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Tuberculosis (TB) treatment is more challenging for patients with silicosis, as it complicates the diagnosis of both diseases and increases mortality risk. Silicosis, an incurable occupational disease, confounds the diagnosis of TB and vice versa, making it more difficult to accurately identify and treat either condition. Moreover, TB appears to accelerate the progression of silicosis. Exposure to silica dust, a common cause of silicosis, can also trigger latent TB to become active TB. This correspondence outlines a proposed framework for implementing collaborative TB-silicosis activities in India, aimed at improving early diagnosis and management for both diseases. An expert panel of medical professionals developed this framework through online consultations in October and November 2022. The panel's goal was to establish a consensus on integrating TB-silicosis activities, with a focus on early detection and proper management. The framework suggests testing all patients with silicosis for active TB and screening workers exposed to silica dust for latent TB infection. It also recommends that patients with TB who have a history of occupational exposure to silica dust should be tested for silicosis. Reliable diagnostic tools, such as chest X-rays, are emphasized, providing guidance on their use for both diseases. The proposed collaborative TB-silicosis framework offers a structured approach to identifying and managing these two diseases, contributing to the global goal of eliminating silicosis by 2030 and aligning with the World Health Organization's targets for reducing TB incidence and mortality. It recommends specific strategies for implementation, including testing, referral systems, and workplace-based interventions. The framework also underscores the need for coordinated efforts among stakeholders, including the ministries of health, labor, industry, and environment. This correspondence provides valuable insights into how India can successfully implement collaborative TB-silicosis activities, serving as a model for other regions with similar challenges. [ABSTRACT FROM AUTHOR]

The 2021 tuberculosis (TB) preventive treatment guidelines in India included silicosis as a screening group, yet latent TB infection (LTBI) testing for silica-dust-exposed individuals is underemphasized. Focusing on an estimated 52 million silica-dust-exposed workers, particularly agate-stone workers in Khambhat, Gujarat, our study aims to estimate LTBI prevalence, identify predictors, and gather insights from TB and silicosis experts. Employing a sequential explanatory mixed-methods approach, a cross-sectional study involved 463 agate-stone workers aged ≥ 20 years in Khambhat, using IGRA kits for LTBI testing. In-depth interviews with experts complemented quantitative findings. Among agate-stone workers, 58% tested positive for LTBI, with predictors including longer exposure, type of work, and BCG vaccination. Our findings reveal a nearly double burden of LTBI compared to the general population, particularly in occupations with higher silica dust exposure. Experts advocate for including silica-dust-exposed individuals in high-risk groups for LTBI testing, exploring cost-effective alternatives like improved skin sensitivity tests, and shorter TB preventive treatment regimens to enhance compliance. Future research should explore upfront TB preventive treatment for silica-dust-exposed individuals with high LTBI prevalence and optimal exposure duration. This study underscores the urgent need for policy changes and innovative approaches to TB prevention among silica-dust-exposed populations, impacting global occupational health strategies. [ABSTRACT FROM AUTHOR]

Background: HCMV causes severe clinical complications in transplant recipients and may lead to graft rejection. Successful renal transplantation heavily relies on the early prevention and diagnosis of CMV infections, followed by prompt prophylactic treatment before transplantation. Despite the majority of renal rejection cases with acute HCMV infections being asymptomatic and occurring one to two years later, the objective of this research was to comprehend the effect of late HCMV infection on renal rejection by examining specific clinical parameters in the Eastern Indian cohort. Method: In this study, 240 patients were studied for five years following transplantation, and their data were collected from the local metropolitan hospital in Eastern India. Both HCMV-positive and -negative post-transplant patients were investigated using the clinical parameters and viral loads for latent infection. Results: Within the studied population, 79 post-transplant patients were found to be HCMV positive. Among them, 13 (16.45%) patients suffered from renal rejection within less than 2 yrs. of transplantation (early rejection) and 22 (27.84%) patients suffered from renal rejection after 2 yrs. from the operation date (late rejection). Assessment of clinical parameters with respect to HCMV infection revealed that in early rejection cases, fever (p-0.035) and urinary tract infection (p-0.017) were prominent, but in late rejection, hematuria (p-0.032), diabetes (p-0.005), and creatinine level changes (p < 0.001) were significant along with urinary tract infection (p-0.047). Conclusions: This study provides valuable insights into monitoring latent CMV infections and highlights the understanding of reducing renal rejection rates and the need for further research in this field. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) remains a major public health problem in India. Individuals with latent infection do not have active disease and cannot spread Tuberculosis Infection (TBI). The prevalence of latent TB in India is very high, ranging from 40-50%. About 5 to 10% of them may convert into active TB disease. The national program primarily recommends treatment for active TB, while treatment of latent TB is recommended only in special situations. Aim: To assess the efficacy of short-course weekly Isoniazid and Rifapentine (HP) regimen as Tuberculosis Preventive Treatment (TPT) among various risk groups. Materials and Methods: A systematic review and meta-analysis were conducted, involving of about 10 Randomised Control Trials (RCTs). Studies published between 2006 and 2023 were included. Online databases such as PubMed, Google Scholar, Clinical Trial Registry India, and grey literature were searched using keywords like Isoniazid, Rifapentine, and trial. Results: In terms of TB incidence, the pooled risk ratio favoured the weekly HP regimen, estimated at 0.69 (0.49, 0.97, 95% CI). Regarding the incidence of hepatotoxicity, the weekly HP regimen showed neither superiority nor inferiority to comparators, with a pooled risk ratio of 0.50 (0.23, 1.05, 95% CI). The odds of completing treatment were 2.19 times greater for the weekly HP regimen than for controls, with a pooled odds ratio of 2.19 (1.64, 2.92; 95% CI). Conclusion: The weekly HP regimen is superior to other regimens in reducing the incidence of TB. Additionally, the duration of the HP regimen is shorter compared to the commonly advised nine-month Isoniazid regimen. Compared with the daily dosage of Isoniazid, the weekly HP regimen offers better compliance. It also exhibits a significantly higher treatment completion rate. In summary, the weekly HP regimen is superior to other regimens. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this study was to ascertain the acceptance, initiation, implementation and treatment completion rates of tuberculosis (TB) preventive therapy (TPT) using 3HP (INH‐Rifapentine) among household contacts of microbiologically confirmed drug sensitive TB cases on anti‐tubercular treatment under programmatic real‐world settings. The secondary objectives were to estimate the prevalence and predictors of latent TB infection (LTBI) in household contacts of the index TB cases. We also ascertained the safety profile of the 3HP TPT regimen in the household contacts. Methods: This prospective observational study was conducted at 10 TB chest clinics in Delhi, India during 2022–2023. Household contacts aged 14 and older who tested positive for TB infection on a Tuberculin Skin test were initiated on the 3HP regimen. Logistic regression was performed by including statistically significant independent variables in multiple prediction models. p < 0.05 was considered statistically significant. STATA, version 15.1, was used to compute all analyses. Results: A total of 1067 (84.68%) eligible contacts of microbiologically confirmed, drug sensitive TB cases underwent screening with tuberculin skin test (TST), 614 (95.6%) LTBI positive contacts accepted the initiation of TPT, and 564 (91.8%) of those initiated on TPT completed the treatment. The major reason for refusal of screening was the lack of perception of risk of TB disease due to asymptomatic status. The prevalence of LTBI positivity through TST was 61.5% (95% CI, 58.5%, 64.4%). Adverse events were reported by 195 (31.8%) contacts initiated on 3HP of which 20 participants discontinued TPT. None of the sociodemographic factors showed a significant association with LTBI positivity (except age) or TPT completion rates. Conclusion: LTBI management with 3HP is feasible among adolescent and adult household contacts in India with high rates of adherence from initiation until treatment completion. The maximum attrition of participants occurred at the time of screening for LTBI using TST. [ABSTRACT FROM AUTHOR]

Herpes simplex virus 1 (HSV1) is a neuro-invasive virus causing lifelong latent infection in humans. It increases the risk of dementia by entering inside the brain. Herpesviruses have been implicated in Alzheimer's disease (AD) development. More than 50 million people worldwide are affected by Alzheimer's disease. Alzheimer's disease is becoming more prevalent with the increase age-related neurodegenerative diseases, dementia, etc. Therefore, there is an urgent need for better understanding of the pathogenesis of AD as well as its early detection. HSV-1 is a risk factor of for the occurrence of neurodegenerative diseases, sporadic Alzheimer's disease, prior diagnosis of disease cycle of Herpes Simplex Virus Type 1 in brain tissue will help us to prevent AD in elderly patients. Serological assays were the first choice of detection including whole-antigen-based (non-gG-specific) methods and western blotting (WB) assays, but quantitative PCR (qPCR) & genomic sequencing has shown better efficiency. Recently RNAscope, a novel in situ RNA hybridization assay is developed to visualize and detect the multiple phases of HSV-1. In this review, we discussed about early detection of tau and β-amyloid protein which are biomarkers of AD and track the deposition of amyloid plaques reminiscent in brain. We also discussed the current work on HSV detection through RNAscope hybridization technique & summarized the role of dietary habits as a precautionary measure of the infection as well as anthropological diversification of dementia in India and factors influencing it. We also pointed out some knowledge gaps that are further required to be taken after detection of the infection. [ABSTRACT FROM AUTHOR]

Background: Individuals with HIV infection are at increased risk of rapid progression of a recently acquired tuberculous infection, as well as of re-activation of latent TB infection (LTBI). Tuberculin skin tests (TST) are of very low sensitivity in detecting LTBI in a setting of HIV in a high prevalence country like India where both the diseases are co-existing and are endemic. Recently introduced Interferon gamma release assays (IGRA) are promising tests for the diagnosis of LTBI. Hence, in this study, we evaluated the role of Quantiferon TB Gold assay (QFT-G) in detection of LTBI among HIV positive subjects, compared the performance of the two tests for diagnosing LTBI in HIV Positive population and study the determinants of positive latent TB assay results. Methods: 264 patients were enrolled for the study which included 120 HIV-positive persons, 120 healthy controls and 24 patients of Tuberculosis alone (without HIV) who served as positive controls. Some patients were lost to follow up hence only 114 patients with HIV, 111 controls and all 24 patients with active TB (Total 249) were included in analysis All study subjects underwent clinical examination, a radiological examination, sputum examination for AFB and USG Abdomen to detect retroperitoneal lymphadenopathy. Blood was drawn from all the subjects for QFT-G following which the TST was carried out. Data was analyzed using the SPSS software package version 17.0 (SPSS Inc., Chicago, Illinois, USA). Concordance between dichotomized TST and QFG was assessed by kappa (K) coefficient. Fisher's exact test, Chi- square test for association and t test were used for comparisons where appropriate. Results: TST positivity (At a cut off point of 5 mm, Mantoux was positive in 20/24 patients giving it a sensitivity of 83.3% while at a cut off of 10 mm the sensitivity reduced to 66.6%.) and Quantiferon positivity(66.6%) were similar amongst both HIV patients and controls, though both were significantly lesser than in active TB cases as expected. A modest concordance was seen between TST and quantiferon in all 3 groups, both at mantoux positivity level of 5 mm and 10 mm, with kappa coefficient ranging between 0.4 to 0.6. BCG scar presence was associated with a trend towards higher mantoux positivity especially in HIV positive groups. TST was both more sensitive and specific ( at a cut off of 5mm, specificity was 64.8% while at a cut off of 10 mm it increased to 72% ) than QFN as discerned from patients with active TB. However, amongst HIV positive patients, the percentage of QFN positivity was higher than TST suggesting that anergy due to HIV affects TST test more than QFN. This was more marked amongst patients with a CD4< 200 cells. To conclude, sensitivity of both TST and QFN are similar to detect LTBI in India. Considering the high cost of QFN over TST, TST remains the simplest cost effective method to detect LTBI in India. We recommend using 5 TU as a routine, especially in HIV patients rather than 2 TU as the detection rates increase with the same. [ABSTRACT FROM AUTHOR]

In this work we define a modified SEIR model that accounts for the spread of infection during the latent period, infections from asymptomatic or pauci-symptomatic infected individuals, potential loss of acquired immunity, people's increasing awareness of social distancing and the use of vaccination as well as non-pharmaceutical interventions like social confinement. We estimate model parameters in three different scenarios—in Italy, where there is a growing number of cases and re-emergence of the epidemic, in India, where there are significant number of cases post confinement period and in Victoria, Australia where a re-emergence has been controlled with severe social confinement program. Our result shows the benefit of long term confinement of 50% or above population and extensive testing. With respect to loss of acquired immunity, our model suggests higher impact for Italy. We also show that a reasonably effective vaccine with mass vaccination program are successful measures in significantly controlling the size of infected population. We show that for a country like India, a reduction in contact rate by 50% compared to a reduction of 10% reduces death from 0.0268 to 0.0141% of population. Similarly, for a country like Italy we show that reducing contact rate by half can reduce a potential peak infection of 15% population to less than 1.5% of population, and potential deaths from 0.48 to 0.04%. With respect to vaccination, we show that even a 75% efficient vaccine administered to 50% population can reduce the peak number of infected population by nearly 50% in Italy. Similarly, for India, a 0.056% of population would die without vaccination, while 93.75% efficient vaccine given to 30% population would bring this down to 0.036% of population, and 93.75% efficient vaccine given to 70% population would bring this down to 0.034%. [ABSTRACT FROM AUTHOR]

This article discusses the importance of TB preventive treatment (TPT) for household contacts in India. It states that 5-10% of individuals who come into contact with a pulmonary TB case will develop TB disease at some point in their lives. TPT is recommended for all groups who may have latent TB infection, including children, adolescents, and adult household contacts. The article highlights that clear guidance on TPT for those who missed it was lacking, but a new guidance was issued in June 2022, stating that TPT can still be provided up to 2 years after TB exposure. The article acknowledges the importance of operational considerations in implementing TPT effectively. [Extracted from the article]

Introduction: Acute Rheumatic Fever/Rheumatic Heart Disease (ARF/RHD), a sequel of group A streptococcal (GAS) infection, even today constitutes a public health issue in developing countries including India. Differences in the prevalence of ARF/RHD in countries with a similar prevalence of GAS infections indicate the role of other cofactors in pathogenesis of RHD. Methodology: We investigated the prevalence of enterovirus (EV) in RHD by probing for both EV RNA and VP1 protein using Nonisotopic In Situ Hybridization (NISH) and Immunohistochemistry (IHC) respectively in 75 valvectomy specimens obtained from RHD cases. Results: Twenty-eight (37%) of the valves showed tissue inflammation with lymphocytic infiltration in a majority of the cases. Twenty-six and 27 (38% and 40%) of the 68 valves showed the presence of EV by IHC and NISH respectively, indicating a very good association between the two tests; however, only about 46 to 48% of them exhibited tissue inflammation. In eight cases (12%) the EV genome was detectable in absence of VP1 protein perhaps indicating a latent viral infection. Conclusions: Due to a high degree of endemicity of EV in India, we are tempted to speculate that EV may be responsible for the severity and rapid progression of RHD. The virus could either be working synergistically with GAS or could be an opportunist infecting damaged valves. [ABSTRACT FROM AUTHOR]

The yellow mosaic disease (YMD) of blackgram caused by Mungbean yellow mosaic virus has emerged as a serious threat to grain legume production, especially in Southeastern Asia. Seasonal incidence of YMD with its vector population was assessed in three different agroclimatic zones of Tamil Nadu in India for three consecutive cropping seasons namely, Rabi 2018 (October-December), Summer 2019 (March-May), and Kharif 2019 (June-August) at three different time intervals viz., 20, 40, and 60 days after sowing (DAS). For all three seasons, disease incidence and whitefly count were recorded for a resistant and susceptible variety of blackgram in fields without any vector control intervention. The highest disease incidence (87%) was observed in the Panpozhi location during the summer season followed by Vamban and Coimbatore locations. The whitefly count was made through both visual count and yellow sticky traps. The whitefly population was highest at 20 DAS and decreased with the increasing age of crop for all the three locations assessed. Molecular epidemiology was analyzed by determining latent infection of mungbean yellow mosaic virus (MYMV) using molecular diagnosis. Latent infection was found to be well pronounced in the Coimbatore location during the Kharif season, where the crop was asymptomatic in both the resistant and susceptible varieties for all the three time periods assessed. The latent infection of MYMV observed in Coimbatore and Vamban ranged from 16.6 to 83.3% in both resistant and susceptible varieties for all three seasons. In Panpozhi, the latent infection of MYMV ranged from 16.6 to 66.6% for the susceptible variety (CO-5) for all three seasons observed. However, in the Panpozhi location, the resistant variety (VBN-8) failed to record any latent infection., (© 2022. The Author(s) under exclusive licence to International Society of Biometeorology.)

Incidence of Leishmania donovani infection and Visceral Leishmaniasis (VL) was assessed in a prospective study in Indian and Nepalese high-endemic villages. DAT-seroconversion was used as marker of incident infection in 3 yearly surveys. The study population was followed up to month 30 to identify incident clinical cases. In a cohort of 9034 DAT-negative individuals with neither active signs nor history of VL at baseline, 42 VL cases and 375 asymptomatic seroconversions were recorded in the first year, giving an infection∶disease ratio of 8.9 to 1. In the 18 months' follow-up, 7 extra cases of VL were observed in the seroconverters group (N = 375), against 14 VL cases among the individuals who had not seroconverted in the first year (N = 8570) (RR = 11.5(4.5