WorldWideScience

Sample records for publication reported tuberculosis

  1. Global Tuberculosis Report 2016

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    ... WHO Language عربي 中文 English Français Русский Español Tuberculosis (TB) Menu Tuberculosis The End TB Strategy Areas ... data News, events and features About us Global tuberculosis report 2016 WHO has published a global TB ...

  2. Gallbladder tuberculosis: case report

    Institute of Scientific and Technical Information of China (English)

    余日胜; 刘奕青

    2002-01-01

    @@ Abdominal tuberculosis is common in developing countries, but gallbladder involvement is extremely rare. The diagnosis of gallbladder tuberculosis is often not suspected prior to surgery or biopsy.This paper describes the CT and ultrasonographic features of gallbladder tuberculosis in a 35-year-old patient and reviews the literature of gallbladder tuberculosis.

  3. [Cutaneous tuberculosis: case report].

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    Bisero, Elsa; Luque, Graciela; Melillo, Karina; Favier, María Inés; Zapata, Alejandra; Cuello, María Soledad

    2014-06-01

    Cutaneous tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. It is not very frequent and particularly difficult to diagnose. It incidence ranges between 1.5 and 4% of all extrapulmonary tuberculosis, according to bibliography. The clinic presentations depend on the arrival via of the bacillus to the skin, the patient's immune state and the environment. We show a cutaneous tuberculosis on a child with chronic dermatologic lesions, with torpid evolution, without response to treatments; the skin biopsy showed caseous granulomas. The aim is to show a patient with an infrequent clinic presentation of this disease, to emphasize the importance of an early recognition and treatment, avoiding the appearance of complications and sequels.

  4. CASE REPORT: TUBERCULOSIS VERRUCOSA CUTIS

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    Padmaprasad

    2013-10-01

    Full Text Available AB STRACT: Tuberculosis verrucosa cutis, otherwise called as warty tuberculosis is a disease due to acquired infection from an exogenous source in a person who has moderate to high immunity for tuberculosis. Lesions are frequently reported on hands and lower limbs. It is an occupational hazard in people who handle tuberculous tissues during work, example: Veterinarians and mortuary at tenders, farmers, butchers, anatomy at tenders (anatomist’s warts. Auto inoculation by sputum in a pulmonary tuberculosis pati ent can cause the disease. Clinical features are variable, but verrucosity always forms. Lesions are usually single indurated, verrucous plaque with serpigenous edge which may show some scar at centre with keloidal changes and are seen at trauma prone site s. Histopathology shows psedoepitheliomatous hyperplasia with infiltration of plasma cells and sometimes with caseating granuloma. Tissues rarely show positivity to bacilli on staining. Treatment of the disease is by anti TB therapy which will completely resolve the lesion.

  5. Renal tuberculosis: a case report.

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    Toccaceli, S; Persico Stella, L; Diana, M; Taccone, A; Giuliani, G; De Paola, L; Valvano, M; De Padua, C; Di Biasio, G; Ranucci, C; Orsi, E; La Torre, F

    2015-01-01

    Tuberculosis or TB (tubercle bacillus) remains a major public health problem in developing countries. Over the last decades extrapulmonary locations of the disease have become more frequent due to the increased prevalence of acquired immune deficiency syndrome and the increase number of organ transplants. The urogenital localization represents about 27% of all extra-pulmonary localizations of TB and may be due either to a disseminated infection or to a primitive genitourinary localization. The majority of patients, has pyuria, sometimes with hematuria. The diagnosis of urinary tuberculosis is based on the finding of pyuria in the absence of infection by common bacteria. The initial medical treatment includes isoniazide, rifampicin, pyrazinamide, ethambutol and streptomycin. This disease should be suspected in patients with unexplained urinary tract infections, especially if immunocompromised and/or coming from endemic areas.

  6. Urogenital tuberculosis – case report

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    Tomaž Smrkolj

    2015-03-01

    Full Text Available Urogenital tuberculosis is uncommon in developed countries. Numerous and nonspecific urologic complaints are characteristic, e.g. lower urinary tract symptoms, haematuria, renal pain, palpable lesions in testis and epididymis and constitutional symptoms. Microbiological diagnostic tests together with imaging and endoscopy are indicated in urogenital tuberculosis. The role of surgery has changed in the era of modern antimycobacterial agents. Surgery is used in advanced stages and is reconstructive rather than ablative for removal of infected tissue. Article describes procedures for treatment of urinary obstruction, surgical procedures on kidney, ureter, bladder, prostate and urethra and testis with epididymis.Case report presents 69 year old man who presented with left side epididymitis, however after initial diagnostic tests tumour of left testis and epididymis and right kidney with liver metastasis was suspected. Computer tomography of thorax diagnosed miliary tuberculosis. Patient was transferred to pulmonary department, where tuberculosis was confirmed and medical antituberculous therapy was initiated. Adequate treatment response with regression of tuberculous lesions in urogenital tract was observed.

  7. Tuberculosis of Calcaneum: A Rare Case Report

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    Bhat Sandhya K

    2012-08-01

    Full Text Available Tuberculosis is a leading cause of morbidity and mortality in developing countries including India. Skeletal tuberculosis accounts for 1-3%. Tuberculosis of bone may evade the diagnosis for a long time, as it usually remains silent till either involvement of a neighbouring joint or development of a soft tissue swelling due to cold abscess formation. Tuberculosis of bone mimics clinical conditions like Chronic Osteomyelitis, Madura mycosis and Actinomycosis. There have been few case reports of unusual sites being affected and with unusual presentation by this disease.

  8. Primary Tuberculosis of Tonsils: A Case Report

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    Pooja Prasad

    2012-01-01

    Full Text Available Tuberculosis is one of the major causes of ill health and death worldwide. Isolated tuberculosis of tonsil in the absence of active pulmonary tuberculosis is a very rare clinical entity. A 10-year-male child presented with recurrent episodes of upper respiratory tract infections, with 2-3 occurrences per month for the past 6 years. On general physical examination, bilateral tonsils showed grade III enlargement and congestion. Posterior pharyngeal wall was clear. Examination of the chest was within normal limits. Histopathological examination of bilateral tonsils revealed caseating and noncaseating epithelioid cell granulomas with Langhans giant cells. Ziehl-Neelsen stain for acid fast bacillus was positive. Features were consistent with a diagnosis of tuberculosis of tonsils. Tuberculosis of the oral cavity is uncommon and lesions may be either primary or secondary. Early detection and intervention is essential for cure. Isolated and primary tuberculosis of the tonsils in the absence of pulmonary tuberculosis is a rare entity, which prompted us to report this case.

  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. 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

    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. PMID:28117471

  12. 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.

  13. [Isolated testicular tuberculosis: report of a case].

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    Joual, A; Rabii, R; Guessous, H; Benjelloun, M; el Mrini, M; Benjelloun, S

    2000-06-01

    In this study, a case has been reported involving a 66-year old male who was admitted for scrotal pain on the right side with possible testicular involvement, but with no associated urinary disorder. At physical examination, the right testicle was found to have increased in volume: this was further confirmed by ultrasonography, but the findings were insufficient to exclude the hypothesis of testicular cancer. An exploratory orchidectomy by upper inguinal route was therefore carried out, and histopathological examination showed the destruction of testicular tissue by several granulomas, and caseous necrosis with giant cells. Antibacterial chemotherapy was administered after an i.v. urography found no evidence of abnormality or urinary disorder, thereby eliminating an active site of genitourinary tuberculosis. This case shows the importance of considering testicular tuberculosis in the differential diagnosis of testicular enlargement in a region where this disease is endemic, despite the absence of systemic pulmonary and urinary signs of tuberculosis.

  14. [Case report: cutaneous tuberculosis and tuberculous osteomyelitis].

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    Celikbaş, Aysel Kocagul; Ulu, Ayfegül; Ergönül, Onder; Eren, Sebnem; Baykam, Nurcan; Dokuzoguz, Başak

    2005-01-01

    In this report, a 27 years old male patient diagnosed to have skin and bone tuberculosis (TB) has been presented. The patient admitted to the hospital with the complaints of fever, weight loss and night sweats. Patient's history revealed that following a trauma a skin lesion in the right ankle was developed and this was followed by the development of many lesions in different parts of the body. The lesions persisted despite the use of various antibiotics since a year. It has been recorded that his father has already been receiving anti-tuberculosis treatment. Osteomyelitis was detected in the distal part of right tibia by computerized tomography, and Mycobacterium tuberculosis was isolated from the specimens of skin lesion. The patient was immunocompetent, and there was no pulmonary involvement. Isoniazid (INAH), rifampin (RIF), ethambutol and morphozinamid therapy has been started and completed to 12 months with INAH and RIF. In the post-treatment follow-up of patient for one year, no relapse was detected. As a result, tuberculosis should be considered in patients with persistent skin lesions especially in endemic countries.

  15. 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.

  16. Extrapulmonary tuberculosis: are statistical reports accurate?

    OpenAIRE

    Kulchavenya, Ekaterina

    2014-01-01

    Before discussing the epidemiology of extrapulmonary tuberculosis (EPTB) and particularly urogenital tuberculosis (UGTB), unification of the terminology is necessary. The term ‘urogenital tuberculosis’ is preferable to ‘genitourinary tuberculosis’, as renal and urinary tract tuberculosis is more common than genital tuberculosis. Some understand the term ‘extrapulmonary tuberculosis’ as a specific tuberculosis (TB) lesion of all organs excluding the bronchus, lungs, pleura and intrathoracic br...

  17. 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.

  18. Extrapulmonary tuberculosis: are statistical reports accurate?

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    Kulchavenya, Ekaterina

    2014-04-01

    Before discussing the epidemiology of extrapulmonary tuberculosis (EPTB) and particularly urogenital tuberculosis (UGTB), unification of the terminology is necessary. The term 'urogenital tuberculosis' is preferable to 'genitourinary tuberculosis', as renal and urinary tract tuberculosis is more common than genital tuberculosis. Some understand the term 'extrapulmonary tuberculosis' as a specific tuberculosis (TB) lesion of all organs excluding the bronchus, lungs, pleura and intrathoracic bronchopulmonary lymph nodes, but others consider pleural TB as one form of EPTB - and it is a reason for very different proportions in the spectrum of EPTB. Enigmatic tendencies have also been revealed in patients' distribution - in neighbouring regions the incidence rate may differ significantly. Although there is no clear explanation for these tendencies, careful study of the epidemiology of EPTB in different conditions will improve early diagnosis.

  19. Cystic changes associated with pulmonary tuberculosis: a case report

    Institute of Scientific and Technical Information of China (English)

    CAI Hou-rong; CAO Min; MENG Fan-qing; LI Wei-chun

    2006-01-01

    @@ There are a wide range of computed tomography (CT) findings in patients with pulmonary tuberculosis, including diffuse or localized nodules,reticular opacities, ground glass attenuation, air trapping, consolidation, cavitation, fibrosis, lymph nodes enlargement, and septal thickening.1-3However, CT findings of pulmonary tuberculosis that appeared as multiple cystic lesions were very rare.3,4Herein, the CT findings appeared as multiple cystic lesions in a patient with pulmonary tuberculosis are reported.

  20. Role of the Health Department in Tuberculosis Prevention and Control-Legal and Public Health Considerations.

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    Jeffries, Carla; Lobue, Phil; Chorba, Terence; Metchock, Beverly; Kashef, Ijaz

    2017-03-01

    Because tuberculosis is caused by an infectious organism that is spread from person to person through the air, public health measures are essential to control the disease. There are three priority strategies for tuberculosis prevention and control in the United States: (i) identifying and treating persons who have tuberculosis disease; (ii) finding persons exposed to infectious tuberculosis patients, evaluating them for Mycobacterium tuberculosis infection and disease, and providing subsequent treatment, if appropriate; and (iii) testing populations at high risk for latent tuberculosis infection (LTBI) and treating those persons who are infected to prevent progression to disease. These strategies for prevention and control of tuberculosis are discussed in a framework containing the following important topics: historical and epidemiological context of tuberculosis control, organization of public health tuberculosis control programs, legal basis for public health authority, conducting overall planning and development of policy, identifying persons who have clinically active tuberculosis, evaluation of immigrants, managing persons who have or who are suspected of having disease, medical consultation, interjurisdictional referrals, identifying and managing persons infected with Mycobacterium tuberculosis, providing laboratory and diagnostic services, collecting and analyzing data, and providing training and education. This chapter describes the role of the health department in the context of these components. This discussion is primarily applicable to tuberculosis prevention and control programs in the United States.

  1. [Tuberculosis Annual Report 2011--(1) Summary of tuberculosis notification statistics and tuberculosis in foreign nationals].

    Science.gov (United States)

    2013-06-01

    The Tuberculosis Surveillance Center (TSC) at the Research Institute of Tuberculosis has published a series of annual reports on tuberculosis (TB) statistics in Japan since 2008. These reports are based on information on the nationwide computerized TB surveillance system database, which has been in operation since 1987. This is the first of a new series of reports for the "TB Annual Report 2011" that includes a summary of TB statistics and an overview of TB cases with foreign nationality in 2011. A total of 22,681 cases with all types of TB were notified in 2011 with a notification rate of 17.7 per 100,000 population. The TB notification rates decreased to less than 20 per 100,000 population in 2007 and continued to decline until 2011. A total of 8,654 sputum-smear positive pulmonary TB were notified in 2011, at a rate of 6.8 per 100,000 population. The number of latent TB infection (LTBI) cases requiring prophylactic treatment drastically increased from 4,930 cases in 2010 to 10,046 cases in 2011. Surveillance data on TB cases with foreign nationality in Japan have been collected since 1998. The number of TB cases with foreign nationality increased from 739 in 1998 to 931 in 2004 but has been stagnated since then, that indicated 921 in 2011. The TB cases with foreign nationality accounted for 2.1 % of all new TB cases in 1998, and this percentage increased to 4.1% in 2011. Of note, new TB cases with foreign nationality aged 20-29 years accounted for 30.0% of all new TB cases among the same age group in 2011. Among the TB cases with foreign nationality, more than half were from China (29.6%) and the Philippines (23.7%) taken together. In most cases, foreign nationals developed TB within 5 years of entry into Japan, including 80.0% of those aged 10-19 years and 80.8% of those aged 20-29 years. Of these TB cases with foreign nationality, 27% were noted in full-time employees, followed by unemployed persons (21%) and students (20%). With an increase in the number of

  2. 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.

  3. Primary nasal tuberculosis: a case report.

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    Nayar, Ravi C; Al Kaabi, Juma; Ghorpade, Kanchanmala

    2004-03-01

    During the past 2 decades, tuberculosis--both pulmonary and extrapulmonary--has re-emerged as a major health problem worldwide. Nasal tuberculosis--either primary or secondary to pulmonary tuberculosis or facial lupus--is rare, but it should be considered in the differential diagnosis of nasal granulomas. We describe a case of primary nasal tuberculosis in an adult male who presented with a polypoid lesion in one nasal cavity. The diagnosis was based on histopathology and the patient's successful response to antituberculous drug treatment. Given the rising incidence of tuberculosis, it is prudent that otolaryngologists remain cognizant of this infection as a potential cause of unusual lesions in the head and neck.

  4. 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

  5. [Meningeal tuberculosis and renal lithiasis. A case report].

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    Benabdellah, A; Attar, A; Maalem, A; Bekkhoucha, S

    2002-01-01

    Urinary tuberculosis is frequent in Algeria. The discovery of the disease become difficult when one of the three criterium of the diagnostic does not allow a diagnosis of certitude. The authors reported the case of a 44 years-old patient admitted to hospital for tuberculous meningitis recovery from left nephrectomy for urinary lithiasis. The histology does not find specific lesions. Then, no antituberculous treatment is prescribed. The patient has developed renal and meningitis tuberculosis associated with urinary lithiasis. Koch's bacillus is found in the urine. The evolution under medical treatment was excellent. The urinary lithiasis has hided tuberculosis and the discovery of the disease was late.

  6. Splenic tuberculosis. Report of twelve cases; La tuberculose splenique

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    Adil, A.; Chikhaoui, N.; Ousehal, A.; Kadiri, R. [Centre Hospitalier Universitaire Ibn Rochd, Casablanca (Morocco)

    1995-12-31

    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.

  7. [Tuberculosis annual report 2010--(2) Tuberculosis in foreign nationals].

    Science.gov (United States)

    2012-07-01

    Surveillance data on tuberculosis (TB) in foreign nationals in Japan since 1998 have been obtained. The proportion of foreign nationals infected with TB increased from 2.1% (739 patients) in 1998 to 4.2% (952 patients) in 2010. Most importantly, the proportion of TB patients aged 20-29 years among foreign nationals reached 29% in 2010. About half of the foreign nationals with TB were from China (29 %) and the Philippines (23%). In most cases, foreign nationals developed TB within 5 years of immigrating to Japan; moreover, 84% of these patients were 20-29 years old. The proportion of foreign nationals with TB among all TB cases was the highest in Hamamatsu city (9.5%), followed by Gunma prefecture, and Fukuoka city. Twenty-three percent of foreign nationals with TB were employed full-time, 22% were students, and 20% were unemployed. As the number of immigrants to Japan increases, the proportion of foreign nationals with TB is expected to increase, particularly among young adults and in those from countries with a high burden of TB.

  8. 76 FR 26239 - Bovine Tuberculosis and Brucellosis; Public Meetings

    Science.gov (United States)

    2011-05-06

    ...; ] DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service Bovine Tuberculosis and Brucellosis... framework being developed for the bovine tuberculosis and brucellosis programs in the United States. The... tuberculosis (TB) and bovine brucellosis in the United States. In keeping with its commitment to...

  9. 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.

  10. Tuberculosis

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    C. Robert Horsburgh, Jr

    2014-03-01

    Full Text Available 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.

  11. 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.

  12. Progressive Primary Pulmonary Tuberculosis Presenting as the Sudden Unexpected Death in Infancy: A Case Report

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    Dempers, Johan; Sens, Mary Ann; Wadee, Shabbir Ahmed; Kinney, Hannah C.; Odendaal, Hein J.; Wright, Colleen A.

    2010-01-01

    The classification of an unexpected infant death as the sudden infant death syndrome (SIDS) depends upon a complete autopsy and death scene investigation to exclude known causes of death. Here we report the death of a four-month-old infant in a tuberculosis endemic area that presented as a sudden unexpected death in infancy (SUDI) with no apparent explanation based on the death scene characteristics. The autopsy, however, revealed progressive primary pulmonary tuberculosis with intrathoracic adenopathy, compression of the tracheobronchial tree and miliary lesions in the liver. This case underscores the clinical difficulties in the diagnosis of infantile tuberculosis, as well as the possibility of sudden death as part of its protean manifestations. The pathology and clinical progression of tuberculosis in infants differs from older children and adults due to the immature immune response in infants. This case dramatically highlights the need for complete autopsies in all sudden and unexpected infant deaths, as well as the public health issues in a sentinel infant tuberculosis diagnosis. PMID:20705406

  13. Exploitation of Mycobacterium tuberculosis Reporter Strains to Probe the Impact of Vaccination at Sites of Infection

    OpenAIRE

    Neelima Sukumar; Shumin Tan; Bree B Aldridge; Russell, David G.

    2014-01-01

    Mycobacterium tuberculosis (Mtb) remains a major public health problem, with an effective vaccine continuing to prove elusive. Progress in vaccination strategies has been hampered by a lack of appreciation of the bacterium's response to dynamic changes in the host immune environment. Here, we utilize reporter Mtb strains that respond to specific host immune stresses such as hypoxia and nitric oxide (hspX'::GFP), and phagosomal maturation (rv2390c'::GFP), to investigate vaccine-induced alterat...

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

    OpenAIRE

    Karl Peltzer; Julia Louw

    2013-01-01

    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 ...

  15. The zoonotic importance of Mycobacterium tuberculosis : transmission from human to monkey : case report

    Directory of Open Access Journals (Sweden)

    A.L. Michel

    1998-07-01

    Full Text Available A case of zoonotic Mycobacterium tuberculosis infection in a marmoset (Callithrix jacchus is reported. Genomic typing of the relevant M. tuberculosis isolates strongly suggests that the marmoset, which was kept as companion animal, acquired the disease from an infected member in the household who had been treated for pulmonary tuberculosis 8 years prior to this case.

  16. 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…

  17. 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…

  18. Persistent Marked Peripheral Eosinophilia due to Tuberculosis: A Case Report

    Science.gov (United States)

    Garg, Gunjan; Gogia, Atul; Kakar, Atul; Miglani, Pratyush

    2017-01-01

    We report a case of a 68-year-old female who was a known case of diabetes mellitus and chronic liver disease and presented with complaints of dry cough and other constitutional symptoms since one month. During initial investigations, the patient was found to have peripheral blood eosinophilia. Upon investigating further,the patient was found to have mediastinal lymphadenopathy and fine-needle aspiration of mediastinal lymph nodes showed features of tuberculosis. The patient was started on anti-tubercular treatment and her eosinophil counts returned to normal levels. Correlation between eosinophilia and tuberculosis has not been established in classical literature. This case highlights the same association and raises awareness on this crucial finding. Coexistence of eosinophilia and tuberculosis in our patient is suggested since peripheral blood eosinophilia improved with anti-tubercular treatment. The exact pathogenesis of coexistence of tuberculosis and peripheral blood eosinophilia yet remains to be deciphered, but tissue pathology is mainly associated with the discharge of toxic eosinophil products.

  19. Peritoneal tuberculosis. Report of seven cases.

    Science.gov (United States)

    Flores-Alvarez, Efrén; Tello-Brand, Sara Elena; López-López, Froylán; Rivera-Barragán, Virgilio

    2010-01-01

    Peritoneal tuberculosis (TB) is a misdiagnosed clinical entity of low frequency. Due to its rarity, it requires a high index of suspicion in clinical practice. Its incidence has been increasing in recent years. We present and analyze seven cases of peritoneal TB diagnosed and treated at four hospitals in Aguascalientes, Mexico during a 5-year period. Mean age of the patients was 47.5 +/- 6.5 years. There were six females and one male. Two patients had a history of treated lung TB. The most frequent clinical data were abdominal pain (six patients), ascites (four patients), and abdominal tumor (three patients). Symptom duration prior to surgery was 5.0 +/- 1.7 months. Abdominopelvic CT examinations revealed unilateral ovarian tumor in four patients, bilateral ovarian tumor in two patients, ascites in four patients, and retroperitoneal adenopathy in one patient. All female patients had elevated serum CA-125 levels with a median of 419 U/ml (range: 286-512 U/ml). All patients had a preoperative diagnosis of malignant tumor. All surgical procedures were elective and consisted of laparotomy with biopsy in three patients, laparotomy with salpingo-oophorectomy in two patients, and laparoscopy with biopsy in two patients. Diagnosis of TB was suspected in all cases during surgery. Mean hospital stay was 2 +/- 0.5 days. There was no postoperative morbidity or mortality. Peritoneal TB is uncommon. Diagnoses should be considered in all patients with ascites, adnexal tumors and elevated serum CA-125 levels.

  20. 1 Tuberculosis in India: A need of Public Awareness & Education

    African Journals Online (AJOL)

    2015-05-07

    May 7, 2015 ... “India is the highest TB burden country globally, accounting for one fifth of the ... municipal authorities towards the prevention of the disease. The fourth question is to suggest measures for controlling tuberculosis via ... demographic characteristics (sex, age, occupation and educational status), eating habits ...

  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. 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

  3. 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...

  4. 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...

  5. Esophageal tuberculosis; A rare cause of odynophagia: A case report

    Directory of Open Access Journals (Sweden)

    Khalid Hamid Changal

    2013-04-01

    Full Text Available We present a rare case of esophageal tuberculosis causing odynophagia. Tuberculosis of the esophagus is a rare condition, even in countries with a high incidence of tuberculosis (TB and studies estimate that it constitutes about 0.3% of gastrointestinal TB cases. The case emphasizes the diverse ways tuberculosis can present.

  6. Tuberculosis and metastatic carcinoma coexistence in axillary lymph node: A case report

    Directory of Open Access Journals (Sweden)

    K Chandramohan

    2003-04-01

    Full Text Available Abstract Background Coexistence of cancer and tuberculosis in axillary lymph nodes is rare. Only seven cases have been reported in the literature. Case Report We report here a case of infiltrating ductal carcinoma breast metastasizing to the axillary lymph node along with tubercular granuloma in the same lymph node without primary mammary or pulmonary tuberculosis. Conclusion Primary tuberculosis coexisting with carcinoma is of rare occurrence. A possibility should always be borne in mind especially in patients from endemic areas.

  7. 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.

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

    NARCIS (Netherlands)

    Rutherford, M.E.; Ruslami, R.; Anselmo, M.; Alisjahbana, B.; Yulianti, N.; Sampurno, H.; Crevel, R. van; Hill, P.C.

    2013-01-01

    OBJECTIVE: To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. METHODS: A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targe

  9. TUBERCULOSIS OF THE BREAST – A RARE FORM OF EXTRAPULMONARY TUBERCULOSIS – CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jurij Regvat

    2004-04-01

    Full Text Available Background. There is a decline in incidence of tuberculosis in Slovenia. In most patients a tuberculosis occurs in pulmonary form. In one third of patients it appears either as combined pulmonary and extrapulmonary tuberculosis or extrapulmonary form alone, where pleura and lymph nodes are most often affected. Other localizations are rare and therefore sometimes not taken into account.Patient and methods. We present a female patient with tumorous formation in the breast, clinically and radiologicaly suspicious for neoplastic nodule. Citological examinations did not confirm neoplasm. Further microbiological and citological examinations proved the rare form of extrapulmonary tuberculosis. In addition, we also confirmed a pulmonary tuberculosis. At the end of treatment, improvement in radiological picture of the breast, clinical improvement and negativisation of cultures for Mycobacterium tuberculosis were observed.Conclusions. Determination of tumorous formations in the body is crucial because of appropriate treatment and different prognosis. Tuberculosis can grow anywhere in the body.

  10. [TUBERCULOSIS ANNUAL REPORT 2014--(1) Summary of Statistics on Tuberculosis Notification and Foreign-born Tuberculosis Patients].

    Science.gov (United States)

    2016-02-01

    This brief is the first of a series of documents based on the Tuberculosis Annual Report 2014. It includes a summary of tuberculosis (TB) statistics, including data on foreign-born TB patients notified and registered in Japan in 2014. For the first time, the number of newly notified cases (all forms of TB) fell below 20,000. In 2014, a total of 19,615 patients were notified, a rate of 15.4 per 100,000 population The number of sputum-smear positive pulmonary. TB patients notified was 7,651, a rate of 6.0 per 100,000 population. The number of patients with latent TB infections increased slightly from 7,147 in 2013 to 7,562 in 2014. The proportion of miliary TB cases has constantly increased over the past 10 years, especially among women aged 80 years and older. The number of foreign-born TB patients continued to increase from 1,064 in 2013 to 1,101 in 2014. In 2014, new foreign-born TB patients aged 20-29 years accounted for 44.1% of all new TB patients in that age group. Among foreign-born TB patients, half were from the Philippines (26.5%) and China (23.5%). However, the number of patients from Vietnam and Nepal is increasing. Among foreign-born TB patients, 28% were regular employees, 26% were students, and 20% were unemployed. The changing trend in the nationality of foreign students entering Japan may at least partially explain the differences in TB burden among foreign-born patients, by country of birth. As we expect to see the proportion of foreign-born TB patients continue to rise, more tailored case identification and treatment support activities are needed.

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

    Directory of Open Access Journals (Sweden)

    Vinay Pandit

    2009-10-01

    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.

  12. 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.

  13. Gastric Perforation Associated with Tuberculosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Richdeep S. Gill

    2011-01-01

    Full Text Available Gastric tuberculosis is a rare presentation of tuberculosis infection. Gastric perforation associated with tuberculosis is exceedingly rare with five previously published cases. We present a case of a male patient that developed presumed gastric tuberculosis secondary to pulmonary tuberculosis infection. He subsequently developed gastric perforation and sepsis, for which he was treated both surgically and medically. Despite ongoing antituberculosis treatment, the patient's condition worsened and the patient died secondary to multiorgan failure. This case highlights gastric perforation as a rare but devastating complication of pulmonary tuberculosis.

  14. Tuberculosis Amigdalina con foco pulmonar primario: Reporte de un caso

    OpenAIRE

    Lugo Machado, Juan Antonio; Canche Martin, Edwin

    2015-01-01

    La tuberculosis en una enfermedad infecciosa que afecta a varios órganos y tejidos del cuerpo, teniendo mayor tropismo por afección pulmonar, gastrointestinal y sistema nervioso central, e incluso tejido óseo, sin embargo se han reportado casos aislados de afección a otras estructuras en diferentes reportes de casos,  de la misma forma  en el que se presenta  un paciente que acudió con síntomas a nivel deltejido amigdalino y posteriormente se evidenció involucramiento pulmona,r considerándose...

  15. Tuberculosis.

    Science.gov (United States)

    Jacobson, Karen R

    2017-02-07

    This issue provides a clinical overview of tuberculosis, focusing on screening, prevention, diagnosis, and treatment. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  16. 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.

  17. 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.

  18. 76 FR 61251 - Tuberculosis in Cattle and Bison; State and Zone Designations; New Mexico

    Science.gov (United States)

    2011-10-04

    ... determined that prior notice and opportunity for public comment are contrary to the public interest and that... diseases, Bison, Cattle, Reporting and recordkeeping requirements, Transportation, Tuberculosis...

  19. Through the quarantine looking glass: drug-resistant tuberculosis and public health governance, law, and ethics.

    Science.gov (United States)

    Fidler, David P; Gostin, Lawrence O; Markel, Howard

    2007-01-01

    The incident in May-June 2007 involving a U.S. citizen traveling internationally while infected with drug-resistant tuberculosis involved the U.S. federal government's application of its quarantine and isolation powers. The incident and the isolation order raised numerous important issues for public health governance, law, and ethics. This article explores many of these issues by examining how the exercise of quarantine powers provides a powerful lens through which to understand how societies respond to and attempt to govern threats posed by dangerous, contagious pathogens. The article considers historical aspects of governmental power to quarantine and isolate individuals and groups; analyzes the current state of quarantine and isolation law in the United States in light of the recent incident with drug-resistant tuberculosis; and explores global aspects of public health governance and law highlighted by this incident.

  20. Cervical tuberculosis masquerading as cancer cervix: a report of three cases.

    Science.gov (United States)

    Sachan, Rekha; Gupta, Pooja; Patel, M L; Verma, Ajay; Maurya, Malti

    2013-01-01

    Tuberculosis is still frequently observed in third world countries like Africa and Asia. Here we report three cases of genital tuberculosis with variable presentations. First case was a lady of reproductive age group who presented with polymenorrhea and post-coital bleeding with unhealthy cervix. Histopathology of cervical tissue revealed tubercular cervicitis. Second and third cases presented with different complaints like discharge per vaginum, post-coital bleeding and pain in lower abdomen with growth over the cervix. Cervical biopsy was inconclusive of tuberculosis but endometrial tissue sampling for TB PCR was positive. This shows that newer diagnostic marker test can help us to detect secondary genital tuberculosis.

  1. 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.

  2. 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.

  3. Radiologic findings of secondary systemic amyloidosis associated with tuberculosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seong Tae; Lee, Jae Mun; Kim, Choon Yul; Shinn, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

    1995-07-15

    Amyloidosis is a rare systemic disease caused by extracellular deposition of insoluble protein. Systemic amyloidosis is subclassified into idiopathic primary and secondary form. The cause of secondary amyloidosis includes tuberculosis, familial Mediterranean fever, rheumatoid arthritis and multiple myeloma. We report a case of tuberculosis-related, secondary systemic amyloidosis which involved liver, spleen, kidneys, stomach, urinary bladder and lymph nodes.

  4. Tuberculosis tenosynovitis of the flexor tendons in the wrist: a case report

    OpenAIRE

    2015-01-01

    Extra-pulmonarytuberculosis is a rare form of tuberculosis that can pose diagnostic and therapeutic challenges. We report a case of extra-articular tuberculosis tenosynovitis in a 45-year immunocompetent patient. The symptoms of the patient mimicked De Quervain’s disease and carpal tunnel syndrome. Following pathological confirmation of the diagnosis, the patient recovered following a six-month antitubercular chemotherapy.

  5. Predictors of Non-Uptake of Human Immunodeficiency Virus Testing by Tuberculosis Public Primary Patients in Three Districts, South Africa

    Directory of Open Access Journals (Sweden)

    G Matseke

    2012-11-01

    Full Text Available Background: The acceptance of HIV testing among patients with tuberculosis (TB is low in South Africa. The aim of this study was to assess the prevalence, associated factors and reasons of non-uptake of human immunodeficiency virus (HIV testing by tuberculosis public primary care patients in three districts, South Africa.Methods: In May-October 2011, this cross-sectional survey was conducted amongst 4726 TB patients across 42 primary health care facilities in three districts in South Africa. All new TB and new retreatment patients (N=4726 were consecutively interviewed within one month of anti-tuberculosis treatment. The outcome was self-reported HIV testing after TB diagnosis, validated using clinic registers.Results: Almost one in ten (9.6% of the 4726 participants had not undergone HIV testing, with the most often offered explanation being that they were not knowing where to get tested (21.3%, followed by believing not to have or at risk for HIV (24.3%, emotional concerns (not ready for test: 13.2%; afraid to get to know: 12.1%; concerns over confidentiality: 6.3% and concerns about stigma (3.3% and losing the job (2.0%. In multivariable analysis being male, severe psychological distress, having sex with someone HIV negative or unknown and frequency of sex without a condom were associated with not having been tested for HIV.Conclusions: The level of HIV testing among TB public primary care patients was suboptimal, as per policy all patients should be tested. The South African Department of Health should continue to scale-up HIV testing and other collaborative TB-HIV services at health facilities.

  6. 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.

  7. Critical reflections on evidence, ethics and effectiveness in the management of tuberculosis: public health and global perspectives

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-03-01

    Full Text Available Abstract Background Tuberculosis is a major cause of morbidity and mortality globally. Recent scholarly attention to public health ethics provides an opportunity to analyze several ethical issues raised by the global tuberculosis pandemic. Discussion Recently articulated frameworks for public health ethics emphasize the importance of effectiveness in the justification of public health action. This paper critically reviews the relationship between these frameworks and the published evidence of effectiveness of tuberculosis interventions, with a specific focus on the controversies engendered by the endorsement of programs of service delivery that emphasize direct observation of therapy. The role of global economic inequities in perpetuating the tuberculosis pandemic is also discussed. Summary Tuberculosis is a complex but well understood disease that raises important ethical challenges for emerging frameworks in public health ethics. The exact role of effectiveness as a criterion for judging the ethics of interventions needs greater discussion and analysis. Emerging frameworks are silent about the economic conditions contributing to the global burden of illness associated with tuberculosis and this requires remediation.

  8. Primary tuberculosis involving epiglottis: a rare case report.

    Science.gov (United States)

    Edizer, Deniz Tuna; Karaman, Emin; Mercan, Hasan; Alimoglu, Yalcin; Esen, Tugce; Cansiz, Harun

    2010-09-01

    The case of a 29-year-old patient with active laryngeal tuberculosis predominantly involving the epiglottis, without pulmonary disease, is presented. The predominant symptoms are dysphagia, odynophagia, and hoarseness. Laryngeal carcinoma, which shares almost the same symptoms and signs, should be ruled out immediately. Laryngeal tuberculosis is discussed with a brief literature review.

  9. Isolated cystic tuberculosis of medial cuneiform: a case report

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    Nadeem Ali

    2013-08-01

    Full Text Available Isolated tuberculosis of foot is a rare entity. Plenty of literature is available on osteoarticular tuberculosis but literature on tuberculosis of foot is limited. Additionally the condition mimics variety of other foot pathologies which can delay diagnosis and add to morbidity. We present a twelve year old boy who presented clinically with swelling, pain and discharging sinus of foot with a cystic lesion in medial cuneiform on radiography. Though histopathology and Ziehl Nielsen staining later on established the diagnosis, but initially it was mistaken as a case of mycotic osteomyelitis. Tuberculosis of foot, though rare, should always be one of the differential diagnoses in a patient presenting with bony lesion on radiography irrespective of absence of constitutional symptoms and negative tests for tuberculosis. If battery of tests fails to establish diagnosis, open biopsy with curettage and histopathology should be considered to work out the final diagnosis. [Int J Res Med Sci 2013; 1(4.000: 592-595

  10. Urinary tuberculosis presented as isolated bladder lesion - a case report.

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    Siddique, F H; Uddin, B; Saleh, F M; Latif, T; Saha, N; Rahman, M A

    2014-01-01

    Extra-pulmonary Tuberculosis (EPTB) may affect all organs of the body with varied presentations. Genitourinary tuberculosis (GUTB) carries importance for its morbidity, though it is an uncommon form of TB. A widow of 45 years was admitted with several episodes of painless haematuria and recently developed urinary incontinence. Diagnosis of urinary bladder tuberculosis was made only by histopathology from bladder lesion with supportive evidence of few nonspecific constitutional symptoms and positive family history of pulmonary tuberculosis (PTB) and persistent sterile pyuria. Upper urinary tract involvement was not found. Category 1 anti-TB treatment was started. With this treatment recovery of the patient is satisfactory and symptoms are disappearing except for the incontinence. Urinary tuberculosis should be ruled out in a case of painless haematuria, repeated sterile pyuria.

  11. A case report of vascular catheter-associated bacteremia caused by Mycobacterium tuberculosis in a non-immunosuppressed patient

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    PETRILLO Victor Flávio

    1999-01-01

    Full Text Available Mycobacterium tuberculosis was isolated from a central venous catheter in a non-immunosuppressed patient with systemic tuberculosis. This case report represents a very uncommon form of isolation of Mycobacterium tuberculosis. A total improvement was obtained after treatment.

  12. Multiple Tuberculosis Verrucosa Cutis Lesions on One Foot: A Case Report

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    Seyamak Saleky

    2015-09-01

    Full Text Available Tuberculosis verrucosa cutis (TVC is a form of cutaneous tuberculosis caused by an exogenous inoculation of Mycobacterium tuberculosis in previously infected or sensitized individuals. Tuberculin sensitivity is moderate to high in these patients. In adults tuberculosis verrucosa cutis occurs commonly on the dorsal aspect of fingers and toes but in children it often occurs on gluteal region and lower extremities. A 36-year-old man presented with verrucous lesion on his right foot which was present for 9 years. It was understood from history that he worked as a rancher. On dermatologic examination 3 verrucous hiperkeratotic plaques were present on medial and plantar aspects of the right foot and also on dorsal aspect of the forth toe of the same foot. In serial biopsy specimens which was obtained from the lesions, histopathologic findings compatible with tuberculosis verrucosa cutis was observed. On the chest X-ray and thoracic tomography there were no sign of infection related with tuberculosis and changes secondary to previous tuberculosis on the left lung were observed. After commencing anti tuberculosis therapy regime consisting of isoniazid, rifampicin, morphazinamide and ethambutol obvious healing in the lesions occurred. This rarely reported case in Turkey showed the importance of histopathologic changes observed in serial biopsies in diagnosis of TVC besides history and clinical course of the lesions. It also emphasized the role of response to treatment in confirming the diagnosis.

  13. Pancreatic tuberculosis in a human immunodeficiency virus positive patient:A case report

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Despite the increased incidence of tuberculosis related to human immunodeficiency virus (HIV) in recent decades,pancreatic tuberculosis has rarely been described.We report a case of pancreatic tuberculosis in a 39-yearold African man who presented with progressive dysphagia,vomiting,weight loss and productive cough,accompanied by localized epigastric pain and one episode of melena.HIV-1 testing was positive and lymphocyte subset profile showed CD4 count of 9/mm3.Abdominal computed tomography (CT) scan with contrast revealed a cystic mass in the body of the pancreas,significant portal and retroperitoneal cystic adenopathy,and multiple cystic lesions in the spleen and liver.CT guided cyst aspiration and node biopsy detected Mycobacterium tuberculosis.The patient responded well on antituberculosis and antiretroviral therapy.Tuberculosis rarely involves the pancreas,probably due to the presence of pancreatic enzymes which interfere with the seeding of Mycobacterium tuberculosis.Pancreatic tuberculosis is considered to be the result of dissemination of the infection from nearby lymphatic nodes.Endoscopic ultrasound or CT guided fine needle aspiration for cytology is the recommended diagnostic technique.Although the prognosis is good with antituberculosis treatment,it could be fatal without correct diagnosis and treatment.The clinician's high index of suspicion of pancreatic tuberculosis and application of FNAB to obtain pathological evidence are extremely important to a correct diagnosis,especially in young HIV positive patients.

  14. Co-infection of brucellosis and tuberculosis in slaughtered cattle in Ibadan, Nigeria: a case report

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    Judy A. Stack

    2008-09-01

    Full Text Available The authors present a case report on co-infection of brucellosis and tuberculosis in cattle slaughtered at the Bodija abattoir in Ibadan, Nigeria. Out of 32 animals that were seropositive for brucellosis using the Rose Bengal test, indirect enzyme-linked immunosorbent assay (ELISA and competitive ELISA, six were also demonstrated as being infected with tuberculosis through mycobacterial culture. This is the first report of co-infection of brucellosis and tuberculosis in cattle slaughtered in Nigeria. There is a need for further studies to investigate this occurrence.

  15. Pulmonary tuberculosis and lepromatous leprosy co-infection in a single individual: A Case report

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    Satyadeo Choubey

    2014-01-01

    Full Text Available The concomitant occurrence of the two oldest mycobacterial diseases that is tuberculosis and leprosy in a single individual is not rare but has been infrequently reported. Herein, we report a case of 34-year-old laborer who concomitantly presented with both sputum positive pulmonary tuberculosis and lepromatous leprosy. The diagnosis of the two diseases was made simultaneously, which is again infrequent in literature. The treatment of leprosy warrants screening of individual for tuberculosis because multi-drug therapy for leprosy may lead to acquired drug resistance for rifampicin, which is a mainstem of anti-tubercular therapy.

  16. Primary tuberculosis of the thyroid gland:a case report

    Institute of Scientific and Technical Information of China (English)

    Sant; Parkash; Kataria; Parul; Tanwar; Sneh; Singh; Sanjay; Kumar

    2012-01-01

    Tuberculosis of the thyroid gland is an uncommon disease and primary involvement of Uiyroid is even more rare.It is a rare disease even in countries in which tuberculosis is endemic.The diagnosis is often difficult as the clinical presentation has no distinct characteristics.Clinical course of the disease may resemble toxic goiter or acute thyroiditis or may follow a subacute or chronic growth pattern without specific symptomatology.Histologically presence of necrotizing epithelioid cell granulomas along with langhans type giant cells are the hallmark of thyroid tuberculosis.Demonstration of acid fast bacilli by ZN staining confirms the diagnosis,but this stain is frequently negative in tissue sections.

  17. Primary tuberculosis of the thyroid gland:a case report

    Institute of Scientific and Technical Information of China (English)

    Sant Parkash Kataria; Parul Tanwar; Sneh Singh; Sanjay Kumar

    2012-01-01

    Tuberculosis of the thyroid gland is an uncommon disease and primary involvement of thyroid is even more rare. It is a rare disease even in countries in which tuberculosis is endemic. The diagnosis is often difficult as the clinical presentation has no distinct characteristics. Clinical course of the disease may resemble toxic goiter or acute thyroiditis or may follow a subacute or chronic growth pattern without specific symptomatology. Histologically presence of necrotizing epithelioid cell granulomas along with langhans type giant cells are the hallmark of thyroid tuberculosis. Demonstration of acid fast bacilli by ZN staining confirms the diagnosis, but this stain is frequently negative in tissue sections.

  18. A patient with isolated pancreatic tuberculosis: case report

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    Ramin Ebrahimian

    2015-09-01

    Conclusion: During surgery, a completely necrotic mass was in the pancreatic head. samples were sent for frozen section. The tuberculosis granuloma was diagnosed. Four drug anti-tuberculosis medication was started and continued for six months. Repeat imaging of the abdomen performed 6-months after the initiation of anti-TB therapy revealed complete resolution of the pancreatic mass, and antitubercular therapy was discontinued after a 6-month duration. Pancreatic tuberculosis can present with a variable spectrum of imaging findings. Furthermore, TB should be considered as a cause of any suspicious pancreatic lesion, especially in patients from areas where the infection is endemic.

  19. Discriminatory public policies and the New York City tuberculosis epidemic, 1975-1993.

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    Wallace, D N

    2001-05-01

    Discriminatory public policies removed over ten percent of the fire companies in New York City from 1972-1975, mainly from poor communities of color with very old multiple-dwellings. Hundreds of thousands of housing units were destroyed between 1972 and 1978. Patterns of housing overcrowding changed rapidly and social networks were broken. Tuberculosis went into obvious epidemic in 1979. The temporal and geographic dynamics of the TB epidemic is described here as are the lessons for Europe with respect to treatment of marginalized populations.

  20. Tuberculosis of spine as the first clinical presentation of Multiple Myeloma: a case report

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    Zahra Ahmadinejad

    2013-07-01

    Full Text Available Background: Patients with hematologic malignancies are at risk of advanced tuberculosis. The prevalence of tuberculosis between these patients is 2.1- 2.6 percent. The cellular immune deficiency caused by hematologic malignancies and or its treatment increases the risk of tuberculosis in these patients. Multiple Myeloma is malignant proliferations of plasma cells that involves different classes of immune system. Cellular and humeral immune deficiency due to the Multiple Myeloma and drugs for its treatment results in susceptibility to unusual infections. Infections are of the important factors of morbidity and mortality in patients suffering from multiple myeloma ,but coincidence of Multiple Myeloma and tuberculosis  is rare and very little has been reportedCase presentation: In this paper a 60-year-old woman from Kermanshah, Iran who is suffering from back pain, weight loss, weakness and sweating will be introduced. Spondylitis was seen in her lumbar imaging. Her husband suffered from pulmonary tuberculosis. In diagnostic studies tuberculose spondylitis and multiple myeloma were diagnosed simultaneously.Conclusion: Although the accompanying of Multiple Myeloma and tuberculosis is not common, but immunodeficiency caused by a hematologic malignancy as well as a history of close contact with a patient with tuberculosis resulted in tuberculosis of spine in this patient. Clinical features of abovementioned diseases are very similar. But in endemic area for tuberculosis, this disease should be considered because delay in diagnosis leads to increment in mortality and morbidities. Diagnosis of tuberculos spondylitis is based on radiologic and histologic features of the disease and on the response to treatment because the sensitivity of definitive diagnostic tests such as culture and PCR is low in extra pulmonary tuberculosis

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

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    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.

  2. Diffuse calcification of the urinary system and miliary tuberculosis due to delayed diagnosis of genitourinary tuberculosis: a case report.

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    Hairong Chen

    2015-02-01

    Full Text Available Genitourinary tuberculosis (GUTB is difficult to diagnose in the earlier stage owing to the non-specific symptoms. Usually, renal tuberculous involvement is unilateral and the imaging finding is renal calcification, but associated calcifications of bilateral ureter and bladder are rare. We report a 66-year-old man who presented with diffuse calcification of the urinary system (including bilateral pelvicalyceal system, both ureters and bladder and disseminated miliary tuberculosis due to GUTB. He had been misdiagnosed with urinary tract infection and urinary lithiasis for two years before the diagnosis of GUTB was confirmed by microbiological examination of the urine. This case highlights the importance of maintaining a high index of clinical suspicion for GUTB.

  3. Transmission models of tuberculosis in heterogeneous population

    Institute of Scientific and Technical Information of China (English)

    JIA Zhong-wei; LI Xiao-wen; FENG Dan; CAO Wu-chun

    2007-01-01

    Objective To review the transmission models of tuberculosis in heterogeneous population.Data sources The data used in this review were adopted mainly from the studies of models of tuberculosis reported from 1995 to 2006.Study selection Relevant literature on transmission models of tuberculosis in heterogeneous populations are referenced.Results Casual/random factors and genetic factors are the main reasons for epidemics of tuberculosis in recent years.Mass public transport is playing the primary role in casually close contact which can facilitate the transmission of tuberculosis. Genetic susceptibility not only varies endemic prevalence levels, but also drastically alters the effects of treatment for tuberculosis patients. Detailed studies further exhibit that casual contact and genetic factor are responsible for over 30%-40% of the total new cases in recent years. The prevalence of tuberculosis could double (from 33% to 60%)if a genetically susceptible phenotype is present in only 30% of the population. And some challenges have emerged along with these exciting results.Conclusions Casual/random contact, public transport and genetic susceptibility are responsible for most new tuberculosis cases and a wide variation in endemic tuberculosis levels between regions. Hence, the transmission model of tuberculosis in a heterogeneous population can provide more clues to underlying mechanism of tuberculosis transmission than in a homogeneous population. However, many challenges remain for us in understanding transmission of disease.

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

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    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.

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

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    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

  6. Post percutaneous nephrolithotripsy nephrostomy site tuberculosis: A report of six cases

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    Rahul Gupta

    2012-01-01

    Full Text Available With the increase in endoscopic surgery, there is a growing concern about the effectiveness of sterilizing reusable equipment by immersion in 2% glutaraldehyde. Although reports of port site tuberculosis (post laparoscopy are there in the literature, those of nephrostomy site post percutaneous nephrolithotripsy are not available. We describe the clinical features and treatment of six patients who presented with biopsy-proven skin tuberculosis at the nephrostomy-site for non-healing wound.

  7. Post percutaneous nephrolithotripsy nephrostomy site tuberculosis: A report of six cases

    Science.gov (United States)

    Gupta, Rahul; Mahajan, Arti; Gupta, Chaman

    2012-01-01

    With the increase in endoscopic surgery, there is a growing concern about the effectiveness of sterilizing reusable equipment by immersion in 2% glutaraldehyde. Although reports of port site tuberculosis (post laparoscopy) are there in the literature, those of nephrostomy site post percutaneous nephrolithotripsy are not available. We describe the clinical features and treatment of six patients who presented with biopsy-proven skin tuberculosis at the nephrostomy-site for non-healing wound. PMID:22346101

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

    Energy Technology Data Exchange (ETDEWEB)

    Sencer, S.; Aydin, K.; Poyanli, A.; Minareci, O. [Dept. of Radiology, Istanbul School of Medicine, Istanbul Univ., Istanbul (Turkey); Sencer, A.; Hepguel, K. [Dept. of Neurological Surgery, Istanbul School of Medicine, Istanbul Univ., Istanbul (Turkey)

    2003-03-01

    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.)

  9. Self-reported HIV testing practice among physicians treating tuberculosis in Australia and New Zealand.

    Science.gov (United States)

    Emerson, C R; Goldberg, H; Vollmer-Conna, U; Post, J J

    2010-05-01

    Not all people with tuberculosis have their HIV status ascertained despite the interaction between these infections. We investigated the self-reported HIV testing practice among physicians treating tuberculosis in Australia and New Zealand and used logistic regression to assess factors associated with a routine offer of HIV testing in cases of tuberculosis. Of 290 subjects, 61% always recommended an HIV test for a 38-year-old married man with smear-positive pulmonary tuberculosis. A lower proportion (40%) always tested a 78-year-old man or a female patient (58%), and more always HIV tested a South African case (85%), a patient with oral candidiasis (87%) or an unmarried male patient (66%). No scenario was associated with a universal offer of HIV testing. Clinician factors such as specialty (odds ratio [OR] 3.09), jurisdiction of practice (OR 4.09) and number of HIV tests requested in the past five years (OR 0.29) predicted the self-reported frequency of always HIV testing tuberculosis patients. At least 48% of respondents reported that epidemiological or clinical factors influenced their decision to offer testing. Strategies to increase HIV testing in cases of tuberculosis need to consider clinician factors.

  10. SANTA vs. public tuberculosis hospitals: the patient experience in the Free State, 2001/2002

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    J.C Heunis

    2007-09-01

    Full Text Available This paper reflects on the appropriateness of the decision to close down a nongovernmental organisation (NGO, state-aided tuberculosis (TB hospital in the Free State in 2003. Henceforth hospitalisation of TB patients would take place at public district hospitals. A survey conducted late-2001/'early-2002 revealed a more positive patient experience of hospitalisation forTB in public hospitals than in the NGO hospital. Consideration of the patient experience serves to inform the debate concerning continued outsourcing of TB hospital care to NGOs in South Africa. This study discusses comparative findings in respect of patients’ biographic and socio-economic characteristics, health beliefs, satisfaction with hospitalisation, experience of stigmatisation, adherence to treatment and absconding from hospital.

  11. Diagnosis by images of vertebral tuberculosis. A case report

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    Aimara de la Caridad Vergara Santos

    2015-04-01

    Full Text Available Vertebral tuberculosis, also known like espondilitis tuberculous, disease of Pott or Pott's disease, is a presentation of extra-pulmonary tuberculosis. A case of a 35 year old female Venezuelan patient was presented with a history of sacrum lumbar pain. A study of magnetic resonance in a high-technology center was accomplished and Pott's disease was diagnosed. The tuberculosis constitutes a heath problem in Venezuela as well as in many other countries. Pott's disease is not common in adults, but it should be taken into account on persistent or chronic lumbar pain. It is important to diagnose the disease timely to administrate the specific treatment during the first manifestations and avoid vertebral instability, neurological compromise or xiphotic vertebral deformity.

  12. 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.

  13. Fine Needle Aspiration Diagnosis of Isolated Pancreatic Tuberculosis: A Case Report and Review of Literature

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    D'Cruz S

    2003-07-01

    Full Text Available CONTEXT: Tuberculosis is a common disease in the developing world and its incidence is slowly increasing in developed countries where a resurgence has been seen subsequent to the AIDS epidemic. Tuberculosis, in its extrapulmonary form, though emerging as a clinical problem, rarely affects the pancreas. The pancreas is biologically protected from being infected by Mycobacterium tuberculosis. Pancreatic tuberculosis presents with a wide spectrum of symptoms such as abdominal pain, constitutional symptoms, obstructive jaundice, iron deficiency anemia, pancreatic abscess, massive gastro-intestinal bleeding, acute/chronic pancreatitis, secondary diabetes, splenic vein thrombosis and a pancreatic mass mimicking malignancy. It should be suspected clinically in patients having a pancreatic mass, particularly if the patient is young, not jaundiced, coming from an area of high tuberculosis endemicity and having a normal endoscopic retrograde cholangio-pancreatography. Its indolent course and vague symptomatology along with non-specific laboratory and radiological findings call for greater vigilance. CASE REPORT: We report a case of pancreatic tuberculosis which presented with pancreatic pain. Imaging techniques revealed a mass located in the head of the pancreatic gland. Fine needle aspiration cytology revealed caseating granulomas. The diagnosis of pancreatic tuberculosis was made and the patient was put on anti-tubercular therapy. Five months later, a repeat CT scan of the abdomen revealed resolution of the pancreatic lesion. CONCLUSION: The diagnosis of pancreatic tuberculosis is usually not suspected prior to laparotomy. Most patients have been diagnosed at laparotomy, thus fine needle aspiration cytology/biopsy is useful in obviating the need for major surgery with its accompanying morbidity. Exploratory laparotomy may be required in technically difficult cases due to risk of injury to the vessels in the vicinity of the mass.

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

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    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.

  15. Disseminated tuberculosis and tuberculous meningitis in Australian-born children; case reports and review of current epidemiology and management.

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    Smith, Benjamin B; Hazelton, Briony J; Heywood, Anita E; Snelling, Thomas L; Peacock, Kenneth M; Macartney, Kristine K

    2013-03-01

    We present two cases of tuberculous meningitis in Australian-born children. We review the current literature surrounding management of paediatric tuberculosis and disseminated disease, emphasising the importance of prompt diagnosis and intervention. We discuss the epidemiology of tuberculosis in the Australian paediatric population and highlight the sentinel role of childhood infection in public health surveillance.

  16. The relationship between (stigmatizing) views and lay public preferences regarding tuberculosis treatment in the Eastern Cape, South Africa

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground: Tuberculosis (TB) and human immune virus/acquired immune deficiency syndrome (HIV/AIDS) stigmas affect public attitudes toward TB treatment and policy. This study examined 'stigmatizing' ideas and the view that 'TB patients should line-up in the chronic illness queue' in rela

  17. The relationship between (stigmatizing) views and lay public preferences regarding tuberculosis treatment in the Eastern Cape, South Africa

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground: Tuberculosis (TB) and human immune virus/acquired immune deficiency syndrome (HIV/AIDS) stigmas affect public attitudes toward TB treatment and policy. This study examined 'stigmatizing' ideas and the view that 'TB patients should line-up in the chronic illness queue' in

  18. Dual-Reporter Mycobacteriophages (Φ2DRMs) Reveal Preexisting Mycobacterium tuberculosis Persistent Cells in Human Sputum

    Science.gov (United States)

    Jain, Paras; Weinrick, Brian C.; Kalivoda, Eric J.; Yang, Hui; Munsamy, Vanisha; Vilcheze, Catherine; Weisbrod, Torin R.; Larsen, Michelle H.; O’Donnell, Max R.; Pym, Alexander

    2016-01-01

    ABSTRACT Persisters are the minor subpopulation of bacterial cells that lack alleles conferring resistance to a specific bactericidal antibiotic but can survive otherwise lethal concentrations of that antibiotic. In infections with Mycobacterium tuberculosis, such persisters underlie the need for long-term antibiotic therapy and contribute to treatment failure in tuberculosis cases. Here, we demonstrate the value of dual-reporter mycobacteriophages (Φ2DRMs) for characterizing M. tuberculosis persisters. The addition of isoniazid (INH) to exponentially growing M. tuberculosis cells consistently resulted in a 2- to 3-log decrease in CFU within 4 days, and the remaining ≤1% of cells, which survived despite being INH sensitive, were INH-tolerant persisters with a distinct transcriptional profile. We fused the promoters of several genes upregulated in persisters to the red fluorescent protein tdTomato gene in Φ2GFP10, a mycobacteriophage constitutively expressing green fluorescent protein (GFP), thus generating Φ2DRMs. A population enriched in INH persisters exhibited strong red fluorescence, by microscopy and flow cytometry, using a Φ2DRM with tdTomato controlled from the dnaK promoter. Interestingly, we demonstrated that, prior to INH exposure, a population primed for persistence existed in M. tuberculosis cells from both cultures and human sputa and that this population was highly enriched following INH exposure. We conclude that Φ2DRMs provide a new tool to identify and quantitate M. tuberculosis persister cells.

  19. Delay in diagnosis of generalized miliary tuberculosis with osseo-articular involvement: a case report

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    Atukorala Inoshi

    2011-10-01

    Full Text Available Abstract Introduction Diagnosis of atypical tuberculosis is difficult. Therefore, it is important that physicians are aware of rare presentations of tuberculosis to avoid diagnostic delays. Case presentation We present the case of a 17-year-old Sri Lankan man who presented to our facility with an ill-defined large induration over the skin of his left buttock and thigh. A cause could not be found despite extensive investigations. He also complained of chronic knee pain, but this was not investigated further at the time due to spontaneous resolution. Three years later his knee disease flared up again, with pain, swelling and restriction of movement. A synovial biopsy was suggestive of tuberculosis. He was started on antituberculosis therapy, to which he responded well. Our patient was asymptomatic two months after completion of therapy without any subsequent flare-ups. A chest roentgenogram taken on his second presentation showed evidence of tuberculosis sequelae in his lungs. The most likely diagnosis for the buttock and thigh swelling, when considering the entire clinical picture, is a tuberculous abscess. The constellation of skin and skeletal symptoms and pulmonary tuberculosis is a rare occurrence in an immunocompetent individual, but cases have been reported. Conclusions This case demonstrates the different presentations and the diagnostic difficulties posed by atypical manifestations of tuberculosis. It also demonstrates the value of maintaining a high degree of suspicion in endemic areas, even in the absence of microbiological evidence.

  20. [Management of tuberculosis (TB) cases from view points of public health].

    Science.gov (United States)

    Satoh, Ken; Motomiya, Masakichi

    2011-08-01

    Tuberculosis control law was enacted in 1951 and has been the basis for the management of TB cases over the long post-war period. This law has legalized the use of public founds for the treatment of TB patients for the first time and has provided the authentic basis for mandatory hospitalization, routine health examination, vaccination, notification and registration of TB cases. However, this law was abrogated in 2001 and was joined to the comprehensive infectious diseases control law, in order to facilitate a prophylactic measure against TB infection and to protect human rights of TB patients. Concurrently the medical care system and the formalities connected to hospitalization treatment of TB patients were reviewed. The purpose of the present overview is to explain how TB cases are managed under the newly-enacted law.

  1. 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

  2. Exploitation of Mycobacterium tuberculosis reporter strains to probe the impact of vaccination at sites of infection.

    Science.gov (United States)

    Sukumar, Neelima; Tan, Shumin; Aldridge, Bree B; Russell, David G

    2014-09-01

    Mycobacterium tuberculosis (Mtb) remains a major public health problem, with an effective vaccine continuing to prove elusive. Progress in vaccination strategies has been hampered by a lack of appreciation of the bacterium's response to dynamic changes in the host immune environment. Here, we utilize reporter Mtb strains that respond to specific host immune stresses such as hypoxia and nitric oxide (hspX'::GFP), and phagosomal maturation (rv2390c'::GFP), to investigate vaccine-induced alterations in the environmental niche during experimental murine infections. While vaccination undoubtedly decreased bacterial burden, we found that it also appeared to accelerate Mtb's adoption of a phenotype better equipped to survive in its host. We subsequently utilized a novel replication reporter strain of Mtb to demonstrate that, in addition to these alterations in host stress response, there is a decreased percentage of actively replicating Mtb in vaccinated hosts. This observation was supported by the differential sensitivity of recovered bacteria to the front-line drug isoniazid. Our study documents the natural history of the impact that vaccination has on Mtb's physiology and replication and highlights the value of reporter Mtb strains for probing heterogeneous Mtb populations in the context of a complex, whole animal model.

  3. Exploitation of Mycobacterium tuberculosis reporter strains to probe the impact of vaccination at sites of infection.

    Directory of Open Access Journals (Sweden)

    Neelima Sukumar

    2014-09-01

    Full Text Available Mycobacterium tuberculosis (Mtb remains a major public health problem, with an effective vaccine continuing to prove elusive. Progress in vaccination strategies has been hampered by a lack of appreciation of the bacterium's response to dynamic changes in the host immune environment. Here, we utilize reporter Mtb strains that respond to specific host immune stresses such as hypoxia and nitric oxide (hspX'::GFP, and phagosomal maturation (rv2390c'::GFP, to investigate vaccine-induced alterations in the environmental niche during experimental murine infections. While vaccination undoubtedly decreased bacterial burden, we found that it also appeared to accelerate Mtb's adoption of a phenotype better equipped to survive in its host. We subsequently utilized a novel replication reporter strain of Mtb to demonstrate that, in addition to these alterations in host stress response, there is a decreased percentage of actively replicating Mtb in vaccinated hosts. This observation was supported by the differential sensitivity of recovered bacteria to the front-line drug isoniazid. Our study documents the natural history of the impact that vaccination has on Mtb's physiology and replication and highlights the value of reporter Mtb strains for probing heterogeneous Mtb populations in the context of a complex, whole animal model.

  4. Pleuropulmonary Paragonimiasis mimicking Pulmonary Tuberculosis - A Report of Three Cases

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    Singh T

    2005-01-01

    Full Text Available Paragonimiasis is an important cause of pulmonary disease worldwide. Infection in humans mainly occurs by ingestion of raw or undercooked freshwater crabs or crayfishes. The disease is well known in endemic regions of Asian countries, where culturally based methods of food preparation foster human transmission. Three patients with clinical and radiological features compatible with pulmonary tuberculosis had been treated for tuberculosis without remedy despite an inability to demonstrate acid fast bacilli in sputum smears. All patients had history of ingestion of raw crabs and crayfishes. The confirmed diagnosis of pleuropulmonary paragonimiasis was made based on the demonstration of Paragonimus eggs in the sputum, and high absolute eosinophilia in their peripheral blood and pleural fluid. All the patients had been treated with praziquantel successfully.

  5. 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

  6. CASE REPORT: Disseminated Tuberculosis with Strongyloides stercoralis Infestation

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    Maya Patil

    2012-01-01

    Full Text Available Case History: We are presenting a case of seven year old male with disseminated tuberculosis and infection with Strongyloides stercoralis (S.stercoralis The patient had severe hypoproteinemia and anasarca. S.stercoralis is a helminthic infection. Infection is acquired by walking bare foot on contaminated soil. After infection the filariform larvae invade the venous circulation and reach the intestine via respiratory system. Hyperinfection with this parasite leads to steatorrhea, oedema of duodenum, protein losing enteropathy,especially in immunocompromised individual. The patient had disseminated tuberculosis leading to decreased immunity which made the patient susceptible to hyperinfection with strongyloides. The patient responded dramatically to Ivermectin and anti tuberculartreatment. Timely intervention with appropriate drugs may prove to be lifesaving in such condition.

  7. 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)

  8. Laryngeal tuberculosis: A case of a non-healing laryngeal lesion

    Directory of Open Access Journals (Sweden)

    HK Chen and P Thornley

    2012-03-01

    Full Text Available We report a case of laryngeal tuberculosis in a 47-year-old Korean man. Laryngeal tuberculosis is rare and currently accounts for less than 1% of all cases of tuberculosis. Clinical features of laryngeal tuberculosis include hoarseness, odynophagia and dyspnoea. Macroscopically, laryngeal tuberculosis may mimic laryngeal carcinoma, chronic laryngitis or laryngeal candidiasis. The diagnosis is often delayed due to a low index of clinical suspicion and hence may pose a significant public health risk. Laryngeal tuberculosis should be considered in the differential diagnosis of patients who present with any form of laryngeal lesion.

  9. [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.

  10. Bindi Tuberculosis - Lupus Vulgaris Associated with Bindi Use: A Case Report.

    Science.gov (United States)

    Mishra, Gyanshankar; Rathi, Sushil; Mulani, Jasmin

    2015-05-01

    Cutaneous lesions are relatively uncommon manifestations of tuberculosis (TB). A 40-year-old female presented with skin lesion over the forehead since two months. She used to apply bindi over the same area since past 25 years. Based on skin biopsy and other ancillary investigations, she was diagnosed as a case of lupus vulgaris and initiated on anti TB medications following which, the lesion regressed. Thus, we herein report the first case of cutaneous tuberculosis (lupus vulgaris) associated with long term use of bindi.

  11. Spinal Tuberculosis and Cold Abscess without Known Primary Disease: Case Report and Review of the Literature

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    Rima Patel

    2016-01-01

    Full Text Available Extrapulmonary tuberculosis (TB is uncommon but not rare. Bone and joint involvement constitute about 10% of extrapulmonary TB cases, with the spine being the most frequently affected site. Spinal TB patients typically present with back pain but other constitutional or pulmonary symptoms may be absent, rendering the diagnosis difficult. This case explores challenges in the diagnosis of spinal TB. We report a case of a 39-year-old woman presenting with vague back swelling for many years. Imaging revealed osteomyelitis of the spine but initial studies and cultures were negative for Mycobacterium tuberculosis. The diagnosis was confirmed weeks later when cultures demonstrated Mycobacterium tuberculosis. Considering the severe complications of untreated spinal TB including paraplegia and need for surgical intervention, high suspicion is critical in early diagnosis.

  12. Spinal Tuberculosis and Cold Abscess without Known Primary Disease: Case Report and Review of the Literature

    Science.gov (United States)

    Gannamani, Vedavyas; Shay, Emily; Alcid, David

    2016-01-01

    Extrapulmonary tuberculosis (TB) is uncommon but not rare. Bone and joint involvement constitute about 10% of extrapulmonary TB cases, with the spine being the most frequently affected site. Spinal TB patients typically present with back pain but other constitutional or pulmonary symptoms may be absent, rendering the diagnosis difficult. This case explores challenges in the diagnosis of spinal TB. We report a case of a 39-year-old woman presenting with vague back swelling for many years. Imaging revealed osteomyelitis of the spine but initial studies and cultures were negative for Mycobacterium tuberculosis. The diagnosis was confirmed weeks later when cultures demonstrated Mycobacterium tuberculosis. Considering the severe complications of untreated spinal TB including paraplegia and need for surgical intervention, high suspicion is critical in early diagnosis. PMID:28070429

  13. Ocular tuberculosis: current perspectives

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    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. Intestinal obstruction secondary to primary ileocecal tuberculosis: A case report

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    Muayad A Merza

    2012-01-01

    Full Text Available A 22-year-old Iraqi male presented with a case of intestinal obstruction secondary to primary ileocecal tuberculosis (TB. The presumptive diagnosis of either Crohn's disease or neoplasm was expected. A right hemicolectomy was performed. Histopathology revealed an inflammatory mass of TB origin; a polymerase chain reaction (PCR confirmed the diagnosis. The patient was treated with standard anti-TB drugs for 6 months. Following the treatment, the systemic symptoms disappeared and the laboratory investigations returned to normal. Follow-up period showed no recurrence of the disease.

  16. Chronic kidney disease related to renal tuberculosis: a case report

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    Geraldo Bezerra da Silva Junior

    2016-06-01

    Full Text Available Abstract: Genitourinary tuberculosis (TB is the third most common form of extrapulmonary TB. A 34-year-old man with severe kidney function loss secondary to renal TB initially presented with urinary symptoms, including dysuria and polacyuria. The diagnosis was based on clinical history and laboratory tests; the urinalysis revealed acid-fast bacilli. The patient's condition stabilized after beginning TB-specific treatment, but the right kidney function loss persisted. Renal TB can lead to irreversible loss of renal function. As such, renal function should be considered in all patients from TB-endemic areas who present with urinary symptoms and whose urine cultures are negative for common pathogens.

  17. [Multidrug-Resistant Tuberculosis by Strains of Beijing Family, in Patients from Lisbon, Portugal: Preliminary Report].

    Science.gov (United States)

    Maltez, Fernando; Martins, Teresa; Póvoas, Diana; Cabo, João; Peres, Helena; Antunes, Francisco; Perdigão, João; Portugal, Isabel

    2017-03-31

    Beijing family strains of Mycobacterium tuberculosis are associated with multidrug-resistance. Although strains of the Lisboa family are the most common among multidrug-resistant and extensively drug-resistant patients in the region, several studies have reported the presence of the Beijing family. However, the features of patients from whom they were isolated, are not yet known. Retrospective study involving 104 multidrug-resistant and extensively drug-resistant strains of Mycobacterium tuberculosis, from the same number of patients, isolated and genotyped between 1993 and 2015 in Lisbon. We assessed the prevalence of strains of both families and the epidemiologic and clinical features of those infected with Beijing family strains. Seventy-four strains (71.2%) belonged to the Lisboa family, 25 (24.0%) showed a unique genotypic pattern and five (4.8%) belonged to the Beijing family, the latter identified after 2009. Those infected with Beijing family strains were angolan (n = 1), ukrainian (n = 2) and portuguese (n = 2), mainly young-aged and, four of five immunocompetent and with no past history of tuberculosis. All had multidrug-resistant tuberculosis. We did not find any distinctive clinical or radiological features, neither a predominant resistance pattern. Cure rate was high (four patients). Although the number of infected patients with Beijing strains was small, it suggests an important proportion of primary tuberculosis, a potential for transmission in the community but also a better clinical outcome when compared to other reported strains, such as W-Beijing and Lisboa. Although Lisboa family strains account for most of the multidrug and extensively drug-resistant tuberculosis cases in Lisbon area, Beijing strains are transmitted in the city and might change the local characteristics of the epidemics.

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

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    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.

  19. Splenic Tuberculosis –A rare case report

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    Prof. Mrudula Phadke

    2007-07-01

    Full Text Available Tuberculosis of spleen is an extremely rare clinical entity. It often poses diagnostic difficulties as microbiological confirmation of diagnosis is not easy. We came across a case of middle aged immunocompetent female from good socioeconomic background who presented with weight loss and pain in left hypochondriac region. Ultrasonography of abdomen revealed multiple hypo echoic lesions in the spleen. Splenectomy was performed and sample was sent for histopathological examination and also microbiological analysis. Gross examination of the specimen showed multiple nodules coalescing to form large yellowish white colored mass of firm consistency. Histopathological examination showed large areas of caseation surrounded by multiple granulomas of epitheloid cells and Langhan’s type of giant cells throughout the splenic pulp. PCR was done by using IS6110 primers. This was consistent with the diagnosis of Mycobacterial infection. Mycobacterium tuberculosis grew on culture from the tissue after 5 weeks. No primary focus of infection was detected in the lungs or any other organ. Diagnosis within just a few hours was made possible because of PCR.

  20. Isolated Talonavicular Joint Tuberculosis in a Child – Rare Location of Koch’s Bacillus: A Case Report

    Science.gov (United States)

    Faizan, Mohd; Jilani, Latif Z.; Khalid, MRCS; Saifullah; Abbas, Mazhar; Anwar, Dilshad

    2017-01-01

    Tuberculosis of the foot is an uncommon entity and the reported incidence is 0.1% to 0.3%. The isolated tuberculosis of talonavicular joint is exceptionally rare. In tuberculosis of the foot and ankle, the presentation is usually nonspecific. The diagnosis of tuberculosis affecting foot is difficult, especially when it is isolated. In doubtful cases, diagnosis should be confirmed by histopathological examination. Unlike pulmonary Kochs, osteoarticular tuberculosis should be treated with antituberculous drugs for a longer duration, preferably for 18 months. We are reporting a case of a 9-year-old boy with tuberculosis of the isolated talonavicular joint and the diagnosis was suggested on plain radiography, which was further confirmed by histopathological examination. He was treated with first-line antitubercular drugs. A good recovery was seen following the commencement of anti-tuberculosis treatment. After two years of follow-up, he was pain-free and doing all of his routine activities. In tuberculosis of the foot, diagnosis is usually delayed or missed due to vague presentation.

  1. 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.

  2. 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.

  3. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response.

    Science.gov (United States)

    Abdool Karim, Salim S; Churchyard, Gavin J; Karim, Quarraisha Abdool; Lawn, Stephen D

    2009-09-12

    One of the greatest challenges facing post-apartheid South Africa is the control of the concomitant HIV and tuberculosis epidemics. HIV continues to spread relentlessly, and tuberculosis has been declared a national emergency. In 2007, South Africa, with 0.7% of the world's population, had 17% of the global burden of HIV infection, and one of the world's worst tuberculosis epidemics, compounded by rising drug resistance and HIV co-infection. Until recently, the South African Government's response to these diseases has been marked by denial, lack of political will, and poor implementation of policies and programmes. Nonetheless, there have been notable achievements in disease management, including substantial improvements in access to condoms, expansion of tuberculosis control efforts, and scale-up of free antiretroviral therapy (ART). Care for acutely ill AIDS patients and long-term provision of ART are two issues that dominate medical practice and the health-care system. Decisive action is needed to implement evidence-based priorities for the control of the HIV and tuberculosis epidemics. By use of the framework of the Strategic Plans for South Africa for tuberculosis and HIV/AIDS, we provide prioritised four-step approaches for tuberculosis control, HIV prevention, and HIV treatment. Strong leadership, political will, social mobilisation, adequate human and financial resources, and sustainable development of health-care services are needed for successful implementation of these approaches.

  4. Engaging general practitioners in public-private mix tuberculosis DOTS program in an urban area in Pakistan: need for context-specific approach.

    Science.gov (United States)

    Pethani, Amin; Zafar, Mubashir; Khan, Adeel Ahmed; Rabbani Sana, Unaib; Ahmed, Sana; Fatmi, Zafar

    2015-03-01

    A public-private mix tuberculosis (TB) DOTS project was implemented to enhance coverage and collaboration between the public and private sectors, with an objective to increase case detection and to improve TB case management in a large urban area. General practitioners (GPs) were trained to provide DOTS services. Patients were diagnosed and treated as per national guidelines and outcomes were reported to national TB control program. Treatment and sputum microscopy were provided free of cost. A total of 94 GPs were trained. In all, 57.4% of trained GPs remained actively involved in the project. Overall treatment success rate of the patients enrolled with the project was 86.3% with 8.7% default patients. Experience suggests that a more stringent selection criteria need to be followed for inclusion of GPs in the program to improve the success of the program. A multifaceted context specific approach is needed while working with private health care providers.

  5. 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.

  6. 19 CFR 206.36 - Public report.

    Science.gov (United States)

    2010-04-01

    ... Duties UNITED STATES INTERNATIONAL TRADE COMMISSION NONADJUDICATIVE INVESTIGATIONS INVESTIGATIONS RELATING TO GLOBAL AND BILATERAL SAFEGUARD ACTIONS, MARKET DISRUPTION, TRADE DIVERSION, AND REVIEW OF RELIEF ACTIONS Investigations Relating to Bilateral Safeguard Actions § 206.36 Public report. Upon making...

  7. 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.

  8. 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. PMID:27625898

  9. Primary gastric fundus tuberculosis in immunocompetent patient: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Fahmi Yousef Khan

    2008-10-01

    Full Text Available We report on a 29-year-old Pakistani man who presented to the clinic with epigastric pain, of one-month duration. He did not report fever, cough, vomiting blood, passing black stools, loss of appetite or diarrhea. However, he had lost 7 kg since his symptoms had begun. Clinical examination was unremarkable. Laboratory results were within normal limits. An abdominal CT scan showed a mass with enhancement in the stomach. Gastric endoscopy revealed an ulcerative mass in the fundus. An endoscopic-biopsy specimen revealed caseating granulomas with acid-fast bacilli. The patient was diagnosed to have primary gastric tuberculosis, and antituberculous medications were initiated. Cultures of the gastric mass subsequently grew Mycobacterium tuberculosis sensitive to isoniazid and rifampcin. Follow-up after six months showed a good response to treatment; an upper gastrointestinal tract endoscopy after six months was normal.

  10. Dissemination of tuberculosis after biopsy of primary tubercular prostate: a case report

    OpenAIRE

    Onkar Jha; Vidya Nair; Deepak Talwar

    2015-01-01

    Only 15-20% of extrapulmonary tuberculosis (TB) has been attributed to TB of the urogenital system and often Results from haematogenous spread from an active site of infection. Isolated involvement of prostate by TB is relatively less common. The incidence of primary prostatic TB is unknown and in its truest sense is a very rare entity. Here, we report the case of a patient with primary prostatic TB who was misdiagnosed as nonspecific granulomatous inflammation on transrectal ultrasound-guid...

  11. 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)

  12. Bronchial stenosis after tuberculosis - a case report; Estenose bronquica apos tuberculose - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Martins, Renata Romano; Nogueira, Aline Silva; Almeida, Fabiola Assuncao de; Santos, Teresa Cristina C.R.S. dos; Marchiori, Edson; Sales, Anderson Ribeiro [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Lima, Carlos Eduardo T. [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Servico de Cirurgia Toracica

    1999-09-01

    The authors report a case of bronchial stenosis after pulmonary tuberculosis infection in a 46 year-old man presenting symptoms related to upper left lobe collapse, that was identified by chest roentgenograms. The evaluation by computed tomography showed narrowing of the left main bronchus and obliteration of the upper left bronchus. The patient had a postero-lateral thoracotomy, lower left bronchus and left main bronchus bronchoplasty, with upper left lobectomy. (author)

  13. Tuberculosis of the trachea.

    Science.gov (United States)

    Smati, Belhassen; Boudaya, Mohamed Sadok; Ayadi, Aïda; Ammar, Jemal; Djilani, Habiba; El Mezni, Faouzi; Kilani, Tarek

    2006-11-01

    Tracheal tuberculosis is an uncommon localized form of tuberculosis with fewer than 150 reported cases in the literature. We report a case of tracheal stenosis caused by tuberculosis in which the diagnosis was suggested by the patient's past medical history. This patient was successfully treated with tracheal resection, adjuvant steroids and anti-tuberculous therapy. This report will review the various types of tuberculosis of the trachea and their clinical features in addition to discussing the different available treatment modalities.

  14. Disseminated kidney tuberculosis complicating autosomal dominant polycystic kidney disease: a case report.

    Science.gov (United States)

    Takeshita, Hideki; Amemiya, Morimasa; Chiba, Koji; Urushibara, Masayasu; Satoh, Jun-Ichi; Noro, Akira

    2012-03-01

    Mycobacterium tuberculosis infection in patients with autosomal dominant polycystic kidney disease (ADPKD) is rare, and its diagnosis and treatment are difficult because numerous cysts are exposed to infection and antibiotics do not easily penetrate infected cysts. Here, we report the case of a 43-year-old Japanese man with disseminated urogenital tuberculosis (TB) and ADPKD without human immunodeficiency virus (HIV) infection. Delayed diagnosis and ineffective anti-TB chemotherapy worsened his condition. Finally, he underwent bilateral nephrectomy but experienced postoperative complications. In conclusion, kidney TB should be recognized as a cause of renal infection in ADPKD, and surgical treatment should be instituted without delay. The importance of early diagnosis and treatment cannot be overemphasized to prevent kidney TB deterioration.

  15. [Disseminated tuberculosis revealing IgA nephropathy with nephrotic syndrome : A case report].

    Science.gov (United States)

    Morbieu, Caroline; Michel, Pierre-Antoine; Brocheriou, Isabelle; Canestri, Ana; Boffa, Jean-Jacques

    2016-07-01

    A 27-year-old man without any medical history presented concomitantly a pulmonary and urinary tuberculosis and a nephrotic syndrome with hematuria and renal failure. The renal biopsy showed increased mesangial matrix, few focal segmental lesions, and IgA deposits confirming the diagnosis of IgA nephropathy. Nephrotic syndrome remission occurred quickly after antituberculous treatment. The association between tuberculosis and IgA nephropathy has been previously reported in 9 patients. Renal outcome was always favorable with antituberculous treatment. No relapse occurred, with a maximal follow-up of 42 months. Here, we discuss this singular association and previous similar cases. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Ho; Park, Chan Hee; Hwang, Hee Sung; Bae, Moon Sun [Ajou University College of Medicine, Suwon (Korea, Republic of)

    1996-06-15

    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.

  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. Aphasia secondary to tuberculosis: a review of a nineteenth-century case report by Booth and Curtis (1893).

    Science.gov (United States)

    Shafi, Noel

    2015-01-01

    The topic of aphasia secondary to tuberculosis deserves attention for two reasons: first, for better understanding rare etiologies of aphasia in medical history; and secondly, for initiating a multidisciplinary discussion relevant to aphasiologists, neurologists, pathologists, and clinicians generally. This article will focus on clinical observations of tuberculosis-related aphasia in the nineteenth century, highlighting a noteworthy case report presented by Booth and Curtis (1893).

  19. 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.

  20. Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review.

    Science.gov (United States)

    Zou, Hai; Pan, Ke-Hua; Pan, Hong-Ying; Huang, Dong-Sheng; Zheng, Ming-Hua

    2015-12-29

    Tuberculosis (TB) is a common disease to threaten human health. TB of the central nervous system (CNS) is rare but the most serious type of systemic TB because of its high mortality rate, serious neurological complications and sequelae. In this case report, we describe a woman who presented with walking instability, intracerebral hemorrhage and leptomeningeal enhancement due to tuberculosis meningitis. The patient had no significant medical history and the initial clinical symptoms were walking instability. On analysis, the cerebrospinal fluid was colorless and transparent, the pressure was more than 400 mm H2O, there was lymphocytic pleocytosis, increased protein, and decreased glucose levels present. No tuberculosis or other bacteria were detected. The patient's brain computed tomography image showed intra-cerebral hemorrhage (ICH) and contrast magnetic resonance imaging showed ICH in the right frontal lob, and leptomeningeal enhancement. CNS TB is rare but has a high mortality rate. As this disease has no unique characteristics at first presentation such as epidemiology and obvious clinical manifestation, a diagnosis of CNS TB remains difficult.

  1. Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Robert Rejdak

    2014-01-01

    Full Text Available Introduction. We report a case of a male patient presented with sarcoid lesions of the iris and conjunctiva, mimicking tuberculosis due to epithelioid cell granulomas with small central necrosis in conjunctival biopsy. Patient. A 25-year-old man was referred to our department for further management of an “iris tumor with iridocyclitis” in his right eye. Initial examination showed an isolated vascular tumor of the iris and ciliary body with anterior uveitis and mutton-fat keratic precipitates, suggesting the diagnosis of a granulomatous disease. Conjunctival biopsy revealed granulomatous epithelioid cell inflammation with small central necrosis without acid-fast bacilli. Extensive systemic examination, including bronchoscopy and transbronchial biopsy, provided the diagnosis of sarcoidosis stage 2 with pulmonary involvement, thus ruling out tuberculosis. Systemic and local steroid therapy was initiated, leading to complete recovery of our patient with complete disappearance of the iris lesion and improvement of the pulmonary function. Conclusion. Although noncaseating epithelioid cell granulomas are typical for sarcoidosis, small central necrosis can be found in some granulomas, leading to presumption of tuberculosis. Extensive systemic checkup in cooperation with other specialists is essential to confirm the correct diagnosis and to initiate the appropriate therapy.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Tuberculosis of The Parotid Gland in Children A Report of 4 Cases

    Directory of Open Access Journals (Sweden)

    Rajae BORKI

    2016-03-01

    Full Text Available Tuberculosis is a chronic granulomatous infection caused by Mycobacterium tuberculosis or bovis that can affect all organs. However being located in the salivary glands is rare, affecting mainly adults between 20 and 50 years, although a few cases were described in children. We reported a series of 4 children with parotid TB diagnosed and treated at the ENT department of the hospital of specialties of Rabat.The average age was 9.25 years and sex ratio M/F was 1. All children were admitted for parotid swelling evolving over an average period of 6 months which fistulized afterwards, a child had also facial paralysis. Histological analysis of the fine-needle aspiration or the sample taken from the fistula confirmed the diagnosis of tuberculosis with the presence of giant cell granuloma with caseous necrosis. All children received anti-bacillary treatment during 6 months, and showed good evolution.Although being rare, the parotid TB in children remains a condition to be considered at the occurrence of any chronic parotid swelling, especially in endemic countries.

  4. Dissemination of tuberculosis after biopsy of primary tubercular prostate: a case report

    Directory of Open Access Journals (Sweden)

    Onkar Jha

    2015-01-01

    Full Text Available Only 15-20% of extrapulmonary tuberculosis (TB has been attributed to TB of the urogenital system and often Results from haematogenous spread from an active site of infection. Isolated involvement of prostate by TB is relatively less common. The incidence of primary prostatic TB is unknown and in its truest sense is a very rare entity. Here, we report the case of a patient with primary prostatic TB who was misdiagnosed as nonspecific granulomatous inflammation on transrectal ultrasound-guided biopsy of the prostate, who later presented to our centre after 4 months with disseminated TB. The rarity of the case prompted us to report this case.

  5. 75 FR 15443 - Advancing the Development of Diagnostic Tests and Biomarkers for Tuberculosis; Public Workshop...

    Science.gov (United States)

    2010-03-29

    ...-resistant TB (MDR TB) and extensively drug-resistant TB (XDR TB). Both plans addressed domestic and global... of Diagnostic Tests and Biomarkers for Tuberculosis (TB).'' The purpose of the workshop is to provide... and procedural gaps in the current development of TB diagnostic tests, and in exploring models...

  6. Central Nervous System Tuberculosis

    OpenAIRE

    Bano, Shahina; Chaudhary, Vikas; Yadav, Sachchidanand

    2012-01-01

    Central nervous system tuberculosis is a rare presentation of active tuberculosis and accounts for about 1% of cases (1). The three clinical categories include meningitis, intracranial tuberculomas, and spinal tuberculous arachnoiditis. We report a case of a young man who presented with active pulmonary tuberculosis in addition to tuberculous meningitis and the presence of numerous intracranial tuberculomas.

  7. Prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in South Africa

    Directory of Open Access Journals (Sweden)

    Peltzer Karl

    2012-07-01

    Full Text Available Abstract Background Psychological distress has been rarely investigated among tuberculosis patients in low-resource settings despite the fact that mental ill health has far-reaching consequences for the health outcome of tuberculosis (TB patients. In this study, we assessed the prevalence and predictors of psychological distress as a proxy for common mental disorders among tuberculosis (TB patients in South Africa, where over 60 % of the TB patients are co-infected with HIV. Methods We interviewed 4900 tuberculosis public primary care patients within one month of initiation of anti-tuberculosis treatment for the presence of psychological distress using the Kessler-10 item scale (K-10, and identified predictors of distress using multiple logistic regressions. The Kessler scale contains items associated with anxiety and depression. Data on socio-demographic variables, health status, alcohol and tobacco use and adherence to anti-TB drugs and anti-retroviral therapy (ART were collected using a structured questionnaire. Results Using a cut off score of ≥28 and ≥16 on the K-10, 32.9 % and 81 % of tuberculosis patients had symptoms of distress, respectively. In multivariable analysis older age (OR = 1.52; 95 % CI = 1.24-1.85, lower formal education (OR = 0.77; 95 % CI = 0.65-0.91, poverty (OR = 1.90; 95 % CI = 1.57-2.31 and not married, separated, divorced or widowed (OR = 0.74; 95 % CI = 0.62-0.87 were associated with psychological distress (K-10 ≥28, and older age (OR = 1.30; 95 % CI = 1.00-1.69, lower formal education (OR = 0.55; 95 % CI = 0.42-0.71, poverty (OR = 2.02; 95 % CI = 1.50-2.70 and being HIV positive (OR = 1.44; 95 % CI = 1.19-1.74 were associated with psychological distress (K-10 ≥16. In the final model mental illness co-morbidity (hazardous or harmful alcohol use and non-adherence to anti-TB medication and/or antiretroviral therapy were not

  8. Pulmonary mucormycosis mimicking as pulmonary tuberculosis : A case report

    Directory of Open Access Journals (Sweden)

    Garg Rajiv

    2008-01-01

    Full Text Available Pulmonary Mucormycosis is an uncommon disease caused by fungi of class Zygomycetes. It occurs predminantly in an immunodeficient host most common risk factor being diabetes mellitus. The lesions are localized in the lungs or the mediastinum. We are reporting a case of 70 years old male, having cough, haemoptysis, fever and chest pain. He was on antituberculosis treatment (RHEZ for last 10 days and was later found to have Pulmonary Mucormycosis on further evaluation.

  9. Pulmonary mucormycosis mimicking as pulmonary tuberculosis: a case report.

    Science.gov (United States)

    Garg, Rajiv; Marak, Rungmei Sk; Verma, Sanjay Kumar; Singh, Jagdeep; Sanjay; Prasad, Rajendra

    2008-07-01

    Pulmonary Mucormycosis is an uncommon disease caused by fungi of class Zygomycetes. It occurs predminantly in an immunodeficient host most common risk factor being diabetes mellitus. The lesions are localized in the lungs or the mediastinum. We are reporting a case of 70 years old male, having cough, haemoptysis, fever and chest pain. He was on antituberculosis treatment (RHEZ) for last 10 days and was later found to have Pulmonary Mucormycosis on further evaluation.

  10. U.S. medical resident familiarity with national tuberculosis guidelines

    Directory of Open Access Journals (Sweden)

    Amorosa Valerianna C

    2007-08-01

    Full Text Available Abstract Background The ability of medical residents training at U.S. urban medical centers to diagnose and manage tuberculosis cases has important public health implications. We assessed medical resident knowledge about tuberculosis diagnosis and early management based on American Thoracic Society guidelines. Methods A 20-question tuberculosis knowledge survey was administered to 131 medical residents during a single routinely scheduled teaching conference at four different urban medical centers in Baltimore and Philadelphia. Survey questions were divided into 5 different subject categories. Data was collected pertaining to institution, year of residency training, and self-reported number of patients managed for tuberculosis within the previous year. The Kruskal-Wallis test was used to detect differences in median percent of questions answered correctly based on these variables. Results The median percent of survey questions answered correctly for all participating residents was 55%. Medical resident knowledge about tuberculosis did not improve with increasing post-graduate year of training or greater number of patients managed for tuberculosis within the previous year. Common areas of knowledge deficiency included the diagnosis and management of latent tuberculosis infection (median percent correct, 40.7%, as well as the interpretation of negative acid-fast sputum smear samples. Conclusion Many medical residents lack adequate knowledge of recommended guidelines for the management of tuberculosis. Since experience during training influences future practice pattterns, education of medical residents on guidelines for detection and early management of tuberculosis may be important for future improvements in national tuberculosis control strategies.

  11. Analysis of cutaneous tuberculosis cases reported from 2000 to 2013 at a university hospital in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Thales Pereira de Azevedo

    2016-06-01

    Full Text Available Abstract: INTRODUCTION: Tuberculosis (TB is a serious public health problem; however, the cutaneous form remains rare. METHODS: A retrospective analysis examined notified cutaneous tuberculosis (CTB cases from 2000 to 2013 at the University Hospital Clementino Fraga Filho. RESULTS: Twenty-six CTB cases were documented during this period. Erythema induratum of Bazin was the most common form, and 86.7% of such cases occurred in women (p=0.068. Only one patient was HIV positive. CONCLUSIONS: This study confirms the rarity of CTB and highlights the need for multicenter studies in order to obtain an adequate number of cases for analysis.

  12. [Policy counselling through public health reporting?].

    Science.gov (United States)

    Brand, H; Michelsen, K

    2007-10-01

    For about 20 years public health reporting has increasingly been developed as a resource in health policy counselling. Both with regard to its use as well as its further development it is important to reflect on the possibilities and limits of this resource. A basis for this is provided by theories, models and hypotheses derived from the discussion about scientific policy counselling. In early conceptual reflections on the organisation of health reporting a technocratic use was rejected. This is reflected by the ideas and views about the institutional embedding of health reporting activities. Against the background of diverging opinions about the political dimensions of health reporting activities, reflections were guided by the decisionistic and pragmatic model of the "scientification of politics". Public health reporting must provide the possibility for being used in a flexible way in order to add a pragmatistic component to its decisionistic and strategic uses. For action-oriented, pragmatistic and scientific policy counselling through the health reporting discipline it is important to link "information about politically relevant facts" with the "targeted processing of knowledge geared towards problems in the field of decision-making processes" (expertise).

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Gallbladder Tuberculosis Mimicking Gallbladder Carcinoma: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Yao Liu

    2016-01-01

    Full Text Available Gallbladder tuberculosis (GT is extremely rare, and it is difficult to differentiate from other gallbladder diseases, such as gallbladder carcinoma and Xanthogranulomatous Cholecystitis. A correct preoperative diagnosis of GT is difficult. The final diagnosis is usually made postoperatively according to surgical biopsy. Here, we report a case of a patient who underwent surgery with the preoperative diagnosis of gallbladder carcinoma. We reviewed the literature and present the process of differential diagnosis between two or more conditions that share similar signs or symptoms.

  15. The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Progress Report and Issues for Congress

    Science.gov (United States)

    2008-04-14

    Government Accountability Office ITN Insecticide-Treated Net MDR - TB Multi-Drug Resistant Tuberculosis NGO Non-Governmental Organization OGAC Office of the...the Fund in excess of the President’s request are provided at the expense of U.S. bilateral HIV/AIDS, TB , and malaria programs; and because they...Fund has improved its reporting and monitoring practices, greater U.S. contributions to the Fund parallel increases in U.S. bilateral HIV/AIDS, TB , and

  16. Multidrug-resistant tuberculosis in transplant recipients: Case report and review of the literature.

    Science.gov (United States)

    Huaman, Moises A; Brawley, Robert; Ashkin, David

    2017-04-01

    Transplant recipients are at increased risk of tuberculosis (TB). We describe a case of pulmonary and vertebral multidrug-resistant TB (MDR-TB) in a kidney transplant patient who required neurosurgical intervention and unfortunately developed fatal nosocomial complications. Thirteen transplant recipients with MDR-TB were previously reported in the literature (one hematopoietic cell transplant, one heart transplant, one lung transplant, one heart-lung transplant, and nine kidney transplant recipients). Extrapulmonary disease, severe treatment complications, and deaths were observed in patients who developed MDR-TB after transplantation.

  17. Tuberculosis of the cervix and infertility: report of a rare case.

    Science.gov (United States)

    Guié, P; Iovenitti, P; N'guessan, K; Tegnan, J; Koffi, K; Carta, G; Anongba, S

    2008-01-01

    Tubercolosis is a frequent bacterial infection in less developed countries. Lung and lymph node localisations are common, while the genital apparatus is less involved. In this work a rare case of cervical tuberculosis followed by some lesions causing infertility in a 20-year-old woman is reported. The diagnosis was confirmed by a histological examination from a biopsy of the cervix. The patient was offered six-month antituberculosis therapy which eliminated the cervical lesions. A few years later she came under our care for infertility due to uterine adhesions diagnosed by hysterosalpingography. Now the patient is being treated for infertility complicated by amenorrhoea.

  18. Pulmonary tuberculosis in Romania at the dawn of the millennium--a major public health issue.

    Science.gov (United States)

    Marica, C

    2009-01-01

    TB incidence in our country is still quite high compared to the average of the European Union countries (1st place among EU countries and 3rd place among WHO European Region countries), which means that a national coordinated response against this disease needs to become the priority of the current health care policy. The multi-factorial conditioning, which includes the social and economic dimensions of TB spreading, requires a multi-disciplinary and inter-sectorial approach to this pathology, going beyond healthcare services. The National Tuberculosis Control Strategy is a part of Romania's Country Strategy based on the guidelines set out in WHO's 2006-2015 Global Plan to Stop Tuberculosis (MDGs 2015) and it provides the necessary framework for refining and harmonizing the national legislation and regulations with the European laws after Romania's integration in the EU.

  19. Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Getinet Shewaseged Adenager

    2017-01-01

    Full Text Available Background. Early detection and diagnosis of tuberculosis (TB and the timely commencement of antituberculosis (anti-TB treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. Objective. To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. Findings. The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%, 233 (54.8%, and 262 (61.6% of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5 km from TB treatment health facility [AOR = 1.6, 95% CI (1.1–2.5] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70] and [AOR = 0.61 (0.39, 0.94], respectively. Conclusions. A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care.

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

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    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.

  1. 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

  2. Colonic adenocarcinoma, mucosa associated lymphoid tissue lymphoma and tuberculosis in a segment of colon: A case report

    Institute of Scientific and Technical Information of China (English)

    Ambedkar; Raj; Kulandai; Velu; Banushree; C; Srinivasamurthy; Krishnan; Nagarajan; Ilavarasi; Sinduja

    2014-01-01

    Synchronous occurrence of adenocarcinoma and mucosa associated lymphoid tissue(MALT) lymphoma of colon is rare, and its presence with coexisting tuberculosis is still rarer. To our knowledge, this may be the first case report. In the present report, we describe a 43-year-old female who presented with a history of abdominal pain, fever, loss of weight and loss of appetite. Colonoscopy showed a large ulceroproliferative mass arising from the caecum, biopsy of which showed it to be adenocarcinoma of the colon. A right hemicolectomy was performed and microscopic study of the colon revealed tuberculosis and synchronous adenocarcinoma with lymphoma. Eight of sixteen lymph nodes showed tuberculosis and three of sixteenpericoloniclymphnodes showed metastatic deposits. Immunostains further confirmed the tumour to be adenocarcinoma with MALT lymphoma. We would like to highlight the diagnostic challenges arising from the multi-faceted presentations of these three conditions.

  3. End-stage renal disease due to delayed diagnosis of renal tuberculosis: a fatal case report

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    Elizabeth De Francesco Daher

    Full Text Available Renal TB is difficult to diagnose, because many patients present themselves with lower urinary symptoms which are typical of bacterial cystitis. We report a case of a young woman with renal TB and ESRD. She was admitted with complaints of adynamia, anorexia, fever, weight loss, dysuria and generalized edema for 10 months. At physical examination she was febrile (39ºC, and her abdomen had increased volume and was painful at palpation. Laboratorial tests showed serum urea=220mg/dL, creatinine=6.6mg/dL, hemoglobin=7.9g/dL, hematocrit=24.3%, leukocytes=33,600/mm³ and platelets=664,000/mm³. Urinalysis showed an acid urine (pH=5.0, leukocyturia (2+/4+ and mild proteinuria (1+/4+. She was also oliguric (urinary volume <400mL/day. Abdominal echography showed thick and contracted bladder walls and heterogeneous liquid collection in the left pelvic region. Two laparotomies were performed, in which abscess in pelvic region was found. Anti-peritoneal tuberculosis treatment with rifampin, isoniazid and pyrazinamide was started. During the follow-up, the urine culture was found to be positive for M. tuberculosis. Six months later the patient had complaints of abdominal pain and dysuria. New laboratorial tests showed serum urea=187mg/dL, creatinine=8.0mg/dL, potassium=6.5mEq/L. Hemodialysis was then started. The CT scan showed signs of chronic nephropathy, dilated calyces and thinning of renal cortex in both kidneys and severe dilation of ureter. The patient developed neurologic symptoms, suggesting tuberculous meningoencephalitis, and died despite of support measures adopted. The patient had ESRD due to secondary uropathy to prolonged tuberculosis of urinary tract that was caused by delayed clinical and laboratorial diagnosis, and probably also due to inadequate antituberculous drugs administration.

  4. Imaging tuberculosis with endogenous beta-lactamase reporter enzyme fluorescence in live mice.

    Science.gov (United States)

    Kong, Ying; Yao, Hequan; Ren, Hongjun; Subbian, Selvakumar; Cirillo, Suat L G; Sacchettini, James C; Rao, Jianghong; Cirillo, Jeffrey D

    2010-07-06

    The slow growth rate and genetic intractability of tubercle bacilli has hindered progress toward understanding tuberculosis, one of the most frequent causes of death worldwide. We overcame this roadblock through development of near-infrared (NIR) fluorogenic substrates for beta-lactamase, an enzyme expressed by tubercle bacilli, but not by their eukaryotic hosts, to allow real-time imaging of pulmonary infections and rapid quantification of bacteria in living animals by a strategy called reporter enzyme fluorescence (REF). This strategy has a detection limit of 6 +/- 2 x 10(2) colony-forming units (CFU) of bacteria with the NIR substrate CNIR5 in only 24 h of incubation in vitro, and as few as 10(4) CFU in the lungs of live mice. REF can also be used to differentiate infected from uninfected macrophages by using confocal microscopy and fluorescence activated cell sorting. Mycobacterium tuberculosis and the bacillus Calmette-Guérin can be tracked directly in the lungs of living mice without sacrificing the animals. Therapeutic efficacy can also be evaluated through loss of REF signal within 24 h posttreatment by using in vitro whole-bacteria assays directly in living mice. We expect that rapid quantification of bacteria within tissues of a living host and in the laboratory is potentially transformative for tuberculosis virulence studies, evaluation of therapeutics, and efficacy of vaccine candidates. This is a unique use of an endogenous bacterial enzyme probe to detect and image tubercle bacilli that demonstrates REF is likely to be useful for the study of many bacterial infections.

  5. [Lupus vulgaris as a complication of pulmonary tuberculosis--case report].

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    Owczarek, Witold; Targowski, Tomasz; Kozera-Zywczyk, Anna; Paluchowska, Elwira; Patera, Janusz

    2009-10-01

    Tuberculosis is a contagious disease induced by Mycobacterium species, acid-fast bacilli. These are mostly human type--Mycobacterium tuberculosis, less often cattle type--mycobacterium bovis or other: mycobacterium avium, kansasii, marinom, scrofulaceum, heamophilium, gordonae. The infection can affect all organs, but pulmonary tuberculosis is the most common form. The importance of tuberculosis is definitely rising in the context of massive population migrations in regions affected by its higher incidence, increased HIV infections and AIDS development. Cutaneous tuberculosis is a particular tuberculosis form with differentiated clinical picture. Non-typicalness of skin changes and oligobacilleous course of extrapulmonary tuberculosis forms are repeatedly causing difficulties in adequate diagnosis and early treatment. In differential diagnostics of cutaneous tuberculosis one must take leishmaniasis, actinomycosis, leprosy, syphilis and deep mycosis (among others) into consideration. The study is presenting a case of lupus vulgaris as a complication of past pulmonary tuberculosis. In bacteriological diagnostics of skin changes bioptates, no tuberculosis mycobacteria were found. The disease was diagnosed based on specific granulation presence in histopathology test, tuberculin hypersensivity, bacilli DNA presence in polymerase chain reaction (PCR) test and skin changes regression after anti-mycobacterium treatment. According to authors of the study, the described case confirms the usefulness of PCR nucleonic acids amplification test in cutaneous tuberculosis diagnosis.

  6. [Extrapulmonary tuberculosis].

    Science.gov (United States)

    Mazza-Stalder, J; Nicod, L; Janssens, J-P

    2012-04-01

    Extrapulmonary tuberculosis represents an increasing proportion of all cases of tuberculosis reaching 20 to 40% according to published reports. Extrapulmonary TB is found in a higher proportion of women, black people and immunosuppressed individuals. A significant proportion of cases have a normal chest X-Ray at the time of diagnosis. The most frequent clinical presentations are lymphadenitis, pleuritis and osteoarticular TB. Peritoneal, urogenital or meningeal tuberculosis are less frequent, and their diagnosis is often difficult due to the often wide differential diagnosis and the low sensitivity of diagnostic tests including cultures and genetic amplification tests. The key clinical elements are reported and for each form the diagnostic yield of available tests. International therapeutic recommendations and practical issues are reviewed according to clinical presentation.

  7. Mycobacterium tuberculosis and Dual M. tuberculosis/M. bovis Infection as the Cause of Tuberculosis in a Gorilla and a Lioness, Respectively, in Ibadan Zoo, Nigeria

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    Aina Adeogun

    2016-01-01

    Full Text Available Tuberculosis (TB in zoo animals is an important public health problem in places where it occurs. This is even very important in countries where there is little public health awareness about the disease; thus confined animals in the zoo can be infected directly or indirectly by infected humans and vice versa. In Nigeria, the problem of TB is a major concern among both humans and cattle. Here, we present cases of Mycobacterium tuberculosis and M. tuberculosis/M. bovis infections in a female gorilla and a lioness, respectively, in a zoo in Ibadan, Nigeria. These cases were confirmed after bacteriological examinations and DNA from granulomatous lesions of the animals’ carcasses were subjected to the Hain and spoligotyping techniques. Our findings reveal the first documented report of TB infections in a gorilla and a lioness in zoo animals in Nigeria. The public health risks of tuberculosis in zoological settings are therefore reemphasized.

  8. National Tuberculosis Control Programme.

    Science.gov (United States)

    Uke, B T

    1995-01-01

    Tuberculosis (TB) continues to be a major public health problem in India, since there are an estimated 2.5-3 million sputum positive cases and 5-6 million noninfectious cases in the country. The National Tuberculosis Program was established in 1962 with the main objective of reducing the disability and death from TB by effective treatment. Under the District Tuberculosis Program, district TB centers (DTCs) were set up for referral diagnosis, treatment, and community control of TB. Nationally, there are 390 districts with fully equipped DTCs staffed by a team of medical and paramedical personnel. Another 330 TB clinics are mostly located in big cities, caring for the local populace. In addition, 17 tuberculosis training and demonstration centers provide basic training to paramedical personnel, including general practitioners. There are a total of about 47,000 beds available nationwide for TB patients. The majority of patients are treated at home, thus only serious cases or those requiring surgical treatment are admitted. The NTP also stresses health education aimed at the community and general practitioners. Booklets, pamphlets, radio, TV, and newspaper advertisements are utilized for this purpose. International assistance has been provided by UNICEF, WHO, and the Swedish International Development Agency since the 1950s. The National Tuberculosis Institute was established in 1959 in Bangalore and it has engaged in research on epidemiological, sociological, and operations aspects, along with monitoring of the program. Other TB research institutes are the TB Research Center in Madras and the LRS Institute of TB and Allied Diseases in Delhi. BCG vaccination of children up to the age of 1 year continues, although a study showed that vaccination did not protect from adult TB. Evaluation of the NTP comprises quarterly reports for DTCs and countrywide assessment. NTP achievements include 85% coverage of districts, diagnosis of 1,500,000 new cases a year, and short

  9. Report of the Cape Breton Public Review

    Energy Technology Data Exchange (ETDEWEB)

    MacNeil, T.

    2002-04-02

    The Canada-Nova Scotia Offshore Petroleum Board (CNSOPB) conducted a public review to determine the effects of potential offshore oil and gas exploration and drilling activities in Sydney Bight and the southern Gulf of St. Lawrence regions where Corridor Resources Inc. and Hunt Oil Company of Canada are proposing to conduct seismic surveys. In particular, activities within exploration licences 2364, 2365, and 2368 were reviewed to determine their socio-economic impact, the effects on the ecosystem, and the mitigation of impacts. The Commissioner of this public review was not mandated to advise on whether the exploratory programs should proceed or whether a moratorium should be placed on exploration of the license areas. Recommendations, however, were proposed in several areas. The first phase of the inquiry included a series of public meetings to allow groups and individuals to identify concerns and exchange views about the process. The second phase involved a series of public hearings where interested parties presented submissions. In particular, 130 formal submissions were received from the petroleum industry, commercial fisheries, environmental groups, tourism industry, aboriginal leaders, and other organizations. The report describes in some detail, the companies' proposals regarding seismic surveys and exploratory drilling. The effects that these activities will have on marine mammals and birds as well as their habitat was examined. Both Hunt and Corridor provided their assessment of the potential environmental and socio-economic effects of their seismic activities and both concluded that the seismic activity would have no significant effect on the marine environment and its uses. They also concluded that the socio-economic benefits to Cape Breton would be small. The issues that dominated the proceedings were the protection of the marine environment and the coexistence between the fishing and petroleum industry. The Commissioner suggests there is need for

  10. Neuropathy caused by B12 deficiency in a patient with ileal tuberculosis: A case report

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    Toosi Taraneh

    2008-03-01

    Full Text Available Abstract Introduction Vitamin B12 deficiency can result in macrocytic anemia. Neurologic abnormalities of B12 deficiency include sensory deficits, loss of deep tendon reflexes, movement disorders, neuropsychiatric changes and seizures. Segmental involvement of the distal ileum, such as in tuberculosis, can cause vitamin B12 deficiency. To our knowledge, macrocytic anemia with unusual manifestations such as brain atrophy and seizures due to intestinal tuberculosis has not been reported in the literature. Case presentation A 14-year-old girl presented with complaints of paraplegia, ataxia, fever and fatigue that had started a few months earlier and which had been getting worse in the last three weeks. Her laboratory results were indicative of macrocytic anemia with a serum B12 level Conclusion Vitamin B12 deficiency should be considered in patients with neurologic features such as paresthesia, sensory deficits, urinary incontinence, dysarthria, and ataxia. The underlying cause of B12 deficiency should be determined and treated to obviate the patients' need for long term vitamin B12 therapy.

  11. Treatment outcome of human immunodeficiency virus and tuberculosis co-infected patients in public hospitals of eastern and southern zone of Tigray region, Ethiopia

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    Mehretu Belayneh

    2015-02-01

    Full Text Available Background:Tuberculosis is a leading cause of death among people living with human immunodeficiency virus. In sub-Saharan Africa, tuberculosis accounts for more than 78% of all deaths among people with human immunodeficiency virus.Objectives:To assess tuberculosis treatment outcome and the associated factors in adult tuberculosis/human immunodeficiency virus co-infected patients in four public hospitals of eastern and southern zone of Tigray region, Ethiopia.Methodology:Institution based cross-sectional study design was used to examine secondary data from tuberculosis/human immunodeficiency virus co-infected patients attending four public hospitals of eastern and southern zone of Tigray, from January 2009 to August 2011. Systematic random sampling technique was used to select individual patient cards from the respective hospitals. Univariate analysis and multivariate logistic regression modeling was used to assess the impact of each variable in predicting treatment outcome.Results:Out of 342 patients included, 199 (58.2% patients completed treatment, 43 (12.6% patients were cured, 88 (25.7% died, 7 (2% defaulted, and 5 (1.5% patients failed treatment. Treatment success rate was around 71%. In the multivariate logistic regression analysis the factors that were strongly associated with unfavorable tuberculosis treatment outcomes were WHO stage IV (AOR = 3.2, CI = 1.58-6.82, p-value = 0.001, age greater than 45 years (AOR = 6.08, CI = 2.28-16.23 and baseline CD4 count less than 200 cells/L (AOR = 6.19, CI = 2.28-16.89, p-value = 0.001.Conclusion:The rate of treatment success in this study was lower than the rate newly recommended by WHO. Therefore, efforts should be undertaken to improve treatment success rates of both diseases.

  12. Visual Acuity Reporting in Clinical Research Publications.

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    Tsou, Brittany C; Bressler, Neil M

    2017-06-01

    Visual acuity results in publications typically are reported in Snellen or non-Snellen formats or both. A study in 2011 suggested that many ophthalmologists do not understand non-Snellen formats, such as logarithm of the Minimum Angle of Resolution (logMAR) or Early Treatment Diabetic Retinopathy Study (ETDRS) letter scores. As a result, some journals, since at least 2013, have instructed authors to provide approximate Snellen equivalents next to non-Snellen visual acuity values. To evaluate how authors currently report visual acuity and whether they provide Snellen equivalents when their reports include non-Snellen formats. From November 21, 2016, through December 14, 2016, one reviewer evaluated visual acuity reporting among all articles published in 4 ophthalmology clinical journals from November 2015 through October 2016, including 3 of 4 journals that instructed authors to provide Snellen equivalents for visual acuity reported in non-Snellen formats. Frequency of formats of visual acuity reporting and frequency of providing Snellen equivalents when non-Snellen formats are given. The 4 journals reviewed had the second, fourth, fifth, and ninth highest impact factors for ophthalmology journals in 2015. Of 1881 articles reviewed, 807 (42.9%) provided a visual acuity measurement. Of these, 396 (49.1%) used only a Snellen format; 411 (50.9%) used a non-Snellen format. Among those using a non-Snellen format, 145 (35.3%) provided a Snellen equivalent while 266 (64.7%) provided only a non-Snellen format. More than half of all articles in 4 ophthalmology clinical journals fail to provide a Snellen equivalent when visual acuity is not in a Snellen format. Since many US ophthalmologists may not comprehend non-Snellen formats easily, these data suggest that editors and publishing staff should encourage authors to provide Snellen equivalents whenever visual acuity data are reported in a non-Snellen format to improve ease of understanding visual acuity measurements.

  13. Co-Existence of Acinic Cell Carcinoma - Papillary Cystic Variant and Extrapulmonary Tuberculosis - Report of A Case with Brief Review.

    Science.gov (United States)

    Amita, Krishnappa; Vijayshankar, Shivshankar; Sanjay, Manchaiah

    2015-09-01

    Tuberculosis (TB) and cancer are two lethal diseases causing significant morbidity and mortality in developing countries like India. Co-existence of these two disease lead to diagnostic dielemma among the clinicians. Overlapping clinical manifestations lead to delay in diagnosis. We report a case of acinic cell carcinoma -papillary cystic variant of the salivary gland and extra pulmonary tuberculosis in a young female. We emphasize the importance of the awareness of the co-existence of these two diseases and the role of fine needle aspiration cytology in the initial diagnosis.

  14. BOCI-Egypt : Brucellosis and Tuberculosis control 21- 25 March 2011

    NARCIS (Netherlands)

    Nell, A.J.; Vugt, van F.

    2011-01-01

    This is the report of the first mission to Egypt for the project: Impact of brucellosis and tuberculosis on animal production and public health (BO-10-009-118). The objective of this mission was: to make an assessment of the current needs and problems in Egypt related to brucellosis and tuberculosis

  15. The evolution of tuberculosis virulence.

    Science.gov (United States)

    Basu, Sanjay; Galvani, Alison P

    2009-07-01

    The evolution of Mycobacterium tuberculosis presents several challenges for public health. HIV and resistance to antimycobacterial medications have evolutionary implications for how Mycobacterium tuberculosis will evolve, as these factors influence the host environment and transmission dynamics of tuberculosis strains. We present an evolutionary invasion analysis of tuberculosis that characterizes the direction of tuberculosis evolution in the context of different natural and human-driven selective pressures, including changes in tuberculosis treatment and HIV prevalence. We find that the evolution of tuberculosis virulence can be affected by treatment success rates, the relative transmissibility of emerging strains, the rate of reactivation from latency among hosts, and the life expectancy of hosts. We find that the virulence of tuberculosis strains may also increase as a consequence of rising HIV prevalence, requiring faster case detection strategies in areas where the epidemics of HIV and tuberculosis collide.

  16. Organisational innovation and control practices: the case of public-private mix in tuberculosis control in India.

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    Engel, Nora; van Lente, Harro

    2014-07-01

    Partnerships between public and private healthcare providers are often seen as an important way to improve health care in resource-constrained settings. Despite the reconfirmed policy support for including private providers into public tuberculosis control in India, the public-private mix (PPM) activities continue to face apprehension at local implementation sites. This article investigates the causes for those difficulties by examining PPM initiatives as cases of organisational innovation. It examines findings from semi-structured interviews, observations and document analyses in India around three different PPM models and the attempts of innovating and scaling up. The results reveal that in PPM initiatives underlying problem definitions and different control practices, including supervision, standardisation and culture, continue to clash and ultimately hinder the scaling up of PPM. Successful PPM initiatives require organisational control practices which are rooted in different professions to be bridged. This entails difficult balancing acts between innovation and control. The innovators handle those differently, based on their own ideas of the problem that PPM should address and their own control practices. We offer new perspectives on why collaboration is so difficult and show a possible way to mitigate the established apprehensions between professions in order to make organisational innovations, such as PPM, sustainable and scalable.

  17. Violence in public school: reports of teachers

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    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.

  18. Primary cutaneous tuberculosis in a 27-year-old medical intern from needle-stick injury: a case report.

    Science.gov (United States)

    Karoney, Mercy Jelagat; Kaumbuki, Erastus Kanake; Koech, Mathew Kiptonui; Lelei, Lectary Kibor

    2015-01-01

    The authors report a case of cutaneous tuberculosis in a 27-year-old African male medical intern who contracted primary cutaneous from a needle-stick injury. Cultures of pus aspirated from the finger initially grew Staphylococcus aureus that led to a delay in the diagnosis.

  19. Cervical tuberculosis associated with cervical pain and neurologic deficit: a case report and literature review.

    Science.gov (United States)

    Wang, Lei; Liu, Limin; Song, Yueming; Pei, Fuxing; Liu, Hao

    2014-05-01

    Isolated tuberculosis (TB) of posterior elements of the cervical spine is extremely rare. Only few cases are reported in literature, but none describe isolated spinous process and laminae involvement without TB in any other part of the body. To report a case of isolated TB involvement of the spinous process and right laminae of C2 combined with atlantoaxial luxation. A case report of isolated spinous process and right laminae TB of C2 combined with atlantoaxial luxation. A 20-year-old male farmer complained about a 2-month history of aggravating neck pain, a 1-month history of a slowly growing lump at the back of the neck, and numbness and weakness of the right arm that had gradually progressed to involve all the limbs for 2 weeks before presentation. X-ray and computed tomography of cervical spine and Frankel grading of neural function are included to evaluate the therapeutic efficiency. Computed tomography scans showed flake-like bony destruction located in the spinous process and at the right laminae of C2. Magnetic resonance imaging (MRI) showed a large swelling posterior to C2 and atlantoaxial luxation-induced distinct compression of the spinal cord. The patient underwent 2 weeks of skull traction and quadruple anti-TB treatment before surgery. The patient underwent surgical treatment that included posterior radical debridement, decompression, internal fixation with a screw-rod system from C1 to C4, autologous bone grafting, and fusion. The patient gained normal neural function and returned to work 1 year after surgery. Tuberculosis of the posterior elements of the upper cervical spine is very rare and potentially dangerous. Computed tomography and MRI are very useful and important for correct diagnosis. Prompt medical and surgical treatment may avert potential catastrophic event in these cases. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Long, Richard; Heffernan, Courtney; Gao, Zhiwei; Egedahl, Mary Lou; Talbot, James

    2015-01-01

    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.

  1. 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.

  2. Multidrug-resistant tuberculosis in children from 2003 to 2005: A brief report

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    I Shah

    2012-01-01

    Full Text Available Multidrug-resistant tuberculosis (MDR-TB has rarely been reported from children in India. Their response to therapy is also not known. We present four HIV-negative children with MDR-TB (3 children with extra-pulmonary TB and 1 child with pulmonary TB who presented in 2003-2005. All the four children were already on antituberculous therapy (ATT for 3-9 months prior to being detected as MDR-TB. These patients were started on second-line ATT for 18 months. In three patients, there was complete resolution, and one patient with severe bilateral pulmonary TB had the disease localized to one lung after 18 months of therapy.

  3. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2007. A report of the Australian Mycobacterium Reference Laboratory Network.

    Science.gov (United States)

    Lumb, Richard; Bastion, Ivan; Carter, Robyn; Jelfs, Peter; Keehner, Terillee; Sievers, Aina

    2009-09-01

    The Australian Mycobacterium Reference Laboratory Network collects and analyses laboratory data on new cases of disease caused by the Mycobacterium tuberculosis complex. In 2007, a total of 872 cases were identified by bacteriology; an annual reporting rate of 4.1 cases per 100,000 population. Isolates were identified as M. tuberculosis (n=867), M. africanum (n=4) and M. bovis (n=1). Fifteen children aged under 10 years had bacteriologically-confirmed tuberculosis. Results of in vitro drug susceptibility testing were available for 871 of 872 isolates for isoniazid (H), rifampicin (R), ethambutol (E), and pyrazinamide (Z). A total of 98 (11.3%) isolates of M. tuberculosis were resistant to at least one of these anti-tuberculosis agents. Resistance to at least H and R (defined as multi-drug resistance, MDR) was detected in 24 (2.8%) isolates, all from overseas-born patients; 17 were from the respiratory tract (sputum n=16, endotracheal aspirate n=1). Thirteen patients with MDR-TB were from the Papua New Guinea-Torres Strait Islands zone. Of the 98 M. tuberculosis isolates resistant to at least one of the standard drugs, 54 (55.1%) were from new cases, 9 (9.2%) from previously treated cases, and no information was available on the remaining 35 cases. Seven were Australian-born, 90 were overseas- born, and the country of birth of 1 was unknown. Of the 90 overseas-born persons with drug resistant disease, 66 (73.3%) were from 5 countries: India (n=16); Papua New Guinea (n=15); the Philippines (n=12); Vietnam (n=12); and China (n=11). No XDR-TB was detected in 2007.

  4. 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.

    Science.gov (United States)

    Woimo, Tadele Teshome; Yimer, Wondwossen Kassahun; Bati, Temesgen; Gesesew, Hailay Abrha

    2017-03-20

    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. 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. 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. A quarter of Tb patients interrupted their treatment due to knowledge, availability and accessibility of DOTS service. We recommend

  5. Skin, ear and testis--unusual sites of tuberculosis.

    Science.gov (United States)

    Ene, Cătălina Elena; Toma, Claudia; Belaconi, Ionela; Dumitrache-Rujinski, Stefan; Jipa, Daniela; Tudor, Adrian; Leonte, Diana; Bogdan, Miron Alexandru

    2016-01-01

    Pulmonary localization is the most common site of tuberculosis (TB)and the most contagious form. Extrapulmonary tuberculosis with the rarest and most unexpected localizations represents a significant proportion of all cases of tuberculosis and remains an important public health problem. We report three unusual TB locations: skin, ear and testis occurred in three immunocompetent patients. In the case of skin and testicular lesions, diagnosis was based on pathological confirmation of granulomas with caseous necrosis. In the third case the diagnosis was made possible by identification of positive Acid-Fast Bacilli smear and positive culture from othic drainage fluid. The outcome at all three patients was good with antituberculous treatment. These unusual localization of tuberculosis also highlight the possibility of extrapulmonary tuberculosis as a differential diagnosis in many common diseases.

  6. People-centered tuberculosis care versus standard directly observed therapy: study protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Khachadourian, Vahe; Truzyan, Nune; Harutyunyan, Arusyak; Thompson, Michael E; Harutyunyan, Tsovinar; Petrosyan, Varduhi

    2015-06-22

    Tuberculosis is a major public health concern resulting in high rates of morbidity and mortality worldwide, particularly in low- and middle-income countries. Tuberculosis requires a long and intensive course of treatment. Thus, various approaches, including patient empowerment, education and counselling sessions, and involvement of family members and community workers, have been suggested for improving treatment adherence and outcome. The current randomized controlled trial aims to evaluate the effectiveness over usual care of an innovative multicomponent people-centered tuberculosis-care strategy in Armenia. Innovative Approach to Tuberculosis care in Armenia is an open-label, stratified cluster randomized controlled trial with two parallel arms. Tuberculosis outpatient centers are the clusters assigned to intervention and control arms. Drug-sensitive tuberculosis patients in the continuation phase of treatment in the intervention arm and their family members participate in a short educational and counselling session to raise their knowledge, decrease tuberculosis-related stigma, and enhance treatment adherence. Patients receive the required medications for one week during the weekly visits to the tuberculosis outpatient centers. Additionally, patients receive daily Short Message Service (SMS) reminders to take their medications and daily phone calls to assure adherence and monitoring of treatment potential side effects. Control-arm patients follow the World Health Organization--recommended directly observed treatment strategy, including daily visits to tuberculosis outpatient centers for drug-intake. The primary outcome is physician-reported treatment outcome. Patients' knowledge, depression, quality of life, within-family tuberculosis-related stigma, family social support, and self-reported adherence to tuberculosis treatment are secondary outcomes. Improved adherence and tuberculosis treatment outcomes can strengthen tuberculosis control and thereby forestall

  7. Kerala Public Library Network: A Project Report

    OpenAIRE

    Jayakrishnan, J S

    2013-01-01

    Public library systems in India are not so effective due to lack of efficient resource sharing and networking to achieve optimum utility of resources as well as to provide need based services. The present library system can be improved by application of ICT and enabling participation. A Kerala Public Library Network (KPLNET), and use of an integrated library automation package in all public libraries can achieve this. The web portal of the Public Library Network maintained by Kerala State Lib...

  8. Unusual presentation of tuberculosis in an elderly male: a case report.

    Science.gov (United States)

    Kandel, Ramesh; Bhattarai, Bhawana; Maharjan, Santosh

    2015-01-01

    Tuberculous liver abscess is an extremely rare condition, even in tuberculosis endemic countries. A 68-year-old male presented with 2 months of fever, significant weight loss, and hepatomegaly. Ultrasonography revealed a right hepatic lobe abscess. Guided aspiration of the fluid showed tubercular bacilli. He had no evidence of active Tuberculosis elsewhere.

  9. Determining quantitative targets for public funding of tuberculosis research and development.

    Science.gov (United States)

    Walwyn, David R

    2013-03-08

    South Africa's expenditure on tuberculosis (TB) research and development (R&D) is insignificant relative to both its disease burden and the expenditure of some comparator countries with a minimal TB incidence. In 2010, the country had the second highest TB incidence rate in the world (796 per 100,000 population), and the third highest number of new TB cases (490,000 or 6% of the global total). Although it has a large TB treatment program (about $588 million per year), TB R&D funding is small both in absolute terms and relative to its total R&D expenditure. Given the risk and the high cost associated with drug discovery R&D, such neglect may make strategic sense. However in this analysis it is shown that TB R&D presents a unique opportunity to the national treasuries of all high-burden countries. Using two separate estimation methods (global justice and return on investment), it is concluded that most countries, including South Africa, are under-investing in TB R&D. Specific investment targets for a range of countries, particularly in areas of applied research, are developed. This work supports the outcome of the World Health Organization's Consultative Expert Working Group on Research and Development: Financing and Coordination, which has called for "a process leading to the negotiation of a binding agreement on R&D relevant to the health needs of developing countries".

  10. 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.

  11. Single-Sex Education. A Public Policy Issue. Project Report.

    Science.gov (United States)

    Jacobson, Abbe; And Others

    This article reports a study of the public policy implications of publicly supported primary and secondary single-sex education in the United States. Twenty-two public intellectuals concerned with educational issues were interviewed. Subjects were either academic researchers, government officials and legislators, directors of public interest…

  12. Monoarticular Poncet Disease after Pulmonary Tuberculosis: A Rare Case Report and Review of Literature

    Science.gov (United States)

    Garg, Paritosh; Gupta, Nikhil; Arora, Mohit

    2016-01-01

    Introduction: Tuberculosis is a major health problem worldwide, more so in Asian countries and especially India. Being a communicable disease, it can affect the lives of many people. Tuberculosis has varied manifestations and can affect almost every part of the human body. Pulmonary tuberculosis is the most common form. Poncet disease (tuberculous rheumatism) is a polyarticular arthritis that occurs during acute tuberculosis infection in which no mycobacterial involvement can be found or no other known cause of polyarthritis is detected. Case presentation: We describe an atypical presentation of active pulmonary tuberculosis with monoarticular Poncet disease of the right knee in a 24-year-old woman. Discussion: The diagnosis of Poncet disease is mainly clinical with exclusion of other causes. It generally presents as an acute or subacute form; however, chronic forms have been described in the literature. PMID:27455057

  13. Multifocal Skeletal Tuberculosis Mimicking Langerhans Cell Histiocytosis in a Child: a Case Report With a Long-Term Follow-Up

    Science.gov (United States)

    Haghighatkhah, Hamidreza; Jafroodi, Yousef; Sanei Taheri, Morteza; Pourghorban, Ramin; Sadeghian Dehkordy, Afarin

    2015-01-01

    Introduction: Multifocal skeletal tuberculosis is a rare condition that may masquerade as Langerhans cell histiocytosis, especially in children. Case Presentation: We report a case of multifocal osseous tuberculosis in a 5-year-old female patient admitted to our hospital with a complaint of low back pain but no history of respiratory symptoms or malaise. Radiological findings included vertebra plana and multiple lytic lesions in both the frontal and pelvic bones. An initial diagnosis of Langerhans cell histiocytosis was made based on imaging findings; however, the patient underwent further evaluation for Mycobacterium tuberculosis, and histopathologic findings confirmed the diagnosis of tuberculosis. The patient showed a nearly complete response after receiving a course of anti-tuberculosis drugs. Conclusions: A high index of suspicion is required for the early diagnosis and prompt treatment of patients with osseous tuberculosis. Given the high prevalence of tuberculosis in developing countries, tuberculosis should be considered in the differential diagnosis of multifocal lytic lesions and vertebra plana, especially in children. PMID:26744631

  14. 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

  15. Tuberculosis in a child - search for the infected adult nearby; case report, Portugal, 2007.

    Science.gov (United States)

    Duarte, R; Tavares, E; Miranda, A; Carvalho, A

    2009-09-10

    Tuberculosis (TB) transmission in a non-household setting is difficult to detect, because contact with the source case is often not obvious. Here, we report on a case of a four-year-old child who got infected through sporadic non-household exposure at a coffee shop. The source case was a woman who had suffered from weight loss, productive cough and fatigue for two months before being diagnosed with TB. Screening the child s contacts revealed two active TB cases within its family. Overall 148 contacts were screened for both cases and 18 cases of latent TB infection detected. The connection between the child and the source case, who were not aware of their contact, was confirmed by molecular fingerprinting. Our case report illustrates the difficulty in detecting non-household transmission between individuals that do not have significant contact, and draws attention to the need to look for the infected adult whenever a child falls ill with TB. This report is a reminder of the importance to consider possibly neglected ways of TB transmission and highlights once again the need of early diagnosis of TB.

  16. 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

  17. 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

  18. 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 adve

  19. Surgical treatment of abdominal tuberculosis and intestinal obstruction: a report of 152 cases

    Directory of Open Access Journals (Sweden)

    Zhi-yu CAO

    2017-02-01

    Full Text Available Objective To summarize the experiences in surgical treatment of abdominal tuberculosis and intestinal obstruction. Methods The clinical data were retrospectively analyzed of surgically treated 112 cases of abdominal tuberculosis and intestinal obstruction from Jan. 2010 to Dec. 2015. Results Of the 112 cases, 96 were diagnosed with complete intestinal obstruction, including 29 cases of ileocecal tuberculosis (12 cases of ileum perforation, 39 cases of severe adhesions, and 28 cases of strangulated ileus caused by adhesive band; 16 cases were incomplete ileus, including 6 cases of ileocecal tuberculosis, 6 cases of part adhesions caused by mesenteric lymph node tuberculosis, and 4 cases of angulation adhesion. A hundred and six cases were cured surgically. Six cases were obstructed again and cured after antituberculotic treatment. Five cases were with intestinal fistula after surgery, of whom 2 cases died of MODS induced by aggravation of infection, and 3 cases were cured and recovered after antituberculotic and nutritional support treatment through thorough drainage. Conclusions The surgical treatment as early as possible is recommended for the patients with abdominal tuberculosis and intestinal obstruction. Preoperative formulation through full multidisciplinary team (MDT consultation of reasonable anti-tuberculosis treatment and nutritional support scheme is the key to complete recovery and reduce of postoperative complications. DOI: 10.11855/j.issn.0577-7402.2016.12.16

  20. 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.

  1. Extra-pulmonary tuberculosis infection in the dialysis patients with end stage renal diseases: case reports and literature review

    Institute of Scientific and Technical Information of China (English)

    Wen-fang YANG; Fei HAN; Xiao-hui ZHANG; Ping ZHANG; Jiang-hua CHEN

    2013-01-01

    The diagnosis of extra-pulmonary tuberculosis (TB) seems relatively difficult due to the absence of specific symptoms and signs in patients on peritoneal dialysis or hemodialysis.We report four cases of extra-pulmonary tuberculosis on dialysis,with two cases on peritoneal dialysis and two cases on hemodialysis.The presentations,therapy,and outcomes of TB infection in these patients were reviewed.Otherwise,the English literature published in the PubMed database associating extra-pulmonary tuberculosis on dialysis over the last three decades is reviewed.A total of 61 studies containing 70 cases were included.The most common primary disease was diabetic nephropathy (22.86%,16/70).The peritoneum (31.42%,22/70),bone (21.42%,15/70),and lymph node (20%,14/70) were the most frequently infected.Single organ infection was common (90%,63/70).Fever (58.57%,41/70),pain (35.71%,25/70),and enlarged lymph node (20%,14/70) were the most common symptoms.Biopsy (67.14%,47/70) and culture (40%,28/70) provided most reliable methods for clear diagnosis of tuberculosis.The combined treatment of isoniazid,rifampicin,pyrazinamide,and ethambutol (44.29%,31/70) was the most common therapy.The majority of patients improved (82.86%,58/70); however,12 cases got worse (17.14%),with 10 of them dying (14.29%).Physicians should be aware of the non-specific symptoms and location of infection,and consider tuberculosis in their differential diagnoses in dialysis patients presenting with symptoms such as fever,pain,and weight loss.

  2. First reported case of fatal tuberculosis in a wild African elephant with past human-wildlife contact.

    Science.gov (United States)

    Obanda, V; Poghon, J; Yongo, M; Mulei, I; Ngotho, M; Waititu, K; Makumi, J; Gakuya, F; Omondi, P; Soriguer, R C; Alasaad, S

    2013-07-01

    Tuberculosis is emerging/re-emerging in captive elephant populations, where it causes morbidity and deaths, although no case of TB in wild African elephants has been reported. In this paper we report the first case of fatal TB in an African elephant in the wild. The infection with Mycobacterium tuberculosis was confirmed by post-mortem and histological examinations of a female sub-adult elephant aged >12 years that died in Tsavo East National Park, Kenya, while under treatment. This case is unique in that during its lifetime the elephant had contact with both humans and wild elephants. The source of the infection was unclear because the elephant could have acquired the infection in the orphanage or in the wild. However, our results show that wild elephants can maintain human TB in the wild and that the infection can be fatal.

  3. [Status report on public health in Mauritius in 2009].

    Science.gov (United States)

    D'Aoust, L; Munbodh, P; Sookram, C; Paratian, U; Gaüzère, B A; Aubry, P

    2010-06-01

    Mauritius is an island nation off the coast of Africa in the southwestern Indian Ocean. Improved socio-sanitation conditions over the past years have dramatically decreased the incidence of tropical diseases to levels comparable with those observed in developed countries. Some tropical illnesses including malaria, schistosomiasis, cysticercosis and lymphatic filariasis have been eradicated. Others such as amibiasis, typhoid fever and leprosy have become rare. However, because of the island's geographical proximity to countries with uncontrolled and suboptimal socio-sanitation conditions and its humid subtropical climate, there is a continued risk for certain vector transmitted tropical diseases such as Chikungunya and dengue. In addition, the incidence of HIV infection and AIDS has been rising rapidly since 2004 and tuberculosis remains a public health problem. Better living conditions have also been accompanied by an increase in cardiovascular and metabolic diseases that, along with cancer, are now the main causes of morbidity and mortality.

  4. 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

    , studies conducted in animals and humans living in worm-endemic areas have shown that helminths impair resistance against a number of infections of major public health importance, including TB, malaria and HIV/AIDS. Understanding such interactions could assist in the design of vaccines against...

  5. 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

  6. 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

  7. Evaluating the effect of Dracocephalum kotschyi methanol extract on Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    G. Asghari

    2015-06-01

    Full Text Available Background and objectives: Tuberculosis (TB is the major public health problem in the world. Each year there are 2-3 million deaths worldwide caused by TB. The increasing incidence of Multi Drug Resistance tuberculosis (MDR-TB worldwide highlights the urgent need to search for new anti-tuberculosis compounds. It has been reported that medicinal plant, Dracocephalum kotschyi, possesses some antibacterial effect, thus in the present study its anti-mycobacterial property was evaluated. Methods: The sensitivity and resistance of M. tuberculosis strains at concentration of 0.2 µg/mL isoniazid was determined by proportion method. Methanol extract of D. kotschyi was prepared using maceration method. Six concentrations of D. kotschyi, including 20, 40, 80, 160, 320 and 640μg/mL were prepared and its anti-mycobacterial effect on four groups of M. tuberculosis including M. tuberculosis H37Rv (ATCC 27294, isoniazid susceptible and resistance and MDR strains was determined. Results: The methanol extract of D. kotschyi was significantly against M. tuberculosis. The percent of growthwas decreased from 100% to 0% in M. tuberculosis  H37Rv (ATCC 27294,  isoniazid resistant and isoniazid susceptible strains but from 100% to 50% in MDR strain in 640 μg/mL concentration. Conclusion: The results showed that different concentrations of D. kotschyi methanol extracts showed a remarkable inhibitory effect on M. tuberculosis. Identification of the effective fraction of D. kotschyi against M. tuberculosis is a further step to be studied.

  8. Disseminated tuberculosis presenting with finger swelling in a patient with tuberculous osteomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Caplivski Daniel

    2005-11-01

    Full Text Available Abstract Background Extrapulmonary manifestations of tuberculosis have become increasingly important in the era of HIV/AIDS. Case presentation We describe a case of tuberculosis (TB dactylitis in a patient with AIDS who originated from the Ivory Coast. The diagnosis was established by direct visualization of acid-fast bacilli on joint fluid and bone biopsy of the proximal phalanx. Imaging of the chest revealed multiple bilateral nodules. Confirmation of the diagnosis was made by isolation of Mycobacterium tuberculosis from sputum and bone cultures. Conclusion Tuberculosis should be considered in patients with unusual soft tissue or skeletal lesions, especially when an immunosuppressive condition is present. Ziehl-Neelsen staining and culture of tissue obtained via surgical biopsy offer the most direct approach to diagnosis.

  9. Progress and New Directions in Genetics of Tuberculosis: An NHLBI Working Group Report

    OpenAIRE

    Smith, Issar; Nathan, Carl; Peavy, Hannah H.

    2005-01-01

    Tuberculosis (TB), along with AIDS and malaria, is one of the three major killers among infectious diseases. New approaches to preventing, diagnosing, and curing TB are needed, which depend on a better understanding of Mycobacterium tuberculosis and the host. The National Heart, Lung, and Blood Institute convened a working group to develop recommendations for future TB research, including genetic aspects of the disease. The following areas were identified: (1) animal model research to improve...

  10. HIV and tuberculosis in India

    Indian Academy of Sciences (India)

    Soumya Swaminathan; G Narendran

    2008-11-01

    The global impact of the converging dual epidemics of tuberculosis (TB) and human immunodeficiency virus (HIV) is one of the major public health challenges of our time. The World Health Organization (WHO) reports 9.2 million new cases of TB in 2006 of whom 7.7% were HIV-infected. Tuberculosis is the most common opportunistic infection in HIV-infected patients as well as the leading cause of death. Further, there has been an increase in rates of drug resistant tuberculosis, including multi-drug (MDRTB) and extensively drug resistant TB (XDRTB), which are difficult to treat and contribute to increased mortality. The diagnosis of TB is based on sputum smear microscopy, a 100-year old technique and chest radiography, which has problems of specificity. Extra-pulmonary, disseminated and sputum smear negative manifestations are more common in patients with advanced immunosuppression. Newer diagnostic tests are urgently required that are not only sensitive and specific but easy to use in remote and resource-poor settings. Treatment of HIV-TB co-infection is complex and associated with high pill burden, overlapping drug toxicities, risk of immune reconstitution inflammatory syndrome (IRIS) and challenges related to adherence. From a programmatic point of view, screening of all HIV-infected persons for tuberculosis and vice-versa will help identify co-infected patients who require treatment for both infections. This requires good coordination and communication between the TB and AIDS control programs, in India.

  11. Progress and new directions in genetics of tuberculosis: an NHLBI working group report.

    Science.gov (United States)

    Smith, Issar; Nathan, Carl; Peavy, Hannah H

    2005-12-15

    Tuberculosis (TB), along with AIDS and malaria, is one of the three major killers among infectious diseases. New approaches to preventing, diagnosing, and curing TB are needed, which depend on a better understanding of Mycobacterium tuberculosis and the host. The National Heart, Lung, and Blood Institute convened a working group to develop recommendations for future TB research, including genetic aspects of the disease. The following areas were identified: (1) animal model research to improve understanding of persistence, reactivation, and granulomatous reactions; (2) preclinical studies aimed at shortening treatment of TB; (3) new resources for manipulating and characterizing the M. tuberculosis genome, proteome chips for more specific diagnoses, and studies of genes that appear to be essential but whose functions are not known; (4) prospective studies associated with clinical trials in populations with or at risk of TB to advance development of diagnostics and prognostics; (5) new quantitative and bioinformatic approaches to study the interaction between M. tuberculosis and the infected host and how this influences the infection process; (6) molecular characterization of M. tuberculosis genome diversity and phylogenetic analysis; (7) coordinated studies of human genome scans; (8) genetic epidemiology studies; (9) activities to foster knowledge dissemination, education, and training; and (10) coordination between the National Institutes of Health, the Gates Foundation, the Global Alliance for Tuberculosis Drug Development, and other organizations.

  12. 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…

  13. Report on enhanced publications state-of-the-art

    NARCIS (Netherlands)

    Woutersen-Windhouwer, S.; Brandsma, R.

    2009-01-01

    This report provides an overview of the current status of enhanced publications in publishing and repository environments. We define an enhanced publication as a publication that is enhanced with three categories of information: (1) research data (evidence of the research), (2) extra materials (to i

  14. TUBERCULOSIS PRESENTING AS EPIGLOTTITIS

    Directory of Open Access Journals (Sweden)

    FAHIM AHMED SHAH

    2015-03-01

    Full Text Available We report a rare case of laryngeal tuberculosis in Oman Tuberculous affection of larynx is un-common in Oman and is rarely been reported. Tuberculosis is a chronic illness, acute clinical presentation is unusual. We report the case of a thirty One year old lady, post renal transplant with tuberculous involvement of the larynx, who presented with symptoms and clinical signs of acute epiglottitis. ENT examination showed initially a severely swollen epiglottis which turned nodular in about two weeks. The patient had been on immunosuppressive medications and glucocorticoids post renal trans-plant. Tuberculosis still presents sporadically in countries where the overall incidence of tuber-culosis is much lower as compared to developing countries. A strong index of suspicion is needed in immunocompromised patients with suboptimal response to routine medications. Diagnostic difficulty in this peculiar situation with differential diagnosis and management of laryngeal tuberculosis is discussed along with review of literature.

  15. Abdominal tuberculosis after removal of an adjustable gastric band – report of an unusual case

    Directory of Open Access Journals (Sweden)

    Piotr K. Kowalewski

    2017-04-01

    Full Text Available 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.

  16. Respondents report survey Public Private Partnerships

    NARCIS (Netherlands)

    E-H. Klijn (Erik-Hans); J.F.M. Koppenjan (Joop); N. de Boer (Noortje)

    2014-01-01

    markdownabstract__Abstract__ Public private partnerships (PPP) have become a popular policy instrument in many Western European countries. Governments assume that the involvement of private actors in the provision of services, or in the realization of policy goals will increase quality and provide

  17. 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…

  18. Public Notification - Revised Total Coliform Rule Failure To Report Template

    Science.gov (United States)

    When a PWS fails to report their monitoring results for Total Coliform bacteria, it must issue a public notice to inform consumers of its water of that failure to report. This template can be used as a guide for preparing that public notice.

  19. 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.

  20. Is tuberculosis health education reaching the public in China? A cross-sectional survey in Guizhou Province

    Science.gov (United States)

    Chen, Wei; Li, Yang; Yang, Haiqin; Ehiri, John; Chen, Zaiping; Liu, Ying; Wang, Mei; Liu, Shili; Tang, He; Li, Ying

    2016-01-01

    Background Knowledge about tuberculosis (TB) is important for TB control, and China's national TB control guidelines emphasise TB health promotion. A 2010 national TB epidemiology survey showed that the general public had limited knowledge and awareness of TB. Objective To assess the level of TB knowledge after 5 years of TB health promotion in Guizhou Province, one of the regions with the highest TB burden in China. Design and setting A community-based, cross-sectional survey of 10 237 residents of Guizhou Province from June to August 2015. Multiple logistic regression models were used to examine factors associated with core TB knowledge and TB health education among respondents. Results Overall, residents of Guizhou Province had inadequate knowledge of TB. The overall awareness of TB was 41.5%. Less than 30% of respondents were familiar with China's policy of free treatment for TB or knew that the disease could be cured. Factors associated with core TB knowledge included gender, age, ethnicity, education, occupation, region, and having received TB health education. Women, older adults, people employed in non-government institutions, and those living in counties with low TB burdens had little access to TB health education, whereas people with higher education levels had greater access. Respondents' sources of TB knowledge did not necessarily match their preferred channels for delivery of TB health education. Conclusions Our findings indicate that TB health education should be further strengthened in China and other countries with a high TB burden. TB health education programmes require further formative and implementation research in order to improve programme effectiveness. PMID:27670524

  1. The relationship between (stigmatizing views and lay public preferences regarding tuberculosis treatment in the Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Nieboer Anna P

    2011-01-01

    Full Text Available Abstract Background Tuberculosis (TB and human immune virus/acquired immune deficiency syndrome (HIV/AIDS stigmas affect public attitudes toward TB treatment and policy. This study examined 'stigmatizing' ideas and the view that 'TB patients should line-up in the chronic illness queue' in relation to preferences and attitudes toward TB treatment. Methods Data were gathered through a survey administered to respondents from 1,020 households in Grahamstown. The survey measured stigmatization surrounding TB and HIV/AIDS, and determined perceptions of respondents whether TB patients should queue with other chronically ill patients. Respondents selected support and treatment options they felt would benefit TB patients. Statistical analysis identified the prevalence of TB and HIV/AIDS stigmas. Logistic regression analyses explored associations between stigmatizing ideas, views regarding TB patients in the chronic illness queue, and attitudes toward support and treatment. Results Respondents with TB stigmatizing ideas held positive attitudes toward volunteer support, special TB queues, and treatment at clinics; they held negative attitudes toward temporary disability grants, provision of information at work or school, and treatment at the TB hospital. Respondents who felt it beneficial for TB patients to queue with other chronically ill patients conversely held positive attitudes toward provision of porridge and disability grants, and treatment at the TB hospital; they held negative attitudes toward volunteer support, special TB queues, information provision at work or school, and treatment at clinics. Conclusion These results showed that two varying views related to visibility factors that expose patients to stigmatization (one characterized by TB stigma, the other by the view that TB patients should queue with other chronically ill patients are associated with opposing attitudes and preferences towards TB treatment. These opposing attitudes complicate

  2. Individual and social vulnerabilities upon acquiring tuberculosis: a literature systematic review

    Science.gov (United States)

    2014-01-01

    Tuberculosis is a contagious infectious disease mainly caused by the bacteria Mycobacterium tuberculosis that still meets the priority criteria - high magnitude, transcendence and vulnerability - due to the threat it poses to public health. When taking into consideration the vulnerability conditions that favor the onset of the disease, this article aimed to investigate the implications originated from individual and social vulnerability conditions in which tuberculosis patients are inserted. Databases like MEDLINE, LILACS and SciELO were searched in Portuguese, Spanish and English using the descriptors tuberculosis and vulnerability, and 183 articles were found. After the selection criterion was applied, there were 22 publications left to be discussed. Some of the aspects that characterize the vulnerability to tuberculosis are: low-income and low-education families, age, poor living conditions, chemical dependency, pre-existing conditions/aggravations like diabetes mellitus and malnutrition, indigenous communities, variables related to health professionals, intense border crossings and migration, difficulty in accessing information and health services and lack of knowledge on tuberculosis. Much as such aspects are present and favor the onset of the disease, several reports show high incidence rates of tuberculosis in low vulnerability places, suggesting that some factors related to the disease are still unclear. In conclusion, health promotion is important in order to disfavor such conditions or factors of vulnerability to tuberculosis, making them a primary target in the public health planning process and disease control. PMID:25067955

  3. International or national publication of case reports

    DEFF Research Database (Denmark)

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

    2011-01-01

    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.......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....

  4. A report on reporting: Why peers report integrity and law violations in public organizations

    NARCIS (Netherlands)

    Graaf, de G.

    2010-01-01

    The archives of three bureaus of integrity are analyzed in order to study the reasons for reporting integrity and law violations within public organizations. Peer reporting accounts for only a small percentage of cases; most investigations originate from routine and continuous institutional controls

  5. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2000: report of the Australian Mycobacterium Laboratory Reference Network.

    Science.gov (United States)

    Lumb, Richard; Bastian, Ivan; Dawson, David; Gilpin, Chris; Havekort, Frank; Howard, Peter; Sievers, Aina

    2002-01-01

    The Australian Mycobacterium Reference Laboratory Network collected and analysed laboratory data on new diagnoses of disease caused by Mycobacterium tuberculosis complex in the year 2000. A total of 765 cases were identified, representing an annual reporting rate of 4.0 cases of laboratory-confirmed tuberculosis (TB) per 100,000 population. Pulmonary disease was diagnosed in 64.9 per cent of cases with a male:female ratio of 1.5:1. Smears were positive for 209/365 (57.3%) of sputum isolates and 39/117 (33.3%) bronchoscopy isolates. Sputum from males was more likely to be smear-positive (63.3%) than from females (47.5%). Isolates from lymph node accounted for 136 (17.7%) of all cases; only 28.7 per cent were smear-positive. Eighty-four (11.0%) isolates, comprising 82 M. tuberculosis and 2 M. bovis strains, demonstrated in vitro resistance to at least one of the standard anti-TB medications. Resistance to at least isoniazid and rifampicin (defined as multidrug-resistant TB) was observed for only 8 (1.0%) strains, a rate similar to previous years. Almost all (96.3%) of patients with drug resistant strains were classified as having initial resistance. The country of birth was known for 76 (92.7%) of 82 patients with a drug resistant strain of M. tuberculosis; 6 were Australian-born and 70 (92.1%) had migrated from a total of 17 countries. Of these 70 migrants with drug-resistant disease, 68.6 per cent had migrated from one of the following countries: Vietnam (n=15), China (n=11), Philippines (n=11), India (n=6), and Indonesia (n=5).

  6. 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.

  7. 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....

  8. TUBERCULOSIS IN CHILDREN IN IRKUTSK REGION

    Directory of Open Access Journals (Sweden)

    Ye. Yu. Zorkaltseva

    2013-01-01

    Full Text Available Epidemiology situation and factors its determinates was analyzed. Reports of tuberculosis hospitals used and results of observed two hundred and sixty-three children with tuberculosis. It was determinate that reasons of increase children morbidity of tuberculosis: bad epidemiology situation in adults in region, not all adult patients with tuberculosis was hospitalized, defects of prophylactic of tuberculosis. Tuberculosis in children having contact with tuberculosis was determinates earlier and structure of clinical forms was better than in children which have no contact.

  9. 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.

  10. Public Reporting and a More Sustainable Army

    Science.gov (United States)

    2009-04-01

    CorporateRegister.com maintains on its website a global directory of corporate social responsibility ( CSR ), sustainability, and environmental reports. The...one to search for any of 17,252 CSR reports across 4,411 reporting companies. A search of the GRI Register with the parameters “All Sectors, All...largest corporations (Fortune July 27 2007), and for ERDC/CERL TR-09-11 20 the top 20 firms on Interbrand’s list of Best Global Brands – 2007 (Inter

  11. Hemoptysis during general anesthesia in a diabetic patient with healed tuberculosis: a case report

    Science.gov (United States)

    Chung, Mee Young; Jeong, Hyeon-Do; Kim, Seul-Gi

    2017-01-01

    Hemoptysis is a common complication of pulmonary tuberculosis. Most of the cases of hemoptysis originate from hypertrophied bronchial arteries. Also, diabetes induces pulmonary vascular abnormalities such as endothelial dysfunction, inflammatory infiltration and pulmonary vascular remodeling. A 27-year-old male, with diabetes and a history of tuberculosis, underwent the procedure of pars plana vitrectomy under general anesthesia. After an uneventful intra-operative period, he had hemoptysis prior to extubation. Emergency fiberoptic bronchscopy showed blood plugs and spotted fresh blood at the right upper lobar bronchus. After successful embolization of the bronchial artery, the patient made a recovery and was discharged without experiencing any complication. Predisposing factors of hemoptysis in this case are presumed to be tuberculosis and diabetes. The bleeding might had been caused by the rupture of a weakened artery within the cavity in the right upper lobe, through expansion of the lung during manual ventilation by positive pressure. PMID:28184273

  12. A Taxonomy of Injuries for Public Health Monitoring and Reporting

    Science.gov (United States)

    2017-07-25

    of Injuries for Public Health Monitoring and Reporting 15 codes are required to make this distinction. Because surveillance data and field...overall burden of care required for these injuries. PHIP No. 12-01-0717, A Taxonomy of Injuries for Public Health Monitoring and Reporting...is no mandatory reporting requirement in the military health system or the civilian sector for providers and coders to use cause codes. Many medical

  13. 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...

  14. Systemic bovine tuberculosis: a case report/
    Tuberculose bovina sistêmica: um relato de caso

    OpenAIRE

    Selwyn Arlington Headley

    2002-01-01

    Gross and histopathological lesions associated with Mycobacterium bovis in an ox are described. Differential diagnoses of frequently occurring gross lesions in cattle that could be easily confused with bovine tuberculosis are discussed, and a comparative analysis of M. bovis induced tuberculosis lesions in wildlife is made.Alterações macroscópicas e histopatológicas associadas a Mycobacterium bovis são descritas em um bovino. O diagnóstico diferencial de lesões macroscópicas mais freqüentemen...

  15. Detection of rifampicin resistance in tuberculosis by molecular methods: A report from Eastern Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    R Tripathi

    2016-01-01

    Full Text Available Diagnosis of drug resistance tuberculosis (TB by the gold standard method is labour intensive and time consuming. Hence, there is an urgent need for introduction of rapid diagnostic techniques. Line probe assay (LPA and cartridge-based nucleic acid amplification test (CBNAAT have been introduced in India under Revised National Tuberculosis Control Program. Spot and morning sputum samples of previously treated patients by anti-TB drugs were subjected to LPA or CBNAAT. Total 682/1253 (54.4% were diagnosed as rifampicin-resistant. The patients could be diagnosed early by molecular methods and put on second line treatment.

  16. M-X Environmental Technical Report. Public Finance Model.

    Science.gov (United States)

    1980-12-22

    7AD-A095 802 HENNINGSON DURHAM AND RICHARDSON SANTA 1BAR1BARA CA - UF/A 16/1 MA -x E VIRONMENT L fECHN AL REPORT. PUBLIC FINANCE MODEL. U) DEC A0...CATALOG NUMBER 4. TITLE (and Subtitle) 5. PERIOD COVERED-........... . Final1 M-X Environmental Technical Report, Public Finance Model , 6. PERFORMING ORG...KEY WORDS (Continue on reverse side If necessary and Identify by block number) Public Finance Texas iting Analysis Nevada New Mexico viromnental Report

  17. 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.

  18. 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

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

    Directory of Open Access Journals (Sweden)

    German Henostroza

    Full Text Available 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

  20. 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.

  1. 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.

  2. 肺部及腰椎结核一例%Lung and lumbar spinal tuberculosis:a case report

    Institute of Scientific and Technical Information of China (English)

    钱金根; 潘国庆; 范国平

    2014-01-01

    Mycobacterium tuberculosis infection is most common in lung.A misdiagnosis would be made if imaging findings is not typical.Herein we reported one case of lung and lumbar spinal tuberculosis. The patient’s symptoms of tuberculosis were not typical,with negative results of all regular tuberculosis tests, thus a correct diagnosis was not confirmed until further clinical history inquiry and MRI of lumbar spinal was made.The patient was cured after antituberculosis therapy and operation,with good follow-up.From this case, we learned that:detailed clinical history and physical examination as well as scientific thinking,strengthened clinician awareness of atypical tuberculosis infection and a correct understanding of laboratory tests are very im-portant for correct diagnosis.%结核分支杆菌感染以肺结核最多见,影像学检查表现不典型时容易误诊。该文分析1例肺部及腰椎结核的诊治经过,该例因肺结核表现不典型、结核的常规检查均阴性而未能在入院初立即确诊,其后因进一步完善病史询问及行腰椎MRI发现腰椎结核灶而明确诊断,经积极的抗结核及腰椎手术治疗后,患者好转出院,随访情况良好。通过该例的诊治过程,应明确到,详细的病史询问和体格检查,不完全依赖实验室检查结果而应采用科学的综合的临床思维方法,对正确诊断是非常重要的。

  3. Bronchoesophageal fistula secondary to mediastinal lymph node tuberculosis: a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    廖理粤

    2014-01-01

    Objective To analyze the clinical features of 1 case of bronchoesophageal fistula(BEF)secondary to medias-tinal lymph node tuberculosis.Methods The clinical,auxiliary examinational and pathological data of 1 case with BEF were presented,and the literatures were reviewed.Results The patient was a 19 year old female,who was admitted to hospital because of

  4. Disseminated tuberculosis in a patient treated with a JAK2 selective inhibitor: a case report

    Directory of Open Access Journals (Sweden)

    Colomba Claudia

    2012-10-01

    Full Text Available Abstract Background Primary myelofibrosis is a myeloproliferative disorder characterized by bone marrow fibrosis, abnormal cytokine expression, splenomegaly and anemia. The activation of JAK2 and the increased levels of circulating proinflammatory cytokines seem to play an important role in the pathogenesis of myelofibrosis. Novel therapeutic agents targeting JAKs have been developed for the treatment of myeloproliferative disorders. Ruxolitinib (INCB018424 is the most recent among them. Case presentation To our knowledge, there is no evidence from clinical trials of an increased risk of tuberculosis during treatment with JAK inhibitors. Here we describe the first case of tuberculosis in a patient treated with Ruxolitinib, a male with a 12-year history of chronic idiopathic myelofibrosis admitted to our Institute because of fever, night sweats, weight loss and an enlarging mass in the left inguinal area for two months. Conclusion Treatment with Ruxolitinib may have triggered the reactivation of latent tuberculosis because of an inhibition of Th1 response. Our case highlights the importance of an accurate screening for latent tuberculosis before starting an anti-JAK 2 treatment.

  5. Tuberculosis extrapulmonar Extrapulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    P. Fanlo

    2007-01-01

    Full Text Available A pesar de que el pulmón es el órgano diana por excelencia de la tuberculosis, cualquier otro órgano y sistema puede verse afectado. En este trabajo se revisan las formas de tuberculosis extrapulmonar a excepción de la pleural que requieren del facultativo, en ocasiones, su más valiosa pericia diagnóstica. Desde la temida meningitis tuberculosa, pasando por la afectación insidiosa de la espondilodiscitis, la llamativa afectación ganglionar, la afectación genitourinaria, la pericarditis, para terminar las formas menos frecuentes como la ocular o la cutánea. En cada apartado indicaremos lo más característico con la finalidad de que pueda servir de orientación diagnóstica y terapéutica.In spite of the lung being the target organ par excellence of tuberculosis, any other organ and system can be affected. In this article we review the forms of extrapulmonary tuberculosis, with the exception of the pleural form that requires the use of good diagnostic skills. From the dreaded tuberculous meningitis, by way of the insidious affectation of the spondylodiscitis, the so-called ganglionary affectation , the genitourinary affectation, pericarditis, and ending with less frequent forms such as ocular and cutaneous tuberculosis. In each section we will indicate what is most characteristic with the aim of providing a diagnostic and therapeutic orientation.

  6. Texas Public School Technology Survey, 1988. Final Report.

    Science.gov (United States)

    Denton, Jon; Davis, Trina; Strader, Arlen; Jessup, George

    The Texas Association of School Administrators (TASA) with technical support from the South Central Regional Technology in Education Consortia-Texas (SCR*TEC-TX) conducted a survey of the technology infrastructure in all public schools in Texas. This document provides the final report of the 1998 Texas Public School Technology Survey. Following…

  7. Study of the Voluntary Public School Choice Program. Final Report

    Science.gov (United States)

    Yin, Robert K.; Ahonen, Pirkko S.

    2008-01-01

    The Voluntary Public School Choice (VPSC) Program supports the emergence and growth of choice initiatives across the country, by assisting states and local school districts in developing innovative strategies to expand public school choice options for students. This report contains the final assessment of the first five years of the VPSC Program…

  8. The Growth of Alternative Public Schools: The 1975 ICOPE Report.

    Science.gov (United States)

    Barr, Robert D.

    1975-01-01

    This newsletter reports the growth of alternative schools from 1973 when 464 alternative public schools in 36 states were identified to 1975 when 1,250 such schools can be listed. Charts illustrate the growth distributed by states. The reasons for growth are presented as publications, professional recommendations, accreditation procedures, state…

  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 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...

  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. 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.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Bianca Barone

    2006-04-01

    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.

  15. 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

  16. 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...

  17. 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...

  18. How to Write a Research Report for Journal Publication.

    Science.gov (United States)

    West, Leonard J.

    1992-01-01

    Explains and illustrates important differences between writing a thesis or dissertation and writing a research report for publication in a professional journal. Discusses how to speed up the review process and encourage acceptance of the manuscript. (JOW)

  19. Public Use Review Report : St. Vincent National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report provides an overview of public use at St. Vincent National Wildlife Refuge. Suggestions for monitoring visitor use are provided. In January 2001, a...

  20. [The issue of tuberculosis in the elderly in Japan].

    Science.gov (United States)

    Toyota, Makoto; Sasaki, Yuka

    2010-12-01

    Tuberculosis in the elderly remains a health burden in Japan. Most of the elderly aged more than 70 years in Japan had become infected with Mycobacterium tuberculosis in their youth, and the elderly represent a population at a special high risk for developing tuberculosis owing to comorbidity and age-related immunosuppression. The characteristics of tuberculosis in the elderly are different from young patients. To reduce active tuberculosis in the elderly, treatment of latent tuberculosis infection for compromised host could be strengthened, however its impact might be limited. Elderly tuberculosis patients have not only clinical problems but also socioeconomic problems. Major problems of elderly tuberculosis patients are concurrent diseases, bed ridden states, necessity of nursing care, undernourished, poor adherence, and poor performance status of patients. With this symposium, we focused on the issue of tuberculosis in the elderly in Japan. The speakers were invited from various areas, including tuberculosis surveillance center, public health center and national hospital organization medical center. (1) Current trend of elderly TB: Masako OHMORI (Tuberculosis Surveillance Center, Research Institute of Tuberculosis, JATA) Although the tuberculosis (TB) incidence rate in Japan reached 19.4 per 100,000 in 2008, the rates among the elderly (65 + yrs) were high, e.g., 29.5 of those aged 64-74 years, 64.2 of those aged 75-84 years and 97.3 of those aged 85 years and over. The proportion of those aged 65 years and over increased from 36.8% in 1987 to 56.7% in 2008. Regarding the delay of case detection among elderly TB patients, the patient's delay tended to be shorter but the doctor's delay was longer. Although most TB patients including elderly TB patients were detected upon visiting a medical institution with some symptoms, in the case of elderly TB more patients were detected as outpatients or inpatients for a disease other than TB. Among TB patients aged 65 years

  1. Reporting and sealing regulations for Alaskan natives, a proposed rule: Report on public attitudes

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report covers the proposed reporting and sealing regulations for Alaskan natives- a report on public attitudes. At the direction of the U.S. congress, the...

  2. Tuberculosis abdominal Abdominal tuberculosis

    OpenAIRE

    Rubio, T.; M. T. Gaztelu; Calvo, A.; 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...

  3. Strathcona County energy exploration public consultation report

    Energy Technology Data Exchange (ETDEWEB)

    Blair, C. [Bearing Point Inc., Edmonton, AB (Canada)

    2003-12-09

    A committee was established by the Strathcona County Council in response to resident concerns regarding oil and gas exploration in the region. Bearing Point Inc. was hired to report on the results of a workshop where residents voiced their opinion on how their land is used. Many people live in Strathcona for its beauty, solitude and recreational activities, and consider the oil and gas exploration as compromising their lifestyles. The workshop focused on the following six categories which reflected the citizen's views regarding oil and gas exploration: environment, health and safety; communication and planning; regulation and rights; economics; accountability; and, other. Residents expressed concerns regarding water supply, air pollution, light pollution, noise pollution, soil contamination, land damage, wildlife disruption, asthma and other health conditions, pipeline safety, land use and reclamation, use of technology and environmental damage. They also expressed concerns regarding landowners rights and resources. The residents felt that regulations governing oil and gas exploration were inadequate and favoured the oil and gas industry. Other concerns were based on property devaluation and increase in the volume and use of heavy equipment to the road system. Residents proposed various approaches to address each of these concerns.

  4. 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.

  5. [Epidemiology of tuberculosis].

    Science.gov (United States)

    Mjid, M; Cherif, J; Ben Salah, N; Toujani, S; Ouahchi, Y; Zakhama, H; Louzir, B; Mehiri-Ben Rhouma, N; Beji, M

    2015-01-01

    Tuberculosis is a contagious disease caused by Mycobacterium tuberculosis. It represents, according to World Health Organization (WHO), one of the most leading causes of death worldwide. With nearly 8 million new cases each year and more than 1 million deaths per year, tuberculosis is still a public health problem. Despite of the decrease in incidence, morbidity and mortality remain important partially due to co-infection with human immunodeficiency virus and emergence of resistant bacilli. All WHO regions are not uniformly affected by TB. Africa's region has the highest rates of morbidity and mortality. The epidemiological situation is also worrying in Eastern European countries where the proportion of drug-resistant tuberculosis is increasing. These regional disparities emphasize to develop screening, diagnosis and monitoring to the most vulnerable populations. In this context, the Stop TB program, developed by the WHO and its partner's, aims to reduce the burden of disease in accordance with the global targets set for 2015.

  6. [Future prospects of molecular epidemiology in tuberculosis].

    Science.gov (United States)

    Matsumoto, Tomoshige; Iwamoto, Tomotada

    2009-12-01

    easily compare the genotypic data of independent studies between different laboratories. With the advantages, VNTR surpassed IS6110 RFLP and became the first line genotyping method in molecular epidemiology. One of the most attractive potentials on this method is its applicability for establishment of the database of M. tuberculosis genotype which covers not only local area but also world wide scale. This would open the door to "in silico epidemiology" which brings a breakthrough on the current TB control program. The optimization and standardization of the combination of VNTR loci for strain genotyping is the only but hard issue for the development of global database system. Road to the global Mtb genotype database is hard, but we believe, "Yes, We Can!". Another attractive potential of VNTR is its use for phylogenetic analysis, although more intensive research on this with using comprehensive marker sets, such as large sequence polymorphisms and single-nucleotide polymorphisms are required. Again, with the advantages of VNTR analysis, i.e., easy, rapid, specific, and digit-based data, VNTR became the first line method in molecular epidemiology. Molecular epidemiology of tuberculosis is expanding its research field from the investigation of TB transmission to more basic science such as evolution and phylogeographic distribution. In this symposium, we have invited four opinion leaders in molecular epidemiology of TB in Japan who are talking about each title as followed. 1. Establishment of the standard VNTR analysis systems for Tuberculosis (TB) and preparation of databases for TB genotyping: Shinji MAEDA and Yoshiro MURASE (Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, JATA). We have already reported the JATA (12)-VNTR system for TB genotyping in Japan. However, by comparison of cluster formation rate, the discrimination power of JATA (12)-VNTR was lower than that of IS6110 RFLP analysis. Therefore, we improved the JATA (12

  7. 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.

  8. REVIEW ON TUBERCULOSIS AND MENTAL DISORDERS COMMON

    Directory of Open Access Journals (Sweden)

    Gleide Santos de Araújo

    2014-05-01

    Full Text Available Despite having vaccine and treatment , TB remains a public health problem . Publications have described high proportion of TB among people with anxiety , depression and mental disorders . This study aimed to identify publications on the association between common mental disorders and tuberculosis and describe the state of the art . This is a literature review with keywords tuberculosis,common mental disorders , anxiety and depression , we excluded studies of extra- pulmonary tuberculosis and animals. 09 articles, only on a specific common mental disorders , comparing the proportion of these in tuberculosis cases ( 46.7 % and tuberculosis infected by the human immunodeficiency virus ( 63.7 % , there are few studies concerning the topic were elected , the most specific problems of anxiety and depression , are from countries where the incidence of tuberculosis is high, ethodological strategies have low analytical power and do not investigate the causal mechanisms underlying the relationship between mental health and tuberculosis.

  9. Evaluación del estudio de contactos de tuberculosis: Servicio de Salud Metropolitano Occidente. 1994-2008 Evaluation of the study of tuberculosis contacts in Western Public Health Service of Santiago de Chile: 1994-2008

    Directory of Open Access Journals (Sweden)

    Victoria Pickett S

    2012-09-01

    Full Text Available Se presenta la evaluación de 15 anos del estudio de contactos de tuberculosis (TBC del Servicio de Salud Metropolitano Occidente de la Región Metropolitana, correspondiente alperíodo 1994-2008, en el que se observa una mejoría creciente de la cobertura de estos estudios, la que incluso superó la meta propuesta por el Ministerio de Salud. El método utilizado para esta investigación consistió en el análisis retrospectivo de los casos ingresados en el período. Para la definición de contacto sano o enfermo se tomó como referencia el Manual de Organización y Normas Técnicas y el Manual de Procedimientos para la Atención Primaria del Programa Nacional de Control de la Tuberculosis de Chile. Se analizó 9.344 contactos intra-domiciliarios y habituales extra-domiciliarios, que correspondieron a 2.129 casos indices de adultos con TBC pulmonar con bacteriología positiva y casos indices infantiles de TBC en todas sus formas. Se evaluó la cobertura, morbilidad, diagnóstico de casos TBC y quimioprofilaxis efectuadas. El estudio de contactos es probablemente la actividad de pesquisa tuberculosa focalizada de mayor rendimiento del Programa de Control. En el menor de 15 anos de edad, este estudio permite pesquisar infecciones recientes, que tratadas adecuadamente con quimioprofilaxis, evitan la aparición de nuevos enfermos y la mantención de la cadena de transmisión de la enfermedad.The evaluation of 15 years of study of TB contacts done in the western area of the Public Health Service of Santiago de Chile, 1994-2008, is presented. During this period an improvement on the coverage of this studies -even beyond the Ministry of Health aims- was observed. For this purpose the retrospective analysis of cases incorporated during the period was used. For definitions of healthy or diseased contact we followed the Manual of Tuberculosis of the National Tuberculosis Control Program of Chile. 9,344 intra-domicilliary and extra-domicilliary contacts

  10. Genitourinary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Matos, Maria Joao [Department of Radiology, Instituto Portugue-circumflex s de Oncologia, Porto (Portugal); Bacelar, Maria Teresa [Department of Radiology, Instituto Portugue-circumflex s de Oncologia, Porto (Portugal)]. E-mail: tbacelar@yahoo.com; Pinto, Pedro [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)

    2005-08-01

    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.

  11. Pulmonary tuberculosis

    Science.gov (United States)

    ... ray Pulmonary nodule, solitary - CT scan Miliary tuberculosis Tuberculosis of the lungs Erythema nodosum associated with sarcoidosis Respiratory system Tuberculin skin test References Fitzgerald DW, Sterling TR, Haas DW. ...

  12. 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).

  13. Recurrent Tuberculosis Risk Among HIV-Infected Adults in Tanzania With Prior Active Tuberculosis

    Science.gov (United States)

    Lahey, Timothy; MacKenzie, Todd; Arbeit, Robert D.; Bakari, Muhammad; Mtei, Lillian; Matee, Mecky; Maro, Isaac; Horsburgh, C. Robert; Pallangyo, Kisali; von Reyn, C. Fordham

    2013-01-01

    Background. Active tuberculosis is common among human immunodeficiency virus (HIV)–infected persons living in tuberculosis-endemic areas, but the hazard of subsequent tuberculosis disease has not been quantified in a single prospective cohort. Methods. Among HIV-infected, BCG-immunized adults with CD4 counts ≥200 cells/μL who received placebo in the DarDar tuberculosis vaccine trial in Tanzania, we compared the prospective risk of active tuberculosis between subjects who did and who did not report prior active tuberculosis. All subjects with a positive tuberculin skin test without prior active tuberculosis were offered isoniazid preventive treatment. Definite or probable tuberculosis was diagnosed during active follow-up using rigorous published criteria. Results. We diagnosed 52 cases of definite and 92 cases of definite/probable tuberculosis among 979 subjects during a median follow-up of 3.2 years. Among the 80 subjects who reported prior active tuberculosis, 11 (13.8%) subsequently developed definite tuberculosis and 17 (21.3%) developed definite/probable tuberculosis, compared with 41 (4.6%) and 75 (8.3%), respectively, of 899 subjects without prior active tuberculosis (definite tuberculosis risk ratio [RR], 3.01; 95% confidence interval [CI], 1.61–5.63, P tuberculosis RR, 2.55; 95% CI, 1.59–4.09, P tuberculosis had substantially greater hazard of subsequent definite tuberculosis (hazard radio [HR], 3.69; 95% CI, 1.79–7.63, P tuberculosis (HR, 2.78; 95% CI, 1.58–4.87, P tuberculosis, the hazard of active tuberculosis is increased 3-fold among HIV-infected adults with prior active tuberculosis. Clinical Trials Registration. NCT0052195. PMID:22972862

  14. 5 CFR 2634.308 - Reporting periods and contents of public financial disclosure reports.

    Science.gov (United States)

    2010-01-01

    ... financial disclosure reports. 2634.308 Section 2634.308 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS EXECUTIVE BRANCH FINANCIAL DISCLOSURE, QUALIFIED TRUSTS, AND CERTIFICATES OF DIVESTITURE Contents of Public Reports § 2634.308 Reporting periods and contents of public financial disclosure...

  15. Genitourinary tuberculosis - report of two cases; Tuberculose genitourinaria - relato de dois casos

    Energy Technology Data Exchange (ETDEWEB)

    Turtelli, Celso Montenegro; Fonseca, Cristiano Rezio; Barbosa, Luciana; Nogueira, Andre Messias; Furtado, Rogerio Abrao; Rehder, Gustavo Frederico Correa; Correa, Adriana Cristina; Tiveron, Gustavo Roberto Carvalho [Faculdade de Medicina do Triangulo Mineiro (FMTM), Uberaba, MG (Brazil)

    2000-06-01

    The incidence of urogenital tuberculosis has decreased in recent years. However, due to insidious character, it remains clinically important. The recognition of the multiple radiological findings is of great importance. In the early stages, the excretory urogram may be normal in spite of positive urine cultures for acid-fast organisms. Subsequently, the calyces may present irregularities. The use of ultrasonography in the evaluation of renal tuberculosis has been sporadically described in the literature. It can determine the site of the obstruction when there is a nonfunctioning kidney. Computed tomography may demonstrate the presence and the site of the obstruction, and evaluate any remaining renal function after injection of contrast medium. Its ability to detect calcification surpasses that of plain films. The renal parenchyma may also be evaluated in the obstructed kidney. (author)

  16. Systemic bovine tuberculosis: a case report/ Tuberculose bovina sistêmica: um relato de caso

    Directory of Open Access Journals (Sweden)

    Selwyn Arlington Headley

    2002-05-01

    Full Text Available Gross and histopathological lesions associated with Mycobacterium bovis in an ox are described. Differential diagnoses of frequently occurring gross lesions in cattle that could be easily confused with bovine tuberculosis are discussed, and a comparative analysis of M. bovis induced tuberculosis lesions in wildlife is made.Alterações macroscópicas e histopatológicas associadas a Mycobacterium bovis são descritas em um bovino. O diagnóstico diferencial de lesões macroscópicas mais freqüentemente encontradas em bovinos que podem ser confundidas com a tuberculose bovina é discutida. Uma análise comparativa de lesões induzidas por M. bovis em animais silvestres foi realizada.

  17. Spontaneous atraumatic fracture of a cervical vertebra in tuberculosis: a case report

    Directory of Open Access Journals (Sweden)

    Gupta Sumit

    2012-05-01

    Full Text Available Abstract Introduction Spontaneous pathological fractures of the cervical spine due to tuberculosis are rare. But with escalating incidences of atypical presentations of tubercular disease, clinicians should exercise a high index of suspicion for early diagnosis of such cases. Case presentation We present a case of a 50-year-old Hindu man from northern India, who complained of pain and stiffness in his neck. His radiographs showed a fracture in his second cervical vertebral body. But further investigations raised the suspicion of an infective pathology, which was corroborated by magnetic resonance imaging and fine needle aspiration cytology. His symptoms improved and the fracture healed following antitubercular chemotherapy and immobilization. Conclusion In endemic regions like India, clinicians should be on the lookout for atypical presentations of tuberculosis. Any suspicious lesion should be evaluated with care for clinical, radiological and laboratory evidences of the infection. The affected spine should be protected and appropriate chemotherapy should be instituted at the earliest opportunity.

  18. Peritoneal tuberculosis: radiographic diagnosis

    Directory of Open Access Journals (Sweden)

    Carolina Ospina-Moreno

    2014-12-01

    Full Text Available Peritoneal tuberculosis (TB is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.

  19. Dual presentation of tuberculosis: Otitis media with retropharyngeal abscess - The first case report

    Directory of Open Access Journals (Sweden)

    Priyanka Gairola

    2016-01-01

    Full Text Available Tubercular otitis media is a rare disease and its association with retropharyngeal abscess is rarer. We have not come across any such case in the English literature of the dual presentation of tuberculosis to the best of our knowledge so far. Early diagnosis and prompt management are the key to reduce the disease burden and also to avoid life-threatening complications.

  20. Chronic intussuception due to ileocaecal tuberculosis in a young adult with severe anemia: Case report with literature review

    Directory of Open Access Journals (Sweden)

    Mahesh Gupta

    2010-01-01

    Full Text Available Context : Intestinal intussuception in an adult is a rare entity that differs in etiology from its pediatric counterpart owing to underlying pathologic lead points in adults, mostly neoplasms. The main clinical presentation in chronic intussuception in adults remains dull abdominal pain, and acute intussuception is uncommon. Computed tomography (CT remains the diagnostic modality of choice and surgical resection is the optimal treatment. Case Report : We report a case of chronic intussuception in a young adult presenting with severe anemia and chronic abdominal pain in right hypochondrium and lumbar region. Pre operative diagnosis of chronic ileocolocolic intussuception was made on the basis of ultrasound, barium and CT scan findings. Exploratory laparotomy was done and right hemicolectomy with end to end anastomosis was performed. Histopathological examination of resected specimen revealed presence of tuberculosis in the mass along with mesenteric lymph nodes involvement. Postoperative recovery was uneventful and he was put on antitubercular drugs. In follow-up the patient is asymptomatic. Conclusion : Chronic ileocolocolic intussuception due to tuberculosis should be considered as a possible cause of intestinal obstruction in young patients presenting with vague abdominal pain and severe anemia even in the absence of any specific medical history.

  1. An unusual presentation of tuberculosis in pregnancy

    Institute of Scientific and Technical Information of China (English)

    GAO Xue-lian; Rajat Gyaneshwar

    2007-01-01

    @@ Tuberculosis (TB) is a systemic infection caused by Mycobacterium tuberculosis. Extrapulmonary TB accounts for 10% to 27% of all the patients with TB.1 Here we report an unusual case of extrapulmonary TB in a pregnant woman.

  2. 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...

  3. 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.

  4. Avascular necrosis of humeral head in an elderly patient with tuberculosis: a case report

    Directory of Open Access Journals (Sweden)

    Agarwal Renu

    2008-12-01

    Full Text Available Abstract Introduction Osteonecrosis (avascular necrosis is known to be caused by high-dose corticosteroid therapy, alcoholism and rarely by infections. However, a tubercular etiology of this condition is very rare. A review of the literature yielded only a few cases of polyarticular tuberculosis with osteonecrosis in immunosuppressed individuals. No case of monoarticular tubercular osteonecrosis diagnosed by aspiration cytology was found. Since tuberculosis is a curable disease, an early and accurate diagnosis is essential. Case presentation A 60-year-old Indian man presented with diffuse swelling and pain in the left shoulder for the previous 6 months. A computed tomography scan of the left shoulder revealed crescentic lucency in the humeral head, suggestive of osteonecrosis. Fine needle aspiration cytology smears from the swelling showed features of an acute suppurative lesion. Stain for acid-fast bacillus was positive and thus, a final clinico-pathological diagnosis of osteonecrosis of humeral head with tubercular etiology was rendered. The patient was initiated on anti-tuberculous therapy with symptomatic improvement in his condition. Conclusion Osteonecrosis, a debilitating disease, may rarely occur due to tuberculosis, especially in endemic areas. Fine needle aspiration cytology is an effective and inexpensive modality for an early diagnosis of the tubercular etiology of osteonecrosis.

  5. Applying patient centered approach in management of pulmonary tuberculosis: A case report from Malaysia.

    Science.gov (United States)

    Atif, M; Sulaiman, Sas; Shafi, Aa; Muttalif, Ar; Ali, I; Saleem, F

    2011-06-01

    A 24 year university student with history of productive cough was registered as sputum smear confirmed case of pulmonary tuberculosis. During treatment, patient suffered from itchiness associated with anti tuberculosis drugs and was treated with chlorpheniramine (4mg) tablet. Patient missed twenty eight doses of anti tuberculosis drugs in continuation phase claiming that he was very busy in his studies and assignments. Upon questioning he further explained that he was quite healthy after five months and unable to concentrate on his studies after taking prescribed medicines. His treatment was stopped based on clinical improvement, although he did not complete six months therapy. Two major reasons; false perception of being completely cured and side effects associated with anti TB drugs might be responsible for non adherence. Non sedative anti histamines like fexofenadine, citrizine or loratidine should be preferred over first generation anti histamines (chlorpheniramine) in patients with such lifestyle. Patient had not completed full course of chemotherapy, which is preliminary requirement for a case to be classified as "cure" and "treatment completed". Moreover, patient had not defaulted for two consecutive months. Therefore, according to WHO treatment outcome categories, this patient can neither be classified as "cure" or "treatment completed" nor as "defaulter". Further elaboration of WHO treatment outcome categories is required for adequate classification of patients with similar characteristics. Likelihood of non adherence can be significantly reduced by applying the WHO recommended "Patient Centered Approach" strategy. Close friend, class mate or family member can be selected as treatment supporter to ensure adherence to treatment.

  6. 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…

  7. 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 catt...

  8. 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...

  9. 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

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

    OpenAIRE

    Stuart Tooley; Jill Hooks

    2010-01-01

    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 purpos...

  11. [Tuberculosis in Asia].

    Science.gov (United States)

    2002-10-01

    1. Philippines: The development, expansion and maintenance of pilot area activities: Cristina B. Giango (Technical Division, Cebu Provincial Health Office, the Philippines) In 1994, the Department of Health developed the new NTP policies based on WHO recommendations and started a pilot project in Cebu Province in collaboration with the Japan International Cooperation Agency. To test its feasibility and effectiveness, the new NTP policies were pre-tested in one city and one Rural Health Unit. The test showed a high rate of three sputum collection (90%), high positive rate (10%), and high cure rate (80%). Before the new guidelines were introduced, the new policy was briefed, a baseline survey of the facility was conducted, equipment was provided, and intensive training was given. Recording/Reporting forms and procedures were also developed to ensure accurate reporting. Supervision, an important activity to ensure effective performance, was institutionalized. Laboratory services were strengthened, and a quality-control system was introduced in 1995 to ensure the quality of the laboratory services. With the implementation of DOTS strategy, barangay health workers were trained as treatment partners. In partnership with the private sector, the TB Diagnostic Committee was organized to deliberate and assess sputum negative but X-ray positive cases. The implementation of the new NTP guidelines in Cebe Province has reached a satisfactory level, the cure rate and positive rate have increased, and laboratory services have improved. Because of its successful implementation, the new NTP guidelines are now being used nationwide. 2. Nepal: The DOTS Strategy in the area with hard geographic situation: Dirgh Singh Bam (National Tuberculosis Center, Nepal) Three groups of factors characterize the population of Nepal: 1) Socio-cultural factors, e.g. migration, poverty, language; 2) Environmental factors, e.g. geography and climate; and 3) Political factors, prisoners and refugee

  12. An urgent need for building technical capacity for rapid diagnosis of multidrug-resistant tuberculosis (MDR-TB) among new cases: A case report from Maharashtra, India.

    Science.gov (United States)

    Atre, Sachin

    2015-01-01

    Multidrug-resistant tuberculosis (MDR-TB), the prevalence of which has increased across the globe in recent years, is a serious threat to public health. Timely diagnosis of MDR-TB, especially among new TB cases, is essential to facilitate appropriate treatment, which can prevent further emergence of drug resistance and its spread in the population. The present case report from India aims to address some operational challenges in diagnosing MDR-TB among new cases and potential measures to overcome them. It argues that even after seven years of implementing the DOTS-Plus program for controlling MDR-TB, India still lacks the technical capacity for rapid MDR-TB diagnosis. The case report underscores an urgent need to explore the use of WHO-endorsed techniques such as Xpert MTB/Rif and commercial assays such as Genotype MTBDR for rapid diagnosis of MDR-TB among new cases. Suitable applications may be found for other TB high-burden countries where MDR-TB is a major concern.

  13. Zoonotic tuberculosis and brucellosis in Africa: neglected zoonoses or minor public-health issues? The outcomes of a multi-disciplinary workshop.

    Science.gov (United States)

    Marcotty, T; Matthys, F; Godfroid, J; Rigouts, L; Ameni, G; Gey van Pittius, N; Kazwala, R; Muma, J; van Helden, P; Walravens, K; de Klerk, L M; Geoghegan, C; Mbotha, D; Otte, M; Amenu, K; Abu Samra, N; Botha, C; Ekron, M; Jenkins, A; Jori, F; Kriek, N; McCrindle, C; Michel, A; Morar, D; Roger, F; Thys, E; van den Bossche, P

    2009-07-01

    Late in 2007, veterinary, medical and anthropological professionals from Europe and Africa met in a 2-day workshop in Pretoria, South Africa, to evaluate the burden, surveillance and control of zoonotic tuberculosis and brucellosis in sub-Saharan Africa. Keynote presentations reviewed the burden of these diseases on human and livestock health, the existing diagnostic tools, and the available control methods. These presentations were followed by group discussions and the formulation of recommendations. The presence of Mycobacterium bovis and Brucella spp. in livestock was considered to be a serious threat to public health, since livestock and animal products are the only source of such infections in human beings. The impact of these pathogens on human health appears to be relatively marginal, however, when compared with Mycobacterium tuberculosis infections and drug resistance, HIV and malaria. Appropriate diagnostic tools are needed to improve the detection of M. bovis and Brucella spp. in humans. In livestock, the 'test-and-slaughter' approach and the pasteurization of milk, which have been used successfully in industrialized countries, might not be the optimal control tools in Africa. Control strategies should fit the needs and perceptions of local communities. Improved intersectoral and international collaboration in surveillance, diagnosis and control, and in the education of medical and veterinary personnel, are advocated.

  14. Balancing authority, deference and trust across the public-private divide in health care: tuberculosis health visitors in western Maharashtra, India.

    Science.gov (United States)

    Kielmann, Karina; Datye, Vinita; Pradhan, Anagha; Rangan, Sheela

    2014-01-01

    While concepts such as 'partnership' are central to the terminology of private-public mix (PPM), little attention has been paid to how social relations are negotiated among the diverse actors responsible for implementing these inter-sectoral arrangements. India's Revised National Tuberculosis Control Programme (RNTCP) has used intermediary agents to facilitate the involvement of private providers in the expansion of Directly Observed Therapy, Short-Course (DOTS). We examine the roles of tuberculosis health visitors (TB HVs) in mediating working relationships among private providers, programme staff and patients that underpin a PPM-DOTS launched by the RNTCP in western Maharashtra. In addition to observations and informal interactions with the programme and participating health providers, researchers conducted in-depth interviews with senior programme officers and eight TB HVs. Framed by a political discourse of clinical governance, working relationships within the PPM are structured by the pluralistic context, social and professional hierarchies and paternalism of health care in India. TB HVs are at the nexus of these relationships, yet remain undervalued partly because accountability is measured through technical rather than social outcomes of the 'partnership'. Close attention to the dynamics of power relations in working practices within the health system can improve accountability and sustainability of partnerships.

  15. Greater Trochanter Tuberculosis : MRI Findings

    Directory of Open Access Journals (Sweden)

    My Youssef Alaoui Lamrani

    2016-12-01

    Full Text Available Tuberculosis has been reported in almost all bones of body. The great trochanter tuberculosis (GTT installation is insidious and clinical symptoms are often vague with moderate painful swelling and stiffness. GTT is about 0,2 to 2% of all osteo-articular tuberculosis, occurring most commonly by hematogenous seeding secondary to primary focus elsewhere, more commonly in the lungs. Isolated GTT is unusual and thus its awareness is slow and diagnosis is often delayed.

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

    OpenAIRE

    Abubakar, I; Zignol, M; Falzon, D; Raviglione, M.; Ditiu, L; Masham, S; Adetifa, I; Ford, N.; Cox, H.; Lawn, SD; Marais, BJ; McHugh, TD; Mwaba, P.; Bates, M; M. Lipman

    2013-01-01

    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 rough...

  17. The history of tuberculosis.

    Science.gov (United States)

    Daniel, Thomas M

    2006-11-01

    Tuberculosis has claimed its victims throughout much of known human history. It reached epidemic proportions in Europe and North America during the 18th and 19th centuries, earning the sobriquet, "Captain Among these Men of Death." Then it began to decline. Understanding of the pathogenesis of tuberculosis began with the work of Théophile Laennec at the beginning of the 19th century and was further advanced by the demonstration of the transmissibility of Mycobacterium tuberculosis infection by Jean-Antoine Villemin in 1865 and the identification of the tubercle bacillus as the etiologic agent by Robert Koch in 1882. Clemens von Pirquet developed the tuberculin skin test in 1907 and 3 years later used it to demonstrate latent tuberculous infection in asymptomatic children. In the late 19th and early 20th centuries sanatoria developed for the treatment of patients with tuberculosis. The rest provided there was supplemented with pulmonary collapse procedures designed to rest infected parts of lungs and to close cavities. Public Health measures to combat the spread of tuberculosis emerged following the discovery of its bacterial cause. BCG vaccination was widely employed following World War I. The modern era of tuberculosis treatment and control was heralded by the discovery of streptomycin in 1944 and isoniazid in 1952.

  18. The Swedish national public health policy report 2010.

    Science.gov (United States)

    Linell, Anita; Richardson, Matt X; Wamala, Sarah

    2013-02-01

    In 2003, the Swedish Parliament adopted a cross-sectorial national public health policy based on the social determinants of health, with an overarching aim--to create societal conditions that will ensure good health, on equal terms, for the entire population--and eleven objective domains. At that time the policy was globally unique, and serves as guidance for public health practice at the national, regional and local levels. The development of the public health policy and the determinants of health are presented regularly in various reports by the Swedish National Institute of Public Health. This supplement is a condensed version of the 174-page Public Health Policy Report 2010, the second produced since the national policy was adopted in 2003. In order to provide a holistic approach to analysing implemented measures and providing new recommendations within the eleven objective domains of the Swedish national public health policy, we have divided these in three strategic areas. These are: Good Living Conditions, Health-Promoting Living Environments and Living Habits, and Alcohol, Illicit Drugs, Doping, Tobacco and Gambling, each described in the respective introductions for Chapters 3-5. The production of the report was supported by a common analytical model that clarified the societal prerequisites for health in the eleven objective domains. These are factors that can be influenced by political actions in order to create a change. Economic analyses have also been developed to provide a priority basis for political decisions. Analyses of the development of public health determinants were based on data from the National Public Health Survey and data delivered from about 15 various national agencies. Measures that have been implemented between 2004 and 2009 are analysed in details, as the basis for new recommendations for future measures. The introduction describes Swedish public health policy in the new millennium and how it has developed, the role of the Swedish

  19. Tuberculosis (TB): Treatment

    Science.gov (United States)

    ... Training Home Conditions Tuberculosis (TB) Treating Tuberculosis Treating Tuberculosis Make an Appointment Refer a Patient Ask a ... bones is treated longer. NEXT: Preventive Treatment Diagnosing Tuberculosis History of TB Clinical Trials Tuberculosis (TB) Causes ...

  20. 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 ...

  1. Standardised PCR-based molecular epidemiology of tuberculosis.

    Science.gov (United States)

    Allix-Béguec, C; Supply, P; Wanlin, M; Bifani, P; Fauville-Dufaux, M

    2008-05-01

    A population-based molecular epidemiology investigation has been undertaken to evaluate tuberculosis transmission and control in the Brussels-Capital Region (Belgium). All tuberculosis cases reported from January 2003 to December 2004 were investigated. In total, 536 Mycobacterium tuberculosis isolates (89% of culture-positive samples) were genotyped by the newly standardised 24 loci-based mycobacterial interspersed repetitive unit-variable number tandem-repeat typing, spoligotyping and IS6110 fingerprinting. Of all the patients, 30% were grouped based on strain clusters, suggesting a transmission index of 20%. An unsuspected outbreak entailing > or = 23 patients was evidenced by molecular typing analysis and confirmed by contact tracing. Foreign-born status accounted for 79% of the studied patients, including 37.9% illegal immigrants and asylum seekers. Among foreign-born patients, asylum seekers and illegal immigrants were significantly less abundant in strain clusters than settled residents. Tuberculosis in the Brussels-Capital Region is a bi-faceted problem, comprising both persisting recent transmission and "imported diseases". Molecular epidemiology based on real-time genotyping techniques has proven invaluable in better understanding tuberculosis transmission. However, it will most efficiently contribute to tuberculosis control when implemented in an integrated public health system.

  2. Isolated hepatosplenic tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Vinay Kumar; Durgatosh Pandey

    2008-01-01

    BACKGROUND:Tuberculosis rarely involves the liver and spleen and when it does so, it is usually associated with disseminated disease. METHOD:We report a patient with isolated tuberculosis of the liver and spleen. RESULTS:A 50-year-old man presented with weakness and loss of weight for two months. CT scan of the abdomen showed multiple small hypodense lesions in the liver and spleen. Image-guided biopsy of liver lesion was inconclusive as it showed normal hepatocytes with interspersed lymphocytes. On laparotomy, the liver and spleen were studded with multiple small nodules. A 5-cm wedge of the liver was resected. Histopathological examination conifrmed the diagnosis of tubercular hepatitis. A detailed work-up failed to identify any other focus of tuberculosis. CONCLUSION:Although rare, tuberculosis should also be considered in the differential diagnosis for multiple nodules in the liver and spleen, along with lymphoproliferative diseases and metastatic lesions.

  3. 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

  4. Utah Public Library Service, 2001: An Annual Report.

    Science.gov (United States)

    Long, Sandi

    This annual report of Utah public library services presents data useful for local library planning. This information is presented in two sections: core performance measures and general tables. Statewide summary data and breakouts by the populations of the library jurisdictions are provided for the following core performance measures: (1) visits…

  5. Study of the Voluntary Public School Choice Program. Interim Report

    Science.gov (United States)

    Yin, Robert K.; Ahonen, Pirkko; Kim, Dawn

    2007-01-01

    The purpose of the Voluntary Public School Choice (VPSC) Program is to assist states and local school districts in the development of innovative strategies to expand options for students, and to encourage transfers of students from low-performing to higher-performing schools. This report presents interim findings from the National Evaluation of…

  6. ECO-Report - Research-management-public partnership continues

    Science.gov (United States)

    Jane Kapler Smith; Greg Jones; Nan Christianson; Lucia Solorzano; Gloria Weisgerber; Steve Arno; Sallie J. Hejl; F. Jeremy Wheeler; Timothy S. Redman; Joshua J. Tewksbury; Tom DeLuca; K. Zouhar

    1998-01-01

    ECO-Report is an annual Rocky Mountain Research Station (RMRS) publication which contains a set of articles showcasing the Bitterroot Ecosystem Management Research Project (BEMRP) research projects and activities. The articles are concise, user-friendly, and designed to inform a broad range of audiences interested in ecosystem management. Articles featured in...

  7. Role of pharmacogenomics in the treatment of tuberculosis: a review

    Directory of Open Access Journals (Sweden)

    Ramachandran G

    2012-09-01

    Full Text Available Geetha Ramachandran, Soumya SwaminathanNational Institute for Research in Tuberculosis, Indian Council of Medical Research, Chennai, IndiaBackground: Tuberculosis is one of the major public health problems worldwide. Modern antituberculous treatment can cure most patients; cure rates > 95% are achieved with standard short-course chemotherapy regimens containing isoniazid, rifampicin, pyrazinamide, and ethambutol among patients with drug-susceptible strains of tuberculosis; however, a small proportion do not respond to treatment or develop serious adverse events. Pharmacogenomic studies of drugs used in the treatment of tuberculosis could help us understand intersubject variations in treatment response. In this review, we compiled pharmacogenomic data on antituberculous drugs that were available from different settings that would give a better insight into the role of pharmacogenomics in the treatment of tuberculosis, thereby enhancing the efficacy and limiting the toxicity of existing antituberculosis medications.Methods: The PubMed database was searched from 1960 to the present using the keywords "tuberculosis", "antituberculosis treatment", "isoniazid", "rifampicin", "pyrazinamide", "ethambutol", "pharmacogenomics", and "polymorphism". Abstracts from meetings and review articles were included.Conclusion: Studies conducted in different settings suggest that pharmacogenomics plays a significant role in isoniazid metabolism, and impacts both treatment efficacy and frequency of adverse reactions. Single nucleotide polymorphisms influencing plasma rifampicin concentrations are also reported. No data are available regarding other first-line drugs, ie, ethambutol and pyrazinamide. There is a need to incorporate pharmacogenomics into clinical trials of tuberculosis in order to understand the factors impacting therapeutic success and occurrence of adverse drug effects.Keywords: tuberculosis, antituberculous treatment, pharmacogenomics, polymorphism

  8. Differences in VigiBase® reporting of aminoglycoside and capreomycin-suspected ototoxicity during tuberculosis treatment.

    Science.gov (United States)

    Sagwa, Evans L; Souverein, Patrick C; Ribeiro, Inês; Leufkens, Hubert G M; Mantel-Teeuwisse, Aukje K

    2017-01-01

    To evaluate the association between the use of streptomycin, amikacin, kanamycin and capreomycin in tuberculosis (TB) treatment and the pharmacovigilance reporting of ototoxicity (deafness or hearing loss, tinnitus and vertigo). Second, to analyze patient demographic and geographic factors that influence the reporting of ototoxicity in TB treatment. A case/non-case disproportionality analysis of the VigiBase® individual case safety reports (ICSRs) of patients treated for TB using multidrug regimens that contain either of streptomycin, amikacin, kanamycin or capreomycin. Cases were reports of ototoxicity; non-cases were other adverse drug reactions (ADRs). The unit of analysis was the drug-ADR pair. We calculated reporting odds ratios (RORs) and their 95% confidence intervals (CI). The referent drug was streptomycin. By June 2014, there were 3361 drug-ADR pairs in VigiBase® (1693 ICSRs) where the parenteral administration of the four drugs for TB treatment was suspected of causing the reported ADRs. Deafness, tinnitus and vertigo were reported in 576 drug-ADR pairs (cases), the rest being other ADRs (non-cases). Reporting of deafness was most disproportionately associated with amikacin use (ROR 9.3; 95%CI 3.8-23.0), followed by kanamycin use (ROR 4.3; 95%CI 1.3-14.2). Reporting of vertigo was inversely associated with capreomycin use (ROR 0.1; 95%CI 0.01-0.4). Geographic region affected the reporting of ototoxicity while age and sex did not. Spontaneous reporting of deafness cases within VigiBase® was most disproportionately associated with amikacin use, followed by kanamycin. There were regional variations in the global reporting of ototoxicity. These findings should be verified through a follow up study. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Tuberculosis Comorbidity with Communicable and Noncommunicable Diseases.

    Science.gov (United States)

    Bates, Matthew; Marais, Ben J; Zumla, Alimuddin

    2015-02-06

    The 18th WHO Global Tuberculosis Annual Report indicates that there were an estimated 8.6 million incident cases of tuberculosis (TB) in 2012, which included 2.9 million women and 530,000 children. TB caused 1.3 million deaths including 320,000 human immunodeficiency virus (HIV)-infected people; three-quarters of deaths occurred in Africa and Southeast Asia. With one-third of the world's population latently infected with Mycobacterium tuberculosis (Mtb), active TB disease is primarily associated with a break down in immune surveillance. This explains the strong link between active TB disease and other communicable diseases (CDs) or noncommunicable diseases (NCDs) that exert a toll on the immune system. Comorbid NCD risk factors include diabetes, smoking, malnutrition, and chronic lung disease, all of which have increased relentlessly over the past decade in developing countries. The huge overlap between killer infections such as TB, HIV, malaria, and severe viral infections with NCDs, results in a "double burden of disease" in developing countries. The current focus on vertical disease programs fails to recognize comorbidities or to encourage joint management approaches. This review highlights major disease overlaps and discusses the rationale for better integration of tuberculosis care with services for NCDs and other infectious diseases to enhance the overall efficiency of the public health responses. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.

  10. SHORT TERM ADVANTAGES OF A PUBLIC-PRIVATE PARTNERSHIP FOR TUBERCULOSIS IN GUINEA BISSAU: REDUCTION OF MORTALITY AND INCREASED DIAGNOSTIC CAPACITY

    Directory of Open Access Journals (Sweden)

    Fina Vieira

    2014-06-01

    Full Text Available 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 patients. Methods: Clinical outcomes and costs for TB patients at the TB National Reference Center of Bissau, in Guine Bissau, West Africa were determined during the first 5 months of the public-private management and compared to the ones of previous years when the hospitals was under  direct Government’s management. Results: 215 (2009 and 194 (2013 patients were admitted, respectively. Improvement (p<0.05 was observed in mortality reduction (21% vs 6%, analysis prescription and diagnosis (39% vs 100%, cause of death determination (50% vs 85%, treatment abandonment (15 vs 1. Direct costs for patients during TB diagnostic pathway and inpatient care were significantly reduced, 475 vs 0 USD. Conclusions: Public-private partnerships displays important short term benefits in National TB reference centers, even in post-conflict and low-resource countries. Further studies could aid in determining the overall long term benefits of  this type of cooperation and the specific characteristic of TB and concomitant hematologic and infectious diseases in TB admitted patients.

  11. [Tuberculous cheilitis revealing pulmonary tuberculosis].

    Science.gov (United States)

    Bricha, Myriem; Slimani, Hajar; Hammi, Sanae; Bourkadi, Jamal Eddine

    2016-01-01

    Tuberculosis of the oral cavity is rare. It is associated with clinical polymorphism and poses above all a diagnostic problem. We report the case of a 42-year-old male patient with tubercular cheilitis. This study aims to focus attention on tuberculosis that can be detected exceptionally in specific locations, such as the oral lip.

  12. Molecular epidemiology of tuberculosis in the Tula area, Central Russia, before the introduction of the Directly Observed Therapy Strategy.

    Science.gov (United States)

    Dubiley, S; Ignatova, A; Mukhina, T; Nizova, A; Blagodatskikh, S; Stepanshina, V; Shemyakin, I

    2010-09-01

    Tuberculosis remains a major public health concern in Russia and worldwide. Given the great geographical, ethnic, and socio-economic heterogeneities between Russian regions, epidemiological data cannot be generalized from a regional to a country-wide level. We present data on the epidemiology of tuberculosis in Central Russia. We report a high level of resistance to major antitubercular drugs in both new and previously treated patients in the region. The level of drug resistance in new cases was almost twice as high as the estimated average national level. The Mycobacterium tuberculosis strains that circulated in the region were predominantly represented by LAM-RUS and Beijing genotypes. These two lineages were strongly associated with drug resistance and clustering. Using molecular epidemiology techniques, we showed a high interpenetration by M. tuberculosis strains between the prison and civilian populations. A limited number of identical strains were responsible for the majority of drug-resistant tuberculosis cases in both settings.

  13. [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.

  14. The treatment of tuberculosis in South Korea.

    Science.gov (United States)

    Seung, K J; Bai, G H; Kim, S J; Lew, W J; Park, S K; Kim, J Y

    2003-10-01

    South Korea's complex system of tuberculosis control has never been fully described. The prevalence of tuberculosis has dropped dramatically since 1965, partly because of farsighted governmental policy that provided low-cost, accessible tuberculosis treatment to the entire population. Within the tuberculosis control system, public and private sector entities provide a wide variety of treatment options. The National Tuberculosis Program focuses on improving cure rates for new cases, while the private sector has taken more of a role in the treatment of drug-resistant tuberculosis and other types of complicated cases. There has been a decrease in drug-resistant tuberculosis since 1980 for multiple reasons, including increased cure rates from the introduction of rifampin-based regimens, improved nutrition and living standards, and the treatment of drug-resistant cases in the private sector. Multidrug-resistant tuberculosis, however, still poses a significant threat to public health. The limited outcomes data that exist in South Korea for multidrug-resistant tuberculosis treatment suggest that cure rates are low and failure and abandonment rates are high. New public health measures are needed to improve the control of multidrug-resistant tuberculosis.

  15. Public Attitudes toward Reporting Partner Violence against Women and Reporting Behavior

    Science.gov (United States)

    Gracia, Enrique; Herrero, Juan

    2006-01-01

    Drawing from attitude-behavior research tradition, this study used a national probabilistic sample of the Spanish adult population (N = 2,432) to test hypotheses regarding correlates of public attitudes toward reporting partner violence against women, and the relationship between attitudes toward reporting and actual reporting behavior. Results…

  16. Analysis of Epidemiological Characteristics of Patients with Tuberculosis Reported Directly by Network in Huairou District of Beijing City in 2008%北京市怀柔区2008年网络直报肺结核病人流行病学特征分析

    Institute of Scientific and Technical Information of China (English)

    崔国强

    2009-01-01

    目的 了解北京市怀柔区2008年网络直报肺结核病人和疑似肺结核病人流行病学特征.方法 对怀柔区2008年网络直报的肺结核病人和疑似病人进行统计学分析.结果 怀柔区2008年共报告196人,确诊126人,占64.29%;归口管理99人,占78.57%.农村地区的发病率(70.92%)远高于城区(29.08%);职业以农民为主,占53.06%.结论 加强结核病防治知识及国家免费政策的宣传,提高农民对肺结核的知晓率,加强结核病的归口管理,确保肺结核病人得到及时规律的治疗,从而扼制传染源,减少肺结核的传播.%[Objective] To understand the epidemiological characteristics of patients with suspected tuberculosis and tuberculosis reported directly by network in Huairou District of Beijing City in 2008.[Methods]The suspected cases and confirmed cases of tuberculosis were analyzed statistically.[Results]A total of 196 cases were reported in 2008, 12 (64.29%)were confirmed; the major occupation was peasant, occupied 53.06%.[Conclusion]Tuberculosis control knowledge and the publicity of the national free policies should be strengthened, awareness of tuberculosis among farmers should be improved, and the centralized management of tuberculosis should be strengthened to ensure that tuberculosis patients can receive timely and disciplinary treatment, so that the source of infection can be controlled to reduce the spread of tuberculosis.

  17. Haemophagocytic syndrome in an adult suffering from pyrexia of unknown origin: an uncommon presentation of tuberculosis: a case report.

    Science.gov (United States)

    Haque, Wasim Md Mohosin Ul; Shuvo, Md Erfanur Rahman; Rahim, Muhammad Abdur; Mitra, Palash; Samad, Tabassum; Haque, Jalaluddin Ashraful

    2017-02-27

    Tuberculosis is common, can involve various organs of the body and may have diverse presentations. Haemophagocytic syndrome is one of the rare presentations of tuberculosis carrying a very high mortality. Early detection and institution of anti-tuberculosis medications can be life-saving. A 23-year-old Bengali man presented with prolonged fever, weight loss, hepatosplenomegaly, pancytopenia and altered liver function. He had high erythrocyte sedimentation rate, positive tuberculin test, granuloma in liver biopsy, and haemophagocytosis was evidenced by histopathological examination of bone marrow. He recovered with anti-tuberculosis therapy. This case demonstrates that consideration of tuberculosis as an underlying cause of haemophagocytic syndrome could be rewarding and life-saving in this rapidly fatal condition.

  18. Tuberculosis in Blacks

    Science.gov (United States)

    ... the Facts Tuberculosis - The Connection between TB and HIV 12-Dose Regimen for Latent TB Infection-Patient Education Brochure Posters Mantoux Tuberculin Skin Test Wall Chart World TB Day Think TB Stop TB Reports & Articles Morbidity and Mortality Weekly Reports (MMWRs) DTBE Authored ...

  19. [PECULIARITY OF NATIONAL TUBERCULOSIS PROGRAM, JAPAN--Public-Private Mix from the Very Beginning, and Provision of X-ray Apparatus in Most General Practitioner's Clinics].

    Science.gov (United States)

    Shimao, Tadao

    2016-02-01

    Modern National Tuberculosis Program (NTP) of Japan started in 1951 when Tuberculosis (TB) Control Law was legislated, and 3 major components were health examination by tuberculin skin test (TST) and miniature X-ray, BCG vaccination and extensive use of modern TB treatment. As to the treatment program, Japan introduced Public-Private Mix (PPM) from the very beginning, and major reasons why PPM was adopted are (1) TB was then highly prevalent (Table 1), (2) TB sanatoria where many specialists are working are located in remote inconvenient places due to stigma against TB, (3) health centers (HCs) in Japan are working exclusively on prophylactic activities, and minor exceptions are treatment of sexually transmitted diseases and artificial pneumothorax for TB cases, however, as it covers on the average 100,000 population, access is not so easy in rural area, (4) Out-patients clinics mainly operated by general practitioners (GPs) are located throughout Japan, and the access is easy. Methods of TB treatment was developing rapidly in early 1950s, however, in 1952, as shown in Table 2, artificial pneumothorax and peritoneum were still used in many cases, and to fix the dosage of refill air, fluoroscopy was needed. Hence, GPs treating TB under TB Control Law had to be equipped with X-ray apparatus. To maintain the quality of TB treatment, "Criteria for TB treatment" was provided and revised taking into consideration the progress in TB treatment. If applied methods of treatment fit with the above criteria, public support is made for the cost of TB treatment. To discuss the applied treatment, TB Advisory Committee was set in each HC, composing of 5 members, director of HC, 2 TB specialists and 2 doctors recommended by the local medical association. In 1953, the first TB prevalence survey using stratified random sampling method was carried out, and the prevalence of TB requiring treatment was estimated at 3.4%, and only 21% of found cases knew their own disease, and more than

  20. Mycobacterium tuberculosis infection in a HIV-positive patient

    Directory of Open Access Journals (Sweden)

    Maria Theresa Montales

    2015-01-01

    Full Text Available Mycobacterium tuberculosis (MTB and human immunodeficiency virus (HIV coinfection remains a global public health challenge. We report a 40 year old African American male who is a known HIV-positive patient, non-compliant with his antiretrovirals and developed pulmonary tuberculosis. His chief complaints were chronic cough, fever, night sweats and undocumented weight loss. He had a prior positive T-SPOT-TB test; however, chest radiograph and sputum smear examination revealed normal results. PCR-based GeneXPERT MTB/RIF assay was ordered and confirmed MTB infection. The sputum cultures grew MTB and sensitivities showed susceptibility to all primary anti-tuberculosis medications. A delay in diagnosis and initiation of MTB therapy, in the setting of HIV or AIDS, may result in rapid disease progression and worse clinical outcome.

  1. 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.

  2. 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.

  3. Enfermedad de Addison asociado a tuberculosis pulmonar: reporte de un caso

    Directory of Open Access Journals (Sweden)

    Maria Ofelia Foronda Rios

    2012-12-01

    Full Text Available La enfermedad de Addison resulta de la destrucción progresiva de las glándulas adrenales pudiendo llegar a destruir hasta el 90% antes de que aparezca una insuficiencia corticosuprarrenal clínicamente observable.Históricamente, la tuberculosis fue una causa frecuente de la enfermedad de Addison, aunque otras enfermedades también pueden producir la enfermedad.La enfermedad de Addison estima una prevalencia de aproximadamente 110 casos por millón de habitantes y una incidencia de 5 a 6 casos por millón al año.Presentamos el caso clínico de un paciente de sexo masculino que ingresa al servicio de infectología del hospital Clínico Viedma, con el antecedente de cambio de coloración de la piel en miembros de cinco meses de evolución, cuadro se acompaño de disnea de clase III. En el examen físico general se observó hiperpigmentación generalizada que compromete mucosas, signos vitales normales. Al examen físico regional presentó adinamia, anorexia y astenia.

  4. Primary Enterolith in a Patient with Intestinal Tuberculosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohd. Habib Raza

    2016-11-01

    Full Text Available Primary enterolithiasis is a rare surgical ailment. The underlying cause is intestinal stasis. Numerous anatomical and micro environmental factors such as enteritis, incarcerated hernia, malignancy, diverticula, blind loops, and enteroenterostomy predispose to clinically significant concretions. Enterolithiasis in tuberculosis can be due to the presence of strictures, intestinal bands, or interbowel/parietal adhesions, leading to intestinal stasis. Secondary enterolithiasis is generally caused by gallstones or renal stones migrating to the gastrointestinal tract due to fistula formation. During stasis, food particles act as a nidus and calcium salts are deposited over the food particles, leading to stone formation. A 57-year-old male patient presented to the Emergency Department of Jawaharlal Nehru Medical College, AMU, Aligarh, with features of intestinal obstruction. The patient underwent emergency laparotomy, revealing 2 strictures in the distal ileum with 15.24cm of the bowel between them containing a 2×2 cm enterolith. The strictured segment was resected, and end ileostomy and mucus fistula were created. The patient’s postoperative recovery was fine, and he wasdischarged with ileostomy on antitubercular treatment (after histopathologicalconfirmation. Ileostomy closure wasplanned after 6 weeks. The incidence and prevalence of enterolithiasis has been on the rise recently because of advancement in radiological imaging studies. Endoscopic and surgical stone removal along with the treatment of the underlying pathology is recommended.

  5. Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

    Directory of Open Access Journals (Sweden)

    Assadi Majid

    2009-11-01

    Full Text Available Abstract Introduction Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations. Case presentation A 73-year-old cachectic Asian man (Iranian presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement. Conclusion Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.

  6. 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.

  7. Crescentic Glomerulonephritis Associated with Pulmonary Tuberculosis.

    Science.gov (United States)

    Kanodia, K V; Vanikar, A V; Patel, R D; Suthar, K S; Trivedi, H L

    2016-01-01

    Tuberculosis of kidney and urinary tract is caused by members of the Mycobacterium tuberculosis complex. Kidney is usually infected by haematogenous spread of bacilli from focus of infection in the lungs. Glomerular involvement in tuberculosis presenting as a rapidly progressive glomerulonephritis is a rare entity. We report a rare case of crescentic glomerulonephritis associated with pulmonary tuberculosis in a 26-year-old man. Patient was treated with corticosteroids, haemodialysis, intravenous immunoglobulin and four cycles of plasmapheresis. He did not respond to 4-drug anti-tuberculosis treatment for renal pathology and was switched over to maintenance haemodialysis. However, he responded to pulmonary TB.

  8. 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.

  9. 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.

  10. 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.

  11. Recent advancements in the development of anti-tuberculosis drugs.

    Science.gov (United States)

    Chetty, Sarentha; Ramesh, Muthusamy; Singh-Pillay, Ashona; Soliman, Mahmoud E S

    2017-02-01

    Modern chemotherapy has significantly improved patient outcomes against drug-sensitive tuberculosis. However, the rapid emergence of drug-resistant tuberculosis, together with the bacterium's ability to persist and remain latent present a major public health challenge. To overcome this problem, research into novel anti-tuberculosis targets and drug candidates is thus of paramount importance. This review article provides an overview of tuberculosis highlighting the recent advances and tools that are employed in the field of anti-tuberculosis drug discovery. The predominant focus is on anti-tuberculosis agents that are currently in the pipeline, i.e. clinical trials. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Quality of life among tuberculosis (TB, TB retreatment and/or TB-HIV co-infected primary public health care patients in three districts in South Africa

    Directory of Open Access Journals (Sweden)

    Louw Julia

    2012-06-01

    Full Text Available Abstract Introduction TB and HIV co-morbidity amount to a massive burden on healthcare systems in many countries. This study investigates health related quality of life among tuberculosis (TB, TB retreatment and TB-HIV co-infected public primary health care patients in three districts in South Africa. Methods A cross sectional study was conducted among 4900 TB patients who were in the first month of anti-TB treatment in primary public health care clinics in three districts in South Africa. Quality of life was assessed using the social functioning (SF-12 Health Survey through face to face interviews. Associations of physical health (Physical health Component Summary = PCS and mental health (Mental health Component Summary = MCS were identified using logistic regression analyses. Results The overall physical and mental health scores were 42.5 and 40.7, respectively. Emotional role, general health and bodily pain had the lowest sub-scale scores, while energy and fatigue and mental health had the highest domain scores. Independent Kruskal–Wallis tests found significant positive effects of being TB-HIV co-infected on the domains of mental health functioning, emotional role, energy and fatigue, social function and physical role, while significant negative effects were observed on general health, bodily pain and physical function. In multivariable analysis higher educational, lower psychological distress, having fewer chronic conditions and being HIV negative were significantly positively associated with PCS, and low poverty, low psychological distress and being HIV positive were positively significantly associated with MCS. Conclusion TB and HIV weaken patients’ physical functioning and impair their quality of life. It is imperative that TB control programmes at public health clinics design strategies to improve the quality of health of TB and HIV co-infected patients.

  13. Social and cultural factors in the successful control of tuberculosis.

    Science.gov (United States)

    Rubel, A J; Garro, L C

    1992-01-01

    The burden of tuberculosis on the public health is staggering. Worldwide, annual incidence of new cases is estimated to be about 8 million. Almost 3 million deaths occur yearly. Early case identification and adherence to treatment regimens are the remaining barriers to successful control. In many nations, however, fewer than half those with active disease receive a diagnosis, and fewer than half those beginning treatment complete it. The twin problems of delay in seeking treatment and abandonment of a prescribed regimen derive from complex factors. People's confusion as to the implications of the tuberculosis symptoms, costs of transportation to clinic services, the social stigma that attaches to tuberculosis, the high cost of medication, organizational problems in providing adequate followup services, and patients' perception of clinic facilities as inhospitable all contribute to the complexity. Sociocultural factors are emphasized in this report because hitherto they have not been adequately explored. Salient among those sociocultural factors is the health culture of the patients. That is, the understanding and information people have from family, friends, and neighbors as to the nature of a health problem, its cause, and its implications. A knowledge of the health culture of their patients has become a critical tool if tuberculosis control programs are to be successful. Several anthropological procedures are recommended to help uncover the health culture of people served by tuberculosis clinics.

  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. Migrant tuberculosis

    DEFF Research Database (Denmark)

    Kamper-Jorgensen, Zaza; Andersen, Aase Bengaard; Kok-Jensen, Axel;

    2012-01-01

    ABSTRACT: BACKGROUND: Human migration caused by political unrest, wars and poverty is a major topic in international health. Infectious diseases like tuberculosis follow their host, with potential impact on both the migrants and the population in the recipient countries. In this study, we evaluate...... Mycobacterium tuberculosis transmission between the national population and migrants in Denmark. METHODS: Register study based on IS6110-RFLP results from nationwide genotyping of tuberculosis cases during 1992 through 2004. Cases with 100% identical genotypes were defined as clustered and part...

  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. 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.

  18. [The intervention against an outbreak of pulmonary tuberculosis in the dormitory of construction laborers--Connection with approaches from public health, medical treatment, social welfare, and labor management].

    Science.gov (United States)

    Iburi, S; Fujita, J; Yajima, H; Kakuda, H; Sakamoto, M; Matsumura, A

    2001-11-01

    An outbreak of pulmonary tuberculosis (TB) in a dormitory of construction laborers took place, and this outbreak was presumed to be caused by the same sourse of infection, based on the results of restriction fragment length polymorphism (RFLP) analysis and other findings. After the first patient was admitted to the hospital with active TB, 18 new other TB patients were discovered by repeated contacts examinations. They were all male and single, and were aged from 41 to 67 years old (mean age 51.7). Among 19 patients, only 4 patients had a health insurance. As these patients lived together in the same dormitory, to prevent infection through close contact in the dormitory, repeated contacts examinations were further performed. In addition, several medical, social, and economical interventions were needed for these patients. It was also required to improve labor conditions in this construction company. It was concluded that comprehensive approaches including public health, medical treatment, social welfare, and labor management aspects were indispensable to prevent TB among relatively poor laborers.

  19. Clinico-Pathological Profile and Surgical Outcome of Patients of Gastrointestinal Tuberculosis Undergoing Laparotomy.

    Science.gov (United States)

    Pathak, Priyank; Sahu, Shantanu Kumar; Agrawal, Saurabh

    2016-01-01

    Tuberculosis is one of the earliest diseases affecting the mankind. Abdominal tuberculosis constitutes a common public health issue in developing countries like ours. Gastrointestinal tuberculosis often involves the ileocecal region. Surgery in case of abdominal tuberculosis is required to overcome the deleterious effects of the disease like tissue disorganization, obstruction and perforatio.

  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 control relies on the identification and preventive treatment of individuals who are latently infected with Mycobacterium tuberculosis. However, direct identification of latent tuberculosis infection is not possible. The diagnostic tests used to identify individuals latently infected...... with M. tuberculosis, the in vivo tuberculin skin test and the ex vivo interferon-gamma release assays (IGRAs), are designed to identify an adaptive immune response against, but not necessarily a latent infection with, M. tuberculosis. The proportion of individuals who truly remain infected with M....... 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. Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst

    Directory of Open Access Journals (Sweden)

    Hajime Takase

    2014-01-01

    Full Text Available Background: Tuberculous peritonitis (TBP is a well-known complication of ventriculo-peritoneal (VP shunt treatment for hydrocephalus resulting from tuberculous meningitis (TBM. However, a case of hydrocephalus unrelated to TBM resulting from VP shunt malfunction due to TBP has not been reported. Case Description: A 21-year-old male presented with nausea, abdominal pain, and headache. VP and cysto-peritoneal (CP shunts had been inserted to treat hydrocephalus due to a suprasellar arachnoid cyst, replaced the VP and removed the CP in his childhood. Computed tomography demonstrated acute hydrocephalus and an abdominal pseudocyst surrounding the distal end of the peritoneal tube. Initial laboratory data showed elevated white blood cell count and C-reactive protein level, but no causative pathogen was identified. External drainage of cerebrospinal fluid (CSF and of the fluid in the peritoneal cyst was established, and empirical antibiotic therapy was initiated. Bacterial cultures eventually revealed Mycobacterium tuberculosis infection, and TBP was diagnosed. The patient responded well to antituberculosis (anti-TB agents and insertion of a ventriculo-pleural shunt. Conclusion: This case highlights the possibility of CSF shunt failure and concomitant neurological sequelae from TB infection even when the pathogen has not invaded the central nervous system, as in TBM. Moreover, TBP is rare in developed countries and therefore may be misdiagnosed because of nonspecific clinical features and low sensitivity of common TB screening methods.

  2. Canadian geothermal code for public reporting: reporting of exploration results, geothermal resources and geothermal reserves

    Energy Technology Data Exchange (ETDEWEB)

    Deibert, Lee [Meridian Environmental Consulting Ltd. (Canada); Hjartarson, Arnar [Mannvit Engineering (Canada); McDonald, Ian; Toohey, Brian [Nexen Inc. (Canada); McIlveen, John [Jacob Securities, (Canada); Thompson, Alison [Magma Energy Corp. (Canada); Yang, Daniel [Borealis Geopower Inc. (Canada)

    2010-07-01

    In December 2008, the Canadian geothermal code committee sponsored by the Canadian Geothermal Energy Association (CanGEA) was created with the intention of developing a code for public reporting of geothermal resources and reserves. The code was based on key elements of the Australian code which was developed in 2008 by the Australian Geothermal Energy Association in collaboration with the Australian Geothermal Energy Group. The Canadian Code was developed with the purpose of being applicable to both Canadian and international geothermal plays and to offer a reporting basis which satisfies investors, shareholders and capital markets. The Canadian Geothermal Reporting Code for Public Reporting is provided herein, it is intended for all Canadian companies and their competitors. Since reporting of geothermal results is a recent activity, this Code will require further input during its implementation.

  3. Calcified Pulmonary Nodules Identified in a 350-Year-Old-Joseon Mummy: the First Report on Ancient Pulmonary Tuberculosis from Archaeologically Obtained Pre-modern Korean Samples

    Science.gov (United States)

    2016-01-01

    We found calcified pulmonary nodules in a middle-aged female mummy discovered from 350-yr-old Joseon tomb of Korea. In the CT scan, we found six radiopaque nodules in right lung, through the levels of thoracic vertebrae 1 to 6. We also found presumptive pleural adhesions in right thoracic cavity of CT images. We re-confirmed radiological findings by our post-factum dissection on the same mummy. By the differential diagnosis, we speculate that the radiopaque calcification nodules and associated pleural adhesion could have been caused by tuberculosis. This is the first-ever report on the pulmonary tuberculosis identified in archaeologically obtained, pre-modern Korean samples. PMID:26770051

  4. Self-reported risks for multiple-drug resistance among new tuberculosis cases: implications for drug susceptibility screening and treatment.

    Directory of Open Access Journals (Sweden)

    Timothy F Brewer

    Full Text Available BACKGROUND: Multiple drug-resistance in new tuberculosis (TB cases accounts for the majority of all multiple drug-resistant TB (MDR-TB worldwide. Effective control requires determining which new TB patients should be tested for MDR disease, yet the effectiveness of global screening recommendations of high-risk groups is unknown. METHODS: Sixty MDR-TB cases with no history of previous TB treatment, 80 drug-sensitive TB and 80 community-based controls were recruited in Lima, Peru between August and December, 2008 to investigate whether recommended screening practices identify individuals presenting with MDR-TB. Odd ratios (OR and 95% confidence intervals (CI were calculated using logistic regression to study the association of potential risk factors with case/control variables. RESULTS: MDR-TB cases did not differ from drug-sensitive TB and community controls in rates of human immunodeficiency virus infection, reported hospital or prison visits in the 3 years prior to diagnosis. MDR-TB cases were more likely than drug-sensitive TB controls to have had a recent MDR-TB household contact (OR 4.66, (95% CI 1.56-13.87; however, only 15 cases (28.3% reported this exposure. In multivariate modeling, recent TB household contact, but not contact with an MDR-TB case, remained predictive of MDR-TB, OR 7.47, (95% CI 1.91-29.3. Living with a partner rather than parents was associated with a lower risk of MDR-TB, OR 0.15, (95% CI 0.04-0.51. CONCLUSION: Targeted drug susceptibility testing (DST linked to reported MDR-TB contact or other high-risk exposures does not identify the majority of new TB cases with MDR disease in Lima where it is endemic. All new TB cases should be screened with DST to identify MDR patients. These findings are likely applicable to other regions with endemic MDR-TB.

  5. Tumor vasoproliferativo associado à tuberculose ocular presumida: relato de caso Vasoproliferative tumor associated with presumed ocular tuberculosis: case report

    Directory of Open Access Journals (Sweden)

    Luciana Duarte Rodrigues

    2007-06-01

    hipofluorescência por bloqueio (proliferação do EPR. Os tumores vasoproliferativos secundários são proliferações gliovasculares da retina e estão associados a várias condições oculares que afetam a retina e a coróide. Devido ao grande número de complicações associadas aos tumores vasoproliferativos da retina, com perda visual significativa, estes devem ser tratados no momento do diagnóstico. O tratamento de escolha para estes tumores é a crioterapia. A triancinolona intravítrea, por seus efeitos antiangiogênicos, pode ser utilizada como tratamento adjuvante. Até o presente momento, a associação de tumor vasoproliferativo e tuberculose ocular não foi relatada na literatura. O tratamento do tumor vasoproliferativo secundário com crioterapia e injeção intravítrea da triancionolona surge como nova opção terapêutica. Mais estudos são necessários para comprovar a eficácia deste tratamento.PURPOSE: To describe a case of vasoproliferative tumor associated with presumed ocular tuberculosis treated with cryotherapy and intravitreal triamcinolone injection. STUDY DESIGN/PATIENT AND METHODS: Interventional case report. A 42-year-old female patient reported inflammation of the right eye 1 year ago, treated with oral prednisone for 30 days. She referred blurred vision in the right eye since childhood. Ophthalmologic examination showed 20/400 visual acuity in the right eye. Biomicroscopy and intraocular pressure were normal. Fundus examination showed vascularized elevated lesion, associated with serous retinal detachment and hard exudates at the inferior periphery. The lesion was surrounded by extensive area of hyperplastic retinal pigment epithelium. The macula showed attenuation of the foveal reflex. Ocular ultrasound showed a 2.25 mm height vascularized lesion. Serologic examination, hemogram and thorax RX were normal. PPD was considered strong reactor and tuberculosis was diagnosed after positive BK research. Considering the clinical aspects, the ocular

  6. PVMapper: Report on the Second Public Opinion Survey

    Energy Technology Data Exchange (ETDEWEB)

    Juliet Carlisle; Jeffrey Joe; Stephanie Kane; Dave Koehler; David Solan

    2013-06-01

    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

  7. Rhodococcus equi isolation from sputum of patients with suspected tuberculosis

    Directory of Open Access Journals (Sweden)

    Paulo da Silva

    2010-03-01

    Full Text Available Rhodococcus equi has emerged as an opportunistic pathogen associated with pulmonary, invasive or systemic infections in immunocompromised patients. We report the identification of 51 R. equi isolates found in sputum samples of 546 individuals suspected to have pulmonary tuberculosis in two Public Health Hospital Units in Brazil. The epidemiology of R. equi infection as well as the phenotypic identification and drug susceptibility profile of isolates are described in this paper.

  8. Tuberculosis and Cardiovascular Disease: Linking the Epidemics.

    Science.gov (United States)

    Huaman, Moises A; Henson, David; Ticona, Eduardo; Sterling, Timothy R; Garvy, Beth A

    The burden of tuberculosis and cardiovascular disease (CVD) is enormous worldwide. CVD rates are rapidly increasing in low- and middle-income countries. Public health programs have been challenged with the overlapping tuberculosis and CVD epidemics. Monocyte/macrophages, lymphocytes and cytokines involved in cellular mediated immune responses against Mycobacterium tuberculosis are also main drivers of atherogenesis, suggesting a potential pathogenic role of tuberculosis in CVD via mechanisms that have been described for other pathogens that establish chronic infection and latency. Studies have shown a pro-atherogenic effect of antibody-mediated responses against mycobacterial heat shock protein-65 through cross reaction with self-antigens in human vessels. Furthermore, subsets of mycobacteria actively replicate during latent tuberculosis infection (LTBI), and recent studies suggest that LTBI is associated with persistent chronic inflammation that may lead to CVD. Recent epidemiologic work has shown that the risk of CVD in persons who develop tuberculosis is higher than in persons without a history of tuberculosis, even several years after recovery from tuberculosis. Together, these data suggest that tuberculosis may play a role in the pathogenesis of CVD. Further research to investigate a potential link between tuberculosis and CVD is warranted.

  9. 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.

  10. 86(th) 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 (social media for the conference agenda/syllabus, and decreasing workshop sessions to 45 minutes. Most rated the conference as "good" or "excellent."

  11. 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.

  12. Tuberculosis lymphadenitis in Ethiopia.

    Science.gov (United States)

    Biadglegne, Fantahun; Tesfaye, Weghata; Anagaw, Belay; Tessema, Belay; Debebe, Tewodrose; Anagaw, Berhanu; Mulu, Andargachew; Sack, Ulrich; Rodloff, Arne C

    2013-01-01

    Tuberculosis (TB) is one of the most serious public health challenges in Ethiopia. Indeed, Ethiopia ranks 7th among 22 countries with a high burden of TB worldwide. Both pulmonary TB and extrapulmonary TB (EPTB) are issues of concern. Ethiopia ranks 3rd in terms of the number of EPTB patients worldwide, with TB lymphadenitis (TBL) being the most common. According to the World Health Organization's Global TB Report 2009, the estimated number of TB patients in Ethiopia was 314,267 in 2007, with an estimated incidence rate of 378 patients per 100,000 population. Furthermore, 36% patients suffered from EPTB, with TBL accounting for 80% of these patients. In Ethiopia, pathological services, culture, and drug susceptibility testing for mycobacterium species are not available as routine tests, not even for cases with suspected infection by drug-resistant strains. Therefore, the management of multidrug-resistant (MDR) TB in Ethiopia is currently unsatisfactory. Against this background, a high index of clinical doubt and timely use of diagnostic methods, prompt confirmation of diagnosis, and early initiation of specific anti-TB treatment are the key factors for the successful management of MDR-TB and TBL in Ethiopia.

  13. [A meningitis case of Brucella and tuberculosis co-infection].

    Science.gov (United States)

    Karsen, Hasan; Karahocagil, Mustafa Kasim; Irmak, Hasan; Demiröz, Ali Pekcan

    2008-10-01

    Turkey is located at an endemic area for brusellosis and tuberculosis which are both important public health problems. Meningitis caused by Brucella and Mycobacterium spp. may be confused since the clinical and laboratory findings are similar. In this report, a meningitis case with Brucella and tuberculosis co-infection has been presented. A 19-years-old woman was admitted to our clinic with severe headache, fever, vomiting, meningeal irritation symptoms, confusion and diplopia. The patient was initially diagnosed as Brucella meningitis based on her history (stockbreeding, consuming raw milk products, clinical symptoms concordant to brucellosis lasting for 4-5 months), physical examination and laboratory findings of cerebrospinal fluid (CSF). Standard tube agglutination test for brucellosis was positive at 1/80 titer in CSF and at 1/640 titer in serum, whereas no growth of Brucella spp. was detected in CSF and blood cultures. Antibiotic therapy with ceftriaxone, rifampicin and doxycyclin was started, however, there was no clinical improvement and agitation and confusion of the patient continued by the end of second day of treatment. Repeated CSF examination yielded acid-fast bacteria. The patient was then diagnosed as meningitis with double etiology and the therapy was changed to ceftriaxone, streptomycin, morphozinamide, rifampicin and isoniazid for thirty days. Tuberculosis meningitis was confirmed with the growth of Mycobacterium tuberculosis on the 14th day of cultivation (BACTEC, Becton Dickinson, USA) of the CSF sample. On the 30th day of treatment she was discharged on anti-tuberculous treatment with isoniazid and rifampicin for 12 months. The follow-up of the patient on the first and third months of treatment revealed clinical and laboratory improvement. Since this was a rare case of Brucella and tuberculosis co-infection, this report emphasizes that such co-infections should be kept in mind especially in the endemic areas for tuberculosis and brucellosis.

  14. The growing impact of HIV infection on the epidemiology of tuberculosis in England and Wales: 1999–2003

    Science.gov (United States)

    Ahmed, Aliko B; Abubakar, Ibrahim; Delpech, Valerie; Lipman, Marc; Boccia, Delia; Forde, Josh; Antoine, Delphine; Watson, John M

    2007-01-01

    Background Previous studies have estimated the prevalence of tuberculosis and HIV infection in population subgroups in the UK. This study was undertaken to describe recent trends in the proportion of individuals with HIV infection among reported cases of tuberculosis in England and Wales, and to review the implications for clinical and public health care. Methods A population‐based matching study using national surveillance databases was used to investigate all persons aged 15 years and over reported with a diagnosis of tuberculosis to the Health Protection Agency in England and Wales in 1999–2003. Record linkage was used to match the national tuberculosis and HIV/AIDS surveillance databases to identify all cases of tuberculosis and determine the proportion of patients with tuberculosis co‐infected with HIV. The distribution and characteristics of the cases were determined and the trend examined by year. Results Of 30 670 cases of tuberculosis reported in England and Wales between 1999 and 2003, an estimated 1743 (5.7%) were co‐infected with HIV. There was a year on year increase in the proportion from 3.1% (169/5388) in 1999 to 8.3% (548/6584) in 2003 (p for trend <0.0001). Co‐infected patients contributed to almost a third of the increase in the number of cases of tuberculosis during the 5 year period. Patients co‐infected with HIV were predominantly those born abroad. 18.5% (n = 323) of co‐infected patients had not been reported as active cases of tuberculosis on the national tuberculosis database. Conclusion The proportion of patients with tuberculosis co‐infected with HIV in England and Wales is increasing, with the greatest impact on those born abroad regardless of their ethnic origin. With HIV infection contributing substantially to the increase in the number of cases of tuberculosis, close cooperation in the clinical management and accurate notification of patients is vital if appropriate care and public health action is to be

  15. Tuberculosis and pregnancy, infection beyond

    OpenAIRE

    Aránzazu Ceballos, Andrés David; Universidad Pontificia Bolivariana; Martínez Sanchez, Lina María; Universidad Pontificia Bolivariana

    2016-01-01

    La tuberculosis (TB) es una enfermedad infecciosa crónica, transmitida por un microorganismo denominado M. tuberculosis. Esta enfermedad afecta principalmente los pulmones, pero potencialmente puede comprometer cualquier órgano del ser humano.La TB representa un problema de salud pública que afecta a las gestantes a nivel mundial. El más reciente reporte de la OMS “Global Tuberculosis Report” estima que cada año adquieren la infección 9,6 millones de personas, de las cuales 3.2 millones son m...

  16. The road to tuberculosis (Mycobacterium tuberculosis elimination in Arkansas; a re-examination of risk groups.

    Directory of Open Access Journals (Sweden)

    Anna Berzkalns

    Full Text Available OBJECTIVES: This study was conducted to generate knowledge useful for developing public health interventions for more effective tuberculosis control in Arkansas. METHODS: The study population included 429 culture-confirmed reported cases (January 1, 2004-December 31, 2010. Mycobacterium tuberculosis genotyping data were used to identify cases likely due to recent transmission (clustered versus reactivation (non-clustered. Poisson regression models estimated average decline rate in incidence over time and assessed the significance of differences between subpopulations. A multinomial logistic model examined differences between clustered and non-clustered incidence. RESULTS: A significant average annual percent decline was found for the overall incidence of culture-confirmed (9%; 95% CI: 5.5%, 16.9%, clustered (6%; 95% CI: 0.5%, 11.6%, and non-clustered tuberculosis cases (12%; 95% CI: 7.6%, 15.9%. However, declines varied among demographic groups. Significant declines in clustered incidence were only observed in males, non-Hispanic blacks, 65 years and older, and the rural population. CONCLUSIONS: These findings suggest that the Arkansas tuberculosis control program must target both traditional and non-traditional risk groups for successful tuberculosis elimination. The present study also demonstrates that a thorough analysis of TB trends in different population subgroups of a given geographic region or state can lead to the identification of non-traditional risk factors for TB transmission. Similar studies in other low incidence populations would provide beneficial data for how to control and eventually eliminate TB in the U.S.

  17. Joint Public-Parochial Planning Councils. Final Report 1975-1976. Report No. 7702.

    Science.gov (United States)

    Philadelphia School District, PA. Office of Research and Evaluation.

    This report briefly describes Philadelphia's Joint Public Parochial Planning Councils (JPC) project and presents an evaluation of the project's impact during the 1975-76 school year. The JPC project is intended to provide sustained interaction between the Philadelphia School District and the Archdiocese of Philadelphia. During 1975-76, 102 joint…

  18. Treatment paradox in musculo-skeletal tuberculosis in an immunocompetent adult male; a case report from a tertiary care hospital.

    Science.gov (United States)

    Chaskar, Priyanka; Rana, Geetika; Anuradha; Duggal, Nandini; Arora, Jyoti

    2015-04-01

    Paradoxical reactions like immune reconstitution inflammatory syndrome (IRIS) as seen with patients on retroviral treatment in HIV infection, have also been identified in HIV sero-negative patients with extra pulmonary tuberculosis especially lymph-node tuberculosis. Musculo-skeletal tuberculosis presenting as a cold abscess of the anterior chest wall is a rare entity which poses diagnostic and therapeutic challenge. A 35-year-old immunocompetent male came with complains of painless lump on right side of his chest over 9th and 10th intercostal space which gradually increased and extended upto 11th rib area. Clinically, diagnosis of cold abscess was made and anti-tubercular therapy (ATT) was started. Despite of being on ATT for 3 weeks, patient developed pain and signs of inflammation. Fluid was aspirated and sent for biochemical and microbiological investigations. The aspirated fluid was positive for acid fast bacilli by ZN stain and grew Mycobacterium tuberculosis in culture, sensitive to first line ATT. Pyogenic and fungal culture was negative. This case presented as an anterior chest wall cold abscess which deteriorated on initiation of first line ATT, thus creating a suspicion of resistance to ATT which was cleared on ATT susceptibility testing. Hence, this case underlines the possibility of treatment paradoxes seen in immunocompetent musculo-skeletal tuberculosis.

  19. 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.

  20. 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.

  1. 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.

  2. Lymph node infection by Trichomonas tenax: report of a case with co-infection by Mycobacterium tuberculosis.

    Science.gov (United States)

    Duboucher, C; Farto-Bensasson, F; Chéron, M; Peltier, J Y; Beaufils, F; Périé, G

    2000-10-01

    In an 82-year-old woman, presenting with fever and asthenia, cervical adenopathy was noted. Clinical and radiological investigations were fruitless. Laboratory examinations detected a refractory anemia. The lymph node was excised and showed numerous trichomonads on touch preparations. Histologically, the node showed caseous necrosis and macrophagic reaction. Diagnosis of lymph node infection by Trichomonas tenax was made. Three weeks later, culture of the node showed Mycobacterium tuberculosis and let us conclude co-infection. T tenax is usually regarded as a harmless saprophyte of the oral cavity. This exceptional observation shows for the first time an invasive potential of T tenax. It raises questions about links with tuberculosis and refractory anemia.

  3. ENCOAL mild coal gasification project public design and construction report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-01

    This Public Design Report describes the 1000 ton per day ENCOAL mild coal gasification demonstration plant now in operation at the Buckskin Mine near Gillette, Wyoming. The objective of the project is to demonstrate that the proprietary Liquids From Coal (LFC) technology can reliably and economically convert low Btu PRB coal into a superior, high-Btu solid fuel (PDF), and an environmentally attractive low-sulfur liquid fuel (CDL). The Project`s plans also call for the production of sufficient quantities of PDF and CDL to permit utility companies to carry out full scale burn tests. While some process as well as mechanical design was done in 1988, the continuous design effort was started in July 1990. Civil construction was started in October 1990; mechanical erection began in May 1991. Virtually all of the planned design work was completed by July 1991. Most major construction was complete by April 1992 followed by plant testing and commissioning. Plant operation began in late May 1992. This report covers both the detailed design and initial construction aspects of the Project.

  4. PDF text classification to leverage information extraction from publication reports.

    Science.gov (United States)

    Bui, Duy Duc An; Del Fiol, Guilherme; Jonnalagadda, Siddhartha

    2016-06-01

    Data extraction from original study reports is a time-consuming, error-prone process in systematic review development. Information extraction (IE) systems have the potential to assist humans in the extraction task, however majority of IE systems were not designed to work on Portable Document Format (PDF) document, an important and common extraction source for systematic review. In a PDF document, narrative content is often mixed with publication metadata or semi-structured text, which add challenges to the underlining natural language processing algorithm. Our goal is to categorize PDF texts for strategic use by IE systems. We used an open-source tool to extract raw texts from a PDF document and developed a text classification algorithm that follows a multi-pass sieve framework to automatically classify PDF text snippets (for brevity, texts) into TITLE, ABSTRACT, BODYTEXT, SEMISTRUCTURE, and METADATA categories. To validate the algorithm, we developed a gold standard of PDF reports that were included in the development of previous systematic reviews by the Cochrane Collaboration. In a two-step procedure, we evaluated (1) classification performance, and compared it with machine learning classifier, and (2) the effects of the algorithm on an IE system that extracts clinical outcome mentions. The multi-pass sieve algorithm achieved an accuracy of 92.6%, which was 9.7% (pPDF documents. Text classification is an important prerequisite step to leverage information extraction from PDF documents. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. Mycobacterium tuberculosis bacteremia diagnosed in an HIV-negative patient in Brazil: a rare or an under-reported event?

    Directory of Open Access Journals (Sweden)

    D. J. Hadad

    Full Text Available A case of Mycobacterium tuberculosis bacteremia in an HIV negative immunodepressed patient was described using the BACTEC 460 TB system. This bacterium should be investigated in the blood of immunodepressed non-HIV infected patients with prolonged fever.

  10. Status Report on Publicly Traded Child Care Companies--An Interview with John McLaughlin.

    Science.gov (United States)

    Neugebauer, Roger

    1997-01-01

    Interview with editor of "Education Industry Report" reveals why child care companies choose to go public on stock exchanges and how publicly traded child care companies are faring. Discusses potential for growth in the industry, advantages of private placement, and recommended steps for going public. Describes nine publicly traded…

  11. Status Report on Publicly Traded Child Care Companies--An Interview with John McLaughlin.

    Science.gov (United States)

    Neugebauer, Roger

    1997-01-01

    Interview with editor of "Education Industry Report" reveals why child care companies choose to go public on stock exchanges and how publicly traded child care companies are faring. Discusses potential for growth in the industry, advantages of private placement, and recommended steps for going public. Describes nine publicly traded companies. (KB)

  12. 75 FR 17331 - Public Hearings for the Mandatory Reporting Rule for Greenhouse Gases

    Science.gov (United States)

    2010-04-06

    ... 2060-AP99, AP88, AQ00 Public Hearings for the Mandatory Reporting Rule for Greenhouse Gases AGENCY... two public hearings to be held for proposed rules related to mandatory reporting of greenhouse gases... Mandatory Reporting of Greenhouse Gases rule, published on October 30, 2009 by requiring reporting...

  13. Whole genome sequencing of M.tuberculosis in Kazakhstan: preliminary data

    Directory of Open Access Journals (Sweden)

    Ulykbek Kairov

    2014-03-01

    Full Text Available Background: Tuberculosis is a major public health problem which infects one third of the world’s population, resulting in more than two million deaths every year. The emergence of whole genome sequencing (WGS technologies as a primary research tool has allowed for the detection of genetic diversity in Mycobacterium tuberculosis (MTB with unprecedented resolution. WGS has been used to address a broad range of topics, including the dynamics of evolution, transmission, and treatment. To our knowledge, studies involving WGS of Kazakhstani strains of M. tuberculosis have not yet been performed. Aim: To perform whole genome sequencing of M. tuberculosis strains isolated in Kazakhstan and analyze sequence data (first experience and preliminary data. Results: In the present report, we announce the whole-genome sequences of the two clinical isolates of Mycobacterium tuberculosis, MTB-489 and MTB-476, isolated from the Almaty region. These strains were part of a repository that was created during our project “Creating prerequisites of personalized approach in the diagnosis and treatment of tuberculosis, based on whole genome-sequencing of M. tuberculosis”. Two strains were isolated from sputum samples of patients P1 and P2. Phenotypically, two isolates were drug-susceptible M. tuberculosis. Sequence data was compared with the publicly available data on M. tuberculosis laboratory strain H37Rv and others. The sequencing of the strains was performed on a Roche 454 GS FLX+ next-generation sequencing platform using a standard protocol for a shotgun genome library. The whole genome sequencing was performed for two M.tuberculosis isolates MTB-476 and MTB-489. 96 M bp with an average read length of 520 bp, approximately 21.8X coverage and 104.2 M bp with an average read length of 589 bp and approximately 23.7X coverage were generated for the MTB-476 and MTB-489, respectively. The genome of MTB-476 consists of 257 contigs, 4204 CDS, 46 tRNAs and 3 rRNAs. MTB

  14. Public reporting of clinical quality data: an update for cardiovascular specialists.

    Science.gov (United States)

    Dehmer, Gregory J; Drozda, Joseph P; Brindis, Ralph G; Masoudi, Frederick A; Rumsfeld, John S; Slattery, Lara E; Oetgen, William J

    2014-04-08

    Public reporting of hospital and individual provider quality of care measures is not a new concept. In the United States, the first national public reports of hospital mortality data occurred in 1986, and detailed physician-level data for cardiac surgery are now reported in 4 states. The development of the "Hospital Compare," and more recently, the "Physician Compare" websites has further expanded public reporting for hospitals and providers. Several professional organizations, including the American Medical Association, Society of Thoracic Surgeons, and the American College of Cardiology, have published policy statements articulating key principles to guide the public reporting process. Despite the rapid proliferation of public reporting efforts, more research is needed to better define meaningful measures to report and fully understand the impact of public reporting on healthcare delivery.

  15. 46 CFR 503.34 - Annual report of public information request activity.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Annual report of public information request activity... PUBLIC INFORMATION Requests for Records Under the Freedom of Information § 503.34 Annual report of public information request activity. (a) On or before February 1 of each year, the Commission shall submit to the...

  16. 5 CFR 2634.205 - Special waiver of public reporting requirements.

    Science.gov (United States)

    2010-01-01

    ... EXECUTIVE BRANCH FINANCIAL DISCLOSURE, QUALIFIED TRUSTS, AND CERTIFICATES OF DIVESTITURE Persons Required To File Public Financial Disclosure Reports § 2634.205 Special waiver of public reporting requirements. (a... interest; and (4) Public financial disclosure by the individual is not necessary under the...

  17. [Tampa Electric Company IGCC project]. Final public design report; Technical progress report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    This final Public Design Report (PDR) provides completed design information about Tampa Electric Company`s Polk Power Station Unit No. 1, which will demonstrate in a commercial 250 MW unit the operating parameters and benefits of the integration of oxygen-blown, entrained-flow coal gasification with advanced combined cycle technology. Pending development of technically and commercially viable sorbent for the Hot Gas Cleanup System, the HGCU also is demonstrated. The report is organized under the following sections: design basis description; plant descriptions; plant systems; project costs and schedule; heat and material balances; general arrangement drawings; equipment list; and miscellaneous drawings.

  18. [A clinical observation on urogenital tuberculosis].

    Science.gov (United States)

    Noguchi, S; Shuin, T; Kitajima, N; Ishizuka, E

    1986-05-01

    A clinical observation was made on 30 cases of urogenital tuberculosis diagnosed and treated at the urological department of our Hospital between January, 1976 and December, 1984. Furthermore, 20 of them were examined for drug resistance and investigated for this tendency. They accounted for 0.23% of the outpatients. Male to female ratio was 2 to 1, but on urological tuberculosis this ratio was even. The average age was 43.7 and 50% of the patients who had a history of tuberculosis. Mycobacterium tuberculosis could be detected in 24 of the 30 cases (80%) and 18 of the 21 cases (85.4%) of urological tuberculosis. Drug resistance was examined in 20 patients. The resistant ratio of M. tuberculosis against primary drugs such as SM, PAS, INAH was low and a high resistant ratio was observed on secondary drugs such as EB, RFP, TH. These clinical observations are reported and herein discussed.

  19. Primary disseminated extrapulmonary multidrug resistant tuberculosis

    Directory of Open Access Journals (Sweden)

    S K Das

    2012-01-01

    Full Text Available Disseminated tuberculosis is a common mode of presentation of tuberculosis in patients both with and without HIV/AIDS in India. However, primary multidrug resistance in disseminated tuberculosis involving only the extrapulmonary sites in an immunocompetent adult is rare. Here, we report a case of a 19-year-old man who had disseminated tuberculosis involving left pleura, pericardium, peritoneum and intraabdominal lymph nodes. He was initially taking WHO category I antituberculous drugs, but was not responding in spite of 5 months of chemotherapy. Culture of the pleural biopsy specimen grew Mycobacterium tuberculosis which was resistant to isoniazid and rifampicin. He was put on therapy for multidrug resistant tuberculosis,following 24 months of chemotherapyhe had an uneventful recovery.

  20. Evidence of probable tuberculosis in Lithuanian mummies.

    Science.gov (United States)

    Piombino-Mascali, D; Jankauskas, R; Tamošiūnas, A; Valančius, R; Gill-Frerking, H; Spigelman, M; Panzer, S

    2015-10-01

    Tuberculosis has affected Europe for millennia and continues to be a burden upon modern society. It is estimated that one-third of the world's population is infected with Mycobacterium tuberculosis, the causative agent of this condition. Despite the introduction of control strategies, the disease continues to be one of the most common causes of death globally. Within the framework of the Lithuanian Mummy Project, seven spontaneously mummified human bodies from a church crypt in Vilnius, dating from the 18th and 19th century, were CT-scanned to assess the presence of tuberculosis or other lung diseases. We encountered pulmonary lesions suggestive of cases of pulmonary tuberculosis. In addition, one case might have been affected by extra-pulmonary tuberculosis. This report replicates the image findings from previous studies on ancient mummies that provided evidence of tuberculosis in soft tissues, thus helping reconstruct the history of this disease over time.

  1. HIV and Tuberculosis (TB)

    Science.gov (United States)

    ... AIDS-Related Opportunistic Infections and Coinfections HIV and Tuberculosis (TB) (Last updated 9/1/2016; last reviewed ... depends on a person’s individual circumstances. What is tuberculosis? Tuberculosis (TB) is a contagious disease that can ...

  2. 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 ...

  3. Reasons for the low bacteriological coverage of tuberculosis reported in Mpumalanga Province, South Africa.

    Science.gov (United States)

    Mngomezulu, N; Cameron, D; Olorunju, S; Luthuli, T; Dunbar, R; Naidoo, P

    2015-06-21

    Contexte : Hôpitaux publics et centres de santé primaire de la province de Mpumalanga en Afrique du Sud.Objectif : Déterminer si le défaut de respecter les directives de diagnostic de la tuberculose (TB) (c'est-à-dire soumettre des crachats à la microscopie de frottis) a contribué à la faible couverture bactériologique rapportée en 2008.Méthodes : Nous avons revu les dossiers cliniques des nouveaux cas de TB pulmonaire dans 30 de 118 structures sélectionnées au hasard qui ont atteint la couverture bacteriologique visée de 80% et 30 de 87 structures qui ne l'ont pas atteinte. Les données des cas suivis dans les hôpitaux et les dispensaires ont été résumées sur des formulaires, saisies en informatique et comparées aux données du registre électronique de la TB (ETR). Nous avons évalué l'âge, le sexe, l'infection au virus de l'immunodéficience humaine (VIH) et le type de structure en tant que facteurs de confusion de l'enregistrement des frottis.Résultats : L'âge, le sexe et l'infection VIH n'ont pas influencé l'enregistrement des frottis. Dans les hôpitaux, 61,8% des cas de TB pulmonaire ont eu des résultats de frottis de crachats dans leurs dossiers cliniques comparés à 93,6% dans les dispensaires (P < 0,001). Sur les 711 cas (30,3%) qui n'avaient pas de résultats de frottis dans le ETR, 342 (48,1%) avaient des résultats de frottis dans leurs dossiers cliniques.Conclusion : La faible couverture bactériologique constatée est due à la fois à des pratiques cliniques médiocres (surtout dans les hôpitaux) et à une maintenance insuffisante des dossiers. Ces deux problèmes doivent être résolus afin d'améliorer la prise en charge des patients et la gestion du programme.

  4. A Rare Cause of Hypopituitarism: Pituitary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Şazi İmamoğlu

    2012-03-01

    Full Text Available Pituitary tuberculosis is a rare condition that can present with hypopituitarism even without any evidence of systemic tuberculosis and is easily confused with pituitary adenomas. Headache and hypopituitarism are the most common presenting symptoms. We report the case of pituitary tuberculosis in a 39-year-old male patient who presented with panhypopituitarism. Although it is rare and difficult to diagnose, pituitary tuberculosis should be considered in every nonfunctional sellar masses, especially in fairly small ones with unexpected hypopituitarism. Turk Jem 2012; 16: 26-8

  5. Mycobacterium Tuberculosis in Spinal Tuberculosis

    Science.gov (United States)

    Kim, Sung-Sim; Moon, Han-Lim; Kim, Dong-Hyeon

    2017-01-01

    Even in an era of remarkable medical advances, there is an issue of why tuberculosis remains in the list of disastrous diseases, afflicting humans and causing suffering. There has not been a plausible answer to this, and it has been suggested that clinicians and medical scientists could presently not win the war against the tubercle bacilli. With regards to this issue, based on the authors' own clinical and research experiences, in this review, the available literature was revisited in order to address the raised questions and to provide recent information on characteristics of tubercle bacilli and possible ways to more effectively treat tuberculosis. PMID:28243382

  6. Tuberculosis perinatal

    Directory of Open Access Journals (Sweden)

    Jessica Sáenz-Gómez

    2015-01-01

    Conclusiones: La infección perinatal debe sospecharse en niños con sepsis o neumonía sin respuesta a antibióticos. En este caso, el antecedente de la madre con tuberculosis orientó al diagnóstico.

  7. Cost effectiveness of high resolution computed tomography with interferon-gamma release assay for tuberculosis contact investigation

    Energy Technology Data Exchange (ETDEWEB)

    Kowada, Akiko, E-mail: kowadaa@gmail.com [Kojiya Haneda Healthcare Service, Ota City Public Health Office, Tokyo (Japan)

    2013-08-15

    Background: Tuberculosis contact investigation is one of the important public health strategies to control tuberculosis worldwide. Recently, high resolution computed tomography (HRCT) has been reported as a more accurate radiological method with higher sensitivity and specificity than chest X-ray (CXR) to detect active tuberculosis. In this study, we assessed the cost effectiveness of HRCT compared to CXR in combination with QuantiFERON{sup ®}-TB Gold In-Tube (QFT) or the tuberculin skin test (TST) for tuberculosis contact investigation. Methods: We constructed Markov models using a societal perspective on the lifetime horizon. The target population was a hypothetical cohort of immunocompetent 20-year-old contacts with smear-positive tuberculosis patients in developed countries. Six strategies; QFT followed by CXR, QFT followed by HRCT, TST followed by CXR, TST followed by HRCT, CXR alone and HRCT alone were modeled. All costs and clinical benefits were discounted at a fixed annual rate of 3%. Results: In the base-case analysis, QFT followed by HRCT strategy yielded the greatest benefit at the lowest cost ($US 6308.65; 27.56045 quality-adjusted life-years [QALYs])[year 2012 values]. Cost-effectiveness was sensitive to BCG vaccination rate. Conclusions: The QFT followed by HRCT strategy yielded the greatest benefits at the lowest cost. HRCT chest imaging, instead of CXR, is recommended as a cost effective addition to the evaluation and management of tuberculosis contacts in public health policy.

  8. Public Use Reports from Loess Bluffs National Wildlife Refuge 1994-1995

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Public use reports documenting visitor usage of the refuge for calendar year 1994 and calendar year 1995. Public use encompasses vehicle traffic, foot traffic,...

  9. 78 FR 15020 - Report on Carcinogens Webinar on Pentachlorophenol; Notice of Public Webinar and Registration...

    Science.gov (United States)

    2013-03-08

    ... HUMAN SERVICES National Institutes of Health Report on Carcinogens Webinar on Pentachlorophenol; Notice of Public Webinar and Registration Information SUMMARY: The National Toxicology Program (NTP) announces a public webinar, ``Human cancer studies on exposure to pentachlorophenol (PCP):...

  10. 77 FR 57566 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...

    Science.gov (United States)

    2012-09-18

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review and Request for Public Comment on Potential Approaches to Electronic Delivery of the CCR;...

  11. 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 detection...... of M. bovis and M. tuberculosis from specimens of lungs and pulmonary lymph nodes of four cattle died in an organized herd of 183 cattle in the state of Himachal Pradesh, India, with inconclusive skin test results. Identification and distinction of these closely related mycobacterial species was done...

  12. Primary tuberculosis of larynx in an immunocompetent host:a rare entity

    Institute of Scientific and Technical Information of China (English)

    Sameer Singhal

    2009-01-01

    Laryngeal Tuberculosis generally occurs in association with Pulmonary Tuberculosis and that too in an immuno-compromised host.Here,We are presenting a case report of an immunocompetent host,initially thought of suf-fering from Pulmonary Tuberculosis but was finally diagnosed a case of Primary Laryngeal Tuberculosis on serial investigations with review of literature.

  13. 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…

  14. 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.

  15. Oak Ridge Reservation Public Warning Siren System Annual Test Report

    Energy Technology Data Exchange (ETDEWEB)

    R. F. Gee

    2000-10-01

    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.

  16. Tuberculosis in the aftermath of the 2010 earthquake in Haiti.

    Science.gov (United States)

    Koenig, Serena P; Rouzier, Vanessa; Vilbrun, Stalz Charles; Morose, Willy; Collins, Sean E; Joseph, Patrice; Decome, Diessy; Ocheretina, Oksana; Galbaud, Stanislas; Hashiguchi, Lauren; Pierrot, Julma; Pape, Jean William

    2015-07-01

    In 2010, Haiti sustained a devastating earthquake that crippled the health-care infrastructure in the capital city, Port-au-Prince, and left 1.5 million people homeless. Subsequently, there was an increase in reported tuberculosis in the affected population. We conducted active tuberculosis case finding in a camp for internally displaced persons and a nearby slum. Community health workers screened for tuberculosis at the household level. People with persistent cough were referred to a physician. The National Tuberculosis Program continued its national tuberculosis reporting system. Even before the earthquake, Haiti had the highest tuberculosis incidence in the Americas. About half of the tuberculosis cases occur in the Port-au-Prince region. The number of reported tuberculosis cases in Haiti has increased after the earthquake, but data are too limited to determine if this is due to an increase in tuberculosis burden or to improved case detection. Compared to previous national estimates (230 per 100,000 population), undiagnosed tuberculosis was threefold higher in a camp for internally displaced persons (693 per 100,000) and fivefold higher in an urban slum (1165 per 100,000). With funding from the World Health Organization (WHO), active case finding is now being done systematically in slums and camps. Household-level screening for prolonged cough was effective in identifying patients with active tuberculosis in this study. Without accurate data, early detection of rising tuberculosis rates is challenging; data collection should be incorporated into pragmatic disease response programmes.

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

    Science.gov (United States)

    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 Jr, 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 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. PMID:26405286

  18. 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 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.

  19. 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.

  20. Multifoci Bone Tuberculosis and Lymphadenitis in Mediastinum Mimics Malignancy on FDG-PET/CT: A Case Report

    Directory of Open Access Journals (Sweden)

    Nalan Alan Selçuk

    2014-02-01

    Full Text Available Positron Emission Tomography with 2-deoxy-[F-18]-fluoro-D-glucose (FDG-PET has become a reliable diagnostic tool in clinical practice similar to Magnetic Resonance (MR imaging and Computed Tomography (CT. FDG-PET has especially been used to differentiate malignant from benign lesions, and for staging and follow- up malignant tumors. However, FDG-PET has some pitfalls in cancer screening and FDG tracer accumulates at sites of infection and inflammation. Bone tuberculosis may be confused with malignant tumors of bone and its metastases, and can accumulate focally increased FDG in active period. We present a 60-year-old woman with lytic bone lesions and mediastinal hypermetabolic foci, initially suspected to be malignant by means of FDG-PET and the other imaging modalities; however, bone biopsy confirmed the diagnosis of bone tuberculosis

  1. Psoriatic Disease and Tuberculosis Nowadays

    Directory of Open Access Journals (Sweden)

    Nicola Balato

    2012-01-01

    Full Text Available Psoriasis is a chronic, relapsing and remitting inflammatory skin and joint disease that has a prevalence of 2-3% in the world’s population, whereas of 1–2% in Europe. The traditional concept of psoriasis as the “healthy people’s” disease has been recently revised because of ever-increasing reports of associations with various pathological conditions (hypertension, Crohn’s disease, type II diabetes mellitus, obesity, dyslipidemia, metabolic syndrome, infectious conditions. Particularly, advances in psoriasis therapies have introduced biologic agents. All the tumor necrosis factor-alpha inhibitors are associated with an increased risk of developing active disease in patients with latent tuberculosis infection, because of TNF-α key role against Mycobacterium tuberculosis. For this reason, exclusion of active tuberculosis and treatment of latent tuberculosis infection are clinical imperatives prior to starting this therapy. Moreover active surveillance for a history of untreated or partially treated tuberculosis or latent form has already been shown to be effective in reducing the number of incident tuberculosis cases.

  2. Psoriatic disease and tuberculosis nowadays.

    Science.gov (United States)

    Balato, Nicola; Di Costanzo, Luisa; Ayala, Fabio; Balato, Anna; Sanduzzi, Alessandro; Bocchino, Marialuisa

    2012-01-01

    Psoriasis is a chronic, relapsing and remitting inflammatory skin and joint disease that has a prevalence of 2-3% in the world's population, whereas of 1-2% in Europe. The traditional concept of psoriasis as the "healthy people's" disease has been recently revised because of ever-increasing reports of associations with various pathological conditions (hypertension, Crohn's disease, type II diabetes mellitus, obesity, dyslipidemia, metabolic syndrome, infectious conditions). Particularly, advances in psoriasis therapies have introduced biologic agents. All the tumor necrosis factor-alpha inhibitors are associated with an increased risk of developing active disease in patients with latent tuberculosis infection, because of TNF-α key role against Mycobacterium tuberculosis. For this reason, exclusion of active tuberculosis and treatment of latent tuberculosis infection are clinical imperatives prior to starting this therapy. Moreover active surveillance for a history of untreated or partially treated tuberculosis or latent form has already been shown to be effective in reducing the number of incident tuberculosis cases.

  3. 77 FR 5471 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review

    Science.gov (United States)

    2012-02-03

    ... AGENCY 40 CFR Parts 141 and 142 Announcement of Public Meeting on the Consumer Confidence Report (CCR... Internet on February 23, 2012, to obtain stakeholder input on the Consumer Confidence Report (CCR) Rule as.... Background: Consumer Confidence Reports are a key part of the public's right-to-know as established in...

  4. Primary tuberculosis of the adenoids in an 11-year-old male presenting with hearing loss: a case report.

    Science.gov (United States)

    Taghipour-Zahir, S; Baradaranfar, M H; Zolfaghari, A A

    2013-04-01

    Hypertrophy of adenoids is usually caused by repeated throat infections, especially viral and bacterial infections, that in microscopic examination reveal reactive lymphoid follicular hyperplasia. Herein, we present an 11-year-old boy who developed hearing loss in his left ear three months before admission, and in direct examination the adenoids were hypertrophied. Histopathological study of the resected adenoid revealed caseating granulomatous inflammation. Based on histopathological and clinical findings, primary tuberculosis of adenoids was suggested which was confirmed by PCR.

  5. The challenge of managing extensively drug-resistant tuberculosis at a referral hospital in the state of São Paulo, Brazil: a report of three cases

    Science.gov (United States)

    Arbex, Marcos Abdo; de Siqueira, Hélio Ribeiro; D'Ambrosio, Lia; Migliori, Giovanni Battista

    2015-01-01

    ABSTRACT Here, we report the cases of three patients diagnosed with extensively drug-resistant tuberculosis and admitted to a referral hospital in the state of São Paulo, Brazil, showing the clinical and radiological evolution, as well as laboratory test results, over a one-year period. Treatment was based on the World Health Organization guidelines, with the inclusion of a new proposal for the use of a combination of antituberculosis drugs (imipenem and linezolid). In the cases studied, we show the challenge of creating an acceptable, effective treatment regimen including drugs that are more toxic, are more expensive, and are administered for longer periods. We also show that treatment costs are significantly higher for such patients, which could have an impact on health care systems, even after hospital discharge. We highlight the fact that in extreme cases, such as those reported here, hospitalization at a referral center seems to be the most effective strategy for providing appropriate treatment and increasing the chance of cure. In conclusion, health professionals and governments must make every effort to prevent cases of multidrug-resistant and extensively drug-resistant tuberculosis. PMID:26785966

  6. Concomitant cutaneous metastatic tuberculous abscesses and multifocal skeletal tuberculosis

    Directory of Open Access Journals (Sweden)

    Sezgin Betul

    2008-01-01

    Full Text Available Tuberculosis, one of the oldest diseases known to affect humans is caused by the bacteria mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one third of cases, other organs are involved. Metastatic tuberculosis abscess is a rare form of skin tuberculosis. It is characterized by nodule and abscess formation throughout the body after hematogenous spread of mycobacterium tuberculosis from a primary focus during a period of impaired immunity. Tuberculosis osteomyelitis is also a rare form of extrapulmonary tuberculosis in pediatric age group. Skeletal tuberculosis pathogenesis is related to reactivation of hematogenous foci or spread from adjacent paravertebral lymph nodes. Weight-bearing joints are affected most commonly. Bilateral hand and foot bone involvement is rarely reported. We present a five-year-old girl with two very rare presentations of the disease such as osteomyelitis and metastatic skin abscess.

  7. Report on an analysis of selected EIA publications

    Energy Technology Data Exchange (ETDEWEB)

    1980-10-01

    Results of a critical analysis of the EIA publication Electric Power Monthly (EPM) are presented. A general review of the publication, a review of the tables, and a review of the graphs are given. Each of these is divided into two areas: substantive review, which concentrates on the organization and comparability of the data; and the cosmetic review, which focuses on the graphic presentations of the data. Recommendations, the rationale behind each recommendation, and examples of improvements that can be made to the various parts of the publication are discussed. (MCW)

  8. 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.

  9. Analsysis of frequency of tuberculosis in smokers

    Directory of Open Access Journals (Sweden)

    Škodrić-Trifunović Vesna

    2013-01-01

    Full Text Available Introduction. Smoking and tuberculosis are among the most important problems of public health. Smoking and tuberculosis are responsible for 5 million and 2 million deaths per year, respectively, whereas smoking is responsible for half a million deaths in patients with tuberculosis. Discussion and Review of Literature. Nicotine is a significant suppressor of function of macrophages, dendritic cells and T-cells, which explains the immunosuppressive features of smoking that help develop the infection. Tobacco smoke contains many substances with immunomodulatory effects, including nicotine, carbon monoxide, acrolein, peroxynitrite and many others. The dominant immune and pathophysiological mechanism is the reduction of synthesis of tumor necrosis factor in lung macrophages, leading to increased susceptibility of persons who are exposed to tobacco smoke for developing active tuberculosis after infection and increased susceptibility to the development of other infections, such as infections of Gram-negative bacteria. Based on epidemiological studies and studies on this problem in the past 50 years, the World Health Organization has published the finding that smoking increases the risk of infection with M. tuberculosis, increases the risk of progression of infection to active disease and the risk of death. The prevalence of tuberculosis is higher in smokers and former smokers than in nonsmokers. The risk of tuberculosis depends on the number of cigarettes smoked and length of period the person has been a smoker. Passive smoking accelerates the development of active tuberculosis. in children who live with persons suffering from active tuberculosis, Conclusion. Given the multiple consequences of the association between smoking and tuberculosis, prevention of smoking may be an important measure in the control of tuberculosis. [Projekat Ministarstva nauke Republike Srbije, br. 175046 i br. 175081

  10. 肿瘤坏死因子-α拮抗剂引发结核二例分析并文献复习%Tuberculosis following tumor necrosis factor alpha antagonists therapy: two cases report and fiteratnere review

    Institute of Scientific and Technical Information of China (English)

    梁东风; 张江林; 黄烽

    2008-01-01

    Objective To improve clinicians' understanding of tuberculosis as the adverse event of the tumor necrosis factor alpha (TNF-α) antagonists therapy. Methods Two rheumatoid arthritis (RA) patients were reported to develop lymphoid tuberculosis and pulmonary tuberculoma after TNF-α antagonists therapy. The relevant literature were reviewed. Results The first ease was a 62 year-old female RA patient. Her skin PPD reaction was negative and chest X-ray was normal before the therapy. Following 4 doses of infliximab injection (each dose of 3 mg/kg) which were completed within 3 months, the patient developed fight supraclavicular lymphoids tuberculosis in the 5th month after the last treatment. The patient completely recovered after lymphoids excision and antituberculosis therapy with 4 anti-tuberculosis medications combination. The second case was a 44 year-old female RA patient. She did not take the skin PPD test and chest X-ray before the therapy. The patient developed fever and chest distress after etanercept therapy (25 mg hypodermic twice per week ) for 1.5 months. The chest X-ray showed a shadow in the median lobe of the right lung, which had gradually developed to a pulmonary tuberculoma. The patient's physical condition improved after the tubereuloma resection. It has been reported in recent years that ① TNF-α antagonists therapy could increase the incidence of tuberculosis, ② the incidence at which infliximab associated tuberculosis was higher than etanercept, ③ the majority of the patient having tuberculosis were old people, and ④ the incidence of extrapulmonary tuberculosis and the disseminated tuberculosis were higher than regular tuberculosis. Conclusion TNF-α antagonists may decrease the host defense ability against mycobacterium tuberculosis and increase the incidence of tuberculosis. The pre-treatment tuberculosis screening, as well as tuberculosis monitoring during and after treatment is mandatory.%目的 提高临床医生对肿瘤坏死因

  11. 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.

  12. Wilderness Study Report : Volume III : Public Hearing Transcripts

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document contains public hearing transcripts from the Kenai National Moose Range Wilderness Hearing. This hearing was held to obtain information relating to...

  13. Tuberculosis ocular

    OpenAIRE

    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...

  14. Prevalence of Mycobacterium tuberculosis in the samples referred to the tuberculosis research laboratory in Mashhad Ghaem Hospital during 2005-2006

    Directory of Open Access Journals (Sweden)

    Mohammad Derakhshan

    2009-12-01

    Full Text Available Background: Tuberculosis continues to be a serious public health problem causing nearly three million deaths per year all"nover the world. Despite major improvement in diagnosis, it is not possible to control the disease in the absence of surveillance"ntreatment, and follow-up programs."nObjectives: This research was designed to study the frequency of Mycobacterium tuberculosis among specimens referred to"nthe tuberculosis research laboratory in Qaem Hospital, Mashhad, North- East of Iran in 2005-2006."nMaterials and Methods: 3207 samples (1331 sputum, 1209 bronchial lavage, 69 ascitis aspirates, 52 urine samples, 30 CSF"nsamples, 25 joint aspirates and 15 wound secretions were cultured according to standard procedure and examined microscopically"nusing Ziehl Neelsen staining method."nResults: 536 samples (16.7% recognized as positive for Mycobacterium tuberculosis. (bronchial lavage 18.6%, sputum 17%,"ngastric lavage 13.3%, CSF 10%, ascitis aspirates 7.2%, wound 6.25%, pleural aspiration 4.5%. No Mycobacterium tuberculosis"nwas found in urine samples and joint aspirates."nConclusion: Considering reported prevalence of 13 cases per 100,000 in the Iranian population, these results are acceptable"nbut more preventive measures should be sought for controlling TB.

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

    Science.gov (United States)

    2016-01-01

    OBJECTIVES: This study examined job satisfaction, empowerment, job stress, and burnout among tuberculosis management nurses and physicians in public healthcare institutions. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. PMID:26971698

  16. Erythema induratum of Bazin and renal tuberculosis: report of an association Eritema indurado de Bazin e tuberculose renal: relato de uma associação

    Directory of Open Access Journals (Sweden)

    Elizabeth De Francesco Daher

    2004-10-01

    Full Text Available Erythema induratum of Bazin is a disease that usually affects women, in whom erythematous subcutaneous nodules and plaques appear on the posterior part of the lower extremities, some of which ulcerate. In many countries, tuberculosis is still the main etiologic factor. We report a case of a 40-year-old woman who presented a course of protracted and recurrent episodes over five years of cutaneous lesions on her legs. These tend to involute, but new crops appear at irregular intervals. It was painful, erythematous-violaceous nodules, some of which drained a reddish secretion. The histopathologic features of the lesions demonstrated inflammatory infiltration, with predominance of neutrophils in dermis and hypodermis, necrotizing vasculitis in the arterioles and septal fibrosis. There was no granuloma. The Ziehl-Neelsen stain did not revealed acid-fast bacilli, and the culture of biopsy specimen was negative. The tuberculin skin test was strongly positive (17 mm. The chest X-ray was normal. Few months later she presented adynamia and urinary complaints, such as polacyuria and dysuria. It has been done an urynalysis, which demonstrated acid pH urine, sterile pyuria and microscopic hematuria. It was then raised the diagnostic hypothesis of renal tuberculosis. The urine culture for M. tuberculosis was positive in two out of ten samples. The treatment was instituted with rifampin, isoniazid and pyrazinamide, with complete regression. This case illustrates a clear association between erythema induratum and renal tuberculosis, demonstrated by the remission of the cutaneous lesions after the treatment of the renal tuberculosis.O eritema indurado de Bazin é doença caracterizada por erupções cutâneas que usualmente ocorrem nos membros inferiores de mulheres adolescentes e de meia idade. Relatamos o caso de paciente de 40 anos que apresentava há 5 anos lesões cutâneas em região inferior de ambas as pernas. Tratavam-se de nódulos eritemato

  17. Unusual case of tuberculosis

    Directory of Open Access Journals (Sweden)

    Vatsal Bachkaniwala

    2015-12-01

    Full Text Available Though commonly encountered, extrapulmonary tuberculosis (TB can sometimes present with variable clinical picture intricating the diagnosis. The nonspecific symptoms include pyrexia of unknown origin, hepatosplenomegaly, lymphadenopathy, meningitis, and, rarely, variety of hematological abnormalities, namely, anemia, pancytopenia, and leukemoid reaction. When it presents with bone marrow (BM involvement, prognosis is usually poor. We, hereby, report a case of unusual TB presentation with a 4 month history of fever associated with fatigability, and diarrhea. During the hospital stay and follow up, the patient showed a spectrum of interesting hematological findings, including pancytopenia on peripheral smear, caseating granulomas consistent with TB on bone marrow examination. The patient showed a good clinical as well as hematological response to anti-tuberculosis treatment. This paper highlights the significance of a hematological picture in the final confirmation of TB, which may otherwise be passed off as nutritional or other unrelated causes. [Int J Res Med Sci 2015; 3(12.000: 3921-3923

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

    Directory of Open Access Journals (Sweden)

    Angelica Espinosa Miranda

    2009-04-01

    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.

  19. 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.

  20. Tuberculosis Information for International Travelers

    Science.gov (United States)

    ... the Facts Tuberculosis - The Connection between TB and HIV 12-Dose Regimen for Latent TB Infection-Patient Education Brochure Posters Mantoux Tuberculin Skin Test Wall Chart World TB Day Think TB Stop TB Reports & Articles Morbidity and Mortality Weekly Reports (MMWRs) DTBE Authored ...

  1. Tuberculosis (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Tuberculosis KidsHealth > For Parents > Tuberculosis A A A What's in this article? Signs ... When to You Call the Doctor en español Tuberculosis Tuberculosis (popularly known as "TB") is a disease ...

  2. Tuberculosis (For Parents)

    Science.gov (United States)

    ... Teaching Kids to Be Smart About Social Media Tuberculosis KidsHealth > For Parents > Tuberculosis Print A A A What's in this article? ... When to You Call the Doctor en español Tuberculosis Tuberculosis (popularly known as "TB") is a disease ...

  3. 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...

  4. 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.

  5. 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. PMID:25973117

  6. [A new case of pseudotumoral renal tuberculosis].

    Science.gov (United States)

    Sarf, I; Dahami, Z; Dakir, M; Aboutaeib, R; el Moussaoui, A; Joual, A; El Mrini, M; Meziane, F; Benjelloun, S

    2001-01-01

    The incidence of urogenital tuberculosis is still frequent and constitutes a current public health problem in Morocco, a country in which tuberculosis is endemic. The clinical presentation of this form of the disease may be misleading. The pseudotumoral type of renal tuberculosis is extremely uncommon, and in this study this disease has been described in a young patient. The radiological findings suggested the possibility of this lesion being renal cancer. The preliminary diagnosis was corrected and a definitive diagnosis of pseudotumor was made following pathological examination of the surgically-removed kidney.

  7. Tuberculosis: New Aspects of an Old Disease

    Directory of Open Access Journals (Sweden)

    Luisa Jordao

    2011-01-01

    Full Text Available Tuberculosis is an ancient infectious disease that remains a threat for public health around the world. Although the etiological agent as well as tuberculosis pathogenesis is well known, the molecular mechanisms underlying the host defense to the bacilli remain elusive. In this paper we focus on the innate immunity of this disease reviewing well-established and consensual mechanisms like Mycobacterium tuberculosis interference with phagosome maturation, less consensual mechanism like nitric oxide production, and new mechanisms, such as mycobacteria translocation to the cytosol, autophagy, and apoptosis/necrosis proposed mainly during the last decade.

  8. 75 FR 52355 - Draft National Conversation on Public Health and Chemical Exposures Work Group Reports...

    Science.gov (United States)

    2010-08-25

    ... Prevention Draft National Conversation on Public Health and Chemical Exposures Work Group Reports... exposures. This notice announces the availability of draft National Conversation work group reports for... National Conversation Leadership Council and facilitating the work group process. DATES: Draft work...

  9. Analysis of 30 patients with acupuncture-induced primary inoculation tuberculosis.

    Science.gov (United States)

    Liu, Yangbo; Pan, Jingye; Jin, Keke; Liu, Cailong; Wang, Jing; Chen, Li; Chen, Lei; Yuan, Jiandong

    2014-01-01

    Primary inoculation tuberculosis is a skin condition that develops at the site of inoculation of Mycobacterium tuberculosis in tuberculosis-free individuals. This report describes the diagnosis, treatment and >1 year follow-up of 30 patients presenting with acupuncture-induced primary inoculation tuberculosis. Our data provide a deeper insight into this rare route of infection of tuberculosis. We also review effective treatment options.

  10. 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…

  11. 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.

  12. Concomittant pulmonary tuberculosis and borderline leprosy with type-II lepra reaction in single patient.

    Science.gov (United States)

    Prasad, Rajendra; Verma, Sanjay Kumar; Singh, Rajni; Hosmane, Giridhar

    2010-01-01

    The concommitant occurrence of both tuberculosis and leprosy in a single individual are not an uncommon clinical condition but is being reported infrequently in literature. We report a case of leprosy, diagnosed previously and also diagnosed as pulmonary tuberculosis.

  13. A review of tuberculosis prevention, diagnosis and treatment system in the Democratic People's Republic of Korea (DPRK).

    Science.gov (United States)

    Linton, John A; Tan, Bernard; Casey, Michael

    2008-10-01

    This paper describes the current prevalence of tuberculosis and its management in the Democratic People's Republic of Korea. A review of technical reports of NGOs' experience working in North Korea with Democratic People's Republic of Korea officials, tuberculosis healthcare personnel and tuberculosis patients. Site visits, observations and experiences are also included. Until 2001, the Democratic People's Republic of Korea, was predominately isolated with an unknown healthcare system but has since allowed NGOs, WHO and international agencies to rehabilitate the healthcare infrastructure involving 200 people's Country Hospitals, 13 Prophylactic Hospitals, 62 Sanitariums and 4 Special Hospitals. The mid 1990s witnessed a resurgence of tuberculosis in North Korea with 100,000 new cases reported yearly. Preliminary analysis revealed that poverty, neglect, lack of resources and isolation resulted in the overall deterioration of public health services. Present estimates suggest a prevalence of 220 per 100,000 with 45,000 new cases. Tuberculosis is a major public health problem in North Korea that will require increased efforts by the national government and international agencies to control

  14. Tuberculosis ganglionar cervical simulando una enfermedad de Kikuchi: Reporte de un caso y revisión de la literatura

    OpenAIRE

    Valoyes G,Lisbeth; García D,Iván; Muntané S,Amadeo; Mora M,Paloma; Aja R,Lucía

    2014-01-01

    La linfadenitis cervical tuberculosa es la manifestación más común de tuberculosis en cabeza y cuello. La enfermedad de Kikuchi es una enfermedad rara que consiste en una linfadenitis necrotizante histocitiaria. La presentación clínica en ambas entidades suele consistir en una o más masas cervicales dolorosas, que pueden ser duras o fluctuantes. Los hallazgos por imagen no permiten distinguir de manera absoluta la linfadenitis tuberculosa de la enfermedad de Kikuchi. Por lo tanto es imprescin...

  15. Renal Tuberculosis in the Modern Era

    OpenAIRE

    De Francesco Daher, Elizabeth; Bezerra da Silva Junior, Geraldo; Barros, Elvino José Guardão

    2013-01-01

    Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. The disease remains as an important public health problem in developing countries. Extrapulmonary TB became more common with the advent of infection with human immunodeficiency virus and by the increase in the number of organ transplantation, which also leads to immunosuppression of thousand of persons. Urogenital TB represents 27% of extrapulmonary cases. Renal involvement in TB can be part of a disseminated infection or a ...

  16. 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.

  17. 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.

  18. Tuberculosis of the chest

    Energy Technology Data Exchange (ETDEWEB)

    Curvo-Semedo, Luis [Department of Radiology, Hospitais da Universidade de Coimbra, Praceta Mota Pinto/Avenida Bissaya Barreto, 3000-075 Coimbra (Portugal)]. E-mail: curvosemedo@gmail.com; Teixeira, Luisa [Department of Radiology, Hospitais da Universidade de Coimbra, Praceta Mota Pinto/Avenida Bissaya Barreto, 3000-075 Coimbra (Portugal); Caseiro-Alves, Filipe [Department of Radiology, Hospitais da Universidade de Coimbra, Praceta Mota Pinto/Avenida Bissaya Barreto, 3000-075 Coimbra (Portugal)

    2005-08-01

    The relationship between tuberculosis and mankind has been known for many centuries, with the disease being one of the major causes of illness and death. During the early 1980s, there was a widespread belief that the disease was being controlled, but by the mid-1980s, the number of cases increased. This change in the epidemiological picture has several causes, of which the AIDS epidemic, the progression of poverty in developing countries, the increase in the number of elderly people with an altered immune status and the emergence of multidrug-resistant tuberculosis are the most important. Mainly due to this epidemiological change, the radiological patterns of the disease are also being altered, with the classical distinction between primary and postprimary disease fading and atypical presentations in groups with an altered immune response being increasingly reported. Therefore, the radiologist must be able not only to recognize the classical features of primary and postprimary tuberculosis but also to be familiar with the atypical patterns found in immuno-compromised and elderly patients, since an early diagnosis is generally associated with a greater therapeutic efficacy. Radiologists are, in this way, presented with a new challenge at the beginning of this millennium.

  19. 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…

  20. Implementing rapid testing for tuberculosis in Mozambique.

    Science.gov (United States)

    Cowan, James; Michel, Cathy; Manhiça, Ivan; Monivo, Claudio; Saize, Desiderio; Creswell, Jacob; Gloyd, Stephen; Micek, Mark

    2015-02-01

    In Mozambique, pulmonary tuberculosis is primarily diagnosed with sputum smear microscopy. However this method has low sensitivity, especially in people infected with human immunodeficiency virus (HIV). Patients are seldom tested for drug-resistant tuberculosis. The national tuberculosis programme and Health Alliance International introduced rapid testing of smear-negative sputum samples. Samples were tested using a polymerase-chain-reaction-based assay that detects Mycobacterium tuberculosis deoxyribonucleic acid and a mutation indicating rifampicin resistance; Xpert® MTB/RIF (Xpert®). Four machines were deployed in four public hospitals along with a sputum transportation system to transfer samples from selected health centres. Laboratory technicians were trained to operate the machines and clinicians taught to interpret the results. In 2012, Mozambique had an estimated 140,000 new tuberculosis cases, only 34% of which were diagnosed and treated. Of tuberculosis patients, 58% are HIV-infected. From 2012-2013, 1558 people were newly diagnosed with tuberculosis using sputum smears at intervention sites. Xpert® detected M. tuberculosis in an additional 1081 sputum smear-negative individuals, an increase of 69%. Rifampicin resistance was detected in 58/1081 (5%) of the samples. However, treatment was started in only 82% of patients diagnosed by microscopy and 67% of patients diagnosed with the rapid test. Twelve of 16 Xpert® modules failed calibration within 15 months of implementation. Using rapid tests to diagnose tuberculosis is promising but logistically challenging. More affordable and durable platforms are needed. All patients diagnosed with tuberculosis need to start and complete treatment, including those who have drug resistant strains.

  1. [Prevalence of latent infection of mycobacterium tuberculosis among healthcare students in a public university in Vitória, state of Espírito Santo, Brazil].

    Science.gov (United States)

    Rogerio, Wesley Pereira; Baraona, Catarina Maria Oliveira; do Prado, Thiago Nascimento; Lacerda, Thamy Carvalho; Carlesso, Geisa Fregona; Maciel, Ethel Leonor Noia

    2013-05-01

    This article seeks to determine the prevalence of Mycobacterium tuberculosis infection in medical and nursing students of the Federal University of Espirito Santo (UFES) This is a cross-sectional study in which data were collected through a questionnaire assessing personal characteristics, information about tuberculosis, use of preventive measures, etc. This was followed by the application of the tuberculin skin test, with readings after 72 hours by trained nurses, the positive cutoff point for the TST being 10 mm of induration in the 72-hour reading. Participants in the study included 225 volunteers, namely 98 Medical students and 127 Nursing students. A positive tuberculin skin test was found in 54 students of both courses, resulting in a prevalence of 24%. Among Nursing Students the result of a positive TST was obtained in 24% and in 23%, of Medical Students, such that this difference was not statistically significant. It is necessary to carry out a routine program of tuberculin testing, for confirmation, combined with interventions to reduce the risk of nosocomial transmission in the workplace, as well as further studies to evaluate the effectiveness of new tests to detect latent tuberculosis infection.

  2. Evaluation of polymerase chain reaction in space-occupying lesions of liver reported as granulomatous inflammation/tuberculosis on fine-needle aspiration cytology

    Science.gov (United States)

    Sharma, Kusum; Gupta, Nalini; Goyal, Kapil; Duseja, Ajay Kumar; Sharma, Aman; Rajwanshi, Arvind

    2017-01-01

    Background: Tubercular involvement of the liver is uncommon, but is a serious consideration in differential diagnosis of granulomatous conditions, especially in endemic regions like India. Objective: To assess the role of polymerase chain reaction (PCR) done on archival cytological material in diagnosing tuberculosis (TB) in cases reported as granulomatous inflammation/TB in liver lesions. Materials and Methods: This was a retrospective study including a total of 17 cases of liver space-occupying lesions (SOLs) reported as granulomatous inflammation (n = 12) and TB (n = 5). The smears were retrieved from the archives of the department and were reviewed for the cytomorphologic features. Air-dried smears stained with May–Grünwald–Giemsa (MGG) stain were assessed for the representative material in the form of epithelioid granulomas and giant cells. One/two MGG smears from each case were destained and the material was used for performing PCR for Mycobacterium tuberculosis by amplification of 123 bp fragment of the IS6110 insertion element. Results: The age of the patients ranged from 3 to 61 years. There were 12 females and 5 males. The patients presented with solitary/multiple liver SOLs. DNA could be extracted from 10/17 cases from archival MGG smears. PCR positivity was noted in 8/10 cases (including four acid-fast bacilli smear-positive cases), confirming a diagnosis of TB. Conclusion: Cytomorphology alone may not be sufficient for differentiating various granulomatous lesions reported in liver SOLs. DNA can be extracted from the archival cytological MGG-stained smears. PCR should be carried out if Ziehl–Neelsen staining is negative in granulomatous lesions, especially when material has not been submitted for culture. PMID:28217140

  3. Evaluation of polymerase chain reaction in space-occupying lesions of liver reported as granulomatous inflammation/tuberculosis on fine-needle aspiration cytology.

    Science.gov (United States)

    Sharma, Kusum; Gupta, Nalini; Goyal, Kapil; Duseja, Ajay Kumar; Sharma, Aman; Rajwanshi, Arvind

    2017-01-01

    Tubercular involvement of the liver is uncommon, but is a serious consideration in differential diagnosis of granulomatous conditions, especially in endemic regions like India. To assess the role of polymerase chain reaction (PCR) done on archival cytological material in diagnosing tuberculosis (TB) in cases reported as granulomatous inflammation/TB in liver lesions. This was a retrospective study including a total of 17 cases of liver space-occupying lesions (SOLs) reported as granulomatous inflammation (n = 12) and TB (n = 5). The smears were retrieved from the archives of the department and were reviewed for the cytomorphologic features. Air-dried smears stained with May-Grünwald-Giemsa (MGG) stain were assessed for the representative material in the form of epithelioid granulomas and giant cells. One/two MGG smears from each case were destained and the material was used for performing PCR for Mycobacterium tuberculosis by amplification of 123 bp fragment of the IS6110 insertion element. The age of the patients ranged from 3 to 61 years. There were 12 females and 5 males. The patients presented with solitary/multiple liver SOLs. DNA could be extracted from 10/17 cases from archival MGG smears. PCR positivity was noted in 8/10 cases (including four acid-fast bacilli smear-positive cases), confirming a diagnosis of TB. Cytomorphology alone may not be sufficient for differentiating various granulomatous lesions reported in liver SOLs. DNA can be extracted from the archival cytological MGG-stained smears. PCR should be carried out if Ziehl-Neelsen staining is negative in granulomatous lesions, especially when material has not been submitted for culture.

  4. 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.

  5. Crystal River National Wildlife Refuge public use survey report

    OpenAIRE

    Buckingham, Cheryl A.

    1989-01-01

    In creating a management plan that includes both the needs of the manatee and the desires of the public, the Crystal River National Wildlife Refuge must necessarily gather together a great deal of information. This project was intended to find out more about the people who use Kings Bay, to discaver what they know about the manatee and to d i i e r how well they understand the protection measures as they exist today (Document has 104 pages.)

  6. 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

    2015-06-05

    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.

  7. 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

  8. Practitioner fraud and abuse: a public policy status report.

    Science.gov (United States)

    Tulli, C G

    1987-01-01

    In summary, a public policy to get rid of practitioner fraud and abuse has been established. It resulted initially from the changing attitude of the electorate on spending for social as well as health service programs. It is reflected by the congressional enactment of new laws against practitioner fraud and abuse, i.e., the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977 and the Civil Money Penalties Law of 1981. It has been implemented through the prosecution of numerous practitioners involved in fraudulent activities and abuses using the new laws as well as many others, including the False Claims Act of 1963 and the fraud penalties codes recognized under the Federal Old Age, Survivors and Disability Insurance Act. The ultimate success of this public policy, however, will certainly depend, at least in part, on our ability to obtain an objective and realistic analysis of the degree of fraud and abuse in these programs, as well as to define the characteristics of "Medical Mills" and to determine to what extent they still exist. Finally, if this public policy is to mature, it must follow a path that assures that we do not disrupt or hamper the delivery of health care services to our poor and elderly populations through the needless introduction of regulatory requirements or legal excesses.

  9. 孤立性胰腺结核国内文献的荟萃分析%Solitary pancreatic tuberculosis: A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    李俊霞; 王化虹; 尹洪芳; 刘新光

    2012-01-01

    tuberculosis. METHODS: A case of solitary pancreatic tuberculosis was reported. In addition, 48 similar cases in published Chinese literature were identified to conduct a literature review. The data were identified by searching CNKI and CBM databases and browsing the relevant reference lists. The keywords were "pancreatic tuberculosis" and "tuberculosis and pancreas". The clinical manifestations were analyzed by descriptive methods. Criteria for the diagnosis of solitary pancreatic tuberculosis were: all lesions localized only in the pancreas and neighboring tissues, no other detectable foci of tuberculosis, no history of tuberculosis, having a clear chest radiograph, and a positive histological diagnosis. RESULTS: Predominant symptoms consisted of abdominal pain (63.27%), weight loss (59.18%), fever (36.73%), jaundice (34.69%), and abdominal distention/bloating, without night sweats. Most patients were misdiagnosed with pancreatic tumors, and other misdiagnoses were pseudo-pancreatic cysts, chronic cholecystitis with pancreatitis, and cholecystic tumors. Erythrocyte sedimentation rate was elevated in 85.71% (12/14) of cases; PPD test was strongly positive in 55.56% (5/9); and CA19-9 was mildly elevated in 25% (2/8). CT scans showed a pancreatic mass (31/41) with heterogeneous hy-podensity focus (9/41), calcification (6/41), or peripancreatic nodal enlargement (14/41). Ultrasound or CT-guided biopsies were performed in 8.16% (4/49) of cases, including one undergoing EUS-guided fine needle aspiration for cytologic diagnosis. Laparotomy was performed in 45 of 49 cases, and most received combined antituber-culosis therapy. Anti-tuberculosis therapy was successful in 42 of 49 cases. CONCLUSION: Solitary pancreatic tuberculosis is a rare condition with no specific clinical manifestations. The possibility of solitary pancreatic tuberculosis should be considered in patients presenting with a pancreatic mass and irregular pancreas enlargement. Diagnosis should be made cytologically

  10. 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.

  11. User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine.

    Science.gov (United States)

    Konduri, Niranjan; Sawyer, Kelly; Nizova, Nataliya

    2017-04-01

    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.

  12. 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.

  13. [Hemophagocytic syndrome secondary to cavitary pulmonary tuberculosis].

    Science.gov (United States)

    Rakotoson, J L; Rakotonirainy, O H; Moroyandsa, F; Rakotoharivelo, H; Rakotomizao, J R; Andrianarisoa, A C F

    2012-01-01

    Hemophagocytic syndrome is due to the activation and nonmalignant proliferation of macrophages and T lymphocytes. The purpose of this report is to describe a 25-year-old man who presented with fever, coughing, and weight loss over the past month. Laboratory findings demonstrated pancytopenia, hyperferritinemia, and cytolysis. The myelogram showed a hemophagocytic syndrome, and tuberculosis bacilli were found in the sputum. Chest radiography and thoracic computed tomography depicted a cavitary lesion suggestive of pulmonary tuberculosis. Treatment of tuberculosis alone, without an immunosuppressant agent, was effective and led to improvement. In a country where tuberculosis is highly endemic, hemophagocytic syndrome should be considered in the differential diagnosis of patients with active tuberculosis complicated by pancytopenia.

  14. Miliary tuberculosis in an Indian lady: Looking beyond miliary tuberculosis

    Directory of Open Access Journals (Sweden)

    Arjun Lakshman

    2015-01-01

    Full Text Available Presence of miliary shadows in chest imaging in the appropriate clinical setting is often taken as a marker of miliary tuberculosis. If sputum is negative for acid -fast bacillus, empirical anti-tubercular therapy is given without securing a histological or microbiological diagnosis. We report a young female with human immunodeficiency virus infection who had miliary infiltrates on chest radiography. She was started on empirical anti-tubercular therapy. But an alternate diagnosis was achieved later with invasive sampling and ATT was stopped. This case illustrates the need for physicians to remain alert to diseases which mimic tuberculosis in presentation.

  15. Cumulative Reports and Publications through December 31, 1992

    Science.gov (United States)

    1993-04-01

    tip body and time hysteresis camping. ICASE Report No. 89-22, April 18, 1989. 24 pages. Matematica Aplicada e Computacional , Vol. 8, No. 2, pp. 101-118...distributed parameter systems. ICASE Report No. 85-58, November 22, 1985, 102 pages. Mathematica Applicada e Computacional , Vol. 5, No. 3, 1987, pp. 203-248

  16. 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

    2016-01-01

    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.

  17. Ovarian tuberculosis mimicking a malignant tumour

    Directory of Open Access Journals (Sweden)

    Eric Yebouet

    2015-01-01

    Full Text Available There has been reported increased incidence of ovarian tuberculosis in the tropics since the advent of HIV/AIDS disease. We report a case of bilateral ovarian tuberculosis associated with a single right kidney of uncertain origin in an immunocompetent 15-year-old generally healthy-looking girl. Abdominopelvic scan was equivocal about the diagnosis of the lesion as it failed to differentiate it from malignancy. Tuberculin and histopathology were necessary to confirm the diagnosis of ovarian tuberculosis. Antituberculous medical therapy successfully resolved the disease.

  18. Cost-effectiveness of using Quantiferon Gold (QFT-G)® versus tuberculin skin test (TST) among U.S. and foreign born populations at a public health department clinic with a low prevalence of tuberculosis.

    Science.gov (United States)

    Iqbal, Ayesha Z; Leighton, Jenelle; Anthony, John; Knaup, Richard C; Peters, Eleanor B; Bailey, Thomas C

    2014-01-01

    The purpose of this study was to determine the cost benefit to routinely using QFT-G versus the standard TST for screening U.S. and foreign born populations at a public health department clinic with a low prevalence of tuberculosis. A comparative cost analysis of the monetization between QFT-G and TST was conducted: Data from the health department's Chest Clinic patients seen in 2007 were used to model cost predictions. The net costs of screening, x-rays, the standard 9 months of latent tuberculosis infection treatment, laboratory, and administration for U.S. born patients and foreign born patients were investigated. There are no apparent cost savings for U.S. born individuals, but due to the higher specificity of QFT-G for foreign born BCG-vaccinated individuals, there are unnecessary expenditures associated with the higher number of false positives incurred when using TST compared with QFT-G on 1,000 foreign born individuals (69%, 18%). QFT-G is cost-effective and should be used at local health department clinics that want to achieve savings in screening and treating those suspected of having TB infection, especially for high-risk populations such as foreign born individuals. © 2013 Wiley Periodicals, Inc.

  19. Intensified tuberculosis case finding, implementation of isoniazid preventive therapy and associated factors among people living with human immunodeficiency virus at public health facilities of Harari Region, Eastern Ethiopia: A cross-sectional study

    Science.gov (United States)

    Geleto, Ayele; Abate, Degu; Egata, Gudina

    2017-01-01

    Objective: Globally, the number of people living with human immunodeficiency virus (PLHIV) particularly in sub-Saharan Africa is growing. This has been resulted in increased number of tuberculosis (TB) new cases. To control burden of TB among PLHIV, a number of collaborative TB/HIV activities were recommended. However, data about collaborative TB/HIV services in the study area is scarce. The objective of this study is to assess intensified TB case finding, implementation of isoniazid preventive therapy (IPT) and associated factors among PLHIV. Methods: A facility based cross-sectional study design was employed among 419 randomly selected PLHIV from public health facilities of Harari region. Systematic sampling method was used to obtain sample from each health facilities. Interviewer-administered questionnaire was used to collect data. Data were entered into EpiData and analyzed by SPSS statistical software. Multivariate logistic regression analysis was conducted to determine the presence of association between variables using odds ratio with 95% confidence interval and association was declared significant at P ≤ 0.05. Results: One hundred fifteen (75.2%) of the respondents reported that they offered screening for TB during their HIV chronic cares and 94 (29.8%) of them were found to be positive for active TB. Female sex [AOR 2.51; 95%CI (1.52, 6.14)], educated patients [AOR 0.52; 95%CI (0.21, 0.83)], CD4 count greater than 350 cells/dl3 [AOR 0.62; 95%CI(0.22,0.82)], Antiretroviral Therapy (ART) initiation [AOR 0.50; 95%CI (0.35, 0.88)] and missing dose of ART [AOR 2.57; 95%CI (1.21, 5.32)] were significantly associated with TB infection. Nearly four-fifth (78.7 %) of the study participants were provided IPT. Conclusions: Screening of TB among PLHIV and implementation of IPT in the region is lower when compared to the findings of other studies conducted in different parts of the country and needs to be improved through implementation of national and international

  20. Posterior scleritis associated with systemic tuberculosis

    Directory of Open Access Journals (Sweden)

    Gupta Amit

    2003-01-01

    Full Text Available Infective isolated posterior scleritis is rare. We report a case of isolated posterior scleritis associated with histopathologically documented systemic tuberculosis, a hitherto unreported association. The patient responded well to a combination of oral corticosteroids with antituberculosis therapy.

  1. 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...

  2. Cumulative Reports and Publications through December 31, 1990.

    Science.gov (United States)

    1991-02-01

    in MatemaLica Aplicada e Computacional . Hall, Philip and Yibin Fu: On the Ghrtler vortex instability in :chanism at hypersonic speeds. ICASE Report...Report No. 85-58, November 22, 1985, 102 pages. Mathematica Applicada e Computacional , Vol. 5, No. 3, 1987, pp. 203-248. Revised under the title...June 20, 1984, 42 pages. Matematica Aplicada Computacional , Vol. 4, No. 2, 1985, pp. 95-124. Rosen, I. G.: A numerical scheme for the identification

  3. Role of Mycobacterium tuberculosis pknD in the Pathogenesis of central nervous system tuberculosis

    Directory of Open Access Journals (Sweden)

    Be Nicholas A

    2012-01-01

    Full Text Available Abstract Background Central nervous system disease is the most serious form of tuberculosis, and is associated with high mortality and severe neurological sequelae. Though recent clinical reports suggest an association of distinct Mycobacterium tuberculosis strains with central nervous system disease, the microbial virulence factors required have not been described previously. Results We screened 398 unique M. tuberculosis mutants in guinea pigs to identify genes required for central nervous system tuberculosis. We found M. tuberculosis pknD (Rv0931c to be required for central nervous system disease. These findings were central nervous system tissue-specific and were not observed in lung tissues. We demonstrated that pknD is required for invasion of brain endothelia (primary components of the blood-brain barrier protecting the central nervous system, but not macrophages, lung epithelia, or other endothelia. M. tuberculosis pknD encodes a "eukaryotic-like" serine-threonine protein kinase, with a predicted intracellular kinase and an extracellular (sensor domain. Using confocal microscopy and flow cytometry we demonstrated that the M. tuberculosis PknD sensor is sufficient to trigger invasion of brain endothelia, a process which was neutralized by specific antiserum. Conclusions Our findings demonstrate a novel in vivo role for M. tuberculosis pknD and represent an important mechanism for bacterial invasion and virulence in central nervous system tuberculosis, a devastating and understudied disease primarily affecting young children.

  4. [Pseudotumor form of urinary tuberculosis].

    Science.gov (United States)

    Rabii, Redouane; Moufid, Kamal; Joual, Abdenbi; Maani, Ahmed; Bennani, Saad; el Mrini, Mohamed

    2002-12-01

    Urogenital tuberculosis is an increasingly frequent serious disease. The diagnosis is often delayed due to the marked clinical polymorphism, leading to serious sequelae. The diagnosis of typical forms is easy, but some forms are misleading and can lead to an incorrect diagnosis. The authors report a pseudoneoplastic form of urogenital tuberculosis in a young patient that was initially diagnosed as lymphoma. In the light of this case and a review of the literature, the authors emphasize the diagnostic difficulties of these forms and the treatment modalities.

  5. Disseminated Tuberculosis Mimicking Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Valérie Huyge

    2011-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disorder affecting mainly the axial skeleton. Here we report a case of a man with a clinical suspicion of ankylosing spondylitis but with a persistence of increased inflammatory markers. In this case, 18F-FDG-PET/CT revealed multiple hypermetabolic lesions in axial skeleton, lymph nodes, and the lung, suggestive of either disseminated tuberculosis or lymphoma. Histological analysis of the pulmonary lesion revealed mycobacterium tuberculosis. This case highlights, firstly, the importance of excluding other diagnoses in the presence of clinical picture of ankylosing spondylitis and high inflammatory markers and, secondly, the determining role of PET/CT.

  6. TB SCENARIO & PUBLIC HEALTH

    Directory of Open Access Journals (Sweden)

    Mihir K. R.

    2013-04-01

    Full Text Available Tuberculosis is a major public health problem world o ver and it is India’s worst scourge. In the words of Charles Dickens “it is the disease medicine never cured, wealth warded off, or poverty could boast exemption from.... Which sometimes moves in giant strides & sometimes at tardy sluggish pace, but slow or quick... is never sur e and certain”. India bears 28.4% of the entire world’s burden of Tuberculosis. Every year 2 2 lakh persons contract Tuberculosis, but only half of them seek medical care. One Indian die s of Tuberculosis every 3 minutes! Tuberculosis is not only a medical malady but an ec onomic disaster too it perpetuates poverty and poverty begets Tuberculosis. In view of the enor mity of the problem let us leaf through the pages of history

  7. 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.

  8. Global control of tuberculosis: from extensively drug-resistant to untreatable tuberculosis

    Science.gov (United States)

    Dheda, Keertan; Gumbo, Tawanda; Gandhi, Neel R; Murray, Megan; Theron, Grant; Udwadia, Zarir; Migliori, G B; Warren, Robin

    2017-01-01

    Extensively drug-resistant tuberculosis is a burgeoning global health crisis mainly affecting economically active young adults, and has high mortality irrespective of HIV status. In some countries such as South Africa, drug-resistant tuberculosis represents less than 3% of all cases but consumes more than a third of the total national budget for tuberculosis, which is unsustainable and threatens to destabilise national tuberculosis programmes. However, concern about drug-resistant tuberculosis has been eclipsed by that of totally and extremely drug-resistant tuberculosis—ie, resistance to all or nearly all conventional first-line and second-line antituberculosis drugs. In this Review, we discuss the epidemiology, pathogenesis, diagnosis, management, implications for health-care workers, and ethical and medicolegal aspects of extensively drug-resistant tuberculosis and other resistant strains. Finally, we discuss the emerging problem of functionally untreatable tuberculosis, and the issues and challenges that it poses to public health and clinical practice. The emergence and growth of highly resistant strains of tuberculosis make the development of new drugs and rapid diagnostics for tuberculosis—and increased funding to strengthen global control efforts, research, and advocacy—even more pressing. PMID:24717628

  9. Drug susceptibility patterns of the Mycobacterium tuberculosis isolated from previously treated and new cases of pulmonary tuberculosis at German-Nepal tuberculosis project laboratory, Kathmandu, Nepal

    Directory of Open Access Journals (Sweden)

    Gobinda Thapa

    2016-08-01

    Full Text Available Abstract Background Multidrug resistant tuberculosis (MDR-TB is a serious public health problem in Nepal. It is a major obstacle for the control of the tuberculosis. The main objectives of this study were to determine the prevalence of the multidrug resistant pulmonary tuberculosis and to evaluate the drug susceptibility patterns of Mycobacterium tuberculosis isolated from previously treated and newly diagnosed cases of pulmonary tuberculosis. Methods A cross-sectional study was conducted from March 2013 to August 2013 at German-Nepal tuberculosis project (GENETUP laboratory, Kathmandu, Nepal. For this the sputum samples from total of 153 (49 new and 104 previously treated suspected pulmonary tuberculosis patients were used. The diagnosis of the tuberculosis was performed by using fluorescent microscopy and culture, while the drug susceptibility testing of Mycobacterium tuberculosis was performed by proportion method. Lowenstein-Jensen (L-J medium was used for the culture of Mycobacterium tuberculosis and the colonies grown were identified on the basis of the colony morphology, pigment production and biochemical characteristics. Results The prevalence of MDR-TB among all the cases of culture positive pulmonary tuberculosis was 15.6 %. The rate of MDR-TB among previously treated culture positive tuberculosis patients was 19.4 % and that among newly diagnosed culture positive pulmonary tuberculosis cases was 7.1 %. The highest rate of resistance of Mycobacterium tuberculosis, was toward streptomycin (24.4 % followed by isoniazid (23 %, rifampicin (17.8 % and ethambutol (15.6 %. Among the total of MDR-TB cases among previously treated patients, highest percentage of the cases were relapse (61.1 % followed by chronic (16.7 %. Conclusions The high prevalence of DR/MDR-TB in our study reflects poor implementation of tuberculosis control program. On the basis of the drug susceptibility patterns of M. tuberculosis we found in our study, we

  10. Development of a public health reporting data warehouse: lessons learned.

    Science.gov (United States)

    Rizi, Seyed Ali Mussavi; Roudsari, Abdul

    2013-01-01

    Data warehouse projects are perceived to be risky and prone to failure due to many organizational and technical challenges. However, often iterative and lengthy processes of implementation of data warehouses at an enterprise level provide an opportunity for formative evaluation of these solutions. This paper describes lessons learned from successful development and implementation of the first phase of an enterprise data warehouse to support public health surveillance at British Columbia Centre for Disease Control. Iterative and prototyping approach to development, overcoming technical challenges of extraction and integration of data from large scale clinical and ancillary systems, a novel approach to record linkage, flexible and reusable modeling of clinical data, and securing senior management support at the right time were the main factors that contributed to the success of the data warehousing project.

  11. Non-HIV AIDS presenting with adrenal histoplasmosis and pulmonary tuberculosis: a mesmerising case report and discussion

    Directory of Open Access Journals (Sweden)

    Arnab Banerjee

    2015-09-01

    Full Text Available Non-HIV AIDS or idiopathic CD4 lymphocytopenia (ICL is an acquired immunodeficiency syndrome resulting in CD4 lymphopenia without any evidence of HIV infection or any other apparent cause of immunosuppression. A non-diabetic patient presented with adrenal histoplasmosis and UTI leading to adrenal failure. No immediate cause of immunosuppression was found, HIV, HTLV screening were negative. A CD4 count was done and the patient was found to be having non-HIV AIDS (idiopathic CD4 lymphocytopenia. He was treated and discharged. Few months later the patient presented again with adrenal failure and pulmonary tuberculosis. Adrenal FNAC showed persisting adrenal histoplasmosis. CD4 count found to be low again, but this time it was worse than the previous scenario. [Int J Res Med Sci 2015; 3(9.000: 2463-2467

  12. Tuberculosis: a disease without boundaries.

    Science.gov (United States)

    Fogel, Nicole

    2015-09-01

    Tuberculosis (TB) is an airborne disease caused by Mycobacterium tuberculosis (MTB) that usually affects the lungs leading to severe coughing, fever, and chest pains. Although current research in the past four years has provided valuable insight into TB transmission, diagnosis, and treatment, much remains to be discovered to effectively decrease the incidence of and eventually eradicate TB. The disease still puts a strain on public health, being only second to HIV/AIDS in causing high mortality rates. This review will highlight the history of TB as well as provide an overview of the current literature on epidemiology, pathogenesis and the immune response, treatment, and control of TB. In this race to combat a disease that knows no boundaries, it is necessary to have a conceptual and clear understanding of TB overall with the hope of providing better treatment through novel and collaborative research and public health efforts.

  13. 76 FR 38602 - Bovine Tuberculosis and Brucellosis; Program Framework

    Science.gov (United States)

    2011-07-01

    ... Animal and Plant Health Inspection Service Bovine Tuberculosis and Brucellosis; Program Framework AGENCY... extending the comment period on a new framework being developed for the bovine tuberculosis and brucellosis... bovine brucellosis in the United States. The notice stated that USDA would hold four public...

  14. Immunodiagnosis of latent tuberculosis : new answers to an old question?

    NARCIS (Netherlands)

    Franken, Wilhelmina Petronella Josephine

    2009-01-01

    Tuberculosis (TB) remains one of the most serious public health problems with one third of the world population latently infected with Mycobacterium tuberculosis. The diagnosis of LTBI relied until recently on the tuberculin skin test (TST) where a crude mixture of antigens is injected intradermally

  15. The Association between Access to Public Transportation and Self-Reported Active Commuting

    DEFF Research Database (Denmark)

    Djurhuus, Sune; Hansen, Henning S; Aadahl, Mette

    2014-01-01

    more moderate physical activity than non-users. Understanding how public transportation characteristics are associated with active transportation is thus important from a public health perspective. This study examines the associations between objective measures of access to public transportation...... and self-reported active commuting. Self-reported time spent either walking or cycling commuting each day and the distance to workplace were obtained for adults aged 16 to 65 in the Danish National Health Survey 2010 (n = 28,928). Access to public transportation measures were computed by combining GIS......-based road network distances from home address to public transit stops an integrating their service level. Multilevel logistic regression was used to examine the association between access to public transportation measures and active commuting. Distance to bus stop, density of bus stops, and number...

  16. Tuberculosis vaccine: time to look into future.

    Science.gov (United States)

    Chawla, Sumit; Garg, Dinesh; Jain, Ram Bilas; Khanna, Pardeep; Choudhary, Satvinder; Sahoo, Soumya; Singh, Inderjeet

    2014-01-01

    Global burden of tuberculosis is nearly 12 million. As per the WHO Global TB Report 2013, there were an estimated 8.6 million incident cases of TB globally in 2012. Tuberculosis is an issue that affects development through its effect on the health of individuals and families. In humans, neither prior latent infection nor recovery from active TB confers reliable protection against reinfection or reactivation disease. The power of vaccines as a public health intervention lies in their ability to reduce onward transmission of disease as much as in their ability to protect vaccinated individuals; a feature generally referred to as "herd immunity." MVA85A is a booster vaccine, used in con-junction with BCG as part of a prime-boost strategy. BCG serves as the prime vaccination and MVA85A as the boost, operating under the theory that the addition of MVA85A will produce a better immune response and more protection against TB than BCG vaccination alone. There is a critical need to raise the profile of TB vaccine research at the community, national, regional, and global levels in order to generate support and political will, increase investment, create an enabling and supportive environment for clinical trials, and lay the groundwork for acceptance and adoption of new TB vaccines once licensed.

  17. 14 CFR 1260.22 - Technical publications and reports.

    Science.gov (United States)

    2010-01-01

    ... supported by NASA under award No(s) GRNASM99G000001, etc.”). (2) Except for articles or papers published in... Institution. An example follows: “Photograph courtesy of NASA and the .” (b) Reports shall be in the English language, informal in nature, and ordinarily not exceed three pages (not counting bibliographies,...

  18. Report of the Working Group on Publicity and Funding

    DEFF Research Database (Denmark)

    Gammeltoft, Peder

    2014-01-01

    The report highlights the activities of the working group in raising awareness of the need for geographical names standardization and the work of the Group of Experts, particularly in advancing the digital presence of UNGEGN, through web presence and updated Media Kit and Wikipedia presence...

  19. [Retrospect of tuberculosis control in Brazil].

    Science.gov (United States)

    Hijjar, Miguel Aiub; Gerhardt, Germano; Teixeira, Gilmário M; Procópio, Maria José

    2007-09-01

    The aim of the study was to look back on the course of action involving measures of tuberculosis control in Brazil since the end of the 19th century, covering the history of social struggles and pointing out institutions and people that have dedicated themselves to looking for solutions to these issues. The Brazilian response to tuberculosis started in society with the Ligas Contra a Tuberculose (Leagues Against Tuberculosis), promoting scientific advances, such as the BCG vaccination, which begun in 1927. From the public power, the Inspetoria de Profilaxia da TB (TB Prophylaxis Inspection Service - 1920), the Serviço Nacional de Tuberculose (National Service of Tuberculosis - 1940), and the Campanha Nacional Contra a Tuberculose (National Campaign Against Tuberculosis - 1946), coordinated national policies such as chemotherapy, beginning with the discovery of streptomycin in 1944. The emergence of bacterial resistance led to the development of several therapeutic schemes. The Scheme 1 (rifampycin, hydrazide and pyrazinamid), which was the main one in 1979 and is still used nowadays, had a great epidemiological effect. The WHO declared TB a public health emergency in 1993. In response, Brazil developed some strategies; the first one was the Plano Emergencial para Controle da Tuberculose (Emergency Plan for Tuberculosis Control - 1994), prioritizing 230 municipalities. The current prospects are an effective municipalization of actions and their greater integration with the Programas de Agentes Comunitários e Saúde da Família (Humanitarian Agents and Family Health Programs).

  20. First report of Lagochilascaris (Nematoda: Ascarididae) eggs in a public park in Southern Brazil.

    Science.gov (United States)

    de Moura, Micaele Quintana; Jeske, Sabrina; Gallina, Tiago; Borsuk, Sibele; Berne, Maria Elisabeth Aires; Villela, Marcos Marreiro

    2012-03-23

    Public parks, especially in developing countries, are places where stray animals run free and may contaminate the environment with different species of parasites. In an evaluation of environmental sanitation of these sites, soil samples were collected monthly from public parks in the Pelotas city, Rio Grande do Sul State, Southern Brazil. Eggs of the nematode Lagochilascaris sp. were found in a public playground. This is the first report of identification of this nematode in Southern Brazil.

  1. GLOBAL CHANGE RESEARCH NEWS #6: PUBLICATION OF FIRST REPORT FROM MID-ATLANTIC REGIONAL ASSESSMENT (MARA)

    Science.gov (United States)

    This research news edition announces the publication of the first report from the Mid-Atlantic Regional Assessment (MARA). The report is entitled, *Climate Change Impacts in the Mid-Atlantic Region -- A Workshop Report.* MARA is being conducted as part of the USGCRP First Nation...

  2. 77 FR 58204 - International Joint Commission Invites Public Comment on Upper Great Lakes Report via...

    Science.gov (United States)

    2012-09-19

    ... International Joint Commission Invites Public Comment on Upper Great Lakes Report via Teleconference and Extends Public Comment Period The International Joint Commission (IJC) announced that it is holding a... below: U.S. Section Secretary, International Joint Commission, 2000 L Street NW., Suite 615,...

  3. Health on Course? The 2002 Dutch Public Health Status and Forecasts Report

    NARCIS (Netherlands)

    Oers JAM van; VTV

    2003-01-01

    The third Dutch Public Health Status and Forecasts (PHSF) report once again contains a large amount of up-todate information about public health status, prevention and healthcare in the Netherlands. International comparisons and regional comparisons within the Netherlands are presented as well. Dut

  4. Health on Course? Key Messages from the 2002 Dutch Public Health Status and Forecasts Report

    NARCIS (Netherlands)

    Oers JAM van; VTV

    2003-01-01

    The third Dutch Public Health Status and Forecasts (PHSF) report once again contains a large amount of up-todate information about Dutch public health status, prevention and healthcare and includes international and regional comparisons. This brochure contains the Key Messages of the 2002 PHSF summa

  5. Public Library Internet Services: Impacts on the Digital Divide. Stage I Final Report.

    Science.gov (United States)

    McClure, Charles R.; Bertot, John Carlo

    This report provides preliminary findings and a summary of study activities for Stage I of a project that examined public library Internet services that could impact the Digital Divide. The first section discusses the E-rate program and the Digital Divide, including closing the gap in the Digital Divide and public library Internet connectivity and…

  6. The Association between Access to Public Transportation and Self-Reported Active Commuting

    Directory of Open Access Journals (Sweden)

    Sune Djurhuus

    2014-12-01

    Full Text Available Active commuting provides routine-based regular physical activity which can reduce the risk of chronic diseases. Using public transportation involves some walking or cycling to a transit stop, transfers and a walk to the end location and users of public transportation have been found to accumulate more moderate physical activity than non-users. Understanding how public transportation characteristics are associated with active transportation is thus important from a public health perspective. This study examines the associations between objective measures of access to public transportation and self-reported active commuting. Self-reported time spent either walking or cycling commuting each day and the distance to workplace were obtained for adults aged 16 to 65 in the Danish National Health Survey 2010 (n = 28,928. Access to public transportation measures were computed by combining GIS-based road network distances from home address to public transit stops an integrating their service level. Multilevel logistic regression was used to examine the association between access to public transportation measures and active commuting. Distance to bus stop, density of bus stops, and number of transport modes were all positively associated with being an active commuter and with meeting recommendations of physical activity. No significant association was found between bus services at the nearest stop and active commuting. The results highlight the importance of including detailed measurements of access to public transit in order to identify the characteristics that facilitate the use of public transportation and active commuting.

  7. Tuberculosis, a re-emergent disease

    Energy Technology Data Exchange (ETDEWEB)

    Valadas, Emilia [Faculdade de Medicina, Universidade de Lisboa (Portugal)]. E-mail: evaladas@fm.ul.pt; Antunes, Francisco [Faculdade de Medicina, Universidade de Lisboa (Portugal)

    2005-08-01

    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.

  8. [Analysis of infection and drug-resistance in 6 107 cases of extrapulmonary tuberculosis in Chengdu area].

    Science.gov (United States)

    Wang, D M; Li, Q F; Zhu, M; Xu, Y H; Luo, J; Li, Y J; Zhong, J; Wu, Z J

    2017-08-12

    Objective: To analyze the infection and drug resistance of extrapulmonary tuberculosis, in order to provide useful references for prevention and treatment of tuberculosis (TB). Methods: A total of 6 107 suspected cases of extrapulmonary tuberculosis, including lymph node, pleural, peritoneal, meningeal, urinary tract, and bone tuberculosis, were collected retrospectively from January 2013 to December 2015 in Public Health Clinical Center of Chengdu. There were 4 033 male and 2 074 female patients, and the average age was 37 years.The epidemiological data, infection and drug resistance were analyzed statistically. Results: There were 21 036 cases of mycobacterial culture from January 2013 to December 2015, of which 7 119 were positive(33.8%). Extrapulmonary tuberculosis was found in 6 107 cases, of which 896 were positive, accounting for 12.6% of the positive cases(896/7 119). Culture-positive cases of extra-pulmonary tuberculosis showed a rising trend from 2013 to 2015 (n=174, 310, 421, respectively), and the annual average increasing rate was over 50%.Cases were distributed at younger ages (21-40 years), with an average age of 34 years.There were more male patients, with a male to female ratio of 2.1∶1. The most common site of extrapulmonary tuberculosis was the bone(62/243, 25.5%), followed by lymph node(283/1 297, 21.8%), pleural(289/1 840, 15.7%), urinary tract(63/452, 13.9%), peritoneum(41/303, 13.5%), meningeal(156/1 915, 8.1%)and other types of tuberculosis(2/57, 3.5%). Drug sensitivity test of 896 extrapulmonary tuberculosis strains showed that the resistance rate (from high to low) was in the order of isoniazid, rifampicin, streptomycin, ofloxacin, ciprofloxacin, amikacin, capreomycin and ethambutol. Multidrug-resistant(MDR)and extremely-drug resistant (XDR) rate was 9.7 %(87/896)and 2.0%(17/896)respectively. Conclusions: Cases of extrapulmonary tuberculosis sent for bacterial culture and the positive rate showed a rising trend by years in Chengdu area

  9. Tuberculosis Data and Statistics

    Science.gov (United States)

    ... Search The CDC 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 ...

  10. TUBERCULOSIS AND THE EYE

    African Journals Online (AJOL)

    Key words: Mycobacteria; Tuberculosis; Eye ... of tuberculous eye disease or ocular tuberculosis has also been raised. Ocular ... patients with ocular complaints, compiled in an area ..... tuberculomas are usually solitary and may measure up.

  11. 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 ...

  12. 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. ...

  13. Tuberculosis Treatment and Pregnancy

    Science.gov (United States)

    ... Search The CDC 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 ...

  14. Blast Furnace Granulated Coal Injection System Demonstration Project public design report. Topical report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    The public design report describes the Blast Furnace Granulated Coal Injection (BFGCI) project under construction at Bethlehem Steel Corporation`s (BSC) Burns Harbor, Indiana, plant. The project is receiving cost-sharing from the U.S. Department of Energy (DOE), and is being administrated by the Morgantown Energy Technology Center in accordance with the DOE Cooperative Agreement No. DE-FC21-91MC27362. The project is the first installation in the United States for the British Steel technology using granular coal in blast furnaces. The objective is to demonstrate that granular coal is an economic and reliable fuel which can successfully be applied to large North American blast furnaces. These include: coal grind size, coal injection rate, coal source (type) and blast furnace conversion method. To achieve the program objectives, the demonstration project is divided into the following three Phases: Phase I-Design; Phase II-Procurement & Construction; and Phase III-Operation. Preliminary design (Phase I) began in 1991 with detailed design commencing in April 1993. Construction at Burns Harbor (Phase II) began August 1993. Construction is expected to be complete in the first quarter of 1995 which will be followed by a demonstration test program (Phase III).

  15. RECRUITING, RETAINING, AND REPORTING EXPOSURE STUDY RESULTS TO PARTICIPANTS AND THE PUBLIC

    Science.gov (United States)

    EPA's National Exposure Research Laboratory (NERL) is developing techniques and capabilities to recruit and retain participants in exposure measurement studies and to effectively report study results to participants and the public. These techniques are being applied in three N...

  16. 75 FR 54802 - Account Ownership and Control Report; Notice of Public Meeting

    Science.gov (United States)

    2010-09-09

    ... accounts active on U.S. futures exchanges and other reporting entities.\\1\\ Written comments on the proposed... first-come, first-served basis. Members of the public may also listen by telephone. Call-in...

  17. Tuberculosis presenting as immune thrombocytopenic purpura

    Directory of Open Access Journals (Sweden)

    Bahadir-Erdogan Beril

    2004-09-01

    Full Text Available Abstract Background Although various hematologic abnormalities are seen in tuberculosis, immune thrombocytopenic purpura is a rare event. Case Presentation We report a case of a 29 year-old male who was presented with immune thrombocytopenia-induced hemoptysis, macroscopic hematuria and generalized petechiae. The patient was found to have clinical, microbiological and radiological evidence of active pulmonary tuberculosis. The immune thrombocytopenic purpura was successfully treated with anti-tuberculous drugs combined with corticosteroids and high dose immune globulin therapy. Conclusion Immune thrombocytopenic purpura can be one of the hematological manifestations of tuberculosis which has a global prevalence with increasing incidence secondary to HIV infection.

  18. Analysis of Imaging Characteristics of 18F-FDG PET/CT in Misdiagnosed Bone Tuberculosis: A Report of 12 Cases

    Directory of Open Access Journals (Sweden)

    Qi-yong DING

    2015-12-01

    Full Text Available Abstract Objective: To analyze the imaging characteristics of 18F-fluorodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT in 12 cases of misdiagnosed bone tuberculosis so as to explore the differential diagnostic method with metastatic bone tumors. Methods: The images of 12 patients with bone tuberculosis diagnosed by 18F-FDG PET/CT were retrospectively analyzed. Distribution of lesion locations in the whole body and characteristics of glucose metabolism were analyzed by qualitative and semi-quantitative methods, especially for bone lesion location, number and range, glucose uptake form and CT imaging characteristics, and the maximum of standardized uptake value (SUVmax was measured and recorded. Results: Of 12 patients, 1 showed increased glucose uptake of diffuse bone marrow in the whole body, whereas the rest suffered from 19 bone lesions, in which each one had 1 bone lesion in 9 cases, accounting for 75.0%. The images of PET/CT in 12 patients primarily manifested annular or nonuniform increase of glucose uptake (63.2%, sequestrum within osteolytic lesions (31.6%, injured intervertebral disc caused by vertebral lesions (61.5% and cold abscess es around the lesions (68.4%. The glucose uptake rate of cold abscesses was higher than that of bone lesion locations. The tuberculosis complicated with other parts included lymphatic tuberculosis (100.0%, pulmonary tuberculosis (66.7%, pericardial or pleural tuberculosis (25.0% and hepatolienal tuberculosis (8.3%. Conclusion: The characteristics of bone tuberculosis lesions are prominent in 18F-FDG PET/CT imaging, which could contribute to diagnosis of whole body tuberculosis and has a greater value in the differentiation of bone tuberculosis and metastatic bone tumors.

  19. Avaliação da notificação no Distrito Federal de casos de tuberculose residentes em dez municípios goianos do entorno e análise da incidência de tuberculose nestas localidades 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

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Carmo Moreira

    2007-06-01

    Full Text Available OBJETIVO: Avaliar a notificação, no Distrito Federal (DF, de casos de tuberculose em residentes nos municípios goianos da região do Entorno e possíveis influências no Plano de Controle da Tuberculose; analisar a taxa de incidência da tuberculose nos municípios e a interferência da situação socioeconômica e das características demográficas sobre esta taxa. MÉTODO: Analisaram-se dados relativos à incidência de tuberculose, taxas de cura, abandono, falência de tratamento, óbito, transferência e informações socioeconômicas e demográficas de dez municípios goianos. RESULTADOS: No período de 2000 a 2004, foram notificados 714 casos novos de tuberculose em residentes nos municípios estudados, sendo que 436 (61,0% foram atendidos no DF, não sendo registrados no Sistema de Informação de Goiás. Considerando-se os casos atendidos somente em Goiás, a média de incidência de tuberculose do grupo variou de 4,40 a 10,02/100.000 habitantes; somando-se os atendidos no DF, a incidência aumentou significativamente, variando de 15,16 a 20,54/100.000 habitantes (p OBJECTIVE: 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. METHODS: 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. RESULTS: 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

  20. Multi Drug Resistant (MDR and Extensively Resistant (XDR Tuberculosis

    Directory of Open Access Journals (Sweden)

    Salih Cesur

    2013-08-01

    Full Text Available Multi drug resistant tuberculosis (MDR-TB is defined as tuberculosis that is resistant to at least isoniazid and rifampicin, the two most powerful first-line anti-TB drugs. Extensively drug resistant tuberculosis (XDR-TB is defined as tuberculosis that is resistant to resistant to isoniazid and rifampin and to any fluoroquinolone and at least one of three injectable second-line drugs (namely, amikacin, kanamicin, or capreomycin. MDR-TB and XDR- TB are great dangers that threaten the public health. XDR-TB has been reported from many countries including the United States. In Turkey, among newly diagnosed cases, it was reported that the number of MDR-TB patients was 101 (3.1%, MDR-TB rate in the retreatment cases was 17.7% (90 patients, and MDR-TB rate in all cases was 5.1 (191 patients in 2005. The percentages were calculated through the number of patients who were tested in terms of susceptibility for both isoniazide and rifampin. In 2009, it was reported that the number of MDR-TB patients was 99 (2.7% among newly diagnosed cases, it was 123 (20.5 % in the retreatment cases and the total number of MDR-TB cases was 222 (5.1%. The first patient with XDR-TB was identified in 2010 in Turkey. Diagnosis of XDR TB takes several weeks by using conventional culture-based methods, although (however some molecular test can detect it rapidly. Treatment of XDR-TB patients is difficult and usually requiring at least 18-24 months of four to six second-line anti-TB drugs. The success rate with the treatment is about 30-50%, and mortality rate is higher in HIV-infected patients. Prevention of contact to XDR-TB patients is more complicated by the lack of a proven effective preventive treatment for XDR latent tuberculosis infection. Rapid diagnostic tests and new anti-TB drugs are needed to control the spread of this worldwide public health problem. [Dis Mol Med 2013; 1(4.000: 72-76