Mycobacterium tuberculosis(MTB) and human immunodeficiency virus(HIV) co-infections have remained a major public health concern worldwide,particularly in Southern Africa.Yet our understanding of the molecular interact...Mycobacterium tuberculosis(MTB) and human immunodeficiency virus(HIV) co-infections have remained a major public health concern worldwide,particularly in Southern Africa.Yet our understanding of the molecular interactions between the pathogens has remained poor,primarily due to lack of suitable preclinical models for such studies.We reviewed the use,this far,of mammalian cell culture models in HIV-MTB interaction studies.Studies have described the use of primary human cell cultures,including monocyte-derived macrophage(MDM) fractions of peripheral blood mononuclear cell(PBMC),alveolar macrophages(AM),cell lines such as the monocyte-derived macrophage cell line(U937),T lymphocyte cell lines(CEMx174,ESAT-6-specific CD4+ T-cells) and an alveolar epithelial cell line(A549) and special models such as stem cells,three dimensional(3D) or organoid cell models [including a blood-brain barrier(BBB) cell model] in HIV-MTB interaction studies.The use of cell cultures from other mammals,including:mouse cell lines [macrophage cell lines RAW 264.7 and J774.2,fibroblast cell lines(NIH 3T3,C3 H clones),embryonic fibroblast cell lines and T-lymphoma cell lines(S1A.TB,TIMI.4 and R1.1)]; rat(T cells:Rat2,RGE,XC and HH16,and alveolar cells:NR8383) and primary guinea pigs derived AMs,in HIV-MTB studies is also described.Given the spectrum of the models available,cell cultures offer great potential for host-HIV-MTB interactions studies.展开更多
Background: Pyrazinamide (PZA) is one of the most important drugs for tuberculosis (TB) treatment, however, its susceptibility is not routinely tested. High-resolution melting (HRM) curve analysis has been widely used...Background: Pyrazinamide (PZA) is one of the most important drugs for tuberculosis (TB) treatment, however, its susceptibility is not routinely tested. High-resolution melting (HRM) curve analysis has been widely used for many applications. In this study, HRM assay was developed and evaluated for the detection of PZA resistance in Mycobacterium tuberculosis clinical isolates. Methods: Ninety five M. tuberculosis clinical isolates with different susceptibility patterns to anti-TB drugs were used to evaluate this assay. Isolates were phenotypically (Bactec MGIT 960) and genotypically (HRM and pncA gene sequencing) analysed for PZA resistance. Results: Bactec MGIT 960 analysis revealed that 29 of the 95 M. tuberculosis isolates were PZA resistant. In comparison to the Bactec MGIT 960, HRM showed a sensitivity of 47.7% and specificity of 74.6%, and the overall agreement between the two methods was 68.4%. Based on DNA sequencing, a correlation of 0.67 (significant at p-value pncA mutations was observed. PZA resistance was strongly associated with multi-drug resistant (MDR)-TB as it was shown in 79.3% of the MDR isolates included in the study. Conclusion: HRM is simple and useful for screening clinical M. tuberculosis isolates for PZA resistance, however, further modifications to improve its performance are required.展开更多
A major challenge in the treatment of Tuberculosis (TB) is emergence of Multi-Drug Resistant <em>Mycobacterium tuberculosis</em> (MDRTB) strains. Efflux genes have been established to be among factors for ...A major challenge in the treatment of Tuberculosis (TB) is emergence of Multi-Drug Resistant <em>Mycobacterium tuberculosis</em> (MDRTB) strains. Efflux genes have been established to be among factors for drug resistance in <em>Mycobacterium tuberculosis</em> (<em>M. tuberculosis</em>) pulmonary infections by conferring bacterial ability to pump-out drugs from intracellular compartment, making it impossible for drugs to attain intracellular concentration lethal to the organism. There is paucity of data on the role of efflux pump in MDRTB in Nigerian strains of<em> M. tuberculosis</em>. Hence, the aim of this study was to detect the carriage, distribution and frequency of efflux pump genes among MDRTB and non-MDRTB isolates from participants with pulmonary tuberculosis in Lagos, Nigeria. This study was carried out on <em>M. tuberculosis</em> isolated from 1020 participants suspected of pulmonary tuberculosis in Lagos State, Nigeria. A total of 78 <em>M. tuberculosis</em> isolates were obtained from the participants suspected of pulmonary tuberculosis. Forty Eight isolates were confirmed as MDRTB and 30 non-MDRTB. Efflux pump genes were investigated in the isolates using the conventional polymerase chain reaction. Statistical analysis was carried out using the Statistical Package for Social Science (SPSS version 20) to compare the efflux pump gene results between MDRTB and non- MDRTB isolates. Different efflux genes types and frequency were detected in MDRTB and non-MDRTB isolates. Carriage of 2 or more alleles of efflux gene types Rv2486c (efpA), Rv2459c (jefA), Rv1877, Rv1002c, Rv0342, Rv2686c and drrC associated with MDR were detected. Additionally, the frequency of efflux genes alleles in MDRTB was significantly different from those in non- MDRTB isolates.展开更多
Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their households.The study sought to identify the determinants for...Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their households.The study sought to identify the determinants for cata-strophic costs among patients with drug-sensitive TB(DSTB)and their households in Kenya.Methods::The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample(n=1071).Treatment related costs and productivity losses were estimated.Total costs exceeding 20%of household income were defined as catastrophic and used as the outcome.Multivariable Poisson regression analysis was performed to measure the association between selected individual,household and disease characteristics and occurrence of catastrophic costs.A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were explored.Results::The proportion of catastrophic costs among DSTB patients was 27%(n=294).Patients with catastrophic costs had higher median productivity losses,39 h[interquartile range(IQR):20-104],and total median costs of USD 567(IQR:299-1144).The incidence of catastrophic costs had a dose response with household expenditure.The poorest quintile was 6.2 times[95%confidence intervals(CI):4.0-9.7]more likely to incur catastrophic costs compared to the richest.The prevalence of catastrophic costs decreased with increasing household expenditure quintiles(proportion of catastrophic costs:59.7%,32.9%,23.6%,15.9%,and 9.5%)from the lowest quintile(Q1)to the highest quintile(Q5).Other determinants included hospitalization:prevalence ratio(PR)=2.8(95%CI:1.8-4.5)and delayed treatment:PR=1.5(95%CI:1.3-1.7).Protective factors included receiving care at a public health facility:PR=0.8(95%CI:0.6-1.0),and a higher body mass index(BMI):PR=0.97(95%CI:0.96-0.98).Pre TB expenditure,hospitalization and BMI were significant predictors in all sensitivity analysis scenarios.Conclusions::There are significant inequities in the occurrence of catastrophic costs.Social protection interventions in addition to existing medical and public health interventions are important to implement for patients most at risk of incurring catastrophic costs.展开更多
Background: The world is currently experiencing a healthcare crisis caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) are at the forefront of controlling the spread of t...Background: The world is currently experiencing a healthcare crisis caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) are at the forefront of controlling the spread of the disease;this response has resulted in a huge number of infections amongst HCWs and unfortunately some casualties. Infection prevention and control practices (IPC) are practical, proven methods that prevent avoidable harm to patients and protect health workers from contagious infection. This study was done to evaluate the effectiveness of IPC practices utilized in COVID-19 testing drive through facility in Lagos Nigeria. Method: The facility recruited 42 HCWs who were trained on IPC and use of Personal Protective Equipment (PPEs). Training on donning and doffing of PPEs, preparation of decontaminants and sample handling were done for relevant personnel. A daily log for monitoring COVID-19 symptoms was deployed to all HCWs;to help early detection of COVID-19 infection and prevent transmission amongst staff. Results: Of 42 personnel, 92.8% had a tertiary level of education while 71.4% had at least 5 years work experience. A total of 5 (11.9%) out of 42 HCWs were positive by week six of the study. All infected persons worked at the drive through centre. Most common symptom filled in the daily log tool was headache and fatigue. Conclusion: Despite all the measures introduced, 11.9% of HCWs became positive within 6 weeks, showing the highly infectious nature of the virus and the need to research into more effective measures in preventing the transmission of highly infectious pathogens to HCWs during outbreaks.展开更多
Objective To summarize the clinical features of spontaneous remission in classic fever of unknown origin(FUO).Methods Medical records of 121 patients diagnosed with FUO at admission in Peking Union Medical College Hos...Objective To summarize the clinical features of spontaneous remission in classic fever of unknown origin(FUO).Methods Medical records of 121 patients diagnosed with FUO at admission in Peking Union Medical College Hospital between January 2018 and June 2018 were reviewed retrospectively.Patients who were discharged without etiological diagnoses were followed for 2 years.The clinical features and outcomes of these patients were summarized.Multivariate logistic regression was used to analyze related factors of spontaneous remission of FUO.Results After excluding 2 patients who lost to follow-up,the etiology of 119 FUO patients were as follows:infectious diseases in 30(25.2%)cases,connective tissue diseases in 28(23.5%)cases,tumor diseases in 8(6.7%)cases,other diseases in 6(5.0%)cases,and unknown diagnoses in 47(39.5%)cases.Totally,41 patients experienced spontaneous remission of fever(the median time from onset to remission was 9 weeks,ranging from 4 to 39 weeks).In patients with spontaneous remission in FUO,lymphadenopathy was less common clinical manifestation,the levels of inflammatory markers including leukocyte count,neutrophil count,neutrophil ratio,C-reactive protein,and ferritin were lower,and the proportion of CD8 positive T lymphocytes expressing CD38 was lower.Multivariate logistic regression analysis of factors with a P-value<0.05 in univariate analysis shown that white blood cell count(OR:0.S45,95%CI:0.306-0.971,P=0.039),neutrophil count(OR:2.074,95%CI:1.004-4.284,P=0.049),and proportion of neutrophils(OR:0.928,95%Cl:0.871-0.990,P=0.022)were independent significant factors associated with spontaneous remission in FUO.Conclusions This study suggested that most patients discharged with undiagnosed classic FUO would remit spontaneously.Thus,for patients with stable clinical conditions,follow-up and observation could be the best choice.Patients with lower level of some inflammatory factors may have a high likelihood of spontaneous remission in classic FUO.展开更多
What is already known about this topic?The incidence of tuberculosis(TB)was declining in China but has plateaued in recent years.What is added by this report?Notifications of pulmonary TB declined by 27.7%between 2008...What is already known about this topic?The incidence of tuberculosis(TB)was declining in China but has plateaued in recent years.What is added by this report?Notifications of pulmonary TB declined by 27.7%between 2008 and 2018,with an average crude decline of 3.4%per year and an average age-adjusted decline of 4.3%per year.Notifications decreased faster among older people,but slower in western China;the combination of trends led to an inflection in 2016 in the overall notification trend from decreasing to stable.What are the implications for public health practice?Population ageing and geographic disparities slowed tuberculosis control progress in China.Enhanced,targeted,and proactive responses are recommended to achieve the End TB targets.展开更多
Background Stigma experienced by people with infectious diseases impedes access to care,leading to adverse psychosocial consequences.Community-based interventions could prevent or mitigate these consequences but lack ...Background Stigma experienced by people with infectious diseases impedes access to care,leading to adverse psychosocial consequences.Community-based interventions could prevent or mitigate these consequences but lack robust evidence.This scoping review aimed to identify and critically appraise community-based psychosocial support interventions to reduce stigma and improve mental health for people affected by stigmatizing infectious diseases including tuberculosis(TB),HIV/AIDS,and leprosy.Methods This was a scoping review of literature indexed in PubMed,Web of Science,Elton B.Stephens Company(EBSCO)database,as well as reports in the World Health Organization repository,published from January 2000 to June 2023.We included research articles and reports addressing stigma and mental health disorders among indi-viduals with TB,HIV/AIDS,or leprosy and/or their household members in low-and middle-income and/or high TB burden countries.We extracted information regarding types of psychosocial interventions and their reported impact on health and psychosocial indicators.Results Thirty studies were included in this review:21(70%)related to HIV/AIDS,seven(23%)leprosy,and two(7%)TB.Of these,eleven were quantitative studies,nine qualitative,and ten mixed-methods.Eleven community-based interventions were reported to reduce infectious disease-related stigma,predominantly internalized and enacted stigma,and improve adherence to medication,quality of life,health-related knowledge,depression symptoms,and psychosocial wellbeing.Most studies involved lay people in the community as supporters of those affected.The predominant reported mechanism of intervention effect was the ability of supporters to enable those affected to feel seen and listened to,to accept their diagnosis,to improve their self-esteem,and to facilitate continuation of their daily lives,and thereby reducing anticipated stigma,self-stigma,and mental illness.Adequate training for lay people was reported to be essential to ensure success of interventions.Conclusions This review identified a paucity of high-quality evidence relating to community-based interven-tions to reduce stigma for infectious diseases.However,such interventions have been reported to reduce stigma and improve mental health among people with HIV/AIDS,leprosy,and TB.Engaging affected communities and peers,through the conception,planning,training,implementation,and evaluation phases,was reported to be essential to optimise intervention uptake,impact,and sustainability.展开更多
基金funded by the South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation (NRF) of South Africa,award number UID 86539
文摘Mycobacterium tuberculosis(MTB) and human immunodeficiency virus(HIV) co-infections have remained a major public health concern worldwide,particularly in Southern Africa.Yet our understanding of the molecular interactions between the pathogens has remained poor,primarily due to lack of suitable preclinical models for such studies.We reviewed the use,this far,of mammalian cell culture models in HIV-MTB interaction studies.Studies have described the use of primary human cell cultures,including monocyte-derived macrophage(MDM) fractions of peripheral blood mononuclear cell(PBMC),alveolar macrophages(AM),cell lines such as the monocyte-derived macrophage cell line(U937),T lymphocyte cell lines(CEMx174,ESAT-6-specific CD4+ T-cells) and an alveolar epithelial cell line(A549) and special models such as stem cells,three dimensional(3D) or organoid cell models [including a blood-brain barrier(BBB) cell model] in HIV-MTB interaction studies.The use of cell cultures from other mammals,including:mouse cell lines [macrophage cell lines RAW 264.7 and J774.2,fibroblast cell lines(NIH 3T3,C3 H clones),embryonic fibroblast cell lines and T-lymphoma cell lines(S1A.TB,TIMI.4 and R1.1)]; rat(T cells:Rat2,RGE,XC and HH16,and alveolar cells:NR8383) and primary guinea pigs derived AMs,in HIV-MTB studies is also described.Given the spectrum of the models available,cell cultures offer great potential for host-HIV-MTB interactions studies.
文摘Background: Pyrazinamide (PZA) is one of the most important drugs for tuberculosis (TB) treatment, however, its susceptibility is not routinely tested. High-resolution melting (HRM) curve analysis has been widely used for many applications. In this study, HRM assay was developed and evaluated for the detection of PZA resistance in Mycobacterium tuberculosis clinical isolates. Methods: Ninety five M. tuberculosis clinical isolates with different susceptibility patterns to anti-TB drugs were used to evaluate this assay. Isolates were phenotypically (Bactec MGIT 960) and genotypically (HRM and pncA gene sequencing) analysed for PZA resistance. Results: Bactec MGIT 960 analysis revealed that 29 of the 95 M. tuberculosis isolates were PZA resistant. In comparison to the Bactec MGIT 960, HRM showed a sensitivity of 47.7% and specificity of 74.6%, and the overall agreement between the two methods was 68.4%. Based on DNA sequencing, a correlation of 0.67 (significant at p-value pncA mutations was observed. PZA resistance was strongly associated with multi-drug resistant (MDR)-TB as it was shown in 79.3% of the MDR isolates included in the study. Conclusion: HRM is simple and useful for screening clinical M. tuberculosis isolates for PZA resistance, however, further modifications to improve its performance are required.
文摘A major challenge in the treatment of Tuberculosis (TB) is emergence of Multi-Drug Resistant <em>Mycobacterium tuberculosis</em> (MDRTB) strains. Efflux genes have been established to be among factors for drug resistance in <em>Mycobacterium tuberculosis</em> (<em>M. tuberculosis</em>) pulmonary infections by conferring bacterial ability to pump-out drugs from intracellular compartment, making it impossible for drugs to attain intracellular concentration lethal to the organism. There is paucity of data on the role of efflux pump in MDRTB in Nigerian strains of<em> M. tuberculosis</em>. Hence, the aim of this study was to detect the carriage, distribution and frequency of efflux pump genes among MDRTB and non-MDRTB isolates from participants with pulmonary tuberculosis in Lagos, Nigeria. This study was carried out on <em>M. tuberculosis</em> isolated from 1020 participants suspected of pulmonary tuberculosis in Lagos State, Nigeria. A total of 78 <em>M. tuberculosis</em> isolates were obtained from the participants suspected of pulmonary tuberculosis. Forty Eight isolates were confirmed as MDRTB and 30 non-MDRTB. Efflux pump genes were investigated in the isolates using the conventional polymerase chain reaction. Statistical analysis was carried out using the Statistical Package for Social Science (SPSS version 20) to compare the efflux pump gene results between MDRTB and non- MDRTB isolates. Different efflux genes types and frequency were detected in MDRTB and non-MDRTB isolates. Carriage of 2 or more alleles of efflux gene types Rv2486c (efpA), Rv2459c (jefA), Rv1877, Rv1002c, Rv0342, Rv2686c and drrC associated with MDR were detected. Additionally, the frequency of efflux genes alleles in MDRTB was significantly different from those in non- MDRTB isolates.
文摘Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their households.The study sought to identify the determinants for cata-strophic costs among patients with drug-sensitive TB(DSTB)and their households in Kenya.Methods::The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample(n=1071).Treatment related costs and productivity losses were estimated.Total costs exceeding 20%of household income were defined as catastrophic and used as the outcome.Multivariable Poisson regression analysis was performed to measure the association between selected individual,household and disease characteristics and occurrence of catastrophic costs.A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were explored.Results::The proportion of catastrophic costs among DSTB patients was 27%(n=294).Patients with catastrophic costs had higher median productivity losses,39 h[interquartile range(IQR):20-104],and total median costs of USD 567(IQR:299-1144).The incidence of catastrophic costs had a dose response with household expenditure.The poorest quintile was 6.2 times[95%confidence intervals(CI):4.0-9.7]more likely to incur catastrophic costs compared to the richest.The prevalence of catastrophic costs decreased with increasing household expenditure quintiles(proportion of catastrophic costs:59.7%,32.9%,23.6%,15.9%,and 9.5%)from the lowest quintile(Q1)to the highest quintile(Q5).Other determinants included hospitalization:prevalence ratio(PR)=2.8(95%CI:1.8-4.5)and delayed treatment:PR=1.5(95%CI:1.3-1.7).Protective factors included receiving care at a public health facility:PR=0.8(95%CI:0.6-1.0),and a higher body mass index(BMI):PR=0.97(95%CI:0.96-0.98).Pre TB expenditure,hospitalization and BMI were significant predictors in all sensitivity analysis scenarios.Conclusions::There are significant inequities in the occurrence of catastrophic costs.Social protection interventions in addition to existing medical and public health interventions are important to implement for patients most at risk of incurring catastrophic costs.
文摘Background: The world is currently experiencing a healthcare crisis caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) are at the forefront of controlling the spread of the disease;this response has resulted in a huge number of infections amongst HCWs and unfortunately some casualties. Infection prevention and control practices (IPC) are practical, proven methods that prevent avoidable harm to patients and protect health workers from contagious infection. This study was done to evaluate the effectiveness of IPC practices utilized in COVID-19 testing drive through facility in Lagos Nigeria. Method: The facility recruited 42 HCWs who were trained on IPC and use of Personal Protective Equipment (PPEs). Training on donning and doffing of PPEs, preparation of decontaminants and sample handling were done for relevant personnel. A daily log for monitoring COVID-19 symptoms was deployed to all HCWs;to help early detection of COVID-19 infection and prevent transmission amongst staff. Results: Of 42 personnel, 92.8% had a tertiary level of education while 71.4% had at least 5 years work experience. A total of 5 (11.9%) out of 42 HCWs were positive by week six of the study. All infected persons worked at the drive through centre. Most common symptom filled in the daily log tool was headache and fatigue. Conclusion: Despite all the measures introduced, 11.9% of HCWs became positive within 6 weeks, showing the highly infectious nature of the virus and the need to research into more effective measures in preventing the transmission of highly infectious pathogens to HCWs during outbreaks.
基金funded by the Major National Science and Technology Projects for the Control and Prevention of Major Infectious Diseases of China(2017ZX10201302-003)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2016-I2M-1-013).
文摘Objective To summarize the clinical features of spontaneous remission in classic fever of unknown origin(FUO).Methods Medical records of 121 patients diagnosed with FUO at admission in Peking Union Medical College Hospital between January 2018 and June 2018 were reviewed retrospectively.Patients who were discharged without etiological diagnoses were followed for 2 years.The clinical features and outcomes of these patients were summarized.Multivariate logistic regression was used to analyze related factors of spontaneous remission of FUO.Results After excluding 2 patients who lost to follow-up,the etiology of 119 FUO patients were as follows:infectious diseases in 30(25.2%)cases,connective tissue diseases in 28(23.5%)cases,tumor diseases in 8(6.7%)cases,other diseases in 6(5.0%)cases,and unknown diagnoses in 47(39.5%)cases.Totally,41 patients experienced spontaneous remission of fever(the median time from onset to remission was 9 weeks,ranging from 4 to 39 weeks).In patients with spontaneous remission in FUO,lymphadenopathy was less common clinical manifestation,the levels of inflammatory markers including leukocyte count,neutrophil count,neutrophil ratio,C-reactive protein,and ferritin were lower,and the proportion of CD8 positive T lymphocytes expressing CD38 was lower.Multivariate logistic regression analysis of factors with a P-value<0.05 in univariate analysis shown that white blood cell count(OR:0.S45,95%CI:0.306-0.971,P=0.039),neutrophil count(OR:2.074,95%CI:1.004-4.284,P=0.049),and proportion of neutrophils(OR:0.928,95%Cl:0.871-0.990,P=0.022)were independent significant factors associated with spontaneous remission in FUO.Conclusions This study suggested that most patients discharged with undiagnosed classic FUO would remit spontaneously.Thus,for patients with stable clinical conditions,follow-up and observation could be the best choice.Patients with lower level of some inflammatory factors may have a high likelihood of spontaneous remission in classic FUO.
文摘What is already known about this topic?The incidence of tuberculosis(TB)was declining in China but has plateaued in recent years.What is added by this report?Notifications of pulmonary TB declined by 27.7%between 2008 and 2018,with an average crude decline of 3.4%per year and an average age-adjusted decline of 4.3%per year.Notifications decreased faster among older people,but slower in western China;the combination of trends led to an inflection in 2016 in the overall notification trend from decreasing to stable.What are the implications for public health practice?Population ageing and geographic disparities slowed tuberculosis control progress in China.Enhanced,targeted,and proactive responses are recommended to achieve the End TB targets.
基金funded by grant MR/Y503216/1 from the Medical Research Council Public Health Intervention Development(PHIND)UK.TW is also supported by grants from the Wellcome Trust,UK(209075/Z/17/Z)+2 种基金the Medical Research Council,Department for International Development,and Wellcome Trust(Joint Global Health Trials,MR/V004832/1)a Dorothy Temple Cross Tuberculosis International Collaboration Grant from the Medical Research Foundation(MRF-131-0006-RG-KHOS-C0942)UK.AF is also supported by PUTI Q1 grant(NKB-230/UN2.RST/HKP.05.00/2024)by Universitas Indonesia.All funders had no involvement in data collection,analysis,report writing and decision to submission.
文摘Background Stigma experienced by people with infectious diseases impedes access to care,leading to adverse psychosocial consequences.Community-based interventions could prevent or mitigate these consequences but lack robust evidence.This scoping review aimed to identify and critically appraise community-based psychosocial support interventions to reduce stigma and improve mental health for people affected by stigmatizing infectious diseases including tuberculosis(TB),HIV/AIDS,and leprosy.Methods This was a scoping review of literature indexed in PubMed,Web of Science,Elton B.Stephens Company(EBSCO)database,as well as reports in the World Health Organization repository,published from January 2000 to June 2023.We included research articles and reports addressing stigma and mental health disorders among indi-viduals with TB,HIV/AIDS,or leprosy and/or their household members in low-and middle-income and/or high TB burden countries.We extracted information regarding types of psychosocial interventions and their reported impact on health and psychosocial indicators.Results Thirty studies were included in this review:21(70%)related to HIV/AIDS,seven(23%)leprosy,and two(7%)TB.Of these,eleven were quantitative studies,nine qualitative,and ten mixed-methods.Eleven community-based interventions were reported to reduce infectious disease-related stigma,predominantly internalized and enacted stigma,and improve adherence to medication,quality of life,health-related knowledge,depression symptoms,and psychosocial wellbeing.Most studies involved lay people in the community as supporters of those affected.The predominant reported mechanism of intervention effect was the ability of supporters to enable those affected to feel seen and listened to,to accept their diagnosis,to improve their self-esteem,and to facilitate continuation of their daily lives,and thereby reducing anticipated stigma,self-stigma,and mental illness.Adequate training for lay people was reported to be essential to ensure success of interventions.Conclusions This review identified a paucity of high-quality evidence relating to community-based interven-tions to reduce stigma for infectious diseases.However,such interventions have been reported to reduce stigma and improve mental health among people with HIV/AIDS,leprosy,and TB.Engaging affected communities and peers,through the conception,planning,training,implementation,and evaluation phases,was reported to be essential to optimise intervention uptake,impact,and sustainability.
