrasekaran / Gupte, Akshay

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2024  

    Abstract: Undernutrition is the leading risk factor for tuberculosis (TB) globally and in India. This multicenter prospective cohort analysis from India suggests that undernutrition is associated with increased risk of TB disease but not TB infection among ... ...

    Abstract Undernutrition is the leading risk factor for tuberculosis (TB) globally and in India. This multicenter prospective cohort analysis from India suggests that undernutrition is associated with increased risk of TB disease but not TB infection among household contacts of persons with TB.
    Language English
    Publishing date 2024-04-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciae149
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Comparison of IGRA and TST in the diagnosis of latent tuberculosis among women of reproductive age in South India.

    Prakash Babu, Senbagavalli / Ezhumalai, Komala / Raghupathy, Kalaivani / Sundaresan, Madhusudanan / Jain, Komal / Narasimhan, Prakash Babu / Knudsen, Selby / Horsburgh, C Robert / Hochberg, Natasha S / Salgame, Padmini / Ellner, Jerrold / Sarkar, Sonali

    The Indian journal of tuberculosis

    2022  Volume 70, Issue 1, Page(s) 12–16

    Abstract: Background: Latent tuberculosis infection (LTBI) is a mycobacterial infection defined on the basis of cellular immune response to mycobacterial antigens. The tuberculin skin test (TST) and the Interferon-Gamma Release Assay (IGRA) are the two tests ... ...

    Abstract Background: Latent tuberculosis infection (LTBI) is a mycobacterial infection defined on the basis of cellular immune response to mycobacterial antigens. The tuberculin skin test (TST) and the Interferon-Gamma Release Assay (IGRA) are the two tests currently used to establish the diagnosis of LTB. Literature suggests that a study regarding tuberculosis (TB) infection among women of reproductive age group is limited.
    Methods: Female household contact, married, aged 18-49 years underwent written consent form and are screened for LTBI using the TST and IGRA. Participants are injected with TST [5 tuberculin unit (TU), purified protein derivative (PPD)] and IGRA [QuantiFERON®-TB Gold Plus kit (QFT-Plus)]. All the household contacts were followed-up for one year for incident TB cases. Statistical analysis was done using STATA version 14 (StataCorp., Texas, USA). Cohen's kappa test was used to determine the agreement between two tests.
    Results: The prevalence of LTBI was found to be 69% (either TST or IGRA positive). Positivity rate of IGRA was higher when compared to that of TST. Out of 139 participants, 68 (49%) tested positive for TST, 80 (57.6%) tested positive for IGRA and 52 (37.4%) tested positive for both. Discordant results were observed in about two fifth of the study population and there was poor agreement between the two tests.
    Conclusion: Longitudinal studies are required to detect incident TB cases to evaluate the usefulness of these tests. The study was found that IGRA is more consistent to diagnosis of latent tuberculosis infection than the TST. Such studies can also be performed in varied settings among different populations which would help us to improve the diagnosis of LTBI and consequently help in TB control.
    MeSH term(s) Humans ; Female ; Interferon-gamma Release Tests/methods ; Latent Tuberculosis/diagnosis ; Latent Tuberculosis/epidemiology ; Tuberculin Test/methods ; Tuberculosis ; India/epidemiology
    Language English
    Publishing date 2022-03-16
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 603129-8
    ISSN 0019-5707 ; 0019-5705
    ISSN 0019-5707 ; 0019-5705
    DOI 10.1016/j.ijtb.2022.03.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Predictors of weight loss during the intensive phase of tuberculosis treatment in patients with drug-susceptible pulmonary tuberculosis in South India.

    Kalva, Jayashree / Babu, Senbagavalli P / Narasimhan, Prakash B / Raghupathy, Kalaivani / Ezhumalai, Komala / Knudsen, Selby / Horsburgh, Charles R / Hochberg, Natasha / Salgame, Padmini / Roy, Gautam / Ellner, Jerrold / Sarkar, Sonali

    Journal of public health (Oxford, England)

    2022  Volume 45, Issue 3, Page(s) 545–552

    Abstract: Background: Tuberculosis (TB) is well-known for causing wasting. Patients on treatment gain weight and weight loss is associated with unfavorable treatment outcomes. There is limited description of weight loss and its predictors during intensive ... ...

    Abstract Background: Tuberculosis (TB) is well-known for causing wasting. Patients on treatment gain weight and weight loss is associated with unfavorable treatment outcomes. There is limited description of weight loss and its predictors during intensive treatment phase. The objective of this study was to assess the predictors of weight loss during intensive phase and to see if there is any association exists with sputum conversion at the end of intensive phase of treatment.
    Methods: Data collected as a part of the prospective TB cohort (Regional Prospective Observational Research for TB India Phase 1) conducted in Pondicherry, Cuddalore and Viluppuram districts of Tamil Nadu were used for this study. Sputum smear and body weight comparison were made in the baseline and at the end of second month of treatment.
    Results: In all, 726 participants had weight measurements at the two time points and 18.7% had weight loss; mean weight lost being 2.3 kg (SD 3.05). Mean weight loss was more among males (2.4 kg, SD 3.2), diabetics (2.8 kg, SD 3.9) and alcoholics (2.1 kg, SD 2.4). Alcohol consumption was the only predictor of weight loss after adjusting for age, diabetes, marital status and BMI (aRR 1.52, P 0.02). Weight loss was not associated with sputum conversion at the end of second month.
    Conclusions: Alcohol use emerged as the major predictor for weight loss during intensive phase.
    MeSH term(s) Male ; Humans ; Antitubercular Agents/therapeutic use ; Prospective Studies ; India/epidemiology ; Tuberculosis, Pulmonary/drug therapy ; Tuberculosis, Pulmonary/epidemiology ; Tuberculosis/drug therapy ; Treatment Outcome ; Diabetes Mellitus ; Weight Loss
    Chemical Substances Antitubercular Agents
    Language English
    Publishing date 2022-11-30
    Publishing country England
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2142082-8
    ISSN 1741-3850 ; 1741-3842
    ISSN (online) 1741-3850
    ISSN 1741-3842
    DOI 10.1093/pubmed/fdac141
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Development of prognostic scoring system for predicting 1-year mortality among pulmonary tuberculosis patients in South India.

    Krishnamoorthy, Yuvaraj / Ezhumalai, Komala / Murali, Sharan / Rajaa, Sathish / Majella, Marie Gilbert / Sarkar, Sonali / Lakshminarayanan, Subitha / Joseph, Noyal Mariya / Soundappan, Govindarajan / Prakash Babu, Senbagavalli / Horsburgh, Charles / Hochberg, Natasha / Johnson, W Evan / Knudsen, Selby / Pentakota, Sri Ram / Salgame, Padmini / Roy, Gautam / Ellner, Jerrold

    Journal of public health (Oxford, England)

    2022  Volume 45, Issue 2, Page(s) e184–e195

    Abstract: Background: Development of a prediction model using baseline characteristics of tuberculosis (TB) patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did ... ...

    Abstract Background: Development of a prediction model using baseline characteristics of tuberculosis (TB) patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did this study to develop a prognostic-scoring model for predicting the death among newly diagnosed drug sensitive pulmonary TB patients in South India.
    Methods: We undertook a longitudinal analysis of cohort data under the Regional Prospective Observational Research for Tuberculosis India consortium. Multivariable cox regression using the stepwise backward elimination procedure was used to select variables for the model building and the nomogram-scoring system was developed with the final selected model.
    Results: In total, 54 (4.6%) out of the 1181 patients had died during the 1-year follow-up period. The TB mortality rate was 0.20 per 1000 person-days. Eight variables (age, gender, functional limitation, anemia, leukopenia, thrombocytopenia, diabetes, neutrophil-lymphocyte ratio) were selected and a nomogram was built using these variables. The discriminatory power was 0.81 (95% confidence interval: 0.75-0.86) and this model was well-calibrated. Decision curve analysis showed that the model is beneficial at a threshold probability ~15-65%.
    Conclusions: This scoring system could help the clinicians and policy makers to devise targeted interventions and in turn reduce the TB mortality in India.
    MeSH term(s) Humans ; Prognosis ; Tuberculosis, Pulmonary ; Tuberculosis ; Nomograms ; Probability ; India/epidemiology ; Retrospective Studies
    Language English
    Publishing date 2022-08-29
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2142082-8
    ISSN 1741-3850 ; 1741-3842
    ISSN (online) 1741-3850
    ISSN 1741-3842
    DOI 10.1093/pubmed/fdac087
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Prevalence and risk factors associated with latent tuberculosis infection among household contacts of smear positive pulmonary tuberculosis patients in South India.

    Krishnamoorthy, Yuvaraj / Ezhumalai, Komala / Murali, Sharan / Rajaa, Sathish / Jose, Maria / Sathishkumar, Abilasha / Soundappan, Govindarajan / Horsburgh, Charles / Hochberg, Natasha / Johnson, William Evan / Knudsen, Selby / Salgame, Padmini / Ellner, Jerrold / Prakash Babu, Senbagavalli / Sarkar, Sonali

    Tropical medicine & international health : TM & IH

    2021  Volume 26, Issue 12, Page(s) 1645–1651

    Abstract: Objective: We aimed to determine the prevalence and find the risk factors associated with latent tuberculosis infection (LTBI) among the household contacts (HHC) of pulmonary TB patients.: Methods: This cohort study was conducted from 2014 to 2019. ... ...

    Abstract Objective: We aimed to determine the prevalence and find the risk factors associated with latent tuberculosis infection (LTBI) among the household contacts (HHC) of pulmonary TB patients.
    Methods: This cohort study was conducted from 2014 to 2019. Pretested standardised questionnaires and tools were used for data collection. The prevalence of LTBI among HHCs of TB patients was summarised as proportion with 95% confidence interval (CI). Mixed-effects generalised linear modelling function (meglm) in STATA with family Poisson and log link was performed to find the factors associated with LTBI.
    Results: In total, 1523 HHC of pulmonary TB patients were included in the study. Almost all HHC shared their residence with the index case (IC) for more than a year; 25% shared the same bed with the IC. The prevalence of LTBI among the HHC of TB patients was 52.6% (95% CI: 50.1-55.1%). In an adjusted model, we found that among HHC belonging to the age group of 19-64 years (aIRR = 1.2; 95% CI: 1.1-1.3; p-value: 0.02), to the age group >65 years (aIRR = 1.4, 95% CI: 1.1-1.9, p-value: 0.02) and sharing the same bed with the IC (aIRR = 1.2, 95% CI: 1.1-1.3, p value: 0.04) were independent determinants of LTBI among the HHC.
    Conclusion: One in two household contacts of TB patients have latent tuberculosis infection. This underscores the need of targeted contact screening strategies, effective contact tracing and testing using standardised methods in high TB burden settings.
    MeSH term(s) Adolescent ; Adult ; Aged ; Cohort Studies ; Contact Tracing ; Family Characteristics ; Female ; Humans ; India/epidemiology ; Latent Tuberculosis/diagnosis ; Latent Tuberculosis/epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Tuberculosis, Pulmonary/diagnosis ; Tuberculosis, Pulmonary/epidemiology ; Young Adult
    Language English
    Publishing date 2021-10-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 1314080-2
    ISSN 1365-3156 ; 1360-2276
    ISSN (online) 1365-3156
    ISSN 1360-2276
    DOI 10.1111/tmi.13693
    Database MEDical Literature Analysis and Retrieval System OnLINE

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