BMF CP133: The Roles of Host and Disease Factors in the Development of Extrapulmonary Tuberculosis

Ni Putu Wulan Purnama Sari

Faculty of Nursing, Widya Mandala Surabaya Catholic University, East Java, Indonesia

“In the Bird Village, Starling clearly has a clever mind that can grasp good ideas…”

In “Innovation”; Wild Wise Weird (2024)

1. Project description

This study investigates the roles of host and disease predictors of extrapulmonary Tuberculosis (EPTB), e.g., lymph nodes, pleura, bones and joints, genitourinary tract, meninges and central nervous system (CNS), peritoneum and abdomen, skin and soft tissue, and in multiple organs or miliary TB, focusing on sex, age, immune vulnerability, cavitary manifestation, and drug-resistance condition as reflected by current TB status. Providing intriguing results, this study challenges most published studies in TB epidemiology. Rather than closing the reports, we provide a signal of a new pathway to EPTB development. Employing the Granular Interaction Thinking Theory (GITT) in study conceptualization and the Bayesian Mindsponge Framework (BMF) analytics in statistical analysis, we explore a systems thinking orientation in better understanding EPTB development.

1.1. Main objectives

The current study is conducted to examine the following research questions:

• How are the host factors, i.e., sex, age, and immune vulnerability, and the disease factors, i.e., cavitary manifestation and current TB status, associated with EPTB?
• How does cavitary manifestation, which demonstrates a concentrated pulmonary TB progressive infection, moderate the relationship between sex, age, immune vulnerability, and current TB status with EPTB?
• How does current TB status, e.g., multidrug-resistant Tuberculosis (MDR-TB), moderate the relationship between sex, age, immune vulnerability, and cavitary manifestation with EPTB?

1.2. Materials

The GITT was employed for the conceptual development of this study [1,2], while the Bayesian Mindsponge Framework (BMF) analytics were utilized for statistical analysis [3]. The dataset comprises responses from 73 multidrug-resistant TB (MDR-TB) patients and 219 TB patients in West Sumatra, Indonesia [4]. Statistical analyses were conducted using the bayesvl R package, which utilizes the Markov chain Monte Carlo (MCMC) algorithm for estimation [2].

1.3. Main findings

Results of preliminary analysis showed that current TB status and immune vulnerability, composed through Diabetes comorbidity, nutritional status, and alcohol consumption, are positively associated with EPTB, while sex and age remain ambiguous, and cavitary manifestation is consistent in pulmonary TB only.

While cavitary manifestation shows a moderately reliable positive association with EPTB in the moderation analysis, its interactions with sex and age yield synergistic effects, clarifying the roles of sex and age in predicting EPTB. Conversely, the effects of immune vulnerability and current TB status are attenuated to the point of showing negative associations, with increased uncertainty in EPTB development involvement (see Figure 1).

Findings suggest that while most literature frames cavitary manifestation as a hallmark of pulmonary TB, this study suggests a potential new pathway from severe pulmonary disease progression into a systemic dissemination of Mycobacterium tuberculosis beyond the pulmonary parenchyma.



Figure 1: The estimated posterior distributions with HPDI at 95%

2. Collaboration procedure

Portal users should follow these steps to register to participate in this research project:

1. Create an account on the website (preferably using an institution email).
2. Comment your name, affiliation, and your desired role in the project below this post.
3. Patiently wait for the formal agreement on the project from the AISDL mentor.

If you have further inquiries, please contact us at aisdl_team@mindsponge.info

If you have been invited to join the project by an AISDL member, you are still encouraged to follow the above formal steps.

All the resources for conducting and writing the research manuscript will be distributed upon project participation.

Mentor for this project: Ni Putu Wulan Purnama Sari.

Other members who have joined this project: Minh-Hoang Nguyen and Quan-Hoang Vuong.

The research project strictly adheres to scientific integrity standards, including authorship rights and obligations, without incurring an economic burden on participants’ expenses.

References

[1] Vuong QH, Nguyen MH (2025). Developing Bayesian probabilistic reasoning capacity in HSS disciplines: Qualitative evaluation on bayesvl and BMF analytics for ECRs. https://dipot.ulb.ac.be/dspace/bitstream/2013/397326/3/wp25008.pdf

[2] Vuong QH, La VP, Nguyen MH. (2025). Informational entropy-based value formation: A new paradigm for a deeper understanding of value. Evaluation Review, 50(3), 516-540.

[3] Vuong QH, Nguyen MH, La VP. (2022). The mindsponge and BMF analytics for innovative thinking in social sciences and humanities. Walter de Gruyter GmbH. https://books.google.com/books?id=EGeEEAAAQBAJ

[4] Nindrea RD, Sari NP, Harahap WA, Haryono SJ, Kusnanto H, Dwiprahasto I, Lazuardi L, Aryandono T. (2020). Survey data of multidrug-resistant tuberculosis, Tuberculosis patients characteristics and stress resilience during COVID-19 pandemic in West Sumatera Province, Indonesia. Data in Brief, 32, 106293.

[5] Vuong QH. (2024). Innovation. http://books.google.com/books/about?id=XV3yEQAAQBAJ