{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:18:36Z","timestamp":1787678316525,"version":"build-2784847793"},"reference-count":27,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"accepted":{"date-parts":[[2026,5,19]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>SETTINGS<\/jats:title>\n                    <jats:p>A multicentric study in eight primary health centres across four geographically diverse regions of India (Puducherry, Telangana, Maharashtra, and Chandigarh).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Among persons with diabetes (PWD) registered for care, to determine the conversion and reversion rates of tuberculosis infection (TBI) at 6 and 12 months and its associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Cohort study with serial interferon-gamma release assay (IGRA) at baseline and at 6 and 12 months after excluding active TB. Conversion (baseline TBI negative to positive) and reversion (baseline TBI positive to negative) was assessed, and modified Poisson regression was used to identify associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of 750 recruited, 748 PWD underwent baseline IGRA (excluding two newly diagnosed TB), and 339 (45%) were positive. At 12 months, reversion among baseline positives was 38% (95% confidence interval [CI]: 32\u201344), while conversion among baseline negatives was 22% (95% CI: 17\u201326). Tobacco non-use was associated with reversion, while older age (\u226560 years) and lower body mass index compared to obesity\n                      <jats:underline>(&gt;<\/jats:underline>\n                      25 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) were associated with conversion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>High rates of IGRA conversion and reversion among PWD highlight the dynamic nature of TBI and question the utility of single time-point TBI testing for making decisions regarding initiation of TB preventive therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/pha.26.0039","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:23:46Z","timestamp":1787675026000},"page":"222-228","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic tuberculosis infection pattern: high conversion and reversion among persons with type 2 diabetes in India"],"prefix":"10.5588","volume":"16","author":[{"given":"L.","family":"Devaraj","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Subramanian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Ramaswamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.P.","family":"Tripathy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Soundappan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.P.","family":"Babu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.N.","family":"Aggarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Selvaraj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Venugopal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sampath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.E.","family":"John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bhoyar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sethi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Sachdeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sarkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rajaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.B.","family":"Narasimhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Vijayageetha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Nair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Thekkur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Chinnakali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"2026082509233364000_16.3.222.1","unstructured":"World Health Organization . Latent tuberculosis infection: updated and consolidated guidelines for the management of latent tuberculosis infection. Geneva: WHO, 2018."},{"key":"2026082509233364000_16.3.222.2","unstructured":"Centers for Disease Control and Prevention (CDC) . Clinical testing and diagnosis for tuberculosis. Atlanta, GA: Centers for Disease Control and Prevention (CDC), 2025. https:\/\/www.cdc.gov\/tb\/hcp\/testing-diagnosis\/index.html."},{"key":"2026082509233364000_16.3.222.3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040208"},{"key":"2026082509233364000_16.3.222.4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-472OC"},{"issue":"1","key":"2026082509233364000_16.3.222.5","first-page":"84","article-title":"T-cell assay conversions and reversions among household contacts of tuberculosis patients in rural India","volume":"13","author":"Pai","year":"2009","journal-title":"Int J Tuberc Lung Dis"},{"issue":"5","key":"2026082509233364000_16.3.222.6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3390\/tropicalmed10050141","article-title":"Prevalence, conversion and reversion of tuberculosis infection among healthcare workers of tertiary care centres in Puducherry, India: a prospective cohort study","volume":"10","author":"Subramanian","year":"2025","journal-title":"Trop Med Infect Dis"},{"key":"2026082509233364000_16.3.222.7","unstructured":"Central TB Division, Ministry of Health & Family Welfare . National Strategic Plan (NSP) for Tuberculosis Elimination 2017-2025. New Delhi, India: Central TB Division, Ministry of Health & Family Welfare, Government of India, 2017. https:\/\/tbcindia-wp.azurewebsites.net\/national-strategic-plan-2017-2025-for-tb-elimination-in-india\/."},{"key":"2026082509233364000_16.3.222.8","doi-asserted-by":"crossref","first-page":"155333","DOI":"10.1016\/j.cyto.2020.155333","article-title":"Anti-inflammatory cytokines IL-27, IL-10, IL-1Ra and TGF-\u03b2 in subjects with increasing grades of glucose intolerence (DM-LTB-2)","volume":"137","author":"Bobhate","year":"2021","journal-title":"Cytokine"},{"key":"2026082509233364000_16.3.222.9","doi-asserted-by":"crossref","first-page":"899821","DOI":"10.3389\/fmed.2022.899821","article-title":"The association between diabetes mellitus and the risk of latent tuberculosis infection: a systematic review and meta-analysis","volume":"9","author":"Liu","year":"2022","journal-title":"Front Med"},{"issue":"8","key":"2026082509233364000_16.3.222.10","first-page":"CD016013","article-title":"Diabetes as a risk factor for tuberculosis disease","volume":"8","author":"Franco","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"2026082509233364000_16.3.222.11","doi-asserted-by":"crossref","first-page":"e0233385","DOI":"10.1371\/journal.pone.0233385","article-title":"Screening for prevalence of current TB disease and latent TB infection in type 2 diabetes mellitus patients attending a diabetic clinic in an Indian tertiary care hospital","volume":"15","author":"Dabhi","year":"2020","journal-title":"PLOS ONE"},{"key":"2026082509233364000_16.3.222.12","unstructured":"Central TB Division, Ministry of Health & Family Welfare . Guidelines for programmatic management of tuberculosis preventive treatment in India 2021. New Delhi, India: National TB Elimination Programme, Central TB Division, Ministry of Health & Family Welfare, Government of India, 2021. https:\/\/tbcindia.mohfw.gov.in\/wp-content\/uploads\/2023\/05\/Guidelines-for-Programmatic-Management-of-Tuberculosis-Preventive-Treatment-in-India.pdf."},{"key":"2026082509233364000_16.3.222.13","unstructured":"World Health Organization . Global tuberculosis report 2025. Geneva: WHO, 2025."},{"key":"2026082509233364000_16.3.222.14","unstructured":"International Diabetes Federation . IDF diabetes atlas, 11th edition. Brussels, Belgium: International Diabetes Federation, 2025."},{"key":"2026082509233364000_16.3.222.15","unstructured":"Central TB Division, Ministry of Health and Family Welfare, Government of India . Concept note on TB Mukt Bharat Abhiyan 100 days campaign. New Delhi, India: Ministry of Health and Family Welfare, 2024. https:\/\/tbcindia.mohfw.gov.in\/wp-content\/uploads\/2025\/02\/Concept-note-on-TB-Mukt-Bharat-Abhiyan-100-Days-Campaign-1.pdf."},{"key":"2026082509233364000_16.3.222.16","unstructured":"Centers for Disease Control and Prevention . Adult BMI categories. Atlanta, GA: CDC, 2024."},{"issue":"2","key":"2026082509233364000_16.3.222.17","doi-asserted-by":"crossref","first-page":"383","DOI":"10.3904\/kjim.2019.002","article-title":"QuantiFERON-TB Gold PLUS versus QuantiFERON-TB Gold In-Tube test for diagnosing tuberculosis infection","volume":"35","author":"Kim","year":"2020","journal-title":"Korean J Intern Med"},{"key":"2026082509233364000_16.3.222.18","doi-asserted-by":"publisher","DOI":"10.4137\/BMI.S38440"},{"key":"2026082509233364000_16.3.222.19","unstructured":"Mazurek GH , Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection - United States, 2010. Centers for Disease Control and Prevention (CDC), 2010."},{"issue":"RR-15","key":"2026082509233364000_16.3.222.20","first-page":"49","article-title":"Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States","volume":"54","author":"Mazurek","year":"2005","journal-title":"MMWR Recomm Rep"},{"key":"2026082509233364000_16.3.222.21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040192"},{"key":"2026082509233364000_16.3.222.22","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6673-7-6"},{"issue":"1","key":"2026082509233364000_16.3.222.23","doi-asserted-by":"crossref","first-page":"34","DOI":"10.20411\/pai.v5i1.349","article-title":"Conversion and reversion rates of tuberculosis screening assays in patients with rheumatic diseases and negative baseline screening under long-term biologic treatment","volume":"5","author":"Thomas","year":"2020","journal-title":"Pathog Immun"},{"key":"2026082509233364000_16.3.222.24","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit418"},{"key":"2026082509233364000_16.3.222.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2007.03.004"},{"key":"2026082509233364000_16.3.222.26","doi-asserted-by":"publisher","DOI":"10.1086\/503690"},{"key":"2026082509233364000_16.3.222.27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0001850"}],"container-title":["Public Health Action"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.5588\/pha.26.0039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:23:49Z","timestamp":1787675029000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.theunion.org\/lookup\/doi\/10.5588\/pha.26.0039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,8,1]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.5588\/pha.26.0039"],"URL":"https:\/\/doi.org\/10.5588\/pha.26.0039","relation":{},"ISSN":["2220-8372"],"issn-type":[{"value":"2220-8372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}