WorldWideScience

Sample records for publication reported tuberculosis

  1. Global Tuberculosis Report 2016

    Science.gov (United States)

    ... Alt+0 Navigation Alt+1 Content Alt+2 Tuberculosis (TB) Menu Tuberculosis Data and statistics Regional Framework Resources Meetings and events Global tuberculosis report 2017 WHO has published a global TB ...

  2. Primary Oral Tuberculosis - A Case Report

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    B N Praveen

    2007-01-01

    Full Text Available Tuberculosis is most common disease in developing countries because of lack of public health awareness, poverty, nutritional deficiencies, absence of medical facilities. Primary oral lesions in tuberculosis are still exceedingly rare. Oral involvement may be primary or secondary to systemic involvement. Involvement of oral cavity is rare accounting for 0.2-1.5% of cases. A rare case report of primary oral tuberculosis is presented.

  3. WHO GLOBAL TUBERCULOSIS REPORTS: COMPILATION AND INTERPRETATION

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    I. A. Vаsilyevа

    2017-01-01

    Full Text Available The purpose of the article is to inform national specialists involved in tuberculosis control about methods for compilation of WHO global tuberculosis statistics, which are used when developing strategies and programmes for tuberculosis control and evaluation of their efficiency.  The article explains in detail the notions of main WHO epidemiological rates, used in the international publications on tuberculosis along with the data on their registered values, new approaches to making the list of country with the highest burden of tuberculosis, drug resistant tuberculosis and tuberculosis with concurrent HIV infection. The article compares the rates in the Russian Federation with global data as well as data from countries within WHO European Regions and countries with highest TB burden. It presents materials on the achievement of Global goals in tuberculosis control and main provisions of WHO End TB Strategy for 2015-2035 adopted as a part of UNO Sustainable Development Goals.  

  4. 76 FR 26239 - Bovine Tuberculosis and Brucellosis; Public Meetings

    Science.gov (United States)

    2011-05-06

    ... Inspection Service [Docket No. APHIS-2011-0044] Bovine Tuberculosis and Brucellosis; Public Meetings AGENCY... bovine tuberculosis and brucellosis programs in the United States. The meetings are being organized by... tuberculosis (TB) and bovine brucellosis in the United States. In keeping with its commitment to partnering...

  5. Tuberculosis of the Breast: A Case Report

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    Zohreh Azarkar

    2011-02-01

    Full Text Available Primary tuberculosis of the breast is a rare disease. It usually occurs in female of reproductive age. Any form of tuberculosis mastitis may present with feature of malignancy. Diagnosis is mainly based on identification of tubercle bacilli. We report a 42-year-old woman with primary tuberculosis abscess of the breast, who underwent surgical resection. Fine needle biopsy failed to achieve specific diagnosis before surgical operation. She responded to anti-TB therapy postoperatively. In endemic area, tuberculosis should be considered in the differential diagnosis of breast tumors

  6. Primary breast tuberculosis. A case report

    International Nuclear Information System (INIS)

    Filippou, D.C.; Rizos, S.; Nissiotis, A.

    2003-01-01

    Background. The differential diagnosis of primary breast tuberculosis with other benign or malignant conditions can be difficult with the current imaging techniques that used to recognize breast pathologies. In many cases mammographic and ultrasound characteristics of breast tuberculosis are similar to those of breast cancer. Case report. We present a case of primary breast tuberculosis, with no previous history of the disease, which was diagnosed during the operation. Conclusions. Primary breast tuberculosis can be misdiagnosed. In these cases a tuberculosis infection history is negative, the mammographic and radiological findings obscure and the mass can be misdiagnosed as carcinoma. The diagnosis is achieved after the surgical removal of the mass and histological examination of the specimen. (author)

  7. Splenic tuberculosis. Report of twelve cases

    International Nuclear Information System (INIS)

    Adil, A.; Chikhaoui, N.; Ousehal, A.; Kadiri, R.

    1995-01-01

    Tuberculosis of the spleen is not exceptional. The authors report ten cases which occurred with a predominance in young male adults. All patients had at least one other site of tuberculosis without any HIV infection. All patients had focal splenic lesions in the form of scattered hypo-echogenic and hypodense nodules. These nodules had a pseudo-tumor appearance in one case. CT-guided puncture was performed in one case. Splenic tuberculosis is not as rare as is sometimes thought. The CT-guided splenic puncture is now performed routinely and remains the ideal diagnostic approach. (authors). 9 refs., 5 figs

  8. [Penile Tuberculosis : A Case Report].

    Science.gov (United States)

    Imanaka, Takahiro; Nomura, Hironori; Tsujimura, Go; Ko, Yoko; Kinjyo, Takanori; Yoshioka, Iwao; Takada, Shingo; Yahata, Yoko; Mizutani, Tetsu

    2017-04-01

    A 66-year-old man presented with a chief complaint of glans penis pain, induration, and discharge of pus. He was prescribed a course of antibiotics, but the condition persisted despite treatment. Thus, we differrentially diagnosed the patient with penile tuberculosis and pyoderma gangrenosum, and performed a biopsy of the penis. The biopsy result was thickening of the horny layer epidermis with only a foreign body granuloma composed of inflammatory cells, and did not lead to a definitive diagnosis. Thoraca-abdominal computed tomography revealed axillary lymphadenopathy with necrosis. Suspecting tuberculosis lymphadenitis, we performed T-spot and QuantiFERONtests. The result was T-spot negative and QuantiFERONpositive, so we diagnosed the patient with penile tuberculosis, and started antituberculosis medication. In about half a year after the start of treatment the symptoms subsided, and lymphadenopathy showed reduction.

  9. Miliary tuberculosis in the XXI century - a case report

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    Liliana Pinho

    2016-03-01

    Full Text Available Introduction: Tuberculosis is still a serious public health problem. Young age and HIV infection are important risk factors for severe or disseminated disease. Case report: We report the case of a three-year-old girl who presented a prolonged fever without a source on physical examination. Initial laboratory fi ndings were suggestive of urinary tract infection and empirical antibiotic therapy was started. Urine culture confi rmed that diagnosis, but fever had persisted. On complementary investigation, chest X-ray revealed an< infiltrate with a miliary pattern. Mycobacterium tuberculosis was isolated on gastric aspirate, cerebrospinal fluid and urine. Antituberculous therapy and corticoid were initiated with signifi cant clinical improvement. Conclusions: Even in this era of advanced medical technology, tuberculosis is still a diagnostic challenge, especially when the presentation is atypical and extra-pulmonary. A high index of suspicion by the physician is required because prompt institution of adequate treatment is decisive for fi nal outcome.

  10. Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012

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    Renato Simões Gaspar

    Full Text Available ABSTRACT Objective: To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. Methods: This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Results: Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Conclusions: Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished.

  11. Base of Tongue Tuberculosis: A Case Report

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    Prepageran Narayanan

    2012-02-01

    Full Text Available We report a rare case of base of tongue tuberculosis following pulmonary tuberculosis. Patient presented to us with chief complaints of sore throat and pain on swallowing for period of 3 months. On examination with 70 degree telescope, we observed an ulcer on right side of base of tongue. The edges of the ulcer appeared to be undermined with whitish slough at the centre of the ulcer. Examination of neck showed a multiple small palpable middle deep cervical lymph nodes on right side of neck. Biopsy of the ulcer was taken, which showed granulomatous inflammation, suggestive of tuberculosis. Laboratory investigations revealed a raise in erythrocyte sedimentation rate, sputum for acid fast bacilli was strongly positive. Chest X ray was performed for patient showed multiple areas of consolidation. Patient was referred to chest clinic for further management of tuberculosis and was started on anti-tuberculous drugs. In conclusion tuberculosis of oral cavity is rare, but should be considered among one of the differential diagnosis of the oral lesions and biopsy is necessary to confirm the diagnosis.

  12. Tumor like tuberculosis of the descending duodenum; One case report

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    Choi, Seung Wook; Choi, Byung Sook [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1971-10-15

    Tuberculosis of the duodenum is a definite clinical entity, of which incidence is not common. One case of tuberculosis of the duodenum in 37 years old Korean housewife, which is experienced by writers recently, is reported.

  13. Tuberculosis.

    Science.gov (United States)

    Tabbara, Khalid F

    2007-11-01

    The purpose of this report is to present an update on the manifestations and management of ocular tuberculosis. Tuberculosis affects one-third of the world's population. The incidence of tuberculosis has increased with the increase in the HIV infected population. Following a resurgence of the disease in the US, the incidence has recently declined. Patients may develop scleritis that can be focal, nodular or diffuse with or without keratitis. Anterior granulomatous uveitis may occur. The posterior segment reveals vitritis, choroiditis, and can mimic serpiginous choroiditis and other entities. Patients who are immunosuppressed or HIV infected may develop active mycobacterial disease in the eye leading to rapid destruction of the ocular structures. The diagnosis of ocular tuberculosis is made by isolation of Mycobacterium tuberculosis on Löwestein-Jensen medium or by PCR. The diagnosis is supported by the clinical findings, imaging techniques including optical coherence tomography, fluorescein angiography, indocyanine green and ultrasonography. Tuberculin skin test helps to confirm the diagnosis. Ocular tuberculosis may occur in the absence of pulmonary disease. Patients present with a spectrum of clinical signs. The disease may mimic several clinical entities. Early diagnosis and prompt treatment of ocular tuberculosis may prevent ocular morbidity and blindness.

  14. Tuberculosis of the Spermatic Cord: Case Report

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    Amine Benjelloun

    2014-09-01

    Full Text Available The spermatic cord tuberculoma is uncommon, especially in its lower portion. Most cases were described in Japanese literature. We report a case of tuberculosis of the spermatic cord in a sexually active young man, revealed by a scrotal mass mimicking a tumor of the testicle and discuss the suitable diagnostic and therapeutic procedures, with preservation of the testes and the other sexual organs.

  15. Base of Tongue Tuberculosis: A Case Report

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    Carlos Chiesa Estomba

    2015-05-01

    Full Text Available Introduction: Tuberculosis is an infectious disease that has displayed increasing incidence in the last decades. It is estimated that up to 20% of tuberculosis cases affect extra-pulmonary organs. In the ENT area, soft palate and tongue are the least probable locations.   Case Report A 62-year-old female with a history of rheumatoid arthritis and treatment with corticosteroids and Adalimumab, developed a foreign body sensation in the pharynx accompanied by a sore throat and halitosis. The laryngoscopy with a 70 degree rigid telescope showed an ulcerated hypertrophic lesion in the right vallecula of about 2-3 cm in the base of the tongue. Acid-alcohol resistant bacilli were found positive for M. tuberculosis, through the Ziehl Neelsen method and Löwenstein culture the patient was treated with tuberculostatic medication. Conclusion:  TB is a possible diagnosis when in the presence of an ulcerated lesion at the base of the tongue, accompanied by sore throat, dysphagia, or foreign body sensation.

  16. Hypertrophic osteoarthropathy in association with pulmonary tuberculosis: a case report

    International Nuclear Information System (INIS)

    Moreira, Luiza Beatriz Melo; Marchiori, Edson; Melo, Alessandro Severo Alves de; Pinto, Ana Lucia de Araujo; Monteiro, Nicolau Pedro

    2002-01-01

    In this article the authors report a case of a patient with hypertrophic osteoarthropathy associated with pulmonary tuberculosis. This disorder is a rare complication of tuberculosis and may be associated with severe and fulminant disease. The imaging methods used in the diagnosis of this disease included lower limbs radiographs that showed bilateral periosteal reaction, and chest radiographs and computed tomography that revealed a mass in the upper lobe of the right lung. Although a fine needle aspiration was suggestive of tuberculosis, the definitive diagnosis was made after thoracotomy and histopathological examination of the mass. The patient presented symptomatic and radiological improvement after treatment of tuberculosis. (author)

  17. Tuberculosis

    International Nuclear Information System (INIS)

    Aleksandrova, A.V.

    1983-01-01

    Classification of clinical forms of tuberculosis of respiratory organs is m ade. It is shown, that diagnosis, determination of the clinical form of pulmona ry tuberculosis, extent and phase of the process are mainly based on the data of roentgenologic studies and in certain cases tomography is preferable. Roentgenologic picture of primary tuberculosis, tuberculosis of intrathoracis l ymp nodes, dissemenated tuberculosis, focal and infiltrative tuberculosis of lungs, tuberculomas of lungs, cavernous and fibrocavernous form of pulmonary tub erculosis, cirrhotic tuberculosis of lungs, tuberculosis of upper respiratory tracks, tuberculous pleurite and tuberculosis of respiratory organs, combined wi th dust occupational diseases, has been described

  18. Public transportation and tuberculosis transmission in a high incidence setting.

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    Zamudio, Carlos; Krapp, Fiorella; Choi, Howard W; Shah, Lena; Ciampi, Antonio; Gotuzzo, Eduardo; Heymann, Jody; Seas, Carlos; Brewer, Timothy F

    2015-01-01

    Tuberculosis (TB) transmission may occur with exposure to an infectious contact often in the setting of household environments, but extra-domiciliary transmission also may happen. We evaluated if using buses and/or minibuses as public transportation was associated with acquiring TB in a high incidence urban district in Lima, Peru. Newly diagnosed TB cases with no history of previous treatment and community controls were recruited from August to December 2008 for a case-control study. Crude and adjusted odd ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression to study the association between bus/minibus use and TB risk. One hundred forty TB cases and 80 controls were included. The overall use of buses/minibuses was 44.9%; 53.3% (72/135) among cases and 30.4% (24/79) among controls [OR: 3.50, (95% CI: 1.60-7.64)]. In the TB group, 25.7% (36/140) of subjects reported having had a recent household TB contact, and 13% (18/139) reported having had a workplace TB contact; corresponding figures for controls were 3.8% (3/80) and 4.1% (3/73), respectively[OR: 8.88 (95% CI: 2.64-29.92), and OR: 3.89 (95% CI: 1.10-13.70)]. In multivariate analyses, age, household income, household contact and using buses/minibuses to commute to work were independently associated with TB [OR for bus/minibus use: 11.8 (95% CI: 1.45-96.07)]. Bus/minibus use to commute to work is associated with TB risk in this high-incidence, urban population in Lima, Peru. Measures should be implemented to prevent TB transmission through this exposure.

  19. "Impact of and response to increased tuberculosis prevalence among Syrian refugees compared with Jordanian tuberculosis prevalence: case study of a tuberculosis public health strategy".

    Science.gov (United States)

    Cookson, Susan T; Abaza, Hiba; Clarke, Kevin R; Burton, Ann; Sabrah, Nadia A; Rumman, Khaled A; Odeh, Nedal; Naoum, Marwan

    2015-01-01

    By the summer of 2014, the Syrian crisis resulted in a regional humanitarian emergency with 2.9 million refugees, including 608,000 in Jordan. These refugees access United Nations High Commissioner for Refugees (UNHCR)-sponsored clinics or Jordan Ministry of Health clinics, including tuberculosis diagnosis and treatment. Tuberculosis care in Syria has deteriorated with destroyed health infrastructure and drug supply chain. Syrian refugees may have undiagnosed tuberculosis; therefore, the UNHCR, the International Organization for Migration (IOM), the National Tuberculosis Program (NTP), and the Centers for Disease Control and Prevention developed the Public Health Strategy for Tuberculosis among Syrian Refugees in Jordan. This case study presents that strategy, its impact, and recommendations for other neighboring countries. UNHCR determined that World Health Organization (WHO) criteria for implementing a tuberculosis program in an emergency were met for the Syrian refugees in Jordan. Jordan NTP assessed their tuberculosis program and found that access to Syrian refugees was the one component of their program missing. Therefore, a strategy for tuberculosis control among Syrian refugees was developed. Since that development through work with IOM, UNHCR, and NTP, tuberculosis case detection among Syrian refugees is almost 40 % greater (74 cases/12 months or 1.01/100,000 monthly through June 2014 vs. 56 cases/16 months or 0.73/100,000 monthly through June 2013) using estimated population figures; more than two fold the 2012 Jordan tuberculosis incidence. Additionally, the WHO objective of curing ≥85 % of newly identified infectious tuberculosis cases was met among Syrian refugees. Tuberculosis (TB) rates among displaced persons are high, but increased detection is possible. High TB rates were found among Syrian refugees through active screening and will probably persist as the Syrian crisis continues. Active screening can detect tuberculosis early and reduce risk

  20. A Case Report of Peritoneal Tuberculosis: A Challenging Diagnosis

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    Dilara Bulut Gökten

    2018-01-01

    Full Text Available Peritoneal tuberculosis is a disease which can mimick malignancy especially in women who present with ascites and elevated CA125 levels. It should always be considered in differential diagnosis, but the diagnosis is rarely easy for clinicians. A young female patient who presented with abdomen tenderness and diagnosed with peritoneal tuberculosis as a result of performed tests is discussed hereby in the case report. We expect that this case report adds to the existing literature on this subject.

  1. Tuberculosis notificada en cuatro municipios de la capital cubana Tuberculosis reported in four municipalities of the Cuban capital

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    Tamine Jordán Severo

    2011-09-01

    Full Text Available INTRODUCCIÓN: La detección de casos es la actividad fundamental de pesquisa que se realiza en Cuba y una de las estrategias fundamentales para lograr la eliminación de la tuberculosis como problema de salud pública. OBJETIVO: Describir algunas características encontradas en los casos de tuberculosis notificados en los municipios Boyeros, 10 de Octubre, Arroyo Naranjo y Cotorro, en el 2008. MÉTODOS: Se realizó un estudio descriptivo de los casos de tuberculosis notificados en el 2008, en cuatro municipios del sur de la capital del país. Estas personas fueron visitadas en sus hogares y se entrevistaron, utilizando un cuestionario adicional validado previamente. Se creó una base de datos y se procesó en Epi Info 2002. RESULTADOS: Se notificaron 59 casos de tuberculosis en estos cuatro municipios, los que mostraron tasas de incidencia de la enfermedad entre 6,2 y 10,1/100 000 habitantes. El 72,9 % de los casos se encontró entre 15 y 59 años y el 78 % fue del sexo masculino; el 86,4 % tuvo tuberculosis pulmonar y el 13,6 % falleció. El 91,5 % perteneció a grupos de riesgo, de estos fundamentalmente ancianos, alcohólicos y exreclusos. El 100 % de los fallecidos pertenecía a grupos de riesgo. CONCLUSIONES: Los cuatro municipios mostraron tasas de incidencia > 5/ 100 000 habitantes y todos excepto Arroyo Naranjo estuvieron por encima de la tasa nacional; predominó el grupo de edades de 15 a 59 años, el sexo masculino y la tuberculosis pulmonar con baciloscopia positiva, pertenecientes en su mayoría a grupos vulnerables importantes, en los cuales ocurrió la totalidad de los fallecidos.INTRODUCTION: The case detection is the fundamental activity of screening carried out in Cuba and one of the essential strategies to achieve the eradication of tuberculosis as a problem of public health. OBJECTIVE: To describe some characteristics found in the cases of tuberculosis reported in 2008 at the Boyeros, 10 de Octubre, Arroyo Naranjo and

  2. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa.

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    Peltzer, Karl; Louw, Julia

    2013-01-01

    In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5%) consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. A total of 322 patients (9.0%) reported suicidal ideation and 131 (3.1%) had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR)= 0.56, Confidence Interval (CI)= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29), post-traumatic stress disorders (PTSD) (OR=4.98, CI=3.76-6.59), harmful alcohol use (OR=1.97, CI=1.25-3.09) and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34) were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10), PTSD symptoms (OR=4.48, CI=3.04-6.61) and harmful alcohol use (OR=3.01, CI=1.83-4.95) were associated with a suicide attempt. Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

  3. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa

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    Karl Peltzer

    2013-01-01

    Full Text Available Background & objectives: In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. Methods: In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5% consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. Results: A total of 322 patients (9.0% reported suicidal ideation and 131 (3.1% had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR= 0.56, Confidence Interval (CI= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29, post-traumatic stress disorders (PTSD (OR=4.98, CI=3.76-6.59, harmful alcohol use (OR=1.97, CI=1.25-3.09 and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34 were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10, PTSD symptoms (OR=4.48, CI=3.04-6.61 and harmful alcohol use (OR=3.01, CI=1.83-4.95 were associated with a suicide attempt. Interpretation & conclusions: Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

  4. A case report on esophageal tuberculosis – A rare entity

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    Vatsal Khanna

    2017-01-01

    Full Text Available This is a case report of a rare form of tuberculosis in a patient presenting with dysphagia. Patient was subjected to upper gastrointestinal endoscopy, which revealed an ulcerative growth in the distal esophagus. Histopathology revealed esophageal tuberculosis. Patient was managed conservatively with Anti-Tuberculosis Treatment (ATT. Follow up endoscopy after two months revealed resolution of the growth and patient was symptomatically better. In spite of the rare nature of the disease, it can be managed effectively with ATT to avoid complications (fistula, stricture, and esophageal perforation, which might warrant surgery.

  5. Case report : tuberculosis liver abscess in male alcoholism patient

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    Siahaan, W. P.; Ginting, F.

    2018-03-01

    A liver abscess often occurs in low-middle income countries such as Indonesia. Two most common liver abscesses are amoebic and pyogenic liver abscess. Data that reported tuberculosis liver abscess (TLA) is extremely rare. A diagnostic criterion for tuberculosis liver abscess is rare and remains unclear. A 52-year-old man developed a TLA which was not associated with any pulmonary or gastrointestinal tract foci of tuberculosis. An ultrasonogram and abdominal scan showed an abscess in the right lobe. We performed paracentesis, and the pus from the lesion was positive tubercular bacilli on acid-fast bacilli staining. The patient was started on systemic antitubercular therapy to which he responded favorably. This report emphasizes the fact that, although a TLA is a very rare entity, it should be included in the differential diagnosis of liver abscess especially in Indonesia where the prevalence of tuberculosis is extremely high.

  6. How accurate are self‐reported smoking habits in patients with tuberculosis?

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    Cope GF

    2017-01-01

    Full Text Available Background Smoking or chewing tobacco is a global public health problem that is becoming increasingly prevalent in developing countries. These same countries often also have high rates of tuberculosis disease and infection. As smoking can adversely affect tuberculosis severity, response to treatment and relapse, it is therefore important that clinicians have an accurate picture of patients’ smoking habits. Self‐reported smoking habits may be unreliable and objective measurements of tobacco exposure more accurate. Objective To determine the reliability of self‐reported smoking habits in patients with tuberculosis by measurement of urinary cotinine levels, an objective measure of tobacco exposure. Methods Self‐reported tobacco use was recorded in 100 patients receiving treatment for active or latent tuberculosis using an interviewer administered ‘questionnaire. Urinary cotinine levels were measured by the SmokeScreen test 24hours after the end of treatment. Findings Of 81 reported non‐smokers, 10 had a positive test for cotinine, six of whom gave a result indicative of heavy (11‐15 cigarettes/day or very heavy (>16/day smoking. Of the 17 self‐confessed smokers and two chewers of tobacco, nine gave a result consistent with very heavy smoking although none had reported this degree of tobacco use. Conclusions Important discrepancies exist between subjective and objective smoking habits. Reliance on patient history may adversely affect response to tuberculosis treatment, and some patients will be denied appropriate intervention for smoking cessation.

  7. Tonsillar tuberculosis, with primary pulmonary focus: A Case Report

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    Juan Antonio Lugo Machado

    2015-09-01

    Full Text Available Tuberculosis is an infectious disease that affects various organs and tissues, with greater tropism for lung disease, gastrointestinal and central nervous system tissue and even bone. However isolated cases of affection to other structures have been reported, just like this patient who came with symptoms in the tonsils and subsequently, lung involvement became apparent. The tonsillar infection in this case was considered a secondary tuberculosis with primary focus in the lungs.

  8. Tuberculosis

    OpenAIRE

    C. Robert Horsburgh, Jr

    2014-01-01

    This article reviews the published literature on tuberculosis from September 2012 to August 2013 and describes important advances in tuberculosis epidemiology, microbiology, pathology, clinical pharmacology, genetics, treatment and prevention.

  9. Tuberculosis

    OpenAIRE

    Mochammad, Hatta

    2008-01-01

    This book chapter for medical students and researcher Tuberculosis is still one of the leading causes of death by infectious diseases with 2 million deaths per year and 9.2 million new cases of tuberculosis disease annually [1-3]. Besides, more than 2 milliard people are infected with latent tuberculosis infection (LTBI) [1-3]. Despite continuous effort in the prevention, monitoring and treatment of tuberculosis, the disease remains a major health problem in many countries [4-6...

  10. Tuberculosis

    International Nuclear Information System (INIS)

    Latorre Tortello, Pablo

    1998-01-01

    The tuberculosis is an infection bacterial chronicle of world distribution. Three organisms of the family of the mycobacterium, the m. tuberculosis, the m. bovis and m. africanum, phenotypic and genetically similar, produce it, but only the m. tuberculosis has importance; the others rarely produce illness in the human. By definition, the lung tuberculosis is the localization of the m. tuberculosis in the breathing tract, the most common and main form in the affection and the only able to contaminate to other people. The koch bacillus, transmits the illness directly person to person. The paper Includes topics like pathogenesis, natural history, epidemiology, diagnose, symptomatology and treatment

  11. Case report 513: Tuberculosis of manubrium serni

    International Nuclear Information System (INIS)

    Rajah, R.

    1989-01-01

    The case of a 32-year-old Turkish woman was presented showing soft tissue swelling over the manubrium and surrounding sclerotic changes. A CT-guided needle biopsy in the area of the lesion demonstrated mycobacterium tuberculosis. The author stressed that tuberculous infection of the manubrium is extremely rare. The literature was reviewed, confirming this statement. It was emphasized by the author that the possibility of tuberculosis must be considered in any immigrant from the Middle East, Africa or Asia presenting with an unusual bony lesion. (orig./MG)

  12. TUBERCULOSIS

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    Tarik Bajrović; Mahmud Nurkić; Šukrija Zvizdić

    2013-01-01

    Tuberculosis, known as the "White Plague" in the early 19th century, is the infectious disease, which is being researched today even in some of the most developed countries in the world. Epidemiological- epizootiological research points to the importance of pasteurizing milk as well as the transmission in aerosolized droplets in humans and animals. Mycobacterium tuberculosis (Mtb), M. bovis, M. africanum and M. microti are the mycobacteria that cause tuberculosis. Other mycobacteria cause dis...

  13. Tuberculosis

    NARCIS (Netherlands)

    Ankrah, Alfred O; Glaudemans, Andor W J M; Maes, Alex; Van de Wiele, Christophe; Dierckx, Rudi A J O; Vorster, Mariza; Sathekge, Mike M

    Tuberculosis (TB) is currently the world's leading cause of infectious mortality. Imaging plays an important role in the management of this disease. The complex immune response of the human body to Mycobacterium tuberculosis results in a wide array of clinical manifestations, making clinical and

  14. Tuberculosis

    Science.gov (United States)

    Friend, Milton

    1999-01-01

    Avian tuberculosis is usually caused by the bacterium Mycobacterium avium. At least 20 different types of M. avium have been identified, only three of which are known to cause disease in birds. Other types of Mycobacterium rarely cause tuberculosis in most avian species; however, parrots, macaws, and other large perching birds are susceptible to human and bovine types of tuberculosis bacilli. Avian tuberculosis generally is transmitted by direct contact with infected birds, ingestion of contaminated feed and water, or contact with a contaminated environment. Inhalation of the bacterium can cause respiratory tract infections. Wild bird studies in the Netherlands disclosed tuberculosis-infected puncture-type injuries in birds of prey that fight at the nest site (kestrels) or on the ground (buteo-type buzzards), but tuberculosisinfected injuries were not found in accipiters (falco

  15. Dental technician pneumoconiosis mimicking pulmonary tuberculosis: a case report.

    Science.gov (United States)

    Tan, Han Loong; Faisal, Mohamed; Soo, Chun Ian; Ban, Andrea Y L; Manap, Roslina Abdul; Hassan, Tidi M

    2016-09-07

    Dental laboratory technicians are at risk of developing occupational respiratory diseases due to exposure to various potentially toxic substances in their working environment. Since 1939, few cases of silicosis among dental technician have been reported. We illustrate a 38 year-old female, who worked in a dental laboratory for 20 years, initially treated as pulmonary tuberculosis and chronic necrotising aspergillosis without much improvement. Computed tomography guided lung biopsy and bronchoscopic transbronchial lung biopsy were performed. Lung tissue biopsies showed presence of refractile dental materials within the areas of histiocyte proliferation. The diagnosis of dental technician pneumoconiosis was obtained and our patient underwent pulmonary rehabilitation. This case highlights the importance of obtaining a detailed occupational history in tuberculosis endemic area, as pulmonary tuberculosis is a great mimicker of other respiratory diseases.

  16. HIV related isolated tuberculosis of the spleen: A case report ...

    African Journals Online (AJOL)

    A patient with left upper quadrant pain, intermittent fever, and weight loss but no radiographic evidence suggestive of pulmonary tuberculosis is presented. Abdominal sonography showed multiple hypo echoic nodular splenic lesions reported as foci of infection/abscess. Histopathology study of splenectomy specimen ...

  17. Triple valve endocarditis by mycobacterium tuberculosis. A case report

    Directory of Open Access Journals (Sweden)

    Shaikh Quratulain

    2012-09-01

    Full Text Available Abstract Background Granulomas caused by Mycobacterium Tuberculosis have been observed at autopsy in the heart, pre-dominantly in the myocardium and endocardium, but rarely involving the coronary vessels and valvular structures. Mycobacterium tuberculosis valvular endocarditis is extremely rare, with most reports coming from autopsy series. Case presentation We report the case of a 17 year old immunocompetent girl who presented with history of fever, malaise, foot gangrene and a left sided hemiparesis. On investigation she was found to have infective endocarditis involving the aortic, mitral and tricuspid valves. She had developed a right middle cerebral artery stroke. She underwent dual valve replacement and tricuspid repair. The vegetations showed granulomatous inflammation but blood cultures and other biological specimen cultures were negative for any organisms. She was started on antituberculous treatment and anticoagulation. Conclusion This is the first reported case of triple valve endocarditis by Mycobacterium Tuberculosis in an immunocompetent host. Especially important is the fact that the right heart is involved which has been historically described in the setting of intravenous drug abuse. This implies that Tuberculosis should be considered in cases of culture negative endocarditis in endemic areas like Pakistan even in immunocompetent hosts.

  18. Cystic change in pulmonary tuberculosis in an immunocompetent adult: a case report

    International Nuclear Information System (INIS)

    Ko, Sung Min; Seo, Soo Ji; Choi, Won Il; Jeon, Young June

    2008-01-01

    Cystic change associated with pulmonary tuberculosis is rarely encountered, and few reports are available on the radiologic findings of pulmonary tuberculosis presenting as multiple cystic lesions associated with consolidation or bronchohematogenous nodules. The cystic lesions in our pulmonary tuberculosis patient occurred during steroid treatment without antituberculous chemotherapy and progressively increased in size, but subsequently became smaller after the initiation of antituberculous chemotherapy. Herein, we report the chest radiographic and computed tomographic findings of cystic change in pulmonary tuberculosis in an immunocompetent adult

  19. A systematic assessment of the concept and practice of public-private mix for tuberculosis care and control.

    Science.gov (United States)

    Malmborg, Rasmus; Mann, Gillian; Squire, S Bertel

    2011-11-10

    The STOP TB Partnership aims to improve global tuberculosis (TB) control through expanding access to the directly observed treatment short course (DOTS) strategy. One approach to this is 'Engaging all Care Providers', which evolved from 'Public-Private Mix (PPM) DOTS'. The overall aim of this study was to systematically assess whether and to what degree the STOP TB Partnership's four global objectives of engaging all care providers are met through existing PPM interventions. These four objectives are; 1) Increase TB case detection; 2) Improve TB treatment outcomes; 3) Enhance access and equity; 4) Reduce financial burden on patients. The specific objectives of this assessment were to 1) Understand what PPM means to the STOP TB Partnership's PPM Subgroup and to National Tuberculosis Programme managers; 2) Scope the nature of existing country-level PPM interventions and 3) Review PPM practice against the global PPM objectives. We undertook a systematic, multi-facetted assessment. The methods included interviews with National Tuberculosis Programme managers from high burden countries, clarification of key issues with the STOP TB Partnership PPM secretariat and a review of publicly accessible reports and published articles on PPM projects. Both the literature review and interviews with the National Tuberculosis Programme managers yielded data on project characteristics; PPM models at country level; National Tuberculosis Programme partners; and mechanisms for engagement. Matrices were developed from the literature review and the interviews to show the relationship between services and service providers for different PPM projects. Data from the literature were assessed against each of the four global PPM objectives. Twelve National Tuberculosis Programme managers from high burden countries were interviewed about the scope of PPM partnerships. Understanding of PPM and types of engaged providers varied considerably; 'private-for-profit qualified clinical providers' were

  20. TUBERCULOSIS

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    Tarik Bajrović

    2013-10-01

    Full Text Available Tuberculosis, known as the "White Plague" in the early 19th century, is the infectious disease, which is being researched today even in some of the most developed countries in the world. Epidemiological- epizootiological research points to the importance of pasteurizing milk as well as the transmission in aerosolized droplets in humans and animals. Mycobacterium tuberculosis (Mtb, M. bovis, M. africanum and M. microti are the mycobacteria that cause tuberculosis. Other mycobacteria cause diseases commonly known as mycobacteriosae. Pathogenesis of tuberculosis includes both host- related and mycobacterium-related factors (virulence. Mtb acts through the expression of various genes and their proteins that are detectable in the serums of the diseased only, proving these proteins are formed in the course of the disease. In humans, a diagnosis is established by the detection of antigens (and antibodies, and in animals, with the allergy tests. As far as the bovine tuberculosis is concerned, the combination of skin tuberculin and blood gamma interferon test is recommended. Sequential genome (Mtb analysis has given the basis for further research of the new vaccines.Key words: Tuberculosis, pathogenesis, immunity

  1. Tuberculosis

    Directory of Open Access Journals (Sweden)

    Elena Morán López

    2001-04-01

    Full Text Available En la actualidad la incidencia de la tuberculosis ha aumentado. El Mycobacterium tuberculosis infecta frecuentemente a las personas con SIDA, debido a que en estos pacientes hay una reducción de la resistencia mediada por células T, lo que propicia que este bacilo pueda desarrollar la enfermedad con una frecuencia superior a la de las personas sanas. La transmisión de la enfermedad puede ser por vía directa, de un individuo afectado a otro, fundamentalmente por las gotitas de saliva que contengan a este microorganismo, o por vía indirecta por la inhalación del bacilo que se puede encontrar por meses en los objetos de uso diario, debido a su gran resistencia. Las micobacterias que producen tuberculosis en el hombre inmunocompetente son la Mycobacterium tuberculosis y la bovis, otros tipos pueden provocar tuberculosis en individuos inmunocomprometidos. La patogenicidad de este bacilo está relacionada con su capacidad para escapar de la destrucción inducida por los macrófagos y para provocar hipersensibilidad de tipo retardado. Esta enfermedad tiene muy pocas manifestaciones bucales, lo que se observa generalmente es una úlcera que toma como asiento fundamental el dorso de la lengua. La tuberculosis amenaza con convertirse en una enfermedad incurable por la deficiente administración de los programas contra ésta, por lo que la OMS plantea para su detección y tratamiento el DOTS (tratamiento observado directamente, de corta duración que comienza a tener resultados satisfactorios, aunque en el último quinquenio, el 88 % de los pacientes que se estimaban como infectados por tuberculosis no recibieron DOTS.At present, the incidence of tuberculosis is on the rise. Mycobacterium tuberculosis often infests AIDS patients due to the fact that these persons´T-cell mediated resistance is reduced, which favors the development of the disease at a higher rate than in healthy people. The disease can be transmitted directly, that is , from an

  2. 1 Tuberculosis in India: A need of Public Awareness & Education

    African Journals Online (AJOL)

    2015-05-07

    May 7, 2015 ... MDR-TB(Multi-drug resistant tuberculosis) in absolute numbers during 2008 ... treatment units, One TB Hospital, 501 DOT centres, 38 NGOs and 2829 private .... presence of the family member or accompanying person.

  3. Primary tuberculosis of the breast manifested as abscess: a rare case report.

    Science.gov (United States)

    Gupta, Samita; Singh, Vikram J; Bhatia, Gaurav; Dhuria, Kshitiz

    2014-01-01

    Primary breast tuberculosis is a rare entity. We are reporting a case of primary breast tuberculosis, which presented as breast abscess. On histopathology, it was diagnosed as breast tuberculosis. Aspiration cytology was not done due breast abscess. Patient was put on anti-tubercular drugs. In follow up, after 3 months patient condition was improved.

  4. Trends in Tuberculosis Reported from the Appalachian Region: United States, 1993-2005

    Science.gov (United States)

    Wallace, Ryan M.; Armstrong, Lori R.; Pratt, Robert H.; Kammerer, J. Steve; Iademarco, Michael F.

    2008-01-01

    Context: Appalachia has been characterized by its poverty, a factor associated with tuberculosis, yet little is known about the disease in this region. Purpose: To determine whether Appalachian tuberculosis risk factors, trends, and rates differ from the rest of the United States. Methods: Analysis of tuberculosis cases reported to the Centers for…

  5. Report of a case with Hodgkin's lymphoma, tuberculosis and autoimmune hemolytic anemia

    OpenAIRE

    TUĞCU, Deniz; KEBUDİ, Rejin; ZÜLFİKAR, Bülent; AYAN, İnci; GÖRGÜN, Ömer; AĞAN, Mehmet; SOMER, Alper; AKINCI, Ferhan

    2007-01-01

    Tuberculosis has been described in association with malignancies including Hodgkin's disease (HD). In this article, a patient with diagnoses of H D, tuberculosis and hemolytic anemia is reported. Both tuberculosis and HD may present with similar symptoms and signs, and one of the diagnoses may be overlooked. The physicians should be aware of the simultaneous occurrence of both of these diseases when they are faced with initial therapeutic failure, during care of H D and tuberculosis patients.

  6. Tuberculosis

    OpenAIRE

    Latorre Tortello, Pablo

    2011-01-01

    Por definición, la tuberculosis pulmonar es la localizaci6n del M. tuberculosis en el tracto respiratorio, la forma más común y principal de la afección y la única capaz de contagiar a otras personas. El M. tuberculosis, descubierto por Robert Koch en 1882, el bacilo de Koch, es un bacilo delgado, inmóvil, de 4 micras de longitud media, aerobio obligado, que se tiñe de rajo por la tinción de Ziehl-Neelsen. Debido a la coraza lipídica de su pared, lo hace resistente a la decoloración con ácido...

  7. Tuberculosis

    Directory of Open Access Journals (Sweden)

    Pablo Latorre Tortello

    1998-10-01

    Full Text Available Por definición, la tuberculosis pulmonar es la localizaci6n del M. tuberculosis en el tracto respiratorio, la forma más común y principal de la afección y la única capaz de contagiar a otras personas. El M. tuberculosis, descubierto por Robert Koch en 1882, el bacilo de Koch, es un bacilo delgado, inmóvil, de 4 micras de longitud media, aerobio obligado, que se tiñe de rajo por la tinción de Ziehl-Neelsen. Debido a la coraza lipídica de su pared, lo hace resistente a la decoloración con ácidos y alcohol, de ahí el nombre de bacilos ácido-alcohol resistente (BAAR. Su transmisión es directa, de persona a persona.

  8. Tuberculosis

    OpenAIRE

    Pablo Latorre Tortello

    1998-01-01

    Por definición, la tuberculosis pulmonar es la localizaci6n del M. tuberculosis en el tracto respiratorio, la forma más común y principal de la afección y la única capaz de contagiar a otras personas. El M. tuberculosis, descubierto por Robert Koch en 1882, el bacilo de Koch, es un bacilo delgado, inmóvil, de 4 micras de longitud media, aerobio obligado, que se tiñe de rajo por la tinción de Ziehl-Neelsen. Debido a la coraza lipídica de su pared, lo hace resistente a la decoloración con ácido...

  9. Disseminated histoplasmosis simulating miliary tuberculosis: a case report

    International Nuclear Information System (INIS)

    Tavares Junior, Wilson Campos; Madureira, Marcus Magalhaes; Andrade, Diego Correa de; Guimaraes, Silvana Mangeon Meireles; Queiroz, Leonardo Campos; Avila, Renata Eliane de; Lambertucci, Jose Roberto

    2005-01-01

    Histoplasmosis is a disease caused by inhalation of the fungus Histoplasma capsulatum. In rare cases the disease affects immunocompetent individuals. Disseminated and severe disease is seen in immunocompromised patients. We report a case of a 45 year old immunocompromised patient presenting with weight loss and abdominal pain. Chest x-ray and computerized tomography examinations showed interstitial infiltrate and diffuse micro nodules. The initial diagnosis was miliary tuberculosis. However, the definitive diagnosis of miliary histoplasmosis was made later on. (author)

  10. Tuberculosis

    OpenAIRE

    Mendoza Zuñiga, Marleny; Bastidas Párraga, Gustavo; León Untiveros, Paúl Albert

    2013-01-01

    La tuberculosis es una enfermedad infectocontagiosa producida por el bacilo de Koch, que ataca a los pulmones pero puede ser difuminada por todo el cuerpo. El siguiente artículo de información nos da una visión amplia de la detección, diagnóstico y tratamiento de la misma.

  11. Endometrial Tuberculosis i ninfertility: Report of 2 cases and a ...

    African Journals Online (AJOL)

    Tuberculosis is a chronic granulomatous disease affecting human and many other mammals. Most human diseases are caused by M.tuberculosis but some are due to M.bovis.(1). Tuberculosis of the tubes and endometrium is intimately bound to the problem of sterility. Despite the decline in frequency of genital tuberculosis ...

  12. Diffuse Type Primary Mycobacterium Tuberculosis of the Breast: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun A; Kang, Bong Joo; Kim, Sung Hun; Kim, Hnana; Lee, Ah Won [Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-12-15

    Tuberculous mastitis is a rare manifestation of mycobacterium tuberculosis infection. It mimics inflammatory breast cancer or other pyogenic inflammations. In most of the tuberculous mastitis reports, coexisting or prior tuberculosis infection and secondary infection of the breast by direct spread via axillary or cervical lymphadenopathy, or hematogenous spread have been noted. We describe the mammographic and ultrasonographic findings of a case of diffuse type mycobacterium tuberculosis of the breast showing diffuse edema which was confirmed as tuberculosis through biopsy and had no evidence of old or concurrent pulmonary tuberculosis on chest computed tomography

  13. PRIMARY CONJUNCTIVAL TUBERCULOSIS – A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kulkarni Dinesh R, Sulegaon Ritesh V, Chulki Shashidhar F

    2015-07-01

    Full Text Available Tuberculosis is an endemic disease in India. Primary conjunctival tuberculosis is an uncommon condition and with better treatment of pulmonary tuberculosis it is now becoming extremely rare. Primary conjunctival Tuberculosis can present as unilateral conjunctivitis, hence laterality, chronicity and non-resolution of symptoms on treatment are indications for biopsy. In our patient conjunctival Tuberculosis was diagnosed on histopathology, which resulted in early implementation of antikochs’ treatment and complete resolution of the disease condition.

  14. The World Health Organization and public health research and practice in tuberculosis in India.

    Science.gov (United States)

    Banerji, Debabar

    2012-01-01

    Two major research studies carried out in India fundamentally affected tuberculosis treatment practices worldwide. One study demonstrated that home treatment of the disease is as efficacious as sanatorium treatment. The other showed that BCG vaccination is of little protective value from a public health viewpoint. India had brought together an interdisciplinary team at the National Tuberculosis Institute (NTI) with a mandate to formulate a nationally applicable, socially acceptable, and epidemiologically sound National Tuberculosis Programme (NTP). Work at the NTI laid the foundation for developing an operational research approach to dealing with tuberculosis as a public health problem. The starting point for this was not operational research as enunciated by experts in this field; rather, the NTI achieved operational research by starting from the people. This approach was enthusiastically welcomed by the World Health Organization's Expert Committee on Tuberculosis of 1964. The NTP was designed to "sink or sail with the general health services of the country." The program was dealt a major blow when, starting in 1967, a virtual hysteria was worked up to mobilize most of the health services for imposing birth control on the people. Another blow to the general health services occurred when the WHO joined the rich countries in instituting a number of vertical programs called "Global Initiatives". An ill-conceived, ill-designed, and ill-managed Global Programme for Tuberculosis was one outcome. The WHO has shown rank public health incompetence in taking a very casual approach to operational research and has been downright quixotic in its thinking on controlling tuberculosis worldwide.

  15. Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report

    Directory of Open Access Journals (Sweden)

    Vinay Pandit

    Full Text Available Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infection have been reported. But tuberculosis presenting simultaneously with mesenteric and brain abscess has not been reported yet. We report a case of disseminated tuberculosis presenting as mesenteric and cerebral abscess in a HIV case without involving lung and lymph nodes. Bone marrow smears and fine needle aspiration cytology (FNAC from mesenteric lesion were positive for acid fast bacilli (AFB and the diagnosis of tuberculosis was confirmed by positive polymerase chain reaction (PCR. He responded well to treatment with anti tubercular drugs.

  16. Bovine tuberculosis at the human-livestock-wildlife interface: Is it a public health problem in Tanzania? A review

    Directory of Open Access Journals (Sweden)

    Bugwesa Z. Katale

    2012-06-01

    Full Text Available Despite the apparent public health concern about Bovine tuberculosis (BTB in Tanzania, little has been done regarding the zoonotic importance of the disease and raising awareness of the community to prevent the disease. Bovine tuberculosis is a potential zoonotic disease that can infect a variety of hosts, including humans. The presence of multiple hosts including wild animals, inefficient diagnostic techniques, absence of defined national controls and eradication programs could impede the control of bovine TB. In Tanzania, the diagnosis of Mycobacterium bovis in animals is mostly carried out by tuberculin skin testing, meat inspection in abattoirs and only rarely using bacteriological techniques. The estimated prevalence of BTB in animals in Tanzania varies and ranges across regions from 0.2% to 13.3%, which is likely to be an underestimate if not confirmed by bacteriology or molecular techniques. Mycobacterium bovis has been detected and isolated from different animal species and has been recovered in 10% of apparently healthy wildebeest that did not show lesions at post-mortem. The transmission of the disease from animals to humans can occur directly through the aerosol route and indirectly by consumption of raw milk. This poses an emerging disease threat in the current era of HIV confection in Tanzania and elsewhere. Mycobacterium bovis is one of the causative agents of human extra pulmonary tuberculosis. In Tanzania there was a significant increase (116.6% of extrapulmonary cases reported between 1995 and 2009, suggesting the possibility of widespread M. bovis and Mycobacterium tuberculosis infection due to general rise of Human Immunodeficiency virus (HIV. This paper aims to review the potential health and economic impact of bovine tuberculosis and challenges to its control in order to safeguard human and animal population in Tanzania.

  17. Tuberculosis

    OpenAIRE

    Juan Carlos Rodríguez, D.

    2014-01-01

    La tuberculosis sigue constituyendo un problema de salud pública a nivel mundial con casi nueve millones de casos nuevos en 2012 y se estima que un tercio de la humanidad está infectada. A nivel nacional, si bien las tasas son alentadoras, la variación regional es muy importante. En los últimos años se han registrado progresos importantes tanto en el conocimiento de la conducta del bacilo de Koch, el causante de la enfermedad, como en los métodos para detectarlo. Así los IGRAS (Interferon G R...

  18. Primary Pelvic Tuberculosis That Mimics Ovarian Cancer: A Case Report

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    Özlem Seçilmiş Kerimoğlu

    2016-05-01

    tubal tuberculosis. Surgeons should consider genital tuberculosis in the differential diagnosis by avoiding large surgical procedure and intra-operative frozen-section analysis should be done to prevent overtreatment.

  19. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

    NARCIS (Netherlands)

    Getahun, Haileyesus; Matteelli, Alberto; Abubakar, Ibrahim; Aziz, Mohamed Abdel; Baddeley, Annabel; Barreira, Draurio; den Boon, Saskia; Borroto Gutierrez, Susana Marta; Bruchfeld, Judith; Burhan, Erlina; Cavalcante, Solange; Cedillos, Rolando; Chaisson, Richard; Chee, Cynthia Bin-Eng; Chesire, Lucy; Corbett, Elizabeth; Dara, Masoud; Denholm, Justin; de Vries, Gerard; Falzon, Dennis; Ford, Nathan; Gale-Rowe, Margaret; Gilpin, Chris; Girardi, Enrico; Go, Un-Yeong; Govindasamy, Darshini; D Grant, Alison; Grzemska, Malgorzata; Harris, Ross; Horsburgh, C. Robert; Ismayilov, Asker; Jaramillo, Ernesto; Kik, Sandra; Kranzer, Katharina; Lienhardt, Christian; LoBue, Philip; Lönnroth, Knut; Marks, Guy; Menzies, Dick; Migliori, Giovanni Battista; Mosca, Davide; Mukadi, Ya Diul; Mwinga, Alwyn; Nelson, Lisa; Nishikiori, Nobuyuki; Oordt-Speets, Anouk; Rangaka, Molebogeng Xheedha; Reis, Andreas; Rotz, Lisa; Sandgren, Andreas; Sañé Schepisi, Monica; Schünemann, Holger J.; Sharma, Surender Kumar; Sotgiu, Giovanni; Stagg, Helen R.; Sterling, Timothy R.; Tayeb, Tamara; Uplekar, Mukund; van der Werf, Marieke J.; Vandevelde, Wim; van Kessel, Femke; van't Hoog, Anna; Varma, Jay K.; Vezhnina, Natalia; Voniatis, Constantia; Vonk Noordegraaf-Schouten, Marije; Weil, Diana; Weyer, Karin; Wilkinson, Robert John; Yoshiyama, Takashi; Zellweger, Jean Pierre; Raviglione, Mario

    2015-01-01

    Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health

  20. [Tuberculosis of the penis: report of a case and review of the literature].

    Science.gov (United States)

    Tanikawa, K; Matsushita, K; Ohkoshi, M

    1985-06-01

    Tuberculosis of the penis is a rare disease. We report a case of tuberculosis of the penis. A 51-year-old man noticed a painless induration with a central ulceration on the glans penis. He had a history of tuberculosis of cervical lymph-nodes, right epididymis and leg skin. Examination of the other parts showed no evidence of tuberculosis. Tuberculin test was strongly positive. The skin lesion of the glans was excised. The pathology was epithelioid cell granuloma with Langhans' giant cell, indicative of tuberculosis. But acid-fast bacilli were not detected in the Ziehl-Neelsen preparation of the tissue. The patient was treated with isoniazid, rifampicin and cycloserine. After the treatment for approximately 5 months, recurrence was not observed and enlargement of cervical lymphadenopathy improved. We reviewed 39 cases of tuberculosis of the penis reported in Japan during the past 14 years.

  1. Common Bile Duct Perforation Due to Tuberculosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Razman Jarmin

    2004-10-01

    Full Text Available A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

  2. Common Bile Duct Perforation Due to Tuberculosis: A Case Report

    OpenAIRE

    Razman Jarmin; Shaharin Shaharuddin

    2004-01-01

    A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

  3. Subdeltoid Bursa Tuberculosis with Rice Body Formation–A Case Report

    Directory of Open Access Journals (Sweden)

    Santosh L. Munde

    2015-01-01

    Full Text Available Tuberculous tenosynovitis and bursitis account for approximately 1%. A 56 years old female presented with swelling in left shoulder, gradually increasing in size with slight restriction in movement since last three months. X-ray revealed no abnormality of humerus head. Histopathological examination showed granulomatous tissue with multiple rice bodies. A positive culture of mycobacterium tuberculosis confirmed the diagnosis of tuberculosis. We here report a case of subdeltoid bursitis with rice body formation and without active bone and joint tuberculosis.

  4. The Precariousness of Public Health: On Tuberculosis Control in Contemporary France.

    Science.gov (United States)

    Kehr, Janina

    2016-01-01

    Through an ethnographic exploration of tuberculosis control in one of France's poorest regions, Seine-Saint-Denis, I interrogate the relationships between public health planning and interventions in conditions of multiple precarity. I show that the encounter between the feasible and the fantastic in the realm of public health generates feelings of absurdity and futility among medical professionals, characteristic of disease control in the precarious present. Precarity is neither a social and economic condition per se, nor is the link between disease and precarity static. It is a dynamic process of political inclusions, exclusions, and inequalities, which differ substantially within the unequal spheres of precarious lives. The contradictions in tuberculosis control that I describe are thus not only characteristic of French public health but of global public health today, where illusions in disease control encounter the exclusionary realities of social life.

  5. Tuberculosis of the penis: report of a case and review of the literature

    OpenAIRE

    谷川, 克己; 松下, 一男; 大越, 正秋

    1985-01-01

    Tuberculosis of the penis is a rare disease. We report a case of tuberculosis of the penis. A 51-year-old man noticed a painless induration with a central ulceration on the glans penis. He had a history of tuberculosis of cervical lymph-nodes, right epididymis and leg skin. Examination of the other parts showed no evidence of tuberculosis. Tuberculin test was strongly positive. The skin lesion of the glans was excised. The pathology was epithelioid cell granuloma with Langhans' giant cell, in...

  6. Using routinely reported tuberculosis genotyping and surveillance data to predict tuberculosis outbreaks.

    Directory of Open Access Journals (Sweden)

    Sandy P Althomsons

    Full Text Available We combined routinely reported tuberculosis (TB patient characteristics with genotyping data and measures of geospatial concentration to predict which small clusters (i.e., consisting of only 3 TB patients in the United States were most likely to become outbreaks of at least 6 TB cases. Of 146 clusters analyzed, 16 (11.0% grew into outbreaks. Clusters most likely to become outbreaks were those in which at least 1 of the first 3 patients reported homelessness or excess alcohol or illicit drug use or was incarcerated at the time of TB diagnosis and in which the cluster grew rapidly (i.e., the third case was diagnosed within 5.3 months of the first case. Of 17 clusters with these characteristics and therefore considered high risk, 9 (53% became outbreaks. This retrospective cohort analysis of clusters in the United States suggests that routinely reported data may identify small clusters that are likely to become outbreaks and which are therefore candidates for intensified contact investigations.

  7. Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012.

    Science.gov (United States)

    Gaspar, Renato Simões; Nunes, Natália; Nunes, Marina; Rodrigues, Vandilson Pinheiro

    2016-01-01

    To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished. Investigar os casos notificados de tuberculose e de sua coinfecção com o HIV na população brasileira no período entre 2002 e 2012. Realizou-se um estudo observacional de série temporal, no qual

  8. Visceral leishmaniasis and peritoneal tuberculosis: a case report

    Directory of Open Access Journals (Sweden)

    Zamani A

    2009-03-01

    Full Text Available "nBackground: Leishman Denovani is an obligatory intracellular parasite that is seen such as Leishmanbody or Amustigote in intra reticolo-endothelial system. Leishmanenios is seen as sporadic-endemic or epidemic in many places in the world. In Iran in Fars state and west Azarbayjan is endemic and in other places are in sporadic form and is found in rural areas. "nCase report: A four year-old girl was admitted with visceral Leishmaniasis and Subsequently developed peritoneal tuberculosis. The patient who lived in Dashte- Moghan, complained of abdominal pain and distention and weight loss from 1.5 years ago. The titre of IFA test for leishmansis was 1/1280. Leishman body was seen in bone marrow aspiration specimen. Bone marrow culture for leishmania was negative. The specimen of acsities fluid revealed sero- fibrino- purulent exudate with lymphocyic dominancy (over 90%. No response to classic lishmanisis treatment had been started unless the patient treated with anti tuberculoid regimen.  "nConclusion: The function of the T-helper (Tht lymphocytes will decrease in Kala-azar disease. This is why there is no skin reaction to Manteaux (PPD diagnostic test the patient. The patient have been suffering from long-term malnutrition with its consequent immune defect. There was no evidences of cure in our patient during classic Kala-azar therapy. After she received anti tuberculosis therapy she revealed clinical improvement with Glucantim regimen as well.

  9. Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

    Science.gov (United States)

    Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

    2009-04-01

    Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

  10. Modeling the role of public transportation in sustaining tuberculosis transmission in South Africa.

    Science.gov (United States)

    Andrews, Jason R; Morrow, Carl; Wood, Robin

    2013-03-15

    Current tuberculosis notification rates in South Africa are among the highest ever recorded. Although the human immunodeficiency virus epidemic has been a critical factor, the density of respiratory contacts in high-risk environments may be an important and underappreciated driver. Using a modified Wells-Riley model for airborne disease transmission, we estimated the risk of tuberculosis transmission on 3 modes of public transit (minibus taxis, buses, and trains) in Cape Town, South Africa, using exhaled carbon dioxide as a natural tracer gas to evaluate air exchange. Carbon dioxide measurements were performed between October and December of 2011. Environmental risk, reflected in the rebreathed fraction of air, was highest in minibus taxis and lowest in trains; however, the average number of passengers sharing an indoor space was highest in trains and lowest in minibus taxis. Among daily commuters, the annual risk of tuberculosis infection was projected to be 3.5%-5.0% and was highest among minibus taxi commuters. Assuming a duration of infectiousness of 1 year, the basic reproductive number attributable to transportation was more than 1 in all 3 modes of transportation. Given its poor ventilation and high respiratory contact rates, public transportation may play a critical role in sustaining tuberculosis transmission in South African cities.

  11. SOCIO - CULTURAL ASPECTS OF TUBERCULOSIS AND DIALOGUE WITH PUBLIC HEALTH POLICIES IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Débora Regina Marques Barbosa

    2013-03-01

    Full Text Available Tuberculosis away from individuals affected by their social and affective and reconstructionof collective values, relegating them to the condition of inferiority and subservience Sartrean,liabilities oppressive conditions imposed by society, which dismisses the other as legitimatein the intersubjective social construction. This work aims to address the social, psychologicaland symbolic carrier of tuberculosis and PPS in Brazil through integrative review in databasesScientific Electronic Library Online (Scielo and Google Scholar using the descriptorsTuberculosis Society, Culture, Psychosocial Aspects, Sociocultural Aspects; Public Policy inHealth, Social Movements and Social Control, individually or grouped according to theirproximity or remoteness to the guiding question: "How Public Policies on Health dialoguewith social movements and sociocultural aspects of Tuberculosis?". Whereas the way ofseeing a situation and its meaning in a certain reality is guiding factor, even though subjective,of actions, it is stressed that interventions should take in the full measure of human socio-economic-political-cultural. In this sense, knowledge of cultural and socioeconomic situationof a region is essential to confronting the chain of events that disease primarily social in agiven community.

  12. Global Fund financing of public-private mix approaches for delivery of tuberculosis care.

    Science.gov (United States)

    Lal, S S; Uplekar, Mukund; Katz, Itamar; Lonnroth, Knut; Komatsu, Ryuichi; Yesudian Dias, Hannah Monica; Atun, Rifat

    2011-06-01

    To map the extent and scope of public-private mix (PPM) interventions in tuberculosis (TB) control programmes supported by the Global Fund. We reviewed the Global Fund's official documents and data to analyse the distribution, characteristics and budgets of PPM approaches within Global Fund supported TB grants in recipient countries between 2003 and 2008. We supplemented this analysis with data on contribution of PPM to TB case notifications in 14 countries reported to World Health Organization in 2009, for the preparation of the global TB control report. Fifty-eight of 93 countries and multi-country recipients of Global Fund-supported TB grants had PPM activities in 2008. Engagement with 'for-profit' private sector was more prevalent in South Asia while involvement of prison health services has been common in Eastern Europe and central Asia. In the Middle East and North Africa, involving non-governmental organizations seemed to be the focus. Average and median spending on PPM within grants was 10% and 5% respectively, ranging from 0.03% to 69% of the total grant budget. In China, India, Nigeria and the Philippines, PPM contributed to detecting more than 25% TB cases while maintaining high treatment success rates. In spite of evidence of cost-effectiveness, PPM constitutes only a modest part of overall TB control activities. Scaling up PPM across countries could contribute to expanding access to TB care, increasing case detection, improving treatment outcomes and help achieve the global TB control targets. © 2011 Blackwell Publishing Ltd.

  13. Report of two cases of tuberculosis of pubis

    Energy Technology Data Exchange (ETDEWEB)

    Jung, L W; Jeon, B H; Kim, B S [Busan National University College of Medicine, Busan (Korea, Republic of)

    1972-12-15

    Two cases of the tuberculosis of pubis were reported which confirmed by the x-ray and microscopic findings, a case was 12 years old boy, and the other was 13 years old boy, who complained tenderness and moderate swelling over the symphysis pubis region, slight limping gait, and local redness and hotness. Their family histories were not contributory. The x-ray findings of the chest showed the old hilar lymphadenopathy with almost fibroconsolidated patterns, and the pelvis showed the destructions of the pubis with sequestrums and hazy shadows around the pubis, but no evidence of any productive bony changes. The operation was done, and the specimen showed the edematous connective tissues infiltrated with chronic inflammatory cells and granulomatas, which were composed of the epitheloid cells, macrophages, fibroblasts and small round cells.

  14. Inconsistent condom use among public primary care patients with tuberculosis in South Africa.

    Science.gov (United States)

    Matseke, Gladys; Peltzer, Karl; Louw, Julia; Naidoo, Pamela; McHunu, Gugu; Tutshana, Bomkazi

    2012-01-01

    The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR = 1.66; 95% CI 1.25-2.20) or cohabitating or separated, divorced, or widowed (OR = 3.67; 1.85-7.29), lower educational level (OR = 0.66; 0.46-0.94), greater poverty (OR = 1.60; 1.25-2.20), not having HIV status disclosed (OR = 0.34; 0.25-0.48), sexual partner on antiretroviral treatment (OR = 0.38; 0.23-0.60), and partner alcohol use before sex (OR = 1.56; 1.30-1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

  15. MRI diagnosis of intracranial tuberculosis (73 cases report)

    International Nuclear Information System (INIS)

    Zeng Qingyong; Li Xin; He Zhihui; Cheng Chuanhu; Deng Kaijun; Deng Ming

    2008-01-01

    Objective: To assess the MRI features, classification and diagnostic value for intracranial tuberculosis. Methods MRI findings of 73 patients suffering from intracranial tuberculosis proved by pathology or clinic were analyzed respectively. Among the total 73 patients, 39 cases were tuberculosis meningitis, 12 cases simple intracranial tuberculoma, while 22 cases were tuberculoma combining with meningitis. Results: The MRI features of tuberculous meningitis are cerebral infarction, hydrocephalus, abnormal meningeal and cerebral cistern enhancement. 12 cases mature tuberculoma demon- strated typical features with high or low density on T 2 WI images and ring contrast enhancement; 22 cases non-mature tuberculoma showed focal nodular contrast enhancement with evident cerebral edema. FLAIR is more sensitive to find out focus than T 2 WI. Small lesions could be showed definitively by contrast-enhanced scan. Conclusion: MRI possess typical features in the diagnosis of intracranial tuberculosis. It plays an important role in evaluating location, range, classification of intracranial tuberculosis, and is helpful to clinical treatment. (authors)

  16. Congenital tuberculosis

    African Journals Online (AJOL)

    Prof Ezechukwu

    2012-06-20

    Jun 20, 2012 ... Key words: Congenital tuberculo- sis, case report, miliary tuberculosis. Introduction. Congenital tuberculosis defines tuberculosis in infants of .... tary TB and otitis media, resulting in seizures, deafness, and death. It is therefore not surprising that the index case who presented at twelve weeks of age, had ...

  17. Dysphagia as a manifestation of esophageal tuberculosis: a report of two cases

    Directory of Open Access Journals (Sweden)

    Carvalho Aurora

    2011-09-01

    Full Text Available Abstract Introduction Esophageal involvement by Mycobacterium tuberculosis is rare and the diagnosis is frequently made by means of an esophageal biopsy during the evaluation of dysphagia. There are few cases reported in the literature. Case presentation We present two cases of esophageal tuberculosis in 85- and 65-year-old male Caucasian patients with initial complaints of dysphagia and epigastric pain. Upper gastrointestinal endoscopy resulted in the diagnosis of esophageal tuberculosis following the biopsy of lesions of irregular mucosa in one case and a sessile polyp in the other. Pulmonary tuberculosis was detected in one patient. In one patient esophageal stricture developed as a complication. Antituberculous therapy was curative in both patients. Conclusion Although rare, esophageal tuberculosis has to be kept in mind in the differential diagnosis of dysphagia. Pulmonary involvement has important implications for contact screening.

  18. Cutaneous tuberculosis after mesotherapy: report of six cases.

    Science.gov (United States)

    Orjuela, Dora; Puerto, Gloria; Mejía, Graciela; Castro, Claudia; Garzón, María Consuelo; García, Luz Mary; Hernández, Elkin; Ribón, Wellman; Rodríguez, Gerzaín

    2010-01-01

    Cutaneous tuberculosis as a result of a needle injection is a rare event; it generally occurs among medical and laboratory personnel and among patients receiving percutaneous treatment. Six patients are presented who developed cutaneous tuberculosis after mesotherapy cosmetic treatment. One to four months after injection of an unknown product as treatment for obesity and cellulites, five women and a man developed papules, nodules and drainage of wax like material at the inoculated sites; this was interpreted clinically as a non tuberculous mycobacterium infection. Skin biopsies were taken for a histopathologic study; the biopsy and exudates were cultured to make a phenotypic identification. Polymerase chain reaction and restriction enzyme pattern analyses (PCR-restriction pattern analysis)) procedures were applied to the skin biopsies. Mycobacterium tuberculosis was confirmed in the culture and by PRA analysis in the paraffin-embedded biopsies. The patients had never had tuberculosis. Their thoracic X rays were normal and the size of the tuberculin reaction was 17 to 20 mm. Five patients recovered with antituberculosis treatment and the sixth spontaneously healed after the removal of the largest cutaneous module. No satellite adenopathy or recurrences were observed. A previously undescribed mode of acquisition cutaneous tuberculosis was described. This was the second incident of a demonstrated cutaneous tuberculosis following mesotherapy in Colombia. Skin lesions induced by injections must be tested to detect mycobacterias to include M. tuberculosis.

  19. Management of children exposed to Mycobacterium tuberculosis: a public health evaluation in West Java, Indonesia.

    Science.gov (United States)

    Rutherford, Merrin E; Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; van Crevel, Reinout; Hill, Philip C

    2013-12-01

    To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targets for programme performance indicators were derived from established programme indicator targets, the scientific literature and expert opinion. Compliance with tuberculosis screening, the initiation of isoniazid preventive therapy in children younger than 5 years, the accuracy of tuberculosis diagnosis and adherence to preventive therapy were assessed in 755 child contacts in two cohorts. In addition, 22 primary caregivers and 34 clinic staff were interviewed to evaluate knowledge and acceptance of child contact management. The cost to caregivers was recorded. Gaps between observed and target indicator values were quantified. THE GAPS BETWEEN OBSERVED AND TARGET PERFORMANCE INDICATORS WERE: 82% for screening compliance; 64 to 100% for diagnostic accuracy, 50% for the initiation of preventive therapy, 54% for adherence to therapy and 50% for costs. Many staff did not have adequate knowledge of, or an appropriate attitude towards, child contact management, especially regarding isoniazid preventive therapy. Caregivers had good knowledge of screening but not of preventive therapy and had difficulty travelling to the clinic and paying costs. The study identified widespread gaps in the performance of a child contact management system in Indonesia, all of which appear amenable to intervention. The public health evaluation framework used could be applied in other settings where child contact management is failing.

  20. Evaluation of a u.s. Public health laboratory service for the molecular detection of drug resistant tuberculosis.

    Science.gov (United States)

    Yakrus, Mitchell A; Metchock, Beverly; Starks, Angela M

    2015-01-01

    Crucial to interrupting the spread of tuberculosis (TB) is prompt implementation of effective treatment regimens. We evaluated satisfaction, comfort with interpretation, and use of molecular results from a public health service provided by the Centers for Disease Control and Prevention (CDC) for the molecular detection of drug resistant Mycobacterium tuberculosis complex (MTBC). An electronic survey instrument was used to collect information anonymously from U.S. Public Health Laboratories (PHL) that submitted at least one isolate of MTBC to CDC from September 2009 through February 2011. Over 97% of those responding expressed satisfaction with the turnaround time for receiving results. Twenty-six PHL (74%) reported molecular results to healthcare providers in less than two business days. When comparing the molecular results from CDC with their own phenotypic drug susceptibility testing, 50% of PHL observed discordance. No respondents found the molecular results difficult to interpret and 82% were comfortably discussing them with TB program officials and healthcare providers. Survey results indicate PHL were satisfied with CDC's ability to rapidly provide interpretable molecular results for isolates of MTBC submitted for determination of drug resistance. To develop educational materials and strategies for service improvement, reasons for discordant results and areas of confusion need to be identified.

  1. Evaluation of a U.S. Public Health Laboratory Service for the Molecular Detection of Drug Resistant Tuberculosis

    Directory of Open Access Journals (Sweden)

    Mitchell A. Yakrus

    2015-01-01

    Full Text Available Crucial to interrupting the spread of tuberculosis (TB is prompt implementation of effective treatment regimens. We evaluated satisfaction, comfort with interpretation, and use of molecular results from a public health service provided by the Centers for Disease Control and Prevention (CDC for the molecular detection of drug resistant Mycobacterium tuberculosis complex (MTBC. An electronic survey instrument was used to collect information anonymously from U.S. Public Health Laboratories (PHL that submitted at least one isolate of MTBC to CDC from September 2009 through February 2011. Over 97% of those responding expressed satisfaction with the turnaround time for receiving results. Twenty-six PHL (74% reported molecular results to healthcare providers in less than two business days. When comparing the molecular results from CDC with their own phenotypic drug susceptibility testing, 50% of PHL observed discordance. No respondents found the molecular results difficult to interpret and 82% were comfortably discussing them with TB program officials and healthcare providers. Survey results indicate PHL were satisfied with CDC’s ability to rapidly provide interpretable molecular results for isolates of MTBC submitted for determination of drug resistance. To develop educational materials and strategies for service improvement, reasons for discordant results and areas of confusion need to be identified.

  2. Emergence of Extensively Drug Resistant Tuberculosis

    Centers for Disease Control (CDC) Podcasts

    Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.

  3. Prolonged fever in peritoneal tuberculosis: A case report

    Science.gov (United States)

    Zein, U.; Irwandi, S.; Habib, H.; Lim, H.; Pasha, M.; Janis, I.; Saragih, R. H.; Ginting, Y.; Effendy-Y S, R.

    2018-03-01

    Peritoneal tuberculosis may lead to delayed diagnosis because of the nonspecific features such as fever, abdominal distension, abdominal tenderness, ascites, and weight loss. Here, wereported a case of prolonged fever and abdominal pain which was due to peritoneal tuberculosis. Initial examinations including acomplete blood test and serologic tests did not lead to the diagnosis. A final diagnosis was made by abdominal CT-scan and laparoscopy combined with histopathological studies. Antituberculous medications provided a good clinical response in this patient.

  4. Miliary Tuberculosis with Concurrent Brain and Spinal Cord Involvement: A Case Report

    International Nuclear Information System (INIS)

    Sung, Chang Keun; Na, Hyoung Il; Yu, Hyeon; Byun, Jun Soo; Youn, Young Chul; Seo, Jae Seung; Kim, Gi Hyeon

    2008-01-01

    Central nervous system involvement by tuberculosis is rare, and intramedullary involvement is even more rare. A patient that developed intermittent amnesia during anti-tuberculous therapy underwent brain CT and MRI and spine MRI. The latter showed multiple small enhancing nodules in the brain and spinal cord. The patient was treated with anti-tuberculous medication and steroids under the suspected diagnosis of miliary tuberculosis. Follow-up CT showed decreased nodule size and number. We report a case of miliary tuberculosis in the brain and spinal cord and present a review of the literature related to similar cases

  5. Miliary Tuberculosis with Concurrent Brain and Spinal Cord Involvement: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Chang Keun; Na, Hyoung Il; Yu, Hyeon; Byun, Jun Soo; Youn, Young Chul; Seo, Jae Seung; Kim, Gi Hyeon [Chung-Ang University, Seoul (Korea, Republic of)

    2008-11-15

    Central nervous system involvement by tuberculosis is rare, and intramedullary involvement is even more rare. A patient that developed intermittent amnesia during anti-tuberculous therapy underwent brain CT and MRI and spine MRI. The latter showed multiple small enhancing nodules in the brain and spinal cord. The patient was treated with anti-tuberculous medication and steroids under the suspected diagnosis of miliary tuberculosis. Follow-up CT showed decreased nodule size and number. We report a case of miliary tuberculosis in the brain and spinal cord and present a review of the literature related to similar cases.

  6. Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in Cambodia.

    Science.gov (United States)

    Bell, Carolyn A; Ilomäki, Jenni; Pichenda, Koeut; Duncan, Gregory J; Saini, Bandana

    2015-04-01

    Cambodia is one of the 22 countries with a high burden of tuberculosis (TB). People often first seek treatment for cough and other TB symptoms through private pharmacies. The National Tuberculosis Programme trained willing private sector pharmacies to refer TB symptomatic clients to their closest public sector clinic for diagnosis and treatment. The study objective was to investigate factors associated with referral of TB symptomatic clients from pharmacies to public sector clinics in Phnom Penh, Cambodia. Face-to-face structured interviews were conducted with staff from a stratified random sample of 180 private pharmacies in Phnom Penh in 2012. Trained interviewers were Khmer speakers. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with self-reported referral during the previous 3 months. Fifty (29.6%) pharmacies reported that they had referred 125 clients (range 1-10) to public sector clinics during the previous 3 months. In total, 164 (96.5%) pharmacies reported that they always referred all TB symptomatic clients to DOTS (directly observed treatment, short course) clinics. More than 6-year participation in the programme (OR 5.23, 95% CI 1.93-14.18) and willingness to always continue referring (OR 12.24, 95% CI 11.61-93.10) were associated with referral of one or more clients in the previous 3 months. Referral to the client's closest clinic was negatively associated with referral (OR 0.45, 95% CI 0.23-0.99). Pharmacies' ongoing commitment to the Referral Programme was strongly associated with referral. Increased advocacy among the high number of non-referring pharmacies may improve programme performance. Factors negatively associated with referral may need investigation. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  7. Elephantiasis of the external genitalia: A sequel to cutaneous tuberculosis

    Directory of Open Access Journals (Sweden)

    Padmavathy L

    2009-01-01

    Full Text Available Tuberculosis continues to be an important public health problem and cutaneous tuberculosis constitutes a minor proportion of extra pulmonary manifestations of tuberculosis. Elephantiasis of the external genitalia, as a sequel to cutaneous tuberculosis, in a 40-year-old diabetic lady is being reported for its rarity. The patient also had lesions of healed scrofuloderma of 27 years′ duration, in both axillae, with residual pedunculated nodules.

  8. Tuberculosis report among injection drug users and their partners in Kazakhstan.

    Science.gov (United States)

    Hermosilla, S; El-Bassel, N; Aifah, A; Terlikbayeva, A; Zhumadilov, Z; Berikkhanova, K; Darisheva, M; Gilbert, L; Schluger, N; Galea, S

    2015-05-01

    Tuberculosis (TB) is a major threat to global public health. Kazakhstan has the second highest percentage of multidrug-resistant tuberculosis (MDR-TB) cases among incident tuberculosis cases in the world (WHO 2013). A high burden of MDR-TB suggests TB prevention, control, and treatment programs are failing. This study provides an epidemiologic profile of TB among injection drug users (IDUs), a high-risk and chronically underserved population, in Kazakhstan. Cross-sectional study. The authors studied the characteristics and risk environment of IDUs with self-reported previous active TB and their primary sexual partners in Almaty, Kazakhstan. 728 individuals (364 couples) participated in a couple-based study in 2009. 16.75% of participants reported at least one positive TB test (x-ray) in their lifetime. In a multivariable logistic regression adjusting for couple-based sampling, persons with positive TB test were significantly more likely to be older (odds ratio (OR) 7.26, 95% confidence interval (CI): 1.73, 30.43), male (OR 5.53, 95% CI: 2.74, 11.16), have a shorter duration of injection drug use (OR 0.17, 95% CI: 0.04, 0.65), have received high social support from their significant other (OR 2.13, 95% CI: 1.03, 4.40) and more likely (non-significantly) to have been incarcerated (OR 7.03, 95% CI: 0.64, 77.30). Older men with a history of incarceration and recent injection drug use were more likely to have positive TB test in Kazakhstan. Social network support, while potentially positive for many aspects of population health, may increase risk of TB among IDUs in this context. Public health policies that target high-risk populations and their at-risk networks may be necessary to stem the rise of MDR-TB in Central Asia. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. Completeness of tuberculosis reporting forms in five Brazilian capitals with a high incidence of the disease *

    Science.gov (United States)

    dos Santos, Normeide Pedreira; Lírio, Monique; Passos, Louran Andrade Reis; Dias, Juarez Pereira; Kritski, Afrânio Lineu; Galvão-Castro, Bernardo; Grassi, Maria Fernanda Rios

    2013-01-01

    The aim of this study was to evaluate the completeness of tuberculosis reporting forms in the greater metropolitan areas of five Brazilian capitals where the incidence of tuberculosis was high in 2010-Salvador, Rio de Janeiro, Cuiabá, Porto Alegre, and Belém-using tabulations obtained from the Sistema Nacional de Informação de Agravos de Notificação (National Case Registry Database). The degree of completeness was highest in Porto Alegre and Cuiabá, whereas it was lowest in Rio de Janeiro, where there are more reported cases of tuberculosis than in any other Brazilian capital. A low degree of completeness of these forms can affect the quality of the Brazilian National Tuberculosis Control Program, which will have negative consequences for health care and decision-making processes. PMID:23670508

  10. Undiagnosed tuberculosis as clinical, epidemiological and medicolegal problem: Report of two cases

    Directory of Open Access Journals (Sweden)

    Savić Slobodan

    2006-01-01

    Full Text Available The authors present two cases of undiagnosed tuberculosis in order to point out clinical, epidemiological and medicolegal importance of such cases. The first patient was a 29- year old woman, who died after 10-day hospital treatment, but true nature of her disease remained undiscovered. Due to her known marital problems, as well as numerous bruises developed as a consequence of hemorrhagic syndrome, violent death caused by injuries inflicted by her husband was suspected. Medicolegal autopsy and microscopic examination revealed fatal tuberculosis of the lungs, and small and large intestines. In another case, a 35-year old male died suddenly and unexpectedly, being found dead in his flat where numerous blood traces were noticed during the scene investigation. Therefore, possible homicide was suspected. Medicolegal investigation proved pulmonary tuberculosis as a cause of natural death. Presented cases point out the fact that even nowadays both pulmonary and extrapulmonary tuberculosis may remain clinically undiscovered, even when this disease is a cause of death. Hence, physicians should always keep in mind possible tuberculosis, especially in patients with long-lasting typical symptoms and signs. In both reported cases, the individuals suffered from cavernous pulmonary tuberculosis being thus a permanent source of infection. From medicolegal point of view, described cases represent examples of so called suspicious natural death. On the other hand, the fact that fatal tuberculosis remained clinically undiagnosed may make physicians be accused of medical negligence and malpractice.

  11. Tuberculosis infection of the breast mistaken for granulomatous mastitis: a case report

    OpenAIRE

    Sriram, KB; Moffatt, D; Stapledon, R

    2008-01-01

    Background Tuberculosis of the breast is an uncommon disease with non-specific clinical, radiological and histological findings. Misdiagnosis is common as biopsy specimens are pauci-bacillary and investigations such as microscopy and culture are frequently negative. Case presentation We report a case of a breast abscess in a 34-year old Bangladeshi woman attributed to tuberculosis infection. Equivocal histology, negative Ziehl-Neelsen stain and culture for acid-fast bacilli resulted in the ab...

  12. Imaging in tuberculosis of the skull and skull-base: case report

    International Nuclear Information System (INIS)

    Sencer, S.; Aydin, K.; Poyanli, A.; Minareci, O.; Sencer, A.; Hepguel, K.

    2003-01-01

    We report a 19-year-old girl, who presented with headache and tonic/clonic seizures. Imaging revealed a lytic parietal skull lesion with an adjacent epidural mass, masses in the right parietal lobe and a posterior skull-base mass. The diagnosis of tuberculosis was made after resection of the extradural mass and later verified with culture of Mycobacterium tuberculosis. The parenchymal and skull-base lesions resolved following antituberculous treatment. We present CT, scintigraphic, angiographic and MRI findings. (orig.)

  13. The dynamic of tuberculosis case finding in the era of the public-private mix strategy for tuberculosis control in Central Java, Indonesia.

    Science.gov (United States)

    Reviono, Reviono; Setianingsih, Wahyu; Damayanti, Kusmadewi Eka; Ekasari, Ratna

    2017-01-01

    The public-private mix (PPM) strategy has strengthened tuberculosis care and control in many countries. Indonesia, a country with a high tuberculosis burden, has a low tuberculosis case detection rate (CDR), despite PPM implementation in 2003. The PPM in Indonesia involves primary healthcare centers, hospitals, and specialized chest clinics. The long-term impact of the strategy is unknown.  We aimed to explore the case detection achievements of the tuberculosis program since PPM implementation in Central Java in 2003. This retrospective cohort study covered the period 1 January 2000 to 31 December 2014. The data from tuberculosis patients treated in all health facilities in Central Java implementing directly observed treatment short-course, recorded via a standardized form, were analyzed after being validated by the Office of Health of Central Java Province. We evaluated the CDR, case notification rate, and total number of cases, using linear regression to analyze the temporal trends of those indicators in the phases of PPM implementation. The CDR increased during the initial phase (2000-2005), decreased during the mid-phase (2006-2009), and increased slightly during the late phase (2010-2014), ranging from 13 to 61.72. These trends were observed despite a steady increase in the number of participating healthcare facilities. The regression analysis showed that the CDR of referral institutions contributed the most to the total CDR of Central Java Province. Many of the smear-negative tuberculosis cases recorded at primary healthcare centers may have been smear positive; this probable misclassification could have been partially avoided if more specific and sensitive diagnostic tools were available. The CDR remains below the national target (70%). Early awareness of a negative trend in certain program indicators is important to ensure program sustainability. Careful observation of the indicator pattern will secure the long-term success of the program.

  14. Mammary tuberculosis mimicking breast cancer: a case report

    Directory of Open Access Journals (Sweden)

    Maroulis Ioannis

    2008-02-01

    Full Text Available Abstract Introduction The incidence of tuberculosis is rising worldwide and rare manifestations of the past are seen more often nowadays. Mammary tuberculosis is a rare clinical entity, often mimicking breast cancer or abscesses of benign or malignant origin. Clinical awareness is necessary during diagnostic work-up for establishing the correct diagnosis and treatment. Case presentation We present a case of breast tuberculosis diagnosed in a 73 year old woman at our institution. The patient presented with a palpable mass of the right breast with clinical, laboratory and mammographic findings indicative of breast carcinoma. The patient underwent lumpectomy and sentinel lymph node biopsy. Frozen section of the tumor and the sentinel node revealed "granulomatous inflammation", while gross examination confirmed the diagnosis of tuberculous mastitis. The patient received anti-tuberculosis therapy for six months with no side effects or any further complications. Conclusion Breast tuberculosis is an obscure disease often mistaken for carcinoma or pyogenic abscess of the breast, especially if well-defined clinical features are absent. A high index of suspicion is required because the disease can usually be treated conservatively with current antituberculous modalities while surgical intervention is reserved for rare cases only.

  15. Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-01-01

    Full Text Available The high rate of HIV infections among tuberculosis (TB patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20 or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29, lower educational level (OR=0.66; 0.46–0.94, greater poverty (OR=1.60; 1.25–2.20, not having HIV status disclosed (OR=0.34; 0.25–0.48, sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60, and partner alcohol use before sex (OR=1.56; 1.30–1.90 were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

  16. Chronic helminth infections may negatively influence immunity against tuberculosis and other diseases of public health importance

    DEFF Research Database (Denmark)

    Elias, Daniel; Britton, Sven; Kassu, Afework

    2007-01-01

    Tuberculosis (TB) has once again become a major public health threat owing to the combined effects of deteriorating socioeconomic situations and the emergence of the HIV/AIDS pandemic. The only vaccine available against TB, although effective in reducing the burden of childhood TB, shows enormous...... variability in its efficacy against pulmonary TB, which is the most common form of the disease in adults. Most areas of high TB incidence and poor TB vaccine efficacy have a high prevalence of intestinal helminth infections. Such infections have been shown to cause a range of immunomodulation characterized...

  17. http://ijmrhs.com/isolated-gastric-tuberculosis-masquerading-as-chronic-peptic-ulcer-a-case-report/

    Directory of Open Access Journals (Sweden)

    Poflee Sandhya V, Baste Balaji D, Umap Pradeep S, Shrivastava Alok C

    2015-10-01

    Full Text Available Abdominal Tuberculosis (TB most commonly affects ileo-caecal region. Isolated stomach involvement by TB, without pulmonary infection is rare. Clinical presentation of Stomach TB may be non-specific, radiological findings non-contributory and superficial endoscopic biopsies may not be able to settle the diagnosis. Many cases are diagnosed only after histopathological examination of surgical specimens. High degree of suspicion is needed for early diagnosis of gastric tuberculosis, if unnecessary surgical interventions are to be avoided. A young patient who was being treated as a case of chronic peptic ulcer for one year was referred for treatment of gastric outlet obstruction. Histopathological examination of gastrectomy specimen of the patient showed multiple caseating granulomas characteristic of tuberculosis and presence of acid-fast bacilli on Fite-Faraco staining, with no evidence of tuberculosis at pulmonary or other body sites. This case of isolated gastric TB is reported for its rarity.

  18. Economics of United States tuberculosis airline contact investigation policies: a return on investment analysis.

    Science.gov (United States)

    Coleman, Margaret S; Marienau, Karen J; Marano, Nina; Marks, Suzanne M; Cetron, Martin S

    2014-01-01

    In 2011, the Centers for Disease Control and Prevention modified its 2008 protocol for flight-related tuberculosis contact investigation initiation. The 2011 Modified protocol was implemented and replaced the 2008 CDC protocol based on comparative epidemiologic and economic analyses; this publication reports the economic analysis results. A return on investment model compared relative changes in tuberculosis disease treatment costs resulting from expenditures on tuberculosis contact investigations and latent tuberculosis infection treatment for the 2008 CDC and Modified protocols. At moderate/high rates of latent tuberculosis infection and tuberculosis disease, positive returns on investment indicated each $1.00 spent on tuberculosis contact investigations and latent tuberculosis treatment resulted in more than $1.00 of savings from reduced tuberculosis disease treatment costs. Low rates of latent tuberculosis infection and tuberculosis disease resulted in negative returns on investment, indicating economic losses from tuberculosis disease treatment costs. There were smaller economic losses at low latent tuberculosis infection and tuberculosis disease rates with the Modified protocol in comparison to the 2008 CDC protocol, while both identified comparable numbers of persons at risk for tuberculosis. The Modified protocol for conducting flight-related tuberculosis contact investigations represents a better use of resources and protects public health. Published by Elsevier Ltd.

  19. Short Report: Worsening and unmasking of tuberculosis in HIV-1 ...

    African Journals Online (AJOL)

    Objectives: To determine the proportion of patients developing active tuberculosis (TB) versus that of patients who experience worsening of TB, after initiating highly active anti retroviral therapy (HAART). Methods: Charts of HAART naïve patients with or without clinically active TB who consecutively commenced HAART at ...

  20. Unusual presentation of extrapulmonary tuberculosis: a case report ...

    African Journals Online (AJOL)

    This case study highlights an unusual manifestation of extrapulmonary tuberculosis (TB) in a person living with HIV, namely mammary TB. Clinicians practising in settings where HIV and TB are endemic need to be aware of the clinical presentation, diagnosis and management of mammary TB.

  1. Publication of the 'Smyth Report'

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, H D

    1962-12-02

    The author discusses the problem of informing the public about the consequences of the discovery of chain reaction, as well about the possible use of atomic energy for military and civil purposes. The history of the releasing of the so called 'Smyth Report' is given

  2. Screening for genital tuberculosis in a limited resource country: case report.

    Science.gov (United States)

    Namani, Sadie; Qehaja-Buçaj, Emine; Namani, Diellëza

    2017-02-07

    Screening for benign or malignant process of pelvis in young females is a challenge for a physician in a limited resource country. Tuberculosis should be always considered in the differential diagnosis of a pelvic mass in countries with high prevalence of tuberculosis. Negative results of analysis of peritoneal fluid for acid-fast staining, late cultures, and unavailability of new diagnostics methods such as polymerase chain reaction and adenosine deaminase of the aspirated fluid from peritoneal cavity can often result in invasive diagnostic procedures such as laparotomy. We report a case of a 24 year old Albanian unemployed female living in urban place in Kosovo who presented with abdominal pain, loss of appetite, fever, headache, a weight loss, nonproductive cough and menstrual irregularity for three weeks. In this example case, the patient with cystic mass in tubo-ovarial complex and elevated serum cancer antigen 125 levels was diagnosed for genital tuberculosis after performing laparotomy. Caseose mass found in left tubo-ovarial complex and histopathological examination of biopsied tissue were the fastest diagnostic tools for confirming pelvis TB. The Lowenstein-Jensen cultures were positive after six weeks and her family history was positive for tuberculosis. Young females with abdominopelvic mass, ascites, a positive family history for tuberculosis and high serum cancer antigen 125, should always raise suspicion of tuberculosis especially in a limited resource country. A laparoscopy combined with peritoneal biopsy should be performed to confirm the diagnosis as this could lead to a prevention of unnecessary laparotomies.

  3. Total Hip Arthroplasty Loosening Due to Mycobacterium Tuberculosis: A Case Report and Review of the Literature

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    Anis Tebourbi

    2017-04-01

    Full Text Available Context: Prosthetic joint infection due to Mycobacterium tuberculosis with no previous history of pulmonary or extra pulmonary tuberculosis is an extremely rare complication. Aims To report the case of a patient with tuberculous mycobacterial prosthetic hip infection, 14 years after surgery for post traumatic osteoarthritis, with no previous history of tuberculosis. Methods A 46-year-old male presented an acetabular loosening of a cemented total hip arthroplasty with subnormal biologic parameters. A one stage revision surgery was planned. Intraoperative findings suggested mycobacterial tuberculous infection with presence of periacetabular yellowish rice-shaped granules. Results A one-stage prosthesis exchange was performed; Culture on Löwenstein-Jensen medium grew MTB days after inoculation and histological examination confirmed tuberculous infection. Patient was treated by antituberculous agents for 12 months with optimal clinical and biological response and no prosthetic loosening signs at eighteen months follow up. Conclusions Total hip arthroplasty loosening due to mycobacterium tuberculosis is a rare entity, which should be evoked even when no inflammatory signs are shown. Discovery of yellowish rice-shaped granules is an indicator to investigate for tuberculosis. Management of prosthetic joint infection due to M.tuberculosis must involve both medical and surgical approach.

  4. Tuberculosis treatment managed by providers outside the Public Health Department: lessons for the Affordable Care Act.

    Directory of Open Access Journals (Sweden)

    Melissa Ehman

    Full Text Available INTRODUCTION: Tuberculosis (TB requires at least six months of multidrug treatment and necessitates monitoring for response to treatment. Historically, public health departments (HDs have cared for most TB patients in the United States. The Affordable Care Act (ACA provides coverage for uninsured persons and may increase the proportion of TB patients cared for by private medical providers and other providers outside HDs (PMPs. We sought to determine whether there were differences in care provided by HDs and PMPs to inform public health planning under the ACA. METHODS: We conducted a retrospective, cross-sectional analysis of California TB registry data. We included adult TB patients with culture-positive, pulmonary TB reported in California during 2007-2011. We examined trends, described case characteristics, and created multivariate models measuring two standards of TB care in PMP- and HD-managed patients: documented culture conversion within 60 days, and use of directly observed therapy (DOT. RESULTS: The proportion of PMP-managed TB patients increased during 2007-2011 (p = 0.002. On univariable analysis (N = 4,606, older age, white, black or Asian/Pacific Islander race, and birth in the United States were significantly associated with PMP care (p<0.05. Younger age, Hispanic ethnicity, homelessness, drug or alcohol use, and cavitary and/or smear-positive TB disease, were associated with HD care. Multivariable analysis showed PMP care was associated with lack of documented culture conversion (adjusted relative risk [aRR] = 1.37, confidence interval [CI] 1.25-1.51 and lack of DOT (aRR = 8.56, CI 6.59-11.1. CONCLUSION: While HDs cared for TB cases with more social and clinical complexities, patients under PMP care were less likely to receive DOT and have documented culture conversion. This indicates a need for close collaboration between PMPs and HDs to ensure that optimal care is provided to all TB patients and TB transmission is

  5. Prevalence of self-reported tuberculosis, knowledge about tuberculosis transmission and its determinants among adults in India: results from a nation-wide cross-sectional household survey

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    Sreeramareddy Chandrashekhar T

    2013-01-01

    Full Text Available Abstract Background Knowledge about symptoms and transmission of tuberculosis determines health seeking behavior and helps in prevention of tuberculosis transmission in the community. Such data is useful for policy makers to formulate information, education and communication strategies for tuberculosis control. Methods A secondary data analysis of India demographic and health survey, 2005/6 was carried out. Questions about self-reported tuberculosis, transmission and curability of tuberculosis were analysed. Correct knowledge (without misconceptions about tuberculosis transmission was used as a dependant variable and the explanatory variables tested were: demographic data, education, wealth quintiles, frequency of exposure to media and the curability of tuberculosis. Determinants of correct knowledge without misconceptions were tested by univariate and multivariate analyses using national weighting factor to adjust for complex sampling design. Results A total of 109,070 households (response rate of 93.5% and 198,718 participants (response rate of 91.6% completed the survey. The samples of men and women interviewed were 74,360 and 124,358 respectively. Prevalence rate of self-reported tuberculosis was 445 per 100,000 usual household residents and 4.60 per 1,000 participants. The number of respondents who had “heard of an illness called tuberculosis” was 177,423 (89.3%. Of these 47,487 (26.8% participants did not know and 55.5% knew about the correct mode of tuberculosis transmission i.e. “Through the air when coughing or sneezing”. The common misconceptions about transmission were “Through food” (32.4%, “Sharing utensils” (18.2%, and “Touching a person with tuberculosis” (12.3%. Only 52,617 (29.7% participants had correct knowledge without misconceptions. Being male (aOR 1.17, 95% CIs 1.14, 1.21, being a Hindu (aOR 1.20, 95% CIs 1.14, 1.26 or Muslim (aOR 1.26, 95% CIs 1.18, 1.34, listening to radio (aOR 1.08, 95% CIs 1.04, 1

  6. Public health nihilism vs pragmatism: history, politics, and the control of tuberculosis.

    Science.gov (United States)

    Fairchild, A L; Oppenheimer, G M

    1998-01-01

    Tuberculosis (TB) began to decline in the Western world in the mid- to late 1800s. In the United States, the disease receded until the mid-1980s, when that trend was reversed. Although the TB epidemic in the United States subsided in response to public health interventions, it sparked a controversy regarding the relative value of targeted public health measures vs broad social reform. That controversy, which echoed earlier debates calling for structural reform over public health programs, was further strengthened by the historical and demographic studies of Thomas McKeown. His influential thesis maintains that clinical and primary prevention efforts had little effect on TB mortality. In this paper, the historical literature is used to examine whether public health had a significant impact on the decline of TB mortality rates in several countries. Specifically, the paper describes the arguments for and data affirming the efficacy of 2 major public health interventions over time: segregation of those infected with pulmonary TB and eradication of bovine TB. This review finds support for the hypothesis that public health measures, along with other factors, led to falling rates of TB mortality beginning in the late 19th century. Images FIGURE 3 p1112-a p1113-a PMID:9663166

  7. Pseudocyst in Omentum caused by Abdominal Tuberculosis : Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, So Yeon; Kim, Hyun Jin; Park, Soo Youn; Choi, Hyun Joo; Hwang, Seong Su; Cha, Eun Suk; Park, Young Ha [Catholic University of Korea, St.Vincent' s Hospital, Suwon (Korea, Republic of)

    2006-06-15

    A 25-year-old woman presented with abdominal discomfort and weight loss. Sonography demonstrated a well defined, anechoic, cystic mass with posterior acoustic enhancement, internal thin septations, and a peripheral hypoechoic solid portion that had no increased blood flow on Doppler ultrasound. Contrast-enhanced CT revealed a cystic omental mass with internal thin septations and an enhancing solid portion which appeared as the hypoechoic solid portion on ultrasonography. A pathologic specimen demonstrated a pseudocyst containing serous fluid with gelatinous material. The solid component at the peripheral portion of the pseudocyst indicated caseous necrosis with multinucleated giant cells. This histologic finding was consistent with tuberculosis and supported the final diagnosis of omental pseudocyst caused by tuberculous peritonitis. Therefore, intraperitoneal pseudocyst with tuberculosis should be considered in the differential diagnosis of an intraperitoneal cystic mass in a young adult

  8. Knowledge and Attitude about Multidrug-Resistant Tuberculosis among Healthcare Workers in Public Health Centres

    Directory of Open Access Journals (Sweden)

    Bony Wiem Lestari

    2016-12-01

    Full Text Available Background: Multidrug-resistant Tuberculosis (MDR-TB is a significant public health problem and poses a threat to global tuberculosis (TB control. In 2015, at least 504 new MDR-TB cases were identified in Indonesia. Treating MDR-TB patients is very challenging. It may take more than two years for MDR-TB treatment. Therefore, it is crucial healthcare workers (HCWs are knowledgeable about MDR-TB. The aim of this study was to measure level of knowledge and attitude regarding MDR-TB among HCWs in public health centres. Methods: A cross-sectional study was conducted at 73 Public Health Centres in Bandung the capital of West Java Province from August until November 2015. The samples were 73 TB nurses and 32 laboratory staff. A self-administered questionnaire was given comprising 27 knowledge questions and 29 attitude questions. Correlation between knowledge and attitude scores was calculated by Pearson correlation test. Results: The majority of study participants were women (82.9%, married (92.4%, nursing staff (65.7% with history of TB training (98.1%. Most of the participants were 40-59 years old (69.5% with working experience in TB programme < 10 years (69.5%. Less than half (38.1% of study participants had good knowledge. In terms of attitude, more than half (53.3% of study participants had a positive attitude towards MDR-TB. Conclusions: The level of knowledge among HCWs about MDR-TB is still at an unacceptable level. Certain educational interventions aim to ensure prompt diagnosis, implement infection control and accurate treatment should be established among those HCWs.

  9. How well can physicians manage tuberculosis? A public-private sector comparison from Karachi, Pakistan.

    Science.gov (United States)

    Naseer, Maliha; Khawaja, Ali; Pethani, Amin S; Aleem, Salik

    2013-10-25

    Tuberculosis (TB) is endemic in Pakistan which ranks fifth amongst the twenty two countries designated to be highly burdened by TB according to the World Health Organization. However, there is paucity of data regarding the knowledge of diagnosis of TB and its management amongst public and private practitioners. In this study, we endeavor to identify this gap in knowledge regarding the diagnosis and management of TB between public and private doctors and the factors affecting these knowledge scores in urban Pakistan. This cross sectional survey was conducted between June and December 2011. Doctors from public hospitals, private hospitals and private clinics scattered in all eighteen towns of Karachi were included in the study. Qualified MBBS doctors working in any specialty were eligible to participate whereas doctors working in both the public and private sectors were excluded from the study. Vignette based clinical scenarios were given to assess the knowledge score regarding the diagnosis and management of TB. A total of 196 doctors participated in the study. There was a significant difference between private and public physicians in terms of age and years of practice (p-value differences in the proportion of knowledge scores were observed between the public and private doctors and National TB Control Program trained and untrained doctors in Karachi. Factors associated with inadequate knowledge scores were being female gender [OR: 2.76 (95% CI: 1.418-5.384)], private employment status [OR: 1.50 (95% CI: 1.258-2.439)], and not trained by NTP [OR: 2.98 (95% CI: 1.286-3.225)] on multivariate logistic regression analysis. It is concluded that a knowledge gap exists between the public and private doctors in Karachi. Strengthening of currently implemented public private mix model along with improvement in the trainings of public and private practitioners is highly recommended to control TB in Pakistan.

  10. The making of a public health problem: multi-drug resistant tuberculosis in India.

    Science.gov (United States)

    Engel, Nora C

    2013-07-01

    This paper examines how actors construct the public problem of multi-drug resistant tuberculosis (MDR-TB) in India. MDR-TB has been framed by the World Health Organization as a pressing, global public health problem. The responses to MDR-TB are complicated as treatment takes longer and is more expensive than routine TB treatment. This is particularly problematic in countries, such as India, with high patient loads, a large and unregulated private sector, weak health systems and potentially high numbers of MDR-TB cases. This paper analyses how actors struggle for control over ownership, causal theories and political responsibility of the public problem of MDR-TB in India. It combines Gusfield's theory on the construction of public problems with insights from literature on the social construction of diseases and on medical social control. It highlights that there are flexible definitions of public problems, which are negotiated among actor groups and which shift over time. The Indian government has shifted its policy in recent years and acknowledged that MDR-TB needs to be dealt with within the TB programme. The study results reveal how the policy shift happened, why debates on the construction of MDR-TB as a public problem in India continue, and why actors with alternative theories than the government do not succeed in their lobbying efforts. Two main arguments are put forward. First, the construction of the public problem of MDR-TB in India is a social and political process. The need for representative data, international influence and politics define what is controllable. Second, the government seems to be anxious to control the definition of India's MDR-TB problem. This impedes an open, critical and transparent discussion on the definition of the public problem of MDR-TB, which is important in responding flexibly to emerging public health challenges.

  11. Hypertrophic osteoarthropathy in association with pulmonary tuberculosis: a case report; Osteoartropatia hipertrofica associada a tuberculose pulmonar: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Luiza Beatriz Melo; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]. E-mail: edmarchiori@zipmail.com.br; Melo, Alessandro Severo Alves de [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Servico de Radiologia; Pinto, Ana Lucia de Araujo [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Servico de Pneumologia; Monteiro, Nicolau Pedro [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Medicina Clinica

    2002-02-01

    In this article the authors report a case of a patient with hypertrophic osteoarthropathy associated with pulmonary tuberculosis. This disorder is a rare complication of tuberculosis and may be associated with severe and fulminant disease. The imaging methods used in the diagnosis of this disease included lower limbs radiographs that showed bilateral periosteal reaction, and chest radiographs and computed tomography that revealed a mass in the upper lobe of the right lung. Although a fine needle aspiration was suggestive of tuberculosis, the definitive diagnosis was made after thoracotomy and histopathological examination of the mass. The patient presented symptomatic and radiological improvement after treatment of tuberculosis. (author)

  12. [Central nervous tuberculosis in patients non-VIH: seven case reports].

    Science.gov (United States)

    Mazodier, K; Bernit, E; Faure, V; Rovery, C; Gayet, S; Seux, V; Donnet, A; Brouqui, P; Disdier, P; Schleinitz, N; Kaplanski, G; Veit, V; Harlé, J-R

    2003-02-01

    Tuberculosis involving the central nervous system (CNS) is rarely observed in non immuno-compromised hosts. We report herin the various clinical, biological and radiological manifestations observed in 7 patients with CNS tuberculosis. Clinical and biological records of 7 patients with CNS tuberculosis were retrospectively studied. All patients had encephalic CT-scan and MRI in the course of the disease. 5 women and 2 men with a mean age of 38.4 years initially initially presented with headache (n = 6), fever (n = 5), meningeal irritation (n = 3), localizing neurological signs (n = 1). Lumbar punction revealed lymphocytic meningitis (n = 6/7). Mycobacterium tuberculosis or bovis was isolated in 3 patients only. Cerebral tomodensitography or magnetic resonance imaging were initially normal in most of cases (n = 4/7), but discovered in the course of disease basilar meningitis (n = 6), hydrocephalus (n = 6), abcess or tuberculoma (n = 4). In all the patients, initiation of the treatment was complicated by clinical and/or biological deterioration, called paradoxal reaction, leading in all cases to glucocorticoid adjunction, with various final results. Indeed, 4 patients developed neurological sequelae. No patient died. CNS tuberculosis is a rare disease in non immunocompromised patients whose diagnostic may be difficult due to the absence of specific clinical symptoms, negative initial radiological examination, as well as delayed and often negative bacterial isolation. Paradoxal reaction appeared to be frequent despite specific antibiotherapy and underlines the beneficial effects of addictive corticosteroids.

  13. Ocular tuberculosis: current perspectives

    Directory of Open Access Journals (Sweden)

    Shakarchi FI

    2015-11-01

    Full Text Available Faiz I Shakarchi1,21Ibn Al-Haetham Teaching Eye Hospital, 2Department of Opthalmology, Medical College, Al-Mustansiriya University, Baghdad, IraqAbstract: The World Health Organization currently estimates that nearly two billion people, or one-third of the world’s population, are infected by tuberculosis, and that roughly 10% of the infected people are symptomatic. Tuberculosis affects the lungs in 80% of patients, while in the remaining 20% the disease may affect other organs, including the eye. Uveitis can be seen concurrently with tuberculosis, but a direct association is difficult to prove. Ocular tuberculosis is usually not associated with clinical evidence of pulmonary tuberculosis, as up to 60% of extrapulmonary tuberculosis patients may not have pulmonary disease. The diagnosis of tuberculous uveitis is often problematic and in nearly all reported cases, the diagnosis was only presumptive. Tuberculous uveitis is a great mimicker of various uveitis entities and it can be considered in the differential diagnosis of any type of intraocular inflammation. It is still unknown if ocular manifestations result from a direct mycobacterium infection or hypersensitivity reaction and this is reflected on the management of tuberculous uveitis. Prevalence of tuberculosis as an etiology of uveitis may reach up to 10% in endemic areas. Tuberculous uveitis is a vision-threatening disease that inevitably leads to blindness if not properly diagnosed and treated. The aim of this review is to illustrate the various clinical features and management of presumed tuberculous uveitis. The current review focuses on the diagnostic criteria, significance of tuberculin skin test, and use of systemic corticosteroids in the management of tuberculous uveitis as recommended in recent publications.Keywords: tuberculosis, uveitis, choroiditis, tuberculin skin test

  14. An Unusual Radiologic Manifestation of Pulmonary Tuberculosis with Bilateral Multiple Lung Nodules and Diffuse Alveolar Hemorrhage: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seo In; Seon, Hyun Ju; Kim, Yun Hyeon [Dept. of Radiology, Chunnam National University Hospital, Gwangju (Korea, Republic of); Choi, Sung [Dept. of Radiology, Chunnam National University Hwasun Hospital, Hwasun(Korea, Republic of)

    2011-12-15

    Pulmonary tuberculosis presenting as bilateral multiple lung nodules or diffuse alveolar hemorrhage is very rare. Here, we report a case of pulmonary tuberculosis presenting as bilateral multiple lung nodules and diffuse alveolar hemorrhage mimicking granulomatous vasculitis, such as Wegener's granulomatosis.

  15. Predictors of pediatric tuberculosis in public health facilities of Bale zone, Oromia region, Ethiopia: a case control study.

    Science.gov (United States)

    Gebremichael, Bereket; Abebaw, Tsega-Ab; Moges, Tsedey; Abaerei, Admas Abera; Worede, Nadia

    2018-06-04

    Tuberculosis is among the top ten cause of death (9th) from a single infectious agent worldwide. It even ranks above HIV/AIDS. It is among the top 10 causes of death among children. Globally there are estimates of one million cases of TB in children, 76% occur in 22 high-burden countries among which Ethiopia ranked 8th. Despite this fact, children with TB are given low priority in most national health programs. Moreover reports on childhood TB and its predictors are very limited. Therefore this study aimed to assess predictors of pediatric Tuberculosis in Public Health Facilities. Unmatched case control study among a total samples of 432 (144 cases and 288 controls) were done from August to December 2016 in Bale zone, South East Ethiopia. Pediatric TB patients who attended health facilities for DOTS and those who attended health facilities providing DOTS service for any health problem except for TB were the study population for cases and controls, respectively. For each case two consecutive controls were sampled systematically. Data were collected using pretested and structured questionnaire through face to face interview with parents. Binary and multivariable logistic regression analyses were employed to identify predictors of Tuberculosis. Among cases there were equal number of male and female 71(50%). However among control 136 (47.9%) were male and the rest were female. The mean (standard deviation) of age among cases was 8.4 (±4.3) and controls were 7.3 (±4.1). The odds of TB were 2 times (AOR, 95% CI = 1.94(1.02-3.77)) more likely among 11-15 age group children when compared with children of age group ≤5. HIV status of the child, children who were fed raw milk and absence of BCG vaccination were the other predictors of pediatric TB with AOR 13.6(3.45-53.69), 4.23(2.26-7.88), and 5.46(1.82-16.32) respectively. Children who were not BCG Vaccinated were at risk of developing TB. Furthermore, HIV status, age of the child and family practice of feeding

  16. Evaluation of tuberculosis cases occurring in ten outlying cities and reported in the Entorno region of the state of Goiás and reported in the neighboring Federal District: analysis of the incidence of tuberculosis in those cites.

    Science.gov (United States)

    Moreira, Maria Auxiliadora Carmo; Bello, Aline Sampaio; Alves, Maristela dos Reis Luz; Silva, Miramar Vieira da; Lorusso, Vincenza

    2007-01-01

    To evaluate tuberculosis cases occurring in the greater metropolitan area of the Distrito Federal (MADF, encompassing the Federal District, i.e., the national capital of Brasília, located in the state of Goiás) but reported in Brasília itself and to analyze the influence that this has on the effectiveness of the tuberculosis control program, as well as on the collection of socioeconomic and demographic data related to tuberculosis incidence rates. Rates of tuberculosis incidence, cure, noncompliance, treatment failure, mortality, and referral, as well as socioeconomic and demographic data, were reviewed for patients from ten MADF cities. From 2000 to 2004, 714 new cases of tuberculosis were reported in the cities studied, 436 (61%) of which were treated in Brasília and were therefore not included in the Goiás database. Among patients treated only in the MADF cities studied, the mean incidence of tuberculosis ranged from 4.40 to 10.02/100,000 inhabitants. When those treated in Brasília were included, the incidence significantly increased, ranging from 15.16 to 20.54/100,000 inhabitants (p < 0.001). The rate at which contacts of tuberculosis patients were investigated was low, and treatment outcomes were unsatisfactory in the MADF cities studied and in Brasília. Socioeconomic and demographic data were consistent with the tuberculosis incidence. The number of tuberculosis patients treated in the city in which they resided was lower than expected. Treatment in another city might impair tuberculosis control. The recalculated tuberculosis incidence is consistent with the socioeconomic and demographic profile of the region. A federal surveillance system could be efficiently optimized, improving the control of this disease.

  17. Acute Purulent Tuberculosis Pericarditis with Cardiac Tamponade: a Case Report.

    Directory of Open Access Journals (Sweden)

    F. Z. Benaich

    2015-12-01

    Full Text Available Tuberculosis is a disease caused by Mycobacterium tuberculosis. Pulmonary localization is the most frequent. However, pericardial including extra- pulmonary disease, can cause fatal complications. A 37 years old man , without pathological history , who consults for emergency mid-thoracic pain associated with dyspnea, preceded by 10 days before a febrile syndrome with night sweats. Clinical examination showed patient in poor general condition, dyspneic and tachycardia. Cardiovascular examination showed spontaneous jugular veins and painful hepatomegaly, auscultation showed muted heart sounds without pericardial friction and breathless. Chest radiography showed cardiomegaly with symmetric edge straightness, electrocardiogram showed sinus tachycardia at 125bpm, microvoltage and electric alternating QRS complexes. A diffuse ST elevation ascending .Diagnosis of tamponade is suspected, transthoracic echocardiography showed abundance circumferential pericardial effusion measuring 40mm, with prolonged collapse of the right atrium and right ventricle , paradoxical septum , and significant changes in the flow inspiration. Pericardiocentesis ultrasound-guided has allowed a gradual evacuation of 2 liters of a cloudy yellow pericardial fluid, slightly viscous. Direct examination revealed the presence of 14 400 white cells, 99 % are neutrophils with gram-negative bacilli. Research bacillus by PCR and culture in the middle of LOWENSTEIN, later returned negative. Biologically, it is an important infectious syndrome. Taking into account the epidemiological profile of the country, diagnosis tuberculous primary infection tamponade was certain. quadruple anti- tuberculous treatment associated to corticosteroid therapy is instituted, The outcome was good, the patient was asymptomatic, with complete remission, echocardiography control finds no signs suggesting chronic constrictive pericarditis.

  18. Hepatic tuberculosis presenting with extreme hyperferritinemia masquerading as adult-onset Still’s disease: a case report

    Directory of Open Access Journals (Sweden)

    Manoj Edirisooriya

    2012-07-01

    Full Text Available Abstract Introduction Isolated hepatic tuberculosis is an uncommon manifestation of one of the most common infections worldwide, caused by Mycobacterium tuberculosis. Extremely high serum ferritin, which is regarded as a marker of adult onset Still’s disease, has not been observed in patients with tuberculosis of the liver. We report a case of hepatic tuberculosis who presented with clinical criteria of adult-onset Still’s disease and extreme hyperferritinemia, which posed a diagnostic confusion. Case presentation Our patient was a 48-year-old Sri Lankan man who presented with fever, polyarthralgia and a generalized skin rash of three months duration. He had marked constitutional symptoms, oral ulcers, hair loss, anemia and hepatomegaly. Laboratory investigations disclosed an inflammatory syndrome, evidence of hepatic dysfunction, bone marrow suppression and a raised serum ferritin level of 34,674 ng/ml. A rapidly deteriorating course of illness prompted treatment based on a presumptive diagnosis of adult-onset Still’s disease until liver histology was available. The patient died of sepsis followed by multi-organ dysfunction. Later, the liver histology revealed tuberculosis. Conclusion Extrapulmonary tuberculosis, although well known to present with peculiar manifestations, has not been reported to be associated with extremely high levels of serum ferritin in immunocompetent individuals. Isolated hepatic tuberculosis presenting with clinical criteria of adult-onset Still’s disease is remarkable. Since tuberculosis remains a potentially curable disease, an awareness of its’ protean manifestations is essential.

  19. Uses of tuberculosis mortality surveillance to identify programme errors and improve database reporting.

    Science.gov (United States)

    Selig, L; Guedes, R; Kritski, A; Spector, N; Lapa E Silva, J R; Braga, J U; Trajman, A

    2009-08-01

    In 2006, 848 persons died from tuberculosis (TB) in Rio de Janeiro, Brazil, corresponding to a mortality rate of 5.4 per 100 000 population. No specific TB death surveillance actions are currently in place in Brazil. Two public general hospitals with large open emergency rooms in Rio de Janeiro City. To evaluate the contribution of TB death surveillance in detecting gaps in TB control. We conducted a survey of TB deaths from September 2005 to August 2006. Records of TB-related deaths and deaths due to undefined causes were investigated. Complementary data were gathered from the mortality and TB notification databases. Seventy-three TB-related deaths were investigated. Transmission hazards were identified among firefighters, health care workers and in-patients. Management errors included failure to isolate suspected cases, to confirm TB, to correct drug doses in underweight patients and to trace contacts. Following the survey, 36 cases that had not previously been notified were included in the national TB notification database and the outcome of 29 notified cases was corrected. TB mortality surveillance can contribute to TB monitoring and evaluation by detecting correctable and specific programme- and hospital-based care errors, and by improving the accuracy of TB database reporting. Specific local and programmatic interventions can be proposed as a result.

  20. Thematic report on public governance

    International Nuclear Information System (INIS)

    Bouder, F.

    2002-01-01

    The objective of the FSC workshop was to learn from the process that led to the ratification by the Finnish Parliament, on 18 May 2001, of the Decision in Principle on the final disposal facility for spent nuclear fuel in Olkiluoto, Eurajoki. One of the objectives clearly expressed by the NEA was to help government to make the right decisions, including by looking at successful policy making and decision-making practices. This gave 'Public Governance' issues a prominent role in the debates. In addition, the meeting was conceived as a discussion between stakeholders, which, interestingly, also made it an exercise in 'Public Governance'. This purpose of this report is to identify some key governance lessons that emerged from looking at this process in detail. It looks at the difficult policy context in which the Decision in Principle had to be taken. It highlights the governance challenge that emerged and suggests some key findings that could possibly be relevant in other similar circumstances. (author)

  1. Report : public transportation in Washington State, 1984

    Science.gov (United States)

    1984-10-01

    This report is an update of the Public Transportation in Washington State publication, dated December 1981. In order to reflect the changes that have occurred since that time, this report contains the most current data obtainable. Chapter One of this...

  2. Evaluation of tuberculosis public health surveillance, Al-Madinah province, Kingdom of Saudi Arabia, 2012

    Directory of Open Access Journals (Sweden)

    Mohammed J. Alkhalawi

    2016-03-01

    Full Text Available The objective of the study is to evaluate the quality of the data, the sensitivity of the surveillance, and the completeness of identification and investigation of tuberculosis (TB patient’s contacts. The study covered the TB surveillance program in Al-Madinah province in 2011. First, we reviewed all the notifications, treatment cards, and register books, as well as monthly and quarterly reports, for completeness and accuracy of data. Then, we searched for the missed cases that were not reported. Finally, we reviewed all the patients’ household contacts’ reports to assess the degree of completion of identification and investigation. There were 444 cases detected during the study period; only 200 cases were reported. The sensitivity of the TB surveillance system was 45%. Among the 200 reported cases, the results revealed high completeness rates for demographic and disease data and low completeness rates for the test result fields. The contact identification and investigation showed that 34.4% of smear-positive cases’ contacts were not identified. Only 67% of identified contacts were investigated. The review of hospital records and lab registers showed that 244 cases were not reported. In conclusion, the TB surveillance system has several areas that need improvement.

  3. Drug-resistant tuberculosis: time for visionary political leadership.

    Science.gov (United States)

    Abubakar, Ibrahim; Zignol, Matteo; Falzon, Dennis; Raviglione, Mario; Ditiu, Lucica; Masham, Susan; Adetifa, Ifedayo; Ford, Nathan; Cox, Helen; Lawn, Stephen D; Marais, Ben J; McHugh, Timothy D; Mwaba, Peter; Bates, Matthew; Lipman, Marc; Zijenah, Lynn; Logan, Simon; McNerney, Ruth; Zumla, Adam; Sarda, Krishna; Nahid, Payam; Hoelscher, Michael; Pletschette, Michel; Memish, Ziad A; Kim, Peter; Hafner, Richard; Cole, Stewart; Migliori, Giovanni Battista; Maeurer, Markus; Schito, Marco; Zumla, Alimuddin

    2013-06-01

    Two decades ago, WHO declared tuberculosis a global emergency, and invested in the highly cost-effective directly observed treatment short-course programme to control the epidemic. At that time, most strains of Mycobacterium tuberculosis were susceptible to first-line tuberculosis drugs, and drug resistance was not a major issue. However, in 2013, tuberculosis remains a major public health concern worldwide, with prevalence of multidrug-resistant (MDR) tuberculosis rising. WHO estimates roughly 630 000 cases of MDR tuberculosis worldwide, with great variation in the frequency of MDR tuberculosis between countries. In the past 8 years, extensively drug-resistant (XDR) tuberculosis has emerged, and has been reported in 84 countries, heralding the possibility of virtually untreatable tuberculosis. Increased population movement, the continuing HIV pandemic, and the rise in MDR tuberculosis pose formidable challenges to the global control of tuberculosis. We provide an overview of the global burden of drug-resistant disease; discuss the social, health service, management, and control issues that fuel and sustain the epidemic; and suggest specific recommendations for important next steps. Visionary political leadership is needed to curb the rise of MDR and XDR tuberculosis worldwide, through sustained funding and the implementation of global and regional action plans. Copyright © 2013 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.

  4. Quality Tuberculosis Care in Indonesia: Using Patient Pathway Analysis to Optimize Public-Private Collaboration.

    Science.gov (United States)

    Surya, Asik; Setyaningsih, Budiarti; Suryani Nasution, Helmi; Gita Parwati, Cicilia; Yuzwar, Yullita E; Osberg, Mike; Hanson, Christy L; Hymoff, Aaron; Mingkwan, Pia; Makayova, Julia; Gebhard, Agnes; Waworuntu, Wiendra

    2017-11-06

    Tuberculosis (TB) is the fourth leading cause of death in Indonesia. In 2015, the World Health Organization estimated that nearly two-thirds of the TB patients in Indonesia had not been notified, and the status of their care remained unknown. As such, Indonesia is home to nearly 20% of the world's "missing" TB patients. Understanding where patients go for care may enable strategic planning of services to better reach them. A patient pathway analysis (PPA) was conducted to assess the alignment between patient care seeking and the availability of TB diagnostic and treatment services at the national and subnational level in Indonesia. The PPA results revealed that only 20% of patients encountered diagnostic capacity at the location where they first sought care. Most initial care seeking occurred in the private sector and case notification lagged behind diagnostic confirmation in the public sector. The PPA results emphasize the role that the private sector plays in TB patient care seeking and suggested a need for differentiated approaches, by province, to respond to variances in care-seeking patterns and the capacities of public and private providers. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  5. Testicular tuberculosis presenting with metastatic intracranial tuberculomas only: a case report

    Directory of Open Access Journals (Sweden)

    Ukperi Samson O

    2011-03-01

    Full Text Available Abstract Introduction Intracranial tuberculomas are a rare complication of tuberculosis occurring through hematogenous spread from an extracranial source, most often of pulmonary origin. Testicular tuberculosis with only intracranial spread is an even rarer finding and to the best of our knowledge, has not been reported in the literature. Clinical suspicion or recognition and prompt diagnosis are important because early treatment can prevent patient deterioration and lead to clinical improvement. Case presentation We present the case of a 51-year-old African man with testicular tuberculosis and multiple intracranial tuberculomas who was initially managed for testicular cancer with intracranial metastasis. He had undergone left radical orchidectomy, but subsequently developed hemiparesis and lost consciousness. Following histopathological confirmation of the postoperative sample as chronic granulomatous infection due to tuberculosis, he sustained significant clinical improvement with antituberculous therapy, recovered fully and was discharged at two weeks post-treatment. Conclusion The clinical presentation of intracranial tuberculomas from an extracranial source is protean, and delayed diagnosis could have devastating consequences. The need to have a high index of suspicion is important, since neuroimaging features may not be pathognomonic.

  6. Genital tuberculosis in postmenopausal women with variable clinical presentations: A report of 3 cases

    Directory of Open Access Journals (Sweden)

    Ashima Arora

    2018-04-01

    Full Text Available Genital tuberculosis is usually diagnosed in young women being assessed for infertility. After menopause it usually presents with symptoms resembling endometrial malignancy, such as postmenopausal bleeding, persistent vaginal discharge and pyometra. The diagnosis is made by detection of acid-fast bacilli on microscopy or bacteriological culture and/or presence of epithelioid granuloma on biopsy. Anti-tubercular therapy involves the use of rifampicin, isoniazid, pyrazinamide and ethambutol. Surgery is indicated if a pelvic mass and recurrence of pain or bleeding persist after 9 months of treatment. Three cases of genital tuberculosis in postmenopausal women with different clinical presentations are reported. The first woman presented with ascites and weight loss. The second had postmenopausal bleeding with a pipelle biopsy suggestive of endometrial intraepithelial neoplasia. The third presented with weight loss and a palpable abdominal mass. Pelvic malignancy was initially suspected but a diagnosis of tuberculosis was made following pre-operative endometrial biopsy, bacteriological culture and intra-operative frozen section. All three women responded to anti-tubercular therapy. Keywords: Genital tuberculosis, Postmenopausal, Endometrial intraepithelial neoplasia, Anti-tubercular therapy, Endometrial biopsy

  7. Congenital Multidrug-resistant Tuberculosis in a Neonate: A Case Report.

    Science.gov (United States)

    Lhadon, Tenzin; Jullien, Sophie

    2018-04-20

    Multidrug-resistant tuberculosis (MDR-TB) is a well-identified raising public health concern worldwide. However, the data available on MDR-TB in children and particularly in the neonate age group are limited. Congenital tuberculosis (TB) is rare, and its diagnosis is challenging because of non-specific manifestations. The choice of anti-tubercular drugs is difficult because of the lack of international consensus as a consequence of the scarcity of evidence-based data on this age group. We hereby present a case from Bhutan of a 23-day-old male neonate with congenital MDR-TB. His mother was diagnosed with disseminated TB, and treatment was commenced 11 days post-partum. Congenital transmission of TB was suspected, as direct postnatal transmission was unlikely and thorough screening of contacts for TB was negative. In this case, the mother's MDR-TB status was revealed only after her newborn's MDR-TB diagnosis.

  8. Tuberculosis-associated Fibrosing Mediastinitis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ronald Tan

    2016-01-01

    Full Text Available Fibrosing mediastinitis is a rare condition defined by the presence of fibrotic mediastinal infiltrates that obliterate normal fat planes. It is a late complication of a previous granulomatous infection, such as histoplasmosis or tuberculosis (TB. Due to its rarity, fibrosing mediastinitis is often under-recognized, and the clinical presentation is variable and dependent on the extent of infiltration or encasement of structures within the mediastinum. We present a case of fibrosing mediastinitis in a man with a prior history of TB, who presented with progressive dyspnea and was found to have chronic mediastinal soft tissue opacities and pulmonary hypertension. His diagnosis was delayed due to the lack of recognition of this clinical/radiographic entity. Fibrosing mediastinitis is a rare entity usually caused by granulomatous disease. Most cases develop as a late complication of histoplasmosis or TB. The presence of calcified mediastinal soft tissue infiltrates on advanced chest imaging can be diagnostic of fibrosing mediastinitis in patients with a prior history of a granulomatous infection once active processes such as malignancy are excluded.

  9. Tuberculosis-associated Fibrosing Mediastinitis: Case Report and Literature Review.

    Science.gov (United States)

    Tan, Ronald; Martires, Joanne; Kamangar, Nader

    2016-01-01

    Fibrosing mediastinitis is a rare condition defined by the presence of fibrotic mediastinal infiltrates that obliterate normal fat planes. It is a late complication of a previous granulomatous infection, such as histoplasmosis or tuberculosis (TB). Due to its rarity, fibrosing mediastinitis is often under-recognized, and the clinical presentation is variable and dependent on the extent of infiltration or encasement of structures within the mediastinum. We present a case of fibrosing mediastinitis in a man with a prior history of TB, who presented with progressive dyspnea and was found to have chronic mediastinal soft tissue opacities and pulmonary hypertension. His diagnosis was delayed due to the lack of recognition of this clinical/radiographic entity. Fibrosing mediastinitis is a rare entity usually caused by granulomatous disease. Most cases develop as a late complication of histoplasmosis or TB. The presence of calcified mediastinal soft tissue infiltrates on advanced chest imaging can be diagnostic of fibrosing mediastinitis in patients with a prior history of a granulomatous infection once active processes such as malignancy are excluded.

  10. Epidemiological profile of tuberculosis cases reported among health care workers at the University Hospital in Vitoria, Brazil.

    Science.gov (United States)

    do Prado, Thiago Nascimento; Galavote, Heleticia Scabelo; Brioshi, Ana Paula; Lacerda, Thamy; Fregona, Geisa; Detoni, Valdério do Valle; Lima, Rita de Cássia Duarte; Dietze, Reynaldo; Maciel, Ethel Leonor Noia

    2008-08-01

    To describe the epidemiological profile of tuberculosis cases reported among health care workers in the Tuberculosis Control Program of the Cassiano Antonio of Moraes University Hospital in Vitoria, Brazil. A retrospective descriptive study of secondary data was conducted between 2002 and 2006. Twenty-five cases of health care workers with tuberculosis were reported: 8 in nursing technicians (32%); 4 in doctors (16%); 3 in nurses (12%); 2 in radiology technicians (8%) and 8 in professionals from other categories (32%). Of those 25 health care workers, 14 (56%) were male and 11 (44%) were female. The incidence of the disease was highest among those from 35 to 39 years of age. The predominant clinical presentation was extrapulmonary (12 cases, 48%), followed by pulmonary (11 cases, 44%) and a combination of the two (2 cases, 8%). Regarding comorbidities, AIDS, alcoholism and smoking, respectively, were present in 33.3% of the study population. Outcomes were as follows: 22 cases of cure (88%); 2 transfers (8%); and 1 death (4%). The proportion of health care workers diagnosed with tuberculosis in the period studied was 2.53%. The results show the need for heath care workers who work in the tuberculosis control program to fill out the field "professional occupation" on the tuberculosis case registry database reporting forms. In addition, this situation draws attention to the need to implement an occupational tuberculosis control program.

  11. Emergence of Extensively Drug Resistant Tuberculosis

    Centers for Disease Control (CDC) Podcasts

    2007-03-01

    Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.  Created: 3/1/2007 by Emerging Infectious Diseases.   Date Released: 3/26/2007.

  12. Bilateral multiple pulmonary artery aneurysms associated with cavitary pulmonary tuberculosis: a case report.

    Science.gov (United States)

    Pallangyo, Pedro; Lyimo, Frederick; Bhalia, Smita; Makungu, Hilda; Nyangasa, Bashir; Lwakatare, Flora; Suranyi, Pal; Janabi, Mohamed

    2017-07-19

    Pulmonary artery aneurysms constitute 50%) of cases, however, pulmonary artery aneurysm is a rare sequelae of pulmonary tuberculosis reported in about 5% of patients with chronic cavitary tuberculosis on autopsy. The natural history of this potentially fatal condition remains poorly understood and guidelines for optimal management are controversial. A 24-year-old man, a nursing student of African descent, was referred to us from an up-country regional hospital with a 4-week history of recurrent episodes of breathlessness, awareness of heartbeats and coughing blood 3 weeks after completing a 6-month course of anti-tuberculosis drugs. A physical examination revealed conjuctival and palmar pallor but there were no stigmata of connective tissue disorders, systemic vasculitides or congenital heart disease. An examination of the cardiovascular system revealed accentuated second heart sound (S 2 ) with early diastolic (grade 1/6) and holosystolic (grade 2/6) murmurs at the pulmonic and tricuspid areas respectively. Blood tests showed iron deficiency anemia, prolonged bleeding time, and mild hyponatremia. A chest radiograph revealed bilateral ovoid-shaped perihilar opacities while a computed tomography scan showed bilateral multiple pulmonary artery pseudoaneurysms with surrounding hematoma together with adjacent cystic changes, consolidations, and tree-in-bud appearance. Our patient refused to undergo surgery and died of aneurismal rupture after 9 days of hospitalization. The presence of intractable hemoptysis among patients with tuberculosis even after completion of anti-tuberculosis course should raise an index of suspicion for pulmonary artery aneurysm. Furthermore, despite of its rarity, early recognition and timely surgical intervention of pulmonary artery aneurysm is crucial to reducing morbidity and preventing the attributed mortality.

  13. Universal public finance of tuberculosis treatment in India: an extended cost-effectiveness analysis.

    Science.gov (United States)

    Verguet, Stéphane; Laxminarayan, Ramanan; Jamison, Dean T

    2015-03-01

    Universal public finance (UPF)-government financing of an intervention irrespective of who is receiving it-for a health intervention entails consequences in multiple domains. First, UPF increases intervention uptake and hence the extent of consequent health gains. Second, UPF generates financial consequences including the crowding out of private expenditures. Finally, UPF provides insurance either by covering catastrophic expenditures, which would otherwise throw households into poverty or by preventing diseases that cause them. This paper develops a method-extended cost-effectiveness analysis (ECEA)-for evaluating the consequences of UPF in each of these domains. It then illustrates ECEA with an evaluation of UPF for tuberculosis treatment in India. Using plausible values for key parameters, our base case ECEA concludes that the health gains and insurance value of UPF would accrue primarily to the poor. Reductions in out-of-pocket expenditures are more uniformly distributed across income quintiles. A variant on our base case suggests that lowering costs of borrowing for the poor could potentially achieve some of the health gains of UPF, but at the cost of leaving the poor more deeply in debt. © 2014 The Authors. Health Economics published by John Wiley Ltd.

  14. Disseminated histoplasmosis simulating miliary tuberculosis: a case report; Histoplasmose disseminada simulando tuberculose miliar: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Tavares Junior, Wilson Campos; Madureira, Marcus Magalhaes; Andrade, Diego Correa de; Guimaraes, Silvana Mangeon Meireles; Queiroz, Leonardo Campos [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Hospital das Clinicas. Dept. de Radiologia e Diagnostico por Imagem]. E-mail: wilsontavaresjrmd@yahoo.fr; Avila, Renata Eliane de [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Hospital das Clinicas. Servico de Doencas Infecciosas e Parasitarias; Lambertucci, Jose Roberto [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Faculdade de Medicina. Clinica Medica

    2005-04-15

    Histoplasmosis is a disease caused by inhalation of the fungus Histoplasma capsulatum. In rare cases the disease affects immunocompetent individuals. Disseminated and severe disease is seen in immunocompromised patients. We report a case of a 45 year old immunocompromised patient presenting with weight loss and abdominal pain. Chest x-ray and computerized tomography examinations showed interstitial infiltrate and diffuse micro nodules. The initial diagnosis was miliary tuberculosis. However, the definitive diagnosis of miliary histoplasmosis was made later on. (author)

  15. Positron emission tomography/computed tomography data of a tuberculosis mimicking lung cancer: A Case report

    Directory of Open Access Journals (Sweden)

    Amine Benjelloun

    2014-10-01

    Full Text Available PET/CT is a modern and very valuable tool for detecting primary or secondary lung cancers. However, in countries where tuberculosis is endemic, data must be interpreted with caution because of the frequent tuberculomas. We report here a case of a cancer-like tuberculoma of the lung with paralysis of the left vocal cord, and discuss the PET/CT contribution in tuberculomas as well as the noncancer etiologies of this damage.

  16. Gastrointestinal tuberculosis.

    Science.gov (United States)

    Galloway, D J; Scott, R N

    1986-10-01

    In the developed countries gastrointestinal tuberculosis is no longer common in clinical practice. In this setting the importance of the condition lies in the vagaries of its presentation and the fact that it is eminently treatable, usually by a combination of chemotherapy and surgery. The clinical features and complications of gastrointestinal tuberculosis are highlighted by the seven cases which we report. Diagnosis and treatment of this condition is discussed and attention is drawn to the importance of case notification. Clinicians should bear in mind the diagnosis of gastrointestinal tuberculosis when dealing with any patient with non-specific abdominal symptoms.

  17. Public health interventions involving travelers with tuberculosis--U.S. ports of entry, 2007-2012.

    Science.gov (United States)

    2012-08-03

    Every day, approximately 950,000 international travelers arrive in the United States. The Secretary of the U.S. Department of Health and Human Services is authorized to prevent the introduction, transmission, and spread of communicable diseases by travelers into and within the United States. The Secretary, through the CDC director, delegates this authority to CDC's Division of Global Migration and Quarantine (DGMQ). Of the communicable diseases for which federal quarantine and isolation are authorized by executive orders of the president, infectious tuberculosis (TB) is encountered most commonly by DGMQ's network of quarantine stations at major U.S. ports of entry. Although legal immigrants and refugees undergo U.S. State Department-mandated TB screening overseas, CDC receives approximately 125 reports each year of arriving travelers with active TB, including foreign visitors, foreign students, and temporary workers (CDC, unpublished data, 2012). This report describes two cases that illustrate the TB control and prevention activities of quarantine stations. Such activities, including issuing federal isolation orders, restricting travel, arranging safe transport for patients across state lines, and conducting airline contact investigations, support CDC's mission to limit the spread of infectious disease from travelers.

  18. Under-reporting of tuberculosis in Praia, Cape Verde, from 2006 to 2012.

    Science.gov (United States)

    Furtado da Luz, E; Braga, J U

    2018-03-01

    According to World Health Organization (WHO) estimates, the under-reporting rate for tuberculosis (TB) in Cape Verde between 2006 and 2012 was 49%. However, the WHO recognises the challenges associated with this estimation process and recommends implementing other methods, such as record linkage, to combat TB under-reporting. To estimate and analyse under-reporting of cases by TB surveillance health units and to evaluate TB cases retrieved from other TB diagnostic sources in Praia, Cape Verde, from 2006 to 2012. This cross-sectional study evaluated under-reporting using the following data: 1) the under-reporting index from TB reporting health units (RHUs), where the number of validated TB cases from RHUs was compared with data from the National Programme for the Fight against Tuberculosis and Leprosy (NPFTL); and 2) the under-reporting index among overall data sources, or a comparison of the number of all validated TB cases from all sources with NPFTL data. The TB under-reporting rate was 40% in Praia during the study period, and results were influenced by laboratory findings. The TB under-reporting rate was very similar to the rate estimated by the WHO. TB surveillance must be improved to reduce under-reporting.

  19. Short-course chemotherapy for paediatric respiratory tuberculosis: 5-year report.

    Science.gov (United States)

    Swaminathan, S; Raghavan, A; Duraipandian, M; Kripasankar, A S; Ramachandran, P

    2005-06-01

    This report presents the 5-year follow-up of 137 children with respiratory tuberculosis enrolled in a randomised clinical trial of two different anti-tuberculosis regimens 9HR and 2HRZ3/4RH2. Both regimens had similar cure rates, with low relapse rates and mortality. Of 134 children followed up to 5 years, 86% had normal radiographs, with more sequelae in the 9HR group (15% vs. 1.5%, P < 0.01). One patient relapsed and there was one accidental death. Short-course chemotherapy in children is safe, effective and well tolerated, and leads to excellent long-term results, with a small proportion of children left with radiological sequelae.

  20. Tc-99m-MIBI Uptake in Active Pulmonary Tuberculosis: A Case Report

    International Nuclear Information System (INIS)

    Lee, Chang Ho; Park, Chan Hee; Hwang, Hee Sung; Bae, Moon Sun

    1996-01-01

    Technetium-99m MIBI was developed as a myocardiac perfusion imagine agent and has been used effectively in the detection and post-therapeutic evaluation of various neoplasm such as thyroid, lung, bone and breast tumors. As an infrequent findings, Tc-99m MIBI agent has shown in non-neoplastic pulmonary conditions including fibroding alveolitis, pulmonary actinomycosis, active pulmonary sarcoidosis, pulmonary interstitial fibrosis in progressive systemic sclerosis and active osteomyelitis. In a recent report conducted by Cetin Oncel, Tc-99m MIBI imaging is an effective method in the detection and follow-up of pulmonary tuberculosis. We have also experienced Tc-99m-MIBI uptake in active pulmonary tuberculosis incidentally found in a patient with suspected proliferative villonodular synovitis of the left ankle.

  1. Tuberculosis verrucosa cutis

    Directory of Open Access Journals (Sweden)

    Krishnabharath S

    2017-08-01

    Full Text Available We report a case of 23-year-old male patient with tuberculosis verrucous cutis on the foot for a duration of six months without responding to routine treatment. Tuberculosis is a common disease worldwide. Extrapulmonary tuberculosis contributes to 10% of cases. Cutaneous tuberculosis occupies a small spectrum of extrapulmonary tuberculosis. Tuberculosis verrucosa cutis is an exogenous infection occurring in a previously sensitized patient by direct inoculation of the organism. It occurs in sensitized patients with a moderate to high immune response. The diagnosis in our patient was confirmed by history, clinical examination, histopathological examination and the patient’s response to anti-tuberculous therapy.

  2. Social and clinical predictors of drug-resistant tuberculosis in a public hospital, Monterrey, Mexico.

    Science.gov (United States)

    Young, Bonnie N; Burgos, Marcos; Handal, Alexis J; Baker, Jack; Rendón, Adrian; Rosas-Taraco, Adrian; Long, Jeffrey; Hunley, Keith

    2014-10-01

    Drug-resistant tuberculosis (DRTB) is steadily increasing in Mexico, but little is known of patient risk factors in the Mexico-United States border region. This preliminary case-control study included 95 patients with active pulmonary TB with drug susceptibility results attending the José E. González University Hospital in the urban hub of Nuevo León-the Monterrey Metropolitan Area. We report potential social and clinical risk factors of DRTB among this hospital-based sample. We collected data through face-to-face interviews and medical record reviews from 25 cases with DRTB and 70 drug-sensitive controls. DNA was collected to assess an effect of genetic ancestry on DRTB by using a panel of 291,917 genomic markers. We calculated crude and multivariate logistic regression. After adjusting for potential confounding factors, we found that prior TB treatment (odds ratio, 4.5; 95% confidence interval, 0.9-21.1) and use of crack cocaine (odds ratio, 4.6; 95% confidence interval, 1.1-18.7) were associated with DRTB. No other variables, including genetic ancestry and comorbidities, were predictive. Health care providers may benefit from recognizing predictors of DRTB in regions where routine drug susceptibility testing is limited. Prior TB treatment and illicit drug use, specifically crack cocaine, may be important risk factors for DRTB in this region. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Knowledge and perception about tuberculosis among public transport workers in Lima, Peru

    Directory of Open Access Journals (Sweden)

    Danitza Lukac

    2016-11-01

    Full Text Available Resumen OBJETIVO Describir los conocimientos y percepciones sobre tuberculosis en asistentes a los cursos de educación vial para operarios del transporte público en Lima, Perú. MÉTODOS Estudio transversal realizado entre junio y agosto del año 2014, en asistentes al Curso de Educación Vial en Lima (Perú, que son obligatorios para laborar como trabajador del transporte público en dicha ciudad. Se aplicó una encuesta anónima y voluntaria para recolectar datos incluyendo características sociodemográficas, antecedente de tuberculosis, conocimientos y actitudes sobre tuberculosis. Se evaluaron los factores asociados a la percepción de riesgo de contagio mediante la regresión de Poisson. RESULTADOS De un total de 309 asistentes, se analizaron 216 encuestas (69,9%. El 88,4% fue de sexo masculino, 3,2% había tenido antecedente de tuberculosis, el síntoma más reconocido fue la tos con flema (44,4%, la fuente de información más popular fue la televisión (39,8%, en tanto que sólo 9,7% recibió alguna capacitación sobre tuberculosis. El 41,2% percibió que ser conductor o cobrador de bus es de alto riesgo para contraer tuberculosis, lo cual no estuvo significativamente asociado a otras variables del estudio. CONCLUSIÓN En la población encuestada se observó escaso conocimiento sobre la sintomatología de la tuberculosis, escasa capacitación recibida sobre el tema y baja percepción de riesgo para contraer esta enfermedad. Urge implementar estrategias de educación dirigidas a dicha población.

  4. Tuberculosis non-communicable disease comorbidity and multimorbidity in public primary care patients in South Africa.

    Science.gov (United States)

    Peltzer, Karl

    2018-04-11

     Little is known about the prevalence of non-communicable disease (NCD) multimorbidity among tuberculosis (TB) patients in Africa.Aim and setting: The aim of this study was to assess the prevalence of NCD multimorbidity, its pattern and impact on adverse health outcomes among patients with TB in public primary care in three selected districts of South Africa.  In a cross-sectional survey, new TB and TB retreatment patients were interviewed, and medical records assessed in consecutive sampling within 1 month of anti-TB treatment. The sample included 4207 (54.5% men and 45.5% women) TB patients from 42 primary care clinics in three districts. Multimorbidity was measured as the simultaneous presence of two or more of 10 chronic conditions, including myocardial infarction or angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, dyslipidaemia, malignant neoplasms, tobacco and alcohol-use disorder.  The prevalence of comorbidity (with one NCD) was 26.9% and multimorbidity (with two or more NCDs) was 25.3%. We identified three patterns of multimorbidity: (1) cardio-metabolic disorders; (2) respiratory disorders, arthritis and cancer; and (3) substance-use disorders. The likelihood of multimorbidity was higher in older age, among men, and was lower in those with higher education and socio-economic status. The prevalence of physical health decreased, and common mental disorders and post-traumatic stress disorder increased with an increase in the number of chronic conditions.  High NCD comorbidity and multimorbidity were found among TB patients predicted by socio-economic disparity.

  5. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Science.gov (United States)

    Shiferaw, Melashu Balew; Hailu, Hiwot Amare; Fola, Abebe Alemu; Derebe, Mulatu Melese; Kebede, Aimro Tadese; Kebede, Abayneh Admas; Emiru, Manamnot Agegne; Gelaw, Zelalem Dessie

    2015-01-01

    Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS) strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the World Health Organization (WHO) estimate (70%). This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia. A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS) method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20. Among 201 laboratories enrolled in this study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results. The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  6. Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Melashu Balew Shiferaw

    Full Text Available Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48% in Amhara region compared to the World Health Organization (WHO estimate (70%. This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia.A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.Among 201 laboratories enrolled in this study, 47 (23.4% laboratories had major errors. Forty one (20.4% laboratories had a total of 67 false negative and 29 (14.4% laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%, 133 (66.2% and 126 (62.7% laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013 and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024 were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007 was associated with false positive results.The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

  7. Tuberculose Pélvica Simulando Tumor Ovariano: a Case Report Pelvic Tuberculosis Simulating Ovarian Tumor

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    Marcelo Ivo Campagnolo

    2000-09-01

    Full Text Available A tuberculose pélvica é uma forma de tuberculose extrapulmonar cuja incidência vem aumentando no mundo ocidental. Esta entidade freqüentemente é acompanhada de achados clínicos e laboratoriais que podem ser inespecíficos e mimetizar outras doenças, inclusive neoplasias ginecológicas. Os autores apresentam um caso de tuberculose pélvica associada à tuberculose peritoneal do abdome em uma mulher de 53 anos, que foi submetida a avaliação laboratorial extensa, incluindo laparoscopia diagnóstica, dosagem de CA-125 e reação de Mantoux. Os aspectos clinicopatológicos e os meios propedêuticos para elucidar o caso são discutidos.Pelvic tuberculosis is an extrapulmonary form of tuberculosis with increasing incidence in the western world. Clinical and laboratory findings of this disease are often unspecific and mimic a variety of other disorders, including gynecologic malignant tumors. The authors report a case of a 53-year-old woman with pelvic tuberculosis and associated abdominal tuberculous peritonitis. Laboratory investigation included laparoscopy, CA-125 levels and tuberculin test, among others. Discussion on the clinicopathological aspects and diagnostic methods used to elucidate this case is presented.

  8. Are routine tuberculosis programme data suitable to report on antiretroviral therapy use of HIV-infected tuberculosis patients?

    NARCIS (Netherlands)

    Brouwer, Miranda; Gudo, Paula Samo; Simbe, Chalice Mage; Perdigão, Paula; van Leth, Frank

    2013-01-01

    Antiretroviral therapy (ART) is lifesaving for HIV-infected tuberculosis (TB) patients. ART-use by these patients lag behind compared to HIV-testing and co-trimoxazole preventive therapy. TB programmes provide the data on ART-use by HIV-infected TB patients, however often the HIV services provide

  9. Osteoarticular tuberculosis in an HIV-positive patient: a case report

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    Gabriela de Moraes Rêgo Guedes

    2014-06-01

    Full Text Available The authors report a case of a 38-year-old HIV-positive woman, with subcutaneous nodules on the thoracic region with 3 months of evolution. Clinical, laboratory, and epidemiological features were evaluated and associated with apparent damage to the T11-T12 vertebrae, identification by imaging tests, positivity in a polymerase chain reaction-based test, and reactivity to the Mantoux tuberculin skin test (PPD-RT 23. The patient was diagnosed with osteoarticular tuberculosis and received treatment for a year, and clinical cure was achieved.

  10. Scapular bone destruction: A case report of skeletal tuberculosis with a series of dynamic radiologic features

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    Lan Lan

    2015-09-01

    Full Text Available Tuberculosis (TB is an extremely common opportunistic infection in human immunodeficiency virus (HIV-positive patients. Pulmonary TB is the most common manifestation while skeletal TB, especially with an involvement of flat bone like scapula, is quite rare. We report the first case scapular TB in an advanced AIDS individual who was initially considered as lymphoma because of the faulty interpretation of the positivity of PET/CT scan. In this article, we present a series of dynamic radiologic data and emphasize the differential diagnostic of skeletal TB.

  11. Tuberculosis infection and disease in children living in households of Filipino patients with tuberculosis: a preliminary report.

    Science.gov (United States)

    Salazar-Vergara, R M L; Sia, I G; Tupasi, T E; Alcañeses, M R; Orillaza, R B; Co, V; Quelapio, M I D; Beltran, G; Legaspi, J D; Rostrata, M P C; Tecson, M E B; Corpuz, M L S B

    2003-12-01

    DOTS Clinic with a DOTS-Plus pilot project for the management of multidrug-resistant tuberculosis (MDR-TB) in a high burden country. To determine the prevalence of tuberculosis (TB) infection and disease among pediatric household contacts of patients with pulmonary TB (PTB). Cross-sectional study. One hundred and fifty-three children aged 0-15 years in the households of 62 bacteriologically confirmed PTB patients, including 44 with MDR-TB, were studied. BCG scars were noted, and tuberculin skin test (TST), screening chest radiography, and sputum or gastric aspirate smear and culture for Mycobacterium tuberculosis in those with radiographic findings suggestive of PTB were done. For children in this study, the prevalences of latent TB infection (LTBI), radiographically diagnosed pulmonary TB, and bacillary pulmonary TB were 69.2%, 3.3%, and 0.65%, respectively. Only age > or = 5 years was found to be a significant predictor of LTBI (OR 3.17, 95%CI 1.43-7.01). Contact investigation for active case-finding and early treatment of TB in children from households of patients with active PTB is essential for TB control. Further study on a more precise definition of TB infection and strategies for control in this population will be pursued.

  12. Treatment of Active Tuberculosis in Chicago, 2008-2011: The Role of Public Health Departments.

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    Reid Fletcher

    Full Text Available Evaluate differences in TB outcomes among different provider types in Chicago, IL.We retrospectively reviewed all TB cases reported to the Chicago Department of Public Health (CDPH from 2008 through 2011. Provider type was stratified into three groups: public, public-private, and private providers. Multivariate regression was used to evaluate treatment duration and time to sputum culture conversion. A Cox proportional hazard model was used to assess treatment completion.Of 703 cases, 203 (28.9%, 314 (44.7%, and 186 (26.5% were treated by public, public-private and private providers, respectively. Adjusted regression showed private provider patients had a 48-day (95% CI 22.0-74.3 increase in treatment duration and a 30-day (95% C.I. 9.5-51.1 increase in time to sputum culture conversion. Cox model showed increased risk of remaining on treatment was associated with extra-pulmonary TB (aHR 0.78, 95% C.I. 0.62-0.98, being foreign-born (aHR 0.74, 95% C.I. 0.58-0.95, and any drug resistance (aHR 0.59, 95% C.I. 0.46-0.76. There were no differences in outcomes between public and public-private providers.Patients treated solely in the private sector had prolonged time to sputum culture conversion and treatment duration which lead to increased cost for treatment, prolonged infectiousness, potential for transmission, and the possibility for increased medication side effects.

  13. Tuberculosis genitourinaria: Reporte de 9 casos en el Hospital Universitario de Santander, Colombia, 2003-2008 Genitourinary tuberculosis: A report of 9 cases in Santander University Hospital, Colombia, 2003-2008

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    Julio Cesar Mantilla Hernández

    2009-08-01

    Full Text Available Introducción: La tuberculosis constituye aún un problema de salud pública en el mundo, el cual se agrava por la pandemia del SIDA. La tuberculosis extrapulmonar puede comprometer cualquier órgano, siendo el sistema genitourinario uno de los más afectados, por lo cual es importante conocer su magnitud en cada institución. Objetivos: Caracterizar la tuberculosis genitourinaria desde el punto de vista epidemiológico, clínico y paraclínico de los pacientes en los cuales la enfermedad constituyó la causa básica de muerte y su compromiso genitourinario fue un hallazgo principal de autopsia. Metodología: Estudio descriptivo retrospectivo realizado entre el 2003 y el 2008 mediante revisión de los protocolos de autopsias efectuadas en el Departamento de Patología de la Universidad Industrial de Santander, de los pacientes que fallecieron a causa de tuberculosis en el Hospital Universitario de Santander, Colombia. Resultados: Se encontraron 9 casos, con rango de edad entre 20 y 66 años, de los cuales 8 correspondían a hombres y 5 se asociaron con síndrome de inmunodeficiencia adquirida. Las manifestaciones clínicas más frecuentes fueron los síntomas constitucionales, seguido de los respiratorios, los urinarios, el dolor lumbar y los testiculares. El diagnóstico se realizó a través de los hallazgos anatomopatológicos durante la autopsia. Conclusiones: La tuberculosis genitourinaria es una forma severa de tuberculosis extra pulmonar, que por la poca especificidad del cuadro clínico, tiene un índice de sospecha bajo, lo que resulta inconveniente, ya que no permite diagnóstico oportuno, ni tratamiento adecuado para prevenir daños severos irreversibles. Salud UIS 2009; 41: 181-196Introduction: Tuberculosis continues to be a serious public health problem worldwide, which increases with AIDS pandemic. Extra-pulmonary tuberculosis can compromise any organ, genitourinary system being one of the most affected therefore it is important to

  14. Tuberculosis Information for International Travelers

    Science.gov (United States)

    ... Reports (MMWRs) DTBE Authored Journal Articles Tuberculosis Laboratory Aggregate Reports Slide Sets Epidemiology of Tuberculosis Among Non- ... of time for taking the drugs; when the supply of drugs is not always available; or when ...

  15. Incidence and Prevalence of Tuberculosis in Iran and Neighboring Countries

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    Arezoo Tavakoli

    2017-07-01

    Full Text Available Background Tuberculosis is one of the major public health concerns in many countries, however the available and effective treatment is known. Tuberculosis typically determined with socio-economic problems such as war, malnutrition and HIV prevalence. In Iran, many progresses are carried to control tuberculosis but, different factors such as immigration from neighboring countries are affective to tuberculosis infection. Objectives In this paper, the incidence and prevalence of tuberculosis is evaluated in different regions of Iran and neighboring countries. Methods The data are collected from different and valid sources such as Scopus, Pubmed and also many reports from world health organization (WHO and center of disease control and prevention (CDC for a period of 25 years (1990 - 2015 evaluated for Iran and neighboring countries. Results This study as a descriptive- analytical research is conducted cross- sectional among Iran and neighboring countries since 1990. The information is obtained from exact and valid informative data from web of sciences. The east and west border countries of Iran which are faced with war and immigration in Afghanistan, Pakistan and Iraq are source of tuberculosis infection that effect on tuberculosis prevalence in Iran. The data were analyzed by SPSS 22 and Excel 2013. Conclusions The incidence of tuberculosis in Iran has been decreased because of many controlling actions such as BCG vaccination, electronic reporting system for tuberculosis and free access to tuberculosis medication. Some of Iran neighboring countries such as Tajikistan and Pakistan have the highest incidence of tuberculosis which known as a challenge for tuberculosis control in Iran while Saudi Arabia and Turkey have the lowest incidence.

  16. [Reporting and interviewing delays in contact investigation of tuberculosis, Seine-Saint-Denis, from April to June 2008].

    Science.gov (United States)

    Fourcade, C; Le Mab, G; Vincenti-Delmas, M

    2012-08-01

    In France, one of the main components of the tuberculosis control program is contact investigation around all tuberculosis cases. For this purpose, all cases of tuberculosis are to be reported to the health authorities (Centre de lutte antituberculeuse) within 48 hours of diagnosis. The Centre then conducts an initial patient interview within three days of the report in order to establish a list of contacts requiring evaluation. Given that a delay in action may play a role in the continued disease transmission, it appeared necessary to study more precisely this subject in a French area with a high annual new case rate, the Seine-Saint-Denis. A descriptive and retrospective study included all tuberculosis cases reported and received between April and June 2008. The two periods were statistically analyzed with socio-demographic, clinical-biological and investigations data. For the 148 cases reported during this period, a first interview was required for 123. The average time period between initiation of anti-tuberculosis therapy and reception of the report was 11.08 days. The overly long delay could be explained in part by the inappropriate use of the notification form (45.5%) designed for non-urgent collection of epidemiological data, and in part by the underuse of telephone reporting (8.1%). The first interview was not performed for 19 cases and the average time between reception of the notification and the patient interview was 6.58 days. Having the patient's phone number appeared essential to meet the deadline (odds ratio: 5.3; 95% confidence interval [1.7-16.9]). Few interviews were made in person. Shortage in financial and human resources and the delayed case reporting could be part of the explanations. Deadlines were met much better for cases of pleuro-pulmonary tuberculosis compared with other localizations, for reporting (39.2% versus 13.5%, preports some risk factors associated with delayed action and highlights the need for improved reporting of

  17. [Legitimizing and responsibilities of public health reports: public health reports or social court reports?].

    Science.gov (United States)

    Borgers, D; Streich, W

    1996-11-01

    Since 1970 various initiatives have been taken to improve the information bases of health reporting. However, the efforts made up to now by the Länder, the Federal Government and its corporate bodies are characterised by a lack of experience and shortage of resources; moreover, they are viewed with a critical eye by the public and in the political area. In this contribution the authors describe various topics and delimitations of a health reporting system which go far beyond health statistics and health programmes altogether. The chances of a national health reporting system are based on the assumption that an objective judgement based on expert knowledge and science will be possible and that beyond all particularistic interests, expert knowledge can be organised in a democratic process. Public health reporting varies between two extremes: On the one hand, the current reporting in the media on health-related subjects which is characterised by disagreement among experts, particularistic interests and emotions, and on the other hand the national health reporting, which, on the platform of policy marketing and political image shaping, is suspected of degenerating to a kind of "royal court reporting". A health reporting system based on expert knowledge and characterised by topics with relevance to health policy, expert quality of its information and neutrality to particularistic interests, should go beyond these two extremes. Given the political conditions of budgeting and distribution conflicts, health reporting has to deal with two main aspects: effectiveness and efficiency of employed resources and with the problems of a fair distribution of these resources to provide equal chances in the health sector. What cannot be solved, by questions of procedure, however, is the problem of truth and objective knowledge as well as the problem of confidence. If the general public lacks confidence in national expert knowledge, a society discourse will not lead to political

  18. Mycobacterium bovis in a European bison (Bison bonasus) raises concerns about tuberculosis in Brazilian captive wildlife populations: a case report.

    Science.gov (United States)

    Zimpel, Cristina Kraemer; Brum, Juliana Sperotto; de Souza Filho, Antônio Francisco; Biondo, Alexander Welker; Perotta, João Henrique; Dib, Cristina Corsi; Bonat, Marcelo; Neto, José Soares Ferreira; Brandão, Paulo Eduardo; Heinemann, Marcos Bryan; Guimaraes, Ana Marcia Sa

    2017-02-10

    Tuberculosis caused by Mycobacterium bovis is an important worldwide zoonosis and has been reported to cause clinical disease in several animal species, including captive wildlife. This report describes a case of M. bovis infection in a European bison from a Brazilian zoo and compiles a number of literature reports that raise concern regarding tuberculosis among captive wildlife in Brazil. A 13 year-old captive-born male bison (Bison bonasus) from a Brazilian zoo began presenting weight loss, diarrhea and respiratory symptoms, which inevitably led to his death. At the animal's necropsy, inspection of the thoracic and abdominal cavities revealed multiple enlarged lymph nodes, ranging from 4 to 10 cm, and pulmonary nodules containing caseous masses with firm white materials consistent with mineralization. Histopathology findings showed a significant amount of acid-alcohol resistant bacilli compatible with Mycobacterium spp. Specimens from lymph nodes and lungs were cultured on Petragnani and Stonebrink media, and specific PCR assays of the bacterial isolate identified it as M. bovis. The European bison reported herein died from a severe form of disseminated tuberculosis caused by M. bovis. A review of the available literature indicates possible widespread occurrence of clinical disease caused by M. bovis or M. tuberculosis affecting multiple animal species in Brazilian wildlife-related institutions. These likely underestimated numbers raise concern regarding the control of the disease in captive animal populations from Brazil.

  19. History of treated pulmonary tuberculosis will also be an underlying symptom of opportunistic aspergillosis by Aspergillus flavus: A case report

    Directory of Open Access Journals (Sweden)

    Akbar Hossein Nejad

    2015-01-01

    Conclusion: The importance of tuberculosis (TB in the development of aspergillosis, even after treatment, has been highlighted by multiple studies. Microbiological and molecular evaluation are needed to detect PA quickly and accurately. The WHO reported about 8.8 million new cases of TB in 2010. Therefore, it is essential to focus more on monitoring of diagnosis and treatment of PA.

  20. Cavitating lung disease due to concomitant drug resistant tuberculosis and invasive pulmonary Aspergillosis in a post-partum patient: A case report.

    Science.gov (United States)

    Ray, Animesh; Suri, J C; Sen, M K; Chakrabarti, S; Gupta, Ayush; Capoor, Malini

    2015-01-01

    Many disorders can present as cavitating lesions in the lung. In this case report, a case of mixed infection with drug resistant tuberculosis and invasive pulmonary aspergillosis in a post-partum patient has been presented. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  1. Global Reconstruction for Extensive Destruction in Tuberculosis of the Lumbar Spine and Lumbosacral Junction: A Case Report

    Science.gov (United States)

    Uvaraj, Nalli R.; Bosco, Aju; Gopinath, Nalli R.

    2014-01-01

    Study Design Case report. Objective To analyze the surgical difficulties in restoring global spinal stability and to describe an effective surgical option for tuberculosis with extensive destruction of the lumbosacral spine. Advanced tuberculosis with destruction of the lumbosacral spine can result in a kyphosis or hypolordosis, leading to back pain, spinal instability, and neurological deficits. The conventional treatment goals of lumbosacral tuberculosis are to correct and prevent a lumbar kyphosis, treat or prevent a neurological deficit, and restore global spinal stability. Instrumentation at the lumbosacral junction is technically demanding due to the complex local anatomy, the unique biomechanics, and the difficult fixation in the surrounding diseased bone. Methods We report a 21-year-old woman with tuberculosis from L1 to S2 with back pain and spinal instability. The radiographs showed a kyphosis of the lumbar spine. The magnetic resonance imaging and computed tomography scans revealed extensive destruction of the lumbar and lumbosacral spine. Spinopelvic stabilization combined with anterior debridement and reconstruction with free fibular strut graft was performed. Results The radiographs at follow-up showed a good correction of the kyphosis and excellent graft incorporation and fusion. Conclusions Anterior column reconstruction with a fibular strut graft helps restore and maintain the vertebral height. Posterior stabilization with spinopelvic fixation can be an effective surgical option for reconstructing the spine in extensive lumbosacral tuberculosis with sacral body destruction, requiring long fusions to the sacrum. It augments spinal stability, prevents graft-related complications, and accelerates the graft incorporation and fusion, thereby permitting early mobilization and rehabilitation. In spinal tuberculosis, antitubercular therapy may have to be prolonged in cases with large disease load, based on the clinicoradiographic and laboratory

  2. Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study.

    Science.gov (United States)

    Budgell, E P; Evans, D; Schnippel, K; Ive, P; Long, L; Rosen, S

    2016-09-05

    Despite the large number of tuberculosis (TB) patients treated in South Africa (SA), there are few descriptions in the published literature of drug-susceptible TB patient characteristics, mode of diagnosis or treatment outcomes in routine public sector treatment programmes. To enhance the evidence base for public sector TB treatment service delivery, we reported the characteristics of and outcomes for a retrospective cohort of adult TB patients at public sector clinics in the Johannesburg Metropolitan Municipality (JHB), SA. We collected medical record data for a retrospective cohort of adult (≥18 years) TB patients registered between 1 April 2011 and 31 March 2012 at three public sector clinics in JHB. Data were abstracted from National TB Programme clinic cards and the TB case registers routinely maintained at study sites. We report patient characteristics, mode of diagnosis, mode of treatment supervision, treatment characteristics, HIV status and treatment outcomes for this cohort. A total of 544 patients were enrolled in the cohort. Most (86%) were new TB cases, 81% had pulmonary TB, 58% were smear-positive at treatment initiation and 71% were HIV co-infected. Among 495 patients with treatment outcomes reported, 80% (n=394) had successful outcomes, 11% (n=55) were lost to follow-up, 8% (n=40) died and 1% (n=6) failed treatment. Primary healthcare clinics in JHB are achieving relatively high rates of success in treating drug-susceptible TB. Missing laboratory results were common, including follow-up smears, cultures and drug susceptibility tests, making it difficult to assess adherence to guidelines and leaving scope for substantial improvements in record-keeping at the clinics involved.

  3. Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa

    Directory of Open Access Journals (Sweden)

    Kumaranayake Lilani

    2006-06-01

    Full Text Available Abstract Background Public-private partnerships (PPP could be effective in scaling up services. We estimated cost and cost-effectiveness of different PPP arrangements in the provision of tuberculosis (TB treatment, and the financing required for the different models from the perspective of the provincial TB programme, provider, and the patient. Methods Two different models of TB provider partnerships are evaluated, relative to sole public provision: public-private workplace (PWP and public-private non-government (PNP. Cost and effectiveness data were collected at six sites providing directly observed treatment (DOT. Effectiveness for a 12-month cohort of new sputum positive patients was measured using cure and treatment success rates. Provider and patient costs were estimated, and analysed according to sources of financing. Cost-effectiveness is estimated from the perspective of the provider, patient and society in terms of the cost per TB case cured and cost per case successfully treated. Results Cost per case cured was significantly lower in PNP (US $354–446, and comparable between PWP (US $788–979 and public sites (US $700–1000. PPP models could significantly reduce costs to the patient by 64–100%. Relative to pure public sector provision and financing, expansion of PPPs could reduce government financing required per TB patient treated from $609–690 to $130–139 in PNP and $36–46 in PWP. Conclusion There is a strong economic case for expanding PPP in TB treatment and potentially for other types of health services. Where PPPs are tailored to target groups and supported by the public sector, scaling up of effective services could occur at much lower cost than solely relying on public sector models.

  4. Drivers of Tuberculosis Transmission.

    Science.gov (United States)

    Mathema, Barun; Andrews, Jason R; Cohen, Ted; Borgdorff, Martien W; Behr, Marcel; Glynn, Judith R; Rustomjee, Roxana; Silk, Benjamin J; Wood, Robin

    2017-11-03

    Measuring tuberculosis transmission is exceedingly difficult, given the remarkable variability in the timing of clinical disease after Mycobacterium tuberculosis infection; incident disease can result from either a recent (ie, weeks to months) or a remote (ie, several years to decades) infection event. Although we cannot identify with certainty the timing and location of tuberculosis transmission for individuals, approaches for estimating the individual probability of recent transmission and for estimating the fraction of tuberculosis cases due to recent transmission in populations have been developed. Data used to estimate the probable burden of recent transmission include tuberculosis case notifications in young children and trends in tuberculin skin test and interferon γ-release assays. More recently, M. tuberculosis whole-genome sequencing has been used to estimate population levels of recent transmission, identify the distribution of specific strains within communities, and decipher chains of transmission among culture-positive tuberculosis cases. The factors that drive the transmission of tuberculosis in communities depend on the burden of prevalent tuberculosis; the ways in which individuals live, work, and interact (eg, congregate settings); and the capacity of healthcare and public health systems to identify and effectively treat individuals with infectious forms of tuberculosis. Here we provide an overview of these factors, describe tools for measurement of ongoing transmission, and highlight knowledge gaps that must be addressed. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  5. Abdominal tuberculosis after removal of an adjustable gastric band - report of an unusual case.

    Science.gov (United States)

    Kowalewski, Piotr K; Olszewski, Robert; Michalik, Dariusz; Kwiatkowski, Andrzej P

    2017-06-01

    Laparoscopic adjustable gastric banding (LAGB) is the third most popular bariatric procedure. Despite its reversibility and minimal invasiveness, band infection affects 1.2% of patients. We present a case of a 25-year-old, obese woman who was experiencing malaise and feverishness 3 years after gastric band placement. Due to port site infection the port was removed, which did not improve the patient's condition. After 2 years the band was removed via laparotomy with a minor surgical site infection reported. The patient returned 2 weeks after discharge with signs of sepsis. After ruling out pulmonary causes, an exploratory laparotomy was performed, revealing granulomatous peritonitis. Standard histopathological examinations, broncho-alveolar lavage culture and DNA tests along with microbiological cultures were inconclusive. Broad-spectrum antibiotics and antifungal and antiparasitic agents did not improve the patient's condition. Mycobacterium tuberculosis DNA was discovered in a greater omentum specimen. The patient was treated with isoniazid, rifampicin, pyrazinamide and streptomycin for four months.

  6. Public Reporting and a More Sustainable Army

    Science.gov (United States)

    2009-04-01

    Coca - Cola Yes Microsoft Yes International Business Machines (IBM) Yes General Electric (GE) Yes Nokia Yes Toyota Yes Intel Yes McDonald’s Yes...DISCLAIMER: The contents of this report are not to be used for advertising , publication, or promotional purposes. Citation of trade names does not

  7. Public reporting, consumerism, and patient empowerment.

    Science.gov (United States)

    Huckman, Robert S; Kelley, Mark A

    2013-11-14

    Public reporting of health care outcomes is largely ignored by consumers, perhaps because it doesn't include concise, comprehensible information on factors such as out-of-pocket costs, the effectiveness of a procedure or treatment, and applicability to their situation.

  8. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

    OpenAIRE

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a t...

  9. Drug-resistant tuberculosis in two children in Greece: report of the first extensively drug-resistant case.

    Science.gov (United States)

    Katragkou, Aspasia; Antachopoulos, Charalampos; Hatziagorou, Elpis; Sdougka, Maria; Roilides, Emmanuel; Tsanakas, John

    2013-04-01

    Extensively drug-resistant (XDR) tuberculosis (TB) represents a serious and growing problem in both endemic and non-endemic countries. We describe a 2.5-year-old girl with XDR-pulmonary TB and an 18-month-old boy with pre-XDR-central nervous system TB. Patients received individualized treatment with second-line anti-TB agents based on genotypic and phenotypic drug susceptibility testing results. Both children achieved culture conversion 3 months and 1 month after treatment initiation, respectively. The child with XDR-pulmonary TB showed evidence of cure while treatment adverse events were managed without treatment interruption. The child with pre-XDR-central nervous system TB after 6-month hospitalization with multiple infectious complications had a dismal end due to hepatic insufficiency possibly related to anti-TB treatment. This is the first report of children with pre-XDR and XDR TB in Greece, emphasizing the public health dimensions and management complexity of XDR TB.

  10. Atypical imaging of spinal tuberculosis: a case report and review of ...

    African Journals Online (AJOL)

    ... is a rare imaging manifestation and diagnosis was confirmed by pathology after the surgery. Therefore atypical imaging is often appeared in clinical practice and it is meaningful and necessary for the diagnosis of atypical spinal tuberculosis combined with multiple organ tuberculosis. Pan African Medical Journal 2016; 24 ...

  11. Smear Positive Pulmonary Tuberculosis (PTB) Prevalence Amongst ...

    African Journals Online (AJOL)

    Background: World Health organization (WHO) declared tuberculosis as a global emergency because it poses a serious public health threat in different countries especially, in Africa. According to WHO report of 2007, Directly Observed Treatment Short course (DOTS) coverage in Ethiopia reached 95 percent of the ...

  12. The prevalence and factors associated for anti-tuberculosis treatment non-adherence among pulmonary tuberculosis patients in public health care facilities in South Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Tadele Teshome Woimo

    2017-03-01

    Full Text Available Abstract Background Evidence exists pointing out how non-adherence to treatment remains a major hurdle to efficient tuberculosis control in developing countries. Many tuberculosis (Tb patients do not complete their six-month course of anti-tuberculosis medications and are not aware of the importance of sputum re-examinations, thereby putting themselves at risk of developing multidrug-resistant and extensively drug-resistant forms of tuberculosis and relapse. However, there is a dearth of publications about non-adherence towards anti-Tb medication in these settings. We assessed the prevalence of and associated factors for anti-Tb treatment non-adherence in public health care facilities of South Ethiopia. Methods This was a cross-sectional survey using both quantitative and qualitative methods. The quantitative study was conducted among 261 Tb patients from 17 health centers and one general hospital. The qualitative aspect included an in-depth interview of 14 key informants. For quantitative data, the analysis of descriptive statistics, bivariate and multiple logistic regression was carried out, while thematic framework analysis was applied for the qualitative data. Results The prevalence of non-adherence towards anti-Tb treatment was 24.5%. Multiple logistic regression analysis demonstrated that poor knowledge towards tuberculosis and its treatment (AOR = 4.6, 95%CI: 1.4-15.6, cost of medication other than Tb (AOR = 4.7, 95%CI: 1.7-13.4, having of health information at every visit (AOR = 3, 95% CI: 1.1-8.4 and distance of DOTS center from individual home (AOR = 5.7, 95%CI: 1.9-16.8 showed statistically significant association with non-adherence towards anti- tuberculosis treatment. Qualitative study also revealed that distance, lack of awareness about importance of treatment completion and cost of transportation were the major barriers for adherence. Conclusions A quarter of Tb patients interrupted their treatment due to knowledge

  13. Pulmonary tuberculosis

    Science.gov (United States)

    TB; Tuberculosis - pulmonary; Mycobacterium - pulmonary ... Pulmonary TB is caused by the bacterium Mycobacterium tuberculosis (M tuberculosis) . TB is contagious. This means the bacteria is easily spread from an infected person ...

  14. Tuberculosis (TB)

    Science.gov (United States)

    ... with facebook share with twitter share with linkedin Tuberculosis Go to Information for Researchers ► Credit: NIAID Scanning ... are drug resistant. Why Is the Study of Tuberculosis a Priority for NIAID? Tuberculosis is one of ...

  15. Total hip replacement infected with Mycobacterium tuberculosis complicated by Addison disease and psoas muscle abscess: a case report

    Directory of Open Access Journals (Sweden)

    De Nardo Pasquale

    2012-01-01

    Full Text Available Abstract Introduction Prosthetic joint infection due to Mycobacterium tuberculosis is occasionally encountered in clinical practice. To the best of our knowledge, this is the first report of a prosthetic joint infection due to Mycobacterium tuberculosis complicated by psoas abscesses and secondary Addison disease. Case presentation A 67-year-old immunocompetent Caucasian woman underwent total left hip arthroplasty because of osteoarthritis. After 18 months, she underwent arthroplasty revision for a possible prosthetic infection. Periprosthetic tissue specimens for bacteria were negative, and empirical antibiotic therapy was unsuccessful. She was then admitted to our department because of complications arising 22 months after arthroplasty. A physical examination revealed a sinus tract overlying her left hip and skin and mucosal pigmentation. Her levels of C-reactive protein, basal cortisol, adrenocorticotropic hormone, and sodium were out of normal range. Results of the tuberculin skin test and QuantiFERON-TB Gold test were positive. Computed tomography revealed a periprosthetic abscess and the inclusion of the left psoas muscle. Results of microbiological tests were negative, but polymerase chain reaction of a specimen taken from the hip fistula was positive for Mycobacterium tuberculosis. Our patient's condition was diagnosed as prosthetic joint infection and muscle psoas abscess due to Mycobacterium tuberculosis and secondary Addison disease. She underwent standard treatment with rifampicin, ethambutol, isoniazid, and pyrazinamide associated with hydrocortisone and fludrocortisone. At 15 months from the beginning of therapy, she was in good clinical condition and free of symptoms. Conclusions Prosthetic joint infection with Mycobacterium tuberculosis is uncommon. A differential diagnosis of tuberculosis should be considered when dealing with prosthetic joint infection, especially when repeated smears and histology examination from infected

  16. Do "Virtual" and "Outpatient" Public Health Tuberculosis Clinics Perform Equally Well? A Program-Wide Evaluation in Alberta, Canada.

    Directory of Open Access Journals (Sweden)

    Richard Long

    Full Text Available Meeting the challenge of tuberculosis (TB elimination will require adopting new models of delivering patient-centered care customized to diverse settings and contexts. In areas of low incidence with cases spread out across jurisdictions and large geographic areas, a "virtual" model is attractive. However, whether "virtual" clinics and telemedicine deliver the same outcomes as face-to-face encounters in general and within the sphere of public health in particular, is unknown. This evidence is generated here by analyzing outcomes between the "virtual" and "outpatient" public health TB clinics in Alberta, a province of Western Canada with a large geographic area and relatively small population.In response to the challenge of delivering equitable TB services over long distances and to hard to reach communities, Alberta established three public health clinics for the delivery of its program: two outpatient serving major metropolitan areas, and one virtual serving mainly rural areas. The virtual clinic receives paper-based or electronic referrals and generates directives which are acted upon by local providers. Clinics are staffed by dedicated public health nurses and university-based TB physicians. Performance of the two types of clinics is compared between the years 2008 and 2012 using 16 case management and treatment outcome indicators and 12 contact management indicators.In the outpatient and virtual clinics, respectively, 691 and 150 cases and their contacts were managed. Individually and together both types of clinics met most performance targets. Compared to outpatient clinics, virtual clinic performance was comparable, superior and inferior in 22, 3, and 3 indicators, respectively.Outpatient and virtual public health TB clinics perform equally well. In low incidence settings a combination of the two clinic types has the potential to address issues around equitable service delivery and declining expertise.

  17. The Tuberculosis Cascade of Care in India’s Public Sector: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Satyanarayana, Srinath; Pai, Madhukar; Thomas, Beena E.; Chadha, Vineet K.; Swaminathan, Soumya; Mayer, Kenneth H.

    2016-01-01

    Background India has 23% of the global burden of active tuberculosis (TB) patients and 27% of the world’s “missing” patients, which includes those who may not have received effective TB care and could potentially spread TB to others. The “cascade of care” is a useful model for visualizing deficiencies in case detection and retention in care, in order to prioritize interventions. Methods and Findings The care cascade constructed in this paper focuses on the Revised National TB Control Programme (RNTCP), which treats about half of India’s TB patients. We define the TB cascade as including the following patient populations: total prevalent active TB patients in India, TB patients who reach and undergo evaluation at RNTCP diagnostic facilities, patients successfully diagnosed with TB, patients who start treatment, patients retained to treatment completion, and patients who achieve 1-y recurrence-free survival. We estimate each step of the cascade for 2013 using data from two World Health Organization (WHO) reports (2014–2015), one WHO dataset (2015), and three RNTCP reports (2014–2016). In addition, we conduct three targeted systematic reviews of the scientific literature to identify 39 unique articles published from 2000–2015 that provide additional data on five indicators that help estimate different steps of the TB cascade. We construct separate care cascades for the overall population of patients with active TB and for patients with specific forms of TB—including new smear-positive, new smear-negative, retreatment smear-positive, and multidrug-resistant (MDR) TB. The WHO estimated that there were 2,700,000 (95%CI: 1,800,000–3,800,000) prevalent TB patients in India in 2013. Of these patients, we estimate that 1,938,027 (72%) TB patients were evaluated at RNTCP facilities; 1,629,906 (60%) were successfully diagnosed; 1,417,838 (53%) got registered for treatment; 1,221,764 (45%) completed treatment; and 1,049,237 (95%CI: 1,008,775–1

  18. Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review

    Science.gov (United States)

    Hudson, Mollie; Rutherford, George W.; Weiser, Sheri; Fair, Elizabeth

    2018-01-01

    Background Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. Methods We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. Results We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88–2.08). However, HIV-infected TB patients who sought care

  19. Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review.

    Science.gov (United States)

    Hudson, Mollie; Rutherford, George W; Weiser, Sheri; Fair, Elizabeth

    2018-01-01

    Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88-2.08). However, HIV-infected TB patients who sought care in the public sector were

  20. Childhood Tuberculosis, Still with Us...

    Science.gov (United States)

    Chaulet, Pierre; And Others

    1992-01-01

    The first section of this report on childhood tuberculosis in developed and developing countries discusses the epidemiology of tuberculosis in children. Information is presented on: (1) sources and prevalence of infection; (2) risks, frequency, and types of tuberculosis; (3) mortality rates; and (4) the relation of poverty and AIDS to…

  1. Tuberculosis in Liver Transplant Recipients: A Report of Eight Cases During a Five Year Period

    Directory of Open Access Journals (Sweden)

    Diana Póvoas

    2017-01-01

    Conclusion: Although the number of cases of tuberculosis is low, its post-transplant frequency is significant and the observed mortality rate is not to be neglected. The cases of hepatotoxicity and graft rejection seen in this case series demonstrate the challenges associated with tuberculosis diagnosis in liver transplant recipients and management of the interactions between immunosuppressors and rifampin. This study strengthens the recommendation of latent tuberculosis infection screening and treatment in liver transplant candidates or recipients.

  2. Searching for sex- and gender-sensitive tuberculosis research in public health: finding a needle in a haystack

    Science.gov (United States)

    Vissandjee, Bilkis; Mourid, Assia; Greenaway, Christina A; Short, Wendy E; Proctor, Jodi A

    2016-01-01

    Despite broadening consideration of sex- and gender-based issues in health research, when seeking information on how sex and gender contribute to disease contexts for specific health or public health topics, a lack of consistent or systematic use of terminology in health literature means that it remains difficult to identify research with a sex or gender focus. These inconsistencies are driven, in part, by the complexity and terminological inflexibility of the indexing systems for gender- and sex-related terms in public health databases. Compounding the issue are authors’ diverse vocabularies, and in some cases lack of accuracy in defining and using fundamental sex–gender terms in writing, and when establishing keyword lists and search criteria. Considering the specific case of the tuberculosis (TB) prevention and management literature, an analysis of sex and gender sensitivity in three health databases was performed. While there is an expanding literature exploring the roles of both sex and gender in the trajectory and lived experience of TB, we demonstrate the potential to miss relevant research when attempting to retrieve literature using only the search criteria currently available. We, therefore, argue that for good clinical practice to be achieved; there is a need for both public health researchers and users to be better educated in appropriate usage of the terminology associated with sex and gender. In addition, public health database indexers ought to accept the task of developing and implementing adequate definitions of sex and gender terms so as to facilitate access to sex- and gender-related research. These twin advances will allow clinicians to more readily recognize and access knowledge pertaining to systems of redress that respond to gendered risks that compound existing health inequalities in disease management and control, particularly when dealing with already complex diseases. Given the methodological and linguistic challenges presented by the

  3. Searching for sex- and gender-sensitive tuberculosis research in public health: finding a needle in a haystack.

    Science.gov (United States)

    Vissandjee, Bilkis; Mourid, Assia; Greenaway, Christina A; Short, Wendy E; Proctor, Jodi A

    2016-01-01

    Despite broadening consideration of sex- and gender-based issues in health research, when seeking information on how sex and gender contribute to disease contexts for specific health or public health topics, a lack of consistent or systematic use of terminology in health literature means that it remains difficult to identify research with a sex or gender focus. These inconsistencies are driven, in part, by the complexity and terminological inflexibility of the indexing systems for gender- and sex-related terms in public health databases. Compounding the issue are authors' diverse vocabularies, and in some cases lack of accuracy in defining and using fundamental sex-gender terms in writing, and when establishing keyword lists and search criteria. Considering the specific case of the tuberculosis (TB) prevention and management literature, an analysis of sex and gender sensitivity in three health databases was performed. While there is an expanding literature exploring the roles of both sex and gender in the trajectory and lived experience of TB, we demonstrate the potential to miss relevant research when attempting to retrieve literature using only the search criteria currently available. We, therefore, argue that for good clinical practice to be achieved; there is a need for both public health researchers and users to be better educated in appropriate usage of the terminology associated with sex and gender. In addition, public health database indexers ought to accept the task of developing and implementing adequate definitions of sex and gender terms so as to facilitate access to sex- and gender-related research. These twin advances will allow clinicians to more readily recognize and access knowledge pertaining to systems of redress that respond to gendered risks that compound existing health inequalities in disease management and control, particularly when dealing with already complex diseases. Given the methodological and linguistic challenges presented by the

  4. Perinatal tuberculosis: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Edna Lúcia S. de Souza

    Full Text Available Despite the high prevalence of tuberculosis in adults and children, the congenital and perinatal forms of tuberculosis are rare. In Brazil, there has been only one published case of congenital tuberculosis and two cases of the perinatal form of this disease. We report a case of perinatal tuberculosis presenting with pneumonia. Alcohol-acid-resistant bacilli were found in the gastric lavage. Diagnosis of this disease presentation requires a high index of suspicion.

  5. Tuberculosis and Migration: A Challenge for Medical Staff and Public Health

    Directory of Open Access Journals (Sweden)

    Ines Griesshammer

    2016-01-01

    Full Text Available A high number of asylum seekers enter Switzerland every year. They often originate from countries with a high TB prevalence. Our patient from Somalia presented with 2 lipoma-like tumors with pain on palpation on his left chest wall but no symptoms including coughing, fever, night-sweats, or loss of weight. CT scan then showed diffuse infiltrations of his lung and multiple abscesses on his left chest wall. Therefore contagious tuberculosis (TB was suspected and the patient was put in isolation. In the follow-up the diagnosis of open TB was proofed with bronchial secretion and EBUS-guided biopsy that showed acid-fast rods. This particular case shows how difficult the identification of patients with open TB can be, especially if there are no respiratory or systemic symptoms. Therefore awareness of possible infectious disease is paramount for ED Doctors treating patients from countries with high prevalence. Early and strict isolation measures can help to reduce risk of contagion among staff and patients.

  6. Public health measures to control tuberculosis in low-income countries: ethics and human rights considerations.

    Science.gov (United States)

    Kraemer, J D; Cabrera, O A; Singh, J A; Depp, T B; Gostin, L O

    2011-06-01

    In low-income countries, tuberculosis (TB) control measures should be guided by ethical concerns and human rights obligations. Control programs should consider the principles of necessity, reasonableness and effectiveness of means, proportionality, distributive justice, and transparency. Certain measures-detention, infection control, and treatment to prevent transmission-raise particular concerns. While isolation is appropriate under certain circumstances, quarantine is never an acceptable control measure for TB, and any detention must be limited by necessity and conducted humanely. States have a duty to implement hospital infection control to the extent of their available resources and to provide treatment to health care workers (HCWs) infected on the job. HCWs, in turn, have an obligation to provide care unless conditions are unreasonably and unforeseeably unsafe. Finally, states have an obligation to provide adequate access to treatment, as a means of preventing transmission, as broadly as possible and in a non-discriminatory fashion. Along with treatment, states should provide support to increase treatment adherence and retention with respect for patient privacy and autonomy. Compulsory treatment is almost never acceptable. Governments should take care to respect human rights and ethical obligations as they execute TB control programs.

  7. Gastrointestinal Tuberculosis: Still a challenge for radiologists and Gastroenterologists

    International Nuclear Information System (INIS)

    Mohamadnejad, M.; Malekzadeh, R.; Soroush, Z.; Sedighi, N.

    2003-01-01

    Tuberculosis is a major health problem in Iran. All parts of the gastrointestinal tract can be affected by Tuberculosis. Therefore, it should be included in the differential diagnoses of almost and tuberculosis diseases, and physicians should be aware of the imaging characteristics of tuberculosis in the tuberculosis tract. This is a report of 4 patients with different types of tuberculosis involvement by tuberculosis, along with its clinical pictures and imaging characteristics

  8. Tuberculosis tenosynovitis with multiple rice bodies of the flexor tendons in the wrist: A case report

    Directory of Open Access Journals (Sweden)

    Serkan Bayram

    2016-01-01

    Conclusion: M. tuberculosis should be kept in mind as an infectious agent, especially in developing countries. In order to prevent any delay in diagnostic evaluation, all steps should be taken carefully.

  9. Short Term Advantages of a Public-Private Partnership for Tuberculosis in Guinea Bissau: Reduction of Mortality and increased Diagnostic Capacity

    OpenAIRE

    Vieira, F; Sanha, M; Riccardi, F; Colombatti, R

    2014-01-01

    Background: Tuberculosis (TB) is widespread in Africa, but weak health systems in developing countries, often display poor quality of care with delays in case identification, irrational therapy and drug shortage, clinical mismanagement, unnecessary expenditures for patients, reduced adherence and increased mortality. Public-private partnership has demonstrated to increase TB case detection, but less is known about its effects on quality of care, mortality and costs for hospitalized TB patient...

  10. Screening for genital tuberculosis in a limited resource country: case report

    OpenAIRE

    Namani, Sadie; Qehaja-Bu?aj, Emine; Namani, Diell?za

    2017-01-01

    Background Screening for benign or malignant process of pelvis in young females is a challenge for a physician in a limited resource country. Tuberculosis should be always considered in the differential diagnosis of a pelvic mass in countries with high prevalence of tuberculosis. Negative results of analysis of peritoneal fluid for acid-fast staining, late cultures, and unavailability of new diagnostics methods such as polymerase chain reaction and adenosine deaminase of the aspirated fluid f...

  11. Tuberculosis Data and Statistics

    Science.gov (United States)

    ... Advisory Groups Federal TB Task Force Data and Statistics Language: English (US) Español (Spanish) Recommend on Facebook ... Set) Mortality and Morbidity Weekly Reports Data and Statistics Decrease in Reported Tuberculosis Cases MMWR 2010; 59 ( ...

  12. Council of public health. Report of 1978

    International Nuclear Information System (INIS)

    1980-01-01

    Following a general introduction over the organisation and function of the Council of Public Health, of the work carried out by two philosophy committees, two deliberation groups and 60 general committees, during 1978, are presented. Included are reports from the philosophy committee for radiation hygiene and committees for food irradiation, disposal of radioactive waste and categorised radionuclide laboratories, guide-lines for radiation safety in hospitals and clinics, isotope laboratories, legal responsibility of radiation accidents, computer tomography, supplementary advice for nuclear energy, combustion furnace for radioactive waste, experiments on subjects with radioactive materials and systematic dental X-ray examination. (C.F.)

  13. Urgent Living-Donor Liver Transplantation in a Patient With Concurrent Active Tuberculosis: A Case Report.

    Science.gov (United States)

    Jung, B-H; Park, J-I; Lee, S-G

    2018-04-01

    Although active tuberculosis (TB) is considered a contraindication for liver transplantation (LT), this is the only treatment in patients with liver failure and concurrent active TB. We report a case with successful urgent living-donor LT for irreversible liver failure in the presence of active TB. A 48-year-old man, with a history of decompensated alcoholic liver cirrhosis, was presented with stupor. At admission, his consciousness had deteriorated to semi-coma, and his renal function also rapidly deteriorated to hepatorenal syndrome. A preoperative computed tomography scan of the chest revealed several small cavitary lesions in both upper lobes, and acid-fast bacillus stain from his sputum was graded 2+. Adenosine deaminase levels from ascites were elevated, suggesting TB peritonitis. A first-line anti-TB drug regimen was started immediately (rifampin, isoniazid, levofloxacin, and amikacin). An urgent living-donor LT was performed 2 days later. After LT, the regimen was changed to second-line anti-TB drugs (amikacin, levofloxacin, cycloserine, and pyridoxine). The sputum acid-fast bacillus stain tested negative on postoperative day 10. His liver function remained well preserved, even after the reversion to first-line anti-TB treatment. The patient recovered without any anti-TB medication-related complications and was discharged. LT can be prudently performed as a life-saving option, particularly for patients with liver failure and concurrent active TB. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Tuberculosis in Quebec: a review of trends

    Directory of Open Access Journals (Sweden)

    Alexander Klotz

    2012-06-01

    Full Text Available The aim of this research was to conduct a thorough review on the literature of tuberculosis in Canada and the Province of Quebec. To achieve this aim, an exhaustive literature review of tuberculosis in the Province of Quebec was undertaken. Data was collected with the goal of creating an epidemiological and public health evidence base to forecast the spread of tuberculosis. A keyword search strategy was used to find relevant articles from the peer-reviewed literature using the electronic search engine PubMed and a search of other relevant federal and provincial government databases. Twenty-nine peer-reviewed publications and twenty government reports containing information about the incidence or prevalence of tuberculosis in the Province of Quebec were included in the analysis. An analysis of the data revealed that while tuberculosis rates have been decreasing in both Canada and Quebec with an overall incidence below 3 per 100,000 of population in 2007, among immigrants and the Inuit communities in Quebec, the incidence and prevalence of the disease still remains high and reached 18 per 100,000 and 100 per 100,000, respectively in 2007. In general, while tuberculosis does not pose a significant burden to the general population, it does continue to affect certain sub-groups disproportionately, including select immigrants and Inuit communities in Quebec. Efforts to ensure that cost-effective healthcare interventions are delivered in a timely fashion should be pursued to reduce the associated morbidity and mortality of tuberculosis in the Province of Quebec.

  15. Searching for sex- and gender-sensitive tuberculosis research in public health: finding a needle in a haystack

    Directory of Open Access Journals (Sweden)

    Vissandjee B

    2016-12-01

    Full Text Available Bilkis Vissandjee,1 Assia Mourid,2 Christina A Greenaway,3 Wendy E Short,4 Jodi A Proctor5 1Faculty of Nursing, Public Health Research Institute, Université de Montréal, Montréal, Montréal, QC, Canada; 2Allied Health Library, Université de Montréal, Montréal, QC, Canada; 3Department of Medicine, McGill University, Division of Infectious Diseases, Jewish General Hospital, Montréal, QC, Canada; 4Faculty of Humanities and Social Sciences, School of Social Sciences, University of Queensland, St Lucia, QLD, Australia; 5School of Social Work, McGill University, Montréal, QC, Canada Abstract: Despite broadening consideration of sex- and gender-based issues in health research, when seeking information on how sex and gender contribute to disease contexts for specific health or public health topics, a lack of consistent or systematic use of terminology in health literature means that it remains difficult to identify research with a sex or gender focus. These inconsistencies are driven, in part, by the complexity and terminological inflexibility of the indexing systems for gender- and sex-related terms in public health databases. Compounding the issue are authors’ diverse vocabularies, and in some cases lack of accuracy in defining and using fundamental sex–gender terms in writing, and when establishing keyword lists and search criteria. Considering the specific case of the tuberculosis (TB prevention and management literature, an analysis of sex and gender sensitivity in three health databases was performed. While there is an expanding literature exploring the roles of both sex and gender in the trajectory and lived experience of TB, we demonstrate the potential to miss relevant research when attempting to retrieve literature using only the search criteria currently available. We, therefore, argue that for good clinical practice to be achieved; there is a need for both public health researchers and users to be better educated in appropriate

  16. Violence in public school: reports of teachers

    Directory of Open Access Journals (Sweden)

    Renata Carneiro Ferreira

    2010-03-01

    Full Text Available Objective: To assess the perception of violence from the reports of teachers of elementary and high school in a public state school in Fortaleza, Ceará. Method: A qualitative descriptive study conducted with 26 teachers, in the period from January to May 2006. To collect the data we adopted the following procedures: the discussion on school violence during the meetings of the teacher training week; the reading of the school regulations and the distribution of an instrument with the guiding question about the concept of violence as from the school reality, among the participants of the study. Afterwards, the thematic analysis of the reports was carried out. Results: Through the reports of teachers emerged the following categories: physical aggression, verbal aggression and fights as the most cited; to hide personal belongings, cursing, shoving and disrespect for the teacher and pranks were also mentioned. Conclusion: From the reports it appears that violence is perceived in physical, dimension moral and symbolic, and these “typologies” corroborate the descriptions found in literature as bullying or incivility, which dominate the school context.

  17. Immune responses to the Mycobacterium tuberculosis-specific antigen ESAT-6 signal subclinical infection among contacts of tuberculosis patients

    DEFF Research Database (Denmark)

    Doherty, T Mark; Demissie, Abebech; Olobo, Joseph

    2002-01-01

    Diagnosis of latent Mycobacterium tuberculosis infection is considered essential for tuberculosis control but is hampered by the lack of specific reagents. We report that strong recognition of tuberculosis complex-specific antigen ESAT-6 by healthy household contacts of tuberculosis patients...... correlates with the subsequent development of active tuberculosis during a 2-year follow-up period....

  18. Plant natural products research in tuberculosis drug discovery and ...

    African Journals Online (AJOL)

    Plant natural products research in tuberculosis drug discovery and development: A situation report ... African Journal of Biotechnology ... tuberculosis (XDR-TB), call for the development of new anti-tuberculosis drugs to combat this disease.

  19. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures

  20. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

    Science.gov (United States)

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping

  1. Energy and the public. Contry report Sweden

    International Nuclear Information System (INIS)

    Biel, A.; Svensson, O.; Dangaarden, B.

    1989-03-01

    This study reports data from Swedish investigations of attitudes towards different technologies for producing energy and energy conservation. The study surveys opinion polls and research made between 1978 and 1988. The results demonstrate the excessive interest in nuclear power which was in focus in a majority of the studies during that time. The results indicate that the Swedish public oscillates around 50 per cent for nucclear power and 50 per cent against. A number of studies of nuclear power attitudes were reviewed including topics such as worry, behavior following the Chernobyl fallout, beliefs about risks of Swedish program and policy issues regarding the phasing out of the Swedish nuclear power program. Preferences for alternatives to nuclear power were investigated in a series of studies. Here, hydropower was the single leading alternative; solar, wind and natural gas were other preferred alternatives. Attitudes to other energy sources were also summarized in the present study. The study concludes with some remarks on future directions of research on the public's perception of the production and the use of energy. (authors)

  2. OSTEOARTROPATIA HIPERTRÓFICA ASSOCIADA A TUBERCULOSE PULMONAR Hypertrophic osteoarthropathy in association with pulmonary tuberculosis: a case report

    Directory of Open Access Journals (Sweden)

    Luiza Beatriz Melo Moreira

    2002-01-01

    Full Text Available Neste artigo é descrito um caso de osteoartropatia hipertrófica associada a tuberculose pulmonar. Esta alteração é uma complicação rara da tuberculose e pode estar associada à forma grave e fulminante da doença. Entre os métodos de imagem utilizados no diagnóstico estavam radiografias dos membros inferiores, que mostravam reação periosteal bilateralmente, e radiografias e tomografia computadorizada do tórax, que evidenciaram massa no lobo superior do pulmão direito. Embora a punção aspirativa por agulha fina tivesse sido sugestiva de tuberculose, o diagnóstico definitivo foi dado pelo exame histopatológico da massa, após a realização de toracotomia. O paciente evoluiu com melhora sintomática e radiológica após o tratamento com drogas tuberculostáticas.In this article the authors report a case of a patient with hypertrophic osteoarthropathy associated with pulmonary tuberculosis. This disorder is a rare complication of tuberculosis and may be associated with severe and fulminant disease. The imaging methods used in the diagnosis of this disease included lower limbs radiographies that showed bilateral periosteal reaction, and chest radiographies and computed tomography that revealed a mass in the upper lobe of the right lung. Although a fine needle aspiration was suggestive of tuberculosis, the definitive diagnosis was made after thoracotomy and hystopathological examination of the mass. The patient presented symptomatic and radiological improvement after treatment of tuberculosis.

  3. Pulmonary tuberculosis of occupational origin in a funeral director: A case report

    Directory of Open Access Journals (Sweden)

    Anna Witkowska

    2014-06-01

    Full Text Available In Poland the incidence rate of tuberculosis is higher than the average for countries of the European Union, Norway or Iceland. On the other hand, occupational tuberculosis is still rarely recognized in our country. In this paper we present the first in Poland- to our best knowledge - case of pulmonary manifestation of this disease acquired at work in a funeral director. The recognition of the occupational etiology of the discussed illness gave rise to an array of diagnostic problems and became feasible after a thorough analysis of the patient's history and literature data, which allowed finding the relationship between infection and performed job. We speculated that the transfer of the dead body and handling of cadavers may expel residual air from the lungs of the deceased. Although tuberculosis occurs frequently in the general population, the recognition of work-related cases of this disease is still rare, especially among funeral directors. Med Pr 2014;65(3:429–435

  4. [Pulmonary tuberculosis of occupational origin in a funeral director: a case report].

    Science.gov (United States)

    Witkowska, Anna; Wiszniewska, Marta; Krakowiak, Anna; Walusiak-Skorupa, Jolanta

    2014-01-01

    In Poland the incidence rate of tuberculosis is higher than the average for countries of the European Union, Norway or Iceland. On the other hand, occupational tuberculosis is still rarely recognized in our country. In this paper we present the first in Poland--to our best knowledge--case of pulmonary manifestation of this disease acquired at work in a funeral director. The recognition of the occupational etiology of the discussed illness gave rise to an array of diagnostic problems and became feasible after a thorough analysis of the patient's history and literature data, which allowed finding the relationship between infection and performed job. We speculated that the transfer of the dead body and handling of cadavers may expel residual air from the lungs of the deceased. Although tuberculosis occurs frequently in the general population, the recognition of work-related cases of this disease is still rare, especially among funeral directors.

  5. Tuberculosis abdominal Abdominal tuberculosis

    OpenAIRE

    T. Rubio; M. T. Gaztelu; A. Calvo; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría

    2005-01-01

    La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...

  6. Segmental tuberculosis verrucosa cutis

    Directory of Open Access Journals (Sweden)

    Hanumanthappa H

    1994-01-01

    Full Text Available A case of segmental Tuberculosis Verrucosa Cutis is reported in 10 year old boy. The condition was resembling the ascending lymphangitic type of sporotrichosis. The lesions cleared on treatment with INH 150 mg daily for 6 months.

  7. NNDSS - Table III. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table III. Tuberculosis - 2018.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  8. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2016.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  9. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2014.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  10. NNDSS - Table III. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table III. Tuberculosis - 2017.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  11. NNDSS - Table IV. Tuberculosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table IV. Tuberculosis - 2015.This Table includes total number of cases reported in the United States, by region and by states, in accordance with the...

  12. Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil.

    Science.gov (United States)

    Harling, Guy; Lima Neto, Antonio S; Sousa, Geziel S; Machado, Marcia M T; Castro, Marcia C

    2017-05-25

    Tuberculosis (TB) remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil), the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT). These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN) from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%), a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not. Low socioeconomic status areas have higher tuberculosis

  13. 10. A case series report of Tuberculosis patients with Vitamin D ...

    African Journals Online (AJOL)

    user

    An association of Vitamin D deficiency with. Tuberculosis remains a valid ... with darker skins are prone to vitamin D deficiency. The regions inhabited by people with darker skin coincides with high TB burden settings. Vitamin D has a key role in ... melanin which absorb sultraviolet B radiation rendering it less available for ...

  14. Poncet's disease: Reactive arthritis accompanying tuberculosis. Two case reports and a review of the literature

    NARCIS (Netherlands)

    E.-J.A. Kroot (Eric-Jan); J.M.W. Hazes (Mieke); E.M. Colin (Edgar); R.J.E.M. Dolhain (Radboud)

    2007-01-01

    textabstractObjective. Reactive arthritis (ReA) in tuberculosis (TB) is known as Poncet's disease. It is a rare aseptic form of arthritis observed in patients with active TB. We present two such patients and review the literature on Poncet's disease. Methods. Two patients who were identified with

  15. Descriptive review of tuberculosis surveillance systems across the circumpolar regions

    Directory of Open Access Journals (Sweden)

    Annie-Claude Bourgeois

    2016-04-01

    Full Text Available Background: Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB Working Group collaborate to increase knowledge about tuberculosis in Arctic regions. Objective: To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions. Design: Three questionnaires were developed to reflect the different surveillance levels (local, regional and national; all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination. Results: Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon, Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic, United States (Alaska] voluntarily completed the survey – representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7 and commercial software (n=6. Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences. Conclusion: This review successfully establishes

  16. Abdominal tuberculosis, a diagnostic dilemma: report of a series of cases

    Directory of Open Access Journals (Sweden)

    Richard Castillo Ramos

    2015-09-01

    Full Text Available INTRODUCCIÓN La tuberculosis abdominal es una de las variantes extrapulmonares más frecuentes. Se relaciona a estados de inmunodepresión y, dado su cuadro clínico inespecífico, su diagnóstico es difícil. Nuestro objetivo es presentar una serie de siete casos diagnosticados de tuberculosis abdominal que requirieron cirugía en el Hospital Clínico de la Pontificia Universidad Católica de Chile. MÉTODOS Se realizó un análisis descriptivo de los siete casos de tuberculosis abdominal operados en nuestro centro entre agosto de 2001 y junio de 2013, caracterizando su presentación clínica y elementos diagnósticos requeridos. RESULTADOS Cuatro hombres y tres mujeres (entre 29 y 68 años fueron diagnosticados y operados de tuberculosis abdominal: tres en su forma peritoneal, dos ganglionar y dos intestinal. En tres casos la tuberculosis abdominal se asoció a inmunosupresión (VIH y artritis reumatoide en tratamiento y en seis casos se presentó con síndrome consuntivo de al menos un mes de evolución. Tres pacientes tuvieron una presentación aguda con signos de obstrucción intestinal. El diagnóstico fue realizado mediante biopsia quirúrgica. Los siete pacientes fueron intervenidos quirúrgicamente, tres de ellos requirieron resección intestinal en el contexto de obstrucción intestinal.

  17. Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient

    Directory of Open Access Journals (Sweden)

    Bianca Barone

    Full Text Available We describe a case of a male patient, 38 years old, HIV-positive (most recent CD4 count about 259/mm³, with abdominal pain, nausea, vomiting, anorexia, weight loss, and vespertine high fever with chills. His hemogram showed normocytic and normochromic anemia, with a high erythrocyte sedimentation rate (ESR and gross granulations in the neutrophils. Transaminases were normal. Bone marrow biopsy evidenced a chronic disease anemia pattern and a lack of infectious agents. Abdominal ultrasound examination showed a normal-size spleen, which exhibited heterogeneous parenchyma and multiple small hypoechoic images, together with small ascites, peripancreatic and para-aortic lymphadenopathy. These findings were confirmed by abdominal CT. The liver was normal in size, but had a hyperechoic image, which was not visualized on CT. Histopathological analysis of one of the multiple abdominal lymph nodes obtained by laparoscopic biopsy exhibited a chronic granulomatous inflammatory process, with caseous necrosis. Tissue sections were positive for BAAR (acid-alcohol-resistant bacillus, and the cultures were positive for Mycobacterium tuberculosis. Anti-tuberculosis treatment was begun, and the patient evolved with improvement of his general state, fever remission and weight gain. Splenic tuberculosis is a rare disease, occurring predominantly in patients in late stages of AIDS and/or disseminated tuberculosis. It is a difficult diagnosis, since there are no specific findings. Hence, complementary examinations, such as abdominal ultrasound/ CT, or fine needle aspiration, are usually necessary for investigation and differential diagnosis. Often, lesion regression after anti-tuberculosis regimens can be seen, and splenectomy is restricted to complicated or refractory disease.

  18. Hazardous and Harmful Alcohol Use and Associated Factors in Tuberculosis Public Primary Care Patients in South Africa

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-09-01

    Full Text Available The aim of this study was to assess the prevalence of hazardous and harmful alcohol use and associated factors among patients with tuberculosis in South Africa. In a cross-sectional survey new tuberculosis (TB and TB retreatment patients were consecutively screened using the Alcohol Use Disorder Identification Test (AUDIT within one month of anti-tuberculosis treatment. The sample included 4,900 (54.5% men and women 45.5% tuberculosis patients from 42 primary care clinics in three districts. Results indicate that, overall 23.2% of the patients were hazardous or harmful alcohol drinkers, 31.8% of men and 13.0% of women were found to be hazardous drinkers, and 9.3% of men and 3.4% of women meet criteria for probable alcohol dependence (harmful drinking as defined by the AUDIT. Men had significantly higher AUDIT scores than women. In multivariable analyses it was found that among men poor perceived health status, tobacco use, psychological distress, being a TB retreatment patient and not being on antiretroviral therapy (ART, and among women lower education, tobacco use and being a TB retreatment patient were associated with hazardous or harmful alcohol use. The study found a high prevalence of hazardous or harmful alcohol use among tuberculosis primary care patients. This calls for screening and brief intervention and a comprehensive alcohol treatment programme as a key component of TB management in South Africa.

  19. Mycobacterium tuberculosis infection in cattle from the Eastern Cape Province of South Africa.

    Science.gov (United States)

    Hlokwe, Tiny Motlatso; Said, Halima; Gcebe, Nomakorinte

    2017-10-10

    Mycobacterium tuberculosis is the main causative agent of tuberculosis (TB) in human and Mycobacterium bovis commonly causes tuberculosis in animals. Transmission of tuberculosis caused by both pathogens can occur from human to animals and vice versa. In the current study, M. tuberculosis, as confirmed by polymerase chain reaction (PCR) using primers targeting 3 regions of difference (RD4, RD9 and RD12) on the genomes, was isolated from cattle originating from two epidemiologically unrelated farms in the Eastern Cape (E.C) Province of South Africa. Although the isolates were genotyped with variable number of tandem repeat (VNTR) typing, no detailed epidemiological investigation was carried out on the respective farms to unequivocally confirm or link humans as sources of TB transmission to cattle, a move that would have embraced the 'One Health' concept. In addition, strain comparison with human M. tuberculosis in the database from the E.C Province and other provinces in the country did not reveal any match. This is the first report of cases of M. tuberculosis infection in cattle in South Africa. The VNTR profiles of the M. tuberculosis strains identified in the current study will form the basis for creating M. tuberculosis VNTR database for animals including cattle for future epidemiological studies. Our findings however, call for urgent reinforcement of collaborative efforts between the veterinary and the public health services of the country.

  20. Smear positive pulmonary tuberculosis among suspected patients ...

    African Journals Online (AJOL)

    Background: Tuberculosis is a major public health problem throughout the world. Nearly one third of the world's population is infected with Mycobacterium tuberculosis (MTB) and hence at risk of developing active disease. Tuberculosis is a major cause of morbidity and mortality in Ethiopia, and the country belongs to one of ...

  1. Some haematological parameters of tuberculosis infected Nigerians ...

    African Journals Online (AJOL)

    Tuberculosis is a major public health problem in Nigeria. Drug resistant tuberculosis is now common place due to poor patient compliance and lack of detection of resistant strains. The occurrence of HIV has been responsible for an increased frequency of tuberculosis. Knowledge of the blood picture in pulmonary ...

  2. Genitourinary tuberculosis

    International Nuclear Information System (INIS)

    Matos, Maria Joao; Bacelar, Maria Teresa; Pinto, Pedro; Ramos, Isabel

    2005-01-01

    Although uncommon, genitourinary tuberculosis is the most common site of extrapulmonary tuberculosis infection. Its diagnosis is often difficult. This article provides an overview of the pathologic and radiologic findings of this disease process

  3. Tuberculosis Fluoroscopy

    Science.gov (United States)

    Follow-up though Dec 31, 2002 has been completed for a study of site-specific cancer mortality among tuberculosis patients treated with artificial lung collapse therapy in Massachusetts tuberculosis sanatoria (1930-1950).

  4. A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report

    International Nuclear Information System (INIS)

    Oh, Ji Young; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Lee, Seung Ro; Lee, Young Jun

    2010-01-01

    Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis

  5. A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ji Young; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Lee, Seung Ro; Lee, Young Jun [Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of)

    2010-08-15

    Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis

  6. Public Report on Health (India) - Phase II | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Public Report on Health aims to draw federal and state attention to the health needs of ordinary people, so as to develop evidence-based solutions for meeting those needs. The Intensive Village Study carried out during the first phase of ... Outputs. Reports. Public report on health : final technical report. Download PDF ...

  7. Factors associated with performing tuberculosis screening of HIV-positive patients in Ghana: LASSO-based predictor selection in a large public health data set

    Directory of Open Access Journals (Sweden)

    Susanne Mueller-Using

    2016-07-01

    Full Text Available Abstract Background The purpose of this study is to propose the Least Absolute Shrinkage and Selection Operators procedure (LASSO as an alternative to conventional variable selection models, as it allows for easy interpretation and handles multicollinearities. We developed a model on the basis of LASSO-selected parameters in order to link associated demographical, socio-economical, clinical and immunological factors to performing tuberculosis screening in HIV-positive patients in Ghana. Methods Applying the LASSO method and multivariate logistic regression analysis on a large public health data set, we selected relevant predictors related to tuberculosis screening. Results One Thousand Ninety Five patients infected with HIV were enrolled into this study with 691 (63.2 % of them having tuberculosis screening documented in their patient folders. Predictors found to be significantly associated with performance of tuberculosis screening can be classified into factors related to the clinician’s perception of the clinical state, as well as those related to PLHIV’s awareness. These factors include newly diagnosed HIV infections (n = 354 (32.42 %, aOR 1.84, current CD4+ T cell count (aOR 0.92, non-availability of HIV type (n = 787 (72.07 %, aOR 0.56, chronic cough (n = 32 (2.93 %, aOR 5.07, intake of co-trimoxazole (n = 271 (24.82 %, aOR 2.31, vitamin supplementation (n = 220 (20.15 %, aOR 2.64 as well as the use of mosquito bed nets (n = 613 (56.14 %, aOR 1.53. Conclusions Accelerated TB screening among newly diagnosed HIV-patients indicates that application of the WHO screening form for intensifying tuberculosis case finding among HIV-positive individuals in resource-limited settings is increasingly adopted. However, screening for TB in PLHIV is still impacted by clinician’s perception of patient’s health state and PLHIV’s health awareness. Education of staff, counselling of PLHIV and sufficient financing are

  8. Evaluación en salud pública: lecciones aprendidas de la gestión de la tuberculosis pulmonar Measurement in Public Health: what pulmonary tuberculosis management has taught us

    Directory of Open Access Journals (Sweden)

    C. Patrick Chaulk

    2008-08-01

    (case studies, retrospective and case-control studies, forecasting/modeling, and cost effectiveness analysis and 2 emerging and promising approaches (quality of life assessment and indicators of the continuum of care are presented. Several of the evaluation strategies reviewed indicate that treatment programs using directly observed therapy (DOT that are comprehensive, community-based and patient-centered achieve the highest treatment completion rates. Combinations of these strategies are recommended to create a body of evidence capturing the impact and nuances of community-based public health interventions in improving health outcomes, in this case for patients with pulmonary tuberculosis.

  9. Bovine tuberculosis

    Science.gov (United States)

    Tuberculosis (TB) in animals and humans may result from exposure to bacilli within the Mycobacterium tuberculosis complex (i.e., M. tuberculosis, M. bovis, M. africanum, M. pinnipedii, M. microti, M. caprae, or M. canetti) . Mycobacterium bovis is the species most often isolated from tuberculous cat...

  10. 49 CFR 397.73 - Public information and reporting requirements.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Public information and reporting requirements. 397.73 Section 397.73 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL... Hazardous Materials § 397.73 Public information and reporting requirements. (a) Public information...

  11. Market size and sales pattern of tuberculosis drugs in the Philippines.

    Science.gov (United States)

    Islam, T; van Weezenbeek, C; Vianzon, R; Garfin, A M C G; Hiatt, T; Lew, W J; Tisocki, K

    2013-12-21

    To identify the availability, types and quantity of anti-tuberculosis drugs in the public and private sectors from 2007 to 2011 in the Philippines. Analysis of the procurement of and sales data on anti-tuberculosis drugs from both the public and private sectors from 2007 to 2011. Publicly procured anti-tuberculosis drugs were sufficient to treat all reported new tuberculosis (TB) cases from 2007 to 2011 in the Philippines. Nevertheless, the volume of anti-tuberculosis drugs in the private sector would have sufficed for the intensive phase of treatment for an additional 250 000 TB patients annually, assuming compliance with national treatment guidelines. Fixed-dose combination drugs comprised the main bulk (81%) of private market sales, while sales of loose drugs decreased over the years. Combining public and private sales in 2011, 484 725 new TB patients, i.e., 2.4 times the number of notified cases, could have been placed on treatment and treated for at least the intensive phase. Key second-line drugs are not available in the private market, making it impossible to design an adequate treatment regimen for multidrug-resistant TB (MDR-TB) in the private sector. An enormous quantity of anti-tuberculosis drugs was channelled through the private market outside the purview of the Philippine National Tuberculosis Control Program, suggesting significant out-of-pocket expenditure, severe underreporting of TB cases and/or misuse of drugs due to overdiagnosis and overtreatment.

  12. The high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) in a large Zambian prison: a public health alert.

    Science.gov (United States)

    Henostroza, German; Topp, Stephanie M; Hatwiinda, Sisa; Maggard, Katie R; Phiri, Winifreda; Harris, Jennifer B; Krüüner, Annika; Kapata, Nathan; Ayles, Helen; Chileshe, Chisela; Reid, Stewart E

    2013-01-01

    Tuberculosis (TB) and human immunodeficiency virus (HIV) represent two of the greatest health threats in African prisons. In 2010, collaboration between the Centre for Infectious Disease Research in Zambia, the Zambia Prisons Service, and the National TB Program established a TB and HIV screening program in six Zambian prisons. We report data on the prevalence of TB and HIV in one of the largest facilities: Lusaka Central Prison. Between November 2010 and April 2011, we assessed the prevalence of TB and HIV amongst inmates entering, residing, and exiting the prison, as well as in the surrounding community. The screening protocol included complete history and physical exam, digital radiography, opt-out HIV counseling and testing, sputum smear and culture. A TB case was defined as either bacteriologically confirmed or clinically diagnosed. A total of 2323 participants completed screening. A majority (88%) were male, median age 31 years and body mass index 21.9. TB symptoms were found in 1430 (62%). TB was diagnosed in 176 (7.6%) individuals and 52 people were already on TB treatment at time of screening. TB was bacteriologically confirmed in 88 cases (3.8%) and clinically diagnosed in 88 cases (3.8%). Confirmed TB at entry and exit interventions were 4.6% and 5.3% respectively. Smear was positive in only 25% (n = 22) of bacteriologically confirmed cases. HIV prevalence among inmates currently residing in prison was 27.4%. Ineffective TB and HIV screening programs deter successful disease control strategies in prison facilities and their surrounding communities. We found rates of TB and HIV in Lusaka Central Prison that are substantially higher than the Zambian average, with a trend towards concentration and potential transmission of both diseases within the facility and to the general population. Investment in institutional and criminal justice reform as well as prison-specific health systems is urgently required.

  13. The High Burden of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) in a Large Zambian Prison: A Public Health Alert

    Science.gov (United States)

    Henostroza, German; Topp, Stephanie M.; Hatwiinda, Sisa; Maggard, Katie R.; Phiri, Winifreda; Harris, Jennifer B.; Krüüner, Annika; Kapata, Nathan; Ayles, Helen; Chileshe, Chisela; Reid, Stewart E.

    2013-01-01

    Background Tuberculosis (TB) and human immunodeficiency virus (HIV) represent two of the greatest health threats in African prisons. In 2010, collaboration between the Centre for Infectious Disease Research in Zambia, the Zambia Prisons Service, and the National TB Program established a TB and HIV screening program in six Zambian prisons. We report data on the prevalence of TB and HIV in one of the largest facilities: Lusaka Central Prison. Methods Between November 2010 and April 2011, we assessed the prevalence of TB and HIV amongst inmates entering, residing, and exiting the prison, as well as in the surrounding community. The screening protocol included complete history and physical exam, digital radiography, opt-out HIV counseling and testing, sputum smear and culture. A TB case was defined as either bacteriologically confirmed or clinically diagnosed. Results A total of 2323 participants completed screening. A majority (88%) were male, median age 31 years and body mass index 21.9. TB symptoms were found in 1430 (62%). TB was diagnosed in 176 (7.6%) individuals and 52 people were already on TB treatment at time of screening. TB was bacteriologically confirmed in 88 cases (3.8%) and clinically diagnosed in 88 cases (3.8%). Confirmed TB at entry and exit interventions were 4.6% and 5.3% respectively. Smear was positive in only 25% (n = 22) of bacteriologically confirmed cases. HIV prevalence among inmates currently residing in prison was 27.4%. Conclusion Ineffective TB and HIV screening programs deter successful disease control strategies in prison facilities and their surrounding communities. We found rates of TB and HIV in Lusaka Central Prison that are substantially higher than the Zambian average, with a trend towards concentration and potential transmission of both diseases within the facility and to the general population. Investment in institutional and criminal justice reform as well as prison-specific health systems is urgently required. PMID

  14. Socioeconomic status and self-reported tuberculosis: a multilevel analysis in a low-income township in the Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Jane Murray Cramm

    2011-09-01

    Full Text Available Few studies have investigated the interplay of multiple factors affecting the prevalence of tuberculosis in developing countries. The compositional and contextual factors that affect health and disease patterns must be fully understood to successfully control tuberculosis. Experience with tuberculosis in South Africa was examined at the household level (overcrowding, a leaky roof, social capital, unemployment, income and at the neighbourhood level (Gini coefficient of inequality, unemployment rate, headcount poverty rate. A hierarchical random-effects model was used to assess household-level and neighbourhood-level effects on self-reported tuberculosis experience. Every tenth household in each of the 20 Rhini neighbourhoods was selected for inclusion in the sample. Eligible respondents were at least 18 years of age and had been residents of Rhini for at least six months of the previous year. A Kish grid was used to select one respondent from each targeted household, to ensure that all eligible persons in the household stood an equal chance of being included in the survey. We included 1020 households within 20 neighbourhoods of Rhini, a suburb of Grahamstown in the Eastern Cape, South Africa. About one-third of respondents (n=329; 32% reported that there had been a tuberculosis case within the household. Analyses revealed that overcrowding (P≤0.05 and roof leakage (P≤ 0.05 contributed significantly to the probability of a household TB experience, whereas higher social capital (P≤0.01 significantly reduced this probability. Overcrowding, roof leakage and the social environment affected tuberculosis prevalence in this economically disadvantaged community. Policy makers should consider the possible benefits of programs that deal with housing and social environments when addressing the spread of tuberculosis in economically poor districts.

  15. Pulmonary tuberculosis and lung cancer: simultaneous and sequential occurrence

    Directory of Open Access Journals (Sweden)

    Denise Rossato Silva

    2013-06-01

    Full Text Available OBJECTIVE: Lung cancer (LC is the leading cause of cancer-related death and represents a major public health problem worldwide. Another major cause of morbidity and mortality, especially in developing countries, is tuberculosis. The simultaneous or sequential occurrence of pulmonary tuberculosis and LC in the same patient has been reported in various case series and case-control studies. The objective of this study was to describe the characteristics of patients developing tuberculosis and LC, either simultaneously or sequentially. METHODS: This was a cross-sectional study based on the review of medical charts. RESULTS: The study involved 24 patients diagnosed with tuberculosis and LC between 2009 and 2012. The diagnoses of tuberculosis and LC occurred simultaneously in 10 patients, whereas tuberculosis was diagnosed prior to LC in 14. The median time between the two diagnoses was 5 years (interquartile range: 1-30 years. Fourteen patients (58.3% were male, 20 (83.3% were White, and 22 (91.7% were smokers or former smokers. The most common histological type was adenocarcinoma, identified in 14 cases (58.3%, followed by epidermoid carcinoma, identified in 6 (25.0%. Seven patients (29.2% presented with distant metastases at diagnosis; of those 7 patients, 5 (71% were diagnosed with LC and tuberculosis simultaneously. CONCLUSIONS: In the present study, most of the patients with tuberculosis and LC were smokers or former smokers, and tuberculosis was diagnosed either before or simultaneously with LC. Non-small cell lung cancer, especially adenocarcinoma, was the most common histological type.

  16. CDC WONDER: Online Tuberculosis Information System (OTIS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Online Tuberculosis Information System (OTIS) on CDC WONDER contains information on verified tuberculosis (TB) cases reported to the Centers for Disease Control...

  17. LAFLA public transportation public participation pilot program : final technical report.

    Science.gov (United States)

    2012-12-01

    This report documents and presents the results of a pilot project conducted by the Legal Aid Foundation of Los Angeles (LAFLA). LAFLA identified that there is a perception among those living in and providing services to low-income communities that tr...

  18. Multidrug-resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    McNerney Ruth

    2008-01-01

    Full Text Available Abstract Background With almost 9 million new cases each year, tuberculosis remains one of the most feared diseases on the planet. Led by the STOP-TB Partnership and WHO, recent efforts to combat the disease have made considerable progress in a number of countries. However, the emergence of mutated strains of Mycobacterium tuberculosis that are resistant to the major anti-tuberculosis drugs poses a deadly threat to control efforts. Multidrug-resistant tuberculosis (MDR-TB has been reported in all regions of the world. More recently, extensively drug resistant-tuberculosis (XDR-TB that is also resistant to second line drugs has emerged in a number of countries. To ensure that adequate resources are allocated to prevent the emergence and spread of drug resistance it is important to understand the scale of the problem. In this article we propose that current methods of describing the epidemiology of drug resistant tuberculosis are not adequate for this purpose and argue for the inclusion of population based statistics in global surveillance data. Discussion Whereas the prevalence of tuberculosis is presented as the proportion of individuals within a defined population having disease, the prevalence of drug resistant tuberculosis is usually presented as the proportion of tuberculosis cases exhibiting resistance to anti-tuberculosis drugs. Global surveillance activities have identified countries in Eastern Europe, the former Soviet Union and regions of China as having a high proportion of MDR-TB cases and international commentary has focused primarily on the urgent need to improve control in these settings. Other regions, such as sub-Saharan Africa have been observed as having a low proportion of drug resistant cases. However, if one considers the incidence of new tuberculosis cases with drug resistant disease in terms of the population then countries of sub-Saharan Africa have amongst the highest rates of transmitted MDR-TB in the world. We propose

  19. Primary tuberculosis of the glans penis-a rare case report

    Directory of Open Access Journals (Sweden)

    Rajashree Panigrahy

    2014-09-01

    Full Text Available A 36 year old man was diagnosed with tuberculosis of glans penis. The patient was positive to Mantoux test and Ziehl-Neelsen staining of the exuding pus from penile lesion. The antitubercular regimen of directly observed treatment short-course programme, for 3 d a week for 6 months was given to the patient. The tuberculoid growth was disappeared and the patient became normal, and in routine follow ups no ailment was noticed. This was as a case of primary tuberculosis at glans penis. It was discussed that an infection from tubercle bacilli of genitals in adults might arise as a primary focus or as a secondary one from some other foci.

  20. Guidelines for submitting adverse event reports for publication

    NARCIS (Netherlands)

    Kelly, William; Arellano, Felix; Barnes, Joanne; Bergman, Ulf; Edwards, Ralph; Fernandez, Alina; Freedman, Stephen; Goldsmith, David; Huang, Kui; Jones, Judith; McLeay, Rachel; Moore, Nicholas; Stather, Rosie; Trenque, Thierry; Troutman, William; van Puijenbroek, Eugène; Williams, Frank; Wise, Robert

    2009-01-01

    Publication of case reports describing suspected adverse effects of drugs and medical products that include herbal and complementary medicines, vaccines and other biologicals and devices is important for postmarketing surveillance. Publication lends credence to important signals raised in these

  1. Reporting ethics committee approval in public administration research.

    Science.gov (United States)

    Jordan, Sara R; Gray, Phillip W

    2014-03-01

    While public administration research is thriving because of increased attention to social scientific rigor, lingering problems of methods and ethics remain. This article investigates the reporting of ethics approval within public administration publications. Beginning with an overview of ethics requirements regarding research with human participants, I turn to an examination of human participants protections for public administration research. Next, I present the findings of my analysis of articles published in the top five public administration journals over the period from 2000 to 2012, noting the incidences of ethics approval reporting as well as funding reporting. In explicating the importance of ethics reporting for public administration research, as it relates to replication, reputation, and vulnerable populations, I conclude with recommendations for increasing ethics approval reporting in public administration research.

  2. A Case of False-Positive Mycobacterium tuberculosis Caused by Mycobacterium celatum

    Directory of Open Access Journals (Sweden)

    Edward Gildeh

    2016-01-01

    Full Text Available Mycobacterium celatum is a nontuberculous mycobacterium shown to cause symptoms similar to pulmonary M. tuberculosis. Certain strains have been shown to cross-react with the probes used to detect M. tuberculosis, making this a diagnostic challenge. We present a 56-year-old gentleman who developed signs and symptoms of lung infection with computed tomography scan of the chest showing right lung apex cavitation. Serial sputum samples were positive for acid-fast bacilli and nucleic acid amplification testing identified M. tuberculosis ribosomal RNA, resulting in treatment initiation. Further testing with high performance liquid chromatography showed a pattern consistent with M. celatum. This case illustrates the potential for M. celatum to mimic M. tuberculosis in both its clinical history and laboratory testing due to the identical oligonucleotide sequence contained in both. An increasing number of case reports suggest that early reliable differentiation could reduce unnecessary treatment and public health intervention associated with misdiagnosed tuberculosis.

  3. Colorectal tuberculosis

    International Nuclear Information System (INIS)

    Nagi, B.; Kochhar, R.; Bhasin, D.K.; Singh, K.

    2003-01-01

    Our objective was to evaluate the incidence of colorectal tuberculosis in our series and to study its radiological spectrum. A total of 684 cases of proven gastrointestinal tuberculosis with positive barium contrast findings seen over a period of more than one decade were evaluated. The study did not include cases where colon was involved in direct contiguity with ileo-caecal tuberculosis. Seventy-four patients (10.8%) had colorectal tuberculosis. Commonest site involved was transverse colon, closely followed by rectum and ascending colon. Radiological findings observed were in the form of strictures (54%), colitis (39%) and polypoid lesions (7%). Complications noted were in the form of perforations and fistulae in 18.9% of cases. Colorectal tuberculosis is a very common site for gastrointestinal tuberculosis. Typical findings of colorectal tuberculosis are strictures, signs of colitis and polypoid lesions. Common complications are perforation and fistulae. (orig.)

  4. Miliary tuberculosis with no pulmonary involvement in myelodysplastic syndromes: a curable, yet rarely diagnosed, disease: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Krambovitis Elias

    2008-03-01

    Full Text Available Abstract Background Although tuberculosis is not uncommon among patients with myelodysplastic syndrome (MDS, only a few reports of such patients suffering from miliary tuberculosis (MT exist. MT often presents as a fever of unknown origin and it is a curable disease, yet fatal if left untreated. Case presentation We report a case of MT with no clinical or laboratory indications of pulmonary involvement in a patient with MDS, and review the relevant literature. Mycobacterium tuberculosis was isolated from the liquid culture of a bone marrow aspirate. Conclusion Even if the initial diagnostic investigation for a fever of obscure etiology is negative, MT should not be excluded from the differential diagnosis list. Since it is a curable disease, persistent and vigorous diagnostic efforts are warranted. In suspected cases, mycobacterial blood cultures should be collected as soon as possible after hospital admission and early bone marrow aspirate with mycobacterial cultures is advocated.

  5. Public Relations Education: 1983 Survey and Report.

    Science.gov (United States)

    Walker, Albert

    1984-01-01

    Provides results of a survey of public relations education at 30 colleges and universities with respect to an examination of 115 syllabi, course requirements and reading lists, and innovative practices. (PD)

  6. A rare presentation of disseminated tuberculosis: Prostatic abscess.

    Science.gov (United States)

    Verma, Ajay; Singh, Anubhuti; Kishore, Kislay; Kant, Surya

    2017-10-01

    Involvement of the prostate by tuberculosis (TB) occurs rarely and tuberculosis prostate abscess is an even rarer occurrence. It has been reported in immunocompromised patients, mainly human immunodeficiency virus seropositive individuals. We are reporting a case of tuberculosis prostatic abscess in an immunocompetent patient with relapse of TB. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  7. Tuberculosis (TB): Treatment

    Science.gov (United States)

    ... Education & Training Home Conditions Tuberculosis (TB) Tuberculosis: Treatment Tuberculosis: Treatment Make an Appointment Refer a Patient Ask ... or bones is treated longer. NEXT: Preventive Treatment Tuberculosis: Diagnosis Tuberculosis: History Clinical Trials For more than ...

  8. Living with Tuberculosis

    Science.gov (United States)

    ... Diseases > Lung Disease Lookup > Tuberculosis (TB) Living With Tuberculosis What to Expect You will need regular checkups ... XML file."); } }); } } --> Blank Section Header Lung Disease Lookup Tuberculosis (TB) Learn About Tuberculosis Tuberculosis Symptoms, Causes & Risk ...

  9. Adverse event reporting in cancer clinical trial publications.

    Science.gov (United States)

    Sivendran, Shanthi; Latif, Asma; McBride, Russell B; Stensland, Kristian D; Wisnivesky, Juan; Haines, Lindsay; Oh, William K; Galsky, Matthew D

    2014-01-10

    Reporting adverse events is a critical element of a clinical trial publication. In 2003, the Consolidated Standards of Reporting Trials (CONSORT) group generated recommendations regarding the appropriate reporting of adverse events. The degree to which these recommendations are followed in oncology publications has not been comprehensively evaluated. A review of citations from PubMed, Medline, and Embase published between Jan 1, 2009 and December 31, 2011, identified eligible randomized, controlled phase III trials in metastatic solid malignancies. Publications were assessed for 14 adverse event-reporting elements derived from the CONSORT harms extension statement; a completeness score (range, 0 to 14) was calculated by adding the number of elements reported. Linear regression analysis identified which publication characteristics associated with reporting completeness. A total of 175 publications, with data for 96,125 patients, were included in the analysis. The median completeness score was eight (range, three to 12). Most publications (96%) reported only adverse events occurring above a threshold rate or severity, 37% did not specify the criteria used to select which adverse events were reported, and 88% grouped together adverse events of varying severity. Regression analysis revealed that trials without a stated funding source and with an earlier year of publication had significantly lower completeness scores. Reporting of adverse events in oncology publications of randomized trials is suboptimal and characterized by substantial selectivity and heterogeneity. The development of oncology-specific standards for adverse event reporting should be established to ensure consistency and provide critical information required for medical decision-making.

  10. ZBTB16-RARα variant of acute promyelocytic leukemia with tuberculosis: a case report and review of literature.

    Science.gov (United States)

    Palta, Anshu; Dhiman, Pratibha; Cruz, Sanjay D

    2012-09-01

    A 23-year-old male presented with pulmonary tuberculosis and swelling of both lower limbs. He was put on antitubercular treatment. Hemogram showed mild anemia and Pseudo Pelger-huet cells. The bone marrow (BM) examination showed 52% promyelocytes with regular round to oval nuclei, few granules and were positive for CD13 and CD33, and negative for HLA-DR. Cytogenetic analysis of the BM aspirate revealed an apparently balanced t(11;17)(q23;q21). Final diagnosis rendered was acute promyelocytic leukemia (APL) with t(11;17)(q23;q21); ZBTB16/RARA. APL is a distinct subtype of acute myeloid leukemia. The variant APL with t(11;17)(q23;q21) cases that are associated with the ZBTB16/RARA fusion gene have been reported as being resistant to all-trans-retinoic acid (ATRA). Therefore, differential diagnosis of variant APL with t(11;17)(q23;q12) from classical APL with t(15;17)(q22;q12); PML-RARA is very important. Here we have discussed the importance of distinct morphology of variant APL and also significance of rare presentation with tuberculosis.

  11. Renal tuberculosis

    Directory of Open Access Journals (Sweden)

    Džamić Zoran

    2016-01-01

    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  12. International or national publication of case reports.

    Science.gov (United States)

    Lundh, Andreas; Christensen, Mikkel; Jørgensen, Anders W

    2011-02-01

    Case reports are often regarded as second-class research, but are an important part of medical science as they often present first evidence of new discoveries. We here describe the type of case reports published in a Danish general medical journal. We included all case reports published in Ugeskrift for Laeger in 2009. For each report, two authors extracted information on study characteristics and classified the relevance and the role of the report. We included 139 case reports written in Danish. Thirty-nine (28%) were of general relevance and 100 (72%) of speciality relevance. The median number of authors was three (range: 1-7). The first author was a non-specialist physician in 119 (86%) of the reports and the last author a specialist in 103 (78%). A total of 124 (89%) reports had an educational role, six (4%) dealt with new diseases, two (1%) with new side effects, three (2%) with new mechanisms and four (3%) were curiosities. A total of 59 (42%) reports were surgical, 64 (46%) non-surgical and 16 (12%) paraclinical. We found that most case reports published in Ugeskrift for Laeger were of speciality relevance and had an educational perspective. The journal may consider focusing on cases of more general educational relevance and should also consider whether the current form and language suit the aim and role of the various types of case reports.

  13. Report of the Public Cryptography Study Group.

    Science.gov (United States)

    American Council on Education, Washington, DC.

    Concerns of the National Security Agency (NSA) that information contained in some articles about cryptography in learned and professional journals and in monographs might be inimical to the national security are addressed. The Public Cryptography Study Group, with one dissenting opinion, recommends that a voluntary system of prior review of…

  14. Teaching International Public Relations: An Update Report among Educators

    Science.gov (United States)

    Mak, Angela Ka Ying

    2017-01-01

    Involvement in international and multicultural career-related practices is ever on the rise in a global economic and political society, especially in public relations. This article reported an update of examining the attributes of public relations educators and their institutions in teaching of international public relations (IPR) through an…

  15. The Role of Private Health Sector for Tuberculosis Control in Debre Markos Town, Northwest Ethiopia.

    Science.gov (United States)

    Reta, Alemayehu; Simachew, Addis

    2018-01-01

    Tuberculosis has been declared to be a global epidemic. Despite all the effort, only less than half the annual estimated cases are reported by health authorities to the WHO. This could be due to poor reporting from the private sector. In Ethiopia, tuberculosis has also been a major public health problem. The aim of this study was to assess the role of the private health sector in tuberculosis control in Debre Markos. An institution based cross-sectional descriptive study was carried out in private health facilities. A total of 260 tuberculosis suspects attending the private clinics were interviewed. Focus group discussion, checklist, and structured questionnaire were used. Majority of the private clinics were less equipped, poorly regulated, and owned by health workers who were self-employed on a part-time basis. Provider delay of 4 and more months was significantly associated higher likelihood of turning to a private provider (OR = 2.70, 95% CI = (1.20, 6.08)). There is significant delay among tuberculosis patients. Moreover, there is poor regulation of the private health sector by public health authorities. The involvement of the private sector in tuberculosis control should be limited to identification and refer to tuberculosis cases and suspects.

  16. Engineering Research Division publication report, calendar year 1980

    International Nuclear Information System (INIS)

    Miller, E.K.; Livingston, P.L.; Rae, D.C.

    1980-06-01

    Each year the Engineering Research Division of the Electronics Engineering Department at Lawrence Livermore Laboratory has issued an internal report listing all formal publications produced by the Division during the calendar year. Abstracts of 1980 reports are presented

  17. Case report 473: Tuberculosis of the distal metaphysis of the femur

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Gould, E.; Present, D.A.; Klein, M.J.; Nelson, J.

    1988-04-01

    In summary, a case of tuberculous osteomyelitis of the femur in a 16-month-old male child has been presented. The parents illegally immigrated to the United States from Central America before the birth of their child. Both parents had active pulmonary tuberculosis and the child presented with calcified granulomas in his lungs in addition to the lesion in the femur. This presentation is uncommon among the white population in the United States and Europe and is usually limited to non-white immigrants. (orig./SHA).

  18. Case report 473: Tuberculosis of the distal metaphysis of the femur

    International Nuclear Information System (INIS)

    Abdelwahab, I.F.; Gould, E.; Present, D.A.; Klein, M.J.; Nelson, J.

    1988-01-01

    In summary, a case of tuberculous osteomyelitis of the femur in a 16-month-old male child has been presented. The parents illegally immigrated to the United States from Central America before the birth of their child. Both parents had active pulmonary tuberculosis and the child presented with calcified granulomas in his lungs in addition to the lesion in the femur. This presentation is uncommon among the white population in the United States and Europe and is usually limited to non-white immigrants. (orig./SHA)

  19. International or national publication of case reports

    DEFF Research Database (Denmark)

    Lundh, Andreas; Christensen, Mikkel; Jørgensen, Anders W

    2011-01-01

    INTRODUCTION: Case reports are often regarded as second-class research, but are an important part of medical science as they often present first evidence of new discoveries. We here describe the type of case reports published in a Danish general medical journal. MATERIAL AND METHODS: We included...... perspective. The journal may consider focusing on cases of more general educational relevance and should also consider whether the current form and language suit the aim and role of the various types of case reports....

  20. An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients

    OpenAIRE

    Rahman, Md Toufiq; Codlin, Andrew J.; Rahman, Md Mahfuzur; Nahar, Ayenun; Reja, Mehdi; Islam, Tariqul; Qin, Zhi Zhen; Khan, Md Abdus Shakur; Banu, Sayera; Creswell, Jacob

    2017-01-01

    Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert). Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receive...

  1. SCREENING FOR BOVINE TUBERCULOSIS IN AFRICAN BUFFALO (SYNCERUS CAFFER) IN NGORONGORO CONSERVATION AREA, NORTHERN TANZANIA: IMPLICATIONS FOR PUBLIC HEALTH.

    Science.gov (United States)

    Katale, Bugwesa Z; Fyumagwa, Robert D; Mjingo, Eblate E; Sayalel, Kuya; Batamuzi, Emmanuel K; Matee, Mecky I; Keyyu, Julius D; Muumba, Justice; Mdaki, Maulid; Mbugi, Erasto V; Rweyemamu, Mark M; Mpanduji, Donald G

    2017-10-01

    In the Ngorongoro Conservation Area (NCA), Tanzania, where wildlife and livestock interaction is intense, greater potential for intra- and interspecies disease transmission is expected. We assessed the prevalence of bovine tuberculosis in African buffalo (Syncerus caffer) residing on the valley floor of the crater in the NCA. Apparently healthy animals were randomly selected from herds in nine sites of the Ngorongoro Crater. Syncerus caffer buffalo herds were located using very high-frequency radio-aided rangers positioned in various observation points around the crater in the NCA. A total of 102 African buffalo from 16 herds were immobilized from the ground using a cocktail of 4-10 mg etorphine hydrochloride (M99) and 60-150 mg azaperone tartrate. The M99 was reversed using 10-25 mg diprenorphine hydrochloride depending on age of animals. An interferon gamma assay was performed on harvested plasma samples using sandwich enzyme linked immunosorbent assay. Of the 102 animals sampled, two (2%) African buffalo tested positive for bovine tuberculosis. These results corroborate those of the skin test done recently in cattle in the NCA. The presence of bovine tuberculosis in livestock and wildlife suggested the possibility of cross-species transmission of the disease, indicating the need for appropriate intervention measures.

  2. Annual Reports | Publications | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Annual Reports. of the Indian Academy of Sciences. Our Annual Reports since 2000-2001 are freely downloadable. 2016 – 2017. In English. 2015 – 2016. In English. 2014 – 2015. In English | In Hindi. 2013 – 2014. In English | In Hindi. 2012 – 2013. In English | In Hindi. 2011 – 2012. In English | In Hindi. 2010 – 2011.

  3. Prediction of host - pathogen protein interactions between Mycobacterium tuberculosis and Homo sapiens using sequence motifs.

    Science.gov (United States)

    Huo, Tong; Liu, Wei; Guo, Yu; Yang, Cheng; Lin, Jianping; Rao, Zihe

    2015-03-26

    Emergence of multiple drug resistant strains of M. tuberculosis (MDR-TB) threatens to derail global efforts aimed at reigning in the pathogen. Co-infections of M. tuberculosis with HIV are difficult to treat. To counter these new challenges, it is essential to study the interactions between M. tuberculosis and the host to learn how these bacteria cause disease. We report a systematic flow to predict the host pathogen interactions (HPIs) between M. tuberculosis and Homo sapiens based on sequence motifs. First, protein sequences were used as initial input for identifying the HPIs by 'interolog' method. HPIs were further filtered by prediction of domain-domain interactions (DDIs). Functional annotations of protein and publicly available experimental results were applied to filter the remaining HPIs. Using such a strategy, 118 pairs of HPIs were identified, which involve 43 proteins from M. tuberculosis and 48 proteins from Homo sapiens. A biological interaction network between M. tuberculosis and Homo sapiens was then constructed using the predicted inter- and intra-species interactions based on the 118 pairs of HPIs. Finally, a web accessible database named PATH (Protein interactions of M. tuberculosis and Human) was constructed to store these predicted interactions and proteins. This interaction network will facilitate the research on host-pathogen protein-protein interactions, and may throw light on how M. tuberculosis interacts with its host.

  4. Primary prostatic tuberculosis: A rare form of genitourinary tuberculosis

    African Journals Online (AJOL)

    J.M. Ratkal

    HOSTED BY. Pan African Urological Surgeons' Association. African Journal of Urology www.ees.elsevier.com/afju · www.sciencedirect.com. Case report. Primary prostatic tuberculosis: A rare form of genitourinary tuberculosis. J.M. Ratkal. KIMS, Hubli, India. Received 6 August 2014; received in revised form 28 August 2014 ...

  5. Water Fluoridation Reporting System (Public Water Systems)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Water Fluoridation Reporting System (WFRS) has been developed to provide tools to assist states in managing fluoridation programs. WFRS is designed to track all...

  6. 21 CFR 806.40 - Public availability of reports.

    Science.gov (United States)

    2010-04-01

    ... report: (1) Any information that constitutes trade secret or confidential commercial or financial... report all the information in the report concerning that patient. ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Public availability of reports. 806.40 Section 806...

  7. Tuberculosis in quebec: a review of trends.

    Science.gov (United States)

    Klotz, Alexander; Harouna, Abdoulaye; Smith, Andrew F

    2012-06-15

    The aim of this research was to conduct a thorough review on the literature of tuberculosis in Canada and the Province of Quebec. To achieve this aim, an exhaustive literature review of tuberculosis in the Province of Quebec was undertaken. Data was collected with the goal of creating an epidemiological and public health evidence base to forecast the spread of tuberculosis. A keyword search strategy was used to find relevant articles from the peer-reviewed literature using the electronic search engine PubMed and a search of other relevant federal and provincial government databases. Twenty-nine peer-reviewed publications and twenty government reports containing information about the incidence or prevalence of tuberculosis in the Province of Quebec were included in the analysis. An analysis of the data revealed that while tuberculosis rates have been decreasing in both Canada and Quebec with an overall incidence below 3 per 100,000 of population in 2007, among immigrants and the Inuit communities in Quebec, the incidence and prevalence of the disease still remains high and reached 18 per 100,000 and 100 per 100,000, respectively in 2007. In general, while tuberculosis does not pose a significant burden to the general population, it does continue to affect certain sub-groups disproportionately, including select immigrants and Inuit communities in Quebec. Efforts to ensure that cost-effective healthcare interventions are delivered in a timely fashion should be pursued to reduce the associated morbidity and mortality of tuberculosis in the Province of Quebec. Funding for this research was provided to Medmetrics Inc., by McGill University, Montreal, Quebec, Génome Québec and the Ministère de Développement Economique, Innovation et Exportation du Gouvernement du Québec. The authors also wish to thank Drs. John White and Marcel Behr, both of McGill University and Dr Suneil Malik of the Infectious Disease Program in the Office of Biotechnology, Genomics and Population

  8. Association between smoking and tuberculosis infection: a population survey in a high tuberculosis incidence area

    NARCIS (Netherlands)

    den Boon, S.; van Lill, S. W. P.; Borgdorff, M. W.; Verver, S.; Bateman, E. D.; Lombard, C. J.; Enarson, D. A.; Beyers, N.

    2005-01-01

    Background: Associations between smoking and tuberculosis disease including death from tuberculosis have been reported, but there are few reports on the influence of smoking on the risk of developing Mycobacterium tuberculosis infection. The aim of this study was to determine the association between

  9. Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa.

    Science.gov (United States)

    Peltzer, Karl

    2018-12-01

    The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56-4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03-2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09-3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37-0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34-0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25-0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68-6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73-5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36-0.99), being on ART (OR = 0.48, 95% CI = 0.25-0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18-0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15-0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19-3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82-10.48) were associated with a higher odds, and having a partner with

  10. Immune responses to the Mycobacterium tuberculosis-specific antigen ESAT-6 signal subclinical infection among contacts of tuberculosis patients

    DEFF Research Database (Denmark)

    Doherty, T Mark; Demissie, Abebech; Olobo, Joseph

    2002-01-01

    Diagnosis of latent Mycobacterium tuberculosis infection is considered essential for tuberculosis control but is hampered by the lack of specific reagents. We report that strong recognition of tuberculosis complex-specific antigen ESAT-6 by healthy household contacts of tuberculosis patients...

  11. [Progress report on a World Bank loan to China for a tuberculosis control project].

    Science.gov (United States)

    Zhao, F; Chi, Y; Wang, K

    1995-02-01

    The progress of the World Bank loaned TB control project implemented from the second quarter of 1991 to the fourth quarter of 1993 was described in this paper. In the past three years, 737 counties of the 12 provinces with the population of 360 million has been covered by the project. Among 95176 new smear positive cases discovered, 93909 patients received free treatment of TB. The treatment coverage is 98.7%, of which 95% were treated under full course supervision. The smear conversion rate at two, three months of new smear positive TB patients are 83.4% and 90.6% respectively. The cohort analysis showed that the cure rate is 89.8%, which has reached the advanced level of the modern national tuberculosis control programme in the world.

  12. Lessons from Africa: developing a global human rights framework for tuberculosis control and prevention.

    Science.gov (United States)

    Slagle, Tracy; Ben Youssef, Mehdi; Calonge, Golda; Ben Amor, Yanis

    2014-12-03

    Tuberculosis is a highly contagious disease, and there has been a rise in recent years of drug-resistant cases no longer responding to standard treatment. In order to address this threat and contain possible transmission of drug-resistant cases, some countries have taken strong action, including the compulsory detention of non-adherent drug-resistant patients. These measures have been strongly criticized by human rights advocates, and they raise the question of how to legally protect both citizens and the community. Following discussions with National Tuberculosis Programs in Africa (the continent with the highest incidence rates of tuberculosis worldwide), we show that of all the countries surveyed, all but one (Swaziland) had either no specific policy addressing tuberculosis, or only general policies regarding public health applicable to tuberculosis. Six countries also reported having policies that address non-adherence to treatment with containment (isolation in health facilities or incarceration), but laws are not adequately enforced. If the international community wants to effectively respond to the threat of tuberculosis transmission, there is a need to go beyond national tuberculosis policies and to implement an international framework for tuberculosis control, inspired by the Framework Convention on Tobacco Control, a key model for future public health treaties that address global burdens of disease. The framework, for which we clarify the conditions and procedures in this piece, would define the rights and responsibilities of the different stakeholders involved: patients, doctors, pharmaceutical firms and public authorities. To facilitate the governance of the national obligations under the Convention, a coordinating body should be set up, under the leadership of the World Health Organization and the Stop TB Partnership. Successfully implementing policies for tuberculosis that simultaneously address patients' rights and communities' wellbeing will have

  13. Tuberculosis neonatal

    OpenAIRE

    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

  14. Research Projects, Technical Reports and Publications

    Science.gov (United States)

    Oliger, Joseph

    1996-01-01

    The Research Institute for Advanced Computer Science (RIACS) was established by the Universities Space Research Association (USRA) at the NASA Ames Research Center (ARC) on June 6, 1983. RIACS is privately operated by USRA, a consortium of universities with research programs in the aerospace sciences, under contract with NASA. The primary mission of RIACS is to provide research and expertise in computer science and scientific computing to support the scientific missions of NASA ARC. The research carried out at RIACS must change its emphasis from year to year in response to NASA ARC's changing needs and technological opportunities. A flexible scientific staff is provided through a university faculty visitor program, a post doctoral program, and a student visitor program. Not only does this provide appropriate expertise but it also introduces scientists outside of NASA to NASA problems. A small group of core RIACS staff provides continuity and interacts with an ARC technical monitor and scientific advisory group to determine the RIACS mission. RIACS activities are reviewed and monitored by a USRA advisory council and ARC technical monitor. Research at RIACS is currently being done in the following areas: Advanced Methods for Scientific Computing High Performance Networks During this report pefiod Professor Antony Jameson of Princeton University, Professor Wei-Pai Tang of the University of Waterloo, Professor Marsha Berger of New York University, Professor Tony Chan of UCLA, Associate Professor David Zingg of University of Toronto, Canada and Assistant Professor Andrew Sohn of New Jersey Institute of Technology have been visiting RIACS. January 1, 1996 through September 30, 1996 RIACS had three staff scientists, four visiting scientists, one post-doctoral scientist, three consultants, two research associates and one research assistant. RIACS held a joint workshop with Code 1 29-30 July 1996. The workshop was held to discuss needs and opportunities in basic research in

  15. Texas Public School Attrition Study, 2011-12. IDRA Report

    Science.gov (United States)

    Johnson, Roy L.; Montes, Felix

    2012-01-01

    This document contains 3 statistical reports. The first report, "Attrition Rate Decline Seems Promising--Though High Schools are Still Losing One in Four Students" (by Roy L. Johnson), presents results of long-term trend assessments of attrition data in Texas public high schools. The second report, "Slow Declining Pace Keeps Zero…

  16. ASSOCIATION OF VITAMIN D DEFICIENCY WITH TUBERCULOSIS IN ADULT PATIENTS REPORTING TO A TERTIARY CARE HOSPITAL OF RAWALPINDI

    Directory of Open Access Journals (Sweden)

    Syed Fawad Mashhadi

    2014-09-01

    Full Text Available Objectives: To compare the mean vitamin D levels in pulmonary tuberculosis patients and healthy controls and to find out the frequency and association of vitamin D deficiency in patients with tuberculosis. Study Design: Case control study. Place and Duration of Study: Pulmonology department, Military Hospital Rawalpindi from Jan 2013 to Dec 2013. Patients and Methods: Fifty two incident outdoor pulmonary tuberculosis patients were selected with 52 age and gender matched controls. Tuberculosis was diagnosed by the sputum examination through gene Xpert technique from National Institute of Health (NIH, Islamabad. Serum 25-hydroxvitamin D level 0.05. Conclusion: Significant vitamin D deficiency was seen in newly diagnosed TB patients. It was found that vitamin D deficiency is associated with tuberculosis, but its causal role has not been established.

  17. Association of vitamin d deficiency with tuberculosis in adult patients reporting to a tertiary care hospital of rawalpindi

    International Nuclear Information System (INIS)

    Mashhadi, S.F.; Rahman, M.U.; Hashim, R.; Azam, N.

    2014-01-01

    To compare the mean vitamin Dlevels in pulmonary tuberculosis patients and healthy controls and to find out the frequency and association of vitamin D deficiency in patients with tuberculosis. Study Design: Case control study. Place and Duration of Study: Pulmonology department, Military Hospital Rawalpindi from Jan 2013 to Dec 2013. Patients and Methods:Fifty two incident outdoor pulmonary tuberculosis patients were selected with 52 age and gender matched controls. Tuberculosis was diagnosed by the sputum examination through gene Xpert technique from National Institute of Health (NIH), Islamabad. Serum 25-hydroxvitamin D level 0.05). Conclusion: Significant vitamin D deficiency was seen in newly diagnosed TB patients. It was found that vitamin D deficiency is associated with tuberculosis, but its causal role has not been established. (author)

  18. A report on the public perception of risk

    International Nuclear Information System (INIS)

    1986-07-01

    Noting that the public's perception of risk is real whether or not it is based on what experts call scientific fact, the report examines physchological, socio-economic, informational, and cultural factors affecting risk perception. In the case of nuclear energy it is concluded that the public has little knowledge of the many measures taken to control risks

  19. Enhancing disease surveillance reporting using public transport in ...

    African Journals Online (AJOL)

    Enhancing disease surveillance reporting using public transport in Dodoma District, Central Tanzania. ... LEG Mboera, SF Rumisha, EJ Mwanemile, E Mziwanda, PK Mmbuji ... Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  20. Public Reporting and Market Area Exit Decisions by HHAs

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to authors Jung and Feldman, the introduction of Home Health Compare, a public reporting program initiated by Medicare in 2003, had a very small and weak...

  1. Learn About Tuberculosis

    Science.gov (United States)

    ... Diseases > Lung Disease Lookup > Tuberculosis (TB) Learn About Tuberculosis Tuberculosis (TB) is an airborne bacterial infection caused by the organism Mycobacterium tuberculosis that primarily affects the lungs, although other organs ...

  2. Targeting phenotypically tolerant Mycobacterium tuberculosis

    Science.gov (United States)

    Gold, Ben; Nathan, Carl

    2016-01-01

    While the immune system is credited with averting tuberculosis in billions of individuals exposed to Mycobacterium tuberculosis, the immune system is also culpable for tempering the ability of antibiotics to deliver swift and durable cure of disease. In individuals afflicted with tuberculosis, host immunity produces diverse microenvironmental niches that support suboptimal growth, or complete growth arrest, of M. tuberculosis. The physiological state of nonreplication in bacteria is associated with phenotypic drug tolerance. Many of these host microenvironments, when modeled in vitro by carbon starvation, complete nutrient starvation, stationary phase, acidic pH, reactive nitrogen intermediates, hypoxia, biofilms, and withholding streptomycin from the streptomycin-addicted strain SS18b, render M. tuberculosis profoundly tolerant to many of the antibiotics that are given to tuberculosis patients in a clinical setting. Targeting nonreplicating persisters is anticipated to reduce the duration of antibiotic treatment and rate of post-treatment relapse. Some promising drugs to treat tuberculosis, such as rifampicin and bedaquiline, only kill nonreplicating M. tuberculosis in vitro at concentrations far greater than their minimal inhibitory concentrations against replicating bacilli. There is an urgent demand to identify which of the currently used antibiotics, and which of the molecules in academic and corporate screening collections, have potent bactericidal action on nonreplicating M. tuberculosis. With this goal, we review methods of high throughput screening to target nonreplicating M. tuberculosis and methods to progress candidate molecules. A classification based on structures and putative targets of molecules that have been reported to kill nonreplicating M. tuberculosis revealed a rich diversity in pharmacophores. However, few of these compounds were tested under conditions that would exclude the impact of adsorbed compound acting during the recovery phase of

  3. Tests to evaluate public health disease reporting systems in local public health agencies (electronic resource)

    National Research Council Canada - National Science Library

    Ricci, Karen; Lurie, Nicole; Stoto, Michael A; Wasserman, Jeffrey; Dausey, David J; Meade, Barbara; Diamond, Alexis; Molander, Roger C

    2005-01-01

    ... to evaluate the ability to receive and respond to case reports 24 hours a day, 7 days a week. We refined these tests by beta-testing them at 20 metropolitan area local public health agencies across the country over the course of 10 months. The contents of this manual will be of interest to public health professionals at the state and local l...

  4. Tests to evaluate public health disease reporting systems in local public health agencies

    National Research Council Canada - National Science Library

    Dausey, David J

    2005-01-01

    ... to evaluate the ability to receive and respond to case reports 24 hours a day, 7 days a week. We refined these tests by beta-testing them at 20 metropolitan area local public health agencies across the country over the course of 10 months. The contents of this manual will be of interest to public health professionals at the state and local l...

  5. Paradoxical Reaction of Tuberculosis in a Heart Transplant Recipient During Antituberculosis Therapy: A Case Report.

    Science.gov (United States)

    Wakamiya, A; Seguchi, O; Shionoiri, A; Kumai, Y; Kuroda, K; Nakajima, S; Yanase, M; Matsuda, S; Wada, K; Matsumoto, Y; Fukushima, S; Fujita, T; Kobayashi, J; Fukushima, N

    2018-04-01

    Tuberculous paradoxical reactions (PRs) are excessive immune reactions occurring after antituberculosis (TB) treatment and are commonly observed in immunocompromised hosts such as patients infected with the human immunodeficiency virus. We recently encountered a 63-year-old male heart transplant recipient who developed tuberculous PR after treatment for miliary TB. The patient had been receiving immunosuppressive therapy with cyclosporine and mycophenolate mofetil for over 15 years. The diagnosis of miliary TB was made based on the presence of intermittent fever and fatigue; thus, anti-TB treatments (isoniazid, levofloxacin, ethambutol, and pyrazinamide) were started, which led to rapid defervescence and regression of the granular shadow and pleural effusion. However, a new persistent fever and confused state developed 1 month after the anti-TB therapy was started. After excluding possible etiologies of the patient's symptom, a PR was suspected, and anti-TB drugs were continued; corticosteroids were added as anti-inflammatory agents. After that, he has shown a favorable course with long-term anti-TB chemotherapy. A PR should always be considered when the patients' symptoms of tuberculosis re-exacerbate after an appropriate anti-TB therapy. A PR commonly occurs in patients with various immunologic conditions including heart transplant recipients. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. [Tuberculosis in compromised hosts].

    Science.gov (United States)

    2003-11-01

    Recent development of tuberculosis in Japan tends to converge on a specific high risk group. The proportion of tuberculosis developing particularly from the compromised hosts in the high risk group is especially high. At this symposium, therefore, we took up diabetes mellitus, gastrectomy, dialysis, AIDS and the elderly for discussion. Many new findings and useful reports for practical medical treatment are submitted; why these compromised hosts are predisposed to tuberculosis, tuberculosis diagnostic and remedial notes of those compromised hosts etc. It is an important question for the future to study how to prevent tuberculosis from these compromised hosts. 1. Tuberculosis in diabetes mellitus: aggravation and its immunological mechanism: Kazuyoshi KAWAKAMI (Department of Internal Medicine, Division of Infectious Diseases, Graduate School and Faculty of Medicine, University of the Ryukyus). It has been well documented that diabetes mellitus (DM) is a major aggravating factor in tuberculosis. The onset of this disease is more frequent in DM patients than in individuals with any underlying diseases. However, the precise mechanism of this finding remains to be fully understood. Earlier studies reported that the migration, phagocytosis and bactericidal activity of neutrophils are all impaired in DM patients, which is related to their reduced host defense to infection with extracellular bacteria, such as S. aureus and E. colli. Host defense to mycobacterial infection is largely mediated by cellular immunity, and Th1-related cytokines, such as IFN-gamma and IL-12, play a central role in this response. It is reported that serum level of these cytokines and their production by peripheral blood mononuclear cells (PBMC) are reduced in tuberculosis patients with DM, and this is supposed to be involved in the high incidence of tuberculosis in DM. Our study observed similar findings and furthermore indicated that IFN-gamma and IL-12 production by BCG-stimulated PBMC was lower

  7. Financial Reporting for Tennessee Public Colleges and Universities.

    Science.gov (United States)

    Tennessee Higher Education Commission, Nashville.

    This manual provides a framework for accounting practices, budgeting and reporting procedures for Tennessee public higher education institutions. Emphasis is placed on principles and procedures of accounting and financial reporting; the balance sheet; statement of changes in fund balances; statement of current funds revenues, expenditures, and…

  8. Public School Finance Problems in Texas. An Interim Report.

    Science.gov (United States)

    Texas Research League, Austin.

    The U.S. District Court ruling in Rodriguez vs San Antonio Independent School District, which struck down Texas' school finance system as inequitable and unconstitutional, provided the impetus for publishing this interim report. The report documents the growing cost of State-supported public school programs--the primary concern prior to the…

  9. Duodenal tuberculosis

    International Nuclear Information System (INIS)

    Mirza, M.R.; Sarwar, M.

    2004-01-01

    Tuberculosis is a world wide communicable disease caused by tubercle bacilli discovered by Robert Kock in 1882. In 1993 WHO declared TB as a global emergency due to its world wide resurgence. It can involve any organ of the body. Abdomen is the fourth commonest site of involvement in the extra pulmonary tuberculosis after the lymph-nodes, skeletal and Genito urinary variants. In the gastro intestinal tract tuberculosis can affect any part from the mouth to the anus but ileocaecal area is a favourite location. Duodenal involvement is uncommon and accounts for only 2.5% of tuberculous enteritis. Major pathogens are Mycobacterium Tuberculosis and bovis and the usual route of entry is by direct penetration of the intestinal mucosa by swallowed organisms. (author)

  10. Tuberculosis genotyping information management system: enhancing tuberculosis surveillance in the United States.

    Science.gov (United States)

    Ghosh, Smita; Moonan, Patrick K; Cowan, Lauren; Grant, Juliana; Kammerer, Steve; Navin, Thomas R

    2012-06-01

    Molecular characterization of Mycobacterium tuberculosis complex isolates (genotyping) can be used by public health programs to more readily identify tuberculosis (TB) transmission. The Centers for Disease Control and Prevention's National Tuberculosis Genotyping Service has offered M. tuberculosis genotyping for every culture-confirmed case in the United States since 2004. The TB Genotyping Information Management System (TB GIMS), launched in March 2010, is a secure online database containing genotype results linked with case characteristics from the national TB registry for state and local TB programs to access, manage and analyze these data. As of September 2011, TB GIMS contains genotype results for 89% of all culture-positive TB cases for 2010. Over 400 users can generate local and national reports and maps using TB GIMS. Automated alerts on geospatially concentrated cases with matching genotypes that may represent outbreaks are also generated by TB GIMS. TB genotyping results are available to enhance national TB surveillance and apply genotyping results to conduct TB control activities in the United States. Published by Elsevier B.V.

  11. Tuberculosis screening among Bolivian sex workers and their children

    Directory of Open Access Journals (Sweden)

    Silvia S. Chiang

    2015-06-01

    Full Text Available Bolivian sex workers were more likely than other employed women to report tuberculosis screening only if they reported HIV screening. Of all women with household tuberculosis exposure, <40% reported screening for themselves or their children. Coupling tuberculosis screening with sex workers’ mandatory HIV screenings may be a cost-efficient disease-control strategy.

  12. Antigen smuggling in tuberculosis.

    Science.gov (United States)

    Hudrisier, Denis; Neyrolles, Olivier

    2014-06-11

    The importance of CD4 T lymphocytes in immunity to M. tuberculosis is well established; however, how dendritic cells activate T cells in vivo remains obscure. In this issue of Cell Host & Microbe, Srivastava and Ernst (2014) report a mechanism of antigen transfer for efficient activation of antimycobacterial T cells. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Public hearing process for nuclear power plants. Seminar report

    International Nuclear Information System (INIS)

    1979-02-01

    On June 26 and 27, 1978, the Nuclear Regulatory Commission conducted a seminar on the public hearing process for nuclear power plants. The seminar was intended to examine current practices regarding the conduct of public hearings and how these practices related to the statutory intent, to assess whether existing procedures are being followed, and to explore whether administrative or legal changes are warranted. The seminar format allowed exchanges of views among participants in the hearing process and was attended by members of the public, the General Accounting Office, Congressional staffs, NRC, and the nuclear industry. The report contains panel reports on scheduling of public hearings, procedures for Board notification, selection and training of panel members, hearing procedures, and Board functions

  14. Patient satisfaction on tuberculosis treatment service and adherence to treatment in public health facilities of Sidama zone, South Ethiopia

    Science.gov (United States)

    2013-01-01

    Background Patient compliance is a key factor in treatment success. Satisfied patients are more likely to utilize health services, comply with medical treatment, and continue with the health care providers. Yet, the national tuberculosis control program failed to address some of these aspects in order to achieve the national targets. Hence, this study attempted to investigate patient satisfaction and adherence to tuberculosis treatment in Sidama zone of south Ethiopia. Methods A facility based cross sectional study was conducted using quantitative method of data collection from March to April 2011. A sample of 531 respondents on anti TB treatment from 11 health centers and 1 hospital were included in the study. The sample size to each facility was allocated using probability proportional to size allocation, and study participants for the interview were selected by systematic random sampling. A Pre tested, interviewer administered questionnaire was used to collect the data. Collected data was edited, coded and entered to Epi data version 3.1 and exported to SPSS version 16. Confirmatory factor analysis was done to identify factors that explain most of the variance observed in most of the manifested variables. Bivariate and Multivariate analysis were computed to analyze the data. Result The study revealed 90% of the study participants were satisfied with TB treatment service. However, 26% of respondents had poor adherence to their TB treatment. Patient perceived on professional care, time spent with health care provider, accessibility, technical competency, convenience (cleanliness) and consultation and relational empathy were independent predictors of overall patient satisfaction (P patient satisfaction (Beta = 0.262). In multivariate analysis occupational status, area of residence, perceived time spent with health care provider, perceived accessibility, perceived waiting time, perceived professional care and over all patient satisfaction were significantly

  15. Knowledge and awareness of Tuberculosis among Students of ...

    African Journals Online (AJOL)

    Background: Tuberculosis (TB) is a major health problem worldwide, as one third of the world population is infected with M. tuberculosis. It is still a major cause of morbidity and mortality and a major public health concern in Sudan. Objectives: to determine the awareness and knowledge of tuberculosis among students.

  16. 45 CFR 96.127 - Requirements regarding tuberculosis.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Requirements regarding tuberculosis. 96.127... Substance Abuse Prevention and Treatment Block Grant § 96.127 Requirements regarding tuberculosis. (a... Department of Health/Tuberculosis Control Officer, which address how the program— (1) Will, directly or...

  17. Relationship between hospital financial performance and publicly reported outcomes.

    Science.gov (United States)

    Nguyen, Oanh Kieu; Halm, Ethan A; Makam, Anil N

    2016-07-01

    Hospitals that have robust financial performance may have improved publicly reported outcomes. To assess the relationship between hospital financial performance and publicly reported outcomes of care, and to assess whether improved outcome metrics affect subsequent hospital financial performance. Observational cohort study. Hospital financial data from the Office of Statewide Health Planning and Development in California in 2008 and 2012 were linked to data from the Centers for Medicare and Medicaid Services Hospital Compare website. Hospital financial performance was measured by net revenue by operations, operating margin, and total margin. Outcomes were 30-day risk-standardized mortality and readmission rates for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia (PNA). Among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for AMI and PNA. However, improved hospital financial performance (by any of the 3 measures) was associated with a modest increase in CHF mortality rates (ie, 0.26% increase in CHF mortality rate for every 10% increase in operating margin [95% confidence interval: 0.07%-0.45%]). Conversely, there were no significant associations between outcomes from 2008 to 2011 and subsequent financial performance in 2012 (P > 0.05 for all). Robust financial performance is not associated with improved publicly reported outcomes for AMI, CHF, and PNA. Financial incentives in addition to public reporting, such as readmissions penalties, may help motivate hospitals with robust financial performance to further improve publicly reported outcomes. Reassuringly, improved mortality and readmission rates do not necessarily lead to loss of revenue. Journal of Hospital Medicine 2016;11:481-488. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  18. Molecular Diagnosis of Tuberculosis.

    Science.gov (United States)

    Nurwidya, Fariz; Handayani, Diah; Burhan, Erlina; Yunus, Faisal

    2018-01-01

    Tuberculosis (TB) is one of the leading causes of adult death in the Asia-Pacific Region, including Indonesia. As an infectious disease caused by Mycobacterium tuberculosis (MTB), TB remains a major public health issue especially in developing nations due to the lack of adequate diagnostic testing facilities. Diagnosis of TB has entered an era of molecular detection that provides faster and more cost-effective methods to diagnose and confirm drug resistance in TB cases, meanwhile, diagnosis by conventional culture systems requires several weeks. New advances in the molecular detection of TB, including the faster and simpler nucleic acid amplification test (NAAT) and whole-genome sequencing (WGS), have resulted in a shorter time for diagnosis and, therefore, faster TB treatments. In this review, we explored the current findings on molecular diagnosis of TB and drug-resistant TB to see how this advancement could be integrated into public health systems in order to control TB.

  19. Co-infection of visceral leishmaniasis and pulmonary tuberculosis: a case study

    Directory of Open Access Journals (Sweden)

    Shweta

    2014-02-01

    Full Text Available Co-infection of visceral leishmaniasis and pulmonary tuberculosis are increasing public health problem in eastern region of country. A large number of clinical cases of leishmaniasis and tuberculosis have been reported in Sudan. Such type of co-infections lead to decreased host ’s immune system. This is a case report of 48 years old male with visceral leishmaniasis and pulmonary tuberculosis. He arrived at hospital with complaints of fever with rigor, abdominal pain, weakness, loss of appetite, yellowish discoloration of urine and sclerosis at lower back. Bone marrow aspiration cytology revealed the presence of Leishmania donovani bodies (2+. His treatment was initiated with amphotericin B deoxycholate (inj. Fungizone 15 infusions on alternate days with 5% dextrose. He had 20 years past history of pulmonary tuberculosis. His chest X-ray showed increased bronchovascular marking encysted pleural effusion on lower segment of right lung. Ultrasonography guided fine needle aspiration cytology of pleural fluid for protein, sugar, lactate dehydrogenase, adenosine deaminase, cell type and cell count. Cytological reports confirmed pulmonary tuberculosis. Antitubercular therapy (four drug regimen: rifampicin, isoniazid, ethambutal, and pyrazinamide was started. Co-infection of visceral leishmaniasis and pulmonary tuberculosis is a real threat in developing countries. There is a need of cost effective diagnostic and therapeutic facilities for these co-infections.

  20. An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients.

    Science.gov (United States)

    Rahman, Md Toufiq; Codlin, Andrew J; Rahman, Md Mahfuzur; Nahar, Ayenun; Reja, Mehdi; Islam, Tariqul; Qin, Zhi Zhen; Khan, Md Abdus Shakur; Banu, Sayera; Creswell, Jacob

    2017-05-01

    Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved.A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73-0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses.Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software. More studies are needed to evaluate CAR using different screening approaches. Copyright ©ERS 2017.

  1. Pediatric tuberculosis-human immunodeficiency virus co-infection in the United Kingdom highlights the need for better therapy monitoring tools: a case report.

    Science.gov (United States)

    Evangelopoulos, Dimitrios; Whittaker, Elizabeth; Honeyborne, Isobella; McHugh, Timothy D; Klein, Nigel; Shingadia, Delane

    2017-02-26

    Tuberculosis is an infection that requires at least 6 months of chemotherapy in order to clear the bacteria from the patient's lungs. Usually, therapeutic monitoring is dependent on smear microscopy where a decline in acid-fast bacilli is observed. However, this might not be indicative of the actual decline of bacterial load and thus other tools such as culture and molecular assays are required for patient management. Here, we report the case of a 12-year-old Black African boy co-infected with tuberculosis and human immunodeficiency virus who remained smear culture positive and liquid culture negative for a prolonged period of time following chemotherapy. In order to determine whether there was any live bacteria present in his specimens, we applied the newly developed molecular bacterial load assay that detects the presence of 16S ribosomal ribonucleic acid derived from the bacteria. Using this methodology, we were able to quantify his bacterial load and inform the management of his treatment in order to reduce the disease burden. Following this intervention he went on to make a complete recovery. This case report highlights the value of improved biomarkers for monitoring the treatment of tuberculosis and the role of molecular assays such as the molecular bacterial load assay applied here. The molecular bacterial load assay detects bacterial ribonucleic acid which corresponds closely with the number of live bacilli as compared with polymerase chain reaction that detects deoxyribonucleic acid and may include dead bacteria.

  2. Safety assessment in primary Mycobacterium tuberculosis smear ...

    African Journals Online (AJOL)

    Introduction Tuberculosis (TB) is caused by Mycobacterium tuberculosis and is transmitted mainly through aerosolization of infected sputum which puts laboratory workers at risk in spite of the laboratory workersf risk of infection being at 3 to 9 times higher than the general public. Laboratory safety should therefore be ...

  3. Atypical tuberculosis presenting with primary infertility and ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is caused by mycobacterium tuberculosis. It remains a public health concern especially in developing country. Pulmonary infection is the main presentation. However, genitourinary TB is common especially with the increase in Human Immunodeficiency virus (HIV) infection. Genitourinary TB is one of the ...

  4. Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil

    Directory of Open Access Journals (Sweden)

    Guy Harling

    2017-05-01

    Full Text Available Abstract Background Tuberculosis (TB remains a public health problem, despite recent achievements in reducing incidence and mortality rates. In Brazil, these achievements were above the worldwide average, but marked by large regional heterogeneities. In Fortaleza (5th largest city in Brazil, the tuberculosis cure rate has been declining and treatment abandonment has been increasing in the past decade, despite a reduction in incidence and an increase in directly observed therapy (DOT. These trends put efforts to eliminate tuberculosis at risk. We therefore sought to determine social and programmatic determinants of tuberculosis incidence and treatment abandonment in Fortaleza. Methods We analyzed sociodemographic and clinical data for all new tuberculosis cases notified in the Notifiable Diseases Information System (SINAN from Fortaleza between 2007 and 2014. We calculated incidence rates for 117 neighborhoods in Fortaleza, assessed their spatial clustering, and used spatial regression models to quantify associations between neighborhood-level covariates and incidence rates. We used hierarchical logistic regression models to evaluate how individual- and neighborhood-level covariates predicted tuberculosis treatment abandonment. Results There were 12,338 new cases reported during the study period. Case rates across neighborhoods were significantly positively clustered in two low-income areas close to the city center. In an adjusted model, tuberculosis rates were significantly higher in neighborhoods with lower literacy, higher sewerage access and homicide rates, and a greater proportion of self-reported black residents. Treatment was abandoned in 1901 cases (15.4%, a rate that rose by 71% between 2007 and 2014. Abandonment was significantly associated with many individual sociodemographic and clinical factors. Notably, being recommended for DOT was protective for those who completed DOT, but associated with abandonment for those who did not

  5. The biofuel support policy. Public thematic report. Assessing a public policy

    International Nuclear Information System (INIS)

    2012-01-01

    In its first part, this detailed report gives an overview of some key facts regarding biofuels: energy context, biofuels and energy, biofuels and agriculture, multiple and superimposed regulation levels, financial data, and international comparisons. The second part analyses the positions of the different actors (oil industry and dealers, car manufacturers, bio-diesel producers, ethanol producers, farmers producing raw materials, consumer associations, defenders of the environment, public bodies). The third part reports the assessment of the French public policy in terms of efficiency. Some recommendations are made

  6. Publicly Reported Wound Healing Rates: The Fantasy and the Reality

    Science.gov (United States)

    Fife, Caroline E.; Eckert, Kristen A.; Carter, Marissa J.

    2018-01-01

    Significance: We compare real-world data from the U.S. Wound Registry (USWR) with randomized controlled trials and publicly reported wound outcomes and develop criteria for honest reporting of wound outcomes, a requirement of the new Quality Payment Program (QPP). Recent Advances: Because no method has existed by which wounds could be stratified according to their likelihood of healing among real-world patients, practitioners have reported fantastically high healing rates. The USWR has developed several risk-stratified wound healing quality measures for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) as part of its Qualified Clinical Data Registry (QCDR). This allows practitioners to report DFU and VLU healing rates in comparison to the likelihood of whether the wound would have healed. Critical Issues: Under the new QPP, practitioners must report at least one practice-relevant outcome measure, and it must be risk adjusted so that clinicians caring for the sickest patients do not appear to have worse outcomes than their peers. The Wound Healing Index is a validated risk-stratification method that can predict whether a DFU or VLU will heal, leveling the playing field for outcome reporting and removing the need to artificially inflate healing rates. Wound care practitioners can report the USWR DFU and VLU risk-stratified outcome measure to satisfy the quality reporting requirements of the QPP. Future Directions: Per the requirements of the QPP, the USWR will begin publicly reporting of risk-stratified healing rates once quality measure data have met the reporting standards of the Centers for Medicare and Medicaid Services. Some basic rules for data censoring are proposed for public reporting of healing rates, and others are needed, which should be decided by consensus among the wound care community. PMID:29644145

  7. Addison's Disease Caused by Tuberculosis with Atypical Hyperpigmentation and Active Pulmonary Tuberculosis.

    Science.gov (United States)

    Namikawa, Hiroki; Takemoto, Yasuhiko; Kainuma, Shigeto; Umeda, Sakurako; Makuuchi, Ayako; Fukumoto, Kazuo; Kobayashi, Masanori; Kinuhata, Shigeki; Isaka, Yoshihiro; Toyoda, Hiromitsu; Kamata, Noriko; Tochino, Yoshihiro; Hiura, Yoshikazu; Morimura, Mina; Shuto, Taichi

    2017-01-01

    We herein report a case of Addison's disease caused by tuberculosis characterized by atypical hyperpigmentation, noted as exacerbation of the pigmentation of freckles and the occurrence of new freckles, that was diagnosed in the presence of active pulmonary tuberculosis. The clinical condition of the patient was markedly ameliorated by the administration of hydrocortisone and anti-tuberculosis agents. When exacerbation of the pigmentation of the freckles and/or the occurrence of new freckles are noted, Addison's disease should be considered as part of the differential diagnosis. In addition, the presence of active tuberculosis needs to be assumed whenever we treat patients with Addison's disease caused by tuberculosis, despite its rarity.

  8. Report of the 1981 Commission on Public Relations Education.

    Science.gov (United States)

    Smith, Kenneth Owler

    1982-01-01

    Summarizes efforts to (1) review the undergraduate curricula; (2) design a "model" curriculum for graduate studies; and (3) recommend support courses for public relations students. Reports, among other findings, that a "model" already exists, and elements are shared by top-ranked universities in the field. For journal…

  9. School Progress Report 2012. Montgomery County Public Schools

    Science.gov (United States)

    Montgomery County Public Schools, 2013

    2013-01-01

    The 2012 School Progress Report for Montgomery County Public Schools (MCPS) provides state, county, and individual school performance data, as well as information on student attendance, high school graduation rates, and the professional qualifications of teachers at the state, district, and school levels. Montgomery County primary schools are…

  10. School Progress Report 2013. Montgomery County Public Schools

    Science.gov (United States)

    Montgomery County Public Schools, 2014

    2014-01-01

    The 2013 School Progress Report for Montgomery County Public Schools (MCPS) provides state, county, and individual school performance data, as well as information on student attendance, high school graduation rates, and the professional qualifications of teachers at the state, district, and school levels for the 2012-2013 school year. Montgomery…

  11. Portland Public Schools Project Chrysalis: Year 2 Evaluation Report.

    Science.gov (United States)

    Mitchell, Stephanie J.; Gabriel, Roy M.; Hahn, Karen J.; Laws, Katherine E.

    In 1994, the Chrysalis Project in Portland Public Schools received funding to prevent or delay the onset of substance abuse among a special target population: high-risk, female adolescents with a history of childhood abuse. Findings from the evaluation of the project's second year of providing assistance to these students are reported here. During…

  12. Tuberculosis diagnostic methods in buffaloes

    Directory of Open Access Journals (Sweden)

    Gabriela Capriogli Oliveira

    2015-07-01

    Full Text Available The low productivity of buffalo herds and condemnation of carcasses in slaughterhouses due to tuberculosis lesions have resulted in increasing economic losses because these animals cannot be treated and must be destroyed by sanitary slaughter. Tuberculosis is a widely distributed zoonosis that affects the beef supply chain of the Brazilian agribusiness economically and socially. Like cattle, buffaloes are sensitive to Mycobacterium bovis, which is the main causative agent of zoonotic tuberculosis. Tuberculosis in buffaloes has been reported in several countries, including Brazil. In order to control and eradicate this disease among cattle and buffaloes in Brazil, the Ministry of Agriculture, Livestock, and Supply created the National Program for the Control and Eradication of Brucellosis and Tuberculosis with the main objective of finding a significant number of disease-free herds throughout the national territory using reliable methods. This review summarizes the main data on the history of occurrence of M. bovis in Brazilian herds and the diagnostic methods for the disease in buffaloes. Little information is available on buffalo tuberculosis. Due to the increasing population of buffaloes and their economic importance, more studies investigating the occurrence and identification of tuberculosis in this species are clearly needed.

  13. Tuberculosis Multidrogoresistente

    Directory of Open Access Journals (Sweden)

    German A Acevedo

    2013-12-01

    Full Text Available La tuberculosis es una enfermedad infecciosa causada por el Mycobacterium tuberculosis. En el año 2010 se registraron 8.8 millones de casos incidentes en el mundo y en los últimos años han aparecido poblaciones bacterianas de micobacterias con resistencia a los fármacos de primera línea. Se ha definido la presencia de resistencia a rifampicina e isoniacida como multidrogoresistencia, estimándose una incidencia mundial aproximada de 3.6%. Esta revisión de tema se centrará en la situación de la tuberculosis multidrogoresistente en el mundo, incluyendo un análisis regional de la casuística Colombiana. Se comentarán los principales mecanismos de resistencia del microorganismo, los genes implicados en la misma y los factores de riesgo asociados a la generación de resistencia en algunas comunidades.

  14. Massive hemoptysis and complete unilateral lung collapse in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome: a case report.

    Science.gov (United States)

    Masukume, Gwinyai; Sengurayi, Elton; Moyo, Phinot; Feliu, Julio; Gandanhamo, Danboy; Ndebele, Wedu; Ngwenya, Solwayo; Gwini, Rudo

    2013-08-22

    We report an extremely rare case of massive hemoptysis and complete left-sided lung collapse in pregnancy due to pulmonary tuberculosis in a health care worker with good maternal and fetal outcome. A 33-year-old human immuno deficiency virus seronegative African health care worker in her fourth pregnancy with two previous second trimester miscarriages and an apparently healthy daughter from her third pregnancy presented coughing up copious amounts of blood at 18 weeks and two days of gestation. She had a cervical suture in situ for presumed cervical weakness. Computed tomography of her chest showed complete collapse of the left lung; subsequent bronchoscopy was apparently normal. Her serum β-human chorionic gonadotropin, tests for autoimmune disease and echocardiography were all normal. Her lung re-inflated spontaneously. Sputum for acid alcohol fast bacilli was positive; our patient was commenced on anti-tuberculosis medication and pyridoxine. At 41 weeks and three days of pregnancy our patient went into spontaneous labor and delivered a live born female baby weighing 2.6 kg with APGAR scores of nine and 10 at one and five minutes respectively. She and her baby are apparently doing well about 10 months after delivery. It is possible to have massive hemoptysis and complete unilateral lung collapse with spontaneous resolution in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome.

  15. Conventional and Molecular Epidemiology of Tuberculosis in Homeless Patients in Budapest, Hungary

    Science.gov (United States)

    Lukács, Judit; Tubak, Vilmos; Mester, Judit; Dávid, Sándor; Bártfai, Zoltán; Kubica, Tanja; Niemann, Stefan; Somoskövi, Ákos

    2004-01-01

    In Hungary the incidence of tuberculosis among the homeless population was 676 per 100,000 in 2002. Sixty-nine percent (140 patients) of all homeless tuberculosis patients were notified in Budapest (the capital). Therefore, a retrospective study that included 66 homeless tuberculosis patients notified in Budapest in 2002 was conducted to determine the rate of recent transmission of the disease and medical risk factors and to identify transmission pathways by means of conventional and molecular epidemiologic methods. IS6110 DNA fingerprinting revealed that 71.2% of the isolates could be clustered. Thirty-four (51.5%) patients belonged to five major clusters (size, from 4 to 11 individuals), and 13 (19.7%) belonged to six smaller clusters. Additional analysis of patient records found that 2 (18%) of the 11 patients in cluster A, 3 (37.5%) of the 8 patients in cluster B, and 2 (33%) of the 6 patients in cluster C were residents of the same three homeless shelters during the diagnosis of tuberculosis. Review of the database of the National Tuberculosis Surveillance Center (NTSC) revealed that 21.2% of the cases have not been reported to the NTSC. These findings indicate that the screening and treatment of tuberculosis among the homeless need to be strengthened and also warrant the review of environmental control steps in public shelters. Improvement of adherence of clinicians to surveillance reporting regulations is also necessary. PMID:15583345

  16. Mycobacterium tuberculosis Infection in a Domesticated Korean Wild Boar ( Sus scrofa coreanus).

    Science.gov (United States)

    Seo, Min-Goo; Ouh, In-Ohk; Kim, Munki; Lee, Jienny; Kim, Young-Hoan; Do, Jae-Cheul; Kwak, Dongmi

    2017-06-01

    Tuberculosis, a chronic progressive disease, has been reported in bovine, swine, and primate species. Here, we report the first case of Mycobacterium tuberculosis infection in a Korean wild boar ( Sus scrofa coreanus). The owners this domesticated boar brought it to the Gyeongbuk Veterinary Service Laboratory in Korea after it was found dead and severely emaciated. Demarcated yellowish white nodules were found around the larynx and retropharyngeal lymph node during necropsy. The lungs had diffuse fibrinous pleuritis, severe congestion, and scattered nodules. More nodules were found in the spleen. Tuberculosis is characterized by massive macrophage infiltration and central caseous necrosis; both characteristics were found in the lungs. Histopathologic examination revealed that the alveolar lumen had marked fibrosis and exudates. Examination of the fluid revealed extensive macrophage permeation. To confirm a Mycobacterium infection, PCR was performed using two primer sets specific to the rpoB gene of Mycobacterium; Mycobacterium was detected in the lungs and spleen. To identify the species of Mycobacterium, immunohistochemical evaluation was performed using antibodies against Mycobacterium tuberculosis and Mycobacterium bovis . The results revealed immunoreactivity against M. tuberculosis but not against M. bovis . The consumption of undercooked or raw meat from game animals may expose humans and other animals to sylvatic infection. Consequently, Koreans who ingest wild boar may be at risk of a tuberculosis infection. To reduce the risk of foodborne infection and maintain public health, continuous monitoring and control strategies are required.

  17. Evaluating Retirement Income Security for Illinois Public School Teachers. Public Pension Project Report

    Science.gov (United States)

    Johnson, Richard W.; Southgate, Benjamin G.

    2014-01-01

    The financial problems afflicting the Illinois teacher pension plan have grabbed headlines. An equally important problem, though underappreciated, is that relatively few teachers benefit much from the plan. This report evaluates the pension benefits provided to Illinois public school teachers. The researchers project annual and lifetime pension…

  18. An Unusual Gross Appearance of Vulval Tuberculosis Masquerading as Tumor

    Directory of Open Access Journals (Sweden)

    Surekha U. Arakeri

    2014-01-01

    Full Text Available Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized.

  19. An unusual gross appearance of vulval tuberculosis masquerading as tumor.

    Science.gov (United States)

    Arakeri, Surekha U; Sinkar, Prachi

    2014-01-01

    Tuberculosis of the vulva is very rare. It is found in about 0.2% of the cases of genital tract tuberculosis. It usually presents as small shallow ulcers and multiple sinus tracts or rarely as elephantiasis of vulva. Except for very rare cases of primary tuberculosis in the vulva, it is usually associated with tuberculosis elsewhere in the body leading to secondary tuberculosis. Here, we report a case of secondary vulval tuberculosis which presented as a vulval mass in a 40-year-old female patient. The rarity of this presentation in the female genital tract is emphasized.

  20. Importance of reportable events with regard to public acceptance

    International Nuclear Information System (INIS)

    Wehner, G.

    1983-01-01

    Although risk assessments have shown that the transport of radioactive material (RAM) only contributes a very small part of the overall risk of nuclear energy, the public is still concerned about the safety of these transport operations. This is due to the fact that during such an operation RAM may come in the vicinity of everybody and that most people are familiar with the effects of ordinary transport accidents. It is therefore important to achieve public acceptance, that means, to convince the public that transport of RAM is really safe. Four points are of special importance in this connection: (1) information of the public about the safety philosophy and the radiation protection principles developed by the International Atomic Energy Agency (IAEA) for the transport of RAM. The planned edition of explanatory material to the IAEA Safety Series No. 6 - the so-called why document - is very important for this point; (2) information about the average and maximal individual annual doses for members of the public from normal transport of RAM; (3) information of the public about accident experiences in transport of RAM and the excellent safety standard reached in this field; and (4) information of the public about the extent and the results of governmental controls in this field. In the Federal Republic of Germany the states are requested to report to the Federal Ministry of the Interior all special events occurring during handling and carriage of RAM. The main purpose of these reports is to inform the competent authorities and to draw - if necessary - the conclusion for the improvement of protective measures

  1. Success of the control of tuberculosis in Nigeria: a review | Erah ...

    African Journals Online (AJOL)

    Tuberculosis (TB) has emerged as the single leading cause of death from any single infectious agent and has continued to be a major public health problem all over the world. Of the over 14 million cases worldwide reported by World Health Organisation (WHO) in 2008, Nigeria ranked fifth in terms of incidence. Depending ...

  2. Magnetic resonance imaging in acute intractional tuberculosis

    International Nuclear Information System (INIS)

    Venz, S.; Sander, B.; Benndorf, G.; Terstegge, K.; Podrabsky, P.; Cordes, M.; Felix, R.

    1994-01-01

    We reported three cases of acute intracranial tuberculosis including miliary tuberculosis, basal meningitis, tuberculomas and neuritis of cranial nerves. All patients had native and contrast enhanced CT and MRI scans. MRI revealed more granulomas and a better imaging contrast in the detection of basal meningitis. Neuritis was diagnosed only with the MRI. MRI scans should be prefered as the imaging procedure in clinically presumed intracranial tuberculosis. (orig.) [de

  3. Standardizing measurement, sampling and reporting for public exposure assessments

    Energy Technology Data Exchange (ETDEWEB)

    Rochedo, Elaine R.R. [Instituto de Radioprotecao e Dosimetria, Comissao Nacional de Energia Nuclear, Av. Salvador Allende s/No. CEP 22780-160 Rio de Janeiro, RJ (Brazil)], E-mail: elaine@ird.gov.br

    2008-11-15

    UNSCEAR assesses worldwide public exposure from natural and man-made sources of ionizing radiation based on information submitted to UNSCEAR by United Nations Member States and from peer reviewed scientific literature. These assessments are used as a basis for radiation protection programs of international and national regulatory and research organizations. Although UNSCEAR describes its assessment methodologies, the data are based on various monitoring approaches. In order to reduce uncertainties and improve confidence in public exposure assessments, it would be necessary to harmonize the methodologies used for sampling, measuring and reporting of environmental results.

  4. Mortality and associated factors of patients with extensive drug-resistant tuberculosis: an emerging public health crisis in China.

    Science.gov (United States)

    Bei, Chengli; Fu, Manjiao; Zhang, Yao; Xie, Hebin; Yin, Ke; Liu, Yanke; Zhang, Li; Xie, Bangruan; Li, Fang; Huang, Hua; Liu, Yuhong; Yang, Li; Zhou, Jing

    2018-06-07

    Limited treatment options of extensive drug-resistant tuberculosis (XDR-TB) have led to its high mortality worldwide. Relevant data about mortality of XDR-TB patients in literature are limited and likely underestimate the real situation in China, since the majority of patients with XDR-TB are lost to follow-up after discharge from TB hospitals. In this study, we sought to investigate the mortality and associated risk factors of Human Immunodeficiency Virus (HIV)-negative patients with XDR-TB in China. All patients who were diagnosed with XDR-TB for the first time in four TB care centers across China between March 2013 and February 2015 were consecutively enrolled. Active tracking through contacting patients or family members by phone or home visit was conducted to obtain patients' survival information by February 2017. Multivariable Cox regression models were used to evaluate factors associated with mortality. Among 67 patients enrolled, the mean age was 48.7 (Standard Deviation [SD] = 16.7) years, and 51 (76%) were men. Fourteen patients (21%) were treatment naïve at diagnosis indicating primary transmission. 58 (86.8%) patients remained positive for sputum smear or culture when discharged. During a median follow-up period of 32 months, 20 deaths occurred, with an overall mortality of 128 per 1000 person-years. Among patients who were dead, the median survival was 5.4 months (interquartile range [IQR]: 2.2-17.8). Seventeen (85%) of them died at home, among whom the median interval from discharge to death was 8.4 months (IQR: 2.0-18.2). In Cox proportional hazards regression models, body mass index (BMI) study suggested an alarming situation of XDR-TB patients in China with a sizable proportion of newly transmitted cases, a high mortality rate, and a long period in community. This observation calls for urgent actions to improve XDR-TB case management in China, including providing regimens with high chances of cure and palliative care, and enhanced infection

  5. Infecção pelo complexo Mycobacterium tuberculosis em carneiro da Barbária (Ammotragus lervia no Zoológico de Curitiba, sul do Brasil: relato de caso

    Directory of Open Access Journals (Sweden)

    Vivien Midori Morikawa

    2016-10-01

    Full Text Available Tuberculosis is one of the most important mandatory notification diseases in the world caused by bacteria of the Mycobacterium tuberculosis complex, infecting both humans and animals. A sudden death of a Barbary sheep in Curitiba Zoo, and presence of multifocal nodules in lungs at necropsy raised suspicion of tuberculosis. Quantitative polymerase chain reaction (qPCR from organs and fluid was performed and detected M. tuberculosis complex in a lung sample. This research reports the M. tuberculosis complex infection in Barbary sheep, a zoonosis of great relevance to public health and emphasizes the need to implement prevention measures. Furthermore, the research may provide a better understanding for species conservation, occurrence and transmission of diseases in captivity, reservoir potential and public health impact to zoo personnel and visitors.

  6. Situation of bovine tuberculosis in Ecuador Situación de la tuberculosis bovina en el Ecuador

    OpenAIRE

    Freddy Proaño-Pérez; Washington Benítez-Ortiz; Françoise Portaels; Leen Rigouts; Annick Linden

    2011-01-01

    Bovine tuberculosis (BTB) is a chronic and contagious disease that affects domestic animals, wildlife, and humans. Caused by Mycobacterium bovis, BTB causes major economic losses and poses a serious constraint to international livestock trade. Moreover, in developing countries where BTB controls are lacking, M. bovis is a public health concern. In most developing countries, the prevalence of BTB in livestock is unknown because the information is either not reported or not available. In Ecuado...

  7. OROPHARYNGEAL TUBERCULOSIS: AN UNUSUAL PRESENTATION

    Directory of Open Access Journals (Sweden)

    M H Dadgarnia

    2008-12-01

    Full Text Available "nTuberculosis (TB still represents a major public health problem worldwide. The primary form of disease is most often localized to the lung. In a minority of patients, progressive pulmonary disease spreads to other organ systems through self inoculation via infected sputum, blood and lymphatic system, establishing the secondary form of tuberculosis. We present a patient that was referred to us with complaint of ulcerative mouth lesions from 3 months ago. In physical examination multiple erythematous and irregularly ulcerative lesions affecting soft palate area, uvula and anterior tonsillar pillar was noted bilaterally. Punch biopsy was done from several points that revealed chronic granulomatous inflammation. Ziehl-Nielsen staining of cultured specimen demonstrated acid-fast bacilli. Chest X-ray showed apical pulmonary involvement, suggesting tuberculosis infection. Patient was treated with anti-tuberculosis 4 drugs regimen. In the one year follow-up period after complete treatment; patient didn't have any evidence of disease. Oral and oropharyngeal TB lesions are uncommon, it is estimated that only 0.05-5% of total TB cases may present with oral manifestations, but should be an important consideration in the differential diagnosis of lesions that appear in the oral cavity and oropharynx. The secondary form is more frequent and involves mainly the tongue but involvement of pharynx is quite rare condition. Although tuberculosis of oropharynx is relatively rare, with the increasing incidence of tuberculosis, it must be considered in the differential diagnosis of atypical ulcerative lesions of the mouth and oropharynx.

  8. Pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Juhl, J.H.

    1987-01-01

    Dissemination of the tubercle bacillus is of three types: bronchogenic, hematogenous, and lymphangitic. Bronchogenic dissemination occurs when exudate from a cavity or small area of caseation drains into a bronchus and is aspirated into previously uninfected areas either on the same or on the opposite side. This type of spreading occurs frequently after bleeding and when there is a cavity emptying into a bronchus. Hematogenous dissemination leads to miliary tuberculosis and to extrapulmonary lesions throughout the body. Acute massive hematogenous spread causes miliary tuberculosis, while chronic spread in smaller amounts usually results in the chronic extrapulmonary foci. Lymphangitic dissemination is common in primary infection. It is responsible for involvement with subsequent enlargement of hilar and mediastinal nodes that is often seen in children and in young black adults. The reaction to M. tuberculosis depends on the presence or absence of immunity to tuberculoprotein. In individuals having no tissue hypersensitivity or immunity, primary tuberculosis results. In those with immunity produced by previous infection or BCG vaccination, the reactivation (reinfection) disease may develop

  9. Tuberculosis Treatment

    African Journals Online (AJOL)

    Tuberculosis Treatment, Lusaka, Zambia. 1. 2. 2. 3. 3 ... TB treatment has contributed to the steady rise of TB incidence in ... respondents (89.4%) had positive attitude towards TB treatment ..... respondents described feelings of depression, anger and apathy .... Journal of Personality and Social Psychology,. 1979, 37:1-11.

  10. Tuberculosis: General Information

    Science.gov (United States)

    TB Elimination Tuberculosis: General Information What is TB? Tuberculosis (TB) is a disease caused by germs that are spread from person ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination CS227840_A What Does a Positive Test ...

  11. Pulmonary tuberculosis in a patient with rheumatoid arthritis undergoig immunosuppressive treatment: case report

    Directory of Open Access Journals (Sweden)

    Sandro Ceratti

    2014-02-01

    Full Text Available Rheumatoid arthritis is a disease which characteristically affects the joints. Because it is an autoimmune disease, immunosuppressive drugs are widely used in its treatment. The present case report illustrates the association of immunosuppressive treatment with the development of opportunistic infections in a 64-year-old patient.

  12. Patients with secondary amenorrhea due to tuberculosis endometritis towards the induced anti-tuberculosis drug category 1.

    Science.gov (United States)

    Perdhana, Raditya; Sutrisno, Sutrisno; Sugiri, Yani Jane; Baktiyani, Siti Candra Windu; Wiyasa, Arsana

    2016-01-01

    Tuberculosis (TB) is a disease which can affect various organs, including human's genital organs such as the endometrium. Tuberculosis endometritis can cause clinical symptoms of secondary amenorrhea and infertility. Infertility in genital TB caused by the involvement of the endometrium. The case presentation is 33-year-old woman from dr. Saiful Anwar Public Hospital to consult that she has not menstruated since 5 years ago (28 years old). The diagnosis was done by performing a clinical examination until the diagnosis of secondary amenorrhea due to tuberculosis endometritis is obtained. A treatment by using category I of anti-tuberculosis drugs was done for 6 months, afterward an Anatomical Pathology observation found no signs of the tuberculosis symptoms. Based on that, patient, who was diagnosed to have secondary amenorrhea due to tuberculosis endometritis, has no signs of tuberculosis process after being treated by using category I of anti-tuberculosis drugs for 6 months.

  13. Prevalence of post-traumatic stress symptoms and associated factors in tuberculosis (TB), TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa.

    Science.gov (United States)

    Peltzer, Karl; Naidoo, Pamela; Matseke, Gladys; Louw, Julia; McHunu, Gugu; Tutshana, Bomkazi

    2013-01-01

    High rates of tuberculosis (TB) and TB/HIV co-infection is often linked with mental health issues such as post-traumatic stress disorder (PTSD) symptoms, which is further associated with poor health outcomes. In a country such as South Africa where rates of these infectious diseases are high, it is concerning that there is limited/no data on prevalence rates of mental disorders such as PTSD and its associated factors. Therefore, the aim of this study was to establish the prevalence of PTSD symptoms and associated factors in TB, TB retreatment and/or TB-HIV co-infected primary public health-care patients in three districts in South Africa. Brief screening self-report tools were used to measure: PTSD symptoms, psychological distress (anxiety and depression) and alcohol misuse. Other relevant measures, such as adherence to medication, stressful life events and sexual risk-taking behaviours, were obtained through structured questions. A total of 4900 public primary care adult patients from clinics in high TB burden districts from three provinces in South Africa participated. All the patients screened positive for TB (either new or retreatment cases). The prevalence of PTSD symptoms was 29.6%. Patients who screened positive for PTSD symptoms and psychological distress were more likely to be on antidepressant medication. Factors that predicted PTSD symptoms were poverty, residing in an urban area, psychological distress, suicide attempt, alcohol and/or drug use before sex, unprotected sex, TB-HIV co-infected and the number of other chronic conditions. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of TB and HIV.

  14. Public Accountability: The Perceived Usefulness of School Annual Reports

    Directory of Open Access Journals (Sweden)

    Stuart Tooley

    2010-06-01

    Full Text Available Annual reports are an important component of New Zealand schools’ public accountability. Through theannual report the governance body informs stakeholders about school aims, objectives, achievements, use ofresources, and financial performance. This paper identifies the perceived usefulness of the school annualreport to recipients and the extent to which it serves as an instrument of accountability and/or decisionusefulness.The study finds that the annual report is used for a variety of purposes, including: to determine ifthe school has conducted its activities effectively and achieved stated objectives and goals; to examine studentachievements; to assess financial accountability and performance; and to make decisions about the school as asuitable environment for their child/children. Nevertheless, the study also finds that other forms ofcommunication are more important sources of information about the school than the annual report which isseen to fall short of users’ required qualities of understandability, reliability and readability. It would appearimperative that policy makers review the functional role of the school annual report which is a costlydocument to prepare. Further, school managers need to engage in alternative means to communicatesufficient and meaningful information in the discharge of public accountability.

  15. Are any public-reported earthquake precursors valid?

    Directory of Open Access Journals (Sweden)

    N. E. Whitehead

    2004-01-01

    Full Text Available This article examines retrospective public-supplied precursor reports statistically, and confirms published hypotheses that some alleged precursors within 100km and within a day prior to the large 1995 Kobe and 1999 Izmit earthquakes, may be valid. The confirmations are mostly at the p<0.001 level of significance. Most significant were alleged meteorological and geophysical precursors, and less often, animal reports. The chi-squared test used, for the first time eliminates the distorting effects of psychological factors on the reports. However it also shows that correct reports are diluted with about the same number which are merely wishful thinking, and obtaining more reliable data would be logistically difficult. Some support is found for another published hypothesis in which other precursors occurred within the ten days prior to the earthquake.

  16. The Correlation of Initial Sputum Smear Positivity on Treatment Failure of Category 1 Therapy for Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Puput Dyah Ayu

    2016-11-01

    Full Text Available Tuberculosis is an infectious disease and is an important public health problem. Based on data from East Java Province Health Department reported that number of tuberculosis patient in Surabaya is the highest in East Java on year 2014. Early identification and good treatment based on the result of sputum identification are the strategy use to control tuberculosis widespread. So that why, microscopic observation to identify acid fast bacilli (AFB is the fundamental stage to determine recovery treatment. Initial sputum smear positivity is necessary to determine infectious graded. The objectives of the study were to identify of initial sputum smear positivity on treatment failure of category 1 therapy for pulmonary tuberculosis in RS Paru Surabaya year 2011-2014. This study used case control method with quantitative approach. Forty two samples were taken from secondary data. Case group is 21 samples who have treatment failure and control group is 21 successful treatment. Samples were selected by simple random sampling. The chi square correlation showed that highly positive initial smear (p = 0,045; OR = 5,4 have correlated and risk factor to treatment failure on category 1 therapy for pulmonary tuberculosis. The conclusion is patient’s high positive sputum smear initially correlated to treatment failure on category 1 therapy for pulmonary tuberculosis in RS Paru Surabaya year 2011–2014. Keywords: initial sputum smear positivity, treatment failure,, category 1 therapy for pulmonary tuberculosis

  17. Drug-resistance in chronic tuberculosis cases in Southern Nigeria ...

    African Journals Online (AJOL)

    Nigeria has a high burden of tuberculosis but the drug resistant situationwas previously unknown. This report evaluates the firstline drug resistance and associated factors among chronic tuberculosis cases from the tuberculosis control programme in South south and South east zones ofNigeria. Descriptive study of chronic ...

  18. Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: a cross sectional study.

    Science.gov (United States)

    Naidoo, Pamela; Peltzer, Karl; Louw, Julia; Matseke, Gladys; McHunu, Gugu; Tutshana, Bomkazi

    2013-04-26

    Despite the downward trend in the absolute number of tuberculosis (TB) cases since 2006 and the fall in the incidence rates since 2001, the burden of disease caused by TB remains a global health challenge. The co-infection between TB and HIV adds to this disease burden. TB is completely curable through the intake of a strict anti-TB drug treatment regimen which requires an extremely high and consistent level of adherence.The aim of this study was to investigate factors associated with adherence to anti-TB and HIV treatment drugs. A cross-sectional survey method was used. Three study districts (14 primary health care facilities in each) were selected on the basis of the highest TB caseload per clinic. All new TB and new TB retreatment patients were consecutively screened within one month of anti-tuberculosis treatment. The sample comprised of 3107 TB patients who had been on treatment for at least three weeks and a sub-sample of the total sample were on both anti-TB treatment and anti-retro-viral therapy(ART) (N = 757). Data collection tools included: a Socio-Demographic Questionnaire; a Post-Traumatic-Stress-Disorder (PTSD) Screen; a Psychological Distress Scale; the Alcohol Use Disorder Identification Test (AUDIT); and self-report measures of tobacco use, perceived health status and adherence to anti-TB drugs and ART. The majority of the participants (N = 3107) were new TB cases with a 55.9% HIV co-infection rate in this adult male and female sample 18 years and older. Significant predictors of non-adherence common to both anti-TB drugs and to dual therapy (ART and anti-TB drugs) included poverty, having one or more co-morbid health condition, being a high risk for alcohol mis-use and a partner who is HIV positive. An additional predictor for non-adherence to anti-TB drugs was tobacco use. A comprehensive treatment programme addressing poverty, alcohol mis-use, tobacco use and psycho-social counseling is indicated for TB patients (with and without HIV

  19. European public health reports between expectations and reality

    Directory of Open Access Journals (Sweden)

    Birgit Cornelius-Taylor

    2004-06-01

    Full Text Available Despite the great variety of regional and national health reports that have been drawn up in the European Region, authors and users demand that health reports should be conceived as an instrument for health policy. Under the research project “Evaluation of national and regional health reports (Eva PHR” within the Health Monitoring Programme of the European Union, the policy impact of health reports drawn up in 19 European countries has been analysed with the objective of identifying best practice models. Modelled on an agreed list of criteria, regional and national health reports were analysed with regard to their contents, structure and political relevance. Simultaneously, a qualitative analysis of semi-structured interviews held with policy makers (politicians, decision-makers in administration and stakeholders on the experiences, ideas and expectations they have with regard to health reporting was carried out. The presently prevailing practice of descriptive health reporting is characterised by a great heterogeneity among all received reports and by a discrepancy between the expectations of policy makers and actual health reporting. Whereas most health reports in Europe focus on covering the widest possible range of issues and on presenting existing data and indicators accordingly, most decision makers attach considerable importance to linking epidemiology with information about health care provision, financing and evaluation of programmes and activities. To increase the policy relevance of public health reporting, authors should work in close collaboration with policy makers and consider different kinds of products with differing forms and content. Furthermore, the development of methodical instruments for routine policy oriented health reporting could close the current gap between the perceptions of authors and users.

  20. LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement

    DEFF Research Database (Denmark)

    Mack, U; Migliori, G B; Sester, M

    2009-01-01

    . tuberculosis after tuberculin skin test or IGRA conversion is unknown. It is also uncertain how long adaptive immune responses towards mycobacterial antigens persist in the absence of live mycobacteria. Clinical management and public healthcare policies for preventive chemotherapy against tuberculosis could...

  1. Tuberculosis in Pregnancy

    OpenAIRE

    Kecia Gaither; Joseph J. Apuzzio

    1996-01-01

    Tuberculosis (TB) during pregnancy and in the perinatal period was once considered to be an infrequent event in the United States. After a decade of steady decline, however, the disease has begun a resurgence. According to the CDC, a 20% increase in the number of reported cases occurred between 1985 and 1992. The factors associated with this increase are the emergence of human immunodeficiency virus (HIV) infection, the development of drug-resistant organisms, substance abuse, homelessness, a...

  2. Cutaneous tuberculosis over tattoo marks: An unusual occurrence

    Directory of Open Access Journals (Sweden)

    Savita Arya

    2017-04-01

    Full Text Available Among the paucibacillary form of tuberculosis cutaneous tuberculosis occurring very rarely. Lupus vulgaris is a variant of skin tuberculosis. Here we are reporting a case of 20 year old boy presented with proliferative fungating lesion over tattoo mark. Tottooing was done by mobile tattoo artist in a fair. Diagnosis of skin tuberculosis was confirmed by histopathology suggestive of lupus vulgaris and treated with anti-tuberculous drugs.

  3. Maritime illness and death reporting and public health response, United States, 2010-2014.

    Science.gov (United States)

    Stamatakis, Caroline E; Rice, Marion E; Washburn, Faith M; Krohn, Kristopher J; Bannerman, Millicent; Regan, Joanna J

    2017-09-01

    Deaths and certain illnesses onboard ships arriving at US ports are required to be reported to the US Centers for Disease Control and Prevention (CDC), and notifications of certain illnesses are requested. We performed a descriptive analysis of required maritime illness and death reports of presumptive diagnoses and requested notifications to CDC's Division of Global Migration and Quarantine, which manages CDC's Quarantine Stations, from January 2010 to December 2014. CDC Quarantine Stations received 2891 individual maritime case reports: 76.8% (2221/2891) illness reports, and 23.2% (670/2891) death reports. The most frequent individual illness reported was varicella (35.9%, 797/2221) and the most frequently reported causes of death were cardiovascular- or pulmonary-related conditions (79.6%, 533/670). There were 7695 cases of influenza-like illness received within aggregate notifications. CDC coordinated 63 contact investigations with partners to identify 972 contacts; 88.0% (855/972) were notified. There was documentation of 6.5% (19/293) receiving post-exposure prophylaxis. Three pertussis contacts were identified as secondary cases; and one tuberculosis contact was diagnosed with active tuberculosis. These data provide a picture of US maritime illness and death reporting and response. Varicella reports are the most frequent individual disease reports received. Contact investigations identified few cases of disease transmission. Copyright © 2017. Published by Elsevier Ltd.

  4. Socio-economic status and self-reported tuberculosis: A multilevel analysis in a low-income township in the eastern cape, South Africa

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.H.E. Koolman (Xander); V. Møller (Valerie); A.P. Nieboer (Anna)

    2011-01-01

    textabstractFew studies have investigated the interplay of multiple factors affecting the prevalence of tuberculosis in developing countries. The compositional and contextual factors that affect health and disease patterns must be fully understood to successfully control tuberculosis. Experience

  5. Public health financial management needs: report of a national survey.

    Science.gov (United States)

    Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas

    2009-01-01

    The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.

  6. Primary Tuberculosis of the Appendix: A Rare Cause of a Common ...

    African Journals Online (AJOL)

    Tuberculosis is still a common infection in India. Although the ileocecal region is the most affected part in intestinal tuberculosis, acute tuberculous appendicitis is quite a rare entity. Our case report highlights a rare presentation of tuberculosis and a brief review of literature. Key words: Appendix, granuloma, tuberculosis ...

  7. Advanced nuclear reactor public opinion project. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Benson, B.

    1991-07-25

    This Interim Report summarizes the findings of our first twenty in-depth interviews in the Advanced Nuclear Reactor Public Opinion Project. We interviewed 6 industry trade association officials, 3 industry attorneys, 6 environmentalists/nuclear critics, 3 state officials, and 3 independent analysts. In addition, we have had numerous shorter discussions with various individuals concerned about nuclear power. The report is organized into the four categories proposed at our April, 1991, Advisory Group meeting: safety, cost-benefit analysis, science education, and communications. Within each category, some change of focus from that of the Advisory Group has been required, to reflect the findings of our interviews. This report limits itself to describing our findings. An accompanying memo draws some tentative conclusions.

  8. Peritoneal tuberculosis due to Mycobacterium caprae

    Directory of Open Access Journals (Sweden)

    T. Nebreda

    2016-01-01

    Full Text Available The incidence of tuberculosis in humans due to Mycobacterium caprae is very low and is almost confined to Europe. We report a case of a previously healthy 41-year-old Moroccan with a 6 month history of abdominal pain, weight loss, fatigue and diarrhea. A diagnosis of peritoneal tuberculosis due to M. caprae was made.

  9. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

    Directory of Open Access Journals (Sweden)

    Elizabeth da Trindade de Andrade

    Full Text Available The World Health Organization (WHO identifies 8.7 million new cases of tuberculosis (TB annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target.To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment.Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis.Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence.The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health

  10. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence

    Science.gov (United States)

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; de Siqueira, Hélio Ribeiro; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    Introduction The World Health Organization (WHO) identifies 8.7 million new cases of tuberculosis (TB) annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO’s cure target. Goal To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment. Methods Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis. Results Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students’ education. The existence of health programs and policies was mentioned as a potential enabler of adherence. Conclusion The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship

  11. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

    Science.gov (United States)

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; Siqueira, Hélio Ribeiro de; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    The World Health Organization (WHO) identifies 8.7 million new cases of tuberculosis (TB) annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target. To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment. Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis. Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence. The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health strategies.

  12. Tuberculosis ocular

    OpenAIRE

    Infante Barrera, Francisco

    2011-01-01

    La evolución etiológica de la medicina la podemos dividir en dos grandes períodos: período de la sífilis y período de la tuberculosis. El período de la sífilis, gracias a las armas de combate de que hoy disponemos, ocupa un lugar secundario. El período de la tuberculosis y que no es sino el paralelo de la vida moderna, ocupa en vigencia el primer lugar. Es el período presente. Hasta hace poco tiempo el médico en general, iniciaba la exploración de su paciente con un interrogatorio, una inspec...

  13. "What is meant by public?": Stakeholder views on strengthening impacts of public reporting of hospital performance data.

    Science.gov (United States)

    Canaway, Rachel; Bismark, Marie; Dunt, David; Prang, Khic-Houy; Kelaher, Margaret

    2018-04-01

    Public reporting of hospital performance data is a developing area that is gaining increased attention. This is the first study to explore a range of stakeholder opinions on how such public reporting could be strengthened in Australia. Thirty-four semi-structured interviews were conducted with a purposive sample of expert healthcare consumer, provider and purchaser informants who worked in a variety of senior roles and had knowledge of or involvement in public reporting of hospital data within the public or private healthcare sectors. Informants from all Australian states, territory and national jurisdictions participated. Thematic analysis was used to gain an overview of experts' opinions to inform policy and systems-development for strengthening foundational frameworks for public reporting of health services performance. Themes arising were synthesised to generate explanatory figures to highlight key areas for strengthening public reporting. Our findings suggest that in Australia there is a lack of agreement on what the objectives and who the audience are for public reporting of hospital performance data. Without this shared understanding it is difficult to strengthen frameworks and impacts of public reporting. When developing frameworks for public reporting of hospital data in Australia, more explicit definition of what or who are the 'public' is needed along with identification of barriers, desired impacts, data needs, and data collection/reporting/feedback mechanisms. All relevant stakeholders should be involved in design of public reporting frameworks. Offering multiple systems of public reporting, each tailored to particular audiences, might enable greater impact of reporting towards improved hospital quality and safety, and consumer knowledge to inform treatment decisions. This study provides an overview of perspectives, but further research is warranted to develop PR frameworks that can generate greatest impacts for the needs of various audiences

  14. Public Discourse in Energy Policy Decision-Making: Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Idaho Citizen; Eileen DeShazo; John Freemuth; Tina Giannini; Troy Hall; Ann Hunter; Jeffrey C. Joe; Michael Louis; Carole Nemnich; Jennie Newman; Steven J. Piet; Stephen Sorensen; Paulina Starkey; Kendelle Vogt; Patrick Wilson

    2010-08-01

    The ground is littered with projects that failed because of strong public opposition, including natural gas and coal power plants proposed in Idaho over the past several years. This joint project , of the Idaho National Laboratory, Boise State University, Idaho State University and University of Idaho has aimed to add to the tool box to reduce project risk through encouraging the public to engage in more critical thought and be more actively involved in public or social issues. Early in a project, project managers and decision-makers can talk with no one, pro and con stakeholder groups, or members of the public. Experience has shown that talking with no one outside of the project incurs high risk because opposition stakeholders have many means to stop most (if not all) energy projects. Talking with organized stakeholder groups provides some risk reduction from mutual learning, but organized groups tend not to change positions except under conditions of a negotiated settlement. Achieving a negotiated settlement may be impossible. Furthermore, opposition often arises outside pre-existing groups. Standard public polling provides some information but does not reveal underlying motivations, intensity of attitudes, etc. Improved methods are needed that probe deeper into stakeholder (organized groups and members of the public) values and beliefs/heuristics to increase the potential for change of opinions and/or out-of-box solutions. The term “heuristics” refers to the mental short-cuts, underlying beliefs, and paradigms that everyone uses to filter and interpret information, to interpret what is around us, and to guide our actions and decisions. This document is the final report of a 3-year effort to test different public discourse methods in the subject area of energy policy decision-making. We analyzed 504 mail-in surveys and 80 participants in groups on the Boise State University campus for their preference, financial support, and evaluations of eight attributes

  15. Tuberculosis ocular

    Directory of Open Access Journals (Sweden)

    Francisco Infante Barrera

    1950-01-01

    Full Text Available La evolución etiológica de la medicina la podemos dividir en dos grandes períodos: período de la sífilis y período de la tuberculosis. El período de la sífilis, gracias a las armas de combate de que hoy disponemos, ocupa un lugar secundario. El período de la tuberculosis y que no es sino el paralelo de la vida moderna, ocupa en vigencia el primer lugar. Es el período presente. Hasta hace poco tiempo el médico en general, iniciaba la exploración de su paciente con un interrogatorio, una inspección, un tacto y una serología con una obsesión sifilítica. En la época actual el médico y en especial el oftalmólogo debe tener una obsesión tuberculosa en la investigación etiológica. Cuántas veces en una afección ocular que de una manera lenta pero progresiva produce profundas alteraciones oculares, lleva el sello soterrado de una tuberculosis? Cuántos enfermos de una constitución en apariencia envidiable hacen precisamente por un exceso de sus defensas una alergia tuberculosa? Tan traicionera como la sífilis es la tuberculosis. La sífilis quema sus etapas y estalla con una hemorragia cerebral, una locura, una parálisis general, una ataxia locomotriz progresiva, una goma o una meningitis sifilítica. La tuberculosis hace su presentación con una afección ocular, una goma, una granulia, una artritis, una osteítis, o una meningitis óptico-quiasmática. Siendo esto así, es necesario, en la mayoría de las afecciones oculares, tratar de identificarla por los medios de diagnóstico de que hoy disponemos.

  16. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries.

    Science.gov (United States)

    Getahun, Haileyesus; Matteelli, Alberto; Abubakar, Ibrahim; Aziz, Mohamed Abdel; Baddeley, Annabel; Barreira, Draurio; Den Boon, Saskia; Borroto Gutierrez, Susana Marta; Bruchfeld, Judith; Burhan, Erlina; Cavalcante, Solange; Cedillos, Rolando; Chaisson, Richard; Chee, Cynthia Bin-Eng; Chesire, Lucy; Corbett, Elizabeth; Dara, Masoud; Denholm, Justin; de Vries, Gerard; Falzon, Dennis; Ford, Nathan; Gale-Rowe, Margaret; Gilpin, Chris; Girardi, Enrico; Go, Un-Yeong; Govindasamy, Darshini; D Grant, Alison; Grzemska, Malgorzata; Harris, Ross; Horsburgh, C Robert; Ismayilov, Asker; Jaramillo, Ernesto; Kik, Sandra; Kranzer, Katharina; Lienhardt, Christian; LoBue, Philip; Lönnroth, Knut; Marks, Guy; Menzies, Dick; Migliori, Giovanni Battista; Mosca, Davide; Mukadi, Ya Diul; Mwinga, Alwyn; Nelson, Lisa; Nishikiori, Nobuyuki; Oordt-Speets, Anouk; Rangaka, Molebogeng Xheedha; Reis, Andreas; Rotz, Lisa; Sandgren, Andreas; Sañé Schepisi, Monica; Schünemann, Holger J; Sharma, Surender Kumar; Sotgiu, Giovanni; Stagg, Helen R; Sterling, Timothy R; Tayeb, Tamara; Uplekar, Mukund; van der Werf, Marieke J; Vandevelde, Wim; van Kessel, Femke; van't Hoog, Anna; Varma, Jay K; Vezhnina, Natalia; Voniatis, Constantia; Vonk Noordegraaf-Schouten, Marije; Weil, Diana; Weyer, Karin; Wilkinson, Robert John; Yoshiyama, Takashi; Zellweger, Jean Pierre; Raviglione, Mario

    2015-12-01

    Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone. Copyright ©ERS 2015.

  17. Gas tax fund and public transit fund outcomes report

    International Nuclear Information System (INIS)

    2009-01-01

    Federal gas tax and public transit agreements were signed in 2005 by the Government of Canada, the Province of Ontario, the Association of Municipalities of Ontario (AMO) and the City of Toronto in order to address long-term community sustainability and invest in municipal infrastructure. The agreement committed to providing $1.9 billion to Ontario municipalities over a 5-year period. An additional $2.4 billion has been provided for a further 4-year period from 2010 to 2014. The funds are used by communities to invest in capacity building or environmentally sustainable municipal infrastructure projects. This report identified the intermediate and ultimate outcomes of the federal gas tax fund and public transit fund as of December 2008. Outcomes were presented in the categories of community energy systems, public transit, water and wastewater, solid waste, and roads and bridges. Funding highlights and economic spin-offs for the projects were also presented, as well as summaries of ancillary social outcomes. 6 tabs., 4 figs.

  18. Challenges in public awareness: reports of uranium poisoning in Punjab

    International Nuclear Information System (INIS)

    Virk, Hardev Singh

    2012-01-01

    Public interest and concern about environmental radiation hazards has increased after the Chernobyl reactor accident on 26 April 1 986 and, more recently, after the Japanese Radiation Disaster at Fukushima Daiichi Nuclear Power Plant when it was hit by Tsunami on March 11, 2011. Reactor accidents and nuclear explosions have created a media-hype and a 'nuclear neurosis' among the general public to veto setting up any nuclear facility in the neighbourhood or even in remote areas. There is lot of public protest in Tamil Nadu against setting up of Kudankulam Atomic Power Project. Public awareness of environmental radiation hazards is an area which is most neglected in India. A typical case study is the uranium poisoning of ground water Bathinda district of Punjab, where contradictory reports have been published in newspapers during last years (2009-11). Uranium poisoning in Punjab first made news in March 2009, when a South African Clinical Metal Toxicologist, Carin Smit (www.carinsmit.co.za), visiting Faridkot city in Punjab found surprisingly high levels of uranium 88% of the blood samples collected from amongst mentally retarded children in the Malwa region of Punjab. The results of this study were published in a peer review Journal: Clinical Medicine Insights: Therapeutics (2010:2 655-661; doi: 10.4137/CMT.S5154). The results revealed that 87% of children below 12 years and 82% beyond that age having uranium levels high enough to cause diseases, and in the case of one child, the levels were more than 60 times the maximum safe limit. The reports of this study when published in local newspapers created a fear psychosis in the minds of public. Many scientists from Universities of Punjab jumped on the band wagon of Carin Smit to support her claim of high uranium content in blood samples by providing results of uranium analysis of soil and groundwater samples collected from some villages of Bathinda district of Punjab. The present author has carried out an exhaustive

  19. Risk factors for unsuccessful tuberculosis treatment outcome (failure, default and death) in public health institutions, Eastern Ethiopia.

    Science.gov (United States)

    Amante, Tariku Dingeta; Ahemed, Tekabe Abdosh

    2015-01-01

    Unsuccessful TB treatment outcome is a serious public health concern. It is compelling to identify, and deal with factors determining unsuccessful treatment outcome. Therefore, study was aimed to determine pattern of unsuccessful TB treatment outcome and associated factors in eastern Ethiopia. A case control study was used. Cases were records of TB patients registered as defaulter, dead and/or treatment failure where as controls were those cured or treatment complete. Multivariate logistic regression models were used to derive adjusted odds ratios (OR) at 95% CI to examine the relationship between the unsuccessful TB treatment outcome and patients' characteristics. A total of 990 sample size (330 cases and 660 controls) were included. Among cases (n = 330), majority 212(64.2%) were because of death, 100(30.3%) defaulters and 18(5.5%) were treatment failure. Lack of contact person(OR = 1.37; 95% CI 1.14-2.9, P, .024), sputum smear negative treatment category at initiation of treatment (OR = 1.8; 95% CI 1.3-5.5,P, .028), smear positive sputum test result at 2(nd) month after initiation treatment (OR = 14; 95% CI 5.5-36, P,0.001) and HIV positive status (OR = 2.5; 95% CI 1.34-5.7, P, 0.01) were independently associated with increased risk of unsuccessful TB treatment outcome. Death was the major cause of unsuccessful TB treatment outcome. TB patients do not have contact person, sputum smear negative treatment category at initiation of treatment, smear positive on 2(nd) month after treatment initiation and HIV positive were factors significantly associated unsuccessful treatment outcome. TB patients with sputum smear negative treatment category, HIV positive and smear positive on 2(nd) nd month of treatment initiation need strict follow up throughout DOTs period.

  20. Beyond Choice to New Public Schools: Withdrawing the Exclusive Franchise in Public Education. Policy Report No. 8.

    Science.gov (United States)

    Kolderie, Ted

    A strategy for revitalizing public education by stimulating the creation of new public schools is proposed in this report. The proposed system goes beyond school choice and is based on the withdrawal of local districts' exclusive franchise to own and operate public schools. The proposal is based on the premise that the state must provide both…

  1. Imaging in Tuberculosis abdominal

    International Nuclear Information System (INIS)

    Suarez, Tatiana; Garcia, Vanessa; Tamara, Estrada; Acosta, Federico

    2010-01-01

    In this article we illustrate and discuss imaging features resulting from Tuberculosis abdominal affectation. We present patients evaluated with several imaging modalities who had abdominal symptoms and findings suggestive of granulomatous disease. Diagnosis was confirm including hystopatology and clinical outgoing. Cases involved presented many affected organs such as lymphatic system, peritoneum, liver, spleen, pancreas, kidneys, ureters, adrenal glands and pelvic organs Tuberculosis, Tuberculosis renal, Tuberculosis hepatic, Tuberculosis splenic Tomography, x-ray, computed

  2. 86th Annual Georgia Public Health Association Meeting & Conference Report.

    Science.gov (United States)

    Smith, Selina A; Abbott, Regina; Sims, Christy

    2015-01-01

    Ebola crisis, palliative care, and essentials of advocacy in action for public health. Concurrent workshops focused on Board of Health training, public health accreditation, capacity building, collaboration, patient-centered outcomes, synthetic cannabinoid use, the HIV care continuum, use of data for informed decision making, environmental threats, organizational development, epidemiology, policy, and regulation. Thirty-two (32) awards were presented, including Lawmaker of the Year Award to Governor Nathan and First Lady Sandra Deal for their active and engaged role in promoting public health in Georgia; and the Sellers-McCroan Award to Commissioner Brenda Fitzgerald, Georgia Department of Public Health (DPH) State Health Officer, for her leadership of the Georgia Ebola Response Team and leadership of the newly formed department. The conference attracted 569 registrants primarily through pre-registration (n=561) with limited onsite registration (n=8). For this year's conference, there was a significant increase in attendance (36%) and exhibitors (33%) relative to 2014. Of registrants reporting GPHA section participation, representation included: academic (5%); administration (10%); boards of health (13%); career development (15%); emergency preparedness (2%); epidemiology (5%); health education and promotion (2%); information technology (2%); maternal and child health (3%); medical/dental (3%); nursing (10%); nutrition (<1%); and other/no record (15%). There was 100% participation in the conference from the state's 18 public health districts. The conference evaluation completed by a representative sample of registrants indicated areas of potential improvement as: starting sessions on time, using electronic and social media for the conference agenda/syllabus, and decreasing workshop sessions to 45 minutes. Most rated the conference as "good" or "excellent."

  3. Risk Aversion and Public Reporting. Part 2: Mitigation Strategies.

    Science.gov (United States)

    Shahian, David M; Jacobs, Jeffrey P; Badhwar, Vinay; D'Agostino, Richard S; Bavaria, Joseph E; Prager, Richard L

    2017-12-01

    Part 1 of this review summarizes the consequences of risk aversion and the observational studies and surveys relevant to this phenomenon, almost all of which are derived from cardiac surgery and interventional cardiology. In Part 2, we describe the root cause of risk aversion-the belief by providers that current risk adjustment is inadequate to account for the severity of their highest-risk patients, thereby prejudicing their publicly reported performance scores. Evidence supporting the robustness of current risk adjustment is presented, as well as nine potential strategies to further mitigate risk aversion: optimization of data source, risk models, and performance measures; exclusion of high-risk patients; exclusion of non-procedure-related end points; separate reporting of high-risk patients; reporting by condition or diagnosis rather than by procedures; reporting at the hospital or program level rather than the physician level; collaborative, cross-disciplinary decision making; active surveillance for risk aversion; and improved stakeholder education. Of these, the first is most desirable, widely applicable, and resistant to gaming. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  4. PVMapper: Report on the Second Public Opinion Survey

    Energy Technology Data Exchange (ETDEWEB)

    Carlisle, Juliet [Idaho National Lab. (INL), Idaho Falls, ID (United States); Joe, Jeffrey [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kane, Stephanie [Idaho National Lab. (INL), Idaho Falls, ID (United States); Koehler, Dave [Idaho National Lab. (INL), Idaho Falls, ID (United States); Solan, David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2013-06-24

    This report has been developed as an integral part of the PVMapper project, funded by the U.S. Department of Energy’s Office of Energy Efficiency and Renewable Energy’s SunShot program. The objective of the SunShot program is to reduce the total costs of solar energy systems. The scope of PVMapper is to develop a geographic information system (GIS) based project planning tool to identify optimal utility-scale solar facility sites. The specific objectives of the project are to 1) develop the software on an open-source platform; 2) integrate the appropriate data sets and GIS layers; 3) include a measure of social risk and public acceptance; 4) enable customization of variable weights; 5) provide a free and accessible platform for software download; and 6) provide a sustainability plan to ensure future relevance of the software. When completed, PVMapper is intended to be used by solar developers, Authorities Having Jurisdiction (AHJs), and other interested parties. This project supports SunShot’s objective by reducing the non-hardware balance of system costs (“soft costs”) for utility-scale solar project development. In order to accomplish the third project objective – including a measure of social risk and public acceptance within PVMapper – the project team has developed a time-series public opinion survey, administered yearly over the course of the three-year project. This report highlights the results and preliminary analyses from the second survey in this series. While the results of this survey are valuable to both PVMapper and future utility-scale solar development, the time-series design is extremely important. The completion of the series enables the extension of the dataset to much richer information. For example, the research team altered this iteration to sharpen the focus on specific topics (those posing potentially higher risks) and target specific locations in the oversample (such as communities near existing facilities). Using similar

  5. Tuberculosis and AIDS co-morbidity in Brazil: linkage of the tuberculosis and AIDS databases

    Directory of Open Access Journals (Sweden)

    Angelica Espinosa Miranda

    Full Text Available This study evaluated differences in AIDS patients with and without tuberculosis (TB in Espírito Santo State, Brazil. Standard regional AIDS (SINAN, SISCEL, SICLOM and SIM and tuberculosis (SINAN databases were used. TB and AIDS databases were linked using Reclink software, version 3, with SPSS software support to identify co-infected cases. Data from July 2000 to June 2006 in Espírito Santo State were linked. The results showed 3,523 adult AIDS cases and 9,958 adult TB cases resulted in 430 co-infected patients, who were compared to 1,290 AIDS patients who never developed TB. Among 430 co-infected patients, TB was diagnosed first in 223 (51.9%, AIDS was first in 44 (10.2%, and AIDS and TB were diagnosed concurrently in 163 (37.9%. Median age did not differ between co-infected cases (36 years (interquartile range [IQR] 29-43 and non-co-infected cases (34 years; IQR 28-42. Pulmonary tuberculosis was diagnosed in 239 (55.6%; 109 (25.3% had extra-pulmonary TB and 82 (19.1% had both presentations. In the final logistic regression model, living in a metropolitan area [Odds Ratio (OR=1.43 (95% Confidence Interval (CI 1.05-1.95], education < 3 years [OR=3.03 (95%CI 1.56-5.88] and CD4 counts < 200/mm³ [OR=1.14 (95%CI 1.09-1.18] were associated with co-infection. This report emphasizes the significance of tuberculosis among AIDS cases in Brazil, and highlights the importance of evaluating secondary data for purposes of improving data quality and developing public health interventions.

  6. Greenridge Multi-Pollutant Control Project Preliminary Public Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Connell, Daniel P

    2009-01-12

    the commercial readiness of an emissions control system that is specifically designed to meet the environmental compliance requirements of these smaller coal-fired EGUs. The multi-pollutant control system is being installed and tested on the AES Greenidge Unit 4 (Boiler 6) by a team including CONSOL Energy Inc. as prime contractor, AES Greenidge LLC as host site owner, and Babcock Power Environmental Inc. as engineering, procurement, and construction contractor. All funding for the project is being provided by the U.S. Department of Energy, through its National Energy Technology Laboratory, and by AES Greenidge. AES Greenidge Unit 4 is a 107 MW{sub e} (net), 1950s vintage, tangentially-fired, reheat unit that is representative of many of the 440 smaller coal-fired units identified above. Following design and construction, the multi-pollutant control system will be demonstrated over an approximately 20-month period while the unit fires 2-4% sulfur eastern U.S. bituminous coal and co-fires up to 10% biomass. This Preliminary Public Design Report is the first in a series of two reports describing the design of the multi-pollutant control facility that is being demonstrated at AES Greenidge. Its purpose is to consolidate for public use all available nonproprietary design information on the Greenidge Multi-Pollutant Control Project. As such, the report includes a discussion of the process concept, design objectives, design considerations, and uncertainties associated with the multi-pollutant control system and also summarizes the design of major process components and balance of plant considerations for the AES Greenidge Unit 4 installation. The Final Public Design Report, the second report in the series, will update this Preliminary Public Design Report to reflect the final, as-built design of the facility and to incorporate data on capital costs and projected operating costs.

  7. Pancreatic Tuberculosis or Autoimmune Pancreatitis

    Directory of Open Access Journals (Sweden)

    Ayesha Salahuddin

    2014-01-01

    Full Text Available Introduction. Isolated pancreatic and peripancreatic tuberculosis is a challenging diagnosis due to its rarity and variable presentation. Pancreatic tuberculosis can mimic pancreatic carcinoma. Similarly, autoimmune pancreatitis can appear as a focal lesion resembling pancreatic malignancy. Endoscopic ultrasound-guided fine needle aspiration provides an effective tool for differentiating between benign and malignant pancreatic lesions. The immune processes involved in immunoglobulin G4 related systemic diseases and tuberculosis appear to have some similarities. Case Report. We report a case of a 59-year-old Southeast Asian male who presented with fever, weight loss, and obstructive jaundice. CT scan revealed pancreatic mass and enlarged peripancreatic lymph nodes. Endoscopic ultrasound-guided fine needle aspiration confirmed the presence of mycobacterium tuberculosis. Patient also had high immunoglobulin G4 levels suggestive of autoimmune pancreatitis. He was started on antituberculosis medications and steroids. Clinically, he responded to treatment. Follow-up imaging showed findings suggestive of chronic pancreatitis. Discussion. Pancreatic tuberculosis and autoimmune pancreatitis can mimic pancreatic malignancy. Accurate diagnosis is imperative as unnecessary surgical intervention can be avoided. Endoscopic ultrasound-guided fine needle aspiration seems to be the diagnostic test of choice for pancreatic masses. Long-term follow-up is warranted in cases of chronic pancreatitis.

  8. Tuberculosis in Tanzanian wildlife.

    Science.gov (United States)

    Cleaveland, S; Mlengeya, T; Kazwala, R R; Michel, A; Kaare, M T; Jones, S L; Eblate, E; Shirima, G M; Packer, C

    2005-04-01

    Bovine tuberculosis, caused by Mycobacterium bovis, is a pathogen of growing concern in free-ranging wildlife in Africa, but little is known about the disease in Tanzanian wildlife. Here, we report the infection status of Mycobacterium bovis in a range of wildlife species sampled from protected areas in northern Tanzania. M. bovis was isolated from 11.1% (2/18) migratory wildebeest (Connochaetes taurinus) and 11.1% (1/9) topi (Damaliscus lunatus) sampled systematically in 2000 during a meat cropping program in the Serengeti ecosystem, and from one wildebeest and one lesser kudu (Tragelaphus imberbis) killed by sport hunters adjacent to Tarangire National Park. A tuberculosis antibody enzyme immunoassay (EIA) was used to screen serum samples collected from 184 Serengeti lions (Panthera leo) and 19 lions from Ngorongoro Crater sampled between 1985 and 2000. Samples from 212 ungulates collected throughout the protected area network between 1998 and 2001 also were tested by EIA. Serological assays detected antibodies to M. bovis in 4% of Serengeti lions; one positive lion was sampled in 1984. Antibodies were detected in one of 17 (6%) buffalo (Syncerus caffer) in Tarangire and one of 41 (2%) wildebeest in the Serengeti. This study confirms for the first time the presence of bovine tuberculosis in wildlife of northern Tanzania, but further investigation is required to assess the impact on wildlife populations and the role of different wildlife species in maintenance and transmission.

  9. Pulmonary Langerhans cell histiocytosis with cervical lymph node involvement, and coexistence with pulmonary tuberculosis and right pneumothorax: a case report and review of literature.

    Science.gov (United States)

    Gao, Limin; Li, Huifang; Li, Gandi; Liu, Weiping; Li, Jinnan; Zhang, Wenyan

    2015-01-01

    We report an uncommon 22-year-old male Pulmonary Langerhans Cell Histiocytosis (PLCH) case which co-existed with pulmonary tuberculosis (TB). Unlike the common PLCH cases, this PLCH case has cervical lymph node involvement and right pneumothorax. The diagnosis was established by the imaging of lung and the biopsies of the lung and left neck lymph node. Imaging of the chest showed characteristic small nodules and thin-walled cysts and right pneumothorax. The LCH cells in the lung and left neck lymph node were characterized by large convoluted nuclei with cerebriform indentations of the nuclear envelope and longitudinal grooves. The nuclei contained small eosinophilic nucleoli and moderate amount cytoplasm. Immunohistochemically, the histiocytoid cells were positive for Langerin, CD1a and S-100. Acid-fast bacilli were found in sputum and lung biopsy tissue. To the best of our knowledge, this is the first case of PLCH with cervical lymph node involvement, and coexisted with pulmonary tuberculosis, right pneumothorax. A contribution of this case and review three of the five cases of PLCH with extrapulmonary involvement to lymph nodes resolved spontaneously after smoking cessation constitute a novel addition that it is inappropriate to regard pulmonary/nodal LCH as multi-organ or disseminated disease, and the treatment methods are the same whether the PLCH patient with lymph node involvement or not.

  10. Spinal tuberculosis.

    Science.gov (United States)

    Dunn, R N; Ben Husien, M

    2018-04-01

    Tuberculosis (TB) remains endemic in many parts of the developing world and is increasingly seen in the developed world due to migration. A total of 1.3 million people die annually from the disease. Spinal TB is the most common musculoskeletal manifestation, affecting about 1 to 2% of all cases of TB. The coexistence of HIV, which is endemic in some regions, adds to the burden and the complexity of management. This review discusses the epidemiology, clinical presentation, diagnosis, impact of HIV and both the medical and surgical options in the management of spinal TB. Cite this article: Bone Joint J 2018;100-B:425-31.

  11. Peripheral neuropathy in a diabetic child treated with linezolid for multidrug-resistant tuberculosis: a case report and review of the literature.

    Science.gov (United States)

    Swaminathan, Aravind; du Cros, Philipp; Seddon, James A; Mirgayosieva, Shamsiya; Asladdin, Rajabov; Dusmatova, Zulfiya

    2017-06-12

    Extensively drug-resistant (XDR) tuberculosis (TB) and multidrug resistant (MDR)-TB with additional resistance to injectable agents or fluoroquinolones are challenging to treat due to lack of available, effective drugs. Linezolid is one of the few drugs that has shown promise in treating these conditions. Long-term linezolid use is associated with toxicities such as peripheral and optic neuropathies. Diabetes mellitus (DM), especially when uncontrolled, can also result in peripheral neuropathy. The global burden of DM is increasing, and DM has been associated with a three-fold increased risk of developing TB disease. TB and DM can be a challenging combination to treat. DM can inhibit the host immune response to tuberculosis infection; and TB and some anti-TB drugs can worsen glycaemic control. A child experiencing neuropathy that is a possible complication of both DM and linezolid used to treat TB has not been reported previously. We report peripheral neuropathy in a 15-year-old boy with type 1 DM, diagnosed with MDR-TB and additional resistance to injectable TB medications. The boy was treated with a linezolid-based regimen, but after 8 months developed peripheral neuropathy. It was unclear whether the neuropathy was caused by the DM or the linezolid therapy. He had clinical improvement following cessation of linezolid and was declared cured following 21 months of treatment. Following completion of treatment, nerve conduction studies demonstrated significant improvement in neuropathy. To the best of our knowledge, this is the first case of peripheral neuropathy reported in a diabetic child on long-term linezolid therapy for tuberculosis. This case study underlines the importance of stringent follow-up for side effects of linezolid, especially when associated with co-morbidity such as DM that increases the chances of adverse effects. The presence of both DM and TB should alert a physician to strive for optimal glycaemic control to minimize the risk of

  12. Detection of Mycobacterium bovis and Mycobacterium tuberculosis from Cattle: Possible Public Health Relevance

    DEFF Research Database (Denmark)

    Thakur, Aneesh; Sharma, Mandeep; Katoch, Vipin C.

    2012-01-01

    Mycobacterium bovis and Mycobacterium tuberculosis infect both animals and humans. The disease epidemiology by these agents differs in developed and developing countries due to the differences in the implementation of the prevention and control strategies. The present study describes the detectio...

  13. Tuberculosis post-liver transplantation: a rare but complicated disease.

    Science.gov (United States)

    Lu, W; Wai, C T; Da Costa, M; Tambyah, P A; Prabhakaran, K; Lee, K H

    2005-03-01

    Tuberculosis is a rare but serious complication after transplantation. We report a case and discuss its presentation and management. A 60-year-old Indonesian male presented initially with fever, acute confusion and rapidly progressive right upper lobe pneumonia 3.5 months post-liver transplant, and was diagnosed with pulmonary tuberculosis by positive sputum smear for acid-fast bacilli and tuberculosis culture. Standard anti-tuberculosis therapy was administered but was complicated by interaction with cyclosporine and drug-induced cholestasis. A high level of suspicion, prompt antituberculosis treatment and close follow-up are essential in management of post-transplant tuberculosis.

  14. National Energy Strategy: A compilation of public comments; Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    1990-04-01

    This Report presents a compilation of what the American people themselves had to say about problems, prospects, and preferences in energy. The Report draws on the National Energy Strategy public hearing record and accompanying documents. In all, 379 witnesses appeared at the hearings to exchange views with the Secretary, Deputy Secretary, and Deputy Under Secretary of Energy, and Cabinet officers of other Federal agencies. Written submissions came from more than 1,000 individuals and organizations. Transcripts of the oral testimony and question-and-answer (Q-and-A) sessions, as well as prepared statements submitted for the record and all other written submissions, form the basis for this compilation. Citations of these sources in this document use a system of identifying symbols explained below and in the accompanying box. The Report is organized into four general subject areas concerning: (1) efficiency in energy use, (2) the various forms of energy supply, (3) energy and the environment, and (4) the underlying foundations of science, education, and technology transfer. Each of these, in turn, is subdivided into sections addressing specific topics --- such as (in the case of energy efficiency) energy use in the transportation, residential, commercial, and industrial sectors, respectively. 416 refs., 44 figs., 5 tabs.

  15. Predictors of job satisfaction and burnout among tuberculosis management nurses and physicians.

    Science.gov (United States)

    Seo, Hae-Suk; Kim, Hyunjoong; Hwang, Se-Min; Hong, Soo Hyun; Lee, In-Young

    2016-01-01

    This study examined job satisfaction, empowerment, job stress, and burnout among tuberculosis management nurses and physicians in public healthcare institutions. This was a cross-sectional study analyzing survey data collected from 249 nurses and 57 physicians in 105 public health centers, three public tuberculosis hospitals, and one tertiary hospital. The survey questionnaire comprised general characteristics, work-related characteristics, and four index scales (job satisfaction, empowerment, job stress, and burnout). The two-sample t-test was used to estimate the mean differences in the four index scales. Multiple regression analysis was used to determine whether general and work-related characteristics affected the four index scales. The job satisfaction and empowerment scores of the nurses were lower than those of the physicians. Except for the tuberculosis-specialized hospitals alone, the average job satisfaction scores of nurses were higher than those of physicians. Moreover, the nurses reported more job stress and burnout than did the physicians in tuberculosis departments in public healthcare institutions in Korea; in particular, the burnout reported by nurses was significantly higher than that reported by physicians at the National Medical Center. Marital status, nursing position, number of coworkers, the average number of days of overtime work per month, self-rated health, and hospital type were associated with the four index scales. Overall, nurses were more vulnerable to job stress and burnout than physicians. Reducing the workload of nurses by ensuring the presence of sufficient nursing staff and equipment, as well as by equipping facilities to prevent tuberculosis infections, should be considered priorities.

  16. 41 CFR 304-6.8 - Will the reports be made available for public inspection?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false Will the reports be made available for public inspection? 304-6.8 Section 304-6.8 Public Contracts and Property Management Federal...-PAYMENT GUIDELINES Valuation § 304-6.8 Will the reports be made available for public inspection? Yes, OGE...

  17. Mycobacterium tuberculosis TlyA Protein Negatively Regulates T Helper (Th) 1 and Th17 Differentiation and Promotes Tuberculosis Pathogenesis*

    Science.gov (United States)

    Rahman, Md. Aejazur; Sobia, Parveen; Dwivedi, Ved Prakash; Bhawsar, Aakansha; Singh, Dhiraj Kumar; Sharma, Pawan; Moodley, Prashini; Van Kaer, Luc; Bishai, William R; Das, Gobardhan

    2015-01-01

    Mycobacterium tuberculosis, the causative agent of tuberculosis, is an ancient pathogen and a major cause of death worldwide. Although various virulence factors of M. tuberculosis have been identified, its pathogenesis remains incompletely understood. TlyA is a virulence factor in several bacterial infections and is evolutionarily conserved in many Gram-positive bacteria, but its function in M. tuberculosis pathogenesis has not been elucidated. Here, we report that TlyA significantly contributes to the pathogenesis of M. tuberculosis. We show that a TlyA mutant M. tuberculosis strain induces increased IL-12 and reduced IL-1β and IL-10 cytokine responses, which sharply contrasts with the immune responses induced by wild type M. tuberculosis. Furthermore, compared with wild type M. tuberculosis, TlyA-deficient M. tuberculosis bacteria are more susceptible to autophagy in macrophages. Consequently, animals infected with the TlyA mutant M. tuberculosis organisms exhibited increased host-protective immune responses, reduced bacillary load, and increased survival compared with animals infected with wild type M. tuberculosis. Thus, M. tuberculosis employs TlyA as a host evasion factor, thereby contributing to its virulence. PMID:25847237

  18. Tuberculosis screening among Bolivian sex workers and their children.

    Science.gov (United States)

    Chiang, Silvia S; Paulus, Jessica K; Huang, Chi-Cheng; Newby, P K; Castellón Quiroga, Dora; Boynton-Jarrett, Renée; Antkowiak, Lara

    2015-06-01

    Bolivian sex workers were more likely than other employed women to report tuberculosis screening only if they reported HIV screening. Of all women with household tuberculosis exposure, <40% reported screening for themselves or their children. Coupling tuberculosis screening with sex workers' mandatory HIV screenings may be a cost-efficient disease-control strategy. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  19. CT and MR findings of genitourinary tuberculosis

    International Nuclear Information System (INIS)

    Bae, In Young; Kim, Mi Young; Cho, Soon Gu; Suh, Chang Hae; Park, Won Hee

    2000-01-01

    Genitourinary tuberculosis is a disease spread hematogenously from a small tuberculous abscess of the lung. The renal cortex is initially involved, and multiple granulomas form. Ultimately the cortex may cavitate and communicate with the collecting system, allowing downward extension of the infection and subsequent focal caliectasis with infundibular stenosis, ureteral fibrosis, and calcifications of urinary tract organs. The female genitourinary organ is also infected by the hematogenous spread of tuberculosis, the most common lesion being hydrosalpynx with salpingitis. The clinical and radiologic features of genitourinary tuberculosis may mimic other acute abdominal diseases, and the diagnosis of tuberculosis remains difficult. This report describes the ways in which computed tomography and magnetic resonance imaging are valuable aids in the recognition and diagnosis of genitourinary tuberculosis. (author)

  20. How to be Open about Spending : Innovating in Public Sector Reporting in the Information Age

    NARCIS (Netherlands)

    Faber, A.S.C.; Budding, G.

    2017-01-01

    The field of public sector reporting is moving from vertical to horizontal accountability: from hierarchical relationships that mediate between public organisations and citizens to directly disclosing available information. IT developments play an important role in innovative forms of reporting that

  1. How to Be Open About Spending : Innovating in Public Sector Reporting in the Information Age

    NARCIS (Netherlands)

    Faber, A.S.C.

    2018-01-01

    The field of public sector reporting is moving from vertical to horizontal accountability: from hierarchical relationships that mediate between public organisations and citizens to directly disclosing available information. IT developments play an important role in innovative forms of reporting that

  2. Coinfection: A Case Report

    Directory of Open Access Journals (Sweden)

    Huldah I. Nwokeukwu

    2013-01-01

    Full Text Available Background. Tuberculosis is a major public health problem, and its control has been facing a lot of challenges with emergence of HIV. The occurrence of multidrug-resistant strain has also propounded the problem especially in children where diagnosis is difficult to make. Multidrug-resistant tuberculosis (MDR-TB is in vitro resistant to isoniazid (H and rifampicin (R. Paediatric multi-drug resistant tuberculosis with HIV coinfection is rare, and there is no documented report from Nigeria. Objective. To report a case of paediatric MDR-TB in Nigeria about it. Methods. The case note of the patient was retrieved, and relevant data were extracted and summarized. Results. A 9-year-old female HIV-positive pupil with a year history of recurrent cough, 3 months history of recurrent fever, and generalized weight loss was diagnosed and treated for tuberculosis but failed after retreatment. She was later diagnosed with MDR-TB and is presently on DOT-Plus regimen. Conclusion. Paediatric MDR-TB with HIV co-infection is rare. Early diagnosis and treatment is important to prevent spread of the disease. The use of Isoniazid preventive therapy is recommended for children who come in contact with patients with active tuberculosis and also for HIV patients without active tuberculosis.

  3. TUBERCULOSIS: EPIDEMIOLOGY AND CONTROL

    Directory of Open Access Journals (Sweden)

    Giorgia Sulis

    2014-10-01

    Full Text Available Tuberculosis (TB is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012. TB is by all means a poverty-related disease, mainly affecting the most vulnerable populations in the poorest countries. The presence of multidrug-resistant strains of M. tuberculosis in most countries, with some where prevalence is high, is among the major challenges for TB control, which may hinder recent achievements especially in some settings. Early TB case detection especially in resource-constrained settings and in marginalized groups remains a challenge, and about 3 million people are estimated to remain undiagnosed or not notified and untreated. The World Health Organization (WHO has recently launched the new global TB strategy for the “post-2015 era” aimed at “ending the global TB epidemic” by 2035, based on the three pillars that emphasize patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation. This paper aims to provide an overview of the global TB epidemiology as well as of the main challenges that must be faced to eliminate the disease as a public health problem everywhere.

  4. Fast and efficient detection of tuberculosis antigens using liposome encapsulated secretory proteins of Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Dileep Tiwari

    2017-04-01

    Conclusion: Our study demonstrated that the newly developed liposome tuberculosis antigen card test detected antigens in our study population with approximately 97.48% sensitivity and 95.79% specificity. This is the first study to report the liposomal encapsulation of culture filtrate proteins from M. tuberculosis for diagnostic application.

  5. Chromoblastomycosis due to Fonsecaea monophora misdiagnosed as sporotrichosis and cutaneous tuberculosis in a pulmonary tuberculosis patient

    NARCIS (Netherlands)

    Shi, Dongmei; Zhang, Wei; Lu, Guixia; de Hoog, G Sybren; Liang, Guanzhao; Mei, Huan; Zheng, Hailin; Shen, Yongnian; Liu, Weida

    Chromoblastomycosis is caused by dematiaceous fungi. It develops after inoculation of the organism into the skin. We report a case of chromoblastomycosis in a pulmonary tuberculosis patient without known history of trauma. The lesions were initially diagnosed as sporotrichosis and skin tuberculosis.

  6. Sonographic Findings of Abdominal Tuberculosis in Children With Pulmonary Tuberculosis

    NARCIS (Netherlands)

    Bélard, Sabine; Heller, Tom; Orie, Viyanti; Heuvelings, Charlotte C.; Bateman, Lindy; Workman, Lesley; Grobusch, Martin P.; Zar, Heather J.

    2017-01-01

    Ultrasound reports of 102 children with microbiologically confirmed or clinically diagnosed pulmonary tuberculosis (TB) showed that 23 of 37 (64%) and 23 of 65 (36%) had TB suggestive abdominal lymphadenopathy, and 16 of 37 (44%) and 8 of 65 (13%) had splenic microabscesses, respectively. Splenic

  7. "The Impact of Mycobacterium tuberculosis Immune Evasion on Protective Immunity: Implications for TB Vaccine Design" - Meeting report.

    Science.gov (United States)

    Boggiano, Cesar; Eichelberg, Katrin; Ramachandra, Lakshmi; Shea, Jaqueline; Ramakrishnan, Lalita; Behar, Samuel; Ernst, Joel D; Porcelli, Steven A; Maeurer, Markus; Kornfeld, Hardy

    2017-06-14

    Tuberculosis (TB) is the major cause of death from infectious diseases around the world, particularly in HIV infected individuals. TB vaccine design and development have been focused on improving Bacille Calmette-Guérin (BCG) and evaluating recombinant and viral vector expressed Mycobacterium tuberculosis (Mtb) proteins, for boosting BCG-primed immunity, but these approaches have not yet yielded significant improvements over the modest effects of BCG in protecting against infection or disease. On March 7-8, 2016, the National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on "The Impact of Mtb Immune Evasion on Protective Immunity: Implications for TB Vaccine Design" with the goal of defining immune mechanisms that could be targeted through novel research approaches, to inform vaccine design and immune therapeutic interventions for prevention of TB. The workshop addressed early infection events, the impact of Mtb evolution on the development and maintenance of an adaptive immune response, and the factors that influence protection against and progression to active disease. Scientific gaps and areas of study to revitalize and accelerate TB vaccine design were discussed and prioritized. These included a comprehensive evaluation of innate and Mtb-specific adaptive immune responses in the lung at different stages of disease; determining the role of B cells and antibodies (Abs) during Mtb infection; development of better assays to measure Mtb burden following exposure, infection, during latency and after treatment, and approaches to improving current animal models to study Mtb immunogenicity, TB disease and transmission. Copyright © 2017.

  8. User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine

    Directory of Open Access Journals (Sweden)

    Niranjan Konduri

    2017-05-01

    Full Text Available Ukraine has successfully implemented e-TB Manager nationwide as its mandatory national tuberculosis registry after first introducing it in 2009. Our objective was to perform an end-of-programme evaluation after formal handover of the registry administration to Ukraine's Centre for Disease Control in 2015. We conducted a nationwide, cross-sectional, anonymous, 18-point user experience survey, and stratified the registry's transaction statistics to demonstrate usability. Contrary to initial implementation experience, older users (aged >50 years, often with limited or no computer proficiency prior to using the registry, had significantly better user experience scores for at least six of the 12 measures compared to younger users (aged 18–29 years. Using the registry for >3 years was associated with significantly higher scores for having capacity, adequacy of training received and satisfaction with the registry. Of the 5.9 million transactions over a 4-year period, nine out of 24 oblasts (regions and Kiev city accounted for 62.5% of all transactions, and corresponded to 59% of Ukraine's tuberculosis burden. There were 437 unique active users in 486 rayons (districts of Ukraine, demonstrating extensive reach. Our key findings complement the World Health Organization and European Respiratory Society's agenda for action on digital health to help implement the End TB Strategy.

  9. Arizona Public Service - Alternative Fuel (Hydrogen) Pilot Plant Design Report

    Energy Technology Data Exchange (ETDEWEB)

    James E. Francfort

    2003-12-01

    Hydrogen has promise to be the fuel of the future. Its use as a chemical reagent and as a rocket propellant has grown to over eight million metric tons per year in the United States. Although use of hydrogen is abundant, it has not been used extensively as a transportation fuel. To assess the viability of hydrogen as a transportation fuel and the viability of producing hydrogen using off-peak electric energy, Pinnacle West Capital Corporation (PNW) and its electric utility subsidiary, Arizona Public Service (APS) designed, constructed, and operates a hydrogen and compressed natural gas fueling station—the APS Alternative Fuel Pilot Plant. This report summarizes the design of the APS Alternative Fuel Pilot Plant and presents lessons learned from its design and construction. Electric Transportation Applications prepared this report under contract to the U.S. Department of Energy’s Advanced Vehicle Testing Activity. The Idaho National Engineering and Environmental Laboratory manages these activities for the Advanced Vehicle Testing Activity.

  10. Risk assessment of hepatotoxicity among tuberculosis and human immunodeficiency virus/AIDS-coinfected patients under tuberculosis treatment

    OpenAIRE

    Williams Ngouleun; Prosper Cabral Biapa Nya; Anatole Constant Pieme; Phelix Bruno Telefo

    2016-01-01

    Objective/background: Tuberculosis (TB) is a worldwide public health problem. It is a contagious and grave disease caused by Mycobacterium tuberculosis. Current drugs such as isoniazid, pyrazinamide, and rifampicin used for the treatment of tuberculosis are potentially hepatotoxic and can lead to drug hepatitis. In order to improve the follow-up of TB patients in Cameroon, we carried out a study which aimed to evaluate the hepatotoxicity risk factors associated with anti-TB drugs. Methods:...

  11. A systematic review of missed opportunities for improving tuberculosis and HIV/AIDS control in Sub-saharan Africa: what is still missed by health experts?

    Science.gov (United States)

    Keugoung, Basile; Fouelifack, Florent Ymele; Fotsing, Richard; Macq, Jean; Meli, Jean; Criel, Bart

    2014-01-01

    In sub-Saharan Africa, HIV/AIDS and tuberculosis are major public health problems. In 2010, 64% of the 34 million of people infected with HIV were reported to be living in sub-Saharan Africa. Only 41% of eligible HIV-positive people had access to antiretroviral therapy (ART). Regarding tuberculosis, in 2010, the region had 12% of the world's population but reported 26% of the 8.8 million incident cases and 254000 tuberculosis-related deaths. This paper aims to review missed opportunities for improving HIV/AIDS and tuberculosis prevention and care. We conducted a systematic review in PubMed using the terms 'missed'(Title) AND 'opportunities'(Title). We included systematic review and original research articles done in sub-Saharan Africa on missed opportunities in HIV/AIDS and/or tuberculosis care. Missed opportunities for improving HIV/AIDS and/or tuberculosis care can be classified into five categories: i) patient and community; ii) health professional; iii) health facility; iv) local health system; and v) vertical programme (HIV/AIDS and/or tuberculosis control programmes). None of the reviewed studies identified any missed opportunities related to health system strengthening. Opportunities that are missed hamper tuberculosis and/or HIV/AIDS care in sub-Saharan Africa where health systems remain weak. What is still missing in the analysis of health experts is the acknowledgement that opportunities that are missed to strengthen health systems also undermine tuberculosis and HIV/AIDS prevention and care. Studying why these opportunities are missed will help to understand the rationales behind the missed opportunities, and customize adequate strategies to seize them and for effective diseases control.

  12. Diagnosis and treatment of spinal tuberculosis after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Peng-Cheng Gu; Rong-Huan Wu; Xiang-Jin Lin

    2009-01-01

    BACKGROUND: Spinal tuberculosis is a common disease in orthopedic clinical practice; however, it is seldom reported after organ transplantation. The aim of this study was to investigate the diagnosis and treatment of spinal tuberculosis after organ transplantation. METHOD: Two cases were diagnosed as spinal tuberculosis after liver transplantation and were treated with socarboxazide, rifampicin, streptomycin and ethambutol for more than one year. RESULTS: After treatment with anti-tuberculosis drugs for several months, the symptoms of both patients clearly improved. Back pain disappeared, and erythrocyte sedimentation and body temperature returned to normal. CONCLUSIONS: We should highly suspect spinal tuberculosis if notalgia and night sweats are present after organ transplantation. Anti-tuberculosis therapy is an effective treatment for spinal tuberculosis after organ transplantation.

  13. Report of the Public's Right to Information Task Force

    International Nuclear Information System (INIS)

    Rubin, D.M.

    1979-10-01

    Information is presented concerning the public information chronology; Met Ed public relations; flow of public information during the accident at Three Mile Island; flow of public information on five key events during the accident at Three Mile Island; the journalist's perspective; content analysis of mass media coverage of the accident; local radio news coverage of the accident; and qualitative survey of newspaper coverage of the accident

  14. Report of the Public's Right to Information Task Force

    International Nuclear Information System (INIS)

    Rubin, D.M.; Chaapel, H.A.; Cunningham, A.M.

    1979-10-01

    Information is presented concerning the public information chronology; MET ED public relations; flow of public information during the accident at Three Mile Island; flow of public information on five key events during the accident at Three Mile Island; the journalist's perspective; content analysis of mass media coverage of the accident; local radio news coverage of the accident; and qualitative survey of newspaper coverage of the accident

  15. Green Dot Public Schools. What Works Clearinghouse Intervention Report

    Science.gov (United States)

    What Works Clearinghouse, 2018

    2018-01-01

    "Green Dot Public Schools" is a nonprofit organization that operates more than 20 public charter middle and high schools in California, Tennessee, and Washington. The "Green Dot Public Schools" model emphasizes high quality teaching, strong school leadership, a curriculum that prepares students for college, and partnerships…

  16. HIV status and tuberculosis

    African Journals Online (AJOL)

    User

    Failure to perform mycobacterium culture bacterial blood culture and results of other causes of .... for Identification of Highly Infectious Tuberculosis in People Living with HIV in Southeast Asia. ... Indian Journal of Tuberculosis 58, 108-112.

  17. Tuberculosis Lymphoedema Cutis

    Directory of Open Access Journals (Sweden)

    Gangopadhyay Asok Kumar

    2001-01-01

    Full Text Available Lymphoedema following cutaneous tuberculosis is a rare occurrence. A case of elephantiasis of leg following lupus vulgaris is presented. It can still be seen in rural India in untreated advanced cutaneous tuberculosis.

  18. Tuberculosis and Diabetes

    Science.gov (United States)

    TUBERCULOSIS www.who.int/tb & DIABETES THE DUAL EPIDEMIC OF TB AND DIABETES DEADLY LINKAGES  People with ... higher risk of progressing from latent to active tuberculosis.  Diabetes triples a person’s risk of developing TB. ...

  19. Tuberculosis Treatment and Pregnancy

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Tuberculosis (TB) Note: Javascript is disabled or is not ... message, please visit this page: About CDC.gov . Tuberculosis Basic TB Facts How TB Spreads Latent TB ...

  20. Play the Tuberculosis Game

    Science.gov (United States)

    ... Questionnaire Tuberculosis Play Tuberculosis Experiments & Discoveries About the game Discover and experience some of the classic methods ... last will in Paris. Play the Blood Typing Game Try to save some patients and learn about ...

  1. An Annual Report to the Legislature on Oregon Public Schools. Oregon Statewide Report Card. 2014-2015

    Science.gov (United States)

    Oregon Department of Education, 2015

    2015-01-01

    The Oregon Statewide Report Card is an annual publication required by law (ORS 329.115), which reports on the state of public schools and their progress towards the goals of the Oregon Educational Act for the 21st Century. The purpose of the Oregon Report Card is to monitor trends among school districts and Oregon's progress toward achieving the…

  2. Colombia - National Level Public Financial Management and Procurement Report : Status of the Public Financial Management and Procurement System

    OpenAIRE

    World Bank; Inter-American Development Bank

    2009-01-01

    This Public Financial Management Performance Report (PFMPR) analyzes the performance of Colombia's public financial management (PFM) institutions, systems and processes. It documents areas where performance is close to or follows international good practice, as well as opportunities to further enhance PFM contribution to the goals of strengthening fiscal discipline, enabling more efficient...

  3. Colombia - National Level Public Financial Management and Procurement Report : Status of the Colombian Public procurement System - OECD Methodology

    OpenAIRE

    World Bank

    2009-01-01

    This Public Financial Management Performance Report (PFMPR) analyzes the performance of Colombia's public financial management (PFM) institutions, systems and processes. It documents areas where performance is close to or follows international good practice, as well as opportunities to further enhance PFM contribution to the goals of strengthening fiscal discipline, enabling more efficient...

  4. Tuberculosis as occupational disease

    OpenAIRE

    Mendoza-Ticona, Alberto; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico infectólogo tropicalista magister en Epidemiología Clínica.

    2014-01-01

    There is enough evidence to declare tuberculosis as an occupational disease among healthcare workers. In Peru, there are regulations granting employment rights regarding tuberculosis as an occupational disease, such as healthcare coverage for temporary or permanent disability. However, these rights have not been sufficiently socialized. This study presents information on the risk of acquiring tuberculosis in the workplace, and a review of the evidence to declare tuberculosis as an occupationa...

  5. Environmental Public Health Indicators Impact Report: Data and methods that support environmental public health decision-making by communities

    Science.gov (United States)

    This report presents the results of twenty competitively funded Science-To-Achieve-Results (STAR) grants in EPA's Environmental Public Health Indicators (EPHI) research program. The grantsdirectly supported health interventions, informed policy and decision-making, and improved t...

  6. First approach to molecular epidemiology of bovine tuberculosis in Colombia

    Directory of Open Access Journals (Sweden)

    Jimena Jojoa-Jojoa

    2015-12-01

    Full Text Available Objective. To investigate the presence of Mycobacterium bovis and other Mycobacterium species in samples of cattle and buffalo in Colombia, to start the molecular characterization of M. bovis in the country. Material and methods. 492 samples were collected from herds identified with the presence of infected animals through the PPD, by the Group of Bovine Tuberculosis ICA Colombian Agricultural Institute in eight departments of Colombia. Lymph nodes of head, thorax and abdomen, gross lesions of tissues with tuberculosis, nasal swabs, milk, blood and fresh cheeses were included. Samples were subjected to detection of Mycobacterium bovis and other mycobacteria by conventional microbiological analysis and PCR-6110 and spoligotyping molecular assays. Results. In the samples analyzed especially in lymph nodes, Mycobacterium bovis was demonstrated with genotypes reported and not previously reported in the world, as well as M. tuberculosis in Antioquia, Cundinamarca, Boyacá and Magdalena departments. Conclusions. In Colombia there are at least 7 genotypes of M. bovis that are infected and sick cattle and buffalo from four different departments becoming serious threat to public health.

  7. Bureau of Radiological Health Publications Index, August 1978. Report for 1953--1978

    International Nuclear Information System (INIS)

    1978-08-01

    The Bureau of Radiological Health Publications Index to the publications of the Bureau of Radiological Health was prepared to aid in the retrieval and identification of publications originated or authored by Bureau staff or published by the Bureau. These publications include journal articles, government publications and technical reports, selected staff papers and Bureau news releases issued by HEW. For convenience, the document is divided into three sections, KWIC Index, Author Index, and Bibliography Index as described. A section on BRH Technical Reports Index by Subject is included. This portion of the Publications Index lists only those reports published by BRH since 1972

  8. Cutaneous tuberculosis, tuberculosis verrucosa cutis

    Directory of Open Access Journals (Sweden)

    Nilamani Mohanty

    2014-01-01

    Full Text Available Cutaneous tuberculosis because of its variability in presentation, wider differential diagnosis, and difficulty in obtaining microbiological confirmation continues to be the most challenging to diagnose for dermatologists in developing countries. Despite the evolution of sophisticated techniques such as polymerase chain reaction (PCR and enzyme-linked-immunosorbent serologic assay (ELISA, the sensitivity of new methods are not better than the isolation of Mycobacterium tuberculosum in culture. Even in the 21 st century, we rely on methods as old as the intradermal reaction purified protein derivative standard test and therapeutic trials, as diagnostic tools. We describe a case which has been diagnosed and treated as eczema by renowned physicians for 2 years. Incisional biopsy showed the presence of well-defined granulomas and ZN staining of the biopsy specimen showed the presence of acid fast bacilli; a trial of ATT (antitubercular therapy for 6 months lead to permanent cure of the lesion.

  9. Abdominal tuberculosis in children

    Directory of Open Access Journals (Sweden)

    Heda Melinda Nataprawira

    2001-06-01

    supported the diagnosis. There was no positive results of acid fast bacilli and culture done for Mycobacterium tuberculosis in gastric aspirate as well as ascitic fuid. Peritonitis tuberculosis was most commonly diagnosed (80.0%, followed by mesenterial/nodal tuberculosis (20.0%. All of the children followed (60.0% responded well to the drugs therapy.

  10. pulmonary tuberculosis, jimma hospital

    African Journals Online (AJOL)

    and National Tuberculosis and Leprosy Control Program manual. RESULTS: A total of 112 extra pulmonary ... Key words: Clinical audit; extra pulmonary Tuberculosis; National Tuberculosis and. Leprosy Control manual. "Addis Ababa ..... intern influence drug regimen selection. Compliance to the 1997 NTLCP inanual is.

  11. REMap: Operon Map of M. tuberculosis

    Science.gov (United States)

    Xia, Fang Fang; Stevens, Rick L.; Bishai, William R.; Lamichhane, Gyanu

    2016-01-01

    A map of the transcriptional organization of genes of an organism is a basic tool that is necessary to understand and facilitate a more accurate genetic manipulation of the organism. Operon maps are largely generated by computational prediction programs that rely on gene conservation and genome architecture and may not be physiologically relevant. With the widespread use of RNA sequencing (RNAseq), the prediction of operons based on actual transcriptome sequencing rather than computational genomics alone is much needed. Here, we report a validated operon map of Mycobacterium tuberculosis, developed using RNAseq data from both the exponential and stationary phases of growth. At least 58.4% of M. tuberculosis genes are organized into 749 operons. Our prediction algorithm, REMap (RNA Expression Mapping of operons), considers the many cases of transcription coverage of intergenic regions, and avoids dependencies on functional annotation and arbitrary assumptions about gene structure. As a result, we demonstrate that REMap is able to more accurately predict operons, especially those that contain long intergenic regions or functionally unrelated genes, than previous operon prediction programs. The REMap algorithm is publicly available as a user-friendly tool that can be readily modified to predict operons in other bacteria. PMID:27450008

  12. 45 CFR 1355.37 - Opportunity for Public Inspection of Review Reports and Materials.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Opportunity for Public Inspection of Review Reports and Materials. 1355.37 Section 1355.37 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE...

  13. Genomics of Human Pulmonary Tuberculosis: from Genes to Pathways

    DEFF Research Database (Denmark)

    Stein, Catherine M.; Sausville, Lindsay; Wejse, Christian

    2017-01-01

    Purpose of Review Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains a major public health threat globally. Several lines of evidence support a role for host genetic factors in resistance/susceptibility to TB disease and MTB infection. However, results across candidate gene...

  14. [Immigrants treated for tuberculosis in Mazovian Center for Treatment of Lung Diseases and Tuberculosis in Otwock].

    Science.gov (United States)

    Jagodziński, Jacek; Zielonka, Tadeusz M

    2010-01-01

    Migration of population contributes to the transmission of tuberculosis (TB), particularly multidrug-resistant tuberculosis. In the countries of Western Europe, the immigrants' inflow contributes to the deterioration of the epidemiological situation. Majority of newly detected TB cases in some countries were affirmed among immigrant and foreign born population. In Poland, this problem has not been investigated up to 2005. The aim of the study was the assessment of the occurrence of tuberculosis in foreigners treated in the Mazovian Centre for Treatment of Lung Diseases and Tuberculosis in Otwock. This work had a retrospective character. The number of cases of tuberculosis in foreigners admitted between 2002 and 2007 was calculated from the data base of the Mazovian Centre for Treatment of Lung Diseases and Tuberculosis; 125 patients, whose basic demographic data, bacteriological status and the radiological changes suggested TB, were included in the study. The foreigners made up to 0.5-1.7% all tuberculosis cases treated in Mazovian Centre for Treatment of Lung Diseases and Tuberculosis. Among confirmed cases, twenty four nationalities were seen. Nationals of the Russian Federation (coming from the Republic of Chechnya) formed the biggest group (24%), followed by the Vietnamese (21%) and the Ukrainians (12%). Most of all cases were young men (77%; average age - 34 years). Children made up to 12% of all cases. Tuberculosis of lungs was predominating, and there were culture confirmed extrapulmonary locations in 13.6% of cases. Bacteriological confirmation was achieved in 53% of cases, but up to 22.7% cases were resistant to one of the antituberculosis medicines and 13.6% was multidrug-resistant. Despite the fact, that foreigners made up a small proportion among all the patient treated for tuberculosis in Mazovia, their number systematically increases. High proportion of multidrug-resistant tuberculosis reported in foreign-born cases is a concern.

  15. :60 PSA (Anuncio de servicio público): La tuberculosis en nuestra comunidad (Tuberculosis in Our Community)

    Centers for Disease Control (CDC) Podcasts

    Este anuncio de servicio público de 60 segundos en la lengua indígena Mexicana mixteco bajo habla sobre la tuberculosis, una enfermedad infecciosa. This 60 second public service announcement in Mixteco Bajo discusses tuberculosis, a contagious disease.

  16. CD209 genetic polymorphism and tuberculosis disease.

    Directory of Open Access Journals (Sweden)

    Fredrik O Vannberg

    2008-01-01

    Full Text Available Tuberculosis causes significant morbidity and mortality worldwide, especially in sub-Saharan Africa. DC-SIGN, encoded by CD209, is a receptor capable of binding and internalizing Mycobacterium tuberculosis. Previous studies have reported that the CD209 promoter single nucleotide polymorphism (SNP-336A/G exerts an effect on CD209 expression and is associated with human susceptibility to dengue, HIV-1 and tuberculosis in humans. The present study investigates the role of the CD209 -336A/G variant in susceptibility to tuberculosis in a large sample of individuals from sub-Saharan Africa.A total of 2,176 individuals enrolled in tuberculosis case-control studies from four sub-Saharan Africa countries were genotyped for the CD209 -336A/G SNP (rs4804803. Significant overall protection against pulmonary tuberculosis was observed with the -336G allele when the study groups were combined (n = 914 controls vs. 1262 cases, Mantel-Haenszel 2 x 2 chi(2 = 7.47, P = 0.006, odds ratio = 0.86, 95%CI 0.77-0.96. In addition, the patients with -336GG were associated with a decreased risk of cavitory tuberculosis, a severe form of tuberculosis disease (n = 557, Pearson's 2x2 chi(2 = 17.34, P = 0.00003, odds ratio = 0.42, 95%CI 0.27-0.65. This direction of association is opposite to a previously observed result in a smaller study of susceptibility to tuberculosis in a South African Coloured population, but entirely in keeping with the previously observed protective effect of the -336G allele.This study finds that the CD209 -336G variant allele is associated with significant protection against tuberculosis in individuals from sub-Saharan Africa and, furthermore, cases with -336GG were significantly less likely to develop tuberculosis-induced lung cavitation. Previous in vitro work demonstrated that the promoter variant -336G allele causes down-regulation of CD209 mRNA expression. Our present work suggests that decreased levels of the DC-SIGN receptor may therefore be

  17. Economic analysis of public transportation in Reno, Nevada : final report.

    Science.gov (United States)

    2017-08-01

    Access to public transit is important and beneficial economically and socially in numerous ways. Using economic and demographic variables from U.S. Census data, we have examined who is being served by public transit in Reno, as well as examined the f...

  18. Public Service Loan Forgiveness. NASFAA Task Force Report

    Science.gov (United States)

    National Association of Student Financial Aid Administrators, 2014

    2014-01-01

    The Public Service Loan Forgiveness (PSLF) program was established in 2007 to encourage student borrowers to work in the public sector. Qualifying borrowers may have their Direct Loans forgiven after 10 years of full-time service in an eligible job. Currently, qualifying employers include federal, state, or local government agencies and tax-exempt…

  19. Oak Ridge Reservation Public Warning Siren System Annual Test Report

    International Nuclear Information System (INIS)

    R. F. Gee

    2000-01-01

    The full operational test of the Oak Ridge Reservation (ORR) Public Warning Siren System (PWSS) was successfully conducted on September 27, 2000. The annual test is a full-scale sounding of the individual siren systems around each of the three Department of Energy (DOE) sites in Oak Ridge, Tennessee. The purpose of the annual test is to demonstrate and validate the siren systems' ability to alert personnel outdoors in the Immediate Notification Zones (INZ) (approximately two miles) around each site. The success of this test is based on two critical functions of the siren system. The first function is system operability. The system is considered operable if 90% of the sirens are operational. System diagnostics and direct field observations were used to validate the operability of the siren systems. Based on the diagnostic results and field observations, greater than 90% of the sirens were considered operational. The second function is system audibility. The system is considered audible if the siren could be heard in the immediate notification zones around each of the three sites. Direct field observations, along with sound level measurements, were used to validate the audibility of the siren system. Based on the direct field observations and sound level measurements, the siren system was considered audible. The combination of field observations, system diagnostic status reports, and sound level measurements provided a high level of confidence that the system met and would meet operational requirements upon demand. As part of the overall system test, the Tennessee Emergency Management Agency (TEMA) activated the Emergency Alerting System (EAS), which utilized area radio stations to make announcements regarding the test and to remind residents of what to do in the event of an actual emergency

  20. Updates on antibody functions in Mycobacterium tuberculosis infection and their relevance for developing a vaccine against tuberculosis.

    Science.gov (United States)

    Achkar, Jacqueline M; Prados-Rosales, Rafael

    2018-04-12

    A more effective vaccine to control tuberculosis (TB), a major global public health problem, is urgently needed. Current vaccine candidates focus predominantly on eliciting cell-mediated immunity but other arms of the immune system also contribute to protection against TB. We review here recent studies that enhance our current knowledge of antibody-mediated functions against Mycobacterium tuberculosis. These findings, which contribute to the increasing evidence that antibodies have a protective role against TB, include demonstrations that firstly distinct human antibody Fc glycosylation patterns, found in latent M. tuberculosis infection but not in active TB, influence the efficacy of the host to control M. tuberculosis infection, secondly antibody isotype influences human antibody functions, and thirdly that antibodies targeting M. tuberculosis surface antigens are protective. We discuss these findings in the context of TB vaccine development and highlight the need for further research on antibody-mediated immunity in M. tuberculosis infection. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Tuberculosis, a re-emergent disease

    International Nuclear Information System (INIS)

    Valadas, Emilia; Antunes, Francisco

    2005-01-01

    Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. In Western Europe, regions with a high incidence of TB usually also have a high incidence of HIV infection; TB and HIV co-infection have increased over the past decade and among HIV infected patients, nearly half also develop TB. In settings where HIV is prevalent, TB drug resistance has also increased and several reports of TB and multi-drug resistant TB outbreaks, especially in health care settings, raise serious concerns about nosocomial transmission. Further research and new developments into more rapid diagnostic methods and sensitivity testing as well as the development of new anti-TB drugs are important to fight the disease. In addition, public health infrastructures have to be strengthened in order to increase adherence to TB treatment, where directly observed treatment strategy is the cornerstone for a successful outcome

  2. A diagnostic pitfall: pancreatic tuberculosis, not pancreatic cancer

    International Nuclear Information System (INIS)

    Samuel, D.O.; Mukhtar, A.A.M.; Philip, I.O.

    2013-01-01

    Abdominal tuberculosis (TB) is one of the most common forms of extra-pulmonary tuberculosis and is responsible for considerable morbidity and mortality globally. Tuberculosis can involve any part of the gastrointestinal tract from mouth to anus, the peritoneum, liver, spleen and the pancreatobiliary system. The occurrence of abdominal TB is independent of pulmonary disease in most patients, with a reported incidence of co-existing pulmonary disease varying from 6 to 38% worldwide. We report a case of pancreatic tuberculosis also involving the vertebrae, which was initially treated as a case of pancreatic cancer. (author)

  3. Tuberculosis and nutrition

    Directory of Open Access Journals (Sweden)

    Gupta Krishna

    2009-01-01

    Full Text Available Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. These two problems tend to interact with each other. Tuberculosis mortality rates in different economic groups in a community tend to vary inversely with their economic levels. Similarly, nutritional status is significantly lower in patients with active tuberculosis compared with healthy controls. Malnutrition can lead to secondary immunodeficiency that increases the host′s susceptibility to infection. In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis. It has been found that malnourished tuberculosis patients have delayed recovery and higher mortality rates than well-nourished patients. Nutritional status of patients improves during tuberculosis chemotherapy. High prevalence of human immunodeficiency (HIV infection in the underdeveloped countries further aggravates the problem of malnutrition and tuberculosis. Effect of malnutrition on childhood tuberculosis and tuberculin skin test are other important considerations. Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world.

  4. Mountaineer Commercial Scale Carbon Capture and Storage Project Topical Report: Preliminary Public Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Guy Cerimele

    2011-09-30

    This Preliminary Public Design Report consolidates for public use nonproprietary design information on the Mountaineer Commercial Scale Carbon Capture & Storage project. The report is based on the preliminary design information developed during the Phase I - Project Definition Phase, spanning the time period of February 1, 2010 through September 30, 2011. The report includes descriptions and/or discussions for: (1) DOE's Clean Coal Power Initiative, overall project & Phase I objectives, and the historical evolution of DOE and American Electric Power (AEP) sponsored projects leading to the current project; (2) Alstom's Chilled Ammonia Process (CAP) carbon capture retrofit technology and the carbon storage and monitoring system; (3) AEP's retrofit approach in terms of plant operational and integration philosophy; (4) The process island equipment and balance of plant systems for the CAP technology; (5) The carbon storage system, addressing injection wells, monitoring wells, system monitoring and controls logic philosophy; (6) Overall project estimate that includes the overnight cost estimate, cost escalation for future year expenditures, and major project risks that factored into the development of the risk based contingency; and (7) AEP's decision to suspend further work on the project at the end of Phase I, notwithstanding its assessment that the Alstom CAP technology is ready for commercial demonstration at the intended scale.

  5. A cross-sectional study of tuberculosis drug resistance among previously treated patients in a tertiary hospital in Accra, Ghana: public health implications of standardized regimens.

    Science.gov (United States)

    Forson, Audrey; Kwara, Awewura; Kudzawu, Samuel; Omari, Michael; Otu, Jacob; Gehre, Florian; de Jong, Bouke; Antonio, Martin

    2018-04-02

    Mycobacterium tuberculosis drug resistance is a major challenge to the use of standardized regimens for tuberculosis (TB) therapy, especially among previously treated patients. We aimed to investigate the frequency and pattern of drug resistance among previously treated patients with smear-positive pulmonary tuberculosis at the Korle-Bu Teaching Hospital Chest Clinic, Accra. This was a cross-sectional survey of mycobacterial isolates from previously treated patients referred to the Chest Clinic Laboratory between October 2010 and October 2013. The Bactec MGIT 960 system for mycobactrerial culture and drug sensitivity testing (DST) was used for sputum culture of AFB smear-positive patients with relapse, treatment failure, failure of smear conversion, or default. Descriptive statistics were used to summarize patient characteristics, and frequency and patterns of drug resistance. A total of 112 isolates were studied out of 155 from previously treated patients. Twenty contaminated (12.9%) and 23 non-viable isolates (14.8%) were excluded. Of the 112 studied isolates, 53 (47.3%) were pan-sensitive to all first-line drugs tested Any resistance (mono and poly resistance) to isoniazid was found in 44 isolates (39.3%) and any resistance to streptomycin in 43 (38.4%). Thirty-one (27.7%) were MDR-TB. Eleven (35.5%) out of 31 MDR-TB isolates were pre-XDR. MDR-TB isolates were more likely than non-MDR isolates to have streptomycin and ethambutol resistance. The main findings of this study were the high prevalence of MDR-TB and streptomycin resistance among previously treated TB patients, as well as a high prevalence of pre-XDR-TB among the MDR-TB patients, which suggest that first-line and second-line DST is essential to aid the design of effective regimens for these groups of patients in Ghana.

  6. Public consultation in public policy information: a state-of-the-art report

    International Nuclear Information System (INIS)

    Bishop, A.B.; McKee, M.; Hansen, R.D.

    1977-01-01

    The purpose of the National Waste Terminal Storage (NWTS) Program is to site, construct and operate nuclear waste repositories at several locations. Recent experience indicates that the public is aware of the problems of nuclear waste disposal, and correspondingly there is public concern about how and where to dispose of nuclear wastes. The selection of sites involves a wide range of considerations including geological, technical and environmental feasibility. In addition to these, it is important that societal acceptance of repository options also be taken into account in moving foward with the NWTS Program. Such an incorporation of social considerations and preferences correspondingly implies the need for public consultation in the site selection process. In exploring the concept and state-or-the-art of public involvement in public policy decision, a number of important questions are relevant: (1) What are the basic objectives of public participation in policy formation and program decisions. (2) Who are the ''publics'' that should be involved and how can they be identified. (3) What information should be communicated between the agency and the publics. (4) What techniques are available to elicit public participation and involvement and what are their capabilities. At the outset, it should be noted that the purpose of this paper in addressing these questions is not to design public participation procedures for the NWTS program. Rather, the above are questions that provide a broad framework for developing an understanding of citizen participation in public policy decisions, such as nuclear waste disposal. In this sense, the following discussion is to provide a context and guidance for approaching the problem of organizing and structuring involvement in the NWTS program. Annotated bibliography of 95 references is included

  7. Public consultation in public policy information: a state-of-the-art report

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, A.B.; McKee, M.; Hansen, R.D.

    1977-01-01

    The purpose of the National Waste Terminal Storage (NWTS) Program is to site, construct and operate nuclear waste repositories at several locations. Recent experience indicates that the public is aware of the problems of nuclear waste disposal, and correspondingly there is public concern about how and where to dispose of nuclear wastes. The selection of sites involves a wide range of considerations including geological, technical and environmental feasibility. In addition to these, it is important that societal acceptance of repository options also be taken into account in moving foward with the NWTS Program. Such an incorporation of social considerations and preferences correspondingly implies the need for public consultation in the site selection process. In exploring the concept and state-or-the-art of public involvement in public policy decision, a number of important questions are relevant: (1) What are the basic objectives of public participation in policy formation and program decisions. (2) Who are the ''publics'' that should be involved and how can they be identified. (3) What information should be communicated between the agency and the publics. (4) What techniques are available to elicit public participation and involvement and what are their capabilities. At the outset, it should be noted that the purpose of this paper in addressing these questions is not to design public participation procedures for the NWTS program. Rather, the above are questions that provide a broad framework for developing an understanding of citizen participation in public policy decisions, such as nuclear waste disposal. In this sense, the following discussion is to provide a context and guidance for approaching the problem of organizing and structuring involvement in the NWTS program. Annotated bibliography of 95 references is included.

  8. Citoquinas en tuberculosis Cytokines in tuberculosis

    Directory of Open Access Journals (Sweden)

    Jaime I. Rodríguez

    1997-04-01

    specific antigens of Iymphocytes from tuberculin positive healthy subjects induces a type I cytokine pattern (1'IL.2, 1'IFN.y, -VIL.4, -VIL.5 whereas Iymphocytes from tuberculous patients do not exhibit it. Type I cytokines activate macrophages able to inhibit mycobacteria intracellular growth. In mice, nitric oxide produced by activated macrophages is responsible for such effect; however, the productJon of nitric oxide by human macrophages has not been conclusively demonstrated. Recent reports have shown that infection with M. tuberculosis induces apoptosis in infected macrophages. Apoptosis in such conditions is Tumor Necrosis Factor.a and nitric oxide dependent. Paradoxically, mannosylated liparabinomann (ManLAM, a structural component of the rñycobacterial cell wall, inhibits apoptosis of infected macrophages. These results demonstrate a new aspect of the mycobacteria.macrophage relatJonship that must be finely regulated by both the microorganism and the host.

  9. Tuberculosis along the United States-Mexico border, 1993-2001.

    Science.gov (United States)

    Schneider, Eileen; Laserson, Kayla F; Wells, Charles D; Moore, Marisa

    2004-07-01

    Tuberculosis (TB) is a leading public health problem and a recognized priority for the federal Governments of both Mexico and the United States of America. The objectives of this research, primarily for the four states in the United States that are along the border with Mexico, were to: (1) describe the epidemiological situation of TB, (2) identify TB risk factors, and (3) discuss tuberculosis program strategies. We analyzed tuberculosis case reports collected from 1993 through 2001 by the tuberculosis surveillance system of the United States. We used those data to compare TB cases mainly among three groups: (1) Mexican-born persons in the four United States border states (Arizona, California, New Mexico, and Texas), (2) persons in those four border states who had been born in the United States, and (3) Mexican-born persons in the 46 other states of the United States, which do not border Mexico. For the period from 1993 through 2001, of the 16 223 TB cases reported for Mexican-born persons in the United States, 12 450 of them (76.7%) were reported by Arizona, California, New Mexico, and Texas. In those four border states overall in 2001, tuberculosis case rates for Mexican-born persons were 5.0 times as high as the rates for persons born in the United States; those four states have 23 counties that directly border on Mexico, and the ratio in those counties was 5.8. HIV seropositivity, drug and alcohol use, unemployment, and incarceration were significantly less likely to be reported in Mexican-born TB patients from the four border states and the nonborder states than in patients born in the United States from the four border states (P pulmonary tuberculosis patients who were 18-64 years of age and residing in the four border states, the Mexican-born patients were 3.6 times as likely as the United States-born patients were to have resistance to at least isoniazid and rifampin (i. e., to have multidrug-resistant TB) and twice as likely to have isoniazid resistance

  10. Disseminated tuberculosis with prostatic abscesses in an immunocompromised patient—A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Upasana Joneja

    2016-01-01

    Full Text Available We describe a case of disseminated Mycobacterium tuberculosis (mTB with prostatic abscess in a newly diagnosed HIV patient in the United States. The patient is a 34 year-old male who presented with respiratory symptoms and was diagnosed with HIV/AIDS complicated by disseminated mTB infection of the lungs, liver, and prostate. His prostate showed abscess formation on imaging that required drainage however he did not present with any genitourinary complaints. Our literature review revealed that prostatic involvement in mTB in the form of granulomatous prostatitis is uncommon; however, abscess formation is extremely rare and only few such cases have been published. Nearly 50% of the patients with prostatic abscess formation present without symptoms and therefore a high level of suspicion should be maintained; imaging should be performed early and prophylactic antibiotics for non-specific urinary symptoms should be avoided as this may lead to drug resistance of mTB to flouroquinolones.

  11. Antro-duodenal tuberculosis causing gastric outlet obstruction--a rare presentation of a protean disease.

    Science.gov (United States)

    Gheorghe, Liana; Băncilă, Ion; Gheorghe, Cristian; Herlea, Vlad; Vasilescu, Cătălin; Aposteanu, Gabriela

    2002-06-01

    Gastroduodenal tuberculosis is a rare location of abdominal tuberculosis. It usually occurs secondary to pulmonary tuberculosis. We report a case of a 63-year-old woman admitted to the referral center for symptoms of upper gastrointestinal obstruction caused by ulcerohypertrophic antroduodenal tuberculosis. The lesion was misdiagnosed as malignancy at endoscopy. Even at surgery, the lesion was considered gastric cancer and imposed an oncologic resection. The diagnosis was established in the presence of giant-cell granulomas with caseating necrosis in the surgical resected specimens. In our case, the rare gastroduodenal location of abdominal tuberculosis occurred as primary tuberculosis, in the absence of other identifiable locations.

  12. 40 CFR 1612.3 - Published reports and material contained in the public incident investigation dockets.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Published reports and material... Published reports and material contained in the public incident investigation dockets. (a) Demands for published investigation reports should be directed to the Office of Congressional and Public Affairs, U.S...

  13. The risk of unblinding was infrequently and incompletely reported in 300 randomized clinical trial publications

    DEFF Research Database (Denmark)

    Bello, Segun; Moustgaard, Helene; Hróbjartsson, Asbjørn

    2014-01-01

    randomized clinical trials indexed in PubMed in 2010. Two authors read the trial publications and extracted data independently. RESULTS: Twenty-four trial publications, or 8% (95% confidence interval [CI], 5, 12%), explicitly reported the risk of unblinding, of which 16 publications, or 5% (95% CI, 3, 8......%), reported compromised blinding; and 8 publications, or 3% (95% CI, 1, 5%), intact blinding. The reporting on risk of unblinding in the 24 trial publications was generally incomplete. The median proportion of assessments per trial affected by unblinding was 3% (range 1-30%). The most common mechanism...

  14. Rural Public Transportation Technologies: User Needs and Applications. Final Report

    Science.gov (United States)

    1998-08-01

    The Rural Public Transportation Technologies: User Needs and Applications Study was conducted as part of the U.S. DOT's overall Rural Intelligent Transportation System (ITS) Program. The study examined the opportunities and challenges of planning and...

  15. Rural public transportation technologies : user needs and applications : final report

    Science.gov (United States)

    1998-07-01

    The Rural Public Transportation Technologies: User Needs and Applications study was conducted as part of the U.S. Department of Transportations (DOT) overall Rural Intelligent Transportation System (ITS) Program. The study examined the opportuniti...

  16. Performance Measures for Public Participation Methods : Final Report

    Science.gov (United States)

    2018-01-01

    Public engagement is an important part of transportation project development, but measuring its effectiveness is typically piecemealed. Performance measurementdescribed by the Urban Institute as the measurement on a regular basis of the results (o...

  17. Index of Laser Program publications and related reports, 1983

    International Nuclear Information System (INIS)

    1984-05-01

    This document provides a listing of titles and authors of publications from the LLNL Laser Program during calendar year 1983. It is presented as an aid for researchers in the field who may not otherwise have access to a full listing of laser-related work done at LLNL. The intent is to provide a brief and concise listing. Publications are classified by subject, but cross references are not supplied and those documents which logically fall in more than one category may not appear to be in the obvious location. We recognize that gaining access to the publications may be difficult, and have appended a listing of libraries that have microfiche copies of one or more years of LLNL Laser Program publications

  18. Teaching Public Policy for the Arab World : final technical report

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-02-11

    Feb 11, 2016 ... Teaching Public Policy for the Arab World .... integrating politics, policy, economics and other social science research perspectives, this ..... The primary, successful output of this overall project is the viable MA program.

  19. Characterization of extensively drug-resistant Mycobacterium tuberculosis in Nepal.

    Science.gov (United States)

    Poudel, Ajay; Maharjan, Bhagwan; Nakajima, Chie; Fukushima, Yukari; Pandey, Basu D; Beneke, Antje; Suzuki, Yasuhiko

    2013-01-01

    The emergence of extensively drug-resistant tuberculosis (XDR-TB) has raised public health concern for global control of TB. Although molecular characterization of drug resistance-associated mutations in multidrug-resistant isolates in Nepal has been made, mutations in XDR isolates and their genotypes have not been reported previously. In this study, we identified and characterized 13 XDR Mycobacterium tuberculosis isolates from clinical isolates in Nepal. The most prevalent mutations involved in rifampicin, isoniazid, ofloxacin, and kanamycin/capreomycin resistance were Ser531Leu in rpoB gene (92.3%), Ser315Thr in katG gene (92.3%), Asp94Gly in gyrA gene (53.9%) and A1400G in rrs gene (61.5%), respectively. Spoligotyping and multilocus sequence typing revealed that 69% belonged to Beijing family, especially modern types. Further typing with 26-loci variable number of tandem repeats suggested the current spread of XDR M. tuberculosis. Our result highlights the need to reinforce the TB policy in Nepal with regard to control and detection strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. CONSOLIDATED FINANCIAL STATEMENTS – A NEW REPORTING PRACTICE IN THE PUBLIC SECTOR

    OpenAIRE

    Andreea CÎRSTEA; Stefan-Dragos CÎRSTEA

    2015-01-01

    The reforms that have lately influenced the public sector determined several changes in the reporting system, causing the introduction of a new reporting practice in the public sector, namely the consolidated reports. These reports come to bring added value to the accounting and reporting system, but this practice is at the beginning and requires time in order to be taken over at international level. This paper aims to be a theoretical one, with slight empirical traces, analysing the introduc...

  1. DNA repair in Mycobacterium tuberculosis revisited.

    Science.gov (United States)

    Dos Vultos, Tiago; Mestre, Olga; Tonjum, Tone; Gicquel, Brigitte

    2009-05-01

    Our understanding of Mycobacterium tuberculosis DNA repair mechanisms is still poor compared with that of other bacterial organisms. However, the publication of the first complete M. tuberculosis genome sequence 10 years ago boosted the study of DNA repair systems in this organism. A first step in the elucidation of M. tuberculosis DNA repair mechanisms was taken by Mizrahi and Andersen, who identified homologs of genes involved in the reversal or repair of DNA damage in Escherichia coli and related organisms. Genes required for nucleotide excision repair, base excision repair, recombination, and SOS repair and mutagenesis were identified. Notably, no homologs of genes involved in mismatch repair were identified. Novel characteristics of the M. tuberculosis DNA repair machinery have been found over the last decade, such as nonhomologous end joining, the presence of Mpg, ERCC3 and Hlr - proteins previously presumed to be produced exclusively in mammalian cells - and the recently discovered bifunctional dCTP deaminase:dUTPase. The study of these systems is important to develop therapeutic agents that can counteract M. tuberculosis evolutionary changes and to prevent adaptive events resulting in antibiotic resistance. This review summarizes our current understanding of the M. tuberculosis DNA repair system.

  2. Drug development against tuberculosis: Impact of alkaloids.

    Science.gov (United States)

    Mishra, Shardendu K; Tripathi, Garima; Kishore, Navneet; Singh, Rakesh K; Singh, Archana; Tiwari, Vinod K

    2017-09-08

    Despite of the advances made in the treatment and management, tuberculosis (TB) still remains one of main public health problem. The contrary effects of first and second-line anti-tuberculosis drugs have generated extended research interest in natural products in the hope of devising new antitubercular leads. Interestingly, plethoras of natural products have been discovered to exhibit activity towards various resistant strains of M. tuberculosis. Extensive applications of alkaloids in the field of therapeutics is well-established and nowday's researches being pursued to develop new potent drugs from natural sources for tuberculosis. Alkaloids are categorized in quite a few groups according to their structures and isolation from both terrestrial and marine sources. These new drugs might be a watershed in the battle against tuberculosis. This review summarizes alkaloids, which were found active against Mycobacteria since last ten years with special attention on the study of structure-activity relationship (SAR) and mode of action with their impact in drug discovery and development against tuberculosis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Childhood tuberculosis in the State of Qatar: the effect of a limited expatriate screening programme on the incidence of tuberculosis.

    Science.gov (United States)

    Al-Marri, M R

    2001-09-01

    To determine incidence rates and the effectiveness of the expatriate screening programme on paediatric tuberculosis (TB) in the State of Qatar. A state-wide, population-based, retrospective analysis of all cases of tuberculosis among children 0-14 years of age reported to the TB Unit of the Division of Public Health during 1983-1996. One hundred and forty-four children with tuberculous disease were identified, with a steadily declining incidence rate (rate of notification) from 11/100000 children (0-14 years) population in 1983 to 7/100000 in 1996. This decrease in the childhood TB case notification rate correlated with foreign-born children, older children and the implementation of expatriate screening in 1986. Diagnosis in 56% of children was made abroad or within 3 months of arrival from vacation and 30% within one year of arrival. Comparison of the three age groups (nationality, sex, type of TB, radiological findings and screening. However older children were more likely to be symptomatic (P Qatar has a high rate of paediatric tuberculosis. The policy of BCG vaccination at birth should be continued, and screening children at school entry and on return from vacation would be useful for further case identification.

  4. Tuberculosis and migration: a review.

    Science.gov (United States)

    Kronfol, N M; Mansour, Z

    2013-08-01

    In the past decade, the number of new cases of tuberculosis worldwide has barely declined and national tuberculosis control and elimination programmes in many high-income countries worldwide are increasingly challenged to address the problem of disease in foreign-born residents and migrant workers. Routine immigration medical screening, either before or after arrival in the recipient country, is designed to avoid the admission of migrants who pose a public health threat. Screening measures, however, have changed with time largely based on respect for individuals' rights. This paper reviews the measures that are being used by countries to screen immigrants and improve their health well-being, and presents cases studies from two Eastern Mediterranean Region countries.

  5. Tuberculosis Notification: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Manisha Nagpal

    2013-08-01

    Full Text Available Tuberculosis (TB is a major public health problem. An emerging menace in India is drug resistant forms of TB. In order to ensure proper TB diagnosis and case management, reduce TB transmission and address the problems of emergence of spread of Drug Resistant-TB, it is essential to have complete information of all TB cases. Therefore, Govt. of India declared Tuberculosis a notifiable disease on 7th May 2012. This paper highlights the fact that notification of TB in the absence of regulation of diagnostic practices, rational use of anti-TB medicines and availability of diagnostic and treatment facilities for drug-resistant TB will pose more problems rather than provide solutions to this problem.

  6. Tuberculosis in the lung (image)

    Science.gov (United States)

    Tuberculosis is caused by a group of organisms: Mycobacterium tuberculosis, M bovis , M africanum and a few other rarer subtypes. Tuberculosis usually appears as a lung (pulmonary) infection. However, ...

  7. Tuberculosis Facts - Exposure to TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Exposure to TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  8. Tuberculosis Facts - Testing for TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Testing for TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  9. Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study

    Directory of Open Access Journals (Sweden)

    Garåsen Helge

    2009-05-01

    Full Text Available Abstract Background About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment. We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers. Methods Asylum seekers ≥ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test ≥ 6 mm or positive x-ray findings were included in a study group for follow-up. Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care. Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis. Results The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34% of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62% had seen an internist, while 86 of 568 with Mantoux ≥ 15, but negative x-rays (16% were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000 and another 11 were treated for latent infection. Conclusion The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To

  10. PATIENT - 2 year report (2013 - 2014) public version

    NARCIS (Netherlands)

    Drachsler, Hendrik; Henn, Patrick; Hynes, Helen; Stieger, Lina; Schroeder, Hanna; Sopka, Sasa; Hartkopf, Kathleen; Orrego, Carola

    2014-01-01

    This report extends the first project report with a summary of the latest activities of the second year of the PATIENT project. The first report provided an overview about empirical studies of the stakeholder needs, as conducted in WP2, and the target learning outcomes of the handover study

  11. Tuberculosis along the United States-Mexico border, 1993-2001 La tuberculosis en la frontera mexicanoestadounidense

    Directory of Open Access Journals (Sweden)

    Eileen Schneider

    2004-07-01

    Full Text Available OBJECTIVES: Tuberculosis (TB is a leading public health problem and a recognized priority for the federal Governments of both Mexico and the United States of America. The objectives of this research, primarily for the four states in the United States that are along the border with Mexico, were to: (1 describe the epidemiological situation of TB, (2 identify TB risk factors, and (3 discuss tuberculosis program strategies. METHODS: We analyzed tuberculosis case reports collected from 1993 through 2001 by the tuberculosis surveillance system of the United States. We used those data to compare TB cases mainly among three groups: (1 Mexican-born persons in the four United States border states (Arizona, California, New Mexico, and Texas, (2 persons in those four border states who had been born in the United States, and (3 Mexican-born persons in the 46 other states of the United States, which do not border Mexico. RESULTS: For the period from 1993 through 2001, of the 16 223 TB cases reported for Mexican-born persons in the United States, 12 450 of them (76.7% were reported by Arizona, California, New Mexico, and Texas. In those four border states overall in 2001, tuberculosis case rates for Mexican-born persons were 5.0 times as high as the rates for persons born in the United States; those four states have 23 counties that directly border on Mexico, and the ratio in those counties was 5.8. HIV seropositivity, drug and alcohol use, unemployment, and incarceration were significantly less likely to be reported in Mexican-born TB patients from the four border states and the nonborder states than in patients born in the United States from the four border states (P OBJETIVOS: La tuberculosis es un problema de salud pública importante y es una prioridad reconocida por los gobiernos federales de México y Estados Unidos de América. Los objetivos de la presente investigación fueron los siguientes, atendiendo específicamente a los cuatro estados de los

  12. Primary tuberculosis of the glans penis.

    Science.gov (United States)

    Jimenez Parra, Jose David; Alvarez Bandres, Silvia; Garcia Garcia, Diego; Torres Varas, Lorena; Sotil Arrieta, Amaia; Jimenez Calvo, Jesus

    2014-03-01

    Tuberculosis of the penis is an extremely rare disease with few cases reported in the literature. We present the case of a 64 year-old man with a whitish papular-ampullary eruption in the glans penis. After antibiotic/antimycotic therapy and several topical ointments for 3 months without response he was referred to our Department. Biopsy of the ulceration edge was performed and pathology result showed a chronic granulomatous inflammatory necrotizing lesion with granulomatous vasculitis lesions, without tumor infiltration. Systemic examination to rule out other tuberculosis foci was negative. With de suspicion of primary tuberculosis of the glans penis, anti tuberculosis therapy with Isoniazid and Piridoxine was started. Within a period of five months the ulceration healed significantly. Currently, the patient is still asymptomatic without glans penis lesions. Primary glans penis tuberculosis is a rare disease, but we must consider it (both primary and secondary forms) to try to avoid diagnostic delays that may cause prejudice for the patient. This condition promptly responds to anti tuberculosis therapy as evidenced by our case and many other reports.

  13. Clustered tuberculosis in a low-burden country

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Z; Andersen, A B; Kok-Jensen, A

    2012-01-01

    Molecular genotyping of Mycobacterium tuberculosis has proved to be a powerful tool in tuberculosis surveillance, epidemiology, and control. Based on results obtained through 15 years of nationwide IS6110 restriction fragment length polymorphism (RFLP) genotyping of M. tuberculosis cases in Denmark......, a country on the way toward tuberculosis elimination, we discuss M. tuberculosis transmission dynamics and point to areas for control interventions. Cases with 100% identical genotypes (RFLP patterns) were defined as clustered, and a cluster was defined as cases with an identical genotype. Of 4,601 included...... cases, corresponding to 76% of reported and 97% of culture-verified tuberculosis cases in the country, 56% were clustered, of which 69% were Danes. Generally, Danes were more often in large clusters (= 50 persons), older (mean age, 45 years), and male (male/female ratio, 2.5). Also, Danes had a higher...

  14. Asymptomatic pons tuberculoma in an infant with miliary tuberculosis

    International Nuclear Information System (INIS)

    Uysal, Gulnar; Guven, Akif; Gursoy, Tugba; Altunc, Umut

    2005-01-01

    Miliary tuberculosis is caused by the hematogenous spread of Mycobacterium tuberculosis and consists of 1.5% of all tuberculosis cases. It is seen mostly in infants because of the immature immune system, and central nervous system CNS involvement is not rare. Tuberculomas are rarely seen in the localized form of CNS tuberculosis, and only 4% are localized in the brain stem. We report a 4.5-month-old infant who deteriorated during follow-up with the diagnosis of cytomegalovirus pneumonia, and afterwards received the diagnosis of miliary tuberculosis. Although the baby had no neurologic abnormality and cerebrospinal fluid findings were normal, cranial MRI revealed contrast enhanced nodular lesions in pons, cerebellum, and right parietal region. The case is presented to intensify the importance of CNS investigation even if the patient with miliary tuberculosis has no neurologic finding. (author)

  15. Financial Reporting for Public Institutions in New Mexico.

    Science.gov (United States)

    New Mexico Commission on Higher Education.

    This manual is intended to provide public institutions of higher education in New Mexico with a consistent and uniform system for treating institutional finance data. Part 1 presents accounting principles for fund accounting, restricted and unrestricted funds, accrual accounting, and handling other charges and revenues. Part 2 provides general…

  16. Indonesia - Country Procurement Assessment Report : Reforming the Public Procurement System

    OpenAIRE

    World Bank

    2001-01-01

    The main objectives of the Country Procurement Assessment Review (CPAR) are to diagnose the public procurement system in Indonesia, assess actual compliance with the country's procurement laws and regulations on the ground, and identify reforms to improve the existing system in line with internationally accepted principles. Section 1 gives an overview. Section 2 describes Indonesia's exist...

  17. Texas Public School Attrition Study, 2013-14. IDRA Report

    Science.gov (United States)

    Johnson, Roy L.; Montes, Felix

    2014-01-01

    Since 1986, Intercultural Development Research Association (IDRA) has conducted an annual attrition study to track the number and percent of students in Texas who are lost from public secondary school enrollment prior to graduation. The study builds on the series of studies that began when IDRA conducted the first comprehensive study of school…

  18. Texas Public School Attrition Study, 2016-17. IDRA Report

    Science.gov (United States)

    Johnson, Roy L.; Montes, Felix

    2017-01-01

    Since 1986, Intercultural Development Research Association (IDRA) has conducted an annual attrition study to track the number and percent of students in Texas who are lost from public secondary school enrollment prior to graduation. The study builds on the series of studies that began when IDRA conducted the first comprehensive study of school…

  19. Texas Public School Attrition Study, 2014-15. IDRA Report

    Science.gov (United States)

    Johnson, Roy L.; Montes, Felix

    2015-01-01

    Since 1986, Intercultural Development Research Association (IDRA) has conducted an annual attrition study to track the number and percent of students in Texas who are lost from public secondary school enrollment prior to graduation. The study builds on the series of studies that began when IDRA conducted the first comprehensive study of school…

  20. Texas Public School Attrition Study, 2015-16. IDRA Report

    Science.gov (United States)

    Johnson, Roy L.; Montes, Felix; Hinojosa, David

    2016-01-01

    Since 1986, Intercultural Development Research Association (IDRA) has conducted an annual attrition study to track the number and percent of students in Texas who are lost from public secondary school enrollment prior to graduation. The study builds on the series of studies that began when IDRA conducted the first comprehensive study of school…

  1. Offshore Resource Assessment and Design Conditions Public Meeting Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2011-09-01

    The Department of Energy's Wind and Water Power Program hosted a public meeting in June 2011 that focused on the critical meteorological and oceanographic measurements and data needed for successful deployment of offshore renewable energy technologies, including wind and marine and hydrokinetic. The objective was to develop a tactical plan to guide future program investments in filling possible information gaps.

  2. Cerebral microcalcifications in a newborn with congenital tuberculosis.

    Science.gov (United States)

    Cifuentes, Yolanda; Murcia, Martha Isabel; Piar, Jorge; Pardo, Patricia

    2016-03-03

    Tuberculosis is a serious public health problem worldwide. In 2012, the World Health Organization estimated 8.6 million new cases and 1.3 million deaths due to the disease. In 2011, the incidence in Colombia was 24 cases per 100,000 inhabitants. There is little information about tuberculosis in pregnant women, and congenital infection is considered a rare disease that is difficult to diagnose, leads to high mortality, and may be confused with tuberculosis acquired after birth. In addition, it has been associated with HIV infection in mothers and infants. Moreover, there is increasing incidence of congenital syphilis in the world. In Colombia, the prevalence is 2.5 cases per 1,000 births and its frequency in the Instituto Materno Infantil-Hospital La Victoria is one case per 57 births. We report the case of a newborn under treatment for congenital syphilis and in whom microcalcifications were found in a transfontanelar ultrasound. This finding warned about the existence of another infectious agent. PCR was negative for cytomegalovirus, and IgM titers for toxoplasma, rubella and herpes I and II were also negative. After learning about a history of incomplete treatment for tuberculosis in the mother, we suspected the presence of an infection by the tubercle bacillus in the newborn. No acid-fast bacilli were demonstrated in three gastric juice samples. The IS6110 PCR assay was found positive in cerebrospinal fluid and urine, but not in blood. The newborn was treated with crystalline penicillin for 10 days along with isoniazid, rifampicin, pyrazinamide and streptomycin. The patient is currently under clinical monitoring.

  3. [Management of tuberculosis during pregnancy and puerperium].

    Science.gov (United States)

    Toyota, Emiko; Minoura, Shigeki; Miyazawa, Hirofumi

    2002-11-01

    We reported 22 cases with tuberculosis in pregnancy and puerperium, who were treated in our hospital from 1993 to 2001. Nine out of 22 cases were foreign women and the onset of tuberculosis was not clear and the diagnosis tended to be delayed in most cases. In the reports from industrial countries, most of those patients are foreign bone and the delay in diagnosis is common because symptoms are apt to be mixed up those for pregnancy and puerperium. In 10 of 22 cases, extrapulmonary lesions were noted. Most of our cases were treated with INH, RFP and EB, and in some severer cases PZA was added. WHO and BTS recommend standard therapy with PZA but ATS recommends INH, RFP and EB without PZA. Generally SM is contraindicated because of adverse effect of hearing loss for all pregnant periods, and the data for PZA and other second line drugs are insufficient. Our cases and their neonates showed normal course and no malformation nor congenital tuberculosis. 2 cases could not keep adherence for drugs and 2 babies got active tuberculosis. Precaution for infection is one of most important problem to deal with cases with tuberculosis during pregnancy and postpartum in the hospital. If she is still infectious on delivery, we should consider prevention for transmission and manage her in isolated manner. CDC recommends not to treat for latent tuberculosis during pregnancy because of high frequency of hepatic damage due to INH. It is the best way to check and treat latent tuberculosis before gestation if she is at high risk with tuberculosis.

  4. 75 FR 52355 - Draft National Conversation on Public Health and Chemical Exposures Work Group Reports...

    Science.gov (United States)

    2010-08-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Draft National Conversation on Public Health and Chemical Exposures Work Group Reports; Opportunity for Public Comment AGENCY.../nationalconversation/work_groups.html . For additional information on the National Conversation on Public Health and...

  5. 40 CFR 166.32 - Reporting and recordkeeping requirements for specific, quarantine, and public health exemptions.

    Science.gov (United States)

    2010-07-01

    ... requirements for specific, quarantine, and public health exemptions. 166.32 Section 166.32 Protection of... AGENCIES FOR USE OF PESTICIDES UNDER EMERGENCY CONDITIONS Specific, Quarantine, and Public Health Exemptions § 166.32 Reporting and recordkeeping requirements for specific, quarantine, and public health...

  6. Disease-related knowledge, attitude and practices of tuberculosis ...

    African Journals Online (AJOL)

    Preferred Customer

    BACKGROUND: Tuberculosis (TB) is a major public health problem. World Health ... hospitals were interviewed on their knowledge, attitude and practice related to TB using pre-tested ..... patients exercise care to limit the spread of. TB, only ...

  7. Public Control of Public Schools: Can We Get It Back? Public Affairs Report, Vol. 15, No. 3.

    Science.gov (United States)

    Guthrie, James W.

    Public control of the schools has steadily eroded in recent years. Population growth and widespread consolidation of school districts, depoliticization of school board elections, adoption of the business model of professional school management, development of a multilevel school bureaucracy, and unionization of teachers all have combined to…

  8. Atypical pleural tuberculosis presenting as an isolated pleural tuberculoma

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Sook Min; Rho, Ji Young; Yoo, Seung Min; Jung, Hae Kyoung (Department of Radiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do (Korea, Republic of)), Email: rhoji@naver.com; Cho, Sang Ho (Department of Pathology, CHA Bundang Medical Center, CHA University, Gyeonggi-do (Korea, Republic of))

    2012-02-15

    Pleural tuberculosis is the most common extrapulmonary manifestation of tuberculosis, and is generally characterized by an effusion. The effusion is usually unilateral and residual pleural thickening or calcification is also observed in some cases. Manifestations of multiple pleural tuberculomas without associated effusion and history of tuberculosis or antituberculous therapy are rare and an isolated pleural tuberculoma is exceedingly rare. Herein, we report the first documented case of an isolated pleural tuberculoma, diagnosed by chest CT and pathological findings. Although rare, an isolated pleural tuberculoma should be added to the differential diagnosis of focal nodular pleural tumors, particularly in areas of high tuberculosis prevalence

  9. GASB 35: The New Financial Reporting Requirements for Public College and Universities.

    Science.gov (United States)

    Qayoumi, Mohammad H.

    2001-01-01

    Presents the basic financial reporting elements of the Governmental Accounting Standards Board (GASB-35) for public colleges and universities, including statements of net assets and cash flow reporting. The GASB-35's impact on facilities managers is discussed. (GR)

  10. Clinics of ocular tuberculosis.

    Science.gov (United States)

    Gupta, Vishali; Shoughy, Samir S; Mahajan, Sarakshi; Khairallah, Moncef; Rosenbaum, James T; Curi, Andre; Tabbara, Khalid F

    2015-02-01

    Ocular tuberculosis is an extrapulmonary tuberculous condition and has variable manifestations. The purpose of this review is to describe the clinical manifestations of ocular tuberculosis affecting the anterior and posterior segments of the eye in both immunocompetent and immunocompromised patients. Review of literature using Pubmed database. Mycobacterium tuberculosis may lead to formation of conjunctival granuloma, nodular scleritis, and interstitial keratitis. Lacrimal gland and orbital caseating granulomas are rare but may occur. The intraocular structures are also a target of insult by M. tuberculosis and may cause anterior granulomatous uveitis, anterior and posterior synechiae, secondary glaucoma, and cataract. The bacillus may involve the ciliary body, resulting in the formation of a localized caseating granuloma. Posterior segment manifestations include vitritis, retinal vasculitis, optic neuritis, serpiginous-like choroiditis, choroidal tubercules, subretinal neovascularization, and, rarely, endophthalmitis. The recognition of clinical signs of ocular tuberculosis is of utmost importance as it can provide clinical pathway toward tailored investigations and decision making for initiating anti-tuberculosis therapy.

  11. Childhood tuberculosis and malnutrition.

    Science.gov (United States)

    Jaganath, Devan; Mupere, Ezekiel

    2012-12-15

    Despite the burden of both malnutrition and tuberculosis in children worldwide, there are few studies on the mechanisms that underlie this relationship. From available research, it appears that malnutrition is a predictor of tuberculosis disease and is associated with worse outcomes. This is supported through several lines of evidence, including the role of vitamin D receptor genotypes, malnutrition's effects on immune development, respiratory infections among malnourished children, and limited work specifically on pediatric tuberculosis and malnutrition. Nutritional supplementation has yet to suggest significant benefits on the course of tuberculosis in children. There is a critical need for research on childhood tuberculosis, specifically on how nutritional status affects the risk and progression of tuberculosis and whether nutritional supplementation improves clinical outcomes or prevents disease.

  12. Annual Survey of Public Employment & Payroll Summary Report: 2013. Economy-Wide Statistics Briefs: Public Sector

    Science.gov (United States)

    Willhide, Robert Jesse

    2014-01-01

    This report is part of a series of reports that provides information on the structure, function, finances, taxation, employment, and pension systems of the United States' approximately 90,000 state and local governments. This report presents data on state and local government employment and payroll based on information collected by the 2013 Annual…

  13. [Writing and publication of a clinical case report].

    Science.gov (United States)

    Târcoveanu, E; Roca, M; Mihăescu, T

    2011-01-01

    A case report represents a collection of detailed information about an individual patient, written with the purpose to disseminate clinical outcomes, not previously reported. Case reports provide a rich resource for teaching and research in medicine. Despite the limitation of case reports, these are useful to generate new hypothesis for future large scale clinical trials. A clinical case report should be well structured and convey a clear message. Elements of a case report are similar to all forms of medical scientific articles: title, structured abstract, introduction, case report, discussion, conclusion and references. A well written case report with literature support and a detailed description of management of the case has the greatest chances to be published. "Uniform Requirements for Manuscripts to Biomedical Journals" form the basis for most journal instructions regarding content and formatting and should be consulted when journal's instructions don't answer to author's questions. In this paper we present a case report check sheet to use as a form of self-evaluation, prior to submitting the articles.

  14. Unusual Features of Extraarticular Skeletal Tuberculosis: New Classification and Differential Diagnosis

    International Nuclear Information System (INIS)

    Kim, Kun Sang; Park, Soo Soung

    1983-01-01

    Twenty two cases of extra articular skeletal tuberculosis which showed unusual radiological features are reported and classified into several categories with discussion on the differential diagnosis. Radiological patterns of skeletal tuberculosis is so variable that with any kind of skeletal changes the possibility of the skeletal tuberculosis should not be excluded between of lack of its classical patterns.

  15. 78 FR 66936 - Advisory Council for the Elimination of Tuberculosis (ACET)

    Science.gov (United States)

    2013-11-07

    ... Council for the Elimination of Tuberculosis (ACET) In accordance with section 10(a)(2) of the Federal... Health, and the Director, CDC, regarding the elimination of tuberculosis. Specifically, the Council makes... tuberculosis. Matters To Be Discussed: Agenda items include the following topics: (1) ACET Chair's report to...

  16. TB transmission on public transportation: a review of published studies and recommendations for contact tracing.

    Science.gov (United States)

    Edelson, Paul J; Phypers, M

    2011-01-01

    The risk of transmission when persons with active tuberculosis travel on buses or trains is uncertain and no recommendations have been published for contact investigations on these conveyances. We conducted a systematic review of the published studies of tuberculosis transmission among bus or train travelers. Twelve published reports were identified, including one retrospective cohort study and eleven contact investigations. One contact investigation involved train travelers and one involved students on a 6 h bus excursion. The remaining nine involved exposures on school buses or in commuter vans. In eight reports, evidence of tuberculosis infection was found in 8.7%-55% of those tested; six of these studies reported identifying 1-24 cases of active tuberculosis. These reports support the need to be alert to the possibility of tuberculosis transmission on buses or trains. However, they do not offer the quantitative estimate of risk needed for defining policy regarding contact tracing for persons exposed on buses or trains. Decisions to carry out contact investigations should take into account the proximity to the index case, duration of exposure, and other risk factors that may affect the infectiousness of the case or the susceptibility of the contact. Additional reports taking these factors into consideration would help clarify the risk of tuberculosis transmission on public transport. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Pictorial essay: Orbital tuberculosis

    International Nuclear Information System (INIS)

    Narula, Mahender K; Chaudhary, Vikas; Baruah, Dhiraj; Kathuria, Manoj; Anand, Rama

    2010-01-01

    Tuberculosis of the orbit is rare, even in places where tuberculosis is endemic. The disease may involve soft tissue, the lacrimal gland, or the periosteum or bones of the orbital wall. Intracranial extension, in the form of extradural abscess, and infratemporal fossa extension has been described. This pictorial essay illustrates the imaging findings of nine histopathologically confirmed cases of orbital tuberculosis. All these patients responded to antituberculous treatment

  18. [Investigation of the presence of Mycobacterium tuberculosis in the lymph node aspirates of the suspected tularemia lymphadenitis cases].

    Science.gov (United States)

    Albayrak, Nurhan; Celebi, Bekir; Kavas, Semra; Simşek, Hülya; Kılıç, Selçuk; Sezen, Figen; Arslantürk, Ahmet

    2014-01-01

    Recently reports of cervical tuberculous lymphadenitis and oropharyngeal tularemia which are the most common infectious causes of granulomatous lymphadenitis, have been significantly increased in Turkey. The differentiation of cervical tuberculous lymphadenitis and oropharyngeal tularemia is usually confusing on the basis of clinical and histopathological findings. Thus, in tularemia endemic areas, the patients are more commonly evaluated in terms of tularemia lymphadenitis leaving tuberculosis out. The aim of this study was to investigate the presence of Mycobacterium tuberculosis in cervical lymph node aspirates, obtained from tularemia suspected cases. A total of 105 oropharyngeal tularemia-suspected cases which were found negative for Francisella tularensis by bacteriological (culture), molecular (PCR) and serological (microagglutination) methods, were included in the study. The samples had been previously studied at National Tularemia Reference Laboratory, Turkish Public Health Institution, between 2009-2011. The study samples were evaluated in terms of M.tuberculosis by culture and real-time PCR (rtPCR) methods in the National Tuberculosis Reference Laboratory. Both Lowenstein-Jensen (LJ) medium and liquid-based MGIT (BD, USA) automated culture system were used for mycobacterial culture. Samples that yielded mycobacterial growth were identified as M.tuberculosis by immunochromotographic test (BD, USA). The lymph node aspirates of 65 patients who were F.tularensis PCR negative but antibody positive, were used as the control group. As a result, M.tuberculosis was found to be positive in 9 (8.6%) of 105 tularemia-negative lymph node aspirates, sent to our laboratory from different geographic regions for the investigation of tularemia. Six of the M.tuberculosis positive cases were male and the age range of the patients was 26-85 years. The presence of M.tuberculosis was detected only by culture in two samples, only by rtPCR in five samples and both by culture and

  19. Mali - Public Expenditure Management and Financial Accountability Review : Public Financial Management Performance Report

    OpenAIRE

    World Bank

    2010-01-01

    The public financial management (PFM) performance assessment in Mali covered all central government revenues and expenditures and the institutions responsible for their management. This means that the assessment covered central government ministries and institutions, along with their de concentrated units in the regions (governors' staff); and autonomous government agencies, of which there...

  20. Reporting of MMR evidence in professional publications: 1988–2007

    Science.gov (United States)

    Hilton, S; Hunt, K; Langan, M; Hamilton, V; Petticrew, M

    2009-01-01

    Objective: To examine how journals and magazines disseminate research evidence and guidance on best practice to health professionals by aligning commentaries on measles, mumps, and rubella vaccine (MMR) evidence in journals with key events in the MMR controversy. Design: Content analysis. Data sources: Comment articles in six commonly read UK publications. Main outcome measures: Number of comment pieces by publication, year and article type; trends in the focus, tone and inclusion of recommendations on MMR. Results: 860 articles met the inclusion criteria (BMJ n = 104, Community Practitioner n = 45, Health Visitor n = 24, Practice Nurse n = 61, Nursing Standard n = 61 and Pulse n = 565). Of these 860 comment pieces, 264 made some reference to evidence endorsing the safety of MMR. Around one in 10 were rated as negative (10.9%, n = 29) or neutral (11.3%, n = 30) in relation to MMR safety, and nearly a quarter (22.7%, n = 60) were rated as mixed. Following the publication of Wakefield et al’s 1998 paper there was a period of neutrality. In 2000, despite growing public concerns and widespread media coverage, fewer than 20 comment pieces were published. Less than a quarter of comment pieces (n = 196, 22.7%) included recommendations. Conclusion: While a period of neutrality may reflect a professional response to uncertainty by holding back until consensus emerges, it may also represent a missed opportunity to promote evidence-based practice. PMID:19414434

  1. Radiometric diagnosis of Mycobacterium tuberculosis

    International Nuclear Information System (INIS)

    Laszlo, A.

    1986-01-01

    The results of this study confirm that rapid radiometric diagnostic tests such as the NAP selective inhibition test for the M. tuberculosis complex followed by the radiometric drug susceptibility tests are extremely reliable and compare favourably with conventional methodologies. This study also shows that referred cultures growing on solid medium can be processed by radiometric procedures without prior subculture. This circumstance by itself shortens the time needed for reporting. (Auth.)

  2. Obstructive jaundice due to tuberculosis of distal CBD and periampullary region mimickcholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Sumantra Ray

    2012-01-01

    Full Text Available Abdominal tuberculosis (TB commonly affects the intestinal tract, lymph nodes, peritoneum, and solid organs in varying combinations. Hepatobiliary or pancreatic TB is rare and the preoperative diagnosis is difficult. Though rare, there have been a few citations of intrahepatic tuberculosis, but isolated bile duct tuberculosis is extremely rare. Here we report a case of obstructive jaundice which was initially thought to be due to lower-end cholangiocarcinoma but postoperatively it was found to be tuberculosis.

  3. Interesting case of spontaneously resolved dysphagia in a young female due to complicated esophageal tuberculosis

    OpenAIRE

    Dhaval Choksi; Alisha Chaubal; Ruchir Patel; Chetan Rathi; Meghraj Ingle; Prabha Sawant

    2017-01-01

    Mycobacterium tuberculosis can affect any organ of the body. Gastrointestinal tubercular involvement is fairly common. Esophageal tuberculosis though is uncommon. Esophageal tuberculosis accounts for only 0.3% of gastrointestinal tuberculosis. It presents with dysphagia, retrosternal pain, cough or constitutional symptoms. Complications like hemorrhage from the ulcer and development of fistulas like esophagomediastinal fistula is extremely uncommon. We report a case of a 27 years old female w...

  4. A novel clinical sign in intraocular tuberculosis: Active chorioretinitis within chorioretinal atrophy

    OpenAIRE

    Avinash Pathengay; Bhavik Panchal; Himadri Choudhury; Soumyava Basu; Nidhi Relhan; Harry W. Flynn, Jr.

    2017-01-01

    Purpose: To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015. Observations: The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along with a positive tuberculin skin testing and chest X-ray consistent with tuberculo...

  5. FINANCIAL REPORTING IN PUBLIC INSTITUTIONS AND NON-FINANCIAL ENTITIES. SIMILARITIES AND DIFFERENCES

    OpenAIRE

    Daniela Vitan

    2011-01-01

    The present paperwork contains issues regarding financial reporting at the public institutions and non – financial entities. The main aspects are regarding the obligation of all entities to present the financial statements, the content of financial statements in public institutions and non-financial entities. Also, is presented the similarities and the differences aspects between financial reporting of these two patrimonial entities.

  6. Tuberculosis treatment among smear positive tuberculosis patients

    International Nuclear Information System (INIS)

    Munir, M.K.; Iqbal, R.; Shabbir, I.; Chaudhry, K

    2012-01-01

    Tuberculosis is a major health problem in many parts of the world. Delay in initiation of the treatment may result in prolonged infectious state, drug resistance, relapse and death. Objectives: To determine the factors responsible for not starting tuberculosis treatment among smear positive tuberculosis patients. Study type, settings and duration: This cross sectional study was done at Pakistan Medical Research Council TB Research Center, King Edward Medical University, Lahore, from fifth March 2010 to fifth December 2010. Patients and Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and presumably did not initiate anti tuberculosis treatment were contacted using telephone or traced by their home addresses. Once contact was established, they were inquired about the reasons for not starting tuberculosis treatment. Results: Of 50 patients 38(76%)belonged to the lower socio economic class and 12(24%) to the lower middle class. Fourteen patients (28%) were illiterate and 23(46%) had only 8 years of education. Of the 50 cases 41(82%) were taking treatment from traditional healers and 4% did not go back to the DOTS program. Physical condition of the patient, social, domestic and religious issues also played some role in default. Conclusions: Lack of health education and poverty were the main factors responsible for non compliance from treatment. Policy message: Sputum testing sites should have a paramedic who should educate the patients about the benefits of treatment and the dangers of default or partial treatment. (author)

  7. Isolated Optic Disc Tuberculosis

    Science.gov (United States)

    Mansour, Ahmad M.; Tabbara, Khalid F.; Tabbarah, Zuhair

    2015-01-01

    We present a healthy male subject who developed progressive visual loss in the left eye initially diagnosed as optic neuritis. Upon suspicion of infectious etiology, testing was positive for tuberculosis. There were no signs or symptoms of active systemic tuberculosis infection. The patient responded swiftly to antimycobacterial therapy with return of vision and resolution of disc swelling. Positive purified protein derivative skin test, negative chest radiograph, negative systemic workup, negative workup for other causes of unilateral optic neuritis and quick response to mycobacterial therapy reaffirm the entity of isolated optic disc tuberculosis similar to isolated choroidal tuberculosis without systemic manifestation. PMID:26483675

  8. Isolated Optic Disc Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ahmad M. Mansour

    2015-09-01

    Full Text Available We present a healthy male subject who developed progressive visual loss in the left eye initially diagnosed as optic neuritis. Upon suspicion of infectious etiology, testing was positive for tuberculosis. There were no signs or symptoms of active systemic tuberculosis infection. The patient responded swiftly to antimycobacterial therapy with return of vision and resolution of disc swelling. Positive purified protein derivative skin test, negative chest radiograph, negative systemic workup, negative workup for other causes of unilateral optic neuritis and quick response to mycobacterial therapy reaffirm the entity of isolated optic disc tuberculosis similar to isolated choroidal tuberculosis without systemic manifestation.

  9. Primary isolated hepatic tuberculosis

    International Nuclear Information System (INIS)

    Sheikh, A.S.F.; Qureshi, I.H.; Saba, K.; Bukhari, M.H.

    2013-01-01

    Isolated hepatic tuberculosis without pulmonary or bowel involvement is a diagnostic challenge and can cause considerable morbidity. A young lady from Lahore presented with fever, pain in right hypochondria, nausea and weight loss. CT scan of abdomen showed multiple small hypodense non-enhancing lesions and a heterogeneous texture of liver. Biopsy confirmed the diagnosis of hepatic tuberculosis. It was concluded a case of isolated hepatic tuberculosis without evidence of other primary sites involvement. It is important to consider tuberculosis in the differential diagnosis when suspecting lymphoproliferative or metastatic diseases in a patient with vague symptoms and abnormal hepatic texture on CT. (author)

  10. TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

    Science.gov (United States)

    Mendoza-Ticona, Alberto

    2014-01-01

    Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

  11. Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review

    Science.gov (United States)

    Tiemersma, Edine W.; van der Werf, Marieke J.; Borgdorff, Martien W.; Williams, Brian G.; Nagelkerke, Nico J. D.

    2011-01-01

    Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting epidemiological data. Methodology and Principal Findings To estimate the duration and case fatality of untreated pulmonary tuberculosis in HIV negative patients we reviewed studies from the pre-chemotherapy era. Untreated smear-positive tuberculosis among HIV negative individuals has a 10-year case fatality variously reported between 53% and 86%, with a weighted mean of 70%. Ten-year case fatality of culture-positive smear-negative tuberculosis was nowhere reported directly but can be indirectly estimated to be approximately 20%. The duration of tuberculosis from onset to cure or death is approximately 3 years and appears to be similar for smear-positive and smear-negative tuberculosis. Conclusions Current models of untreated tuberculosis that assume a total duration of 2 years until self-cure or death underestimate the duration of disease by about one year, but their case fatality estimates of 70% for smear-positive and 20% for culture-positive smear-negative tuberculosis appear to be satisfactory. PMID:21483732

  12. [The International Standards for Tuberculosis Care (ISTC): what is the importance for Japan?].

    Science.gov (United States)

    Fujiwara, Paula I

    2008-07-01

    In 2005, the World Health Assembly resolved that all Member States should ensure that all persons with tuberculosis (TB) "have access to the universal standard of care based on proper diagnosis, treatment and reporting consistent with the DOTS strategy..." The purpose of the International Standards for Tuberculosis Care (ISTC) is to define the widely accepted level of care of persons either suspected of, or diagnosed with, TB by all health practitioners, especially those in the private sector, who often lack guidance and systematic evaluation of outcomes provided by government programs. Since their publication in 2006 on World TB Day, the standards have been endorsed by the major international health organizations as well as many country-level professional societies. The intention is to complement local and national control polices consistent with those of the World Health Organization: they are not intended to replace local guidelines, but are written to accommodate local differences in practice. The ISTC comprise seventeen evidence-based standards on tuberculosis diagnosis and treatment, as well as the responsibility of the public health sector. These are based on the basic principles of TB care: prompt and accurate diagnosis, standardized treatment regimens of proven efficacy, appropriate treatment support and supervision, monitoring of response to treatment and the carrying out of essential public health responsibilities. The relevance of the ISTC to the Japanese context is highlighted, in terms of when persons should be suspected of TB; the appropriate diagnostic modalities, including the use of chest radiographs; the advantages of fixed dose combinations; the importance of follow-up laboratory tests to document response to treatment, the importance of recordkeeping and reporting to public health authorities, the value of HIV testing of TB patients and the use of anti-retrovirals for those dually infected; and the assessment of drug resistance and the

  13. Aspectos radiológicos da tuberculose primária da mama: relato de caso e revisão de literatura Radiological aspects of primary tuberculosis in the breast: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sabrina Ramos Bianco

    2009-04-01

    Full Text Available A tuberculose mamária é uma enfermidade equivalente a menos que 0,1% das lesões deste órgão. Apresentamos a seguir um caso de nosso serviço discutindo os achados radiológicos da mamografia, ultrassonografia e ressonância magnética, incluindo curvas cinéticas. A tuberculose mamária é uma condição ímpar, sendo importante o relato pelos diagnósticos diferenciais com carcinoma mamário e o abscesso piogênico.Mammary tuberculosis is an illness accounting for less than 0.1% of breast lesions. We present a case from our service and discuss the radiological findings from mammography, ultrasound scan and magnetic resonance, including kinetic curves. Mammary tuberculosis is an unusual condition and such reports are important in relation to the differential diagnoses versus breast cancer and pyogenic abscess.

  14. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

    OpenAIRE

    Tegegne, Yalewayker; Wondmagegn, Tadelo; Worku, Ligabaw; Jejaw Zeleke, Ayalew

    2018-01-01

    Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study wa...

  15. Publication Station History Report (PHR) for COOP Elements

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This report pertains to the roughly 9,000 NWS Cooperative Network sites whose observations are published in NCDC's Climatological Data or Hourly Precipitation Data...

  16. Public Policy Report. The Nanny Trap: Child Care Work Today.

    Science.gov (United States)

    Hostetler, Lana

    1984-01-01

    Reports testimony given before the Illinois House Labor and Commerce Committee concerning employment, wages, benefits, and conditions that affect the quality of child care and the status of child care institutions as employers of women. (RH)

  17. Report of the Working Group on Publicity and Funding

    DEFF Research Database (Denmark)

    Gammeltoft, Peder

    2017-01-01

    The report presents the aims and activities of the working group and in its efforts with raising awareness of the need for geographical names standardization and the work of the Group of Experts, through presence on the web and social media and Media Kit. The report also highlights efforts to find...... financial support for training and for representatives from developing countries attending UNSCGN Conferences and UNGEGN Sessions....

  18. Official Reports of Enrollment as of September 30, 2013. Montgomery County Public Schools

    Science.gov (United States)

    Erickson, Marianne

    2013-01-01

    This document is a combination of two reports produced for Montgomery County Public Schools (MCPS) by the Department of Policy, Records, and Reporting: (1) Official Race/Ethnic Membership of Students as of September 30, 2013; and (2) Official Report of Enrollment by Grade and School as of September 30, 2013. Both reports provide student data for…

  19. Prevalence and factors associated with tuberculosis treatment ...

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... health care, HIV co-infection and multi-drug resistant tuberculosis (MDRTB) are ... and default, are a public health concern as they are at risk for clinical ..... national recording systems in Brazil, 2003-2008. PLoS. One 2012 ...

  20. Factors Associated with Prevalent Tuberculosis Among Patients ...

    African Journals Online (AJOL)

    Background: Tuberculosis (TB) causes significant morbidity/mortality among human immunodeficiency virus‑infected individuals in Africa. Reducing TB burden in the era of highly active antiretroviral therapy (HAART) is a public health priority. Aim: We determined the factors associated with prevalent TB among patients ...