The World Health Organization recommends using chest X-ray (CXR) in active case finding (ACF) to improve case detection. This study aimed to describe the spectrum and outcomes of TB disease diagnosed through a mobile community based ACF program in Yogyakarta. This prospective cohort study included people attending a TB ACF program in Yogyakarta between 1 January 2021 to 30 June 2022. Participants ≥10 years old underwent CXR, symptom screening, and Xpert MTB/RIF testing of sputum. Subclinical TB was defined as asymptomatic active TB, whether bacteriologically confirmed or not. Treatment outcome data were obtained from the national program TB database. 47,735 people attended the ACF program; the yield of TB disease was 0.86% (393/45,938). There were 217 symptomatic cases, of whom 72 (33.2%) were bacteriologically confirmed, and 176 asymptomatic cases, with 52 (29.5%) bacteriologically confirmed. Treatment success was 70.7% with high loss to follow up (9%) and not evaluated (17.1%). Multivariate analysis demonstrated weak evidence for lower unsuccessful outcomes in symptomatic versus subclinical TB (aOR 0.6, 95% CI 0.36–0.998). TB ACF programs utilizing CXR may diagnose a high proportion of subclinical TB. Linkage to care in ACF program is important to increase successful treatment outcomes.

Introduction: One of the most serious bacterial infections following kidney transplantation is tuberculosis (TB). Immunosuppressive medications and anti-tuberculosis therapy (ATT) frequently interact with one another and cause adverse effects. This case series focuses on kidney transplant patients who have active TB, with varying clinical manifestations and outcomes. Case-1: A 42-year-old man with end-stage renal disease (ESRD) underwent a kidney transplant from an unrelated living donor. He was diagnosed with disseminated TB post-transplant. Third-month post-ATT, serum creatinine was increased. His kidney allograft failed and required hemodialysis, but he died. Case-2: A 31-year-old female with ESRD underwent a kidney transplant from an unrelated living donor. She was diagnosed with pulmonary TB post-transplant. Third-month post-ATT, her tacrolimus decreased significantly; however, her kidney allograft remained stable and still alive. Case-3: A 29-year-old male with ESRD underwent a kidney transplant from an unrelated living donor. He was diagnosed with pulmonary TB post-transplant. Third-month post-ATT, tacrolimus levels decreased significantly but her kidney allograft remained stable. Case-4: A 60-year-old man with ESRD underwent a kidney transplant from an unrelated living donor. He was diagnosed with Disseminated TB post-transplant. Third-month post-ATT, tacrolimus levels decreased significantly’ since, her kidney allograft remained stable. Conclusion: After kidney transplantation, TB might be difficult to diagnose and treat because of its unusual symptoms and varying outcomes. During the first three months of ATT, there may be significant interactions between tacrolimus and ATT. Therefore, frequent and careful monitoring along with medication modifications are required. Tuberculosis prophylaxis is essential for recipients after transplantation, particularly in endemic countries.

Background: The SARS-CoV-2 Omicron variant has replaced the previously dominant Delta variant because of high transmissibility. However, studies on the impact of the Omicron variant on the severity of COVID-19 are still limited in developing countries. Our study aimed to determine the prognostic factors for the outcomes of patients infected with SARS-CoV-2 Omicron and Delta variants, including age, sex, comorbidities, and smoking. Methods: In this retrospective cross-sectional study, we involved 352 patients with COVID-19 from Yogyakarta and Central Java provinces, Indonesia, from May 2021 to February 2022, consisting of 164 males and 188 females. We included all patients with the PCR’s Ct value of less than 30 for further whole-genome sequencing. Results: Ct value and mean age of COVID-19 patients were not significantly different between both groups (p = 0.146 and 0.273, respectively). Patients infected with Omicron (n = 139) and Delta (n = 213) variants showed similar hospitalization (p = 0.396) and mortality rates (p = 0.565). Multivariate analysis of both groups showed that older age (≥ 65 years) had a higher risk for hospitalization (OR = 3.86 [95% CI = 1.29–11.5]; p = 0.015) and fatalities (OR = 3.91 [95% CI = 1.35–11.42]; p = 0.012). In both groups, patients with cardiovascular disease had a higher risk for hospitalization (OR = 5.36 [95% CI = 1.08–26.52]; p = 0.039), whereas patients with diabetes revealed a higher risk for fatalities (OR = 9.47 [95% CI = 3.23–27.01]; p = < 0.001). Conclusions: Our study shows that patients infected with Omicron and Delta variants reveal similar clinical outcomes, including hospitalization and mortality. Our findings further confirm that older age, cardiovascular disease, and diabetes are substantial prognostic factors for the outcomes of COVID-19 patients. Our findings imply that COVID-19 patients with older age, cardiovascular disease, or diabetes should be treated comprehensively and cautiously to prevent further morbidity and mortality. Furthermore, incomplete data on vaccination status hampered us from analyzing further its impact on hospitalization and mortality in our patients.

Coronavirus disease 2019 (COVID-19) was examined to cause abnormalities within the hemostatic system. Viscoelastic tests, such as thromboelastography (TEG), were employed to evaluate the function of specific components involved in the hemostatic process. This allowed for the identification of coagulopathy, which has the potential to serve as a predictor of mortality in COVID-19 patients. This research aims to evaluate TEG as a predictor of 30-day mortality in patients with severe COVID-19. This study was a prospective observational cohort study conducted from April 2021 through November 2021. TEG and routine coagulation tests were performed during the first 24 h when COVID-19 patients were admitted into the intensive care unit. Coagulation status was determined by using TEG and analysed based on 30-day mortality. Out of the 75 patients evaluated with TEG, 33 died within 30 days (44%), 23 patients exhibited hyper-coagulation (30.7%), 5 patients had hypocoagulation (6.7%), and 47 patients showed normal coagulation (62.7%). Kaplan–Meier analysis revealed that the risk of mortality within 30 days was higher in hyper-coagulation and hypocoagulation compared to the normal coagulation groups. In the hypocoagulation group, the hazard ratio was 3.27 (95% CI 1.141–9.372; p = 0.027), while in the hyper-coagulation group, it was 1.64 (95% CI 0.794–3.379; p = 0.181). Using the TEG as a tool for examination to assess the coagulation status to predict mortality in severe COVID-19 cases, the research finds out that the group of patients exhibiting hypocoagulation was at a 3.27-fold high risk of mortality within 30 days in comparison with the group showing normal coagulation.