Comparison of Latent Tuberculosis Infections among General versus Tuberculosis Health Care Workers in Myanmar.

Health care workers (HCWs) in high tuberculosis (TB) prevalence countries have to care for many cases, thus increasing their risk of infection. The objective of the study was to compare the prevalence of latent TB infection (LTBI) between general HCWs and TB HCWs, and also to explore the associated factors. A cross-sectional study was conducted in Nay Pyi Taw, Myanmar from September 2019 to January 2020. Staff working at two general hospitals were recruited. Those allocated for TB care were classified as TB HCWs, while the remaining were classified as general HCWs. Participants were interviewed using a structured questionnaire, and screened for LTBI using a tuberculin skin test (TST). Individuals who had an induration of 10 mm or more with normal chest radiograph were regarded as having LTBI. The prevalence of LTBI among general HCWs was 2.04 times higher than that of TB HCWs (31.2% vs. 15.3%, p < 0.001). The associated factors for LTBI included low education level, duration of work experience ≥ 10 years, a low knowledge of regular TB screening, and teaching cough etiquette to TB patients. The higher prevalence of LTBI in the general HCWs in this study was due to confounding by education and experience. After adjustment for these, we have no evidence to support that either group of HCWs had higher LTBI risk.

Coverage of tuberculosis and diabetes mellitus screening among household contacts of tuberculosis patients: a household-based cross-sectional survey from Southern Thailand.

BACKGROUND: The comorbid presence of tuberculosis and diabetes mellitus has become an increasingly important public health threat to the prevention and control of both diseases. Thus, household contact investigation may serve a dual purpose of screening for both tuberculosis and diabetes mellitus among household contacts. We therefore aimed to evaluate the coverage of screening for tuberculosis and diabetes mellitus among household contacts of tuberculosis index cases and to determine predictors of tuberculosis screening. METHODS: A household-based survey was conducted in February 2019 in Muang district of Phatthalung Province, Thailand where 95 index tuberculosis patients were newly diagnosed with pulmonary or pleural tuberculosis between October 2017 and September 2018. Household contacts of the index patients were interviewed using a structured questionnaire to ascertain their past-year history of tuberculosis screening and, if appropriate, diabetes mellitus screening. For children, the household head or an adult household member was interviewed as a proxy. Coverage of tuberculosis screening at the household level was regarded as households having all contacts screened for tuberculosis. Logistic regression and mixed-effects logistic regression models were used to determine predictors of tuberculosis screening at the household and individual levels, respectively, with the strengths of association presented as adjusted odds ratios (AOR) and 95% confidence intervals (CI). RESULTS: Of 61 responding households (64%), complete coverage of tuberculosis screening at the household level was 34.4% and among the 174 household contacts was 46.6%. About 20% of contacts did not receive any recommendation for tuberculosis screening. Households were more likely to have all members screened for tuberculosis if they were advised to be screened by a healthcare professional rather than someone else. At the individual level, contacts aged ≥35 years (AOR: 30.6, 95% CI: 2.0-466.0), being an employee (AOR: 0.1, 95% CI: 0.0-0.8) and those who had lived more than 5 years in the same household (AOR: 0.1, 95% CI: 0.0-0.8) were independent predictors for tuberculosis screening. Coverage of diabetes mellitus screening was 80.6% with lack of awareness being the main reason for not being screened. CONCLUSIONS: Compared to diabetes screening, the coverage of tuberculosis screening was low. A better strategy to improve coverage of tuberculosis contact screening is needed.

Colorful patterns indicate common ancestry in diverged tiger beetle taxa: Molecular phylogeny, biogeography, and evolution of elytral coloration of the genus Cicindela subgenus Sophiodela and its allies.

We investigated the phylogenetic relationships among tiger beetles of the subtribe Cicindelina (=Cicindela s. lat.; Coleoptera: Cicindelidae) mainly from the Oriental and Sino-Japanese zoogeographic regions using one mitochondrial and three nuclear gene sequences to examine the position of the subgenus Sophiodela, currently classified in the genus Cicindela s. str., their biogeography, and the evolution of their brilliant coloration. The subgenus Sophiodela was not related to the other subgenera of Cicindela s. str. but was closely related to the genus Cosmodela. In addition, the Oriental genus Calochroa was polyphyletic with three lineages, one of which was closely related to Sophiodela and Cosmodela. The clade comprising Sophiodela, Cosmodela and two Calochroa species, referred to here as the Sophiodela group, was strongly supported, and most species in this clade had similar brilliant coloration. The Sophiodela group was related to the genera Calomera, Cicindela (excluding Sophiodela) and Cicindelidia, and these were related to Lophyra, Hipparidium and Calochroa, except species in the Sophiodela group. Divergence time estimation suggested that these worldwide Cicindelina groups diverged in the early Oligocene, and the Sophiodela group, which is found in the Oriental and Sino-Japanese zoogeographic regions, in the mid Miocene. Some components of the elytral pattern related to maculation and coloration in the Cicindelina taxa studied contained weak, but significant, phylogenetic signals and were partly associated with habitat types. Therefore, the brilliant coloration of the Sophiodela was related to both phylogeny and habitat adaptation, although the function of coloration needs to be studied.