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Tuberculosis (TB) stands as the leading cause of death and a significant threat to humanity in the contemporary world. Early detection of TB is crucial for precise identification and treatment, and Chest X-Rays (CXR) serve as a valuable tool in this regard. Computer-Aided Diagnosis (CAD) systems play a vital role in easing the classification process of active and latent TB. This paper uses an approach called the Double Attention Res-U-Net-based Deep Neural Network (DARUNDNN) to enhance TB detection in the lungs. The detection process involves pre-processing, noise removal, image level balancing, the application of the DARUNDNN model and using the Whale Optimization Algorithm (WOA) for improved accuracy. Experimental validation using Montgomery Country (MC), Shenzhen China (SC), and NIH CXR Datasets compares the results with U-Net, AlexNet, GoogleNet, and convolutional neural network (CNN) models. The findings, particularly from the SC dataset, demonstrate the efficiency of the proposed DARUNDNN model with an accuracy of 98.6%, specificity of 96.24%, and sensitivity of 97.66%, outperforming benchmarked deep learning models. Additionally, validation with the MC dataset reveals an excellent accuracy of 98%, specificity of 97.56%, and sensitivity of 98.52%.

Understanding the impact of human behavior on the spread of infectious diseases might be the key to developing better control strategies. Tuberculosis (TB) is an infectious disease caused by bacteria that mostly affects the lungs. TB remains a global health issue due to its high mortality. The paper proposes a spatiotemporal discrete tuberculosis model, based on the assumption that individuals can be classified as susceptible, exposed, infected, and recovered (SEIR). The objective of this work is to introduce a strategy of control that will reduce the number of exposed and infected individuals. Three controls are established to accomplish this. The first control is a public awareness campaign that will educate the public on the signs, symptoms, and treatments of tuberculosis, allowing them to seek treatment if they are at risk. The second control initiates chemoprophylaxis efforts for people who are latently infected, and the third control characterizes the treatment effort for people who are actively infected. We have shown the existence of optimal controls to give a characterization of controls in terms of states and adjoint functions by using Pontryagin’s maximum principle. Using numerical simulations, our results indicate that awareness campaigns should be combined with treatment and chemoprophylaxis techniques to reduce transmission. As a result, it demonstrates the efficacy of the suggested control strategies in reducing the impact of the disease.

In this work we present an agent-based model for the spread of tuberculosis where the individuals can be infected with either drug-susceptible or drug-resistant strains and can also receive a treatment. The dynamics of the model and the role of each one of the parameters are explained. The whole set of parameters is explored to check their importance in the numerical simulation results. The model captures the beneficial impact of the adequate treatment on the prevalence of tuberculosis. Nevertheless, depending on the treatment parameters range, it also captures the emergence of drug resistance. Drug resistance emergence is particularly likely to occur for parameter values corresponding to less efficacious treatment, as usually found in developing countries.

Tuberculosis (TB) is among the 10 top causes of deaths worldwide, and one-quarter of the world population hosts latent TB pathogens. Therefore, avoiding the emergence of drug-resistant strains has become a central issue in TB control. In this work, we propose a nested model for TB transmission and control, wherein both within-host and between-host dynamics are modeled. We use the model to compare the effects of three types of antibiotic treatment protocols and combinations thereof in an in silico population. For a fixed value of antibiotics clearance rate and relative efficacy against resistant strains, the oscillating intermittent protocol, pure or combined, is the most effective against the sensitive strains. However, this protocol also creates a selective advantage for the resistant strains, returning the worst result in comparison to the other protocols. We suggest that nested models should be further developed, since they might be able to inform decision-makers regarding the optimal TB control protocols to be applied under the specific parameters and other epidemiological factors in different populations.

This paper deals with the problem of modeling and parameter estimation of a deterministic model of tuberculosis (abbreviated as TB for tubercle bacillus). We first propose and analyze a tuberculosis model without seasonality that incorporates the essential biological and epidemiological features of the disease. The model is shown to exhibit the phenomenon of backward bifurcation, where a stable disease-free equilibrium coexists with one or more stable endemic equilibria when the associated basic reproduction number is less than unity. The statistical data of new TB cases show seasonal fluctuations in many countries. Then, we extend the proposed TB model by incorporating seasonality. We propose a numerical study to estimate unknown parameters according to demographic and epidemiological data in Cameroon. Simulation results are in good accordance with the seasonal variation of the reported new cases of active TB in Cameroon.

Modeling the dynamics of persistent infections presents several challenges. These diseases are characterized by long latency periods, which makes it compulsory to consider populations of varying sizes. In this paper, we discuss a model for the spreading of persistent infections in homogeneous, well-mixed, populations. We first derive the equations describing the system's dynamics and find the epidemic threshold by a stability analysis. Analytical solutions are then shown to agree with results obtained with numerical simulations. The present model, although simple, opens the path to more complex approaches to the spreading of persistent infections.

This paper analyzes the dynamics of the spread of tuberculosis (TB) on complex metapopulation, that is, networks of populations connected by migratory flows whose configurations are described in terms of connectivity distribution of nodes (patches) and the conditional probabilities of connections among classes of nodes sharing the same degree. The migration and transmission processes occur simultaneously. For uncorrelated networks, we give a necessary and sufficient condition for the instability of the disease-free equilibrium. The existence of endemic equilibria is also discussed. Finally, the prevalence of the TB infection across the metapopulation as a function of the path connectivity is studied using numerical simulations.

It has been observed that in many cases one infection can partially protect against another infection or it may lead to a co-infection. For instance, the interaction between infections with different strains, like dengue and malaria or tuberculosis and lepra, induces cross immunity. On the other hand, individuals infected with HIV are much more susceptible to other infections, for instance, tuberculosis. We propose a compartmental model to describe the transmission of AIDS and tuberculosis in a closed community as an example of one infection activating the other one. When studying the dynamics of the interactions we obtain basins of attraction where one infection prevails over the other one and where both infections coalesce. Furthermore, we are taking into account an adaptation of the model in order to assess the transmission coefficients for HIV and Mycobacterium tuberculosis infections among women inmates.

The importance of exogenous reinfection versus endogenous reactivation for the resurgence of tuberculosis (TB) has been a matter of ongoing debate. Previous mathematical models of TB give conflicting results on the possibility of multiple stable equilibria in the presence of reinfection, and hence the failure to control the disease even when the basic reproductive number is less than unity. The present study reconsiders the effect of exogenous reinfection, by extending previous studies to incorporate a generalized rate of reinfection as a function of the number of actively infected individuals. A mathematical model is developed to include all possible routes to the development of active TB (progressive primary infection, endogenous reactivation, and exogenous reinfection). The model is qualitatively analyzed to show the existence of multiple equilibria under realistic assumptions and plausible range of parameter values. Two examples, of unbounded and saturated incidence rates of reinfection, are given, and simulation results using estimated parameter values are presented. The results reflect exogenous reinfection as a major cause of TB emergence, especially in high prevalence areas, with important public health implications for controlling its spread.

This paper addresses the synergy between case detection and the implementation of DOTS in Nigeria in the control of tuberculosis using a deterministic model which incorporates many of the essential biological and epidemiological features of TB as well as DOTS surveillance and implementation parameters for Nigeria. The model differentiated between individuals who progress to the "primary" latent stage when they got infected for the first time and those who progress to the "secondary" latent class depending on whether they failed treatment or due to self-cure. The model was shown to have a locally asymptotically stable disease free equilibrium where the reproduction number was less than unity. However, it was also shown that the model is capable of exhibiting the backward bifurcation phenomenon, where the stable disease free equilibrium co-exists with a stable endemic equilibrium where the reproduction number is less than unity. We saw that increasing the case detection parameter actually reduces the backward bifurcation range. For smaller exogenous re-infection values, increasing the case detection parameter could totally eliminate the bifurcation range. Uncertainty and sensitivity analysis using the Latin hypercube sampling technique was also carried out on the parameters as well as the reproduction number and the results showed that there were three parameters that were highly influential in determining the magnitude of the reproduction number; of the three, only one, the case detection parameter, was highly influential in reducing the magnitude of the reproduction number. Results from the numerical simulation and qualitative analysis showed that DOTS expansion in Nigeria must include significant increase in case detection rates, otherwise the impressive cure rates under DOTS will pale into insignificance with the rise in the number of undetected infectious persons and the number of "secondary" latent cases.

Overall, the study shows that increasing the case detection rate will not only lower the backward bifurcation range, in the presence of exogenous re-infection, but could also lower the reproduction number, reducing the severity of the TB epidemic. This is possible as far as the current impressive treatment success rates under DOTS in Nigeria is sustained.

Optimal control theory is applied to a system of ordinary differential equations modeling the population dynamics of tuberculosis with isolation and immigration of infective. Seeking to minimize the number of infectious individuals and reduce the transmission of the disease, we use controls to represent the screening/medical testing of infected immigrants into the population as well as isolation of infective in the population. The optimal controls are characterized in terms of the optimality system, which is solved numerically for several scenarios using an iterative method with Runge-Kutta fourth order scheme. Parameter values used are those reported for Nigeria.

In this paper, mathematical analysis is carried out for a mathematical model of Tuberculosis (TB) with age-dependent latency and active infection. The model divides latent TB infection into two stages: an early stage of high risk of developing active TB and a late stage of lower risk for developing active TB. Infected persons initially progress through the early latent TB stage and then can either progress to active TB infection or progress to late latent TB infection. The model is formulated by incorporating the duration that an individual has spent in the stages of the early latent TB, the late latent TB and the active TB infection as variables. By constructing suitable Lyapunov functionals and using LaSalle’s invariance principle, it is shown that the global dynamics of the disease is completely determined by the basic reproduction number: if the basic reproduction number is less than unity, the TB always dies out; if the basic reproduction number is greater than unity, a unique endemic steady state exists and is globally asymptotically stable in the interior of the feasible region and therefore the TB becomes endemic. Numerical simulations are carried out to illustrate the theoretical results.

This paper deals with the dynamics of tuberculosis transmission model with different genders and age structures. The basic reproduction numbers ${{ℛ}}_0={{ℛ}}_F+{{ℛ}}_M$ are defined, where ${{ℛ}}_F$ and ${{ℛ}}_M$ are the basic reproduction number of tuberculosis transmission in female and male populations, respectively. The global stability of the disease-free equilibrium was discussed when ${{ℛ}}_0<1$; The existence, uniqueness and global stability of the endemic equilibrium, and the persistence of the system both were proved when ${{ℛ}}_0>1$. The findings indicate that the tuberculosis dynamical model with different genders and age structures will experience the classical threshold dynamic behaviors, that is, if ${{ℛ}}_0<1$, the disease will disappear; while if ${{ℛ}}_0>1$, the disease will spread within the population, and eventually lead to a endemic disease. Finally, the theoretical analysis of the model is verified by numerical simulation and we proposed that male infected individuals should be focused on in the prevention and control of tuberculosis in the future.

A 52-year-old woman with systemic lupus erythematosus (SLE) was infected with tuberculosis (TB) on her forearm and hand, after 16 years of steroid therapy. Debridements and anti-TB therapy were performed successfully. Recently, the risk of significant morbidity from TB has been on the rise; this appears to be a complication of steroid therapy used to treat AIDS and some collagen vascular diseases. It is thought that steroid therapy causes an increased risk of TB. In this paper, we report our experience of this SLE patient who developed tuberculous tenosynovitis. We suggest that TB infection must be considered in the differential diagnosis whenever a patient presents with a chronic wrist or hand inflammation that is non-responsive to steroid treatment. Once TB infection is suspected, both histopathological and bacteriological examinations should be performed. Emergent treatment includes surgical debridement and the institution of early anti-TB therapy immediately after completing histopathological examination.

The purpose of the series is to describe the management of tubercular osteomyelitis of metacarpals and phalanges in 11 children (range, 3–12 years) and to retrospectively analyse the relationship between radiological staging and clinical outcome following treatment. The available literature on the clinical and radiological manifestations of tubercular osteomyelitis of the hand (excluding wrist) was also reviewed. Follow-up averaged 17.7 months following completion of treatment. The different radiological descriptions of the condition could be grouped into three stages: Stage 1 (stage of soft tissue swelling and no bony changes), Stage 2 (stage of bony expansion) and Stage 3 (stage of destruction). The previously described different radiological entities of tubercular osteomyelitis of metacarpals and phalanges appear to be a sequential manifestation of the disease spectrum. Healing with non-operative treatment is excellent provided the diagnosis is made when tuberculosis presents with soft tissue swelling alone and before bony destruction occurs.

Introduction: We report the presentation, management, and outcome in five children with osteoarticular tuberculosis of distal radius.

Patients: Patients were recruited in a prospective study. All patients underwent an open biopsy, curettage and diagnosis confirmed by histopathological/microbiological examination. In cavitary lytic lesions, bone grafting was also undertaken. The multidrug anti-tubercular chemotherapy was given for one year.

Observations: Five patients were included in the study. The average follow-up post-completion chemotherapy was 34.8 months. Bony lesions presented as a poorly defined radiolucent lytic area in metaphysis, cavitary lytic lesions with or without sequestrum or spanned the physeal plate. At final follow-up, except for one case, a full pain free range of movements was achieved in all cases. Fibular graft was used in two cases with cavitary lesions and incorporated well in both cases.

Conclusions: Tuberculosis can involve the adjacent physis and can be multifocal. The presentation is usually lytic with minimal sclerosis. For smaller ill defined lesions, curettage and multidrug anti-tubercular chemotherapy results in excellent outcome. Cavitary lytic lesions should be bone grafted as there is a risk of pathological fractures.

We present a rare case of primary tuberculous tenosynovitis in a young patient with an acute history of non-penetrating traumatic injury. The patient had recently visited Pakistan and presented with sudden onset pain at the base of their right fifth digit after trying to catch a cricket ball. A provisional diagnosis of haematoma was made; however, ultrasonography revealed a mass attached to the A2 pulley. Surgical excision followed by histological examination and culture identified Mycobacterium Tuberculosis infection. This case serves to raise clinical awareness of this rare condition and highlight the importance of obtaining a travel history.

In spinal tuberculosis, children bone is easily destroyed, and as a result spinal deformity complicates in higher rates in comparison with the adult tuberculous spine. However, the pediatric spine with tuberculosis is more flexible than those of the adult-spine, because spontaneous intercorporal fusion of the diseased segments in children never occur. Thus, prevention and/or correction of the tuberculous kyphosis is easier than those of the adults. Also in particular by posterior tethering instrumentation surgery the formed kyphosis can be corrected gradually during growth period. The key message is that in pediatric spinal tuberculosis, spontaneous intercorporal fusion of the diseased segment hardly takes place even under the posterior instrument-aided stabilization and the coverage of antituberculous chemotherapy. Therefore, tuberculous spine in children even after cure should be observed until growth maturity.

Spinal tuberculosis typically affects the vertebral bodies, resulting in various degrees of kyphosis. Children <10 years, thoraco-lumbar spine affliction, late presentation, vertebral loss >1.5 bodies and presence of spine at risk signs reasonably predict patients who are prone for worsening kyphosis during both active and healed stages of the disease. Untreated kyphosis is ominous as it can result in spinal fatigue, neurological deficit, cosmetic disfigurement, and respiratory insufficiency. Kyphosis greater than $30^{\circ }$ and presence of risk factors for worsening kyphosis are considered as indications for surgery in active tuberculosis. Different surgical methods have been described with their own merits and demerits. Currently, posterior approach with or without anterior reconstruction is considered the standard technique as it is safe, efficacious, convenient, and versatile.

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