WorldWideScience

Sample records for tb immunodiagnostic tests

  1. Performance of TB immunodiagnostic tests in Eurasian badgers (Meles meles of different ages and the influence of duration of infection on serological sensitivity

    Directory of Open Access Journals (Sweden)

    Sayers Robin

    2009-11-01

    Full Text Available Abstract Background In parts of Great Britain and Ireland, Eurasian badgers (Meles meles constitute a reservoir of Mycobacterium bovis infection and a potential source of infection for cattle. In vitro diagnostic tests for live badgers are an important component of strategies to control TB in this species. Immunological tests have been developed for badgers, although little is known about the influence of the age of the animal on test performance. To address this, we evaluated the performance of three immunological tests for badgers with respect to the age of the animal: the Brock Test and BrockTB STAT-PAK® serological tests and the recently developed interferon-gamma enzyme immunoassay (IFNγ EIA. Data published elsewhere suggested that seropositivity was associated with more progressive forms of TB in the badger. To gain further evidence for this, we used longitudinal data from a well-studied population of badgers to test for an association between the sensitivity of the Brock Test and the duration of TB infection. Results Sensitivity of the two serological tests was approximately 54% for both cubs and adults. Sensitivity of the IFNγ EIA was lower in cubs (57% compared with adults (85% when a common cut-off value was used to define test positivity. Taking data from the cubs alone, the IFNγ EIA cut-off value could be adjusted to increase the sensitivity to 71% with no loss in specificity. As a general observation, specificity of all tests was higher in cubs, although only significantly so in the case of the Brock Test. Using logistic regression analysis to adjust for age, sensitivity of the Brock Test was significantly lower at first culture positive event (58%, but increased to >80% as infection progressed. Conclusion These data suggest that serodiagnosis could be a valuable tool for detecting a higher proportion of badgers with the greatest probability of transmitting infection. The age category of the badger appeared to exert little

  2. Evaluation of a rapid immunodiagnostic test kit for rabies virus.

    Science.gov (United States)

    Kang, BoKyu; Oh, JinSik; Lee, ChulSeung; Park, Bong-Kyun; Park, YoungNam; Hong, KyungSoo; Lee, KyungGi; Cho, ByungKi; Song, DaeSub

    2007-10-01

    A rapid immunodiagnostic test kit for rabies virus detection was evaluated using 51 clinical samples and 4 isolates of rabies virus. The quick detection of rabies virus under field conditions may be helpful in determining if post-exposure prophylaxis is needed, thereby avoiding unnecessary treatments, as well as undue economic burden. There are several widely used diagnostic methods for rabies, including fluorescent antibody tests, reverse transcription polymerase chain reaction, and electron microscopy; however, these methods include time-consuming, intricate, and costly procedures. The rapid immunodiagnostic test was able to detect rabies virus in clinical samples, including brain tissue and saliva, in addition to 10(3.2) 50% lethal dose (LD(50))/mL cell-adapted rabies virus. The assay was not cross-reactive with non-rabies virus microbes. When the performance of the rapid immunodiagnostic test was compared to a fluorescent antibody test, the rapid immunodiagnostic test had a sensitivity of 91.7% and specificity of 100% (95.8% CI).

  3. Evaluation of a rapid immunodiagnostic test kit for detection of African lyssaviruses from brain material

    Directory of Open Access Journals (Sweden)

    W. Markotter

    2009-09-01

    Full Text Available Rapid immunodiagnostic test kit was evaluated against a selection of isolates of lyssavirus genotypes occurring in Africa. The test was carried out in parallel comparison with the fluorescent antibody test (FAT and isolates representing previously established phylogenetic groups from each genotype were included. The specificity of the rapid immunodiagnostic test compared favourably with the FAT and was found to detect all representatives of genotypes 1, 2, 3 and 4 in brain samples of either field cases or suckling mouse brain inoculates.

  4. Tuberculosis Facts - Testing for TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Testing for TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  5. Testing for TB Infection

    Science.gov (United States)

    ... Adverse Events TB Treatment of Persons Living with HIV TB Treatment and Pregnancy TB Treatment for Children Drug-Resistant TB Research TB Epidemiologic Studies Consortium Research Projects Publications TB Trials Consortium Study ...

  6. Development of a Rapid Immunodiagnostic Test for Pork Components in Raw Beef and Chicken Meats: a Preliminary Study

    Directory of Open Access Journals (Sweden)

    S. N. Depamede

    2011-08-01

    Full Text Available A rapid immunodiagnostic test that provides visual evidence of the presence of pork components in raw beef and chicken meats was developed. Colloidal gold was prepared and conjugated with anti-Swine IgG polyclonal antibody. Immunochromatographic test strips were produced, and then were used to test laboratory adulterated raw meat samples. The samples consisted adulteration meat, immunodiagnostic, pork, rapid test of pork-in-beef, or pork-in-chicken at 1/0; 1/100; 1/1,000; 1/5,000; 1/10,000 (w/w adulteration levels that were extracted in phosphate-buffered saline. Raw beef and chicken meats without pork were included as controls. Analysis was completed in 10 min. Detection limit was 1/5,000 (w/w, although 1/10,000 was also observed. This immunodiagnostic tests can be conveniently applied to detect low levels of pork components in raw beef and chicken meat products. For the commercial purposes, further studies need to be carried out.

  7. TB Testing for People Living with HIV

    Centers for Disease Control (CDC) Podcasts

    2012-07-23

    Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, explains why it is important for people living with HIV to be tested for TB.  Created: 7/23/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 7/23/2012.

  8. Development and testing of monoclonal antibody-based rapid immunodiagnostic test kits for direct detection of Vibrio cholerae O139 synonym Bengal.

    Science.gov (United States)

    Hasan, J A; Huq, A; Nair, G B; Garg, S; Mukhopadhyay, A K; Loomis, L; Bernstein, D; Colwell, R R

    1995-11-01

    We report on the development and testing of two monoclonal antibody-based rapid immunodiagnostic test kits, BengalScreen, a coagglutination test, and Bengal DFA, a direct fluorescent-antibody test, for direct detection of Vibrio cholerae O139 synonym Bengal in clinical and environmental specimens. The BengalScreen test requires less than 5 min to complete and can be used in the field. Bengal DFA, being more sensitive than BengalScreen, requires only one reagent and less than 20 min for detection and enumeration of V. cholerae O139 synonym Bengal. In tests for specificity, all 40 strains of V. cholerae O139 reacted with both test kits, whereas 157 strains of heterologous species examined did not, yielding 100% specificity in this study. A field trial was conducted in with both BengalScreen and Bengal DFA, and the results were compared with those obtained by conventional culture methods. BengalScreen demonstrated a sensitivity of 95%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 94%. Results obtained by Bengal DFA, on the other hand, were 100% sensitive and 100% specific and yielded 100% positive and negative predictive values compared with culture methods. In a second evaluation, 93 stool specimens from Mexico that were negative for V. cholerae O139 by culture were also tested with both the BengalScreen and Bengal DFA kits. None of the 93 specimens were positive for V. cholerae O139 by both tests. A concentration method was optimized for screening of environmental water samples for V. cholerae O139 synonym Bengal with rapid test kits. BengalScreen results were unequivocally positive when water samples contained at least 2.0 x 10(3) CFU/ml, whereas Bengal DFA demonstrated an unequivocally positive reaction when the water sample contained at least 1.5 x 10(2) CFU/ml. When Bengal DFA was compared with conventional culture methods for enumeration of V. cholerae O139 synonym Bengal organisms, no difference was observed.

  9. Assessment of the Diagnostic Potential of Clinotech TB Screen Test ...

    African Journals Online (AJOL)

    The Clinotech TB Screen test, a 3rd generation multi-antigen rapid chromatographic immunoassay for detection of IgG antibodies in serum against recombinant protein antigens 38kDa, 16kDa and 6kDa, was assessed for its diagnostic potential for diagnosis of active pulmonary TB in routine TB control programme in Abia ...

  10. Biomarkers of latent TB infection

    DEFF Research Database (Denmark)

    Ruhwald, Morten; Ravn, Pernille

    2009-01-01

    For the last 100 years, the tuberculin skin test (TST) has been the only diagnostic tool available for latent TB infection (LTBI) and no biomarker per se is available to diagnose the presence of LTBI. With the introduction of M. tuberculosis-specific IFN-gamma release assays (IGRAs), a new area...... of in vitro immunodiagnostic tests for LTBI based on biomarker readout has become a reality. In this review, we discuss existing evidence on the clinical usefulness of IGRAs and the indefinite number of potential new biomarkers that can be used to improve diagnosis of latent TB infection. We also present...... early data suggesting that the monocyte-derived chemokine inducible protein-10 may be useful as a novel biomarker for the immunodiagnosis of latent TB infection....

  11. TB Terms

    Science.gov (United States)

    ... sputum can also be used to do a culture. TB blood test – a test that uses a blood sample to find out if you are infected with TB bacteria. The test measures the response to TB proteins when they are mixed with a small amount of blood. Examples of these TB blood tests include QuantiFERON ® -TB ...

  12. Provider-initiated HIV testing and counselling for TB patients and suspects in Nairobi, Kenya.

    Science.gov (United States)

    Odhiambo, J; Kizito, W; Njoroge, A; Wambua, N; Nganga, L; Mburu, M; Mansoer, J; Marum, L; Phillips, E; Chakaya, J; De Cock, K M

    2008-03-01

    Integrated tuberculosis (TB) and human immunodeficiency virus (HIV) services in a resource-constrained setting. Pilot provider-initiated HIV testing and counselling (PITC) for TB patients and suspects. Through partnerships, resources were mobilised to establish and support services. After community sensitisation and staff training, PITC was introduced to TB patients and then to TB suspects from December 2003 to December 2005. Of 5457 TB suspects who received PITC, 89% underwent HIV testing. Although not statistically significant, TB suspects with TB disease had an HIV prevalence of 61% compared to 63% for those without. Of the 614 suspects who declined HIV testing, 402 (65%) had TB disease. Of 2283 patients referred for cotrimoxazole prophylaxis, 1951 (86%) were enrolled, and of 1727 patients assessed for antiretroviral treatment (ART), 1618 (94%) were eligible and 1441 (83%) started treatment. PITC represents a paradigm shift and is feasible and acceptable to TB patients and TB suspects. Clear directives are nevertheless required to change practice. When offered to TB suspects, PITC identifies large numbers of persons requiring HIV care. Community sensitisation, staff training, multitasking and access to HIV care contributed to a high acceptance of HIV testing. Kenya is using this experience to inform national response and advocate wide PITC implementation in settings faced with the TB-HIV epidemic.

  13. Concordant or discordant results by the tuberculin skin test and the quantiFERON-TB test in children reflect immune biomarker profiles

    DEFF Research Database (Denmark)

    Dhanasekaran, S; Jenum, S; Stavrum, R

    2014-01-01

    The tuberculin skin test (TST) and QuantiFERON-TB-Gold-In-tube (QFTGIT) are adjunctive tests used in the diagnosis of pediatric tuberculosis (TB). Neither test can rule out TB; however, a positive test usually triggers preventive treatment in TB contacts aged <5 years. TST and QFTGIT can give div...

  14. Prospective evaluation of a whole-blood test using Mycobacterium tuberculosis-specific antigens ESAT-6 and CFP-10 for diagnosis of active tuberculosis

    DEFF Research Database (Denmark)

    Ravn, Pernille; Munk, Martin E; Andersen, Ase B

    2005-01-01

    A new immunodiagnostic test based on the Mycobacterium tuberculosis-specific antigens CFP-10/ESAT-6(QFT-RD1) has been launched as an aid in the diagnosis of latent tuberculosis (TB) infection (LTBI). The aim of this study was to evaluate this test for the diagnosis of active TB. Eighty-two patients...... with suspicion of TB and 39 healthy BCG-vaccinated persons were enrolled. Forty-eight had active TB, 25 did not, and 9 were excluded. Sensitivity and specificity of the test for active TB were evaluated in a prospective blinded manner in patients suspected of TB. The sensitivity of the QFT-RD1 was 85% (40......% (5/12) by culture (P test, sensitivity increased to 96% (CI, 90 to 102). Ten of 25 (40%) non-TB patients were QFT-RD1 positive, resulting...

  15. Is TB Testing Associated With Increased Blood Interferon-Gamma Levels?

    Directory of Open Access Journals (Sweden)

    Aideen E. Kennedy

    2017-10-01

    Full Text Available The Republic of Ireland reports a relatively low prevalence of Johne’s disease (JD compared to international counterparts. Postulated reasons for this include a lower average herd size and a grass-based production system. Ireland also engages in high levels of bovine tuberculosis (bTB testing. As interferon-gamma (IFN-γ is believed to play a key role in protecting against JD, it is our hypothesis that administration of purified protein derivative (PPD, as part of the bTB test, is associated with a systemic increase in IFN-γ production, which may potentially limit clinical progression of the disease. We studied 265 cows (202 Friesian and 63 “Non-Friesian,” e.g., JerseyX, Norwegian Red to assess IFN-γ levels and Mycobacterium avium subspecies paratuberculosis (MAP antibody response before and after the bTB test. As part of the compulsory annual bTB test, avian and bovine PPD were administered at two separate cervical sites. To assess IFN-γ production, blood samples were taken before and 72 h after PPD administration. MAP antibody response was assessed before and 10 days post-PPD administration. A significant increase in MAP antibody response was identified post-bTB compared to pre-bTB response (p < 0.001. Additionally, IFN-γ production significantly increased at the post-bTB time point (p < 0.001 compared to the pre-bTB test readings. This may indicate a beneficial effect of bTB testing in controlling JD.

  16. Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

    Directory of Open Access Journals (Sweden)

    Neeraj Raizada

    Full Text Available Diagnosis of pulmonary tuberculosis (PTB in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India.The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU, with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm.4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8 pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2 of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4 who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV for rifampicin resistance detection was high (98%, CI 90.1-99.9, with no statistically significant variation with respect to past history of treatment.Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising

  17. Catching the missing million: experiences in enhancing TB & DR-TB detection by providing upfront Xpert MTB/RIF testing for people living with HIV in India.

    Directory of Open Access Journals (Sweden)

    Neeraj Raizada

    Full Text Available A critical challenge in providing TB care to People Living with HIV (PLHIV is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities.The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU, with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing.2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI 29.4‒32.8 HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9-29.3 of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6-14.1 who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8 and 16 (11.2%, CI 6.7‒17.1 rifampicin resistance cases, respectively. Positive predictive value (PPV for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8, with no significant difference with or without prior history of TB treatment.The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV.

  18. Prospects of Nanotechnology in Clinical Immunodiagnostics

    Directory of Open Access Journals (Sweden)

    Abdull S. Aldwayyan

    2010-07-01

    Full Text Available Nanostructured materials are promising compounds that offer new opportunities as sensing platforms for the detection of biomolecules. Having micrometer-scale length and nanometer-scale diameters, nanomaterials can be manipulated with current nanofabrication methods, as well as self-assembly techniques, to fabricate nanoscale bio-sensing devices. Nanostructured materials possess extraordinary physical, mechanical, electrical, thermal and multifunctional properties. Such unique properties advocate their use as biomimetic membranes to immobilize and modify biomolecules on the surface of nanoparticles. Alignment, uniform dispersion, selective growth and diameter control are general parameters which play critical roles in the successful integration of nanostructures for the fabrication of bioelectronic sensing devices. In this review, we focus on different types and aspects of nanomaterials, including their synthesis, properties, conjugation with biomolecules and their application in the construction of immunosensing devices. Some key results from each cited article are summarized by relating the concept and mechanism behind each sensor, experimental conditions and the behavior of the sensor under different conditions, etc. The variety of nanomaterial-based bioelectronic devices exhibiting novel functions proves the unique properties of nanomaterials in such sensing devices, which will surely continue to expand in the future. Such nanomaterial based devices are expected to have a major impact in clinical immunodiagnostics, environmental monitoring, security surveillance and for ensuring food safety.

  19. Inflammatory bowel disease: immunodiagnostics, immunotherapeutics, and ecotherapeutics.

    LENUS (Irish Health Repository)

    Shanahan, F

    2012-02-03

    Treatment options for inflammatory bowel disease (IBD) reflect a continuing shift from empiricism to strategies based on improved understanding of the pathophysiology of disease. In susceptible individuals, IBD appears to be the result of defective regulation of mucosal immune interactions with the enteric microflora. This has prompted research directed at the interface of the traditional disciplines of immunology, microbiology, and epithelial cell biology. Whereas immunodiagnostics have been of limited clinical value in IBD, assessments of mucosal rather than systemic immune function are promising. Therapeutically, there is an increasing trend toward more aggressive and earlier use of immunomodulatory agents, particularly for prevention of relapse, with cytokine manipulation as a bridge therapy to achieve remission in patients with acute severe disease. Although most drug treatments are directed toward altering the host response, the rationale for manipulating the enteric flora appears sound and will be the basis of additional future therapeutic strategies. Notwithstanding the widening range of options for drug therapy in IBD, other outcome modifiers and well-established principles of managing chronic disease are as important as ever.

  20. Physician-initiated courtesy MODS testing for TB and MDR-TB diagnosis and patient management.

    Science.gov (United States)

    Nic Fhogartaigh, C J; Vargas-Prada, S; Huancaré, V; Lopez, S; Rodríguez, J; Moore, D A J

    2008-05-01

    Laboratorio de Investigación de Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia (UPCH) and government health centres, Lima, Peru. To evaluate the contribution of unselected (courtesy) microscopic observation drug susceptibility (MODS) testing to the diagnosis and/or drug susceptibility testing (DST) of tuberculosis and their subsequent impact upon patient management. Retrospective database analysis and case note review of MODS culture-positive cases. Mycobacterium tuberculosis was isolated in 28.9% of 225 samples (209 patients); 22.2% of 63 positive cases were multidrug-resistant. In 58 MODS culture-positive cases with follow-up data available, MODS provided culture confirmation of diagnosis, DST or both in 82.8%, before any standard method. In 41.4%, this result should have prompted a modification in patient management. Delays between laboratory result and initiation or change of treatment, where applicable, took on average 42 and 64 days, respectively, of which a delay of respectively 17 and 48 days occurred after the receipt of results by the health facility. MODS provides important data for clinical management within a meaningful timeframe and should contribute positively to patient outcomes due to earlier initiation of appropriate therapy. Although clinicians may successfully select patients likely to benefit from MODS, ongoing work is required to identify optimal implementation of the assay and to reduce logistical and health system derived delays.

  1. Household HIV Testing Uptake among Contacts of TB Patients in South Africa.

    Directory of Open Access Journals (Sweden)

    Kavindhran Velen

    Full Text Available In high HIV prevalence settings, offering HIV testing may be a reasonable part of contact tracing of index tuberculosis (TB patients. We evaluated the uptake of HIV counselling and testing (HCT among household contacts of index TB patients and the proportion of newly diagnosed HIV-infected persons linked into care as part of a household TB contact tracing study.We recruited index TB patients at public health clinics in two South African provinces to obtain consent for household contact tracing. During scheduled household visits we offered TB symptom screening to all household members and HCT to individuals ≥14years of age. Factors associated with HCT uptake were investigated using a random effects logistic regression model.Out of 1,887 listed household members ≥14 years old, 984 (52% were available during a household visit and offered HCT of which 108 (11% self-reported being HIV infected and did not undergo HCT. Of the remaining 876, a total of 304 agreed to HCT (35%; 26 (8.6% were newly diagnosed as HIV positive. In multivariable analysis, factors associated with uptake of HCT were prior testing (odds ratio 1.6; 95% confidence interval [CI]: 1.1-2.3 and another member in the household testing (odds ratio 2.4; 95% CI: 1.7-3.4. Within 3 months of testing HIV-positive, 35% reported initiating HIV care.HCT as a component of household TB contact tracing reached individuals without prior HIV testing, however uptake of HIV testing was poor. Strategies to improve HIV testing in household contacts should be evaluated.

  2. Comparison of PPD test in household contacts of smear-positive and -negative tuberculosis (TB

    Directory of Open Access Journals (Sweden)

    Zohreh Azarkar

    2015-01-01

    Conclusions: The most important way to prevent TB is omission of the disease transmission sources (TB patients by anti-TB treatment. Extensive studies are needed to ensure that contacts of patients with pulmonary TB are identified and appropriately screened.

  3. Tuberculosis Screening on a Health Science Campus: Use of QuantiFERON-TB Gold Test for Students and Employees

    Science.gov (United States)

    Veeser, Peggy Ingram; Smith, Phillip Karl; Handy, Barry; Martin, Sharon R.

    2007-01-01

    Detecting and managing "Mycobacterium tuberculosis" (TB) infection in a health-science center population is a clinical dilemma. Tuberculin skin tests are still the preferred method for detecting present or past infection of TB. The authors discuss the performance of whole blood interferon gamma release assay test commercially known as…

  4. THE POSSIBLE COLLISIONS IN VIRUS INFECTION IMMUNODIAGNOSTICS AND VACCINATION

    Directory of Open Access Journals (Sweden)

    E. P. Kharchenko

    2016-01-01

    Full Text Available Antibodies (Ab, especially natural, display multiple specificity not only due to intrinsic conformational dynamics. With computational analysis the distribution of identical and homologous peptides has been studied in surface proteins from RNA and DNA viruses of widely distributed infections. It was established that each virus protein shared the fragments homologous to other virus proteins that allowed to propose the existence of the peptide continuum of the protein relationship (PCPR. Possible manifestations of PCPR are multiple reactivity and autoreactivity in Ab and therefore it is not possible to consider the immune methods of virus identification as high reliable because of crossing interactions. The PCPR excludes the existence of 100% specificity in immune tests for virus identification. Immunodiagnostic collisions may occur either in identification of virus itself or identification of Ab to viruses. Also PCPR may be responsible for heterologous immunity and consequently the infection associated with severe pathology. The comparative analysis of peptide relationship of H1N1 influenza virus nucleoprotein and human proteins found out, beyond early described its common motif with human hypocretin receptor 2, peptides homologous to those in melanotonin and glutamate receptors and three ion channels. It allows to propose that the sleep disorder narcolepsy associated with Pandemrix vaccination (an adjuvanted, influenza pandemic vaccine and also with infection by influenza virus during the 2009 A(H1N1 influenza pandemic may be determined not only by Ab to the peptide motif common to influenza nucleoprotein and hypocretin receptor but also Ab to melanotonin and glutamate receptors and ion channels. Decreasing and even avoiding risks of complications from vaccination may be feasible by means of a computer analysis of vaccine proteins for the occurrence of epitopes homologous to the human protein those and particularly by an analysis of Ab profiles

  5. Avian IgY antibodies: characteristics and applications in immunodiagnostic

    Directory of Open Access Journals (Sweden)

    Lívia Silveira Munhoz

    2014-01-01

    Full Text Available Immunoglobulin Y (IgY is the major antibody isotype in birds, reptiles, amphibia, and lungfish, playing a similar biological role as mammal IgG. Due to its phylogenetic distance, immune diversification and presence in the egg yolk, IgY provide a number of advantages in immunodiagnostic compared to IgG from mammals. Moreover, IgY production is in agreement with international efforts to reduce, refine and if possible, to replace animals in experimentation, contributing substantially in favor of animal welfare. This article presents an overview about structural and functional features, production and applications of IgY in immunodiagnostic, as well as the advantages of chicken antibodies use.

  6. Questions and Answers about TB

    Science.gov (United States)

    ... disease. Introduction Testing and Treatment TB Disease Glossary Introduction Introduction What is TB? Why is TB still ... chest x-ray is made by exposing a film to x-rays that pass through the chest. ...

  7. Immunodiagnostic confirmation of hydatid disease in patients with a presumptive diagnosis of injection

    International Nuclear Information System (INIS)

    Varela-Diaz, V.M.; Coltorti, E.A.

    1984-01-01

    Information obtained from the routine application of hydatid immunodiagnostic techniques in different clinical situations over a seven-year period is presented. The immunoelectrophoresis test was used and was replaced by the arc 5 double diffusion (DD5) test. Examination of sera from 1.888 patients with signs and/or symptoms comparatible with hydatid disease revealed that the presurgical confirmation of Echinococcus granulosus infection is only obtained by detection of anti-antigen 5 antibodies. In all patients whose preoperative serum showed three or more uncharacteristic bands in the absence of anti-antigen 5 antibodies, hydatid cysts were found surgically. DD5 testing of a fluid sample collected by puncture estabilished its hydatid etiology. Pos-operative monitoring of hydatidosis patients demonstrated that persintence of DD5-positivity two years after surgery established the presence of ther cysts. (M.A.C.) [pt

  8. Immunodiagnostic confirmation of hydatid disease in patients with a presumptive diagnosis of injection

    Energy Technology Data Exchange (ETDEWEB)

    Varela-Diaz, V.M.; Coltorti, E.A.

    Information obtained from the routine application of hydatid immunodiagnostic techniques in different clinical situations over a seven-year period is presented. The immunoelectrophoresis test was used and was replaced by the arc 5 double diffusion (DD5) test. Examination of sera from 1.888 patients with signs and/or symptoms comparatible with hydatid disease revealed that the presurgical confirmation of Echinococcus granulosus infection is only obtained by detection of anti-antigen 5 antibodies. In all patients whose preoperative serum showed three or more uncharacteristic bands in the absence of anti-antigen 5 antibodies, hydatid cysts were found surgically. DD5 testing of a fluid sample collected by puncture estabilished its hydatid etiology. Post-operative monitoring of hydatidosis patients demonstrated that persistence of DD5-positivity two years after surgery established the presence of ther cysts.

  9. [Analysis of tuberculosis infection among foreigners using QuantiFeron TB-2G test].

    Science.gov (United States)

    Higuchi, Kazue; Harada, Nobuyuki; Nagasaka, Yuji; Mori, Toru

    2007-06-01

    The purpose of this study was to investigate contacts of a tuberculosis patient among foreigners using QuantiFERON TB-2G (QFT-2G) test. Three index cases in this study were all foreigners. Contacts, who were mostly foreigners and some Japanese, were investigated by a chest X-ray examination, tuberculin skin test (TST) and QFT-2G, and all data were compared. Among 48 subjects (30 Vietnamese and 18 Japanese) in case 1, 8 Vietnamese and 2 Japanese were QFT-2G positive. One contacts among 3 most close contacts who lived in the same room with the index case was QFT-2G positive. In case 2, three Chinese among 22 contacts were QFT-2G positive, and a very close contact who lived in the next door to the index case was QFT-2G negative. Seven QFT-2G positive Chinese were identified among 24 contacts in case 3. However, four very close contacts among them were QFT-2G negative. Although it was unclear whether QFT-2G positives in cases 1 and 2 were infected with M. tuberculosis through the index cases, it is possible to speculate that these QFT-2G positives were already infected with M. tuberculosis while they live in their own country based on the prevalence of TB in their countries and the fact that many very close contacts were QFT-2G negative. Also, it was suggested that QFT-2G positives in case 3 may not be infected through the index case, but infected in their country, since all close contacts were QFT-2G negative. The results of this study suggested that using the QFT-2G test for foreigners prior to or soon after their entry to Japan and recommending chemoprophylaxis for those who are QFT-2G positive would be a very efficient control measures against immigrant foreigners with TB infection.

  10. Direct nitrate reductase assay versus microscopic observation drug susceptibility test for rapid detection of MDR-TB in Uganda.

    Directory of Open Access Journals (Sweden)

    Freddie Bwanga

    Full Text Available The most common method for detection of drug resistant (DR TB in resource-limited settings (RLSs is indirect susceptibility testing on Lowenstein-Jensen medium (LJ which is very time consuming with results available only after 2-3 months. Effective therapy of DR TB is therefore markedly delayed and patients can transmit resistant strains. Rapid and accurate tests suitable for RLSs in the diagnosis of DR TB are thus highly needed. In this study we compared two direct techniques--Nitrate Reductase Assay (NRA and Microscopic Observation Drug Susceptibility (MODS for rapid detection of MDR-TB in a high burden RLS. The sensitivity, specificity, and proportion of interpretable results were studied. Smear positive sputum was collected from 245 consecutive re-treatment TB patients attending a TB clinic in Kampala, Uganda. Samples were processed at the national reference laboratory and tested for susceptibility to rifampicin and isoniazid with direct NRA, direct MODS and the indirect LJ proportion method as reference. A total of 229 specimens were confirmed as M. tuberculosis, of these interpretable results were obtained in 217 (95% with either the NRA or MODS. Sensitivity, specificity and kappa agreement for MDR-TB diagnosis was 97%, 98% and 0.93 with the NRA; and 87%, 95% and 0.78 with the MODS, respectively. The median time to results was 10, 7 and 64 days with NRA, MODS and the reference technique, respectively. The cost of laboratory supplies per sample was low, around 5 USD, for the rapid tests. The direct NRA and MODS offered rapid detection of resistance almost eight weeks earlier than with the reference method. In the study settings, the direct NRA was highly sensitive and specific. We consider it to have a strong potential for timely detection of MDR-TB in RLS.

  11. QuantiFERON–TB Gold In-Tube test performance in Denmark

    DEFF Research Database (Denmark)

    Hermansen, Thomas; Lillebaek, Troels; Hansen, Ann-Brit E

    2014-01-01

    BACKGROUND: Little is known about the QuantiFERON-TB Gold In-Tube Test (QFT) in extreme age groups. The test performance has been reported to be impaired in children and elderly, but reports are diverging. The aim of this study was to evaluate QFT performance in patients with and without......, the overall QFT performance was good. The sensitivity in children (≥ 1) was high although few children were included, whereas sensitivity declined with increasing age. Indeterminate rates were higher in infants and elderly. In contrast to current guidelines, our data suggest that the QFT performs well...... in children ≥ 1 years in low endemic regions but that the test should be used with care among the elderly....

  12. [Immunodiagnostic methods in lupus erythematosus disseminatus].

    Science.gov (United States)

    Storch, H; Schwenke, H; Helbig, W

    1975-12-01

    In 27 patients with lupus erythematodes diseminatus the determinations of the LE-cells according to the macromethod (Zimmer and Hargraves) and the micromethod (Mudrik and co-workers) were compared with the demonstration of antinuclear factors according to the indirect immunofluorescence and immune enzyme technique. The sensitiveness of the two last-mentioned immunomorphological methods is somewhat larger. In these cases the size of the titre of the antinuclear factor almost always correlates positively with the number of the LE-cells. For the purpose of the initial diagnostics and the judgment of the course a morphological method cannot be renounced, since in the acute episode a high consumption of the antinuclear factor the immunological methods negatively correlate with the number of the LE-cells. The immune enzyme technique is to be recommended on account of the smaller expenditure, permanence of the preparations and high sensitiveness as alternative method of the immunofluorescence technique. In the micromethod the large variation is opposite to the advantage of the slight quantity of blood and to an always existing evaluability. Investigations of the lymphocytes of patients with lupus erythematodes disseminatus by means of the lymphocyte transformation test and the determination of the B-cells with the help of the direct immune peroxidase technique refer to the close pathogenetic connections of cellular and humoral immune reactions in this disease.

  13. Culture and Next-generation sequencing-based drug susceptibility testing unveil high levels of drug-resistant-TB in Djibouti: results from the first national survey.

    Science.gov (United States)

    Tagliani, Elisa; Hassan, Mohamed Osman; Waberi, Yacine; De Filippo, Maria Rosaria; Falzon, Dennis; Dean, Anna; Zignol, Matteo; Supply, Philip; Abdoulkader, Mohamed Ali; Hassangue, Hawa; Cirillo, Daniela Maria

    2017-12-15

    Djibouti is a small country in the Horn of Africa with a high TB incidence (378/100,000 in 2015). Multidrug-resistant TB (MDR-TB) and resistance to second-line agents have been previously identified in the country but the extent of the problem has yet to be quantified. A national survey was conducted to estimate the proportion of MDR-TB among a representative sample of TB patients. Sputum was tested using XpertMTB/RIF and samples positive for MTB and resistant to rifampicin underwent first line phenotypic susceptibility testing. The TB supranational reference laboratory in Milan, Italy, undertook external quality assurance, genotypic testing based on whole genome and targeted-deep sequencing and phylogenetic studies. 301 new and 66 previously treated TB cases were enrolled. MDR-TB was detected in 34 patients: 4.7% of new and 31% of previously treated cases. Resistance to pyrazinamide, aminoglycosides and capreomycin was detected in 68%, 18% and 29% of MDR-TB strains respectively, while resistance to fluoroquinolones was not detected. Cluster analysis identified transmission of MDR-TB as a critical factor fostering drug resistance in the country. Levels of MDR-TB in Djibouti are among the highest on the African continent. High prevalence of resistance to pyrazinamide and second-line injectable agents have important implications for treatment regimens.

  14. Comparison of sensitivity of quantiferon-tb gold test and tuberculin skin test in active pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Khalil, K.F.; Ambreen, A.; Butt, T.

    2013-01-01

    Objective: To compare the sensitivity of tuberculin skin test (TST) and quantiFERON-TB gold test (QFT-G) in active pulmonary tuberculosis. Study Design: Analytical study. Place and Duration of Study: Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi, from July 2011 to January 2012. Methodology: QuantiFERON-TB gold test (QFT-G) was evaluated and compared it with tuberculin skin test (TST) in 50 cases of active pulmonary tuberculosis, in whom tuberculous infection was suspected on clinical, radiological and microbiological grounds. Sensitivity was determined against positive growth for Mycobacterium tuberculosis. Results: Out of 50 cases, 43 were females and 7 were males. The mean age was 41.84 A+- 19.03 years. Sensitivity of QFT-G was 80% while that of TST was 28%. Conclusion: QFT-G has much higher sensitivity than TST for active pulmonary tuberculosis. It is unaffected by prior BCG administration and prior exposure to atypical mycobacteria. A positive QFT-G result can be an adjunct to diagnosis in patients having clinical and radiological data compatible with pulmonary tuberculosis. (author)

  15. Diagnosis of Latent Tuberculosis in Patients with Systemic Lupus Erythematosus: T.SPOT.TB versus Tuberculin Skin Test

    Directory of Open Access Journals (Sweden)

    Maria Del Mar Arenas Miras

    2014-01-01

    Full Text Available Early studies in patients with systemic lupus erythematosus (SLE reported increased incidence of tuberculosis. The tuberculin skin test (TST is the technique of choice to detect latent tuberculosis infection (LTBI but has several limitations. Objectives. We compared TST and the newer T.SPOT.TB test to diagnose LTBI in SLE patients. Methods. In this observational cohort study conducted between August 2009 and February 2012, we recruited 92 patients from those attending the SLE clinic of our university hospital. Data recorded were epidemiological and sociodemographic characteristics. Laboratory analyses included TST and T.SPOT.TB tests. Results. Of the patients studied, 92% were women with an average age of 42.7 years. Overall, the degree of correlation between the two tests was low (Kappa index = 0.324 but was better in patients not receiving corticosteroids (CTC/immunosuppressive (IS therapy (Kappa = 0.436 and in those receiving hydroxychloroquine (Kappa = 0.473. While TST results were adversely affected by those receiving CTC and/or IS drugs (P=0.021, the T.SPOT.TB results were not. Conclusion. Although the TST test remains a useful tool for diagnosing LTBI in SLE patients, the T.SPOT.TB test is perhaps better employed when the patient is receiving CTC and/or IS drugs.

  16. Provider-initiated HIV testing & counselling in incident tuberculosis cases under National TB Programme conditions at a tertiary care teaching hospital in Tirupati, south India

    Directory of Open Access Journals (Sweden)

    Alladi Mohan

    2017-01-01

    >Interpretation & conclusions: The findings of this study showed that a higher proportion of TB patients underwent HIV testing (75% compared to the national figure of 63 per cent in 2013-2014. HIV seropositivity (4.6% in TB patients who underwent HIV testing was similar to the five per cent figure observed at national level during 2013-2014. The HIV status of 25 per cent of patients with incident TB still remained unknown, suggesting a need for better integration and co-ordination for effective management of HIV-TB co-infection.

  17. Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a TBNET/RESIST-TB consensus statement

    NARCIS (Netherlands)

    Domínguez, J.; Boettger, E. C.; Cirillo, D.; Cobelens, F.; Eisenach, K. D.; Gagneux, S.; Hillemann, D.; Horsburgh, R.; Molina-Moya, B.; Niemann, S.; Tortoli, E.; Whitelaw, A.; Lange, C.

    2016-01-01

    The emergence of drug-resistant strains of Mycobacterium tuberculosis is a challenge to global tuberculosis (TB) control. Although culture-based methods have been regarded as the gold standard for drug susceptibility testing (DST), molecular methods provide rapid information on mutations in the M.

  18. Limitations of the QuantiFERON-TB Gold test in detecting Mycobacterium tuberculosis infection in immunocompromised patients

    DEFF Research Database (Denmark)

    Hornum, M.; Mortensen, K.L.; Kamper, Anne-Lise

    2008-01-01

    Four cases are presented, immunosuppressed by at least three different mechanisms: one HIV-positive patient with a CD4 count of 0.29 x 10(6)/ml, one malnourished patient, and two kidney-transplanted patients. All patients had a negative interferon (IFN)-gamma test for suspected tuberculosis (TB),...

  19. Limitations of the QuantiFERON-TB Gold test in detecting Mycobacterium tuberculosis infection in immunocompromised patients

    DEFF Research Database (Denmark)

    Hornum, Mads; Mortensen, Klaus Leth; Kamper, Anne-Lise

    2008-01-01

    Four cases are presented, immunosuppressed by at least three different mechanisms: one HIV-positive patient with a CD4 count of 0.29 x 10(6)/ml, one malnourished patient, and two kidney-transplanted patients. All patients had a negative interferon (IFN)-gamma test for suspected tuberculosis (TB...

  20. Diagnostic accuracy of the rapid urine lipoarabinomannan test for pulmonary tuberculosis among HIV-infected adults in Ghana-findings from the DETECT HIV-TB study

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie; Kenu, Ernest; Lartey, Margaret

    2015-01-01

    BACKGROUND: Rapid diagnostic tests are urgently needed to mitigate HIV-associated tuberculosis (TB) mortality. We evaluated diagnostic accuracy of the rapid urine lipoarabinomannan (LAM) test for pulmonary TB and assessed the effect of a two-sample strategy. METHODS: HIV-infected adults eligible...

  1. Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa.

    Science.gov (United States)

    Meehan, Sue-Ann; Sloot, Rosa; Draper, Heather R; Naidoo, Pren; Burger, Ronelle; Beyers, Nulda

    2018-01-01

    Diagnosing HIV and/or TB is not sufficient; linkage to care and treatment is conditional to reduce the burden of disease. This study aimed to determine factors associated with linkage to HIV care and TB treatment at community-based services in Cape Town, South Africa. This retrospective cohort study utilized routinely collected data from clients who utilized stand-alone (fixed site not attached to a health facility) and mobile HIV testing services in eight communities in the City of Cape Town Metropolitan district, between January 2008 and June 2012. Clients were included in the analysis if they were ≥12 years and had a known HIV status. Generalized estimating equations (GEE) logistic regression models were used to assess the association between determinants (sex, age, HIV testing service and co-infection status) and self-reported linkage to HIV care and/or TB treatment. Linkage to HIV care was 3 738/5 929 (63.1%). Linkage to HIV care was associated with the type of HIV testing service. Clients diagnosed with HIV at mobile services had a significantly reduced odds of linking to HIV care (aOR 0.7 (CI 95%: 0.6-0.8), p<0.001. Linkage to TB treatment was 210/275 (76.4%). Linkage to TB treatment was not associated with sex and service type, but was associated with age. Clients in older age groups were less likely to link to TB treatment compared to clients in the age group 12-24 years (all, p-value<0.05). A large proportion of clients diagnosed with HIV at mobile services did not link to care. Almost a quarter of clients diagnosed with TB did not link to treatment. Integrated community-based HIV and TB testing services are efficient in diagnosing HIV and TB, but strategies to improve linkage to care are required to control these epidemics.

  2. Survey of the diagnostic retooling process in national TB reference laboratories, with special focus on rapid speciation tests endorsed by WHO in 2007.

    Directory of Open Access Journals (Sweden)

    Sanne C van Kampen

    Full Text Available BACKGROUND: Successful integration of new diagnostics in national tuberculosis (TB control programs, also called 'retooling', is highly dependent on operational aspects related to test availability, accessibility and affordability. This survey aimed to find out whether recommendations to use new diagnostics lead to successful retooling in high TB endemic countries, using immunochromatographic tests (ICTs for TB culture speciation as a case study. ICTs are recommended to accurately confirm the presence of bacteria of the Mycobacterium tuberculosis complex in liquid culture isolates. METHODS AND FINDINGS: Questionnaires were sent to national TB reference laboratories (NRLs in 42 high TB endemic countries to address their access to information on ICT implementation, logistics related to availability, accessibility and affordability of ICTs, and testing algorithms. Results from 16 responding countries indicated that half of the NRLs were aware of the contents of WHO guidance documents on liquid culture and ICT implementation, as well as their eligibility for a negotiated pricing agreement for ICT procurement. No major issues with availability and accessibility of ICTs were raised. When asked about testing algorithms, ICTs were not used as stand-alone or first test for TB culture identification as recommended by WHO. CONCLUSIONS: The low response rate was a limitation of this survey and together with NRLs managers' unawareness of global guidance, suggests a lack of effective communication between partners of the global laboratory network and NRLs. TB tests could become more affordable to high TB endemic countries, if the possibility to negotiate lower prices for commercial products is communicated to them more successfully. NRLs need additional guidance to identify where available technologies can be most usefully implemented and in what order, taking into account long-term laboratory strategies.

  3. [Cloning, Expression and Immunodiagnostic Evaluation of the Fasciola gigantica Thioredoxin Peroxidase].

    Science.gov (United States)

    Wang, Yue-qi; Zhou, Yan; Cheng, Na; Chen, Mu-xin; Ai, Lin; Liu, Yu-hua; Zhang, Jian-guo; Luo, Jia-jun; Xu, Xue-nian

    2015-04-01

    To immunoscreen the gene encoding thioredoxin peroxidase (TPx) from a cDNA library made from adult Fasciola gigantica worms, clone and express the gene, and evaluate the immunodiagnostic value of TPx recombinant protein. The A ZAP cDNA library was immunoscreened with pooled serum of fascioliasis gigantica patients. The obtained positive clones were sequenced and analyzed by multiple sequence alignment. The full-length (rFgTPx) and N-termianal truncated (rFgTPx_nt) sequence of FgTPx was subcloned into prokaryotic plasmid pET28a(+) with a non-fusion expression technique, respectively. The recombinant proteins of rFgTPx and rFgTPx_nt were purified by His-bind affinity column (Ni-NTA). rFgTPx and rFgTPx_nt were used in indirect ELISA to test the antibody response of the serum samples. Sera of 27 fascioliasis gigantica patients, 15 patients with schistosomaisis japonica, 15 clonorchiasis sinensis patients, and 32 healthy donors were tested by using the recombinant protein based ELISA. The TPx recombinant proteins were obtained through expression, purification and renaturation, the relative molecular mass of rFgTPx and rFgTPx_nt were Mr 30,000 and Mr 26,000, respectively. The total diagnostic coincidence rate, sensitivity and specificity of rFgTPx_nt-based ELISA was 87.6% (78/89), 66.7% (18/27), and 96.8% (60/62), respectively. The cross reaction with Schistosoma japonicum and Clonorchis sinensis was 0 and 1/15 for rFgTPx_nt, respectively. Before and after treatment, A450 value of the serum samples from fascioliasis patients was 0.233 ± 0.088 and 0.129 ± 0.072, respectively (t = 4.27, P Fasciola gigantica infection.

  4. The search and identification of the new immunodiagnostic targets of bacillus anthracis spore

    International Nuclear Information System (INIS)

    Biketov, S.; Dunaytsev, I.; Baranova, E.; Marinin, L.; Dyatlov, I.

    2009-01-01

    Spores of Bacillus anthracis have been used as bio warfare agent to bio terrorize purposes. As efficiency of anti-epidemic measures included urgent prevention and treatment is determined by terms within which the bio agent is identified. Direct and rapid spore detection by antibodies based detection system is very attractive alternative to current PCR-based assays or routine phenotyping which are the most accurate but are also complex, time-consumption and expensive. The main difficulty with respect to such kind of anthrax spores detection is a cross-reaction with spores of closely related bacteria. For development of species-specific antibodies to anthrax spores recombinant scFvs or hybridoma technique were used. In both case surface spore antigens contained species-specific epitopes are need. Among exosporium proteins only ExsF(BxpB), ExsK and SoaA are specific to B.cereus group. On the surface of B. anthracis spores, a unique tetrasaccharides containing an novel monosaccharide - anthrose, was discovered. It was shown that anthrose can be serving as species-specific target for B. anthracis spores detection. We have revealed that EA1 isolated from spore of Russians strain STI-1 contain carbohydrate which formed species-specific epitopes and determine immunogenicity of this antigen. Antibodies to this antigen specifically recognized the surface target of B. anthracis spores and do not reacted with others Bacillus spore. Based on these antibodies we developed the test-systems in different formats for rapid direct detection and identification of B. anthracis spores. The results of trial these test-systems with using more than 50 different Bacillus strains were indicated that carbohydrate of EA1 isolated from spore is effective immunodiagnostic target for anthrax spores bio detection.(author)

  5. Safety and efficacy of the C-Tb skin test to diagnose Mycobacterium tuberculosis infection, compared with an interferon γ release assay and the tuberculin skin test: a phase 3, double-blind, randomised, controlled trial.

    Science.gov (United States)

    Ruhwald, Morten; Aggerbeck, Henrik; Gallardo, Rafael Vázquez; Hoff, Søren T; Villate, José I; Borregaard, Bettine; Martinez, José A; Kromann, Ingrid; Penas, Antón; Anibarro, Luis L; de Souza-Galvão, Maria Luiza; Sánchez, Francisca; Rodrigo-Pendás, Jose Ángel; Noguera-Julian, Antoni; Martínez-Lacasa, Xavier; Tuñez, Maria Victoria; Fernández, Virginia Leiro; Millet, Joan P; Moreno, Antonio; Cobos, Nazaret; Miró, José M; Roldan, Llanos; Orcau, Angels; Andersen, Peter; Caylá, Joan A

    2017-04-01

    Targeted screening and treatment of Mycobacterium tuberculosis infection substantially reduces the risk of developing active tuberculosis. C-Tb (Statens Serum Institute, Copenhagen, Denmark) is a novel specific skin test based on ESAT-6 and CFP10 antigens. We investigated the safety and diagnostic potential of C-Tb compared with established tests in the contact-tracing setting. Negative controls, close contacts, occasional contacts, and patients with active pulmonary tuberculosis were enrolled at 13 centres in Spain. We compared C-Tb with the QuantiFERON-TB Gold In-Tube ([QFT] Qiagen, Hilden, Germany) interferon γ release assay (IGRA) and the purified protein derivative (PPD) RT 23 tuberculin skin test ([TST] Statens Serum Institute). All participants older than 5 years were tested with QFT. Some participants in the negative control group received C-Tb without the TST to test for potential interactions between C-Tb and PPD RT 23. The rest were randomly assigned in blocks of ten and tested with both C-Tb and TST, with five in each block receiving injection of C-Tb in the right arm and the TST in the left arm and five vice versa. The primary and safety analyses were done in all participants randomly assigned to a group who received any test. This trial is registered with ClinicalTrials.gov, number NCT01631266, and with EudraCT, number 2011-005617-36. From July 24, 2012, to Oct 2, 2014, 979 participants were enrolled, of whom 263 were negative controls, 299 were occasional contacts, 316 were close contacts, and 101 were patients with tuberculosis. 970 (99%) participants completed the trial. Induration sizes were similar for C-Tb and TST, but TST positivity was affected by BCG vaccination status. We found a strong positive trend towards C-Tb test positivity with increasing risk of infection, from 3% in negative controls to 16% in occasional contacts, to 43% in close contacts. C-Tb and QFT results were concordant in 785 (94%) of 834 participants aged 5 years and older

  6. Relevance and acceptability of using the Quantiferon gold test (QGIT) to screen CD4 blood draws for latent TB infection among PLHIV in South Africa: formative qualitative research findings from the TEKO trial.

    Science.gov (United States)

    Kerrigan, Deanna; Tudor, Carrie; Motlhaoleng, Katlego; Lebina, Limakatso; Qomfu, Cokiswa; Variava, Ebrahim; Chon, Sandy; Martinson, Neil; Golub, Jonathan E

    2018-04-16

    Tuberculosis (TB) is the leading cause of mortality among people living with HIV (PLHIV), despite the availability of effective preventive therapy. The TEKO trial is assessing the impact of using a blood test, Quantiferon-TB Gold In-Tube Test (QGIT), to screen for latent TB compared to the Tuberculin Screening Test (TST) among PLHIV in South Africa. Fifty-six qualitative interviews were conducted with PLHIV and clinical providers participating in the TEKO trial. We explored TB screening, diagnosis, and treatment guidelines and processes and the use of the QGIT to screen for latent TB infection at the time of CD4 blood draw. Thematic content analysis was conducted. Considerable variability in TB screening procedures was documented due to lack of personnel and clarity regarding current national TB guidelines for PLHIV. Few clinics had started using the TST per national guidelines and many patients had never heard of isoniazid preventive therapy (IPT). Nearly all participants supported the idea of latent TB screening using routine blood drawn for CD4 counts. Findings indicate that screening for latent TB infection using QGIT from blood drawn for CD4 counts among PLHIV is an acceptable approach to increase latent TB detection given the challenges associated with ensuring systematic latent TB screening in overburdened public clinics. The results presented here were from formative research related to the TEKO trial (Identifier NCT02119130 , registered 10 April 2014).

  7. Evaluation of the tuberculin skin test and the interferon-γ release assay for TB screening in French healthcare workers

    Directory of Open Access Journals (Sweden)

    Raffi Francois

    2009-11-01

    Full Text Available Abstract Introduction Using French cut-offs for the Tuberculin Skin Test (TST, results of the TST were compared with the results of an Interferon-γ Release Assay (IGRA in Healthcare Workers (HCW after contact to AFB-positive TB patients. Methods Between May 2006 and May 2007, a total of 148 HCWs of the University Hospital in Nantes, France were tested simultaneously with IGRA und TST. A TST was considered to indicate recent latent TB infection (LTBI if an increase of >10 mm or if TST ≥ 15 mm for those with no previous TST result was observed. For those with a positive TST, chest X-ray was performed and preventive chemotherapy was offered. Results All HCWs were BCG-vaccinated. The IGRA was positive in 18.9% and TST ≥ 10 mm was observed in 65.5%. A recent LTBI was believed to be highly probable in 30.4% following TST. Agreement between IGRA and TST was low (kappa 0.041. In 10 (16.7% out of 60 HCWs who needed chest X-ray following TST the IGRA was positive. In 9 (20% out of 45 HCWs to whom preventive chemotherapy was offered following TST the IGRA was positive. Of those considered TST-negative following the French guidelines, 20.5% were IGRA-positive. In a two-step strategy - positive TST verified by IGRA - 18 out of 28 (64.3% IGRA-positive HCWs would not have been detected using French guidelines for TST interpretation. Conclusion The introduction of IGRA in contact tracings of BCG-vaccinated HCWs reduces X-rays and preventive chemotherapies. Increasing the cut-off for a positive TST does not seem to be helpful to overcome the effect of BCG vaccination on TST.

  8. [CLINICAL UTILITY OF T-SPOT.TB ASSAY WITH T-Cell Xtend REAGENT FOR ACTIVE TUBERCULOSIS DIAGNOSIS IN THE FIELD TEST AT OUR HOSPITAL].

    Science.gov (United States)

    Nemoto, Kenji; Oh-ishi, Shuji; Taguchi, Masato; Hyodo, Kentaro; Kanazawa, Jun; Miura, Yukiko; Takaku, Takio; Usui, Shingo; Hayashihara, Kenji; Saito, Takefumi

    2016-04-01

    T-SPOT.TB (T-SPOT), an interferon-gamma release assay, has shown promise as a diagnostic tool for active tuberculosis (TB), and its use is expanding. Addition of the T-Cell Xtend (TCX) reagent may allow delayed processing, and this characteristic is important for using this test in the field. However, limited data is available on the usefulness of T-SPOT with TCX as a field test for diagnosing active TB. To investigate the clinical utility of T-SPOT with TCX and the risk factors for a false-negative result in patients with active TB. A total of 57 patients with active TB who underwent the T-SPOT test with TCX prior to treatment were enrolled between May 2013 and May 2015. One patient with an indeterminate result for T-SPOT was excluded; therefore, the data of 56 patients were eventually included in the final analysis. The basic characteristics and clinical findings were compared between the true-positive and false-negative T-SPOT groups. Of the 56 patients, 40 (71.4%), 13 (23.2%), 3 (5.4%) had true-positive, false-negative, and borderline T-SPOT results, respectively. This study did not reveal any significant risk factors for a false-negative T-SPOT result. In this clinical study, the proportion of patients with a false-negative result for T-SPOT with TCX for active TB was higher than that reported previously. Therefore, careful interpretation of a negative result for T-SPOT with TCX is necessary, regardless of the patient's background.

  9. TB in Children in the United States

    Science.gov (United States)

    ... Regimen for Latent TB Infection-Patient Education Brochure Posters Mantoux Tuberculin Skin Test Wall Chart World TB ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

  10. Specificity of the Tuberculin Skin Test and the T-SPOT."TB" Assay among Students in a Low-Tuberculosis Incidence Setting

    Science.gov (United States)

    Talbot, Elizabeth A.; Harland, Dawn; Wieland-Alter, Wendy; Burrer, Sherry; Adams, Lisa V.

    2012-01-01

    Objective: Interferon-[gamma] release assays (IGRAs) are an important tool for detecting latent "Mycobacterium tuberculosis" infection (LTBI). Insufficient data exist about IGRA specificity in college health centers, most of which screen students for LTBI using the tuberculin skin test (TST). Participants: Students at a low-TB incidence college…

  11. Evaluation of the Sensititre MycoTB plate for susceptibility testing of the Mycobacterium tuberculosis complex against first- and second-line agents.

    Science.gov (United States)

    Hall, Leslie; Jude, Kurt P; Clark, Shirley L; Dionne, Kim; Merson, Ryan; Boyer, Ana; Parrish, Nicole M; Wengenack, Nancy L

    2012-11-01

    The Sensititre MycoTB plate (TREK Diagnostic Systems, Cleveland, OH) uses a microtiter plate MIC format for susceptibility testing of Mycobacterium tuberculosis complex isolates against first- and second-line antituberculosis agents. Categorical agreement versus the agar proportion method for 122 M. tuberculosis complex isolates was 94% to 100%.

  12. [Tuberculosis screening program for undocumented immigrant teenagers using the QuantiFERON(®)-TB Gold In-Tube test].

    Science.gov (United States)

    Salinas, Carlos; Ballaz, Aitor; Díez, Rosa; Aguirre, Urko; Antón, Ane; Altube, Lander

    2015-07-06

    The aim of this study was to determine the prevalence of tuberculosis infection in undocumented immigrant teenagers using a tuberculin skin test (TST) for initial screening and QuantiFERON(®)-TB Gold In-Tube (QFT-GIT) as a confirmatory test. From 2007 to 2012, under 19 year-old immigrant teenagers from 2 accommodation centers of the Basque Country (Spain) were included in the study. The TST was done in all of them and the QFT-GIT was done in selected patients with a TST≥5mm. Eight hundred and forty-five immigrants were included, most of them from Africa (99.5%). Fifty-one percent of immigrants with TST ≥ 5 mm has a positive QFT-GIT. We found 2 cases of active tuberculosis (2/845: 0.24%). The concordance between TST (≥ 10 mm) and QFT-GIT was 63%, with 57% of positive concordance cases and 96% of negative concordances. There were 246 cases with TST ≥ 10 mm (29%), with significant differences between Magrebis (21.5%) and Subsaharians (67%) (Ptuberculosis infection in Subsaharian immigrants, we recommend implementing screening programs in this population. Using QFT-GIT, the number of candidates for chemoprophylaxis was reduced to 43% compared with TST alone (≥ 10 mm). Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  13. Treatment: Latent TB Infection (LTBI) and TB Disease

    Science.gov (United States)

    ... Adverse Events TB Treatment of Persons Living with HIV TB Treatment and Pregnancy TB Treatment for Children Drug-Resistant TB Research TB Epidemiologic Studies Consortium Research Projects Publications TB Trials Consortium Study ...

  14. Family physicians understanding about Mantoux test: A survey from a high endemic TB country

    Directory of Open Access Journals (Sweden)

    Ali Niloufer

    2010-05-01

    Full Text Available Abstract Background Tuberculosis is a global health emergency and is a big challenge to diagnose and manage it. Family physicians being first contact health persons should be well competent to diagnose and manage the patients with tuberculosis. Aims This study was aimed to assess the level of understanding about Mantoux Test amongst Family Physicians in Karachi, Pakistan and to determine the difference of level of understanding by gender and number of tuberculosis patients seen in a month. Methods A cross sectional survey was conducted among 200 Family Physicians working in Karachi; the largest city and economic hub of Pakistan. Family Physicians who attended Continuous Medical Education sessions were approached after taking consent. Pre-tested, self administered questionnaire was filled consisting of: basic demographic characteristics, questions regarding knowledge about Mantoux Test, its application and interpretation. Data of 159 questionnaires was analyzed for percentages, as rest were incomplete. Chi square test was used to calculate the difference of understanding levels between various groups. Results Almost two thirds of respondents were males and above 35 years of age. Majority of Family Physicians were private practitioners and seeing more than five tuberculosis patients per month. Overall, a big gap was identified about the knowledge of Mantoux Test among study participants. Only 18.8% of Family Physicians secured Excellent (≥ 80% correct responses. This poor level of understanding was almost equally distributed in all comparative groups (Male = 20.8% versus Female = 15.9%; p - 0.69 and (Seen Conclusion Our study revealed an overall major deficit in understanding and interpretation of Mantoux Test amongst Family Physicians which needs to be addressed. Continues Medical Education sessions for Family Physicians should be organized in regular basis for upgrading their knowledge in this regards.

  15. Patho-TB test for the rapid diagnosis of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Roya Alavi-Naini

    2009-09-01

    Full Text Available

    • BACKGROUND: Despite recent technologic improvements in identifying mycobacterium tuberculosis, we are still facing problems in rapid diagnosis of tuberculosis. The objective of this study is to determine the diagnostic value of a new rapid screening test (Patho-TB™ for diagnosis of pulmonary tuberculosis.
    • METHODS: Between September 2006 to August 2007, 178 patients were enrolled in the study who were finally classified into two groups; a group of documented pulmonary tuberculosis (n = 67 and a group of non-tuberculous pulmonary infection (n = 111. Patho-TB™ test, Ziehl-Neelsen staining and culture were done on all specimens.
    • RESULTS: Of all, 43 patients with pulmonary tuberculosis were sputum smear positive for acid fast bacilli and the rest were smear negative. Mean age of the patients was 59.8 ± 16.1 years and 44% of them were men. The results of Patho- TB™ test were positive in 40 of smear positive and 20 of smear negative tuberculous patients and 33 cases of nontuberculous control group. The sensitivity, specificity, positive and negative predictive values and accuracy of Patho- TB™ test were estimated 89.5%, 70.2%, 64.5%, 91.7% and 77.5%, respectively.
    • CONCLUSIONS: According to the present study it would be suggested that Patho-TB™ test could be a rapid and inexpensive method for diagnosis of pulmonary tuberculosis, given by its high sensitivity and negative predictive value. Concerning the high number of false positive results, using a confirmatory diagnostic procedure is mandatory.
    • KEYWORDS: Pulmonary Tuberculosis, Rapid Diagnosis, Mycobacterium Tuberculosis Antigens, Iran

  16. HIV/TB co-infection:perspectives of TB patients and providers on the integrated HIV/TB pilot program in Tamilnadu, India

    OpenAIRE

    Lakshminarayanan, Mahalakshmi

    2009-01-01

    The WHO recommends routine HIV testing among TB patients as a key strategy to combat the dual HIV/TB epidemic. India has integrated its HIV and TB control programs and is offering provider initiated HIV testing for all TB patients since 2007. Using a mixed methods approach, this study aims to understand the perspectives of TB patients and providers on the integrated HIV/TB pilot program in Tamilnadu, India. A survey conducted by the Tuberculosis Research Center, India on 300 TB patients is th...

  17. Exploring diagnostic opportunities in active and latent TB: Stratifying transmission risk using PCR, and identification of immunogenic CD8+ T-cell epitopes

    DEFF Research Database (Denmark)

    Fløe, Andreas

    2018-01-01

    : Study I: As a single sputum-sample analyzed with PCR for MTB identifies >97% of smear-positive TB patients, and as the majority of missed smear-positive TB patients have only one low-grade smear, de-isolation of patients with a single negative sputum PCR-result is safe. Study II: Six HLA A*0201......-restricted antigen-specific CD8+ T-cells. Study III: The CD8+ T-cell response to MTB is highly variable and unpredictable, targeting a wide panel of differently expressed antigens. However, the novel epitopes described here could play a role in future immunodiagnostic tools as well as in vaccine development...

  18. TB Screening Tests

    Science.gov (United States)

    ... Medical Center. Medscape from American Journal of Clinical Pathology . 2009;132(5):678-686. [On-line information]. ... default.htm through http://www.cdc.gov . Accessed March 2010. See More See Less Ask a Laboratory ...

  19. Tuberculosis Facts - Exposure to TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Exposure to TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  20. Clinic flow for STI, HIV, and TB patients in an urban infectious disease clinic offering point-of-care testing services in Durban, South Africa.

    Science.gov (United States)

    Stime, Katrina J; Garrett, Nigel; Sookrajh, Yukteshwar; Dorward, Jienchi; Dlamini, Ntuthu; Olowolagba, Ayo; Sharma, Monisha; Barnabas, Ruanne V; Drain, Paul K

    2018-05-11

    Many clinics in Southern Africa have long waiting times. The implementation of point-of-care (POC) tests to accelerate diagnosis and improve clinical management in resource-limited settings may improve or worsen clinic flow and waiting times. The objective of this study was to describe clinic flow with special emphasis on the impact of POC testing at a large urban public healthcare clinic in Durban, South Africa. We used time and motion methods to directly observe patients and practitioners. We created patient flow maps and recorded individual patient waiting and consultation times for patients seeking STI, TB, or HIV care. We conducted semi-structured interviews with 20 clinic staff to ascertain staff opinions on clinic flow and POC test implementation. Among 121 observed patients, the total number of queues ranged from 4 to 7 and total visit times ranged from 0:14 (hours:minutes) to 7:38. Patients waited a mean of 2:05 for standard-of-care STI management, and approximately 4:56 for STI POC diagnostic testing. Stable HIV patients who collected antiretroviral therapy refills waited a mean of 2:42 in the standard queue and 2:26 in the fast-track queue. A rapid TB test on a small sample of patients with the Xpert MTB/RIF assay and treatment initiation took a mean of 6:56, and 40% of patients presenting with TB-related symptoms were asked to return for an additional clinic visit to obtain test results. For all groups, the mean clinical assessment time with a nurse or physician was 7 to 9 min, which accounted for 2 to 6% of total visit time. Staff identified poor clinic flow and personnel shortages as areas of concern that may pose challenges to expanding POC tests in the current clinic environment. This busy urban clinic had multiple patient queues, long clinical visits, and short clinical encounters. Although POC testing ensured patients received a diagnosis sooner, it more than doubled the time STI patients spent at the clinic and did not result in same

  1. QuantiFERON-TB Gold In-Tube as a Confirmatory Test for Tuberculin Skin Test in Tuberculosis Contact Tracing: A Noninferiority Clinical Trial.

    Science.gov (United States)

    Muñoz, Laura; Santin, Miguel; Alcaide, Fernando; Ruíz-Serrano, Maria Jesús; Gijón, Paloma; Bermúdez, Elena; Domínguez-Castellano, Angel; Navarro, María Dolores; Ramírez, Encarnación; Pérez-Escolano, Elvira; López-Prieto, María Dolores; Gutiérrez-Rodriguez, José; Anibarro, Luis; Calviño, Laura; Trigo, Matilde; Cifuentes, Carmen; García-Gasalla, Mercedes; Payeras, Antoni; Gasch, Oriol; Espasa, Mateu; Agüero, Ramon; Ferrer, Diego; Casas, Xavier; González-Cuevas, Araceli; García-Zamalloa, Alberto; Bikuña, Edurne; Lecuona, María; Galindo, Rosa; Ramírez-Lapausa, Marta; Carrillo, Raquel

    2018-01-18

    Screening strategies based on interferon-γ release assays in tuberculosis contact tracing may reduce the need for preventive therapy without increasing subsequent active disease. We conducted an open-label, randomized trial to test the noninferiority of a 2-step strategy with the tuberculin skin test (TST) followed by QuantiFERON-TB Gold In-Tube (QFT-GIT) as a confirmatory test (the TST/QFT arm) to the standard TST-alone strategy (TST arm) for targeting preventive therapy in household contacts of patients with tuberculosis. Participants were followed for 24 months after randomization. The primary endpoint was the development of tuberculosis, with a noninferiority margin of 1.5 percentage points. A total of 871 contacts were randomized. Four contacts in the TST arm and 2 in the TST/QFT arm developed tuberculosis. In the modified intention-to-treat analysis, this accounted for 0.99% in the TST arm and 0.51% in the TST/QFT arm (-0.48% difference; 97.5% confidence interval [CI], -1.86% to 0.90%); in the per-protocol analysis, the corresponding rates were 1.67% and 0.82% in the TST and TST/QFT arms, respectively (-0.85% difference; 97.5% CI, -3.14% to 1.43%). Of the 792 contacts analyzed, 65.3% in the TST arm and 42.2% in the TST/QFT arm were diagnosed with tuberculosis infection (23.1% difference; 95% CI, 16.4% to 30.0%). In low-incidence settings, screening household contacts with the TST and using QFT-GIT as a confirmatory test is not inferior to TST-alone for preventing active tuberculosis, allowing a safe reduction of preventive treatments. NCT01223534. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  2. TB control programmes: the challenges for Africa.

    Science.gov (United States)

    Harries, T

    1996-11-01

    Governmental neglect of tuberculosis (TB), inadequately managed and inaccurately designed TB control programs, population growth, and the HIV epidemic account for the resurgence of TB in sub-Saharan Africa. The World Health Organization and the International Union against TB and Lung Disease have developed a TB control strategy that aims to reduce mortality, morbidity, and transmission of TB. It aims for an 85% cure rate among detected new cases of smear-positive TB and a 70% rate of detecting existing smear-positive TB cases. The strategy involves the provision of short-course chemotherapy (SCC) to all identified smear-positive TB cases through directly observed treatment (DOTS). SCC treatment regimens for smear-positive pulmonary TB recommended for sub-Saharan African countries are: initial phase = daily administration over 2 months of streptomycin, rifampicin, isoniazid, and pyrazinamide; continuation phase = 3 doses over 4 months of isoniazid and rifampicin or daily administration of thiacetazone and isoniazid or of ethambutol and isoniazid. A TB control policy must be implemented to bring about effective TB control. The essential elements of this policy include political commitment, case detection through passive case-finding, SCC, a regular supply of essential drugs, and a monitoring and evaluation system. Political commitment involves establishing a National TB Control Program to be integrated into the existing health structure. Increased awareness of TB in the community and among health workers and a reference laboratory are needed to make case finding successful. A distribution and logistics system is needed to ensure uninterrupted intake of drugs throughout treatment. These regimens have been very successful and cost-effective but pose several disadvantages (e.g., heavy workload of recommended 3 sputum smear tests). A simplified approach involves 1 initial sputum smear for 6 months; 6-months, intermittent rifampicin-based therapy, 100% DOTS throughout

  3. Find TB. Treat TB. Working together to eliminate TB.

    Centers for Disease Control (CDC) Podcasts

    2014-02-26

    In this podcast, Dr. Sundari Mase, Medical Team Lead in the Field Services and Evaluation Branch in the Division of Tuberculosis Elimination, discusses World TB Day and the 2014 theme.  Created: 2/26/2014 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/26/2014.

  4. Performance of QuantiFERON TB Gold test in detecting latent tuberculosis infection in brain-dead organ donors in Iran: a brief report.

    Science.gov (United States)

    Tabarsi, Payam; Yousefzadeh, Amir; Najafizadeh, Katayoun; Droudinia, Atousa; Bayati, Rouzbeh; Marjani, Majid; Shafaghi, Shadi; Farokhzad, Banafsheh; Javanmard, Pedram; Velayati, Ali Akbar

    2014-11-01

    With regard to the significant morbidity and mortality due to tuberculosis in lung transplant recipients, the identification of brain-dead organ donors with latent tuberculosis by use of the QuantiFERON TB Gold (QFT-G) test may be of help to reduce the risk of TB reactivation and mortality in lung recipients. This study was conducted in the National Research Institute of Tuber-culosis and Lung Diseases (NRITLD) in Iran, from January to March 2013. A total of 38 conse-cutive brain-dead donors, not currently infected with active tuberculosis, were recruited. The medi-cal records of all the study enrollees were reviewed. A whole-blood IFN- release assay (IGRA) in reaction to early secreted antigenic target 6 (ESAT-6), culture filtrate protein 10 (CFP-10), and TB7.7 antigens, was performed and the released Interferon- was measured via enzyme-linked immunosorbent assay (ELISA). The data was analyzed with QFT-G software which was provided by the company. The demographic, characteristics and other variables were entered into SPSS version 11.5. The QFT-G test results of three donors (7.9%) turned out to be positive, negative for 24 donors (63.1%), and indeterminate for 11 cases (28.9%). Our study revealed the potential advantages of QFT-G in lowering the incidence of donor-derived post-transplant tuberculosis among lung recipients. However, a high rate of indeterminate results restricted the performance of QFT-G in this study.

  5. Performance of QuantiFERON TB Gold test in detecting latent tuberculosis infection in brain-dead organ donors in Iran: A brief report

    Directory of Open Access Journals (Sweden)

    Payam Tabarsi

    2014-01-01

    Full Text Available With regard to the significant morbidity and mortality due to tuberculosis in lung transplant recipients, the identification of brain-dead organ donors with latent tuberculosis by use of the QuantiFERON TB Gold (QFT-G test may be of help to reduce the risk of TB reactivation and mortality in lung recipients. This study was conducted in the National Research Institute of Tuber-culosis and Lung Diseases (NRITLD in Iran, from January to March 2013. A total of 38 conse-cutive brain-dead donors, not currently infected with active tuberculosis, were recruited. The medi-cal records of all the study enrollees were reviewed. A whole-blood IFN- release assay (IGRA in reaction to early secreted antigenic target 6 (ESAT-6, culture filtrate protein 10 (CFP-10, and TB7.7 antigens, was performed and the released Interferon- was measured via enzyme-linked immunosorbent assay (ELISA. The data was analyzed with QFT-G software which was provided by the company. The demographic, characteristics and other variables were entered into SPSS version 11.5. The QFT-G test results of three donors (7.9% turned out to be positive, negative for 24 donors (63.1%, and indeterminate for 11 cases (28.9%. Our study revealed the potential advantages of QFT-G in lowering the incidence of donor-derived post-transplant tuberculosis among lung recipients. However, a high rate of indeterminate results restricted the performance of QFT-G in this study.

  6. An HIV1/2 point of care test on sputum for screening TB/HIV co-infection in central India - Will it work?

    Institute of Scientific and Technical Information of China (English)

    Prabha Desikan; Sajal De; Nitika Pant Pai; Pradyumna K Mishra; Kaushal Kumar; Nikita Panwalkar; Mayanka Verma; Zia Ul Hasan; Kewal K Maudar

    2013-01-01

    Objective:To determine whether theOraQuick®HIV-1/2Assay(OraSureTechnologies, Inc.,Bethlehem,PA,USA) in sputum is a valid tool forHIV surveillance amongTB patients. Methods:A cross sectional study was carried out on sputa of patients diagnosed with tuberculosis.Sputa were tested for antibodies toHIV usingOraQuick®HIV-1/2Assay(OraSure Technologies,Inc.,Bethlehem,PA,USA).The results were compared with results of serum ELISA.Results:Compared to serumELISA, theOraQuick®HIV-1/2Assay in sputum specimens reported90% sensitivity(9/10) and100% specificity(307/307), with a positive predictive value of 100%(95%CI:66.37%-100.00%) and a negative predictive value of99.68%(95%CI:98.20%-99.99%). Conclusions:This testing method may provide a useful strategy for conductingHIV surveillance in possible co-infectedTB patients at peripheral centres.Since there is no investment on infrastructure, it may be possible for paramedical health professionals to carry out the test, particularly in areas with lowHIV endemicity.

  7. Mycobacteria and TB

    National Research Council Canada - National Science Library

    Kaufmann, S. H. E. (Stephan H. E.); Hahn, Helmut

    2003-01-01

    .... Scientists investigating the epidemiology, immunology and molecular biology of TB or engaged in vaccine and drug development as well as physicians and social workers treating TB patients will benefit...

  8. Tuberculosis: The Connection between TB and HIV (the AIDS Virus)

    Science.gov (United States)

    ... Regimen for Latent TB Infection-Patient Education Brochure Posters Mantoux Tuberculin Skin Test Wall Chart World TB ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

  9. Use of recombinant purified protein derivative (PPD) antigens as specific skin test for tuberculosis.

    Science.gov (United States)

    Stavri, Henriette; Bucurenci, Nadia; Ulea, Irina; Costache, Adriana; Popa, Loredana; Popa, Mircea Ioan

    2012-11-01

    Purified protein derivative (PPD) is currently the only available skin test reagent used worldwide for the diagnosis of tuberculosis (TB). The aim of this study was to develop a Mycobacterium tuberculosis specific skin test reagent, without false positive results due to Bacillus Calmette-Guerin (BCG) vaccination using recombinant antigens. Proteins in PPD IC-65 were analyzed by tandem mass spectrometry and compared to proteins in M. tuberculosis culture filtrate; 54 proteins were found in common. Top candidates MPT64, ESAT 6, and CFP 10 were overexpressed in Escherichia coli expression strains and purified as recombinant proteins. To formulate optimal immunodiagnostic PPD cocktails, the antigens were evaluated by skin testing guinea pigs sensitized with M. tuberculosis H37Rv and BCG. For single antigens and a cocktail mixture of these antigens, best results were obtained using 3 μg/0.1 ml, equivalent to 105 TU (tuberculin units). Each animal was simultaneously tested with PPD IC-65, 2 TU/0.1 ml, as reference. Reactivity of the multi-antigen cocktail was greater than that of any single antigen. The skin test results were between 34.3 and 76.6 per cent the level of reactivity compared to that of the reference when single antigens were tested and 124 per cent the level of reactivity compared to the reference for the multi-antigen cocktail. Our results showed that this specific cocktail could represent a potential candidate for a new skin diagnostic test for TB.

  10. Imunodiagnóstico da leptospirose humana através do teste ELISA-IgM, empregando-se diferentes preparações antigênicas a partir de sorotipos prevalentes de Leptospira interrogans Immunodiagnostic of human leptospirosis by ELISA-IgM, employing: different antigenic preparations as from prevalent serovars of Leptospira interrogans

    Directory of Open Access Journals (Sweden)

    Marcos Vinicius da Silva

    1990-08-01

    Full Text Available Realizou-se estudo comparativo de diferentes sorotipos de Leptospira interrogans utilizados na preparação de antígenos empregados no teste ELISA, para a detecção de anticorpos da classe IgM, em amostras de soro na fase precoce e tardia da leptospirose humana. Foram utilizados dez sorotipos, escolhidos entre os que apresentaram maior reatividade na soroaglutinação microscópica (SAM, na cidade de São Paulo. Os cinco sorotipos que apresentaram melhores resultados individualmente no teste ELISA-IgM (canicola, hebdomadis, icterohaemorrhagiae, cynopteri e brasiliensis, foram também estudados em mistura antigênica. Os antígenos não tratados apresentaram maior reatividade do que os antígenos tratados com Triton X - 100 (4% à temperatura de 50ºC, durante 4 horas. O teste ELISA-IgM empregando os sorotipos não tratados, isoladamente, e em mistura antigênica, mostrou-se altamente sensível, podendo ser empregado como teste de triagem para o diagnóstico precoce da leptospirose humana. Outra aplicação do teste é permitir a detecção do início de situações epidêmicas ou de surtos, possibilitando acionar medidas de vigilância epidemiológica.A comparative study among different serovars of Leptospira interrogans was performed in order to prepare antigens to detect IgM antibodies by ELISA in early and late phase of human leptospirosis. Ten serovars were chosen among the most prevalent detected by microscopic seroagglutination (SAM in São Paulo city. Using ELISA-IgM five of them showed better results (canicola, hebdomadis, icterohaemorrhagiae, cynopteri and brasiliensis. These ones were also studied in a pool. The non-treated antigens showed higher reactivity than the Triton X-100 (4%/50ºC/4h. ELISA-IgM using individually or pool of non treated antigens proved to be reliable with high sensitivity and should be used for an earlier diagnosis of leptospirosis, as a trial test. Faster diagnostic elucidation can be useful to detect

  11. Serial QuantiFERON-TB Gold In-Tube assay and tuberculin skin test to diagnose latent tuberculosis in household Mexican contacts: conversion and reversion rates and associated factors using conventional and borderline zone definitions

    Directory of Open Access Journals (Sweden)

    Joel Monárrez-Espino

    2014-11-01

    Full Text Available A cohort of 123 adult contacts was followed for 18‐24 months (86 completed the follow-up to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT and tuberculin skin test (TST (PPD from TUBERSOL, Aventis Pasteur, Canada for diagnosing latent tuberculosis (TB in household contacts of TB patients using conventional (C and borderline zone (BZ definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL conversion was defined as 0.70 (BZ and reversion was defined as ≥0.35 to 10 (BZ and reversion was defined as ≥5 to <5 (C. The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%. The QFT conversion and reversion rates were higher for TST ≥5; for TST, both rates were lower for QFT <0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.

  12. Host markers in Quantiferon supernatants differentiate active TB from latent TB infection: preliminary report

    Directory of Open Access Journals (Sweden)

    Walzl Gerhard

    2009-05-01

    Full Text Available Abstract Background Interferon gamma release assays, including the QuantiFERON® TB Gold In Tube (QFT have been shown to be accurate in diagnosing Mycobacterium tuberculosis infection. These assays however, do not discriminate between latent TB infection (LTBI and active TB disease. Methods We recruited twenty-three pulmonary TB patients and 34 household contacts from Cape Town, South Africa and performed the QFT test. To investigate the ability of new host markers to differentiate between LTBI and active TB, levels of 29 biomarkers in QFT supernatants were evaluated using a Luminex multiplex cytokine assay. Results Eight out of 29 biomarkers distinguished active TB from LTBI in a pilot study. Baseline levels of epidermal growth factor (EGF soluble CD40 ligand (sCD40L, antigen stimulated levels of EGF, and the background corrected antigen stimulated levels of EGF and macrophage inflammatory protein (MIP-1β were the most informative single markers for differentiation between TB disease and LTBI, with AUCs of 0.88, 0.84, 0.87, 0.90 and 0.79 respectively. The combination of EGF and MIP-1β predicted 96% of active TB cases and 92% of LTBIs. Combinations between EGF, sCD40L, VEGF, TGF-α and IL-1α also showed potential to differentiate between TB infection states. EGF, VEGF, TGF-α and sCD40L levels were higher in TB patients. Conclusion These preliminary data suggest that active TB may be accurately differentiated from LTBI utilizing adaptations of the commercial QFT test that includes measurement of EGF, sCD40L, MIP-1β, VEGF, TGF-α or IL-1α in supernatants from QFT assays. This approach holds promise for development as a rapid diagnostic test for active TB.

  13. Diagnostic accuracy, incremental yield and prognostic value of Determine TB-LAM for routine diagnostic testing for tuberculosis in HIV-infected patients requiring acute hospital admission in South Africa: a prospective cohort.

    Science.gov (United States)

    Lawn, Stephen D; Kerkhoff, Andrew D; Burton, Rosie; Schutz, Charlotte; Boulle, Andrew; Vogt, Monica; Gupta-Wright, Ankur; Nicol, Mark P; Meintjes, Graeme

    2017-03-21

    We previously reported that one-third of HIV-positive adults requiring medical admission to a South African district hospital had laboratory-confirmed tuberculosis (TB) and that almost two-thirds of cases could be rapidly diagnosed using Xpert MTB/RIF-testing of concentrated urine samples obtained on the first day of admission. Implementation of urine-based, routine, point-of-care TB screening is an attractive intervention that might be facilitated by use of a simple, low-cost diagnostic tool, such as the Determine TB-LAM lateral-flow rapid test for HIV-associated TB. Sputum, urine and blood samples were systematically obtained from unselected HIV-positive adults within 24 hours of admission to a South African township hospital. Additional clinical samples were obtained during hospitalization as clinically indicated. TB was defined by the detection of Mycobacterium tuberculosis in any sample using Xpert MTB/RIF or liquid culture. The diagnostic yield, accuracy and prognostic value of urine-lipoarabinomannan (LAM) testing were determined, but urine-LAM results did not inform treatment decisions. Consecutive HIV-positive adult acute medical admissions not already receiving TB treatment (n = 427) were enrolled regardless of clinical presentation or symptoms. TB was diagnosed in 139 patients (TB prevalence 32.6%; median CD4 count 80 cells/μL). In the first 24 hours of admission, sputum (spot and/or induced) samples were obtained from 37.0% of patients and urine samples from 99.5% of patients (P < 0.001). The diagnostic yields from these specimens were 19.4% (n = 27/139) for sputum-microscopy, 26.6% (n = 37/139) for sputum-Xpert, 38.1% (n = 53/139) for urine-LAM and 52.5% (n = 73/139) for sputum-Xpert/urine-LAM combined (P < 0.01). Corresponding yields among patients with CD4 counts <100 cells/μL were 18.9%, 24.3%, 55.4% and 63.5%, respectively (P < 0.01). The diagnostic yield of urine-LAM was unrelated to respiratory symptoms, and

  14. Latent tuberculosis infection in individuals with human immunodeficiency virus infection: comparison of tuberculin skin test to the anti TB-IgM antibodies

    International Nuclear Information System (INIS)

    Alvi, S.M.; Nadimi, M.; Shokri, S.; Zamani, G.A.

    2010-01-01

    To determine Latent Tuberculosis Infection (LTBI) prevalence and compare TST results to the anti TB-IgM anti bodies (ATIA) for the diagnosis of LTBI in HIV infected individuals. Sixty two randomized sampled HIV infected subjects from an addict treatment center in Ahvaz southwest Iran underwent TST, using 5 TU of purified protein derivative, and measuring ATIA. Data were analyzed in SPSS (version 16, USA). Of 62 participants, 34 (54.8%) had positive result for TST, whereas 6(9.7%) had positive ATIA. Overall concordance between TST and ATIA was 45.2% (Kappa= 0.37, P = 0.32). In subjects with positive test results by either TST or ATIA, only 4.8% had positive test results by both tests. Discordant results were found in 54.8% of subjects. Positive results for both tests in subjects categorized in two groups (above and below 200 CD4-cell/mm3) had no significant difference (P>0.05). LTBI prevalence among HIV infected individuals in studied area is higher than other parts of the world. TST is a useful test for LTBI diagnosis and prefer to ATIA. Concordance between TST and ATIA is low. (author)

  15. Application Values of T-SPOT.TB in Clinical Rapid Diagnosis of Tuberculosis.

    Science.gov (United States)

    Zhu, Feng; Ou, Qinfang; Zheng, Jian

    2018-01-01

    This paper aims to explore the application value of tuberculosis-specific enzyme-linked immunospot assay (T-SPOT.TB) in the diagnosis of tuberculosis. Fifty one patients with tuberculosis (TB) admitted to Wuxi No.5 People's Hospital, Wuxi, China from June 2015 to June 2017 were selected as the TB group, and 40 patients without tuberculosis admitted in the same period were randomly selected as the non-TB group. Patients in the two groups received T-SPOT.TB, TB antibody (TB-Ab) test and mycobacterium TB deoxyribonucleic acid (TB-DNA) test, and the results were compared. Comparisons of the sensitivity of the three methods showed that the sensitivity of T-SPOT.TB was the highest, followed by TB-DNA from sputum samples, and that of TB-Ab was the lowest. The specificity of TB-Ab was the highest, followed by T-SPOT.TB, and that of TB-DNA from sputum samples was the lowest. In the receiver operating characteristic (ROC) curve analysis, the area under curve (AUC) of T-SPOT.TB (0.896) was the highest, followed by TB-DNA from sputum samples (0.772), and that of sputum smears (0.698) was the lowest. T-SPOT.TB can quickly and accurately determine the presence of tuberculosis infection, and it is a non-invasive examination, which can further assist in the diagnosis and guide the treatment.

  16. Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe

    DEFF Research Database (Denmark)

    Bothamley, Graham H.; Lange, Christoph; Albrecht, Dirk

    2017-01-01

    AIM: Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. METHODS: TBNET is a pan...

  17. Outbreak of pulmonary tuberculosis in which tuberculosis developed from QuantiFERON-TB second generation (QFT-2G) test negative persons

    International Nuclear Information System (INIS)

    Yamaguchi, Junichi; Ooba, Yuko; Kaneda, Mie; Uchida, Kiyomi; Ishikawa, Yo; Suzuki, Kiminori; Yagi, Takenori; Sasaki, Yuka; Yamagishi, Fumio

    2007-01-01

    The purpose of this study was to clarify the points to be considered when QuantiFERON-TB second generation (QFT-2G) tests are used in the contacts examination by public health center. We analyzed the results of contacts examination on 43 workplace colleagues (39 y/o and younger) of a pulmonary tuberculosis patient (bII2, Gaffky 9, cough for 1.5 months). After two months of the last contact with the index case, tuberculin skin tests, QFT-2G tests and chest X-rays were undertaken. After 6 months, chest X-rays were taken, and after 9 months, QFT-2G tests and chest CT scans were also undertaken. The tuberculin skin tests after two months showed a bimodal distribution, and 10 were QFT-2G positive and 2 showed doubtful reaction. The latter 12 persons underwent chemoprophylaxis. After 6 months, however, out of 31 QFT-2G negative persons, 2 developed pulmonary tuberculosis. Moreover, after 9 months, chest CT scans revealed 5 pulmonary tuberculosis patients. Three out of 7 new patients showed positive or doubtful reactions in QFT-2G tests undertaken after 9 months. The sensitivity of QFT-2G tests is reported to be 80 to 90%, and the possibility of false negative is not negligible. We propose measures for public health center to conduct the contacts examination as follows; In case of high QFT-2G positive (including doubtful reaction) rate and/or a bimodal distribution of tuberculin skin test result, many infected persons are likely to be included in the group; and the following measures are recommended; Necessity of chemoprophylaxis should be judged considering both tuberculin skin test results and the situation of contact with the index case, and not only by QFT-2G test results. QFT-2G negative persons also need to be followed with chest X-rays. (author)

  18. Effect of Pregnancy on Interferon Gamma Release Assay and Tuberculin Skin Test Detection of Latent TB Infection Among HIV-Infected Women in a High Burden Setting.

    Science.gov (United States)

    LaCourse, Sylvia M; Cranmer, Lisa M; Matemo, Daniel; Kinuthia, John; Richardson, Barbra A; Horne, David J; John-Stewart, Grace

    2017-05-01

    Peripartum immunologic changes may affect latent tuberculosis infection (LTBI) diagnostic performance among HIV-infected women. HIV-infected women were serially tested with tuberculin skin test (TST) and interferon gamma release assay [QuantiFERON TB Gold In-tube (QFT)] in pregnancy and 6 weeks postpartum in Kenya. Prevalence, sensitivity and agreement, and correlates of QFT/TST positivity were assessed. Quantitative QFT mitogen and Mycobacterium tuberculosis antigen (Mtb-Ag) responses were compared by peripartum stage. Incidence of test conversion at 6 weeks postpartum was evaluated in baseline TST-/QFT- women. Among 100 HIV-infected women, median age was 26 years, median CD4 was 555 cells per cubic millimeter, and 88% were on antiretrovirals. More women were QFT+ than TST+ in both pregnancy (35.4% vs. 13.5%, P = 0.001) and postpartum (29.6% vs. 14.8%, P pregnancy vs. postpartum, and specifically among persistently QFT+ women (Mtb-Ag: 3.46 vs. 4.48 IU/mL, P = 0.007). QFT indeterminate rate was higher in pregnancy (16%) compared with postpartum (0%) because of lower mitogen response. QFT identified >2-fold more women with LTBI compared with TST in pregnancy and postpartum. Lower QFT Mtb-Ag and mitogen responses in pregnancy compared with postpartum suggest that pregnancy-associated immunologic changes may influence LTBI test performance.

  19. TB in Captive Elephants

    Centers for Disease Control (CDC) Podcasts

    2017-04-27

    Dr. Barry Kreiswirth, founding director of the Public Health Research Institute, TB Center, at Rutgers University, discusses TB in three captive elephants.  Created: 4/27/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/27/2017.

  20. Obstructive lung disease as a complication in post pulmonary TB

    Science.gov (United States)

    Tarigan, A. P.; Pandia, P.; Eyanoer, P.; Tina, D.; Pratama, R.; Fresia, A.; Tamara; Silvanna

    2018-03-01

    The case of post TB is a problem that arises in the community. Pulmonary tuberculosis (TB) can affect lung function. Therefore, we evaluated impaired pulmonary function in subjects with diagnosed prior pulmonary TB. A Case Series study, pulmonary function test was performed in subjects with a history of pulmonary tuberculosis; aged ≥18 years were included. Exclusion criteria was a subject who had asthma, obesity, abnormal thorax and smoking history. We measured FEV1 and FVC to evaluate pulmonary function. Airflow obstruction was FEV1/FVC%pulmonary TB, 5 subjects (23%) had airflow obstruction with FEV1/FVC% value pulmonary TB.

  1. Pre-employment screening of latent tuberculosis infection among healthcare workers using tuberculin skin test and QuantiFERON-TB Gold test at a tertiary care hospital in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohamed El-Helaly

    2014-11-01

    Full Text Available Summary: Objective: To assess the agreement between the tuberculin skin test (TST and the QuantiFERON-TB Gold test (QFT-G as pre-employment screening tests for latent tuberculosis infection (LTBI among healthcare workers. Methods: A retrospective cross-sectional study was conducted among 1412 healthcare workers who were screened for LTBI during the period from August 2009 to May 2011 at a tertiary-care hospital in the Kingdom of Saudi Arabia (KSA. The studied population was screened for LTBI using both TST and QFT-G simultaneously. The agreement between both tests was quantified using the Kappa coefficient (κ. Results: Comparing the results of QFT-G with TST, the tests had a significant overall agreement of 73.7% (1040/1412; κ = 0.33; p < 0.01. Negative concordance comprised 60.1% of the results, and positive concordance comprised 13.5%. However, positive TST but negative QFT comprised 16.3% of the results, and negative TST but positive QFT-G comprised 10.1%. Concordance was significantly associated with young age, female gender, Saudi-born nationals, and early career but not job type (clinical versus non-clinical nor status of Bacillus Calmette–Guerin (BCG vaccination. Conclusions: This study demonstrated 73.7% overall agreement between TST and QFT-G results among healthcare workers during pre-employment screening for LTBI. The results need to be confirmed in future studies before recommending QFT-G as a pre-employment screening test for LTBI. Keywords: Latent tuberculosis infection, Healthcare workers, Tuberculin skin test, QuantiFERON-TB Gold test

  2. Tuberculosis Facts - TB and HIV/AIDS

    Science.gov (United States)

    Tuberculosis (TB) Facts TB and HIV/AIDS What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  3. HIV and Tuberculosis (TB)

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV and Opportunistic Infections, Coinfections, and Conditions Home Understanding ... 4 p.m. ET) Send us an email HIV and Tuberculosis (TB) Last Reviewed: June 14, 2018 ...

  4. 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 ...

  5. Tuberculosis Facts - You Can Prevent TB

    Science.gov (United States)

    Tuberculosis (TB) Facts You Can Prevent TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination TB Facts: You Can Prevent TB What ...

  6. Tuberculosis Facts - TB Can Be Treated

    Science.gov (United States)

    Tuberculosis (TB) Facts TB Can Be Treated What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination Page 1 of 2 TB Facts: TB ...

  7. HIV screening among TB patients and co-trimoxazole preventive therapy for TB/HIV patients in Addis Ababa: facility based descriptive study.

    Science.gov (United States)

    Denegetu, Amenu Wesen; Dolamo, Bethabile Lovely

    2014-01-01

    Collaborative TB/HIV management is essential to ensure that HIV positive TB patients are identified and treated appropriately, and to prevent tuberculosis (TB) in HIV positive patients. The purpose of this study was to assess HIV case finding among TB patients and Co-trimoxazole Preventive Therapy (CPT) for HIV/TB patients in Addis Ababa. A descriptive cross-sectional, facility-based survey was conducted between June and July 2011. Data was collected by interviewing 834 TB patients from ten health facilities in Addis Ababa. Both descriptive and inferential statistics were used to summarize and analyze findings. The proportion of TB patients who (self reported) were offered for HIV test, tested for HIV and tested HIV positive during their anti-TB treatment follow-up were; 87.4%, 69.4% and 20.2%; respectively. Eighty seven HIV positive patients were identified, who knew their status before diagnosed for the current TB disease, bringing the cumulative prevalence of HIV among TB patients to 24.5%. Hence, the proportion of TB patients who knew their HIV status becomes 79.9%. The study revealed that 43.6% of those newly identified HIV positives during anti-TB treatment follow-up were actually treated with CPT. However, the commutative proportion of HIV positive TB patients who were ever treated with CPT was 54.4%; both those treated before the current TB disease and during anti-TB treatment follow-up. HIV case finding among TB patients and provision of CPT for TB/HIV co-infected patients needs boosting. Hence, routine offering of HIV test and provision of CPT for PLHIV should be strengthened in-line with the national guidelines.

  8. EVALUATION OF DTECII AND IIEXAGO 1 TB KJTS USED FOR ...

    African Journals Online (AJOL)

    BSN

    of TB infection and the risk of TB if infection has occurred (ATS-CDC, 1990) or as a dependent on the population being tested (ATS-CDC, 1994; Bass, 1993). ... environment, a cut off point of ;::: l 5mm is positive (ATS-CDC, 1994). Although tuberculin testing is the standard method for screening asymptomatic populations for ...

  9. Interferon gamma release assays for the diagnosis of latent TB infection in HIV-infected individuals in a low TB burden country.

    LENUS (Irish Health Repository)

    Cheallaigh, Clíona Ní

    2013-01-01

    Interferon gamma release assays (IGRAs) are used to diagnose latent tuberculosis infection. Two IGRAs are commercially available: the Quantiferon TB Gold In Tube (QFT-IT) and the T-SPOT.TB. There is debate as to which test to use in HIV+ individuals. Previous publications from high TB burden countries have raised concerns that the sensitivity of the QFT-IT assay, but not the T-SPOT.TB, may be impaired in HIV+ individuals with low CD4+ T-cell counts. We sought to compare the tests in a low TB burden setting.

  10. TB or not TB?: a case of isolated testicular TB with scrotal involvement.

    LENUS (Irish Health Repository)

    Bhargava, A

    2009-06-01

    Despite the genitourinary tract being the most common site affected by extrapulmonary TB, isolated testicular TB remains a rare clinical entity. In patients with co-morbidities such as hepatic impairment, treatment proves a challenge, as first-line hepatotoxic pharmaceuticals are contraindicated. Here, we report a case of isolated testicular TB with scrotal involvement, on a background of hepatic dysfunction.

  11. ASSESSMENT OF EFFECT OF MDR - TB/TB ON SOCIAL, FUNCTIONAL AND ECONOMIC WELL BEING OF PATIENTS – A CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Shiv Kumar

    2015-06-01

    Full Text Available CONTEXT : Tuberculosis is a contagious disease with social stigma attached to it. Various problems which are social and economic in nature are faced by TB patient. Therefore , it is essential to explore the overall effect of MDR - TB/TB on health and patients perception of Well - being. AIMS : To Document the effect of MDR - TB/TB on social , functional and economic well - being of patients. SETTINGS AND DESIGN : A Cross - sectional study , Conveniently Recruited 68 MDR - TB Patients and 136 non - MDR - TB Patients (from Rural as well as urban Area of Surat District diagnosed by CBNAAT were interviewed for investigating the effect of Tuberculosis. METHODS AND MATERIAL : A pre - tested standardized semi - structured questionnaire was used. Data was collected about socio - demographic profile of patients and interpreted in table. Data about effect of MDR - TB/TB was collected on Likert Scale and Frequency was calculated and Data wa s plotted on multiple bar charts. RESULTS : As compared to healthy status in the past , 93% MDR - TB and 82% TB patients have decreased ability to do work , about half of MDR - TB Patients and TB Patients have detiorated relations with family members , 67% of stud y participants have developed disharmonious relations with neighbor’s , 55% of Study participants have decreased income , 88% of study participants have decreased performance in day to day activities and 78% of study participants have faced discordial and di srespectful behavior from co - workers. CONCLUSION : Working ability more detiorated in MDR - TB patients while rest of the effect on social , functional and economic well - being is same in both TB and Multi Drug Resistant TB patients. This study emphasizes very clearly that social stigma still persist in community about Tuberculosis which needs to be eliminated in community by behavior change communication by health workers at all levels of health care.

  12. Utility of urine lipoarabinomannan (LAM) in diagnosing tuberculosis and predicting mortality with and without HIV: prospective TB cohort from the Thailand Big City TB Research Network.

    Science.gov (United States)

    Suwanpimolkul, Gompol; Kawkitinarong, Kamon; Manosuthi, Weerawat; Sophonphan, Jiratchaya; Gatechompol, Sivaporn; Ohata, Pirapon June; Ubolyam, Sasiwimol; Iampornsin, Thatri; Katerattanakul, Pairaj; Avihingsanon, Anchalee; Ruxrungtham, Kiat

    2017-06-01

    To evaluate the applicability and accuracy of the urine lipoarabinomannan (LAM) test in tuberculosis (TB)/HIV co-infected patients and HIV-negative patients with disseminated TB. Frozen urine samples obtained at baseline from patients in the TB research cohort with proven culture-positive TB were selected for blinded urine LAM testing. One hundred and nine patients were categorized into four groups: (1) HIV-positive patients with TB; (2) HIV-negative patients with disseminated TB; (3) HIV-negative immunocompromised patients with TB; and (4) patients with diseases other than TB. The sensitivity of urine LAM testing for culture-positive TB, specificity of urine LAM testing for patients without TB, positive predictive value (PPV), and negative predictive value (NPV) were assessed. The sensitivity of the urine LAM test in group 1 patients with a CD4 T-cell count of >100, ≤100, and ≤50 cells/mm 3 was 38.5%, 40.6%, and 45%, respectively. The specificity and PPV of the urine LAM test were >80%. The sensitivity of the test was 20% in group 2 and 12.5% in group 3, and the specificity and PPV were 100% for both groups. A positive urine LAM test result was significantly associated with death. This promising diagnostic tool could increase the yield of TB diagnosis and may predict the mortality rate of TB infection, particularly in TB/HIV co-infected patients. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  13. Accelerated detection of brown-rot decay : comparison of soil block test, chemical analysis, mechanical properties, and immunodetection

    Science.gov (United States)

    C. A. Clausen; S. N. Kartal

    2003-01-01

    Early detection of wood decay is critical because decay fungi can cause rapid structural failure. The objective of this study was to compare the sensitivity of different methods purported to detect brown-rot decay in the early stages of development. The immunodiagnostic wood decay (IWD)test, soil block test/cake pan test, mechanical property tests, and chemical...

  14. Prevalence of pulmonary TB and spoligotype pattern of Mycobacterium tuberculosis among TB suspects in a rural community in Southwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Deribew Amare

    2012-03-01

    Full Text Available Abstract Background In Ethiopia where there is no strong surveillance system and state of the art diagnostic facilities are limited, the real burden of tuberculosis (TB is not well known. We conducted a community based survey to estimate the prevalence of pulmonary TB and spoligotype pattern of the Mycobacterium tuberculosis isolates in Southwest Ethiopia. Methods A total of 30040 adults in 10882 households were screened for pulmonary TB in Gilgel Gibe field research centre in Southwest Ethiopia. A total of 482 TB suspects were identified and smear microscopy and culture was done for 428 TB suspects. Counseling and testing for HIV/AIDS was done for all TB suspects. Spoligotyping was done to characterize the Mycobacterium tuberculosis isolates. Results Majority of the TB suspects were females (60.7% and non-literates (83.6%. Using smear microscopy, a total of 5 new and 4 old cases of pulmonary TB cases were identified making the prevalence of TB 30 per 100,000. However, using the culture method, we identified 17 new cases with a prevalence of 76.1 per 100,000. There were 4.3 undiagnosed pulmonary TB cases for every TB case who was diagnosed through the passive case detection mechanism in the health facility. Eleven isolates (64.7% belonged to the six previously known spoligotypes: T, Haarlem and Central-Asian (CAS. Six new spoligotype patterns of Mycobacterium tuberculosis, not present in the international database (SpolDB4 were identified. None of the rural residents was HIV infected and only 5 (5.5% of the urban TB suspects were positive for HIV. Conclusion The prevalence of TB in the rural community of Southwest Ethiopia is low. There are large numbers of undiagnosed TB cases in the community. However, the number of sputum smear-positive cases was very low and therefore the risk of transmitting the infection to others may be limited. Active case finding through health extension workers in the community can improve the low case detection rate

  15. TB-IRIS and remodelling of the T cell compartment in highly immunosuppressed HIV+ patients with TB: the CAPRI T (ANRS-12614) study

    Science.gov (United States)

    Haridas, V.; Pean, P.; Jasenosky, L.D.; Madec, Y.; Laureillard, D.; Sok, T.; Sath, S.; Borand, L.; Marcy, O.; Chan, S.; Tsitsikov, E.; Delfraissy, J.-F.; Blanc, F.-X.; Goldfeld, A.E.

    2015-01-01

    Objective To investigate the impact of tuberculosis (TB)-associated immune reconstitution syndrome (IRIS) upon immunological recovery and the T cell compartment after initiation of TB and antiretroviral therapy (ART). Design and methods We prospectively evaluated T cell immunophenotypes by flow cytometry and cytokines by Luminex assays in a subset (n=154) of highly immunosuppressed HIV+ patients with TB from the CAMELIA randomized clinical trial. We compared findings from patients who developed TB-IRIS to findings from patients who did not develop TB-IRIS. Data were evaluated with mixed effect linear regression, Kaplan-Meier estimates, and Wilcoxon rank sum tests, and q-values were calculated to control for multiple comparisons. Results Development of TB-IRIS was associated with significantly greater pre-ART frequencies of HLA-DR+CD45RO+CD4+, CCR5+CD4+, OX40+CD4+, and Fas+ effector memory (EM) CD8+ T cells, and significantly elevated levels of plasma IL-6, IL-1β, IL-8, and IL-10 and viral load. Post-ART initiation, EM CD4+ and Fas+ EM CD4+ T cell frequencies significantly expanded, and central memory (CM) CD4+ T cell frequencies significantly contracted in patients who experienced TB-IRIS. By week 34 post-TB treatment initiation, EM/CM CD4+ T cell ratios were markedly higher in TB-IRIS versus non-TB-IRIS patients. Conclusions A distinct pattern of pre-ART T cell and cytokine markers appear to poise the immune response to develop TB-IRIS. Experience of TB-IRIS is then associated with long-term remodeling of the CD4+ T cell memory compartment towards an EM-dominated phenotype. We speculate that these pre- and post-ART TB-IRIS-associated immune parameters may contribute to superior immune control of TB/HIV co-infection and better clinical outcome. PMID:25486415

  16. Molecular detection of multi drug resistant tuberculosis (mdr-tb) in mdr-tb patients' attendant in north western pakistan

    International Nuclear Information System (INIS)

    Shah, T.; Hayat, A.; Shah, Z.; Hayat, A.; Khan, S.B.

    2017-01-01

    Objective: To determine the drugs susceptibility pattern of mycobacterium tuberculosis (M.TB) in multi-drug resistant tuberculosis (MDR-TB) patients' attendants in North Western, Pakistan. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted at Peshawar Tuberculosis Research Laboratory (PTRL), Provincial TB Control Program Hayatabad Medical Complex Peshawar, (KP) from August 2013 to March 2014. Material and Methods: A cross sectional study in which four hundred and eighty sputum samples from MDR-TB patients' attendants were processed for the detection of M.TB through Ziehl-Neelsen staining, Lowenstein-Jensen, BACTEC MGIT-960 culture and line probe assay. Results: Out of 480 samples, 06 (2.1%) were found positive for M.TB through Ziehl-Neelsen staining while 10 (2.8%) were positive through LJ and BACTEC MGIT-960 culture. The 10 positive samples were further subjected to drugs susceptibility testing and line probes assay test to find out rifampicin, isoniazid, streptomycin and ethambutol resistant and it was found that 6 M.TB isolates were resistant while 4 were sensitive to rifampicin and isoniazid. Among the 6 resistant M.TB strains, 4 showed mutation in rpoB gene at 531, 516 and 526 codons. Conclusion: Majority of MDR-TB patients' attendants had drug-resistant tuberculosis and the rate of drug susceptible TB was low. (author)

  17. Kinetics of the QuantiFERON-TB Gold In-Tube test during treatment of patients with sputum smear-positive tuberculosis in relation to initial TST result and severity of disease

    DEFF Research Database (Denmark)

    Idh, Jonna; Abate, Ebba; Westman, Anna

    2010-01-01

    . Smear-positive TB patients (n = 71) were recruited at Gondar University Hospital, Ethiopia. The TST, QFN, CD4+ cell count and clinical symptoms (TB score) were assessed and followed up during treatment. From baseline to 7 months after treatment, there was a significant decrease in QFN reactivity (93.......8% to 62.5% in HIV-negative/TB; 70.3% to 33.3% in HIV-positive/TB patients) down to a level comparable to a control group of blood donors (51.2%). The agreement between TST and QFN was poor in TB patients compared to healthy controls. A negative TST correlated to more advanced TB in contrast to a negative...

  18. Ability of immunodiagnostic tests to differentiate between dogs naturally infected with Leishmania infantum and Leishmune(®)-vaccinated dogs

    NARCIS (Netherlands)

    Ribeiro, R. A. N.; Teixeira-Neto, R. G.; Belo, V. S.; Ferreira, E. C.; Schallig, H. D. F. H.; Silva, E. S.

    2015-01-01

    Visceral leishmaniasis (VL) is a serious chronic disease with a lethality rate of up to 10 % in humans. In urban areas of Brazil, dogs are the main reservoirs of the etiological agent (Leishmania infantum) of VL, and the Brazilian Ministry of Health recommends the euthanasia of animals that are

  19. Screening for TB by sputum culture in high-risk groups in Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Jensen, Sidse Graff; Wrona Olsen, Nete; Seersholm, Niels

    2015-01-01

    . METHODS: On seven occasions, from September 2012 through June 2014, we offered TB screening to all persons present at 11 locations where socially marginalised people gather in Copenhagen. Spot sputum samples from participants were examined by smear microscopy and culture. Genotype, nucleic acid......INTRODUCTION: Evidence on screening high-risk groups for TB by mobile X-ray in low-incidence countries is building, but knowledge on other possible screening methods is limited. In this retrospective study we report results from a community based programme screening for TB by spot sputum culture...... amplification test and chest X-ray were done if TB was found. RESULTS: Among 1075 participants, we identified 36 cases of TB. Twenty-four cases (66.7%) were identified at the first screening of each participant, that is, the prevalence of TB was 2233/100 000. Thirty-five (97%) of the TB cases were culture...

  20. Evaluation of immune responses in HIV infected patients with pleural tuberculosis by the QuantiFERON® TB-Gold interferon-gamma assay

    Directory of Open Access Journals (Sweden)

    Lekabe Jacob M

    2008-03-01

    Full Text Available Abstract Background Diagnosis of tuberculous (TB pleuritis is difficult and better diagnostic tools are needed. New blood based interferon-gamma (IFN-γ tests are promising, but sensitivity could be low in HIV positive patients. The IFN-γ tests have not yet been validated for use in pleural fluid, a compartment with higher level of immune activation than in blood. Methods The QuantiFERON TB®-Gold (QFT-TB test was analysed in blood and pleural fluid from 34 patients presenting with clinically suspected pleural TB. Clinical data, HIV status and CD4 cell counts were recorded. Adenosine deaminase activity (ADA analysis and TB culture were performed on pleural fluid. Results The patients were categorised as 'confirmed TB' (n = 12, 'probable TB' (n = 16 and 'non-TB' pleuritis (n = 6 based on TB culture results and clinical and biochemical criteria. The majority of the TB patients were HIV infected (82%. The QFT-TB in pleural fluid was positive in 27% and 56% of the 'confirmed TB' and 'probable TB' cases, respectively, whereas the corresponding sensitivities in blood were 58% and 83%. Indeterminate results in blood (25% were caused by low phytohemagglutinin (PHA = positive control IFN-γ responses, significantly lower in the TB patients as compared to the 'non-TB' cases (p = 0.02. Blood PHA responses correlated with CD4 cell count (r = 0.600, p = 0.028. In contrast, in pleural fluid indeterminate results (52% were caused by high Nil (negative control IFN-γ responses in both TB groups. Still, the Nil IFN-γ responses were lower than the TB antigen responses (p Conclusion The QFT-TB test in blood could contribute to the diagnosis of TB pleuritis in the HIV positive population. Still, the number of inconclusive results is too high to recommend the commercial QFT-TB test for routine use in pleural fluid in a TB/HIV endemic resource-limited setting.

  1. Immunodiagnostic confirmation of hydatid disease in patients with a presumptive diagnosis of infection Confirmación inmunodiagnóstica de la hidatidosis en pacientes con diagnóstico presuntivo de la infeccion

    Directory of Open Access Journals (Sweden)

    V. M. Varela-diaz

    1984-04-01

    Full Text Available Information obtained from the routine application of hydatid immunodiagnostic techniques in different clinical situations over a seven-year period is presented. The Immunoelectrophoresis test was used until it was replaced by the simpler, more sensitive and equally specific arc 5 double diffusion (DD5 test. Examination of sera from 1,888 patients with signs and/or symptoms compatible with hydatid disease revealed that the presurgical confirmation of Echinococcus granulosus infection is only obtained by detection of anti-antigen 5 antibodies. The latter were not found in 1,539 presumptive hydatidosis patients whose definitive diagnoses corresponded to other disease conditions. However, false positive latex agglutination test results were obtained in two cases. In all patients whose preoperative serum showed three or more uncharacteristic bands in the absence of anti-antigen 5 antibodies, hydatid cysts were found sur gically. DD5 testing of a fluid sample collected by puncture established its hydatid etiology. Post-operative monitoring of hydatidosis patients demonstrated that persistence of DD5-positivity two years after surgery established the presence of other cysts. Further evidence was obtained in patients with hydatid cysts in intrathoracic, abdominal or other locations associating cyst membrane integrity, antigen release and immunodiagnostic test positivity.Se presenta la información obtenida de la aplicación de las técnicas inmunodiagnósticas para hidatidosis en diferentes situaciones clínicas durante un período de 7 años. Se empleó la prueba de inmunoelectroforesis hasta que se la sustituyó por la prueba de doble difusión arco 5 (DD5, igualmente específica pero de mayor sensibilidad y sencillez. El examen de sueros de 1 888 pacientes con signos y/o sintomas compatibles con la hidatidosis reveló que la confirmación prequirúrgica de la infeccion por Echinococcus granulosus sólo se obtiene mediante la detección de anticuerpos

  2. Characterisation of surface antigens of Strongylus vulgaris of potential immunodiagnostic importance.

    Science.gov (United States)

    Nichol, C; Masterson, W J

    1987-08-01

    When antigens prepared by detergent washes of Strongylus vulgaris and Parascaris equorum were probed in an enzyme-linked immunosorbent assay test with horse sera from single species infections of S. vulgaris and P. equorum, a high degree of cross-reaction between the species was demonstrated. Western blot analysis of four common horse nematode species showed a large number of common antigens when probed with horse infection sera. Antisera raised in rabbits against the four species, including S. vulgaris, were also found to cross-react considerably. Rabbit anti-S. vulgaris sera were affinity adsorbed over a series of affinity chromatography columns, bound with cross-reactive surface antigens, to obtain S. vulgaris-specific antisera and thereby identify S. vulgaris-specific antigens by Western blotting. These studies revealed potentially specific antigens of apparent molecular weights of 100,000, 52,000, and 36,000. Of these bands, only the 52 kDa and 36 kDa appeared to be found on the surface as judged by 125I-labelling of intact worms by the Iodogen method, although neither protein was immunoprecipitated by horse infection sera. Finally, immunoprecipitation of in vitro translated proteins derived from larval S. vulgaris RNA suggests that two proteins may be parasite-derived. These findings are discussed both with respect to the surface of S. vulgaris and to the use of these species-specific antigens in immunodiagnosis.

  3. HUBUNGAN FAKTOR LINGKUNGAN RUMAH DENGAN PENULARAN TB PARU KONTAK SERUMAH

    Directory of Open Access Journals (Sweden)

    Anwar Musadad

    2012-11-01

    Full Text Available Environmental Factor Relation of House With Infection of TB Paru through Housing Contact.Tuberculosis of the Lung (Lung TB still become health problem for world, including Indonesia in the third sequence after India And China. If cannot overcome each and everyone with Active Lung TB with mean infection 10-15 people/year. This research aim to know environmental factor relation of house with infection of Lung TB through contact house. The research population consist of entire household which inside there is 1 (one or more patient of Adult Lung TB with the result of positive bacteria inspection by public health center in 2002, while as sample is entire household which inside there is 1 (one or more patient of Adult Lung TB and have under 5 years baby. Inclusion criteria is patient of Lung TB paru noted by public health center and reside in region of Tangerang District in 2002. The collection of data was conducted with interview using questionnaire, enviromental perception, and tuberculine test. Uji Tuberculin test done by Mantoux (inoculation intracutane for 5 years baby use PPD RT 23 strength 2 TU with tuberkulin 1 cc needle with number 26. Criteria of Lung TB infection if diameter transversal from period that happened as a result of tuberculine test >10 mm and have clinical history of such as coughing more than 3 weeks, pain and recuring or old fever without clear cause, body weight descend or not go up in 1 month; moon without clear cause, or have specific clinical symptom. Result showed that from 254 households there are 33 (13.0% occurence of infection Lung TB. Environmental factor of house which deal with infection TB as an entry of the indoor direct sunlight with value OR=3,50; CI 95% 1,19-10,34 (p=0,015. The conclusion stated that direct sunlight play important role for infection of Lung TB in the same house.Keywords: Tuberculosis, infection through housing ccontact, tuberculine test, sunlight

  4. Immunodiagnostic Value of Echinococcus Granulosus Recombinant B8/1 Subunit of Antigen B.

    Science.gov (United States)

    Savardashtaki, Amir; Sarkari, Bahador; Arianfar, Farzane; Mostafavi-Pour, Zohreh

    2017-06-01

    Cystic echinococcosis (CE), as a chronic parasitic disease, is a major health problem in many countries. The performance of the currently available serodiagnostic tests for the diagnosis of CE is unsatisfactory. The current study aimed at sub-cloning a gene, encoding the B8/1 subunit of antigen B (AgB) from Echinococcus granulosus, using gene optimization for the immunodiagnosis of human CE. The coding sequence for AgB8/1 subunit of Echinococcus granulosus was selected from GenBank and was gene-optimized. The sequence was synthesized and inserted into pGEX-4T-1 vector. Purification was performed with GST tag affinity column. Diagnostic performance of the produced recombinant antigen, native antigen B and a commercial ELISA kit were further evaluated in an ELISA system, using a panel of sera from CE patients and controls. SDS-PAGE demonstrated that the protein of interest had a high expression level and purity after GST tag affinity purification. Western blotting verified the immunoreactivity of the produced recombinant antigen with the sera of CE patients. In an ELISA system, the sensitivity and specificity (for human CE diagnosis) of the recombinant antigen, native antigen B and commercial kit were respectively 93% and 92%, 87% and 90% and 97% and 95%. The produced recombinant antigen showed a high diagnostic value which can be recommended for serodiagnosis of CE in Iran and other CE-endemic areas. Utilizing the combination of other subunits of AgB8 would improve the performance value of the introduced ELISA system.

  5. Detectemos la TB. Tratemos la TB. Trabajemos juntos para eliminar la TB. (Find TB. Treat TB. Working together to eliminate TB.)

    Centers for Disease Control (CDC) Podcasts

    2014-02-26

    Este podcast trata sobre el Día Mundial de la Tuberculosis y el tema de los CDC para el año 2014.  Created: 2/26/2014 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/26/2014.

  6. Radiorespirometry in TB diagnosis and drug discovery

    International Nuclear Information System (INIS)

    Ray Mukti, K.; Kulkarni, Savita; Rajan, M.G.R.

    2015-01-01

    Tuberculosis remains a major health problem worldwide and especially in India with 1.9 million new cases and 0.35 million deaths per year. Early and rapid diagnosis of pulmonary tuberculosis is mandatory for controlling the transmission of the disease. Conventional test like sputum AFB is not sensitive and gold standard culture test is time consuming. Our laboratory has standardized a Radiorespirometry technique for primary diagnosis which offers advantage of both less turnaround time and sensitivity. Radiorespirometry is a true radiotracer technique that detects the presence of live microorganism in a biological sample. In this method, bacteria (or clinical sample) is inoculated into a medium supplemented with radiolabelled ( 14 C) carbon compounds. Only metabolically active organism present in the sample will metabolize the carbon source and produce radiolabelled carbon dioxide ( 14 CO 2 ) . This 14 CO 2 can be efficiently trapped in an alkaline-scintillant matrix and counted in a liquid scintillation counter. The whole thing is suitably assembled in a regular scintillation vial. We used radiorespirometry in a retrospective study using culture positive sputum samples (which was detected positive by culture in 3-8 weeks time) and it detected presence of TB bacilli in 1 to 3 weeks. Further, series of Phenyl acrylamide derivatives synthesized against RecA of mycobacteria were evaluated for anti-TB properties using radiorespirometry. More than 90% of the compounds exhibited anti-TB properties with MIC 3.25 to 25 μg/ml. Structure activity relationship of these compound was studied to understand the anti-TB pharmacophores. Interesting results obtained using radiorespirometry will be discussed. (author)

  7. Initiation and adherence to TB treatment in a Pakistani community influenced more by perceptions than by knowledge of tuberculosis

    Directory of Open Access Journals (Sweden)

    Mubashir Zafar

    2013-01-01

    Full Text Available Background: The tuberculosis (TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. Aims: To investigate knowledge about TB, perceptions of (access to TB treatment, and adherence to treatment among a Pakistani population. Setting and Design: Descriptive cross-sectional study. Materials and Methods: A total of 175 participants were selected nonrandomly, 100 were TB patient and 75 were non-TB patient in proportion to the total number of participants in each ward of hospital. Statistical Analysis: Analysis of attitudes and perceptions toward TB, adherence to TB treatment, health seeking behavior, and TB treatment types done by frequency counts and percentages. Regression analysis and logistic regression analysis were performed to test whether differences in age, gender, and education level led to different knowledge scores and different attitudes and preferences toward TB, adherence to TB treatment, health seeking behavior, and TB treatment types. All statistical analyses were performed using Statistical Package for Social Sciences (SPSS 16.0. Result: TB knowledge can be considered fairly well among this community. Respondents′ perceptions suggest that stigma may influence TB patients′ decision in health seeking behavior and adherence to TB treatment. A full 95% of those interviewed believe people with TB tend to hide their TB status out of fear of what others may say. Conclusion: Most of the subjects were unaware of TB that seems to be due to their illiteracy and those who knew had got the knowledge from media, but the majority of the patients who were on directly observed treatment, short-course (DOTS were found to be satisfied.

  8. Litigation as TB Rights Advocacy

    Science.gov (United States)

    2016-01-01

    Abstract One thousand people die every day in India as a result of TB, a preventable and treatable disease, even though the Constitution of India, government schemes, and international law guarantee available, accessible, acceptable, quality health care. Failure to address the spread of TB and to provide quality treatment to all affected populations constitutes a public health and human rights emergency that demands action and accountability. As part of a broader strategy, health activists in India employ Public Interest Litigation (PIL) to hold the state accountable for rights violations and to demand new legislation, standards for patient care, accountability for under-spending, improvements in services at individual facilities, and access to government entitlements in marginalized communities. Taking inspiration from right to health PIL cases (PILs), lawyers in a New Delhi-based rights organization used desk research, fact-findings, and the Right To Information Act to build a TB PIL for the Delhi High Court, Sanjai Sharma v. NCT of Delhi and Others (2015). The case argues that inadequate implementation of government TB schemes violates the Constitutional rights to life, health, food, and equality. Although PILs face substantial challenges, this paper concludes that litigation can be a crucial advocacy and accountability tool for people living with TB and their allies. PMID:27781000

  9. QuantiFERON®-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting

    DEFF Research Database (Denmark)

    Rose, Michala Vaaben; Kimaro, Godfather; Nissen, Thomas N

    2012-01-01

    To determine whether QuantiFERON®-TB Gold In-Tube (QFT) can contribute to the diagnosis of active tuberculosis (TB) in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST) in a prospective cohort of TB suspect children compared to adults with confi......To determine whether QuantiFERON®-TB Gold In-Tube (QFT) can contribute to the diagnosis of active tuberculosis (TB) in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST) in a prospective cohort of TB suspect children compared to adults...

  10. Mantoux Tuberculin Skin Test

    Centers for Disease Control (CDC) Podcasts

    Learn how to evaluate people for latent TB infection with the Mantoux tuberculin skin test. This podcast includes sections on administering and reading the Mantoux tuberculin skin test, the standard method for detecting latent TB infection since the 1930s.

  11. Prognostic value of interferon-γ release assays, a population-based study from a TB low-incidence country

    DEFF Research Database (Denmark)

    Hermansen, Thomas Stig; Lillebaek, Troels; Langholz Kristensen, Kristina

    2016-01-01

    individuals and data on all TB cases in Denmark from 2005 to 2012 and determined the predictive value of the QFT for coprevalent TB (0-90 days after testing) and incident TB (>90 days). RESULTS: Coprevalent TB was diagnosed in 10.7% (183/1703) and 0.3% (38/13 463) cases with a positive and negative QFT......, respectively. For the QFT-positive cases, coprevalent TB was more frequent among persons 35  years (19.3% vs 7.2%, pvalues (PPV...

  12. Diagnostic Accuracy and Feasibility of Serological Tests on Filter Paper Samples for Outbreak Detection of T.b. gambiense Human African Trypanosomiasis

    Science.gov (United States)

    Hasker, Epco; Lutumba, Pascal; Mumba, Dieudonné; Lejon, Veerle; Büscher, Phillipe; Kande, Victor; Muyembe, Jean Jacques; Menten, Joris; Robays, Jo; Boelaert, Marleen

    2010-01-01

    Control of human African trypanosomiasis (HAT) in the Democratic Republic of Congo is based on mass population screening by mobile teams; a costly and labor-intensive approach. We hypothesized that blood samples collected on filter paper by village health workers and processed in a central laboratory might be a cost-effective alternative. We estimated sensitivity and specificity of micro-card agglutination test for trypanosomiasis (micro-CATT) and enzyme-linked immunosorbent assay (ELISA)/T.b. gambiense on filter paper samples compared with parasitology-based case classification and used the results in a Monte Carlo simulation of a lot quality assurance sampling (LQAS) approach. Micro-CATT and ELISA/T.b. gambiense showed acceptable sensitivity (92.7% [95% CI 87.4–98.0%] and 82.2% [95% CI 75.3–90.4%]) and very high specificity (99.4% [95% CI 99.0–99.9%] and 99.8% [95% CI 99.5–100%]), respectively. Conditional on high sample size per lot (≥ 60%), both tests could reliably distinguish a 2% from a zero prevalence at village level. Alternatively, these tests could be used to identify individual HAT suspects for subsequent confirmation. PMID:20682885

  13. Extensively Drug-Resistant TB

    Centers for Disease Control (CDC) Podcasts

    2016-12-16

    Dr. Charlotte Kvasnovsky, a surgery resident and Ph.D. candidate in biostatistics, discusses various types of drug resistance in TB patients in South Africa.  Created: 12/16/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/16/2016.

  14. TB in Wild Asian Elephants

    Centers for Disease Control (CDC) Podcasts

    2017-05-10

    Dr. Susan Mikota, co-founder of Elephant Care International, discusses TB in wild Asian elephants.  Created: 5/10/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/10/2017.

  15. Community Involvement in TB Research

    NARCIS (Netherlands)

    M. van der Werf (Marloes); S.G. Heumann (Silke); E.M.H. Mitchell

    2011-01-01

    textabstractWhile communities at risk have been both drivers and partners in HIV research, their important role in TB research is yet to be fully realized. Involvement of communities in tuberculosis care and prevention is currently on the international agenda. This creates opportunities and

  16. Measurement of 160Tb and 161Tb in nuclear forensics samples

    International Nuclear Information System (INIS)

    Jiang, J.; Davies, A.V.; Britton, R.E.

    2017-01-01

    160 Tb and 161 Tb are important radionuclides to measure when analysing a Nuclear Forensics sample. An analytical method for the measurement of both 160 Tb and 161 Tb was developed in this study. Terbium was separated and purified using exchange resin and TrisKem LN Resin. The purified fraction containing 160 Tb and 161 Tb was measured by gamma spectrometry and liquid scintillation counting. The counting efficiencies of 160 Tb and 161 Tb were determined using the CIEMAT/NIST efficiency tracing method. The LSC count rate ratio, R160 Tb /R161 Tb , on the reference date was determined by sequential counting and calculated using a custom script based on their half-lives. (author)

  17. Prospective use of soluble urokinase plasminogen activator receptor to screen TB co-infected with HIV patient among TB patient

    Directory of Open Access Journals (Sweden)

    Tri Yudani Mardining Raras

    2017-10-01

    Conclusion: Plasma suPAR level of TB patients co-infected with HIV showed significantly difference from that of TB-AFB(+ patients suggested its potential to screen the TB/HIV among pulmonary TB-AFB(+ patients.

  18. Risk factors for bovine tuberculosis (bTB) in cattle in Ethiopia

    NARCIS (Netherlands)

    Dejene, Sintayehu W.; Heitkonig, Ignas; Prins, Herbert H.T.; Lemma, Fitsum A.; Mekonnen, Daniel A.; Alemu, Zelalem E.; Kelkay, Tessema Z.; Boer, de Fred

    2016-01-01

    Bovine tuberculosis (bTB) infection is generally correlated with individual cattle's age, sex, body condition, and with husbandry practices such as herd composition, cattle movement, herd size, production system and proximity to wildlife - including bTB maintenance hosts. We tested the

  19. TB and HIV co-infection: when to start antiretroviral therapy

    African Journals Online (AJOL)

    2011-10-02

    Oct 2, 2011 ... HIV and TB treatment in co-infected patients is a critical one. Previously, TB ... Indications for ART are based on an assessment of individual risk- benefit analysis of ..... An HIV test was positive, a lumbar puncture was acellular ...

  20. Diagnosing Xpert MTB/RIF-negative TB: Impact and cost of ...

    African Journals Online (AJOL)

    Background. Use of Xpert MTB/RIF is being scaled up throughout South Africa for improved diagnosis of tuberculosis (TB). A large proportion of HIV-infected patients with possible TB are Xpert-negative on their initial test, and the existing diagnostic algorithm calls for these patients to have sputum culture (Xpert followed by ...

  1. Heightened vulnerability to MDR-TB epidemics after controlling drug-susceptible TB.

    Directory of Open Access Journals (Sweden)

    Jason D Bishai

    2010-09-01

    Full Text Available Prior infection with one strain TB has been linked with diminished likelihood of re-infection by a new strain. This paper attempts to determine the role of declining prevalence of drug-susceptible TB in enabling future epidemics of MDR-TB.A computer simulation of MDR-TB epidemics was developed using an agent-based model platform programmed in NetLogo (See http://mdr.tbtools.org/. Eighty-one scenarios were created, varying levels of treatment quality, diagnostic accuracy, microbial fitness cost, and the degree of immunogenicity elicited by drug-susceptible TB. Outcome measures were the number of independent MDR-TB cases per trial and the proportion of trials resulting in MDR-TB epidemics for a 500 year period after drug therapy for TB is introduced.MDR-TB epidemics propagated more extensively after TB prevalence had fallen. At a case detection rate of 75%, improving therapeutic compliance from 50% to 75% can reduce the probability of an epidemic from 45% to 15%. Paradoxically, improving the case-detection rate from 50% to 75% when compliance with DOT is constant at 75% increases the probability of MDR-TB epidemics from 3% to 45%.The ability of MDR-TB to spread depends on the prevalence of drug-susceptible TB. Immunologic protection conferred by exposure to drug-susceptible TB can be a crucial factor that prevents MDR-TB epidemics when TB treatment is poor. Any single population that successfully reduces its burden of drug-susceptible TB will have reduced herd immunity to externally or internally introduced strains of MDR-TB and can experience heightened vulnerability to an epidemic. Since countries with good TB control may be more vulnerable, their self interest dictates greater promotion of case detection and DOTS implementation in countries with poor control to control their risk of MDR-TB.

  2. Community referral for presumptive TB in Nigeria: a comparison of four models of active case finding

    Directory of Open Access Journals (Sweden)

    A. O. Adejumo

    2016-02-01

    Full Text Available Abstract Background Engagement of communities and civil society organizations is a critical part of the Post-2015 End TB Strategy. Since 2007, many models of community referral have been implemented to boost TB case detection in Nigeria. Yet clear insights into the comparative TB yield from particular approaches have been limited. Methods We compared four models of active case finding in three Nigerian states. Data on presumptive TB case referral by community workers (CWs, TB diagnoses among referred clients, active case finding model characteristics, and CWs compensation details for 2012 were obtained from implementers and CWs via interviews and log book review. Self-reported performance data were triangulated against routine surveillance data to assess concordance. Analysis focused on assessing the predictors of presumptive TB referral. Results CWs referred 4–22 % of presumptive TB clients tested, and 4–24 % of the total TB cases detected. The annual median referral per CW ranged widely among the models from 1 to 48 clients, with an overall average of 13.4 referrals per CW. The highest median referrals (48 per CW/yr and mean TB diagnoses (7.1/yr per CW (H =70.850, p < 0.001 was obtained by the model with training supervision, and $80/quarterly payments (Comprehensive Quotas-Oriented model. The model with irregularly supervised, trained, and compensated CWs contributed the least to TB case detection with a median of 13 referrals per CW/yr and mean of 0.53 TB diagnoses per CW/yr. Hours spent weekly on presumptive TB referral made the strongest unique contribution (Beta = 0.514, p < 0.001 to explaining presumptive TB referral after controlling for other variables. Conclusion All community based TB case-finding projects studied referred a relative low number of symptomatic individuals. The study shows that incentivized referral, appropriate selection of CWs, supportive supervision, leveraged treatment support roles, and a

  3. A tuberculosis biomarker database: the key to novel TB diagnostics

    Directory of Open Access Journals (Sweden)

    Seda Yerlikaya

    2017-03-01

    Full Text Available New diagnostic innovations for tuberculosis (TB, including point-of-care solutions, are critical to reach the goals of the End TB Strategy. However, despite decades of research, numerous reports on new biomarker candidates, and significant investment, no well-performing, simple and rapid TB diagnostic test is yet available on the market, and the search for accurate, non-DNA biomarkers remains a priority. To help overcome this ‘biomarker pipeline problem’, FIND and partners are working on the development of a well-curated and user-friendly TB biomarker database. The web-based database will enable the dynamic tracking of evidence surrounding biomarker candidates in relation to target product profiles (TPPs for needed TB diagnostics. It will be able to accommodate raw datasets and facilitate the verification of promising biomarker candidates and the identification of novel biomarker combinations. As such, the database will simplify data and knowledge sharing, empower collaboration, help in the coordination of efforts and allocation of resources, streamline the verification and validation of biomarker candidates, and ultimately lead to an accelerated translation into clinically useful tools.

  4. The QuantiFERON-TB Gold In-Tube Assay in Neuro-Ophthalmology.

    Science.gov (United States)

    Little, Leanne M; Rigi, Mohammed; Suleiman, Ayman; Smith, Stacy V; Graviss, Edward A; Foroozan, Rod; Lee, Andrew G

    2017-09-01

    Although QuantiFERON-TB Gold In-Tube (QFT-GIT) testing is regularly used to detect infection with Mycobacterium tuberculosis, its utility in a patient population with a low risk for tuberculosis (TB) has been questioned. The following is a cohort study analyzing the efficacy of QFT-GIT testing as a method for detection of active TB disease in low-risk individuals in a neuro-ophthalmologic setting. Ninety-nine patients from 2 neuro-ophthalmology centers were identified as having undergone QFT-GIT testing between January 2012 and February 2016. Patients were divided into groups of negative, indeterminate, and positive QFT-GIT results. Records of patients with positive QFT-GIT results were reviewed for development of latent or active TB, as determined by clinical, bacteriologic, and/or radiographic evidence. Of the 99 cases reviewed, 18 patients had positive QFT-GIT tests. Of these 18 cases, 12 had documentation of chest radiographs or computed tomography which showed no evidence for either active TB or pulmonary latent TB infection (LTBI). Four had chest imaging which was indicative of possible LTBI. None of these 18 patients had symptoms of active TB and none developed active TB within the follow-up period. Based on our results, we conclude that routine testing with QFT-GIT in a low-risk cohort did not diagnose active TB infection. We do not recommend routine QFT-GIT testing for TB low-risk individuals, as discerned through patient and exposure history, ocular examination, and clinical judgment, in neuro-ophthalmology practice.

  5. Fixed Dose Combination for TB treatment

    Directory of Open Access Journals (Sweden)

    Tjandra Y. Aditama

    2003-06-01

    common if FDCs are used. Nevertheless, whenever side-effects to one or more components in a FDC are suspected, there will be a need to switch to single-drug formulations. Quality, safety and efficacy of FDC drugs are determined by the manufacturing process i.e. by compliance of the manufacturer with the requirements of good manufacturing practices (GMP and pharmacopoeial specifications. National TB programmes must establish a QA system WHO established a laboratory network that tests the quality of FDCs in the marketplace and registers products upon request from the pharmaceutical industry. (Med J Indones 2003; 12: 114-9 Keywords: fixed dose combination, tuberculosis, treatment

  6. [Comparative study of concordance and costs between tuberculin skin test and QuantiFERON(®)-TB Gold In-Tube in the diagnosis of latent tuberculosis infection among contacts of patients with pulmonary tuberculosis].

    Science.gov (United States)

    Martinez Lacasa, Xavier; Canals Font, Roser; Jaen Manzanera, Angels; Cuchi Burgos, Eva; Lite Lite, Josep

    2015-11-20

    Recently diagnosis of latent tuberculosis infection (LTBI) can be made using the tuberculin skin test (TST) or by techniques known as interferon-γ release assays (IGRAS), being QuantiFERON(®)-TB Gold In-Tube (QF-G-IT) the most used. The IGRAS avoid some drawbacks of the TST, especially cross-reaction with bacillus Calmette-Guérin (BCG) vaccine, but also present some problems such as those arising from cost and the need of having an adequate infrastructure and experience. There is no clear consensus on which technique should be preferentially used for the diagnosis of LTBI. This is a comparative study between the TST and QT-G-IT in a cohort of contacts of patients with pulmonary tuberculosis during the study period. An analysis of global agreement and groups was performed according to whether the contacts were vaccinated with BCG or not. A study of costs of both techniques and diagnostic strategies based on these techniques was performed. The agreement between TST and QF-G-IT was acceptable in the whole sample yet it was very good in the unvaccinated group. Few cases of indeterminate values were recorded. The cost study showed that TST was cheaper than QF-G-IT; however when we analyzed the cost of the strategies according to each technique, the QF-G-IT showed a better cost-benefit. We suggest considering QF-G-IT as the only preferred technique for the diagnosis of LTBI in household contacts, based on good overall agreement between the 2 techniques (even if we eliminate the effect of the vaccine) and a cost analysis favorable to QF-G-IT. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  7. CD4 cell count recovery in HIV/TB co-infected patients versus TB uninfected HIV patients

    Directory of Open Access Journals (Sweden)

    Wanchu A

    2010-10-01

    Full Text Available Background: There is lack of data comparing the improvement in CD4 count following antitubercular (ATT and antiretroviral therapy (ART in patients presenting with Human Immunodeficiency Virus/Tuberculosis (HIV/TB dual infection compared with CD4 matched cohort of TB uninfected HIV patients initiated on ART. We sought to test the hypothesis; TB additionally contributes to reduction in CD4 count in HIV/TB co-infected patients and this would result in greater improvement in count following treatment compared with CD4 matched TB uninfected individuals. Materials and Methods: In a retrospective cohort study design we studied the change in CD4 cell counts in two groups of patients - those with CD4 cell count >100 cells / mm 3 (Group 1 and <100/mm 3 (Group 2 at presentation. In each group the change in CD4 cell count in dually infected patients following six-month ATT and ART was compared to cohorts of CD4 matched TB uninfected patients initiated on ART. Results: In Group 1 (52 patients dually infected subjects′ CD4 count improved from 150 cells/ mm 3 to 345 cells/mm 3 (P=0.001. In the control TB uninfected patients, the change was from 159 cells/mm 3 to 317 cells/mm 3 (P=0.001. Additional improvement in dually infected patients compared to the control group was not statistically significant (P=0.24. In Group 2 (65 patients dually infected subjects count improved from 49 cells/mm3 to 249 cells/mm 3 (P=0.001 where as in control TB uninfected patients improvement was from 50 cells/ mm 3 to 205 cells/mm 3 (P=0.001, there being statistically significant additional improvement in dually infected subjects (P=0.01. Conclusion: Greater increment in CD4 counts with ATT and ART in dually infected patients suggests that TB additionally influences the reduction of CD4 counts in HIV patients.

  8. Knowledge, attitude and practice of private practitioners regarding tb-dots in a rural district of Sindh, Pakistan

    International Nuclear Information System (INIS)

    Ahmed, M.; Fatmi, Z.; Ali, S.; Ahmed, S.; Ara, N.

    2009-01-01

    Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge, attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management have been reported only in urban areas of Pakistan. This survey was conducted for the first time in a rural area of Sindh, Pakistan. This survey was conducted in January 2007 at Thatta, a rural district of Sindh, Pakistan. Study subjects were twenty-two allopathic qualified (MBBS) doctors of district Thatta, who were practicing in private setups for at least last one year. Before TB-DOTS training PPs had filled the KAP questionnaire regarding tuberculosis (TB) diagnosis and management through DOTS. Survey data was analysed through SPSS version 11.05 software. On average, five TB suspects per month were seen by each PP. Only 14% of PPs advised sputum microscopy solely for pulmonary TB diagnosis, while 86% of PPs used different combination of tests (chest x-ray/sputum microscopy/ESR/tuberculin test) for TB diagnosis. Over 40% PPs did not prescribe TB treatment regimen according to TB-DOTS category. Majority PPs (85%) did not follow the treatment through sputum microscopy and instead relied on clinical improvement and x-ray clearance. Nearly 60% of TB patients at PPs clinic did not show compliance to the TB treatment and none of PPs were following the retrieval of default cases. A gross lack of PPs knowledge and right practice regarding TB diagnosis and management through DOTS was identified and needed to be addressed through providing DOTS training. (author)

  9. Strategy to better select HIV-infected individuals for latent TB treatment in BCG-vaccinated population.

    Directory of Open Access Journals (Sweden)

    Chin-Hui Yang

    Full Text Available OBJECTIVE: To evaluate the T-SPOT.TB interferon-γ releasing assay and the tuberculin skin test (TST, for the diagnosis of latent tuberculosis infection(LTBI and the development of subsequent active tuberculosis, in BCG-vaccinated HIV-infected individuals. METHODS: HIV-infected individuals without clinical suspicion of active TB or a past history of TB were enrolled from 1 January 2008 to 30 November 2010. Both T-SPOT.TB test and TST were offered to the participants whom were followed up prospectively until April 30, 2012 for development of TB. RESULTS: Among the 909 participants, 25% had positive TST reactions with cut-off point of 5 mm and 15% had positive T-SPOT.TB results. After a median follow-up of 2.97 years, there were 5 cases developed culture-confirmed active TB (all had dual positive TST and T-SPOT.TB results, and the incidence was 0.17 per 100 person-years. The relative risks (RRs for subsequent active TB in HIV-infected individuals with positive TST results, positive T-SPOT.TB results and dual positive results compared with the risk for individuals with negative results were 40.6 (95% CI 2.1-767.9, 73.9 (95% CI 3.9-1397.7 and 226.5 (95% CI 12.0-4284, respectively. The number needed to treat to prevent one subsequent TB case among patients with a positive TST, a positive T-SPOT.TB and dual positive results was 35, 22 and 8 respectively. CONCLUSIONS: Adopting positive results of the TST and T-SPOT.TB to screen LTBI among BCG-vaccinated HIV-infected individuals might be feasible. Number needed to treat for isoniazid preventive therapy could be reduced significantly by using dual positive strategy.

  10. Why healthcare workers are sick of TB

    Directory of Open Access Journals (Sweden)

    Arne von Delft

    2015-03-01

    Full Text Available Dr Thato Mosidi never expected to be diagnosed with tuberculosis (TB, despite widely prevalent exposure and very limited infection control measures. The life-threatening diagnosis of primary extensively drug-resistant TB (XDR-TB came as an even greater shock. The inconvenient truth is that, rather than being protected, Dr Mosidi and thousands of her healthcare colleagues are at an increased risk of TB and especially drug-resistant TB. In this viewpoint paper we debunk the widely held false belief that healthcare workers are somehow immune to TB disease (TB-proof and explore some of the key factors contributing to the pervasive stigmatization and subsequent non-disclosure of occupational TB. Our front-line workers are some of the first to suffer the consequences of a progressively more resistant and fatal TB epidemic, and urgent interventions are needed to ensure the safety and continued availability of these precious healthcare resources. These include the rapid development and scale-up of improved diagnostic and treatment options, strengthened infection control measures, and focused interventions to tackle stigma and discrimination in all its forms. We call our colleagues to action to protect themselves and those they care for.

  11. NEW SCREENING AND DIAGNOSTIC OPTIONS OF VARIOUS TRAITS OF TB INFECTION AMONG CHILDREN AND ADOLESCENTS IN RUSSIA

    Directory of Open Access Journals (Sweden)

    V.A. Aksenova

    2011-01-01

    Full Text Available In modern epidemiologic conditions revealing of children under the maximal risk of TB infection is the most important object of pediatric phtisiology. Study object: efficacy enhancement of early TB diagnmostics among children and adolescents in public healthcare system. Methods: a multicenter study was carried out in the city of Moscow, Samara and Ryazan regions. Children and adolescents under high risk of TB infection were included into this study. The study consisted of three phases: first — Diaskintest intracutaneous test assessment in children and adolescents within TB dispensery; second — same procedure performed among children and adolescents not registered in TB despensery but taken care of by a local pediatrician; third — among pupils of secondary complementary education institutions. Results: first phase of the study showed that every second child, registered in TB dispensery due to MTB contamination, which was revealed via traditional diagnostic procedures, receives unreasonable chemoprophylaxis. Among pediatric patients (second phase TB was diagnosed in 2.3% of total amount of children from this group and among 26.7% of Diaskintestpositive patients. Testing patients in the third phase of the study (pupils of of secondary complementary education institutions revealed TB infection in 0.6% of tested and in 21.2% among Diaskintest-positive patients. Conclusion: Diaskintest use as a screening method among children helps revealing patients under highest risk of TB infection.Key words: children, tuberculosis, diagnostics, Diaskintest, Mantoux test.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (4: 16–22

  12. Alternative medicine: an ethnographic study of how practitioners of Indian medical systems manage TB in Mumbai.

    Science.gov (United States)

    McDowell, Andrew; Pai, Madhukar

    2016-03-01

    Mumbai is a hot spot for drug-resistant TB, and private practitioners trained in AYUSH systems (Ayurveda, yoga, Unani, Siddha and homeopathy) are major healthcare providers. It is important to understand how AYUSH practitioners manage patients with TB or presumptive TB. We conducted semi-structured interviews of 175 Mumbai slum-based practitioners holding degrees in Ayurveda, homeopathy and Unani. Most providers gave multiple interviews. We observed 10 providers in clinical interactions, documenting: clinical examinations, symptoms, history taking, prescriptions and diagnostic tests. No practitioners exclusively used his or her system of training. The practice of biomedicine is frequent, with practitioners often using biomedical disease categories and diagnostics. The use of homeopathy was rare (only 4% of consultations with homeopaths resulted in homeopathic remedies) and Ayurveda rarer (3% of consultations). For TB, all mentioned chest x-ray while 31 (17.7%) mentioned sputum smear as a TB test. One hundred and sixty-four practitioners (93.7%) reported referring TB patients to a public hospital or chest physician. Eleven practitioners (6.3%) reported treating patients with TB. Nine (5.1%) reported treating patients with drug-susceptible TB with at least one second-line drug. Important sources of health care in Mumbai's slums, AYUSH physicians frequently use biomedical therapies and most refer patients with TB to chest physicians or the public sector. They are integral to TB care and control. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Promising therapy of XDR-TB/MDR-TB with thioridazine an inhibitor of bacterial efflux pumps

    DEFF Research Database (Denmark)

    Amaral, L; Martins, M; Viveiros, M

    2008-01-01

    -TB) - a M. tuberculosis organism that is resistant to the most effective second line drugs available for the treatment of TB. This review provides detailed, significant evidence that supports the use of an old neuroleptic compound, thioridazine (TZ), for the management of MDR-TB and XDR-TB infections...... therapy predictably ineffective and death is inevitable, compassionate therapy with TZ should be contemplated. The risks are small and the rewards great....

  14. Effectiveness of TB sensitization initiatives in improving the involvement of self help group members in rural TB control in south India.

    Science.gov (United States)

    Thomas, Beena; Priscilla Rebecca, B; Dhanalakshmi, A; Rani, S; Deepa Lakshmi, A; Watson, Basilea; Vijayalakshmi, R; Muniyandi, M; Karikalan, N

    2016-12-01

    The 'End TB strategy' has highlighted the importance of inter-sectoral collaboration and community mobilization for achieving zero TB deaths by 2020. The aim of the study was to develop and test a model TB sensitization programme involving self help groups (SHGs). This experimental study was conducted in two blocks (intervention and control), in Tiruvallur district. The intervention content included short-lecture, musical story telling activity, role play, short film on TB. The impact was compared at baseline, third and sixth months in terms of SHGs' awareness, promotion of awareness, identification and referral of presumptive TB cases and provision of TB treatment. A total of 764 vs 796 SHGs were enrolled in control and intervention groups, respectively. The knowledge attitude, and practice score (lower score indicated a better attitude and practice), from baseline to 6 months was significantly reduced (29 to 24) in the intervention group. Similarly, a significant difference was observed in identification and referral of chest symptomatics in the intervention group at 3 and 6 months. During the 3 month follow-up a significantly higher proportion of SHG members were involved in TB awareness activities in the intervention (623/748 [83.3%]) vs control group (471/728 [64.7%]; p<0.001). Findings from this study highlight the feasibility of involving SHGs through a model TB sensitization program for strengthening TB prevention and control activities. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Evaluation of three refurbished Guralp CMG-3TB seismometers.

    Energy Technology Data Exchange (ETDEWEB)

    Hart, Darren M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Merchant, Bion J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-05-01

    The overall objective of testing the Guralp CMG-3TB refurbished seismometers is to determine whether or not the refurbished sensors exhibit better data quality and require less maintenance when deployed than the original Guralp CMG-3TBs. SNL will test these 3 refurbished Guralps to verify performance specifications. The specifications that will be evaluated are sensitivity, bandwidth, self-noise, output impedance, clip-level, dynamic range over application passband, verify mathematical response and calibration response parameters for amplitude and phase.

  16. Stop TB in My Lifetime: A Call for a World Free of TB - World TB Day 2013

    Centers for Disease Control (CDC) Podcasts

    2012-03-12

    In this podcast Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses World TB Day, the 2013 slogan and theme.  Created: 3/12/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/13/2012.

  17. The association between ARV and TB drug resistance on TB treatment outcome among Kazakh TB/HIV patients.

    Science.gov (United States)

    Mishkin, Kathryn; Alaei, Kamiar; Alikeyeva, Elmira; Paynter, Christopher; Aringazina, Altyn; Alaei, Arash

    2018-02-26

    TB drug resistance poses a serious threat to the public health of Kazakhstan. This paper presents findings related to TB treatment outcome and drug resistant status among people coinfected with HIV and TB in Kazakhstan. Cohort study using data were provided by the Kazakhstan Ministry of Health's National Tuberculosis Program for 2014 and 2015. Chi-square and logistical regression were performed to understand factors associated with drug resistant TB status and TB treatment outcome. In bivariate analysis, drug resistant status was significantly associated with year of TB diagnosis (p=0.001) viral load (p=0.03). TB treatment outcome was significantly associated with age at diagnosis (p=01), ARV treatment (p <0.0001), and TB drug resistant status (p=0.02). In adjusted analysis, drug resistance was associated with increased odds of successful completion of treatment with successful result compared to treatment failure (OR 6.94, 95% CI: 1.39-34.44) CONCLUSIONS: Our results suggest that being drug resistant is associated with higher odds of completing treatment with successful outcome, even when controlling for receipt of ARV therapy. Copyright © 2018. Published by Elsevier Ltd.

  18. Comparison of TST and IGRA in Diagnosis of Latent Tuberculosis Infection in a High TB-Burden Setting.

    Science.gov (United States)

    Sharma, Surendra K; Vashishtha, Richa; Chauhan, L S; Sreenivas, V; Seth, Divya

    2017-01-01

    There are currently two tests for diagnosing latent tuberculosis infection (LTBI); TST and IGRA. However, it is still unclear that which one of these tests performs better in high TB-burden settings. 1511 household contacts of pulmonary TB patients were enrolled to compare the performance of TST and IGRA for LTBI. At baseline all participant underwent testing for IGRA [QuantiFERON-TB® Gold In-tube (QFT-GIT) assay] and TST [2 tuberculin unit (TU), purified protein derivative (PPD), RT23, Staten Serum Institute (SSI), Copenhagen, Denmark]. All the household contacts were followed-up for two years for incident TB cases. Active TB was diagnosed in 76 household contacts at an incidence rate of 2.14 per 1000 person-years. Both, TST [Hazard Ratio (HR): 1.14, 95% confidence interval (CI): 0.72-1.79, p = 0.57], as well as QFT-GIT assay (HR: 1.66, 95% CI: 0.97-2.84, p = 0.06) results at baseline were not significantly associated with subsequent development of active TB among household contacts of pulmonary TB patients. Neither TST nor IGRA predicted subsequent development of active TB among household contacts of pulmonary TB patients during follow-up. However, keeping in view the cost, and other logistics, TST remains the most preferred method for LTBI diagnosis in resource-limited, high TB-burden settings.

  19. Viral hepatitis and HIV-associated tuberculosis: Risk factors and TB treatment outcomes in Thailand

    Directory of Open Access Journals (Sweden)

    Likanonsakul Sirirat

    2008-07-01

    Full Text Available Abstract Background The occurrence of tuberculosis (TB, human immunodeficiency virus (HIV, and viral hepatitis infections in the same patient poses unique clinical and public health challenges, because medications to treat TB and HIV are hepatotoxic. We conducted an observational study to evaluate risk factors for HBsAg and/or anti-HCV reactivity and to assess differences in adverse events and TB treatment outcomes among HIV-infected TB patients. Methods Patients were evaluated at the beginning, during, and at the end of TB treatment. Blood samples were tested for aspartate aminotransferase (AST, alanine aminotransferase (ALT, total bilirubin (BR, complete blood count, and CD4+ T lymphocyte cell count. TB treatment outcomes were assessed at the end of TB treatment according to international guidelines. Results Of 769 enrolled patients, 752 (98% had serologic testing performed for viral hepatitis: 70 (9% were reactive for HBsAg, 237 (31% for anti-HCV, and 472 (63% non-reactive for both markers. At the beginning of TB treatment, 18 (26% patients with HBsAg reactivity had elevated liver function tests compared with 69 (15% patients non-reactive to any viral marker (p = 0.02. At the end of TB treatment, 493 (64% were successfully treated. Factors independently associated with HBsAg reactivity included being a man who had sex with men (adjusted odds ratio [AOR], 2.1; 95% confidence interval [CI], 1.1–4.3 and having low TB knowledge (AOR, 1.8; CI, 1.0–3.0. Factors most strongly associated with anti-HCV reactivity were having injection drug use history (AOR, 12.8; CI, 7.0–23.2 and living in Bangkok (AOR, 15.8; CI, 9.4–26.5. The rate of clinical hepatitis and death during TB treatment was similar in patients HBsAg reactive, anti-HCV reactive, both HBsAg and anti-HCV reactive, and non-reactive to any viral marker. Conclusion Among HIV-infected TB patients living in Thailand, markers of viral hepatitis infection, particularly hepatitis C virus

  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. State of affairs of tuberculosis in prison facilities: a systematic review of screening practices and recommendations for best TB control.

    Directory of Open Access Journals (Sweden)

    Natalie V S Vinkeles Melchers

    Full Text Available BACKGROUND: Prisoners are at high risk of developing tuberculosis (TB, causing morbidity and mortality. Prison facilities encounter many challenges in TB screening procedures and TB control. This review explores screening practices for detection of TB and describes limitations of TB control in prison facilities worldwide. METHODS: A systematic search of online databases (e.g., PubMed and Embase and conference abstracts was carried out. Research papers describing screening and diagnostic practices among prisoners were included. A total of 52 articles met the inclusion criteria. A meta-analysis of TB prevalence in prison facilities by screening and diagnostic tools was performed. RESULTS: The most common screening tool was symptom questionnaires (63·5%, mostly reporting presence of cough. Microscopy of sputum with Ziehl-Neelsen staining and solid culture were the most frequently combined diagnostic methods (21·2%. Chest X-ray and tuberculin skin tests were used by 73·1% and 50%, respectively, as either a screening and/or diagnostic tool. Median TB prevalence among prisoners of all included studies was 1,913 cases of TB per 100,000 prisoners (interquartile range [IQR]: 332-3,517. The overall annual median TB incidence was 7·0 cases per 1000 person-years (IQR: 2·7-30·0. Major limitations for successful TB control were inaccuracy of diagnostic algorithms and the lack of adequate laboratory facilities reported by 61·5% of studies. The most frequent recommendation for improving TB control and case detection was to increase screening frequency (73·1%. DISCUSSION: TB screening algorithms differ by income area and should be adapted to local contexts. In order to control TB, prison facilities must improve laboratory capacity and frequent use of effective screening and diagnostic tools. Sustainable political will and funding are critical to achieve this.

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

    Science.gov (United States)

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

    2013-01-01

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

  3. [Duties of physicians or other healthcare workers connected with diagnosis, treatment, dissemination of information, assessment and registration of TB patients].

    Science.gov (United States)

    Zielonka, Tadeusz M

    2015-01-01

    Effective laws provide a series of duties to be performed by physicians and other medical personnel associated with TB. Every TB case and death resulting from TB as well as any case of undesirable result of BCG test requires notification and filling in of a special form. The physician has a duty to inform TB patients their legal guardians, close relatives or friends about the need to undergo sanitary and diagnostic procedure, treatment or vaccination, as well as on how to prevent disease from spreading. Persons failing to comply with the relevant numerous legal requirements in this respect are subject to a fine.TB patients can use special sick benefits extending up to 270 days. There is a requirement to use appropriate codes to define TB irrespective of LCD-10 classification.

  4. Extensively Drug-Resistant Tuberculosis (XDR TB)

    Science.gov (United States)

    ... TB Reference Laboratory Network, the National TB Surveillance System in the United States, the national reference laboratory of South Korea, and ... capacity in the U.S. and abroad; and Developing education, risk, and media communications ... – United States, 1993–2006 CDC. CDC’s Role in Preventing XDR ...

  5. Understanding social context on TB cases

    Science.gov (United States)

    Ariyanto, Y.; Wati, D. M.

    2017-01-01

    Tuberculosis (TB) nowadays still becomes one of the world’s deadliest communicable disease. More than half were in South-East Asia and Western Pacific Regions, including Indonesia. As developing country, Indonesia remains classic problems in overcoming TB, that is discontinuation on treatment. Most of discontinuation on treatment among TB patients are affected by diagnostic delay that caused by patient delay. These phenomena occur in many areas, rural to suburb, coastal to plantation, and so on, and they are related with social context among community that could be social capital for each community to deal with TB. Jember as one of county in East Java is known as plantation area. It also has a high prevalence of TB. This study focused on understanding about social context among community, especially on plantation area. This cross-sectional study involved in three districts of Jember, those are Tanggul, Pakusari, and Kalisat. The data were obtained directly from the TB patients, local community, and Primary Health Care (PHC) where the patients recorded. Spatial analysis and social network analysis (SNA) were applied to obtain health seeking behavior pattern among the TB patients coincide the community. Most of TB patients had already chosen health professionals to lead the treatment, although some of them remained to choose self-medication. Meanwhile, SNA showed that religious leader was considered as main part of countermeasures of TB. But they didn’t ever become central figures. So it can be concluded that there are other parts among community who can contribute due to combatting on TB.

  6. The Risk of Depressive Disorder Among Contacts of Tuberculosis Patients in a TB-endemic Area

    Science.gov (United States)

    Pan, Sheng-Wei; Yen, Yung-Feng; Feng, Jia-Yih; Su, Vincent Yi-Fong; Kou, Yu Ru; Su, Wei-Juin

    2015-01-01

    Abstract Tuberculosis (TB) disease may be transmitted to close contacts of index cases, causing physical illness. No studies have investigated the risk of developing depressive disorder among TB contacts in a TB-endemic area. Adult participants with a new diagnosis of TB contact (ICD-9-CM codes V01.1 plus chest radiographic order) since January 1, 2008, were identified from the National Health Insurance Research Database in Taiwan. A control cohort matched for age (±5 y), sex, enrolled years, and income level was selected. These 2 cohorts were followed until December 31, 2012, and observed for the development of depressive disorder. The Kaplan-Meier method and the log-rank test were used to examine the difference in cumulative incidences of depressive disorder between groups. Cox proportional-hazard models were used to calculate adjusted hazard ratios (aHRs) for depressive disorder. The TB contact cohort consisted of 9046 patients and matched controls of 36,184 ones. The mean age of TB contacts was 44.7 years, and 56.0% of them were women. During a mean follow-up period of 2.5 years, 127 (1.40%) TB contacts and 521 (1.44%) matched controls developed depressive disorder. TB exposure was found to be an independent risk factor of depressive disorder in women (aHR 1.34, 95% confidence interval [CI] 1.07–1.68), but not in men (aHR 0.71, 95% CI 0.48–1.06) after adjusting for age, comorbidities, and income levels. The risk of depression was significantly higher for female TB contacts than for matched controls in the first and second years (aHR 1.49, 95% CI 1.03–2.14; and aHR 1.53, 95% CI 1.05–2.23, respectively), but not thereafter. Of note, 67 (0.74%) TB contacts and 88 (0.24%) matched controls developed active TB, but none of them had subsequent depressive disorder during follow-up periods. Female TB contacts had an increased risk of depression within the first 2 years after exposure. Clinicians should consider conducting depression evaluations in addition to

  7. Diagnostic Value of Cerebrospinal Fluid T-SPOT.TB for Tuberculousis Meningitis in China.

    Science.gov (United States)

    Li, Xue Lian; Xie, Na; Wang, Song Wang; Wu, Qian Hong; Ma, Yan; Shu, Wei; Chen, Hong Mei; Zhang, Li Qun; Wu, Xiao Guang; Ma, Li Ping; Che, Nan Ying; Gao, Meng Qiu

    2017-09-01

    The aim of this study was to evaluate the diagnostic value of the cerebrospinal fluid (CSF) T-SPOT.TB test for the diagnosis of TB meningitis (TBM). A retrospective analysis of 96 patients with manifested meningitis was conducted; T-SPOT.TB test was performed for diagnosing TBM to determine the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A receiver operating characteristic (ROC) curve was also drawn to assess the diagnostic accuracy. The sensitivity, specificity, PPV, and NPV of CSF T-SPOT.TB test were 97.8%, 78.0%, 80.3%, and 97.5%, respectively, for 52 patients (54.2%) of the 96 enrolled patients. The area under the curve (AUC) was 0.910, and the sensitivities of CSF T-SPOT.TB for patients with stages I, II, and III of TBM were 96.7%, 97.2%, and 98.9%, respectively. CSF T-SPOT.TB test is a rapid and accurate diagnostic method with higher sensitivity and specificity for diagnosing TBM. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  8. Molecular epidemiology of TB – Its impact on multidrug-resistant tuberculosis control in China☆

    Directory of Open Access Journals (Sweden)

    Biao Xu

    2015-01-01

    Results: In total, 238 bacteriologic confirmed pulmonary TB patients from DQ and 393 from GY diagnosed between 2008 and 2011 were recruited in the study. Of the 631 isolates, 220 (34.9% were resistant to at least one anti-TB drug, including 95 (15.1% simultaneously resistant to isoniazid and rifampicin or MDR, albeit with the similar distribution between DQ and GY (32/238 vs. 63/393; p, 0.378. The MIRU-VNTR genotyping revealed 35 isolates from DQ and 86 from GY exhibited 15 and 32 clustering patterns with four patterns shared between two counties. Compared with GY county, DQ had a significantly lower clustering proportion in MTB isolates susceptible to first-line drugs (25/167 vs. 46/198; p, 0.047 and total drug resistant TB isolates (12/71 vs. 44/149; p, 0.044, but a similar clustering proportion in MDR-TB isolates (8/32 vs. 18/63; p, 0.712. A significant higher clustering proportion was observed in the previously treated patients in both counties, but in the sputum smear-positive patients with cavitaries only in GY. Comparing the previously treated patients between the two counties, the proportion of MDR-TB and clustering proportion exhibited a similar distribution, while the average age of previously treated patients in DQ is significantly older than that in GY. Conclusions: A lower proportion of recent transmissions was observed in the county with long-term DOTS implementation. However, DOTS itself might not have worked enough on blocking the recent transmission of MDR-TB. This observation suggests the urgent needs of implementing the Stop-TB strategies; in particular, accelerating the use of rapid molecularbasedTBdiagnosisand drug susceptibility testing, providing active case findings in a high risk population of MDR-TB and enhancing infection control in high MDR-TB burden countries.

  9. Integration of TB-HIV services at an ANC facility in Frances Baard District, Northern Cape, South Africa.

    Science.gov (United States)

    Peters, J A; Heunis, C; Kigozi, G; Osoba, T; van der Walt, M

    2015-03-21

    Integrated tuberculosis-human immunodeficiency virus (TB-HIV) service delivery as part of maternal health services, including antenatal care (ANC), is widely recommended. This study assessed the implementation of collaborative TB-HIV service delivery at a hospital-based ANC service unit. A record review of a random sample of 308 pregnant women attending the ANC service between April 2011 and February 2012 was conducted. Data were extracted from registers and patient case notes. Outcomes included the proportion of women who underwent HIV counselling and testing (HCT), CD4 count testing, antiretroviral treatment (ART), cotrimoxazole preventive treatment (CPT), TB screening and isoniazid preventive treatment (IPT). Analysis measured variations in patient characteristics associated with service delivery. All women underwent HCT; 80% of those who tested HIV-positive were screened for TB. Most (85.9%) of the HIV-positive women received a CD4 count. However, only 12.9% of eligible women received ART prophylaxis onsite, only 35.7% were referred for initiation of ART, only 42.3% commenced IPT and none received CPT or further investigations for TB. HIV-negative women had 2.6 higher odds (95%CI 1.3-5.3) of receiving TB screening than their HIV-positive counterparts. Although the identification of HIV-positive women and TB suspects was adequate, implementation of other TB-HIV collaborative activities was sub-optimal.

  10. Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA

    Directory of Open Access Journals (Sweden)

    Maria Isabel Lynch

    2009-09-01

    Full Text Available Toxoplasma gondii causes posterior uveitis and the specific diagnosis is based on clinical criteria. The presence of anti-T. gondii secretory IgA (sIgA antibodies in patients' tears has been reported and an association was found between ocular toxoplasmosis and the anti-T. gondii sIgA isotype in Brazilian patients. The purpose of this study was to provide an objective validation of the published ELISA test for determining the presence of anti-T. gondii sIgA in the tears of individuals with ocular toxoplasmosis. Tears from 156 patients with active posterior uveitis were analysed; 82 of them presented characteristics of ocular toxoplasmosis (standard lesion and 74 patients presented uveitis due to other aetiologies. Cases of active posterior uveitis were considered standard when a new inflammatory focus satellite to old retinochoroidal scars was observed. The determination of anti-T. gondii sIgA was made using an ELISA test with crude tachyzoite antigenic extracts. Tears were collected without previous stimulation. Detection of sIgA showed 65.9% sensitivity (95% CI = 54.5-74.4, 71.6% specificity (95% CI = 59.8-81.2, a positive predictive value of 72% (95% CI = 60.3-81.5 and a negative predictive value of 65.4% (95% CI = 54.0-75.4. sIgA reactivity was higher in the tears of patients with active posterior uveitis due to T. gondii (p < 0.05. The test is useful for differentiating active posterior uveitis due to toxoplasmosis from uveitis caused by other diseases.

  11. Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA.

    Science.gov (United States)

    Lynch, Maria Isabel; Malagueño, Elizabeth; Lynch, Luiz Felipe; Ferreira, Silvana; Stheling, Raphael; Oréfice, Fernando

    2009-09-01

    Toxoplasma gondii causes posterior uveitis and the specific diagnosis is based on clinical criteria. The presence of anti-T. gondii secretory IgA (sIgA) antibodies in patients' tears has been reported and an association was found between ocular toxoplasmosis and the anti-T. gondii sIgA isotype in Brazilian patients. The purpose of this study was to provide an objective validation of the published ELISA test for determining the presence of anti-T. gondii sIgA in the tears of individuals with ocular toxoplasmosis. Tears from 156 patients with active posterior uveitis were analysed; 82 of them presented characteristics of ocular toxoplasmosis (standard lesion) and 74 patients presented uveitis due to other aetiologies. Cases of active posterior uveitis were considered standard when a new inflammatory focus satellite to old retinochoroidal scars was observed. The determination of anti-T. gondii sIgA was made using an ELISA test with crude tachyzoite antigenic extracts. Tears were collected without previous stimulation. Detection of sIgA showed 65.9% sensitivity (95% CI = 54.5-74.4), 71.6% specificity (95% CI = 59.8-81.2), a positive predictive value of 72% (95% CI = 60.3-81.5) and a negative predictive value of 65.4% (95% CI = 54.0-75.4). sIgA reactivity was higher in the tears of patients with active posterior uveitis due to T. gondii (p < 0.05). The test is useful for differentiating active posterior uveitis due to toxoplasmosis from uveitis caused by other diseases.

  12. Risk Factors for Bovine Tuberculosis (bTB in Cattle in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Sintayehu W Dejene

    Full Text Available Bovine tuberculosis (bTB infection is generally correlated with individual cattle's age, sex, body condition, and with husbandry practices such as herd composition, cattle movement, herd size, production system and proximity to wildlife-including bTB maintenance hosts. We tested the correlation between those factors and the prevalence of bTB, which is endemic in Ethiopia's highland cattle, in the Afar Region and Awash National Park between November 2013 and April 2015. A total of 2550 cattle from 102 herds were tested for bTB presence using the comparative intradermal tuberculin test (CITT. Data on herd structure, herd movement, management and production system, livestock transfer, and contact with wildlife were collected using semi-structured interviews with cattle herders and herd owners. The individual overall prevalence of cattle bTB was 5.5%, with a herd prevalence of 46%. Generalized Linear Mixed Models with a random herd-effect were used to analyse risk factors of cattle reactors within each herd. The older the age of the cattle and the lower the body condition the higher the chance of a positive bTB test result, but sex, lactation status and reproductive status were not correlated with bTB status. At herd level, General Linear Models showed that pastoral production systems with transhumant herds had a higher bTB prevalence than sedentary herds. A model averaging analysis identified herd size, contact with wildlife, and the interaction of herd size and contact with wildlife as significant risk factors for bTB prevalence in cattle. A subsequent Structural Equation Model showed that the probability of contact with wildlife was influenced by herd size, through herd movement. Larger herds moved more and grazed in larger areas, hence the probability of grazing in an area with wildlife and contact with either infected cattle or infected wildlife hosts increased, enhancing the chances for bTB infection. Therefore, future bTB control strategies

  13. Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA

    OpenAIRE

    Lynch,Maria Isabel; Malagueño,Elizabeth; Lynch,Luiz Felipe; Ferreira,Silvana; Stheling,Raphael; Oréfice,Fernando

    2009-01-01

    Toxoplasma gondii causes posterior uveitis and the specific diagnosis is based on clinical criteria. The presence of anti-T. gondii secretory IgA (sIgA) antibodies in patients' tears has been reported and an association was found between ocular toxoplasmosis and the anti-T. gondii sIgA isotype in Brazilian patients. The purpose of this study was to provide an objective validation of the published ELISA test for determining the presence of anti-T. gondii sIgA in the tears of individuals with o...

  14. Magnetic properties of ball-milled TbFe2 and TbFe2B

    Indian Academy of Sciences (India)

    Unknown

    1. Introduction. The RFe2 (R = rare earth) Laves phase compounds are known to possess large cubic anisotropy (Clark et al 1972) and highest Curie temperature (TC) of all RT2 compounds. (T = transition metal). RFe2 ... TbFe2 and TbFe2B were prepared by arc melting the high pure elements (Tb and B, 99⋅9% purity; Fe, ...

  15. Providing an address for delivery of nanoencapsulated TB drugs

    CSIR Research Space (South Africa)

    Lemmer, Yolandy

    2010-06-01

    Full Text Available compliance and drug resistance pose a great challenge to TB treatment programs worldwide. To improve the current inadequate therapeutic management of TB, a polymeric anti-TB nanodrug delivery system, for anti-TB drugs, was developed that could enable entry...

  16. HIV-Associated TB: Facts 2013

    Science.gov (United States)

    ... 2012 . Around 75% of these people live in sub-Saharan Africa.  TB is the leading cause of death among ... adopted by policy makers and implemented by all health facilities offering HIV care services.  The number of ...

  17. Thermally stimulated properties in ZnSe:Tb and ZnSe:(Mn, Tb) phosphors

    Science.gov (United States)

    Mishra, A. K.; Mishra, S. K.; Pandey, S. P.; Lakshmi Mishra, Kshama

    2018-02-01

    Thermoluminescence studies were performed of ZnSe:Tb and ZnSe:(Mn, Tb) phosphors. A method of preparation for ZnSe phosphors doped with Tb and (Mn, Tb) has been discussed. The thermoluminescence (TL) properties of these phosphors have been studied from 100 to 370 K temperature after exciting by UV radiation (365 nm) at three uniform heating rates 0.4, 0.6 and 0.9 K/s. The trapping parameters like trap depth, lifetime of electrons and capture cross-section have also been determined using various methods.

  18. Mortality among MDR-TB cases: comparison with drug-susceptible tuberculosis and associated factors.

    Directory of Open Access Journals (Sweden)

    Kocfa Chung-Delgado

    Full Text Available An increase in multidrug-resistant tuberculosis (MDR-TB cases is evident worldwide. Its management implies a complex treatment, high costs, more toxic anti-tuberculosis drug use, longer treatment time and increased treatment failure and mortality. The aims of this study were to compare mortality between MDR and drug-susceptible cases of tuberculosis, and to determine risk factors associated with mortality among MDR-TB cases.A retrospective cohort study was performed using data from clinical records of the National Strategy for Prevention and Control of Tuberculosis in Lima, Peru. In the first objective, MDR-TB, compared to drug-susceptible cases, was the main exposure variable and time to death, censored at 180 days, the outcome of interest. For the second objective, different variables obtained from clinical records were assessed as potential risk factors for death among MDR-TB cases. Cox regression analysis was used to determine hazard ratios (HR and 95% confidence intervals (95%CI. A total of 1,232 patients were analyzed: mean age 30.9 ±14.0 years, 60.0% were males. 61 patients (5.0% died during treatment, whereas the MDR-TB prevalence was 19.2%. MDR-TB increased the risk of death during treatment (HR = 7.5; IC95%: 4.1-13.4 when compared to presumed drug-susceptible cases after controlling for potential confounders. Education level (p = 0.01, previous TB episodes (p<0.001, diabetes history (p<0.001 and HIV infection (p = 0.04 were factors associated with mortality among MDR-TB cases.MDR-TB is associated with an increased risk of death during treatment. Lower education, greater number of previous TB episodes, diabetes history, and HIV infection were independently associated with mortality among MDR-TB cases. New strategies for appropriate MDR-TB detection and management should be implemented, including drug sensitivity tests, diabetes and HIV screening, as well as guarantee for a complete adherence to therapy.

  19. Immunomodulation by vitamin D: implications for TB

    OpenAIRE

    Chun, Rene F; Adams, John S; Hewison, Martin

    2011-01-01

    TB remains a major cause of mortality throughout the world. Low vitamin D status has been linked to increased risk of TB and other immune disorders. These observations suggest a role for vitamin D as a modulator of normal human immune function. This article will detail the cellular and molecular mechanisms by which vitamin D regulates the immune system and how vitamin D insufficiency may lead to immune dysregulation. The importance of vitamin D bioavailability as a mechanism for defining the ...

  20. Sensitivity and specificity of QuantiFERON-TB Gold Plus compared with QuantiFERON-TB Gold In-Tube and T-SPOT.TB on active tuberculosis in Japan.

    Science.gov (United States)

    Takasaki, Jin; Manabe, Toshie; Morino, Eriko; Muto, Yoshikazu; Hashimoto, Masao; Iikura, Motoyasu; Izumi, Shinyu; Sugiyama, Haruhito; Kudo, Koichiro

    2018-03-01

    The QuantiFERON-TB Gold Plus (QFT-Plus) was introduced in 2015 as a new generation of interferon-gamma release assays (IGRAs) designed to detect Mycobacterium tuberculosis infection (TB). Examination of its diagnostic accuracy is crucial before it is launched in Japan. We examined 99 patients with laboratory-confirmed active TB (patients) and 117 healthy volunteers with no risk of TB infection (controls) at a medical center in Tokyo, Japan. Blood samples were collected from both the patients and controls and tested using three types of IGRAs: the QFT-Plus, the QuantiFERON-TB Gold In-Tube (QFT-GIT), and the T-SPOT.TB (T-SPOT). The sensitivity and specificity of each IGRA were examined and compared. The sensitivity of the QFT-Plus was 98.9% (95% confidence interval [CI], 0.934-0.998) and similar to that of the QFT-GIT (97.9%; 95% CI, 0.929-0.998) and T-SPOT (96.9%; 95% CI, 0.914-0.994). The specificity of the QFT-Plus was the same as that of the QFT-GIT and T-SPOT (98.1%; 95% CI, 0.934-0.998). One patient with uncontrolled diabetes mellitus showed negative results on all three IGRAs. The QFT-Plus showed a high degree of agreement with the QFT-GIT and T-SPOT, with high sensitivity and specificity. Severe diabetes mellitus may influence the results of IGRAs. Larger studies are needed to validate the accuracy of the GFT-Plus and determine whether it can contribute as adjunctive method for the early diagnosis of active TB in Japan. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  1. Clinical and laboratory profile of patients with TB/HIV coinfection: A case series of 50 patients

    Directory of Open Access Journals (Sweden)

    Anand K Patel

    2011-01-01

    Full Text Available Background: Tuberculosis (TB is said to be one of the commonest opportunistic infection in patients with HIV/AIDS. Objective: To study the clinical and laboratory profile of patients with HIV/TB coinfection. Materials and Methods: Fifty adult TB patients having confirmed HIV seropositivity were included in randomized manner. A detailed history and thorough physical examination was done. Laboratory and radiological investigations were carried out as appropriately warranted. Results: Most of the patients were farm workers (30% followed by manual laborers (22% and transport drivers (16%. Heterosexual route was found in 86% of patients. Cough was present in 94% while fever and weight loss in 86% and 78% of patients, respectively. Out of 50 patients, 40% had only pulmonary TB (PTB, 46% had pulmonary and extra-pulmonary TB (EPTB, 10% had only EPTB and 4% had multisystemic EPTB. Mediastinal lymphadenopathy was present in 34% while pleural effusion and extra-thoracic lymph nodes was present in 20% and 18% of patients, respectively. Positive smear for acid-fast bacilli (AFB was found in 25.58% while positive Mantoux test was found in 32.14% of patients. Conclusion: HIV/TB coinfection is more common in sexually active age group and commonest mode of HIV infection is heterosexual transfer. Sputum smear AFB and Mantoux test positivity is low in TB patients having HIV. Disseminated TB is common in HIV. Mediastinal lymphadenopathy is common site among extra-pulmonary tuberculosis.

  2. Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

    NARCIS (Netherlands)

    Sachdeva, Kuldeep Singh; Raizada, Neeraj; Sreenivas, Achuthan; van't Hoog, Anna H.; van den Hof, Susan; Dewan, Puneet K.; Thakur, Rahul; Gupta, R. S.; Kulsange, Shubhangi; Vadera, Bhavin; Babre, Ameet; Gray, Christen; Parmar, Malik; Ghedia, Mayank; Ramachandran, Ranjani; Alavadi, Umesh; Arinaminpathy, Nimalan; Denkinger, Claudia; Boehme, Catharina; Paramasivan, C. N.

    2015-01-01

    Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India.

  3. Nilai Diagnostik Metode “Real Time” PCR GeneXpert pada TB Paru BTA Negatif

    Directory of Open Access Journals (Sweden)

    Eka Kurniawan

    2016-09-01

    description of TB and it’s depend on doctor's decision, so this can lead to under or over-diagnosis. Molecular examination with real time PCR method of GeneXpert is a breakthrough invention to diagnose TB quickly. The objective of this study was to assess the validity of GeneXpert in smear negative pulmonary TB and it’s compared with Loweinstein Jensen culture. Study design was diagnostic test with cross sectional study. Research conducted on 40 patients with smear negative pulmonary TB in public health centers around the city of Padang and the patients who were treated at the Internal Medicine department of dr. M. Djamil hospital Padang. Sputum examination conducted by GeneXpert compared with Loweinstein Jensen culture. Diagnostic value of GeneXpert for diagnosing smear negative pulmonary tuberculosis are sensitivity 83.33%, specificity 95.46%, positive predictive value 93.75%, negative predictive value 87.5% and accuracy 90%. Kappa value is 0.796. GeneXpert has a high sensitivity, specificity, positive predictive value, negative predictive value and accuracy on smear negative pulmonary tuberculosis.Keywords: diagnostic value, smear negative pulmonary tuberculosis, GeneXpert

  4. Predictive and prognostic properties of TB-LAM among HIV-positive patients initiating ART in Johannesburg, South Africa.

    Science.gov (United States)

    d'Elia, Alexander; Evans, Denise; McNamara, Lynne; Berhanu, Rebecca; Sanne, Ian; Lönnermark, Elisabet

    2015-01-01

    While the diagnostic properties of the TB LAM urine assay (LAM) have been well-described, little is known about its predictive and prognostic properties at ART initiation in a routine clinic setting. We describe the predictive and prognostic properties of LAM in HIV-positive patients initiating ART at an urban hospital in Johannesburg, South Africa. Retrospective study of HIV-positive adults (>18 years) who initiated standard first-line ART between February 2012 and April 2013 and had a LAM test at initiation. In HIV-positive patients with no known TB at ART initiation, we assessed the sensitivity, specificity and positive/negative likelihood ratios of LAM to predict incident TB within 6 months of ART initiation. In addition, in patients with a TB diagnosis and on TB treatment ART initiation, we measured the CD4 response at 6 months on ART. Of the 274 patients without TB at ART initiation, 65% were female with median CD4 count of 213 cells/mm(3). Among the 14 (5.1%) patients who developed active TB, none were urine LAM +ve at baseline. LAM had poor sensitivity (0.0% 95% CI 0.00-23.2) to predict incident TB within 6 months of initiation. We analyzed 22 patients with a confirmed TB diagnosis at initiation separately. Of these, LAM +ve patients (27%) showed lower CD4 gains compared to LAM negative patients (median increase 103 vs 199 cells/mm(3); p = 0.08). LAM has limited value for accurately predicting incident TB in patients with higher CD4 counts after ART initiation. LAM may help identify TB/HIV co-infected patients at ART initiation who respond more slowly to treatment and require targeted interventions to improve treatment outcomes. Larger studies with longer patient follow-up are needed.

  5. TB and HIV Therapeutics: Pharmacology Research Priorities

    Directory of Open Access Journals (Sweden)

    Kelly E. Dooley

    2012-01-01

    Full Text Available An unprecedented number of investigational drugs are in the development pipeline for the treatment of tuberculosis. Among patients with tuberculosis, co-infection with HIV is common, and concurrent treatment of tuberculosis and HIV is now the standard of care. To ensure that combinations of anti-tuberculosis drugs and antiretrovirals are safe and are tested at doses most likely to be effective, selected pharmacokinetic studies based on knowledge of their metabolic pathways and their capacity to induce or inhibit metabolizing enzymes of companion drugs must be conducted. Drug interaction studies should be followed up by evaluations in larger populations to evaluate safety and pharmacodynamics more fully. Involving patients with HIV in trials of TB drugs early in development enhances the knowledge gained from the trials and will ensure that promising new tuberculosis treatments are available to patients with HIV as early as possible. In this review, we summarize current and planned pharmacokinetic and drug interaction studies involving investigational and licensed tuberculosis drugs and antiretrovirals and suggest priorities for tuberculosis-HIV pharmacokinetic, pharmacodynamic, and drug-drug interaction studies for the future. Priority studies for children and pregnant women with HIV and tuberculosis co-infection are briefly discussed.

  6. Choosing algorithms for TB screening: a modelling study to compare yield, predictive value and diagnostic burden.

    Science.gov (United States)

    Van't Hoog, Anna H; Onozaki, Ikushi; Lonnroth, Knut

    2014-10-19

    To inform the choice of an appropriate screening and diagnostic algorithm for tuberculosis (TB) screening initiatives in different epidemiological settings, we compare algorithms composed of currently available methods. Of twelve algorithms composed of screening for symptoms (prolonged cough or any TB symptom) and/or chest radiography abnormalities, and either sputum-smear microscopy (SSM) or Xpert MTB/RIF (XP) as confirmatory test we model algorithm outcomes and summarize the yield, number needed to screen (NNS) and positive predictive value (PPV) for different levels of TB prevalence. Screening for prolonged cough has low yield, 22% if confirmatory testing is by SSM and 32% if XP, and a high NNS, exceeding 1000 if TB prevalence is ≤0.5%. Due to low specificity the PPV of screening for any TB symptom followed by SSM is less than 50%, even if TB prevalence is 2%. CXR screening for TB abnormalities followed by XP has the highest case detection (87%) and lowest NNS, but is resource intensive. CXR as a second screen for symptom screen positives improves efficiency. The ideal algorithm does not exist. The choice will be setting specific, for which this study provides guidance. Generally an algorithm composed of CXR screening followed by confirmatory testing with XP can achieve the lowest NNS and highest PPV, and is the least amenable to setting-specific variation. However resource requirements for tests and equipment may be prohibitive in some settings and a reason to opt for symptom screening and SSM. To better inform disease control programs we need empirical data to confirm the modeled yield, cost-effectiveness studies, transmission models and a better screening test.

  7. Commercial serological antibody detection tests for the diagnosis of pulmonary tuberculosis: a systematic review.

    Directory of Open Access Journals (Sweden)

    Karen R Steingart

    2007-06-01

    Full Text Available BACKGROUND: The global tuberculosis epidemic results in nearly 2 million deaths and 9 million new cases of the disease a year. The vast majority of tuberculosis patients live in developing countries, where the diagnosis of tuberculosis relies on the identification of acid-fast bacilli on unprocessed sputum smears using conventional light microscopy. Microscopy has high specificity in tuberculosis-endemic countries, but modest sensitivity which varies among laboratories (range 20% to 80%. Moreover, the sensitivity is poor for paucibacillary disease (e.g., pediatric and HIV-associated tuberculosis. Thus, the development of rapid and accurate new diagnostic tools is imperative. Immune-based tests are potentially suitable for use in low-income countries as some test formats can be performed at the point of care without laboratory equipment. Currently, dozens of distinct commercial antibody detection tests are sold in developing countries. The question is "do they work?" METHODS AND FINDINGS: We conducted a systematic review to assess the accuracy of commercial antibody detection tests for the diagnosis of pulmonary tuberculosis. Studies from all countries using culture and/or microscopy smear for confirmation of pulmonary tuberculosis were eligible. Studies with fewer than 50 participants (25 patients and 25 control participants were excluded. In a comprehensive search, we identified 68 studies. The results demonstrate that (1 overall, commercial tests vary widely in performance; (2 sensitivity is higher in smear-positive than smear-negative samples; (3 in studies of smear-positive patients, Anda-TB IgG by enzyme-linked immunosorbent assay shows limited sensitivity (range 63% to 85% and inconsistent specificity (range 73% to 100%; (4 specificity is higher in healthy volunteers than in patients in whom tuberculosis disease is initially suspected and subsequently ruled out; and (5 there are insufficient data to determine the accuracy of most

  8. Non-adherence to anti-TB drugs among TB/HIV co-infected patients ...

    African Journals Online (AJOL)

    Non-adherence to anti-TB drugs among TB/HIV co-infected patients in Mbarara Hospital ... and its associated factors have not been studied in these patients in Uganda. ... Methods: A cross-sectional study with qualitative and quantitative data ...

  9. tb diagnostics challenges of tb diagnosis and treatment in south africa

    African Journals Online (AJOL)

    2007-06-01

    Jun 1, 2007 ... 45 currently provides treatment to 3 000 patients. Eighty-nine per cent of those accessing ART have symptomatic HIV disease. (WHO clinical stage 3 and 4) with a median CD4 cell count of. 95 cells/µl. More than 50% have a history of prior completed. TB treatment, 15% are on current TB treatment, 11% are.

  10. Integration of TB and ART services fails to improve TB treatment ...

    African Journals Online (AJOL)

    The median CD4+ count of HIV-positive patients was 152 cells/μl (interquartile range (IQR) 71 - 277) for integrated facilities and 148 cells/μl (IQR 67 - 260) for single-service facilities. There was no statistical difference in the TB treatment outcome profile between integrated and single-service facilities for all TB patients (p=0.

  11. Influence knowledge and behavior of TB medical personnels’ concordance principle based communications skill at primary healthcare, Medan, Indonesia

    Science.gov (United States)

    Wahyuni, A. S.; Soeroso, N. N.; Alona, I.; Yunanda, Y.; Siregar, I.

    2018-03-01

    Concordance behavior of TB management is a form of collaboration among doctors, personnel, and patients in treating TB. Approvalamong them could be achieved if credibility and policy occur. This study is aimed to analyze the influence of TB medical personnel’s concordance behaviour principle to patient obedience at primary health care in Medan.The design of this study was quasi experimental, focusing on interventional primary health care, which is those who applied concordance behaviour principle to non-interventionalprimary health care. The population is TB patients, starting from 18 years old, TB category I with positive Acid Fast Bacilli Smear Test (AFBST), and taking TB regimens at Medan. Seventy- four patients were selected to be samples. They had undergone interview based on validated concordance principle, knowledge, behavior, and treatment. Data were analyzed using chi- square. The percentage of knowledge, behavior of TB patient to the treatment is higher on interventional primary health care than noninterventional ones. Treatment awareness based on concordance principle is expected to planish DOTS-based TB programs.

  12. The implementation of isoniazid preventive therapy in HIV clinics: the experience from the TB/HIV in Rio (THRio) study.

    Science.gov (United States)

    Durovni, Betina; Cavalcante, Solange C; Saraceni, Valeria; Vellozo, Vitoria; Israel, Giselle; King, Bonnie S; Cohn, Silvia; Efron, Anne; Pacheco, Antonio G; Moulton, Lawrence H; Chaisson, Richard E; Golub, Jonathan E

    2010-11-01

    The TB/HIV in Rio (THRio) study was launched in September 2005 to assess the impact of integrated tuberculosis (TB) and HIV treatment strategies in 29 HIV clinics in Rio de Janeiro, Brazil. THRio is a cluster-randomized trial (CRT) to determine whether routine screening for and treatment of latent TB in HIV clinic patients with access to antiretroviral therapy will reduce TB incidence at the clinic level. THRio is part of the Consortium to Respond Effectively to AIDS/TB Epidemic that is implementing research studies to assess the impact of bold, new public health paradigms for controlling the AIDS/TB epidemic. Twenty-nine public primary HIV clinics were randomly assigned a date to begin implementing TB screening procedures and provision of isoniazid preventive therapy (IPT) for TB/HIV coinfected patients. Final analysis of the CRT is expected in 2011. Starting at date of tuberculin skin test (TST)/IPT implementation at each clinic through August 2010, 1670 HIV-infected patients initiated IPT, of which 215 are still receiving treatment. Of the remaining 1455 patients, 1230 (85%) completed therapy and only 20 (1.2%) patients initiating IPT reported adverse reactions leading to discontinuation of therapy. IPT completion was higher among HIV-infected patients receiving HAART (87%) than those not yet receiving HAART (79%, P effort requires a package of activities including training, advocacy and reorganization of services.

  13. CT screening before treatment of latent tuberculous infection for the diagnosis of clinical TB among contacts

    International Nuclear Information System (INIS)

    Yoshiyama, Takashi; Ogata, Hideo

    2008-01-01

    The objective of this study was to evaluate the value of CT scan for the detection of tuberculous diseases among persons who are suspected to be infected at the contact examination. The settings of this study was to Fukujuji Hospital, Japan. Retrospective review of the medical records of 22 persons who were normal with plain chest X-ray at an outbreak at a private school, with which total 46 tuberculosis (TB) cases and 93 infected persons were detected by either symptomatic visits or contact examinations done mainly at public health centers. Among the 44 persons who visited Fukujuji Hospital, 4 persons were symptomatic visits, 3 persons were detected as TB cases by the contact examination at public health centers and 3 persons visited Fukujuji Hospital for the purpose of contact examination before examinations at the public health centers. Eight of these 10 persons were with abnormal chest plain X-ray findings and the remaining two persons were normal with plain chest X-ray findings (group A). Among the 34 persons who were referred to Fukujuji Hospital from public health centers as the infected person without diseases, one person showed abnormal chest plain X-ray and 33 persons showed normal chest plain X-ray (group B). Group A persons were examined in June and Group B persons were examined in July. The 2 persons in the group A were with abnormal CT findings. They were not diagnosed as TB by the CT findings but followed up after sputum examinations. Both of them were diagnosed as TB by the positive TB culture. Among the 33 persons in the group B, 20 persons were tested with CT scan at the examination done before starting treatment of latent tuberuclous infection and six of these 20 persons were with abnormal findings and were judged as TB diseases. In the case of outbreak with many TB cases and infected persons, CT should be considered for the detection of TB cases among contacts. (author)

  14. Mantoux Tuberculin Skin Test

    Centers for Disease Control (CDC) Podcasts

    2006-11-22

    Learn how to evaluate people for latent TB infection with the Mantoux tuberculin skin test. This podcast includes sections on administering and reading the Mantoux tuberculin skin test, the standard method for detecting latent TB infection since the 1930s.  Created: 11/22/2006 by National Center for HIV, STD and TB Prevention (NCHHSTP).   Date Released: 12/12/2006.

  15. The multi-step process of building TB/HIV collaboration in Cambodia

    Directory of Open Access Journals (Sweden)

    Eang Mao

    2012-10-01

    Full Text Available Abstract Tuberculosis and HIV/AIDS have synergistic health impacts in terms of disease development and progression. Therefore, collaborative TB and HIV/AIDS activities are a logical health systems response. However, the establishment of these activities presents a challenge for countries that have strong vertical disease programs that differ in their implementation philosophies. Here, we review the process by which TB/HIV collaboration was established in Cambodia. A cycle of overlapping and mutually reinforcing initiatives – local research; piloted implementation with multiple options; and several rounds of policy formulation guided by a cross-functional Technical Working Group – was used to drive nationwide introduction of a full set of TB/HIV collaborative activities. Senior Ministry of Health officials and partner organizations brought early attention to TB/HIV. Both national programs implemented initial screening and testing interventions, even in the absence of a detailed, overarching framework. The use of multiple options for HIV testing identified which programmatic options worked best, and early implementation and pilots determined what unanswered questions required further research. Local conduct of this research – on co-treatment timing and TB symptom screening – speeded adoption of the results into policy guidance, and clarified the relative roles of the two programs. Roll-out is continuing, and results for a variety of key indicators, including screening PLHIV for TB, and testing TB patients for HIV, are at 70-80% and climbing. This experience in Cambodia illustrates the influence of health research on policy, and demonstrates that clear policy guidance, the pursuit of incremental advances, and the use of different approaches to generate evidence can overcome structural barriers to change and bring direct benefits to patients.

  16. The role of antiretroviral therapy in reducing TB incidence and mortality in high HIV-TB burden countries

    Directory of Open Access Journals (Sweden)

    Anthony D Harries

    2016-03-01

    Full Text Available With the adoption of the new Sustainable Development Goals in 2016, all countries have committed to end the tuberculosis (TB epidemic by 2030, defined as dramatic reductions in TB incidence and mortality combined with zero TB-induced catastrophic costs for families. This paper explores how antiretroviral therapy (ART in high HIV-TB burden countries may help in reducing TB incidence and mortality and thus contribute to the ambitious goal of ending TB. ART in people living with HIV has a potent TB preventive effect, with this being most apparent in those with the most advanced immunodeficiency. Early ART also significantly reduces the risk of TB, and with new World Health Organization guidance released in 2015 about initiating ART in all persons living with HIV irrespective of CD4 count, there is the potential for enormous benefit at the population level. Already, several countries with high HIVTB burdens have seen dramatic declines in TB case notification rates since ART scale up started in 2004. In patients already diagnosed with HIV-associated TB, mortality can be significantly decreased by ART, especially if started within 2–8 weeks of anti-TB treatment. The benefits of ART on TB incidence and TB mortality can be further augmented respectively by the addition of isoniazid preventive therapy and cotrimoxazole preventive therapy. These interventions must be effectively implemented and scaled up in order to end the TB epidemic by 2030.

  17. Magnetic properties of TbTiGe

    International Nuclear Information System (INIS)

    Prokes, K.; Tegus, O.; Brueck, E.; Gortenmulder, T.J.; Boer, F.R. de; Buschow, K.H.J.

    2001-01-01

    We have studied the magnetic properties of the compound TbTiGe by means of neutron diffraction in the temperature range 1.7-310 K. We also report on magnetization measurements made at different temperatures and fields. The compound TbTiGe adopts the tetragonal CeFeSi-structure type and orders antiferromagnetically at T N =286 K. The structure is collinear antiferromagnetic in the whole temperature range below T N , with the magnetic moments aligned along the tetragonal c-axis. The uncommon shape of the temperature dependence of the magnetization observed in our sample is attributed to small amounts of the ferromagnetic low-temperature modification of TbTiGe

  18. Multi-quasiparticle excitations in 145Tb

    International Nuclear Information System (INIS)

    Zheng Yong; Zhou Xiaohong; Zhang Yuhu; Liu Minliang; Guo Yingxiang; Lei Xiangguo; Kusakari, H.; Sugawara, M.

    2004-01-01

    High-spin states in 145 Tb have been populated using the 118 Sn( 32 S, 1p4n) reaction at a beam energy of 165 MeV. The level scheme of 145 Tb has been established for the first time. The level scheme shows characteristics of spherical or slightly oblate nucleus. Based on the systematic trends of the level structure in the neighboring N=80 isotones, the level structure in 145 Tb below 2 MeV excitation is well explained by coupling an h 11/2 valence proton to the even-even 144 Gd core. Above 2 MeV excitation, most of the yrast levels are interpreted with multi-quasiparticle shell-model configurations. (authors)

  19. Empirical evidence for synchrony in the evolution of TB cases and HIV+ contacts among the San Francisco homeless.

    Directory of Open Access Journals (Sweden)

    Mojdeh Mohtashemi

    Full Text Available The re-emergence of tuberculosis (TB in the mid-1980s in many parts of the world, including the United States, is often attributed to the emergence and rapid spread of human immunodeficiency virus (HIV and acquired immunodeficiency syndrome (AIDS. Although it is well established that TB transmission is particularly amplified in populations with high HIV prevalence, the epidemiology of interaction between TB and HIV is not well understood. This is partly due to the scarcity of HIV-related data, a consequence of the voluntary nature of HIV status reporting and testing, and partly due to current practices of screening high risk populations through separate surveillance programs for HIV and TB. The San Francisco Department of Public Health, TB Control Program, has been conducting active surveillance among the San Francisco high-risk populations since the early 1990s. We present extensive TB surveillance data on HIV and TB infection among the San Francisco homeless to investigate the association between the TB cases and their HIV+ contacts. We applied wavelet coherence and phase analyses to the TB surveillance data from January 1993 through December 2005, to establish and quantify statistical association and synchrony in the highly non-stationary and ostensibly non-periodic waves of TB cases and their HIV+ contacts in San Francisco. When stratified by homelessness, we found that the evolution of TB cases and their HIV+ contacts is highly coherent over time and locked in phase at a specific periodic scale among the San Francisco homeless, but no significant association was observed for the non-homeless. This study confirms the hypothesis that the dynamics of HIV and TB are significantly intertwined and that HIV is likely a key factor in the sustenance of TB transmission among the San Francisco homeless. The findings of this study underscore the importance of contact tracing in detection of HIV+ individuals that may otherwise remain undetected, and

  20. HIV screening among newly diagnosed TB patients: a cross sectional study in Lima, Peru.

    Science.gov (United States)

    Ramírez, Suzanne; Mejía, Fernando; Rojas, Marlene; Seas, Carlos; Van der Stuyft, Patrick; Gotuzzo, Eduardo; Otero, Larissa

    2018-03-20

    Since 2006, the Peruvian National TB program (NTP) recommends voluntary counseling and testing (VCT) for all tuberculosis (TB) patients. Responding to the differential burden of both diseases in Peru, TB is managed in peripheral health facilities while HIV is managed in referral centers. This study aims to determine the coverage of HIV screening among TB patients and the characteristics of persons not screened. From March 2010 to December 2011 we enrolled new smear-positive pulmonary TB adults in 34 health facilities in a district in Lima. NTP staff offered VCT to all TB patients. Patients with an HIV positive result were referred for confirmation tests and management. We interviewed patients to collect their demographic and clinical characteristics and registered if patients opted in or out of the screening. Of the 1295 enrolled TB patients, nine had a known HIV diagnosis. Of the remaining, 76.1% (979) were screened for HIV. Among the 23.9% (307) not screened, 38.4% (118) opted out of the screening. TB patients at one of the health care facilities of the higher areas of the district (OR = 3.38, CI 95% 2.17-5.28 for the highest area and OR = 2.82, CI 95% 1.78-4.49 for the high area) as well as those reporting illegal drug consumption (OR = 1.65, CI 95% 1.15-2.37) were more likely not to be screened. Twenty-four were HIV positive (1.9% of all patients 1295, or 2.4% of those screened). Of 15 patients diagnosed with HIV during the TB episode, ten were enrolled in an HIV program. The median time between the result of the HIV screening and the first consultation at the HIV program was 82 days (IQR, 32-414). The median time between the result of the HIV screening and antiretroviral initiation was 148.5 days (IQR 32-500). An acceptable proportion of TB patients were screened for HIV in Lima. Referral systems of HIV positive patients should be strengthened for timely ART initiation.

  1. TB case detection in Tajikistan – analysis of existing obstacles

    Directory of Open Access Journals (Sweden)

    Alexei Korobitsyn

    2013-10-01

    Full Text Available Background: Tajikistan National TB Control ProgramObjective: (1 To identify the main obstacles to increasing TB Detection in Tajikistan. (2 To identify interventions that improve TB detection.Methods: Review of the available original research data, health normative base, health systems performance and national economic data, following WHO framework for detection of TB cases, which is based on three scenarios of why incident cases of TB may not be notified.Results: Data analysis revealed that some aspects of TB case detection are more problematic than others and that there are gaps in the knowledge of specific obstacles to TB case detection. The phenomenon of “initial default” in Tajikistan has been documented; however, it needs to be studied further. The laboratory services detect infectious TB cases effectively; however, referrals of appropriate suspects for TB diagnosis may lag behind. The knowledge about TB in the general population has improved. Yet, the problem of TB related stigma persists, thus being an obstacle for effective TB detection. High economic cost of health services driven by under-the-table payments was identified as another barrier for access to health services.Conclusion: Health system strengthening should become a primary intervention to improve case detection in Tajikistan. More research on reasons contributing to the failure to register TB cases, as well as factors underlying stigma is needed.

  2. PROFIL PENDERITA TB PARU KLINIS YANG TIDAK BEROBAT DI PELAYANAN KESEHATAN, DI INDONESIA TAHUN 2010

    Directory of Open Access Journals (Sweden)

    Gurendro Putro

    2013-03-01

    Full Text Available ABSTRACT Background: Further analysis of the results of health research foundation in 2010 in this report on the profile penderira clinical pulmonary TB disease is not treated in the health service. The data analyzed is the result of basic health research in clinical pulmonary TB patients who do not seek treatment in health care. Methods: This analysis is the deepening of research on the basic health questionnaire B18 RKD1 ORT question by finding that respondent characteristics of age, gender, education level and job type, and location of residen ce and social situation eskonomi. It is also seen in disease prevention behavior Pulmonary TB and state family room and bedroom sufferers. Results: Having done the analysis, there are 4966 clinical pulmonary TB patients and who do not seek treatment at health care as many as 2842 patients (57.7%. So th at the data analyzed is as much as 2842 people. From the test results of Chi sqaure analysis variables associated with pulmonary TB prevention behaviors are age (p = 0.001, education level (p = 0.001, occupation (p = 0.001, residence ofrespondents (p = 0.001, socioeconomic (p = 0.001, and housing conditions (p = 0.001. Conclusions: Health workers are health care workers provide counseling on the importance of treatment for patients with pulmonary tuberculosis clinical and laboratory examinations do know the existence of BTA +. Also expected clinical pulmonary TB patients do not spit everywhere. Key words: profile, clinic TB case, don't therapy in health services ABSTRAK Latar Belakang: Analisis lanjut hasil riset kesehatan dasar 201 0 dalam laporan ini tentang profil penderira penyakit TB Paru klinis yang tidak berobat di pelayanan kesehatan. Data yang dianalisis merupakan hasil dari riset kesehatan dasar pada penderita TB Paru klinis yang tidak berobat di pelayanan kesehatan. Metode: Analisis ini merupakan pendalaman dari hasil riset kesehatan dasar pada kuesioner RKD 1 O. RT pertanyaan B 18 dengan

  3. A Data-Driven Evaluation of the Stop TB Global Partnership Strategy of Targeting Key Populations at Greater Risk for Tuberculosis.

    Science.gov (United States)

    McLaren, Zoë M; Schnippel, Kathryn; Sharp, Alana

    2016-01-01

    Identifying those infected with tuberculosis (TB) is an important component of any strategy for reducing TB transmission and population prevalence. The Stop TB Global Partnership recently launched an initiative with a focus on key populations at greater risk for TB infection or poor clinical outcomes, due to housing and working conditions, incarceration, low household income, malnutrition, co-morbidities, exposure to tobacco and silica dust, or barriers to accessing medical care. To achieve operational targets, the global health community needs effective, low cost, and large-scale strategies for identifying key populations. Using South Africa as a test case, we assess the feasibility and effectiveness of targeting active case finding to populations with TB risk factors identified from regularly collected sources of data. Our approach is applicable to all countries with TB testing and census data. It allows countries to tailor their outreach activities to the particular risk factors of greatest significance in their national context. We use a national database of TB test results to estimate municipality-level TB infection prevalence, and link it to Census data to measure population risk factors for TB including rates of urban households, informal settlements, household income, unemployment, and mobile phone ownership. To examine the relationship between TB prevalence and risk factors, we perform linear regression analysis and plot the set of population characteristics against TB prevalence and TB testing rate by municipality. We overlay lines of best fit and smoothed curves of best fit from locally weighted scatter plot smoothing. Higher TB prevalence is statistically significantly associated with more urban municipalities (slope coefficient β1 = 0.129, p informal settlement households (β1 = 0.021, p = 0.136, R2 = 0.014). These analyses reveal that the set of characteristics identified by the Global Plan as defining key populations do not adequately predict

  4. Combination of TB lymphadenitis and metastatic LAP in breast cancer

    Directory of Open Access Journals (Sweden)

    Abdolhassan Talaiezadeh

    2015-06-01

    Full Text Available Tuberculosis (TB may present as pulmonary and extra-pulmonary. TB lymphadenitis is the most common presentation of extra-pulmonary TB. TB lymphadenitis should be taken into account in the differential diagnosis of different disorders such as metastatic lymphadenopathy. The reported patient was a 65-year-old lady with breast cancer and conglomerated and matted axillary lymphadenopathy who received chemotherapy. She presented with more extensive axillary LAP contrary to our expectation. Modified radical mastectomy was done and pathology analysis reported TB lymphadenitis associated with metastatic LAP. Under cover of anti-TB therapy adjuvant chemoradiation therapy was started. Accordingly, we recommend TB be ruled out in every patient who needs chemotherapy in the endemic region because chemotherapy may cause the extension of TB in the body.

  5. Patient satisfaction with TB care clinical consultations in Kampala: a ...

    African Journals Online (AJOL)

    ... on treatment outcome. Keywords: Patient satisfaction, TB care clinical consultations, cross sectional study. ... Background: Tuberculosis (TB) remains a major global ... Measurement of outcome: Variables considered were; how long the ... Key: ART= Antiretroviral Therapy. Characteristic. Parameter n (%). Sex. Female.

  6. Tuberculosis: Learn the Signs and Symptoms of TB Disease

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Past Emails Tuberculosis (TB) Disease: Symptoms and Risk Factors Language: English ( ... Español (Spanish) Recommend on Facebook Tweet Share Compartir Tuberculosis (TB) is a disease caused by bacteria that ...

  7. Exploring workplace TB interventions with foreign-born Latino workers.

    Science.gov (United States)

    Eggerth, Donald E; Keller, Brenna M; Flynn, Michael A

    2018-05-15

    Persons born outside the United States are more likely to be diagnosed with tuberculosis disease (TB) than native-born individuals. Foreign-born Latinos at risk of TB may be difficult to reach with public health interventions due to cultural and institutional barriers. Workplaces employing large concentrations of foreign-born Latinos may be useful locations for TB interventions targeting this high-risk population. This study used a two-phase approach to investigate the feasibility of workplace TB interventions. The first phase investigated employer knowledge of TB and receptiveness to allowing TB interventions in their businesses through 5 structured interviews. The second phase investigated foreign-born workers' knowledge of TB and their receptiveness to receiving TB interventions in their places of employment through 12 focus groups stratified by gender and education. Phase 1: Only 1 of the 5 employers interviewed had a high level of knowledge about TB, and three had no knowledge other than that TB was a disease that involved coughing. They were receptive to workplace TB interventions, but were concerned about lost productivity and customers finding out if an employee had TB. Phase 2: There was no observed differences in responses between gender and between the bottom two education groups, so the final analysis took place between a gender-combined lower education group and higher education group. The higher education group tended to have knowledge that was more accurate and to view TB as a disease associated with poverty. The lower education group tended to have more misconceptions about TB and more often expressed concern that their employers would not support worksite interventions. The results from both phases indicate that more TB education is needed among both foreign-born Latino workers and their employers. Obstacles to implementing workplace TB interventions include knowledge, potential productivity loss, employer liability, and perceived customer response

  8. Diagnosis of active TB using aptamers

    CSIR Research Space (South Africa)

    Khati, M

    2013-08-01

    Full Text Available of the disease. We have shown in a proof-of-concept case-controlled study that the aptamer-based diagnostic tool was able to accurately detect all cases of active TB from sputum samples of patients, including smear-negative culture positive and samples from...

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

    Science.gov (United States)

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

    2013-04-26

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

  10. Risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in a tertiary armed force referral and teaching hospital, Ethiopia.

    Science.gov (United States)

    Demile, Biresaw; Zenebu, Amare; Shewaye, Haile; Xia, Siqing; Guadie, Awoke

    2018-05-31

    Ethiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat. This study aimed to identify the prevalence and associated factors of multidrug-resistant tuberculosis (MDR-TB) using all armed force and civilian TB attendants in a tertiary level armed force hospital, where data for MDR-TB are previously unpublished. Cross-sectional study was conducted from September 2014 to August 2015 in a tertiary level Armed Force Referral and Teaching Hospital (AFRTH), Ethiopia. Armed force members (n = 251) and civilians (n = 130) which has been undergone TB diagnosis at AFRTH were included. All the specimens collected were subjected to microscopic smear observation, culture growth and drug susceptibility testing. Data were analyzed using statistical package for social sciences following binary logistic regression and Chi-square. P-values < 0.05 were considered statistically significant. Among 381 TB patients, 355 (93.2%) new and 26 (6.8%) retreatment cases were identified. Culture and smear positive TB cases were identified in 297 (77.9%) and 252 (66.1%) patients, respectively. The overall prevalence of MDR-TB in AFRTH was found 1.8% (1.3% for armed force members and 0.5% for civilian patients) all of which were previously TB treated cases. The entire treatment success rates were 92.6% achieved highest in the armed force (active and pension) than the civilian patients. The failure and dead cases were also found 2.5 and 4.6%, respectively. Using bivariate analysis, category of attendants and TB contact history were strong predictors of MDR-TB in armed force and civilian patients. Moreover, human immunodeficiency virus (HIV) infection also identified a significant (OR = 14.6; 95% CI = 2.3-92.1; p = 0.004) predicting factor for MDR-TB in armed force members. However, sex, age and body mass index were not associated factor for MDR-TB. In AFRTH, lower prevalence of

  11. Antiretroviral treatment uptake in patients with HIV- associated TB ...

    African Journals Online (AJOL)

    ART results in a 64 - 95% reduction in mortality risk 5 and is an essential component of care. How soon to start. ART after TB treatment initiation has become clearer from randomised controlled trials. These show that integration of ART and TB treatment in all HIV-associated TB patients regardless of CD4 count significantly.

  12. Antiretroviral treatment uptake in patients with HIV associated TB ...

    African Journals Online (AJOL)

    Background. Delivery of integrated care for patients with HIV-associated TB is challenging. We assessed the uptake and timing of antiretroviral treatment (ART) among eligible patients attending a primary care service with co-located ART and TB clinics. Methods. In a retrospective cohort study, all HIV-associated TB patients ...

  13. Molecular approaches for detection of the multi-drug resistant tuberculosis (MDR-TB in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Tafsina Haque Aurin

    Full Text Available The principal obstacles in the treatment of tuberculosis (TB are delayed and inaccurate diagnosis which often leads to the onset of the drug resistant TB cases. To avail the appropriate treatment of the patients and to hinder the transmission of drug-resistant TB, accurate and rapid detection of resistant isolates is critical. Present study was designed to demonstrate the efficacy of molecular techniques inclusive of line probe assay (LPA and GeneXpert MTB/RIF methods for the detection of multi-drug resistant (MDR TB. Sputum samples from 300 different categories of treated and new TB cases were tested for the detection of possible mutation in the resistance specific genes (rpoB, inhA and katG through Genotype MTBDRplus assay or LPA and GeneXpert MTB/RIF tests. Culture based conventional drug susceptibility test (DST was also carried out to measure the efficacy of the molecular methods employed. Among 300 samples, 191 (63.7% and 193 (64.3% cases were found to be resistant against rifampicin in LPA and GeneXpert methods, respectively; while 189 (63% cases of rifampicin resistance were detected by conventional DST methods. On the other hand, 196 (65.3% and 191 (63.7% isolates showed isoniazid resistance as detected by LPA and conventional drug susceptibility test (DST, respectively. Among the drug resistant isolates (collectively 198 in LPA and 193 in conventional DST, 189 (95.6% and 187 (96.9% were considered to be MDR as examined by LPA and conventional DST, respectively. Category-II and -IV patients encountered higher frequency of drug resistance compared to those from category-I and new cases. Considering the higher sensitivity, specificity and accuracy along with the required time to results significantly shorter, our study supports the adoption of LPA and GeneXpert assay as efficient tools in detecting drug resistant TB in Bangladesh.

  14. Transmission of Mycobacterium tuberculosis from patients who are nucleic acid amplification test- negative.

    Science.gov (United States)

    Xie, Yingda L; Cronin, Wendy A; Proschan, Michael; Oatis, Richard; Cohn, Silvia; Curry, Scott R; Golub, Jonathan E; Barry Iii, Clifton E; Dorman, Susan E

    2018-04-24

    Among adults with signs and symptoms of pulmonary tuberculosis (TB), recognition of transmissible TB has implications for airborne infection isolation and public health activities. Sputum smear-negative TB patients account for around one-fifth of tuberculosis transmission. The tuberculosis transmission risk of TB patients with negative results on nucleic acid amplification (NAA) testing of respiratory specimens has not been established. We sought to estimate the tuberculosis transmission risk of NAA test-negative TB patients. We retrospectively reviewed Maryland TB program data from 2004 to 2009 during which NAA testing by the Mycobacterium Tuberculosis Direct Test (MTD) was performed routinely. Patients with sputum Mycobacterium tuberculosis (M.tb) isolates having matching genotypes were assigned to clusters. Transmission sequence was approximated by collection order of individuals' first culture-positive specimens. Minimum transmission risks of NAA (MTD)-negative TB patients and of smear-negative TB patients were estimated based on individuals' positions within clusters. Among 809 patients with culture-confirmed TB, M.tb genotypes were available for 782 (96.7%). For NAA-negative TB patients the minimum transmission risk estimate was 5.1% (95% CI 0-11.4). For smear-negative TB patients the minimum transmission risk estimate was 11.2% (95% CI 7.2-15.3). Minimum transmission risk of NAA-negative TB patients was lower than that of smear-negative TB patients. However, transmission risk of NAA-negative TB patients appears to not be negligible.

  15. A Nursing Management Model to Increase Medication Adherence and Nutritional Status of Patients with Pulmonary TB

    Directory of Open Access Journals (Sweden)

    Eka Mishbahatul Mar’ah Has

    2015-04-01

    Full Text Available Introduction: High dropout rate, inadequate treatment, and resistance to medication, still become an obstacle in the treatment of pulmonary TB. Pulmonary TB patient care management at home can be done actively through telenursing. N-SMSI (Ners-Short Message Service Intervention is one of community nursing intervention, in which community nurses send short messages to remind patients to take medication and nutrition. The aim of this study was to analyze the effect of nursing management model N-SMSI to increased medication adherence and nutritional status of patients with pulmonary TB. Method: This study was used prospective design. The populations were new pulmonary TB patient at intensive phase, at Puskesmas Pegirian Surabaya. Samples were taken by purposive sampling technique; consist of 30 people, divided into treatment and control groups. The independent variable was N-SMSI. The dependent variables were medication adherence collected by using questionnaire and nutritional status by using measurement of body weight (kg. The data were then analyzed by using Wilcoxon Signed Rank Test, Mann Whitney, and Independent t-test with α ≤ 0.05 Result: The results of wilcoxon signed rank test had showed difference in the nutritional status of the treatment group before and after intervention, with p = 0.001. It’s similar with the control group, with p = 0.002. Mann whitney test results had showed no signifi cant difference in nutritional status between treatment and control group, as indicated by the value of p=0.589. While independent t-test had showed difference in compliance between treatment and control group, with p=0.031. Conslusion: N-SMSI can improve medication adherence of patient with Pulmonary TB. This model can be developed by nurse as alternative methods to improve medication adherence in patients with Pulmonary TB. Further research should modify nursing management model which can improve the nutritional status of patient with Pulmonary

  16. TIME Impact - a new user-friendly tuberculosis (TB) model to inform TB policy decisions.

    Science.gov (United States)

    Houben, R M G J; Lalli, M; Sumner, T; Hamilton, M; Pedrazzoli, D; Bonsu, F; Hippner, P; Pillay, Y; Kimerling, M; Ahmedov, S; Pretorius, C; White, R G

    2016-03-24

    Tuberculosis (TB) is the leading cause of death from infectious disease worldwide, predominantly affecting low- and middle-income countries (LMICs), where resources are limited. As such, countries need to be able to choose the most efficient interventions for their respective setting. Mathematical models can be valuable tools to inform rational policy decisions and improve resource allocation, but are often unavailable or inaccessible for LMICs, particularly in TB. We developed TIME Impact, a user-friendly TB model that enables local capacity building and strengthens country-specific policy discussions to inform support funding applications at the (sub-)national level (e.g. Ministry of Finance) or to international donors (e.g. the Global Fund to Fight AIDS, Tuberculosis and Malaria).TIME Impact is an epidemiological transmission model nested in TIME, a set of TB modelling tools available for free download within the widely-used Spectrum software. The TIME Impact model reflects key aspects of the natural history of TB, with additional structure for HIV/ART, drug resistance, treatment history and age. TIME Impact enables national TB programmes (NTPs) and other TB policymakers to better understand their own TB epidemic, plan their response, apply for funding and evaluate the implementation of the response.The explicit aim of TIME Impact's user-friendly interface is to enable training of local and international TB experts towards independent use. During application of TIME Impact, close involvement of the NTPs and other local partners also builds critical understanding of the modelling methods, assumptions and limitations inherent to modelling. This is essential to generate broad country-level ownership of the modelling data inputs and results. In turn, it stimulates discussions and a review of the current evidence and assumptions, strengthening the decision-making process in general.TIME Impact has been effectively applied in a variety of settings. In South Africa, it

  17. Technology and tuberculosis control: the OUT-TB Web experience.

    Science.gov (United States)

    Guthrie, Jennifer L; Alexander, David C; Marchand-Austin, Alex; Lam, Karen; Whelan, Michael; Lee, Brenda; Furness, Colin; Rea, Elizabeth; Stuart, Rebecca; Lechner, Julia; Varia, Monali; McLean, Jennifer; Jamieson, Frances B

    2017-04-01

    Develop a tool to disseminate integrated laboratory, clinical, and demographic case data necessary for improved contact tracing and outbreak detection of tuberculosis (TB). In 2007, the Public Health Ontario Laboratories implemented a universal genotyping program to monitor the spread of TB strains within Ontario. Ontario Universal Typing of TB (OUT-TB) Web utilizes geographic information system (GIS) technology with a relational database platform, allowing TB control staff to visualize genotyping matches and microbiological data within the context of relevant epidemiological and demographic data. OUT-TB Web is currently available to the 8 health units responsible for >85% of Ontario's TB cases and is a valuable tool for TB case investigation. Users identified key features to implement for application enhancements, including an e-mail alert function, customizable heat maps for visualizing TB and drug-resistant cases, socioeconomic map layers, a dashboard providing TB surveillance metrics, and a feature for animating the geographic spread of strains over time. OUT-TB Web has proven to be an award-winning application and a useful tool. Developed and enhanced using regular user feedback, future versions will include additional data sources, enhanced map and line-list filter capabilities, and development of a mobile app. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  18. Lay beliefs of TB and TB/HIV co-infection in Addis Ababa, Ethiopia: a qualitative study

    Directory of Open Access Journals (Sweden)

    Frich Jan C

    2011-08-01

    Full Text Available Abstract Background Knowledge about lay beliefs of etiology, transmission and treatment of TB, and lay perceptions of the relationship between TB and HIV is important for understanding patients' health seeking behavior and adherence to treatment. We conducted a study to explore lay beliefs about TB and TB/HIV co-infection in Addis Ababa, Ethiopia. Findings We conducted a qualitative study using in-depth interviews with 15 TB/HIV co-infected patients and 9 health professionals and focus group discussions with 14 co-infected patients in Addis-Ababa, Ethiopia. We found that a predominant lay belief was that TB was caused by exposure to cold. Excessive sun exposure, exposure to mud, smoking, alcohol, khat and inadequate food intake were also reported as causes for TB. Such beliefs initially led to self-treatment. The majority of patients were aware of an association between TB and HIV. Some reported that TB could transform into HIV, while others said that the body could be weakened by HIV and become more susceptible to illnesses such as TB. Some patients classified TB as either HIV-related or non-HIV-related, and weight loss was a hallmark for HIV-related TB. The majority of patients believed that people in the community knew that there was an association between TB and HIV, and some feared that this would predispose them to HIV-related stigma. Conclusion There is a need for culturally sensitive information and educational efforts to address misperceptions about TB and HIV. Health professionals should provide information about causes and treatment of TB and HIV to co-infected patients.

  19. Feasibility of shortening isolation of TB-suspects by first-sample PCR

    DEFF Research Database (Denmark)

    Fløe, Andreas; Wejse, Christian; Thomsen, Vibeke Østergaard

    Rationale: Isolation of patients suspected for tuberculosis (TB) is usually guided by serial sputum smears. Many of patients initially isolated will turn out not to have TB, or will not be regarded as contagious. Current standards imply isolation for hours or days until contagiousness has been...... excluded. Objective: To evaluate the utility of single-specimen polymerase chain-reaction (PCR) for Mycobacterium tuberculosis complex (MTBC) as a parameter to cease isolation when negative. Methods: We evaluated all patients in Denmark who had sputa investigated for MTBC at the National Reference......-positive on the sample that produced the PCR-negative result. Conclusion: Though adequate sensitivity in diagnosing TB still requires serial samples for microbiological examination, the question of isolation can be determined by first-sample PCR in the majority of cases, when the test is negative. In our study, less...

  20. High Field Magnetization of Tb Single Crystals

    DEFF Research Database (Denmark)

    Roeland, L. W.; Cock, G. J.; Lindgård, Per-Anker

    1975-01-01

    Hamiltonian including isotropic exchange interactions, effective single-ion anisotropy and magnetoelastic contributions. The parameters of this Hamiltonian were determined by fitting the theoretical results for the spin wave dispersion and energy gap as a function of temperature and magnetic field to existing...... data on Tb. The conduction-electron polarization at zero field and temperature is (0.33+or-0.05) mu B/ion, and the susceptibility is greater than the Pauli susceptibility calculated from the band-structure....

  1. Magnetostriction of Tb-Dy-Fe crystals

    International Nuclear Information System (INIS)

    Mei Wu; Okane, T.; Umeda, T.

    1998-01-01

    left angle 111 right angle -oriented twin free Tb-Dy-Fe single crystals, left angle 112 right angle - and left angle 110 right angle -oriented twinned ''single'' Tb-Dy-Fe crystals were prepared using floating zone melting crystal growth methods. Magnetostrictive performances of the crystals were investigated. Better low-field properties were observed in the left angle 110 right angle twinned crystals than in the left angle 112 right angle crystals. The highest properties were achieved in the left angle 111 right angle twin free single crystals. Even though there were still oxidized particles in the present left angle 111 right angle single crystals, a large magnetostrictive jump of 1700 ppm and a very low saturation magnetic field of 500 Oe were obtained. To understand magnetization and magnetostriction of different Tb-Dy-Fe crystals, theoretical modeling was carried out based on a simplified domain rotation model. Magnetization moment rotation paths of different domains were simulated and hence the resultant magnetostriction was obtained, which could adequately account for the experimental results of different crystals. The limitation of the domain rotation model was also discussed. (orig.)

  2. [Diagnostic performance of T-SPOT.TB on peripheral blood in combination with adenosine deaminase on pleural fluid for the diagnosis of tuberculous pleurisy within different age group].

    Science.gov (United States)

    Xu, H Y; Zhang, D Q; Ye, J R; Su, S S; Xie, Y P; Chen, C S; Li, Y P

    2017-06-27

    .911. The combination test of 2 tests had the sensitivity of 96.1% and the specificity of 90.2% respectively in the elderly patients. The AUC of T-SPOT.TB in the elderly patients was 0.747, AUC of T-SPOT.TB combined with ADA was 0.911. Conclusion: Peripheral blood T-SPOT.TB combined with pleural fluid ADA can improve the diagnostic performance for TB pleurisy with different ages, especially for elderly patients who can't tolerate pleural biopsy.

  3. Comparison of fastsure tb dna and mgit 960 for the detection of mycobacterium tuberculosis complex in clinical specimens

    International Nuclear Information System (INIS)

    Hussain, A.; Mirza, I.A.; Abbasi, S.A.; Ali, S.; Zia, F.; Ahmed, Z.

    2013-01-01

    Objective: To compare the efficacy of Fastsure TB DNA with fully automated MGIT 960 method for detection of Mycobacterium tuberculosis complex (MTB) in clinical specimens. Study Design: Comparative cross sectional study. Methodology: After decontamination procedure, the clinical specimens were subjected to DNA extraction and amplification. Extracted DNA was separated in a separate tube provided with fastsure TB DNA kit and was then inserted into the cartridge provided and results were observed within 30 minutes. For Processing in MGIT 960, OADC and PANTA were added to the clinical specimens after decontamination and then the tubes were processed in MGIT 960. Results: A total of 80 specimens were tested by both MGIT 960 and fastsure TB DNA. On MGIT 960 system, 57 specimens showed growth of MTB while 23 were negative. On Fastsure TB DNA, 47 Specimens were tested as positive and 33 specimens showed negative result. Sensitivity and specificity of Fastsure TB DNA method was calculated to be 82.45 % and 100 % respectively, while positive and negative predictive values were 100 % and 69.69 % respectively. Conclusion: Fast sure TB DNA is a rapid and accurate method for the detection of Mycobacterium tuberculosis complex (MTB) from clinical specimens. (author)

  4. Dosimetric characterization of KMgF3:Tb+PTFE

    International Nuclear Information System (INIS)

    Ramirez R, M. I.; Garcia S, L.; Villicana M, M.; Huirache A, R.; Apolinar C, J.; Gonzalez M, P. R.

    2017-10-01

    In this work the results obtained from the dosimetric characterization of the new radiation detectors of KMgF 3 :Tb+PTFE are presented. The host salt was obtained by means of the microwave technique, with the polycrystalline powder obtained, dosimeters were made in tablet form, using as Ptfe binder. The thermoluminescent response of these new detectors presented a linear behavior, in the dose range between 1 and 1000 Gy of 60 Co gamma radiation, the reproducibility test in the measurements, during ten cycles of heat treatment, irradiation and reading presented ± 3.7% Ds, in the stability test of thermoluminescent signal, during two months showed that the fading is practically null. Due to the results obtained, this new detector could be very useful for the dosimetry of ionizing radiation in different clinical applications. (Author)

  5. Optimization of TB/HIV co-treatment in Ethiopian patients

    OpenAIRE

    Degu, Wondwossen Amogne

    2015-01-01

    Tuberculosis (TB) and HIV infection act with deadly synergy. HIV is the most important risk factor for latent TB reactivation and active TB progression following exposure or reinfection while TB accelerates HIV progression. TB is the most frequent cause of morbidity and mortality in HIV infection. Anti-TB therapy (ATT) must precede initiation of combination Antiretroviral Therapy (cART), TB being the most immediate threat. Undoubtedly cART benefits; however, important clinical ...

  6. Risk factors for MDR and XDR-TB in a tertiary referral hospital in India.

    Directory of Open Access Journals (Sweden)

    V Balaji

    Full Text Available BACKGROUND: India has a high burden of drug resistant TB, although there are few data on XDR-TB. Although XDR-TB has existed previously in India, the definition has not been widely applied, and surveillance using second line drug susceptibility testing has not been performed. Our objective was to analyze clinical and demographic risk factors associated with isolation of MDR and XDR TB as compared to susceptible controls, at a tertiary center. METHODOLOGY/FINDINGS: Retrospective chart review based on positive cultures isolated in a high volume mycobacteriology laboratory between 2002 and 2007. 47 XDR, 30 MDR and 117 susceptible controls were examined. Drug resistant cases were less likely to be extrapulmonary, and had received more previous treatment regimens. Significant risk factors for XDR-TB included residence outside the local state (OR 7.43, 3.07-18.0 and care costs subsidized (OR 0.23, 0.097-0.54 in bivariate analysis and previous use of a fluoroquinolone and injectable agent (other than streptomycin (OR 7.00, 95% C.I. 1.14-43.03 and an initial treatment regimen which did not follow national guidelines (OR 5.68, 1.24-25.96 in multivariate analysis. Cavitation and HIV did not influence drug resistance. CONCLUSIONS/SIGNIFICANCE: There is significant selection bias in the sample available. Selection pressure from previous treatment and an inadequate initial regimen increases risk of drug resistance. Local patients and those requiring financial subsidies may be at lower risk of XDR-TB.

  7. Treatment Outcomes of Patients with Multidrug-Resistant Tuberculosis (MDR- TB) Compared with Non-MDR-TB Infections in Peninsular Malaysia.

    Science.gov (United States)

    Elmi, Omar Salad; Hasan, Habsah; Abdullah, Sarimah; Mat Jeab, Mat Zuki; Ba, Zilfalil; Naing, Nyi Nyi

    2016-07-01

    Treating patients with multidrug-resistant tuberculosis (MDR-TB) strains is more complicated, complex, toxic, expensive, than treating patients with susceptible TB strains. This study aims to compare the treatment outcomes and potential factors associated between patients with MDR-TB and non MDR TB infections in peninsular Malaysia. This study was a retrospective cohort study. Data were collected from the medical records of all registered MDR-TB patients and Non-MDR-TB patients at five TB hospitals in peninsular Malaysia from January 2010 to January 2014. A total of 314 subjects were studied, including 105 MDR-TB cases and 209 non-MDR-TB. After TB treatment, 24.8% of the MDR-TB patients and 17.7% of non MDR TB relapsed; 17.1% of the MDR-TB patients and 16.3% of non MDR TB defaulted from TB treatment. A significant difference seen in treatment success rate 17.1% for MDR-TB; 63.1% for non MDR TB (P history of TB treatment, and presence of HIV infection.

  8. [Evaluation of T-SPOT.TB assay in the diagnosis of pulmonary tuberculosis within different age groups].

    Science.gov (United States)

    Pan, Liping; Jia, Hongyan; Liu, Fei; Gao, Mengqiu; Sun, Huishan; Du, Boping; Sun, Qi; Xing, Aiying; Wei, Rongrong; Zhang, Zongde

    2015-12-01

    To evaluate the value of T-SPOT.TB assay in the diagnosis of pulmonary tuberculosis within different age groups. We analyzed 1 518 suspected pulmonary tuberculosis (PTB) patients who were admitted to the Beijing Chest Hospital from November 2012 to February 2014 and had valid T-SPOT.TB tests before anti-tuberculosis therapy. The 599 microbiologically and/or histopathologically-confirmed PTB patients (16-89 years old, 388 males and 211 females) and 235 non-TB patients (14-85 years old, 144 males and 91 females) were enrolled for the analysis of diagnostic performance of T-SPOT.TB, while patients with uncertain diagnosis or diagnosis based on clinical impression (n=684) were excluded from the analysis. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the T-SPOT.TB were analyzed according to the final diagnosis. Furthermore, the diagnostic performance of T-SPOT.TB assay in the younger patients (14-59 years old) and elderly patients (60-89 years old) were also analyzed respectively. Categorical variables were compared by Pearson's Chi-square test, while continuous variables were compared by the Mann-Whitney U-test. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the T-SPOT.TB in diagnosis of PTB were 90.1% (540/599), 65.5% (154/235), 86.9% (540/621), 72.3% (154/213), 2.61, and 0.15, respectively. The sensitivity and specificity of T-SPOT.TB assay were 92.6% (375/405) and 75.6% (99/131), respectively in the younger patients, and 85.0% (165/194), 52.9% (55/104) respectively in the elderly patients. The sensitivity and specificity of T-SPOT.TB assay in the younger patients were significantly higher than those in the elderly patients (Pspot forming cells in the younger PTB patients were significantly higher than in the elderly PTB patients [300 (126, 666)/10(6) PBMCs vs. 258 (79, 621

  9. Persistent problems of access to appropriate, affordable TB services in rural China: experiences of different socio-economic groups.

    Science.gov (United States)

    Zhang, Tuohong; Tang, Shenglan; Jun, Gao; Whitehead, Margaret

    2007-02-08

    Large-scale Tuberculosis (TB) control programmes in China have been hailed a success. Concerns remain, however, about whether the programme is reaching all sections of the population, particularly poorer groups within rural communities, and whether there are hidden costs. This study takes a household perspective to investigate receipt of appropriate care and affordability of services for different socio-economic groups with TB symptoms in rural China. Secondary analysis of Chinese National Household Health Survey for 2003: 40,000 rural households containing 143,991 individuals, 2,308 identified as TB suspects. use of services and expenditure of TB suspects, by gender and socio-economic position, indicated by household income, education, material assets, and insurance status. 37% of TB suspects did not seek any professional care, with low-income groups less likely to seek care than more affluent counterparts. Of those seeking care, only 35% received any of the recommended diagnostic tests. Of the 182 patients with a confirmed TB diagnosis, 104 (57%) received treatment at the recommended level, less likely if lacking health insurance or material assets. The burden of payment for services amounted to 45% of annual household income for the low-income group, 16% for the high-income group. Access to appropriate, affordable TB services is still problematic in some rural areas of China, and receipt of care and affordability declines with declining socio-economic position. These findings highlight the current shortcomings of the national TB control programme in China and the formidable challenge it faces if it is to reach all sections of the population, including the poor with the highest burden of disease.

  10. The Relationship Between Education, Job, and Family Income with TB Medication Dropouts in Timor-Leste

    Directory of Open Access Journals (Sweden)

    Valente Da Silva

    2016-06-01

    Full Text Available Background:  TB treatment dropout is one causes of treatment failure, which could increase drug resistant cases. Drug resistant cases of TB were reported by the Ministry of Health of East Timor in 2008 (3 cases, 2009 (3 cases, and in 2010 (6 cases. With drug resistant emerging, TB will require longer treatment time. According to the WHO report (2013 the results of pulmonary tuberculosis BTA (+ treatment were reported: Year 2010 the number of failure of treatment was (0.53%; Died of TB (3.53%; Drop out of treatment (4.05%; Outmigration (3.98%; In 2011 cases of treatment failure (0.50% Died of TB (3.36%; Drop out of treatment (3.36%; Outmigration (1.92%; In 2012 cases of treatment failure (1.03%; Died of TB (3.49% Drop out of treatment (4.59% and migration, (2.26%. According to the National Statistics Directorate (NSD in 2011, that the East Timorese people still live mostly 70.4% in the rural areas. While access to health services remains a challenge, since the people of Timor Leste proclaimed the restoration of its independence. Objective: This study aimed to determine whether there is a relationship between the variables of education, family income, and job with cases of TB medication discontinuation. Methods: This study was conducted using descriptive correlation method. The sample was determined by Ridwan & Akdon (2010 formula. The total of samples was 100 people who met the inclusion and exclusion criteria, and selected randomly. This research was conducted in District Manatuto and Liquica Timor-Leste on March 28, 2015. Results: The correlation test showed a strong positive relationship level if r = 0.51 until +1. Analysis of significance value of r xy = 0.671 and p = 0.000 indicates that there is a significant relationship between the variables of education, job and income with variable discontinuation of treatment. Conclusion: Based on the results of research and data analysis, it can be concluded that the results of this study are as

  11. TB preventive therapy for people living with HIV: key considerations for scale-up in resource-limited settings.

    Science.gov (United States)

    Pathmanathan, I; Ahmedov, S; Pevzner, E; Anyalechi, G; Modi, S; Kirking, H; Cavanaugh, J S

    2018-06-01

    Tuberculosis (TB) is the leading cause of death for persons living with the human immunodeficiency virus (PLHIV). TB preventive therapy (TPT) works synergistically with, and independently of, antiretroviral therapy to reduce TB morbidity, mortality and incidence among PLHIV. However, although TPT is a crucial and cost-effective component of HIV care for adults and children and has been recommended as an international standard of care for over a decade, it remains highly underutilized. If we are to end the global TB epidemic, we must address the significant reservoir of tuberculous infection, especially in those, such as PLHIV, who are most likely to progress to TB disease. To do so, we must confront the pervasive perception that barriers to TPT scale-up are insurmountable in resource-limited settings. Here we review available evidence to address several commonly stated obstacles to TPT scale-up, including the need for the tuberculin skin test, limited diagnostic capacity to reliably exclude TB disease, concerns about creating drug resistance, suboptimal patient adherence to therapy, inability to monitor for and prevent adverse events, a 'one size fits all' option for TPT regimen and duration, and uncertainty about TPT use in children, adolescents, and pregnant women. We also discuss TPT delivery in the era of differentiated care for PLHIV, how best to tackle advanced planning for drug procurement and supply chain management, and how to create an enabling environment for TPT scale-up success.

  12. Antidot patterned single and bilayer thin films based on ferrimagnetic Tb-Co alloy with perpendicular magnetic anisotropy

    Science.gov (United States)

    Kulesh, N. A.; Vázquez, M.; Lepalovskij, V. N.; Vas'kovskiy, V. O.

    2018-02-01

    Hysteresis properties and magnetization reversal in TbCo(30 nm) and FeNi(10 nm)/TbCo(30 nm) films with nanoscale antidot lattices are investigated to test the effect of nanoholes on the perpendicular anisotropy in the TbCo layer and the induced exchange bias in the FeNi layer. The antidots are introduced by depositing the films on top of hexagonally ordered porous anodic alumina substrates with pore diameter and interpore distance fixed to 75 nm and 105 nm, respectively. The analysis of combined vibrating sample magnetometry, Kerr microscopy and magnetic force microscopy imaging measurements has allowed us to link macroscopic and local magnetization reversal processes. For magnetically hard TbCo films, we demonstrate the tunability of magnetic anisotropy and coercive field (i.e., it increases from 0.2 T for the continuous film to 0.5 T for the antidot film). For the antidot FeNi/TbCo film, magnetization of FeNi is confirmed to be in plane. Although an exchange bias has been locally detected in the FeNi layer, the integrated hysteresis loop has increased coercivity and zero shift along the field axis due to the significantly decreased magnetic anisotropy of TbCo layer.

  13. Chest Radiographs for Pediatric TB Diagnosis: Interrater Agreement and Utility

    Directory of Open Access Journals (Sweden)

    G. Kaguthi

    2014-01-01

    Full Text Available The chest radiograph (CXR is considered a key diagnostic tool for pediatric tuberculosis (TB in clinical management and endpoint determination in TB vaccine trials. We set out to compare interrater agreement for TB diagnosis in western Kenya. A pediatric pulmonologist and radiologist (experts, a medical officer (M.O, and four clinical officers (C.Os with basic training in pediatric CXR reading blindly assessed CXRs of infants who were TB suspects in a cohort study. C.Os had access to clinical findings for patient management. Weighted kappa scores summarized interrater agreement on lymphadenopathy and abnormalities consistent with TB. Sensitivity and specificity of raters were determined using microbiologically confirmed TB as the gold standard (n=8. A total of 691 radiographs were reviewed. Agreement on abnormalities consistent with TB was poor; k=0.14 (95% CI: 0.10–0.18 and on lymphadenopathy moderate k=0.26 (95% CI: 0.18–0.36. M.O [75% (95% CI: 34.9%–96.8%] and C.Os [63% (95% CI: 24.5%–91.5%] had high sensitivity for culture confirmed TB. TB vaccine trials utilizing expert agreement on CXR as a nonmicrobiologically confirmed endpoint will have reduced specificity and will underestimate vaccine efficacy. C.Os detected many of the bacteriologically confirmed cases; however, this must be interpreted cautiously as they were unblinded to clinical features.

  14. One of the possible mechanisms for the inhibition effect of Tb(III) on peroxidase activity in horseradish (Armoracia rusticana) treated with Tb(III).

    Science.gov (United States)

    Guo, Shaofen; Cao, Rui; Lu, Aihua; Zhou, Qing; Lu, Tianhong; Ding, Xiaolan; Li, Chaojun; Huang, Xiaohua

    2008-05-01

    One of the possible mechanisms for the inhibition effect of Tb(III) on peroxidase activity in horseradish (Armoracia rusticana) treated with Tb(III) was investigated using some biophysical and biochemical methods. Firstly, it was found that a large amount of Tb(III) can be distributed on the cell wall, that some Tb(III) can enter into the horseradish cell, indicating that peroxidase was mainly distributed on cell wall, and thus that Tb(III) would interact with horseradish peroxidase (HRP) in the plant. In addition, peroxidase bioactivity was decreased in the presence of Tb(III). Secondly, a new peroxidase-containing Tb(III) complex (Tb-HRP) was obtained from horseradish after treatment with Tb(III); the molecular mass of Tb-HRP is near 44 kDa and the pI is about 8.80. Thirdly, the electrocatalytic activity of Tb-HRP is much lower than that of HRP obtained from horseradish without treatment with Tb(III). The decrease in the activity of Tb-HRP is due to the destruction (unfolding) of the conformation in Tb-HRP. The planarity of the heme active center in the Tb-HRP molecule was increased and the extent of exposure of Fe(III) in heme was decreased, leading to inhibition of the electron transfer. The microstructure change in Tb-HRP might be the result of the inhibition effect of Tb(III) on peroxidase activity in horseradish.

  15. Relationship of Personal- Social and Therapeutic Factors with Medication Compliance in TB Patients in Ahwaz

    Directory of Open Access Journals (Sweden)

    S Jahani

    2012-01-01

    Full Text Available Introduction: Despite the implementation of DOTS strategy, TB remains one of the ten leading causes of death in developing countries. Compliance with treatment is affected by social, cultural, and economic factors, and patients’ knowledge and attitude as well. The aim of this study was to determine the relationship between compliance with treatment and personal, social and therapeutic factors in TB patients in Ahwaz. Methods: This cross-sectional descriptive study was conducted on 167 TB patients. Subjects were selected based on target. The data were collected using a questionnaire, and by observation, sputum analysis, and Kvzart Ponce urine test. The validity of the questionnaire was tested by the method of content validity, and its internal consistency and reliability was tested by Cronbach's alpha coefficient. Data analyzed by SpSS. Results: Among all subjects, 52.7% of patients showed complete compliance and 35.2% and 12% of them showed partial and poor compliance, respectively. There was a significant relationship between treatment compliance and gender(p=0.009, quality of monthly income(p=0.007, and addiction(p=0.001. The quality of treatment compliance was not significantly related to age, marital status, educational level, ethnicity, and medical complications. Conclusion: The findings showed that Incomplete treatment of TB is much worse than not treating it, because the lack of precision in the administration and consumption of anti-tuberculosis drugs, leads to the emergence of resistant TB. Paying attention to the factors decreasing treatment compliance and trying to eliminate them may lead to better treatment and lower incidence and prevalence of tuberculosis in the community.

  16. Missed Opportunities for TB Investigation in Primary Care Clinics in South Africa: Experience from the XTEND Trial.

    Directory of Open Access Journals (Sweden)

    Violet N Chihota

    Full Text Available 40 primary health clinics (PHCs in four provinces in South Africa, June 2012 -February 2013.To determine whether health care worker (HCW practice in investigating people with TB symptoms was altered when the initial test for TB was changed from smear microscopy to Xpert MTB/RIF.Cross-sectional substudy at clinics participating in a pragmatic cluster randomised trial, Xpert for TB: Evaluating a New Diagnostic "XTEND", which evaluated the effect of Xpert MTB/RIF implementation in South Africa.Consecutive adults exiting PHCs reporting at least one TB symptom (defined as any of cough, weight loss, night sweats and fever were enrolled. The main outcome was the proportion who self-reported having sputum requested by HCW during the clinic encounter just completed.3604 adults exiting PHCs (1676 in Xpert arm, 1928 in microscopy arm were enrolled (median age 38 years, 71.4% female, 38.8% reported being HIV-positive, 70% reported cough. For 1267 participants (35.2% the main reason for attending the clinic was TB symptom(s. Overall 2130/3604 (59.1% said they reported their symptom(s to HCW. 22.7% (818/3604 reported having been asked to give sputum for TB investigation. Though participants in the Xpert vs. microscopy arm were more likely to have sputum requested by HCW, this was not significantly different: overall (26.0% [436/1676] vs 19.8% [382/1928]; adjusted prevalence ratio [aPR] 1.31, [95% CI 0.78-2.20] and when restricted to those presenting at clinics due to symptoms (49.1% [260/530] vs 29.9% [220/737]; aPR 1.38 [0.89-2.13] and those reporting being HIV-positive (29.4% [190/647] vs 20.8% [156/749]; aPR 1.38[0.88-2.16]. Those attending clinic due to TB symptoms, were more likely to have sputum requested if they had increasing number of symptoms; longer duration of cough, unintentional weight loss and night sweats and if they reported symptoms to HCW.A large proportion of people exiting PHCs reporting TB symptoms did not get tested. Implementation of

  17. Supporting clinical management of the difficult-to-treat TB cases: the ERS-WHO TB Consilium

    Directory of Open Access Journals (Sweden)

    Lia D’Ambrosio

    2015-03-01

    The primary objective of the ERS/WHO TB Consilium is to provide clinical consultation for drug-resistant TB and other difficult-to-treat TB cases, including co-infection with HIV and paediatric cases. Through technical guidance to clinicians managing complex TB cases, the main contribution and outcome of the initiative will be a public health response aimed at achieving correct treatment of affected patients and preventing further development of drug resistance. The Consilum's secondary objective is to ensure monitoring and evaluation of clinical practices on the ground (diagnosis, treatment and prevention.

  18. Patients direct costs to undergo TB diagnosis.

    Science.gov (United States)

    de Cuevas, Rachel M Anderson; Lawson, Lovett; Al-Sonboli, Najla; Al-Aghbari, Nasher; Arbide, Isabel; Sherchand, Jeevan B; Nnamdi, Emenyonu E; Aseffa, Abraham; Yassin, Mohammed A; Abdurrahman, Saddiq T; Obasanya, Joshua; Olanrewaju, Oladimeji; Datiko, Daniel; Theobald, Sally J; Ramsay, Andrew; Squire, S Bertel; Cuevas, Luis E

    2016-03-24

    A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable. We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis. Surveys of 2225 adults attending smear-microscopy centres in Nigeria, Nepal, Ethiopia and Yemen. Adults >18 years with cough >2 weeks were enrolled prospectively. Direct costs were quantified using structured questionnaires. Patients with costs >75(th) quartile were considered to have high expenditure (cases) and compared with patients with costs <75(th) quartile to identify factors associated with high expenditure. The most significant expenses were due to clinic fees and transport. Most participants attended the centres with companions. High expenditure was associated with attending with company, residing in rural areas/other towns and illiteracy. The costs incurred by patients are substantial and share common patterns across countries. Removing user fees, transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic costs. In locations with limited resources, support could be prioritised for those most at risk of high expenditure; those who are illiterate, attend the service with company and rural residents.

  19. Tracing contacts of TB patients in Malaysia: costs and practicality.

    Science.gov (United States)

    Atif, Muhammad; Sulaiman, Syed Azhar Syed; Shafie, Asrul Akmal; Ali, Irfhan; Asif, Muhammad

    2012-01-01

    Tuberculin skin testing (TST) and chest X-ray are the conventional methods used for tracing suspected tuberculosis (TB) patients. The purpose of the study was to calculate the cost incurred by Penang General Hospital on performing one contact tracing procedure using an activity based costing approach. Contact tracing records (including the demographic profile of contacts and outcome of the contact tracing procedure) from March 2010 until February 2011 were retrospectively obtained from the TB contact tracing record book. The human resource cost was calculated by multiplying the mean time spent (in minutes) by employees doing a specific activity by their per-minute salaries. The costs of consumables, Purified Protein Derivative vials and clinical equipment were obtained from the procurement section of the Pharmacy and Radiology Departments. The cost of the building was calculated by multiplying the area of space used by the facility with the unit cost of the public building department. Straight-line deprecation with a discount rate of 3% was assumed for the calculation of equivalent annual costs for the building and machines. Out of 1024 contact tracing procedures, TST was positive (≥10 mm) in 38 suspects. However, chemoprophylaxis was started in none. Yield of contact tracing (active tuberculosis) was as low as 0.5%. The total unit cost of chest X-ray and TST was MYR 9.23 (2.90 USD) & MYR 11.80 (USD 3.70), respectively. The total cost incurred on a single contact tracing procedure was MYR 21.03 (USD 6.60). Our findings suggest that the yield of contact tracing was very low which may be attributed to an inappropriate prioritization process. TST may be replaced with more accurate and specific methods (interferon gamma release assay) in highly prioritized contacts; or TST-positive contacts should be administered 6H therapy (provided that the chest radiography excludes TB) in accordance with standard protocols. The unit cost of contact tracing can be significantly

  20. Association between passive smoking and Mycobacterium tuberculosis infection in children with household TB contact

    Directory of Open Access Journals (Sweden)

    Novaily Zuliartha

    2015-03-01

    Full Text Available Background Tuberculosis (TB and cigarette consumption are relatively high in Indonesia. Passive smoking may increase the risk of infection and disease in adults and children exposed to TB. An association between passive smoking and Mycobacterium tuberculosis infection in children has not been well documented. Objective To assess for an association between passive smoking and M. tuberculosis infection in children who had household contact with a TB patient. Methods This cross-sectional study was conducted in February and March 2011. Children aged 5 to 18 years who had household contact with a TB patient underwent tuberculin testing for M. tuberculosis infection. Subjects were divided into two groups: those exposed to passive smoke and those not exposed to passive smoke. Chi-square test was used to assess for an association between passive smoking and M. tuberculosis infection. Results There were 140 children enrolled in this study, with 70 exposed to passive smoke and 70 not exposed to passive smoke. Prevalence of M. tuberculosis infection was significantly higher in the passive smoking group than in those not exposed to passive smoke [81.4% and 52.9%, respectively, (P= 0.0001]. In the passive smoking group there were significant associations between nutritional state, paternal and maternal education, and M. tuberculosis infection. But no associations were found between M. tuberculosis infection and familial income or BCG vaccination. Conclusion Among children who had household contact with a TB patient, they who exposed to passive smoke are more likely to have M. tuberculosis infection compared to they who not exposed to passive smoke.

  1. Differential Levels of Alpha-2-Macroglobulin, Haptoglobin and Sero-Transferrin as Adjunct Markers for TB Diagnosis and Disease Progression in the Malnourished Tribal Population of Melghat, India.

    Science.gov (United States)

    Bapat, Prachi R; Satav, Ashish R; Husain, Aliabbas A; Shekhawat, Seema D; Kawle, Anuja P; Chu, Justin J; Purohit, Hemant J; Daginawala, Hatim F; Taori, Girdhar M; Kashyap, Rajpal S

    2015-01-01

    Lack of diagnostic capacity has been a crucial barrier preventing an effective response to the challenges of malnutrition and tuberculosis (TB). Point-of-care diagnostic tests for TB in immuno-incompetent, malnourished population are thus needed to ensure rapid and accurate detection. The aim of the study was to identify potential biomarkers specific for TB infection and progression to overt disease in the malnourished population of Melghat. A prospective cohort study was conducted in the year 2009 through 2011 in six villages of the Melghat region. 275 participants consisting of malnourished cases with a) active TB (n = 32), b) latent TB infection (n = 90), c) with no clinical or bacteriological signs of active or latent TB (n = 130) and healthy control subjects (n = 23) were recruited for the study. The proteome changes of the host serum in response to Mycobacterium tuberculosis (M.tb) infection were investigated using one dimensional electrophoresis in combination with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Three most differentially expressed proteins; alpha-2-macroglobulin (A-2-M), sero-transferrin and haptoglobin were identified by MALDI-TOF MS analysis, which were up-regulated in the malnourished patients with active TB and down-regulated in the malnourished patients compared with the healthy controls. Additionally, follow-up studies indicated that the expression of these proteins increased to nearly two folds in patients who developed active disease from latent state. Our preliminary results suggest that A-2-M, sero-transferrin and haptoglobin may be clinically relevant host biomarkers for TB diagnosis and disease progression in the malnourished population. This study provides preliminary framework for an in-depth analysis of the biomarkers in larger well-characterized cohorts. Evaluation of these biomarkers in follow-up cases may further aid in improving TB diagnosis.

  2. Efforts to reduce the disparity between permanent residents and temporary migrants: Stop TB experiences in Shanghai, China.

    Science.gov (United States)

    Lu, Hui; Chen, Jing; Wang, Wei; Wu, Laiwa; Shen, Xin; Yuan, Zhengan; Yan, Fei

    2015-08-01

    Eight of 17 districts of Shanghai have offered transportation and living allowances subsidies to patients with tuberculosis (TB) among the migrant population. The study aimed to assess the impact of the subsidising initiative on the treatment success rate (TSR) and identify the social determinants of treatment outcomes. The participants included 7072 residents and 5703 migrants who were registered in the TB Information Management System with smear-positive pulmonary TB from January 2006 to December 2010. The Cochran-Armitage test was employed to test the trends of TSR and logistic regressions to identify the factors associated with treatment outcome. Without subsidies, migrant TB cases had lower odds of successful treatment [OR = 0.20 (95% CI 0.18-0.23)] than resident cases. Subsidisation was associated with a 65% increased odds ratio of success [1.65 (1.40-1.95)] among migrant cases. The TSR has stabilised at 87% for both permanent residents and temporary migrants since 2009. Living in districts with a population density ≥20,000/km(2) was associated with a low odds ratio [0.42 (0.26-0.68)] among resident cases, whereas among migrant cases those living in districts out of central downtown had a higher odds ratio of treatment success [peripheral downtown: 1.73 (1.36-2.20), suburban: 1.69 (1.16-2.46)]. The TB cases in districts with 2.0-2.9 TB specialists/100 cases had a higher odds ratio [2.99 (1.91-4.69)] of successful treatment than cases from districts with fewer specialists. Besides free medical services, transport and living allowance subsidies to migrant patients with TB improved the treatment outcome significantly. © 2015 John Wiley & Sons Ltd.

  3. The Characteristics of TB Epidemic and TB/HIV Co-Infection Epidemic: A 2007-2013 Retrospective Study in Urumqi, Xinjiang Province, China.

    Directory of Open Access Journals (Sweden)

    Wang Wei

    Full Text Available This study was aimed to find out epidemiologic characteristic of tuberculosis (TB cases, and Human Immunodeficiency Virus (HIV positive cases among TB patients (TB/HIV co-infection through demographic, temporal, and spatial study in Urumqi.Descriptive statistics and multivariate logistic regression were applied to identify the epidemiologic characteristics and risk factors of TB epidemic and TB/HIV co-infection epidemic. All addresses of each TB case, TB/HIV co-infection case, and administrative street were transformed into geographical coordinate. Subsequently, the geocoded address for 82 streets was transformed into a dot map used as the basis of spatial datasets. In addition, the paper also used quantile map and the spatial scan statistic in order to identify the spatial distribution and spatial clusters of TB epidemic and TB/HIV co-infection epidemic.There was a declining trend of the notification rates of TB epidemic from 2007 to 2009, as well as a rising trend from 2010 to 2013. However, the notification rates of TB/HIV co-infection epidemic showed a rising trend from 2007 to 2010, and a declining trend from 2011 to 2013. Moreover, a significant share of TB epidemic and TB/HIV co-infection epidemic happened between the age of 15 to 45 years old, indicating an increase in risk of TB and TB/HIV infection. It is worth noting that the risk of HIV infection for male TB patients was 2.947 times (95% CI [2.178, 3.988] than that of female patients. Han ethnicity and Uygur ethnicity in urban region accounted for a large proportion of total TB and TB/HIV co-infection cases. Most of the TB cases of minorities in Urumqi showed a statistically significant increase in risk of HIV infection than Han ethnicity in Urumqi. In addition, the spatial distribution of TB epidemic and TB/HIV co-infection epidemic was highly skewed. Most of the local clusters were located in urban area and rural-urban continuum where showed an increase in risk of TB and TB

  4. Paediatric TB/HIV co-infection – 'an uncompromising duet that ...

    African Journals Online (AJOL)

    2011-10-01

    Oct 1, 2011 ... tuberculosis (TB) in 2009, childhood TB accounted for 11% (884 000 cases).1 ... reduction in incident TB in ART-treated children compared with ..... Obesity is associated with an increased risk of miscarriage but its effect on.

  5. Prevalence and management out comes of anti TB drugs induced ...

    African Journals Online (AJOL)

    Patients and Methods: All TB patients admitted in the Hospital during the study period are the source of population, the study groups were been selected by detecting the possible confounding factors for jaundice. Base line LFT before anti TB initiation was determined before developed jaundice. Those patients, whom the ...

  6. 46 CFR 31.20-1 - Waters-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Waters-TB/ALL. 31.20-1 Section 31.20-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS INSPECTION AND CERTIFICATION Waters Operated Over § 31.20-1 Waters—TB/ALL. The certificate of inspection shall show the waters over which the tank vessel...

  7. Antiferromagnetism in a 20% Ho-80% Tb alloy single crystal

    DEFF Research Database (Denmark)

    Lebech, Bente

    1968-01-01

    20% Ho-80% Tb exhibits two magnetic phases, similar to those of Tb. The spiral turn angle varies from 31.1° to 21.4°. A minimum effective spin for the occurrence of stable simple ferromagnetic structure at low temperatures is predicted....

  8. The social determinants of tuberculosis and their association with TB ...

    African Journals Online (AJOL)

    Progress made in TB control through the implementation of the DOTS strategy, has been retarded by factors such as poverty, the HIV pandemic and the advent of multidrug resistant tuberculosis. There is currently an increasing shift in TB control ...

  9. Not just pretty pictures: Geographical Information Systems in TB ...

    African Journals Online (AJOL)

    Geographical Information Systems (GIS) is becoming a useful tool in disease control by health planners. However little is known about its potential in tuberculosis (TB) control. In 2000 the National TB Programme (NTP) in Malawi assessed its usefulness. Routinely collected case-finding data from the 3 previous years (1997 ...

  10. 8__Aisha_Detection ofMDR-TB

    African Journals Online (AJOL)

    User

    Among the MDR-TB cases rifampicin resistance was associated with rpoB WT gene and rpoB MUT gene in 100% and 62% of the ... diagnosis of TB patients, and proper treatment and management of the infected cases to minimize the spread and ..... in an amino acid change and concluded that this is one of the reasons ...

  11. HIV/TB CO-INFECTION:THE CHALLENGES

    African Journals Online (AJOL)

    2013-12-02

    Dec 2, 2013 ... latent MTB infection to active TB disease, in which the annual risk of developing TB disease from MTB ... fresh air ventilation; exposure of highly vulnerable individuals; and reduced efficacy or failure of .... Consequently, some patients may develop acute renal failure or acute respiratory distress syndrome.

  12. 46 CFR 30.10-45 - Ocean-TB/O.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Ocean-TB/O. 30.10-45 Section 30.10-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS GENERAL PROVISIONS Definitions § 30.10-45 Ocean—TB/O. Under this designation shall be included all tank vessels normally navigating the waters of any ocean or...

  13. Challenges of TB diagnosis and treatment in South Africa | Wood ...

    African Journals Online (AJOL)

    It is estimated that 2 billion of the world\\'s population are latently infected with Mycobacterium tuberculosis (Mtb) with a resultant 8 - 9 million cases of active tuberculosis (TB) and 1.6 million deaths annually.1 The tools used for diagnosis of TB have remained largely unchanged since the 1880s when sputum microscopy, Mtb ...

  14. A Data-Driven Evaluation of the Stop TB Global Partnership Strategy of Targeting Key Populations at Greater Risk for Tuberculosis.

    Directory of Open Access Journals (Sweden)

    Zoë M McLaren

    Full Text Available Identifying those infected with tuberculosis (TB is an important component of any strategy for reducing TB transmission and population prevalence. The Stop TB Global Partnership recently launched an initiative with a focus on key populations at greater risk for TB infection or poor clinical outcomes, due to housing and working conditions, incarceration, low household income, malnutrition, co-morbidities, exposure to tobacco and silica dust, or barriers to accessing medical care. To achieve operational targets, the global health community needs effective, low cost, and large-scale strategies for identifying key populations. Using South Africa as a test case, we assess the feasibility and effectiveness of targeting active case finding to populations with TB risk factors identified from regularly collected sources of data. Our approach is applicable to all countries with TB testing and census data. It allows countries to tailor their outreach activities to the particular risk factors of greatest significance in their national context.We use a national database of TB test results to estimate municipality-level TB infection prevalence, and link it to Census data to measure population risk factors for TB including rates of urban households, informal settlements, household income, unemployment, and mobile phone ownership. To examine the relationship between TB prevalence and risk factors, we perform linear regression analysis and plot the set of population characteristics against TB prevalence and TB testing rate by municipality. We overlay lines of best fit and smoothed curves of best fit from locally weighted scatter plot smoothing.Higher TB prevalence is statistically significantly associated with more urban municipalities (slope coefficient β1 = 0.129, p < 0.0001, R2 = 0.133, lower mobile phone access (β1 = -0.053, p < 0.001, R2 = 0.089, lower unemployment rates (β1 = -0.020, p = 0.003, R2 = 0.048, and a lower proportion of low-income households

  15. Investigation on the magnetocaloric effect in TbN compound

    Energy Technology Data Exchange (ETDEWEB)

    Ranke, P.J. von, E-mail: von.ranke@uol.com.br [Instituto de Física, Universidade do Estado do Rio de Janeiro—UERJ, Rua São Francisco Xavier, 524, 20550-013 RJ (Brazil); Alvarenga, T.S.T.; Nóbrega, E.P.; Alho, B.P.; Ribeiro, P.O. [Instituto de Física, Universidade do Estado do Rio de Janeiro—UERJ, Rua São Francisco Xavier, 524, 20550-013 RJ (Brazil); Carvalho, A. Magnus G. [Divisão de Metrologia de Materiais (DIMAT), Instituto Nacional de Metrologia, Normalização e Qualidade Industrial (INMETRO), Duque de Caxias, RJ 25250-020 (Brazil); Sousa, V.S.R. de; Caldas, A.; Oliveira, N.A. de [Instituto de Física, Universidade do Estado do Rio de Janeiro—UERJ, Rua São Francisco Xavier, 524, 20550-013 RJ (Brazil)

    2013-09-15

    One of the biggest challenges in materials science is to understand the microscopic mechanisms responsible in storage and release material entropy. TbN compound, which presents non-degeneracy in ground state, was studied and the calculated magnetocaloric effect is in good agreement with the recent experimental data. Also inverse magnetocaloric effect and spin reorientation transition were predicted in TbN. The theoretical investigations were carried out using a Hamiltonian, which includes the crystalline electrical field, Zeeman and exchange interactions. - Highlights: • Theoretical description of the magnetocaloric effect in TbN. • Influence of the crystalline electrical field anisotropy on TbN. • Predictions of inverse and anomalous magnetocaloric effect in TbN.

  16. Treating tuberculosis with high doses of anti-TB drugs: mechanisms and outcomes.

    Science.gov (United States)

    Xu, Yuhui; Wu, Jianan; Liao, Sha; Sun, Zhaogang

    2017-10-03

    Tuberculosis (TB) is considered as one of the most serious threats to public health in many parts of the world. The threat is even more severe in the developing countries where there is a lack of advanced medical amenities and contemporary anti-TB drugs. In such situations, dosage optimization of existing medication regimens seems to be the only viable option. Therapeutic drug monitoring study results suggest that high-dose treatment regimens can compensate the low serum concentration of anti-TB drugs and shorten the therapy duration. The article presents a critical review on the possible changes that occur in the host and the pathogen upon the administration of standard and high-dose regimens. Some of the most common factors that are responsible for low anti-TB drug concentrations in the serum are differences in hosts' body weight, metabolic processing of the drug, malabsorption and/or drug-drug interaction. Furthermore, failure to reach the cavitary pulmonary and extrapulmonary tissues also contributes to the therapeutic inefficiency of the drugs. In such conditions, administration of higher doses can help in compensating the pathogenic outcomes of enhancement of the pathogen's physical barriers, efflux pumps and genetic mutations. The present article also presents a summary of the recorded treatment outcomes of clinical trials that were conducted to test the efficacy of administration of high dose of anti-tuberculosis drugs. This review will help physicians across the globe to understand the underlying pathophysiological changes (including side effects) that dictate the clinical outcomes in patients administered with standard and/or high dose anti-TB drugs.

  17. Association between smoking, tuberculosis and diabetes-TB: an analysis on Indian TB patients

    Directory of Open Access Journals (Sweden)

    Ashok Bhardwaj

    2018-03-01

    400 (100 P value Non Smoker 20 (10.5 170 (89.5 190 (100 0.03 Current 17 (12.5 119 (87.5 136 (100 Ex -Smoker 17 (33.0 57 (77.0 74 (100 Median duration of smoking (IQR in years 20 (30 0.5 (25 3 (65 0.03 [Prevalence of Smoking with TB DM

  18. AtriplaR/anti-TB combination in TB/HIV patients. Drug in focus

    Directory of Open Access Journals (Sweden)

    Semvua Hadija H

    2011-11-01

    Full Text Available Abstract Background Co-administration of anti-tuberculosis and antiretroviral therapy is often inevitable in high-burden countries where tuberculosis is the most common opportunistic infection associated with HIV/AIDS. Concurrent use of rifampicin and several antiretroviral drugs is complicated by pharmacokinetic drug-drug interaction. Method Pubmed and Google search following the key words tuberculosis, HIV, emtricitabine, tenofovir efavirenz, interaction were used to find relevant information on each drug of the fixed dose combination AtriplaR Results Information on generic name, trade name, pharmacokinetic parameter, metabolism and the pharmacokinetic interaction with Anti-TB drugs of emtricitabine, tenofovir, and efavirenz was obtained. Conclusion Fixed dose combination of emtricitabine/tenofovir/efavirenz (ATRIPLAR which has been approved by Food and Drug Administration shows promising results as far as safety and efficacy is concerned in TB/HIV co-infection patients, hence can be considered effective and safe antiretroviral drug in TB/HIV management for adult and children above 3 years of age.

  19. QuantiFERON®-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting.

    Directory of Open Access Journals (Sweden)

    Michala V Rose

    Full Text Available AIM: To determine whether QuantiFERON®-TB Gold In-Tube (QFT can contribute to the diagnosis of active tuberculosis (TB in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST in a prospective cohort of TB suspect children compared to adults with confirmed TB in Tanzania. METHODS: Sensitivity and specificity of QFT and TST for diagnosing active TB as well as indeterminate QFT rates and IFN-γ levels were assessed in 211 TB suspect children in a Tanzanian district hospital and contrasted in 90 adults with confirmed pulmonary TB. RESULTS: Sensitivity of QFT and TST in children with confirmed TB was 19% (5/27 and 6% (2/31 respectively. In adults sensitivity of QFT and TST was 84% (73/87 and 85% (63/74. The QFT indeterminate rate in children and adults was 27% and 3%. Median levels of IFN-γ were lower in children than adults, particularly children <2 years and HIV infected. An indeterminate result was associated with age <2 years but not malnutrition or HIV status. Overall childhood mortality was 19% and associated with an indeterminate QFT result at baseline. CONCLUSION: QFT and TST showed poor performance and a surprisingly low sensitivity in children. In contrast the performance in Tanzanian adults was good and comparable to performance in high-income countries. Indeterminate results in children were associated with young age and increased mortality. Neither test can be recommended for diagnosing active TB in children with immature or impaired immunity in a high-burden setting.

  20. TextTB: A Mixed Method Pilot Study Evaluating Acceptance, Feasibility, and Exploring Initial Efficacy of a Text Messaging Intervention to Support TB Treatment Adherence

    Directory of Open Access Journals (Sweden)

    Sarah Iribarren

    2013-01-01

    Full Text Available Objective. To assess a text messaging intervention to promote tuberculosis (TB treatment adherence. Methods. A mixed-methods pilot study was conducted within a public pulmonary-specialized hospital in Argentina. Patients newly diagnosed with TB who were 18 or older, and had mobile phone access were recruited and randomized to usual care plus either medication calendar (n=19 or text messaging intervention (n=18 for the first two months of treatment. Primary outcomes were feasibility and acceptability; secondary outcomes explored initial efficacy. Results. Feasibility was evidenced by high access to mobile phones, familiarity with texting, most phones limited to basic features, a low rate of participant refusal, and many describing suboptimal TB understanding. Acceptability was evidenced by participants indicating feeling cared for, supported, responsible for their treatment, and many self-reporting adherence without a reminder. Participants in the texting group self-reported adherence on average 77% of the days whereas only 53% in calendar group returned diaries. Exploring initial efficacy, microscopy testing was low and treatment outcomes were similar in both groups. Conclusion. The texting intervention was well accepted and feasible with greater reporting of adherence using text messaging than the diary. Further evaluation of the texting intervention is warranted.

  1. The Risk of Depressive Disorder Among Contacts of Tuberculosis Patients in a TB-endemic Area: A Population-based Cohort Study.

    Science.gov (United States)

    Pan, Sheng-Wei; Yen, Yung-Feng; Feng, Jia-Yih; Su, Vincent Yi-Fong; Kou, Yu Ru; Su, Wei-Juin

    2015-10-01

    Tuberculosis (TB) disease may be transmitted to close contacts of index cases, causing physical illness. No studies have investigated the risk of developing depressive disorder among TB contacts in a TB-endemic area.Adult participants with a new diagnosis of TB contact (ICD-9-CM codes V01.1 plus chest radiographic order) since January 1, 2008, were identified from the National Health Insurance Research Database in Taiwan. A control cohort matched for age (±5 y), sex, enrolled years, and income level was selected. These 2 cohorts were followed until December 31, 2012, and observed for the development of depressive disorder. The Kaplan-Meier method and the log-rank test were used to examine the difference in cumulative incidences of depressive disorder between groups. Cox proportional-hazard models were used to calculate adjusted hazard ratios (aHRs) for depressive disorder.The TB contact cohort consisted of 9046 patients and matched controls of 36,184 ones. The mean age of TB contacts was 44.7 years, and 56.0% of them were women. During a mean follow-up period of 2.5 years, 127 (1.40%) TB contacts and 521 (1.44%) matched controls developed depressive disorder. TB exposure was found to be an independent risk factor of depressive disorder in women (aHR 1.34, 95% confidence interval [CI] 1.07-1.68), but not in men (aHR 0.71, 95% CI 0.48-1.06) after adjusting for age, comorbidities, and income levels. The risk of depression was significantly higher for female TB contacts than for matched controls in the first and second years (aHR 1.49, 95% CI 1.03-2.14; and aHR 1.53, 95% CI 1.05-2.23, respectively), but not thereafter. Of note, 67 (0.74%) TB contacts and 88 (0.24%) matched controls developed active TB, but none of them had subsequent depressive disorder during follow-up periods.Female TB contacts had an increased risk of depression within the first 2 years after exposure. Clinicians should consider conducting depression evaluations in addition to routine TB contact

  2. E-health systems for management of MDR-TB in resource-poor environments: a decade of experience and recommendations for future work.

    Science.gov (United States)

    Fraser, Hamish S F; Habib, Ali; Goodrich, Mark; Thomas, David; Blaya, Joaquin A; Fils-Aime, Joseph Reginald; Jazayeri, Darius; Seaton, Michael; Khan, Aamir J; Choi, Sharon S; Kerrison, Foster; Falzon, Dennis; Becerra, Mercedes C

    2013-01-01

    Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring. Over the last decade we have developed the PIH-EMR electronic medical record system, and subsequently OpenMRS-TB, to support the treatment of MDR-TB in Peru, Haiti, Pakistan, and other resource-poor environments. We describe here the experience with implementing these systems and evaluating many aspects of their performance, and review other systems for MDR-TB management. We recommend a new approach to information systems to address the barriers to scale up MDR-TB treatment, particularly access to the appropriate drugs and lab data. We propose moving away from fragmented, vertical systems to focus on common platforms, addressing all stages of TB care, support for open data standards and interoperability, care for a wide range of diseases including HIV, integration with mHealth applications, and ability to function in resource-poor environments.

  3. Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries.

    Science.gov (United States)

    Patel, L N; Detjen, A K

    2017-06-21

    Introduction: Childhood tuberculosis (TB) and undernutrition are major global public health challenges. In 2015, although an estimated 1 million children aged malnutrition from 17 high TB burden countries were reviewed to gather information on TB symptom screening, exposure history, and treatment. Results: Seven (41%) countries recommend routine TB screening among children with acute malnutrition, and six (35%) recommend obtaining a TB exposure history. Conclusion: TB screening is not consistently included in guidelines for acute malnutrition in high TB burden countries. Routine TB risk assessment, especially history of TB exposure, among acutely malnourished children, combined with improved linkages with TB services, would help increase TB case finding and could impact outcomes. Operational research on how best to integrate services at different levels of the health care system is needed.

  4. Predictors of Prolonged TB Treatment in a Dutch Outpatient Setting.

    Directory of Open Access Journals (Sweden)

    Natasha Van't Boveneind-Vrubleuskaya

    Full Text Available Standard treatment duration for drug-susceptible tuberculosis (TB treatment is 6 months. Treatment duration is often extended-and for various different reasons. The aim of this study was to determine the prevalence and to assess risk factors associated with extended TB treatment.A cross-sectional study was conducted. Data including demographic, clinical, radiological and microbiological information from the Netherlands TB Register (NTR of 90 patients with smear and culture positive pulmonary TB of the region Haaglanden, The Netherlands, was eligible for analysis.Treatment was extended to ≥ 200 days by 46 (51% patients. Extended TB treatment was associated with a higher frequency of symptoms, presumed to be due to adverse drug reactions (ADR; OR 2.39 95% CI: 1.01-5.69, drug-induced liver injury (DILI (OR: 13.51; 95% CI: 1.66-109.82 and longer than 2 month smear and culture conversion rate (OR: 11.00; 95% CI: 1.24-97.96 and OR: 8.56; 95% CI: 1.53-47.96. In the multivariable logistic analysis, development of DILI emerged as the single statistically strong risk factor necessitating extension of TB treatment.This finding will need further confirmation in a prospective study, exploring the possible mutual role of pharmacokinetic and pharmacogenetic determinants of DILI among TB patients.

  5. Immigrants and health system challenges to TB control in Oman

    Directory of Open Access Journals (Sweden)

    Fochsen Grethe

    2010-07-01

    Full Text Available Abstract Background During the past three decades, Oman has made significant progress in controlling TB within it's borders. However, the national TB control program elimination target has yet to be reached. This study aims to explore the perceived roles played by the immigrant population and the private health sector in relation to TB control in Oman. Methods We conducted seventeen interviews with different health care providers. The verbatim transcripts were processed using content analysis. Results Three main themes emerged. Firstly the threat of repatriation faced by underprivileged expatriates, secondly the criticized and forgotten private health sector as a key player and thirdly the user and provider barriers faced by Omani patients in the Omani public health system. Conclusions The study has identified some of the challenges and barriers to TB control in Oman. These challenges are mainly related to unintended negative consequences arising from the current repatriation policy of immigrants and to and the lack of involvement of the private sector in TB control. TB control strategies designed to address these challenges are needed, for Oman to reach its TB elimination targets.

  6. National HIV Testing Day

    Centers for Disease Control (CDC) Podcasts

    2011-06-09

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses National HIV Testing Day, an annual observance which raises awareness of the importance of knowing one's HIV status and encourages at-risk individuals to get an HIV test.  Created: 6/9/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 6/9/2011.

  7. Latent tuberculosis in HIV positive, diagnosed by the M. tuberculosis specific interferon-gamma test

    DEFF Research Database (Denmark)

    Brock, Inger; Ruhwald, Morten; Lundgren, Bettina

    2006-01-01

    Although tuberculosis (TB) is a minor problem in Denmark, severe and complicated cases occur in HIV positive. Since the new M. tuberculosis specific test for latent TB, the QuantiFERON-TB In-Tube test (QFT-IT) became available the patients in our clinic have been screened for the presence of latent...

  8. Latent tuberculosis in HIV positive, diagnosed by the M. tuberculosis specific interferon-gamma test

    DEFF Research Database (Denmark)

    Brock, Inger; Ruhwald, Morten; Lundgren, Bettina

    2006-01-01

    BACKGROUND: Although tuberculosis (TB) is a minor problem in Denmark, severe and complicated cases occur in HIV positive. Since the new M. tuberculosis specific test for latent TB, the QuantiFERON-TB In-Tube test (QFT-IT) became available the patients in our clinic have been screened...

  9. Integration of HIV and TB services results in improved TB treatment outcomes and earlier prioritized ART initiation in a large urban HIV clinic in Uganda.

    Science.gov (United States)

    Hermans, Sabine M; Castelnuovo, Barbara; Katabira, Catherine; Mbidde, Peter; Lange, Joep M A; Hoepelman, Andy I M; Coutinho, Alex; Manabe, Yukari C

    2012-06-01

    The World Health Organization recommends that treatment of tuberculosis (TB) in HIV-infected patients should be integrated with HIV care. In December 2008, a separate outdoor-integrated TB/HIV clinic was instituted for attendees of a large urban HIV clinic in Uganda. We sought to evaluate associated TB and HIV treatment outcomes. Routinely collected clinical, pharmacy, and laboratory data were merged with TB clinic data for patients initiating TB treatment in 2009 and with TB register data for patients in 2007. TB treatment outcomes and (timing of) antiretroviral therapy (ART) initiation in ART-naive patients [overall and stratified by CD4+ T cell (CD4) count] in 2007 and 2009 were compared. Nosocomial transmission rates could not be assessed. Three hundred forty-six patients were initiated on TB treatment in 2007 and 366 in 2009. Median CD4 counts at TB diagnosis did not differ. TB treatment cure or completion increased from 62% to 68%, death or default decreased from 33% to 25% (P ART-naive TB patients were initiated on ART in 2009 versus 2007 (57% and 66%, P = 0.031), but this decrease was only in patients with CD4 counts >250 cells per cubic millimeter (19% vs. 48%, P = 0.003). More patients were started on ART during TB treatment (94% vs. 78%, P ART initiation. This supports rollout of a fully integrated TB/HIV service delivery model throughout high-prevalence TB and HIV settings.

  10. Antigen-Specific Interferon-Gamma Responses and Innate Cytokine Balance in TB-IRIS

    Science.gov (United States)

    Goovaerts, Odin; Jennes, Wim; Massinga-Loembé, Marguerite; Ceulemans, Ann; Worodria, William; Mayanja-Kizza, Harriet; Colebunders, Robert; Kestens, Luc

    2014-01-01

    Background Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) remains a poorly understood complication in HIV-TB patients receiving antiretroviral therapy (ART). TB-IRIS could be associated with an exaggerated immune response to TB-antigens. We compared the recovery of IFNγ responses to recall and TB-antigens and explored in vitro innate cytokine production in TB-IRIS patients. Methods In a prospective cohort study of HIV-TB co-infected patients treated for TB before ART initiation, we compared 18 patients who developed TB-IRIS with 18 non-IRIS controls matched for age, sex and CD4 count. We analyzed IFNγ ELISpot responses to CMV, influenza, TB and LPS before ART and during TB-IRIS. CMV and LPS stimulated ELISpot supernatants were subsequently evaluated for production of IL-12p70, IL-6, TNFα and IL-10 by Luminex. Results Before ART, all responses were similar between TB-IRIS patients and non-IRIS controls. During TB-IRIS, IFNγ responses to TB and influenza antigens were comparable between TB-IRIS patients and non-IRIS controls, but responses to CMV and LPS remained significantly lower in TB-IRIS patients. Production of innate cytokines was similar between TB-IRIS patients and non-IRIS controls. However, upon LPS stimulation, IL-6/IL-10 and TNFα/IL-10 ratios were increased in TB-IRIS patients compared to non-IRIS controls. Conclusion TB-IRIS patients did not display excessive IFNγ responses to TB-antigens. In contrast, the reconstitution of CMV and LPS responses was delayed in the TB-IRIS group. For LPS, this was linked with a pro-inflammatory shift in the innate cytokine balance. These data are in support of a prominent role of the innate immune system in TB-IRIS. PMID:25415590

  11. Culture and drug susceptibility testing among previously treated tuberculosis patients in the Dominican Republic, 2014

    Directory of Open Access Journals (Sweden)

    Katia J. Romero Mercado

    Full Text Available ABSTRACT Multidrug-resistant tuberculosis (MDR-TB is a major public health concern that threatens global progress toward effective TB control. The risk of MDR-TB is increased in patients who have received previous TB treatment. This article describes the performance of culture and drug susceptibility testing (DST in patients registered as previously treated TB patients in the Dominican Republic in 2014, based on operational research that followed a retrospective cohort design and used routine program data. Under the current system of TB culturing and DST, the majority of patients with previously treated TB do not undergo DST, and those who do often experience considerable delay in obtaining their results. The lack of DST and delay in receiving DST results leads to underestimation of the number of MDR-TB cases and hinders the timely initiation of MDR-TB treatment.

  12. Effect of calcinations temperature on the luminescence intensity and fluorescent lifetime of Tb3+-doped hydroxyapatite (Tb-HA nanocrystallines

    Directory of Open Access Journals (Sweden)

    Hairong Yin

    2017-06-01

    Full Text Available Hydroxyapatite luminescent nanocrystallines doped with 6 mol.% Tb3+ (Tb-HA were prepared via chemical deposition method and calcined at different temperature, and the effects of calcinations temperature on the luminescence intensity and fluorescent lifetime were studied. TEM image of Tb-HA revealed that the shape of nanocrystallines changed from needle-like to short rod-like and sphere-like with the increase of calcinations temperature; while the particles sizes decreased from 190 nm to 110 nm. The crystallinity degree increased. The typical emission peaks attributed to Tb3+ ions were observed in emission spectra of 6 mol.% Tb-HA under 378 nm excitation. The luminescent intensity of Tb-HA, which showed the fluorescence quenching, firstly enhanced and then decreased at 700 °C; while the fluorescent lifetime increased firstly and then decreased after 600 °C. Furthermore, the ratio of intensity between 545 nm and 490 nm corresponding to electric-dipole and magnetic-dipole transition (IR: IO increases firstly and then decreases, which revealed that the proportion of substitute type and site of Ca2+ ions by Tb3+ ions were helpful to realize the substitute process and functional structure design.

  13. Immune TB Antibody Phage Display Library as a Tool To Study B Cell Immunity in TB Infections.

    Science.gov (United States)

    Hamidon, Nurul Hamizah; Suraiya, Siti; Sarmiento, Maria E; Acosta, Armando; Norazmi, Mohd Nor; Lim, Theam Soon

    2018-03-01

    B cells and in particular antibodies has always played second fiddle to cellular immunity in regard to tuberculosis (TB). However, recent studies has helped position humoral immunity especially antibodies back into the foray in relation to TB immunity. Therefore, the ability to correlate the natural antibody responses of infected individuals toward TB antigens would help strengthen this concept. Phage display is an intriguing approach that can be utilized to study antibody-mediated responses against a particular infection via harvesting the B cell repertoire from infected individuals. The development of disease-specific antibody libraries or immune libraries is useful to better understand antibody-mediated immune responses against specific disease antigens. This study describes the generation of an immune single-chain variable fragment (scFv) library derived from TB-infected individuals. The immune library with an estimated diversity of 10 9 independent clones was then applied for the identification of monoclonal antibodies against Mycobacterium tuberculosis α-crystalline as a model antigen. Biopanning of the library isolated three monoclonal antibodies with unique gene usage. This strengthens the role of antibodies in TB immunity in addition to the role played by cellular immunity. The developed library can be applied against other TB antigens and aid antibody-derived TB immunity studies in the future.

  14. Evaluation of the performance of two tuberculosis interferon gamma release assays (IGRA-ELISA and T-SPOT.TB) for diagnosing Mycobacterium tuberculosis infection.

    Science.gov (United States)

    Wang, Linchuan; Tian, Xu-Dong; Yu, Yan; Chen, Wei

    2018-04-01

    The IGRA-ELISA and T-SPOT.TB are widely used in China. The aim of the study was to evaluate the performance of the two assays in diagnosis Mycobacterium tuberculosis infection. Of the 3727 patients in the study, 204 underwent testing using both the T-SPOT.TB and IGRA-ELISA, 1794 were tested using the T-SPOT.TB only, and 1729 were tested using the IGRA-ELISA only. The positive rate and consistency of the two assays were analyzed, and their sensitivity and specificity for diagnosing active tuberculosis were compared. There were no significant differences in the positive rate between the T-SPOT.TB test (25.8%) and IGRA-ELISA (28.6%), p = .065. The two assays were highly consistent, with a kappa value of 0.852 (p SPOT.TB test were 82.9% (107/129) and 78.6% (1309/1665), respectively, and those of IGRA-ELISA were 81.7% (94/115) and 75.2% (1214/1614), respectively. There were no significant differences in sensitivity (p > .05), but the specificity of the T-SPOT.TB test was slightly higher than that of IGRA-ELISA (p = .023). Both in terms of diagnosing M. tuberculosis infection and ruling out active tuberculosis, the performance of the IGRA-ELISA-a simple, almost labor-free assay that allows simultaneous processing of a very large number of samples-was well-matched with that of T-SPOT.TB test. However, IGRAs cannot be used as the only test to diagnose active tuberculosis. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Use of QuantiFERON®-TB Gold in-tube culture supernatants for measurement of antibody responses.

    Directory of Open Access Journals (Sweden)

    Simon G Kimuda

    Full Text Available QuantiFERON®-TB Gold in-tube (QFT-GIT supernatants may be important samples for use in assessment of anti-tuberculosis (TB antibodies when only limited volumes of blood can be collected and when a combination of antibody and cytokine measurements are required. These analytes, when used together, may also have the potential to differentiate active pulmonary TB (APTB from latent TB infection (LTBI. However, few studies have explored the use of QFT-GIT supernatants for investigations of antibody responses. This study determined the correlation and agreement between anti-CFP-10 and anti-ESAT-6 antibody concentrations in QFT-GIT nil supernatant and serum pairs from 68 TB household contacts. We also explored the ability of Mycobacterium tuberculosis (M.tb specific antibodies, or ratios of antibody to interferon gamma (IFN-γ in QFT-GIT supernatants, to differentiate 97 APTB cases from 58 individuals with LTBI. Sputum smear microscopy was used to define APTB, whereas the QFT-GIT and tuberculin skin test were used to define LTBI. There were strong and statistically significant correlations between anti-CFP-10 and anti-ESAT-6 antibodies in unstimulated QFT-GIT supernatants and sera (r = 0.89; p<0.0001 for both, and no significant differences in antibody concentration between them. Anti-CFP-10 & anti-ESAT-6 antibodies differentiated APTB from LTBI with sensitivities of 88.7% & 71.1% and specificities of 41.4% & 51.7% respectively. Anti-CFP-10 antibody/M.tb specific IFN-γ and anti-ESAT-6 antibody/M.tb specific IFN-γ ratios had sensitivities of 48.5% & 54.6% and specificities of 89.7% and 75.9% respectively. We conclude that QFT-GIT nil supernatants may be used in the place of sera when measuring antibody responses, reducing blood volumes needed for such investigations. Antibodies in QFT-GIT nil supernatants on their own discriminate APTB from LTBI with high sensitivity but have poor specificity, whereas the reverse is true when antibodies are used in

  16. Accelerating TB notification from the private health sector in Delhi, India.

    Science.gov (United States)

    Kundu, Debashish; Chopra, Kamal; Khanna, Ashwani; Babbar, Neeti; Padmini, T J

    2016-01-01

    In India, almost half of all patients with tuberculosis (TB) seek care in the private sector as the first point of care. The national programme is unable to support such TB patients and facilitate effective treatment, as there is no information on TB and Multi or Extensively Drug Resistant TB (M/XDR-TB) diagnosis and treatment in private sector. To improve this situation, Government of India declared TB a notifiable disease for establishing TB surveillance system, to extend supportive mechanism for TB treatment adherence and standardised practices in the private sector. But TB notification from the private sector is a challenge and still a lot needs to be done to accelerate TB notification. Delhi State TB Control Programme had taken initiatives for improving notification of TB cases from the private sector in 2014. Key steps taken were to constitute a state level TB notification committee to oversee the progress of TB notification efforts in the state and direct 'one to one' sensitisation of private practitioners (PPs) (in single PP's clinic, corporate hospitals and laboratories) by the state notification teams with the help of available tools for sensitising the PP on TB notification - TB Notification Government Order, Guidance Tool for TB Notification and Standards of TB Care in India. As a result of focussed state level interventions, without much external support, there was an accelerated notification of TB cases from the private sector. TB notification cases from the private sector rose from 341 (in 2013) to 4049 (by the end of March 2015). Active state level initiatives have led to increase in TB case notification. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  17. Antigen-Specific Interferon-Gamma Responses and Innate Cytokine Balance in TB-IRIS

    NARCIS (Netherlands)

    Goovaerts, Odin; Jennes, Wim; Massinga-Loembé, Marguerite; Ceulemans, Ann; Worodria, William; Mayanja-Kizza, Harriet; Colebunders, Robert; Kestens, Luc; Loembé, Marguerite Massinga; Mayanja, Harriet; Mascart, Francoise; van den Bergh, Rafael; Locht, Camille; Reiss, Peter; Cobelens, Frank; Ondoa, Pascale; Pakker, Nadine; Mugerwa, Roy

    2014-01-01

    Background: Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) remains a poorly understood complication in HIV-TB patients receiving antiretroviral therapy (ART). TB-IRIS could be associated with an exaggerated immune response to TB-antigens. We compared the recovery of

  18. Magnetic properties of the Tb4 + ion in Li2TbF6

    Science.gov (United States)

    Guillot, M.; El-Ghozzi, M.; Avignant, D.; Ferey, G.

    1993-05-01

    Both oxygen and fluorine have a partiality towards the stabilization of high oxidation states of rare earths such as Ce, Pr, and Tb. During the study of the MF-M'F4 (M=alkaline metal; M' rare ion) the compound Li2TbF6 was found to constitute the only representative obtained under ambient pressure of a structural type, namely α-Li2ZrF6, known until now only through the high pressure form. Magnetic measurements were carried out over the 1.4-300 K temperature range in continuous magnetic fields up to 20 T produced by a Bitter magnet. At low temperature and in H higher than 15 T, the magnetization M was observed to be field independent and very close to the calculated Tb4+ free ion value, i.e., 7μB; on the other hand, the data do not present any departure from the Brillouin function of the pure 8S7/2 state. The reciprocal magnetic susceptibility obeys a Curie-Weiss law leading to an effective moment of 7.86μB. A very unusual behavior of the terbium ion which presents a 4+ oxidation state is concluded: to the best of our knowledge, it is the first observation of this form. The so-found spherical 4f7 electronic configuration is the most compatible with the high coordination number of eight. Finally, the discussion within the series Li2MIVF6 compounds to understand the influence of both electronic configuration and size effects is presented.

  19. Dextran solution optical activity in Tb (III) ion presence

    International Nuclear Information System (INIS)

    Vasconcellos, Sandra S.; Rodrigues, J.F.; Faljoni-Alario, A.

    1984-01-01

    Optical activity studies of aqueous solutions of dextrana in presence of Tb (III) or without it shows the complex with the hidroxyl groups of C 2 and C 3 of monomeric unit participation is formed. (L.M.J.) [pt

  20. management of pulmonary tb in nurse-based cape town

    African Journals Online (AJOL)

    Kurt

    a recording and reporting system enabling assessment of the outcomes of each patient ... scopically at the regional laboratory. (NHLS) for .... auditing of aspects of clinical and resource management. ... and information systems. The TB nurs-.

  1. Health Inequities and HIV, Viral Hepatitis, TB, and STDs

    Centers for Disease Control (CDC) Podcasts

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), discusses health inequities in the United States and how NCHHSTP research, policies, and programs can address them.

  2. Disparities in HIV/AIDS, Viral Hepatitis, STDs, and TB

    Science.gov (United States)

    ... Search The CDC Health Disparities in HIV/AIDS, Viral Hepatitis, STDs, and TB Note: Javascript is disabled or ... Other Pacific Islanders MMWR Publications HIV and AIDS Viral Hepatitis STDs Tuberculosis Training and Networking Resources Call for ...

  3. Luminescence properties of Tb implanted ZnO

    International Nuclear Information System (INIS)

    Cetin, A.; Kibar, R.; Selvi, S.; Townsend, P.D.; Can, N.

    2009-01-01

    ZnO [0 0 0 1] crystals were irradiated at room temperature with Tb + ions of 400 keV with fluences from 1x10 16 to 2x10 17 cm -2 . The implanted layer was examined by several methods, including radioluminescence (RL), Rutherford backscattering spectrometry (RBS) and optical spectroscopy. The optical extinction spectra were simulated using Mie scattering theory. Absorption spectra predicted by Mie theory for particles of decreasing diameter were compared with those obtained experimentally. Some qualitative agreement between theoretical and experimental data was achieved. It was also shown that the intensities of the characteristic green emission bands associated with Tb produced by 5 D 4 → 7 F j=5,4 transitions have increased about 8 times after annealing. Optical spectroscopy and radioluminescence data have revealed that the ion implantation is a promising tool for synthesizing Tb nanoparticles in the ZnO surface. The Tb nanoparticles exhibit a rather weak plasma resonance.

  4. 46 CFR 32.75-1 - Application-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS Hull Requirements for Wood Hull Tank Vessels Constructed Prior to November 10, 1936 § 32.75-1 Application—TB/ALL. All wood hull tank vessels, the construction or conversion of which was started prior to...

  5. Thermomagnetically written domains in TbFeCo thin films

    International Nuclear Information System (INIS)

    Reim, W.; Weller, D.

    1988-01-01

    Characteristic features of thermomagnetically written domains in amorphous Tb x (Fe 90 Co 10 ) 100-x alloy thin films having different magnetic properties are reported. In particular, the writing process in materials with low Tb content chi ≤ 21 dominated by the demagnetizing field is compared to the bias field dominated process in Tb rich samples 22 ≤ chi ≤ 25. Domain wall movement over lateral dimensions of the bit size is found for Tb poor materials while for chi ≥ 22 domain boundaries are primarily determined by the area heated up to the Curie-temperature. The importance of mechanical stress on domain formation and irreversible changes of the storage medium due to overheating in the writing process are reported

  6. Magnetic and crystallographic properties of TbCo4B

    International Nuclear Information System (INIS)

    Caspi, E.N.; Dubman, M.; Ettedgui, H.; Shaked, H.; Melamud, M.; Keller, L.; Avdeev, M.

    2006-01-01

    The compound TbCo 4 B was studied using measurements of AC magnetic susceptibility, magnetization and neutron powder diffraction. It is found that this compound orders at T C ∼450 K. Each of the two Tb and two Co sublattices orders ferromagnetically. The coupling is ferromagnetic within each pair and ferrimagnetic between pairs. A compensation point at ∼300 K and a spin reorientation between 400 and 430 K were found

  7. Health Inequities and HIV, Viral Hepatitis, TB, and STDs

    Centers for Disease Control (CDC) Podcasts

    2010-09-15

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), discusses health inequities in the United States and how NCHHSTP research, policies, and programs can address them.  Created: 9/15/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.   Date Released: 9/15/2010.

  8. The candidate TB vaccine, MVA85A, induces highly durable Th1 responses.

    Directory of Open Access Journals (Sweden)

    Michele Tameris

    Full Text Available Vaccination against tuberculosis (TB should provide long-term protective immunity against Mycobacterium tuberculosis (M.tb. The current TB vaccine, Bacille Calmette-Guerin (BCG, protects against disseminated childhood TB, but protection against lung TB in adolescents and adults is variable and mostly poor. One potential reason for the limited durability of protection may be waning of immunity through gradual attrition of BCG-induced T cells. We determined if a MVA85A viral-vector boost could enhance the durability of mycobacteria-specific T cell responses above those induced by BCG alone.We describe a long-term follow-up study of persons previously vaccinated with MVA85A. We performed a medical history and clinical examination, a tuberculin skin test and measured vaccine-specific T cell responses in persons previously enrolled as adults, adolescents, children or infants into three different Phase II trials, between 2005 and 2011.Of 252 potential participants, 183 (72.6% consented and completed the study visit. Vaccine-induced Ag85A-specific CD4+ T cell responses were remarkably persistent in healthy, HIV-uninfected adults, adolescents, children and infants, up to 6 years after MVA85A vaccination. Specific CD4+ T cells expressed surface markers consistent with either CD45RA-CCR7+ central memory or CD45RA-CCR7- effector memory T cells. Similarly durable Ag85A-specific CD4+ T cell responses were detected in HIV-infected persons who were on successful antiretroviral therapy when MVA85A was administered. By contrast, Ag85A-specific CD4+ T cell frequencies in untreated MVA85A-vaccinated HIV-infected persons were mostly undetectable 3-5 years after vaccination.MVA85A induces remarkably durable T cell responses in immunocompetent persons. However, results from a recent phase IIb trial of MVA85A, conducted in infants from the same geographic area and study population, showed no vaccine efficacy, suggesting that these durable T cell responses do not

  9. Spatial overlap links seemingly unconnected genotype-matched TB cases in rural Uganda

    Science.gov (United States)

    Kato-Maeda, Midori; Emperador, Devy M.; Wandera, Bonnie; Mugagga, Olive; Crandall, John; Janes, Michael; Marquez, Carina; Kamya, Moses R.; Charlebois, Edwin D.; Havlir, Diane V.

    2018-01-01

    Introduction Incomplete understanding of TB transmission dynamics in high HIV prevalence settings remains an obstacle for prevention. Understanding where transmission occurs could provide a platform for case finding and interrupting transmission. Methods From 2012–2015, we sought to recruit all adults starting TB treatment in a Ugandan community. Participants underwent household (HH) contact investigation, and provided names of social contacts, sites of work, healthcare and socializing, and two sputum samples. Mycobacterium tuberculosis culture-positive specimens underwent 24-loci MIRU-VNTR and spoligotyping. We sought to identify epidemiologic links between genotype-matched cases by analyzing social networks and mapping locations where cases reported spending ≥12 hours over the one-month pre-treatment. Sites of spatial overlap (≤100m) between genotype-matched cases were considered potential transmission sites. We analyzed social networks stratified by genotype clustering status, with cases linked by shared locations, and compared network density by location type between clustered vs. non-clustered cases. Results Of 173 adults with TB, 131 (76%) were enrolled, 108 provided sputum, and 84/131 (78%) were MTB culture-positive: 52% (66/131) tested HIV-positive. Of 118 adult HH contacts, 105 (89%) were screened and 3 (2.5%) diagnosed with active TB. Overall, 33 TB cases (39%) belonged to 15 distinct MTB genotype-matched clusters. Within each cluster, no cases shared a HH or reported shared non-HH contacts. In 6/15 (40%) clusters, potential epidemiologic links were identified by spatial overlap at specific locations: 5/6 involved health care settings. Genotype-clustered TB social networks had significantly greater network density based on shared clinics (p<0.001) and decreased density based on shared marketplaces (p<0.001), compared to non-clustered networks. Conclusions In this molecular epidemiologic study, links between MTB genotype-matched cases were only

  10. Magnetic structure of Tb-Fe films with an artificially layered structure

    International Nuclear Information System (INIS)

    Yamauchi, K.; Habu, K.; Sato, N.

    1988-01-01

    The magnetic structure of Tb-Fe films with an artificially layered structure has been investigated by measuring the temperature dependence of the magnetization of the films. Ferrimagnetic coupling between Tb and Fe through the interface was explicitly observed up to about 9-A Tb and 10-A Fe layers. Films with thinner Tb and Fe layers than these thicknesses are composed of only ferrimagnetically coupled Tb-Fe regions. Films with thicker layers of Tb and Fe are composed of ferrimagnetically coupled Tb-Fe, ferromagnetic Fe, ferromagnetic Tb, and/or magnetically compensated Tb regions. The Tb-Fe films exhibit various temperature dependencies of the magnetization corresponding to these magnetic structures

  11. Temperature-dependent structure of Tb-doped magnetite nanoparticles

    International Nuclear Information System (INIS)

    Rice, Katherine P.; Russek, Stephen E.; Shaw, Justin M.; Usselman, Robert J.; Evarts, Eric R.; Silva, Thomas J.; Nembach, Hans T.; Geiss, Roy H.; Arenholz, Elke; Idzerda, Yves U.

    2015-01-01

    High quality 5 nm cubic Tb-doped magnetite nanoparticles have been synthesized by a wet-chemical method to investigate tailoring of magnetic properties for imaging and biomedical applications. We show that the Tb is incorporated into the octahedral 3+ sites. High-angle annular dark-field microscopy shows that the dopant is well-distributed throughout the particle, and x-ray diffraction measurements show a small lattice parameter shift with the inclusion of a rare-earth dopant. Magnetization and x-ray magnetic circular dichroism data indicate that the Tb spins are unpolarized and weakly coupled to the iron spin lattice at room temperature, and begin to polarize and couple to the iron oxide lattice at temperatures below 50 K. Broadband ferromagnetic resonance measurements show no increase in magnetic damping at room temperature for Tb-doped nanoparticles relative to undoped nanoparticles, further confirming weak coupling between Fe and Tb spins at room temperature. The Gilbert damping constant, α, is remarkably low for the Tb-doped nanoparticles, with α = 0.024 ± 0.003. These nanoparticles, which have a large fixed moment, a large fluctuating moment and optically active rare-earth elements, are potential high-relaxivity T1 and T2 MRI agents with integrated optical signatures

  12. Temperature-dependent structure of Tb-doped magnetite nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Rice, Katherine P.; Russek, Stephen E., E-mail: stephen.russek@nist.gov; Shaw, Justin M.; Usselman, Robert J.; Evarts, Eric R.; Silva, Thomas J.; Nembach, Hans T. [National Institute of Standards and Technology, Boulder, Colorado 80305 (United States); Geiss, Roy H. [Colorado State University, Fort Collins, Colorado 80523 (United States); Arenholz, Elke [Lawrence Berkeley National Laboratory, Advanced Light Source, Berkeley, California 94720 (United States); Idzerda, Yves U. [Department of Physics, Montana State University, Bozeman, Montana 59717 (United States)

    2015-02-09

    High quality 5 nm cubic Tb-doped magnetite nanoparticles have been synthesized by a wet-chemical method to investigate tailoring of magnetic properties for imaging and biomedical applications. We show that the Tb is incorporated into the octahedral 3+ sites. High-angle annular dark-field microscopy shows that the dopant is well-distributed throughout the particle, and x-ray diffraction measurements show a small lattice parameter shift with the inclusion of a rare-earth dopant. Magnetization and x-ray magnetic circular dichroism data indicate that the Tb spins are unpolarized and weakly coupled to the iron spin lattice at room temperature, and begin to polarize and couple to the iron oxide lattice at temperatures below 50 K. Broadband ferromagnetic resonance measurements show no increase in magnetic damping at room temperature for Tb-doped nanoparticles relative to undoped nanoparticles, further confirming weak coupling between Fe and Tb spins at room temperature. The Gilbert damping constant, α, is remarkably low for the Tb-doped nanoparticles, with α = 0.024 ± 0.003. These nanoparticles, which have a large fixed moment, a large fluctuating moment and optically active rare-earth elements, are potential high-relaxivity T1 and T2 MRI agents with integrated optical signatures.

  13. QuantiFERON® TB GOLD’ s applications in the tuberculosis disease

    Directory of Open Access Journals (Sweden)

    Maria Saladino

    2014-06-01

    Full Text Available Background. Tuberculosis is the most frequent cause of death from a single infectious agent in humans and remains a serious global health problem. The latent tuberculosis (LTBI treatment can prevent progression to active disease. People infected with LTBI are a dangerous reservoir, since any immunosuppressive factor can cause a reactivation of Mycobacterium leading to overt disease. Recent production and introduction into the healthcare system, on the other hand, are the IGRAs (Interferon-Gamma Release Assay. Materials and Methods. The QuantiFERON-TB Gold test is an ELISA assay of IFN-γ produced by sensitized lymphocytes that allows to overcome some limitations of Mantoux test, being an in vitro test with specific antigens for M. tuberculosis. In the present study we examined a population of 150 patients tested with the Mantoux test and the QuantiFERON-TB Gold test. The patients were divided into categories (contacts of the case, immigrants, health care personnel, and immunocompromised subjects in biological therapy. Results. The analysis of the obtained results from the comparison of the two tests showed a good concordance rate (47.3% in the case of double positivity and detected the highest percentage of discrepancy in the profile QuantiFERON negative/Mantoux positive. Conclusions. Our results allow to state that remains valid and effective use of the QuantiFERON test, provided it is flanked by the Mantoux test and a medical history of patients.

  14. On the role of the ground state Tb(3)/acetylacetone complex in sensitized emission of Tb(3) in ethanol solution

    International Nuclear Information System (INIS)

    Lis, S.; Elbanowski, M.; Marciniak, B.

    1989-01-01

    The Tb(3)-acetylacetone system in ethanol solution has been studied by spectroscopic methods. The formation of a Tb(3)/acetylacetone (1:1) complex in the ground state has been proved and its stability constant determined, K = (0,97 ± 0,06).10 4 dm 3 mol -1 . The role of this complex in the spectrofluorimetric determination of Ln(3) ions in the presence of acetylacetone has been discussed. (Authors)

  15. Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence

    Directory of Open Access Journals (Sweden)

    Keneuoe Hycianth Thinyane

    2015-01-01

    Full Text Available Meningitis causes significant morbidity and mortality globally. The aim of this study was to study the clinical presentation, aetiology, and outcomes of meningitis among adult patients admitted to Queen Mamohato Memorial Hospital in Maseru, Lesotho, with a diagnosis of meningitis. A cross-sectional study was conducted between February and April 2014; data collected included presenting signs and symptoms, laboratory results, and clinical outcomes. Descriptive statistics were used to summarise data; association between variables was analysed using Fisher’s exact test. 56 patients were enrolled; the HIV coinfection rate was 79%. The most common presenting symptoms were altered mental status, neck stiffness, headache, and fever. TB meningitis was the most frequent diagnosis (39%, followed by bacterial (27%, viral (18%, and cryptococcal meningitis (16%. In-hospital mortality was 43% with case fatalities of 23%, 40%, 44%, and 90% for TB, bacterial, cryptococcal, and viral meningitis, respectively. Severe renal impairment was significantly associated with mortality. In conclusion, the causes of meningitis in this study reflect the high prevalence of HIV and TB in our setting. Strategies to reduce morbidity and mortality due to meningitis should include improving diagnostic services to facilitate early detection and treatment of meningitis and timely initiation of antiretroviral therapy in HIV-infected patients.

  16. Tracking and Treating Mobile Populations. The TB Net System. Migrant Clinicians Network Monograph Series. = El Sistema de Red para la TB.

    Science.gov (United States)

    Migrant Clinicians Network, Inc., Austin, TX.

    A comprehensive tracking and referral network that helps provide continuity of care for mobile populations with active tuberculosis (TB) or TB infection is considered essential for effective treatment of TB. However, the interstate referral system that exists between state health departments has been highly inefficient for serving migrant…

  17. Taenia solium porcine cysticercosis in Madagascar: Comparison of immuno-diagnostic techniques and estimation of the prevalence in pork carcasses traded in Antananarivo city.

    Science.gov (United States)

    Porphyre, V; Betson, M; Rabezanahary, H; Mboussou, Y; Zafindraibe, N J; Rasamoelina-Andriamanivo, H; Costard, S; Pfeiffer, D U; Michault, A

    2016-03-30

    Taenia solium cysticercosis was reported in official veterinary and medical statistics to be highly prevalent in pigs and humans in Madagascar, but few estimates are available for pigs. This study aimed to estimate the seroprevalence of porcine cysticercosis among pigs slaughtered in Antananarivo abattoirs. Firstly, the diagnostic performance of two antigen-ELISA techniques (B158B60 Ag-ELISA and HP10 Ag-ELISA) and an immunoblotting method were compared with meat inspection procedures on a sample of pigs suspected to be infected with (group 1; n=250) or free of (group 2; n=250) T. solium based on direct veterinary inspection in Madagascar. Sensitivity and specificity of the antigen ELISAs were then estimated using a Bayesian approach for detection of porcine cysticercosis in the absence of a gold standard. Then, a third set of pig sera (group 3, n=250) was randomly collected in Antananarivo slaughterhouses and tested to estimate the overall prevalence of T. solium contamination in pork meat traded in Antananarivo. The antigen ELISAs showed a high sensitivity (>84%), but the B158B60 Ag-ELISA appeared to be more specific than the HP10 Ag-ELISA (model 1: 95% vs 74%; model 2: 87% vs 71%). The overall prevalence of porcine cysticercosis in Antananarivo slaughterhouses was estimated at 2.3% (95% credibility interval [95%CrI]: 0.09-9.1%) to 2.6% (95%CrI: 0.1-10.3%) depending on the model and priors used. Since the sample used in this study is not representative of the national pig population, village-based surveys and longitudinal monitoring at slaughter are needed to better estimate the overall prevalence, geographical patterns and main risk factors for T. solium contamination, in order to improve control policies. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Comparison of two interferon-gamma assays and tuberculin skin test for tracing tuberculosis contacts

    NARCIS (Netherlands)

    Arend, Sandra M.; Thijsen, Steven F. T.; Leyten, Eliane M. S.; Bouwman, John J. M.; Franken, Willeke P. J.; Koster, Ben F. P. J.; Cobelens, Frank G. J.; van Houte, Arend-Jan; Bossink, Ailko W. J.

    2007-01-01

    The tuberculin skin test (TST) has low specificity. QuantiFERON-TB Gold (QFT-G) and T-SPOT.TB are based on interferon (IFN)-gamma responses to Mycobacterium tuberculosis-specific antigens. A novel in-tube format of QFT-G (QFT-GIT) offers logistical advantages. To compare TST, QFT-GIT, and T-SPOT.TB

  19. Rapid detection of serum antibody by dual-path platform VetTB assay in white-tailed deer infected with Mycobacterium bovis.

    Science.gov (United States)

    Lyashchenko, Konstantin P; Greenwald, Rena; Esfandiari, Javan; O'Brien, Daniel J; Schmitt, Stephen M; Palmer, Mitchell V; Waters, W Ray

    2013-06-01

    Bovine tuberculosis (TB) in cervids remains a significant problem affecting farmed herds and wild populations. Traditional skin testing has serious limitations in certain species, whereas emerging serological assays showed promising diagnostic performance. The recently developed immunochromatographic dual-path platform (DPP) VetTB assay has two antigen bands, T1 (MPB83 protein) and T2 (CFP10/ESAT-6 fusion protein), for antibody detection. We evaluated the diagnostic accuracy of this test by using serum samples collected from groups of white-tailed deer experimentally inoculated with Mycobacterium bovis, M. avium subsp. paratuberculosis, or M. bovis BCG Pasteur. In addition, we used serum samples from farmed white-tailed deer in herds with no history of TB, as well as from free-ranging white-tailed deer culled during field surveillance studies performed in Michigan known to have bovine TB in the wild deer population. The DPP VetTB assay detected antibody responses in 58.1% of experimentally infected animals within 8 to 16 weeks postinoculation and in 71.9% of naturally infected deer, resulting in an estimated test sensitivity of 65.1% and a specificity of 97.8%. The higher seroreactivity found in deer with naturally acquired M. bovis infection was associated with an increased frequency of antibody responses to the ESAT-6 and CFP10 proteins, resulting in a greater contribution of these antigens, in addition to MPB83, to the detection of seropositive animals, compared with experimental M. bovis infection. Deer experimentally inoculated with either M. avium subsp. paratuberculosis or M. bovis BCG Pasteur did not produce cross-reactive antibodies that could be detected by the DPP VetTB assay. The present findings demonstrate the relatively high diagnostic accuracy of the DPP VetTB test for white-tailed deer, especially in the detection of naturally infected animals.

  20. A pivotal registration phase III, multicenter, randomized tuberculosis controlled trial: design issues and lessons learnt from the Gatifloxacin for TB (OFLOTUB project

    Directory of Open Access Journals (Sweden)

    Merle Corinne SC

    2012-05-01

    Full Text Available Abstract Background There have been no major advances in tuberculosis (TB drug development since the first East African/British Medical Research Council short course chemotherapy trial 35 years ago. Since then, the landscape for conducting TB clinical trials has profoundly changed with the emergence of HIV infection, the spread of resistant TB bacilli strains, recent advances in mycobacteriological capacity, and drug discovery. As a consequence questions have arisen on the most appropriate approach to design and conduct current TB trials. To highlight key issues discussed: Is a superiority, equivalence, or non-inferiority design most appropriate? What should be the primary efficacy outcome? How to consider re-infections in the definition of the outcome? What is the optimal length of patient follow-up? Is blinding appropriate when treatment duration in test arm is shorter? What are the appropriate assumptions for sample size calculation? Methods Various drugs are currently in the development pipeline. We are presenting in this paper the design of the most recently completed phase III TB trial, the OFLOTUB project, which is the pivotal trial of a registration portfolio for a gatifloxacin-containing TB regimen. It is a randomized, open-label, multicenter, controlled trial aiming to evaluate the efficacy and safety of a gatifloxacin-containing 4-month regimen (trial registration: ClinicalTrial.gov database: NCT00216385. Results In the light of the recent scientific and regulatory discussions, we discuss some of the design issues in TB clinical trials and more specifically the reasons that guided our choices, in order to best answer the trial objectives, while at the same time satisfying regulatory authority requirements. Conclusion When shortening TB treatment, we are advocating for a non-inferiority, non-blinded design, with a composite unfavorable endpoint assessed 12 months post treatment completion, and added trial procedures specifically

  1. The Impact of a Line Probe Assay Based Diagnostic Algorithm on Time to Treatment Initiation and Treatment Outcomes for Multidrug Resistant TB Patients in Arkhangelsk Region, Russia.

    Science.gov (United States)

    Eliseev, Platon; Balantcev, Grigory; Nikishova, Elena; Gaida, Anastasia; Bogdanova, Elena; Enarson, Donald; Ornstein, Tara; Detjen, Anne; Dacombe, Russell; Gospodarevskaya, Elena; Phillips, Patrick P J; Mann, Gillian; Squire, Stephen Bertel; Mariandyshev, Andrei

    2016-01-01

    In the Arkhangelsk region of Northern Russia, multidrug-resistant (MDR) tuberculosis (TB) rates in new cases are amongst the highest in the world. In 2014, MDR-TB rates reached 31.7% among new cases and 56.9% among retreatment cases. The development of new diagnostic tools allows for faster detection of both TB and MDR-TB and should lead to reduced transmission by earlier initiation of anti-TB therapy. The PROVE-IT (Policy Relevant Outcomes from Validating Evidence on Impact) Russia study aimed to assess the impact of the implementation of line probe assay (LPA) as part of an LPA-based diagnostic algorithm for patients with presumptive MDR-TB focusing on time to treatment initiation with time from first-care seeking visit to the initiation of MDR-TB treatment rather than diagnostic accuracy as the primary outcome, and to assess treatment outcomes. We hypothesized that the implementation of LPA would result in faster time to treatment initiation and better treatment outcomes. A culture-based diagnostic algorithm used prior to LPA implementation was compared to an LPA-based algorithm that replaced BacTAlert and Löwenstein Jensen (LJ) for drug sensitivity testing. A total of 295 MDR-TB patients were included in the study, 163 diagnosed with the culture-based algorithm, 132 with the LPA-based algorithm. Among smear positive patients, the implementation of the LPA-based algorithm was associated with a median decrease in time to MDR-TB treatment initiation of 50 and 66 days compared to the culture-based algorithm (BacTAlert and LJ respectively, ptime to MDR-TB treatment initiation of 78 days when compared to the culture-based algorithm (LJ, ptime to MDR diagnosis and earlier treatment initiation as well as better treatment outcomes for patients with MDR-TB. These findings also highlight the need for further improvements within the health system to reduce both patient and diagnostic delays to truly optimize the impact of new, rapid diagnostics.

  2. Management of MDR-TB in HIV co-infected patients in Eastern Europe

    DEFF Research Database (Denmark)

    Efsen, A M W; Schultze, A; Miller, R F

    2018-01-01

    below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better......OBJECTIVES: Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. METHODS: In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral...... access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care....

  3. Interferon-γ release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Diel, R; Goletti, D; Ferrara, G

    2011-01-01

    We conducted a systematic review and meta-analysis to compare the accuracy of the QuantiFERON-TB® Gold In-Tube (QFT-G-IT) and the T-SPOT®.TB assays with the tuberculin skin test (TST) for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). The Medline, Embase and Cochrane databases...... of IGRAs varied 98-100%. In immunocompetent adults, NPV for progression to tuberculosis within 2 yrs were 97.8% for T-SPOT®.TB and 99.8% for QFT-G-IT. When test performance of an immunodiagnostic test was not restricted to prior positivity of another test, progression rates to tuberculosis among IGRA...

  4. Energy transfer mechanism between Ce and Tb ions in sol–gel synthesized YSO crystals

    International Nuclear Information System (INIS)

    Chiriu, Daniele; Stagi, Luigi; Carbonaro, Carlo Maria; Corpino, Riccardo; Ricci, Pier Carlo

    2016-01-01

    The luminescence properties of Tb and Ce in Rare Earth Doped crystalline oxides largely depend on their relative concentrations: by increasing the dopant concentration, the luminescence profile changes from blue to green because of the energy transfer among centers. The kinetic properties of the luminescence of optically excited Terbium–Cerium co-doped Y_2SiO_5 sol–gel synthesized crystal powders have been investigated as a function of the Tb dopant concentration (Ce content fixed at 1% atomic). The interaction among different Tb emitting centers and their relation with Ce centers was explained within the Inokuti-Hirayama model for a dipole–dipole energy transfer mechanism in the low-middle Tb concentration range whilst the Forster–Dexter model was applied in the middle-high Tb concentration range. The kinetic model allows elucidating the role of sensitizer and activator ion as a function of Tb concentration, successfully estimating the energy transfer mechanism efficiency and calculating the critical Tb concentration. - Highlights: • The kinetic properties of Ce, Tb recombination in YSO matrix were studied. • The Inokuti-Hirayama and Forster–Dexter models were applied. • At high Tb content, the Ce to Tb energy transfer acts through the dipole−quadrupole. • At low Tb content, the Ce to Tb energy transfer acts through the dipole−dipole. • The presence of Ce reduces the critical Tb concentration (at low Tb content).

  5. Energy transfer mechanism between Ce and Tb ions in sol–gel synthesized YSO crystals

    Energy Technology Data Exchange (ETDEWEB)

    Chiriu, Daniele; Stagi, Luigi; Carbonaro, Carlo Maria; Corpino, Riccardo; Ricci, Pier Carlo, E-mail: carlo.ricci@dsf.unica.it

    2016-03-01

    The luminescence properties of Tb and Ce in Rare Earth Doped crystalline oxides largely depend on their relative concentrations: by increasing the dopant concentration, the luminescence profile changes from blue to green because of the energy transfer among centers. The kinetic properties of the luminescence of optically excited Terbium–Cerium co-doped Y{sub 2}SiO{sub 5} sol–gel synthesized crystal powders have been investigated as a function of the Tb dopant concentration (Ce content fixed at 1% atomic). The interaction among different Tb emitting centers and their relation with Ce centers was explained within the Inokuti-Hirayama model for a dipole–dipole energy transfer mechanism in the low-middle Tb concentration range whilst the Forster–Dexter model was applied in the middle-high Tb concentration range. The kinetic model allows elucidating the role of sensitizer and activator ion as a function of Tb concentration, successfully estimating the energy transfer mechanism efficiency and calculating the critical Tb concentration. - Highlights: • The kinetic properties of Ce, Tb recombination in YSO matrix were studied. • The Inokuti-Hirayama and Forster–Dexter models were applied. • At high Tb content, the Ce to Tb energy transfer acts through the dipole−quadrupole. • At low Tb content, the Ce to Tb energy transfer acts through the dipole−dipole. • The presence of Ce reduces the critical Tb concentration (at low Tb content).

  6. [Evaluation of TB-beads assay utilizing the technique of magnetic beads--an innovative assay method for detection of acid fast bacilli].

    Science.gov (United States)

    Ohkuma, Masanori; Ikeda, Katsuyoshi; Obayashi, Konen; Ando, Yukio; Koriyama, Toyoyasu; Kimu, Minhi; Hirose, Nobuyuki; Nagasawa, Zenzo; Miyamoto, Hiroshi

    2012-01-01

    The centrifuge method with the use of Semi-Alkalin Proteinase (SAP) and NALC-NaOH, recommended by the "2007 edition of the assay guideline for detection of Mycobacterium tuberculosis," has significantly contributed to improving the sensitivities and specificities of both smear and culture tests for detection of acid fast bacilli (AFB). However, this method poses some challenges in terms of its cumbersome and time-consuming assay protocol. "TB-beads (Kyokuto Pharmaceutical Industrial Co., Ltd.)" is a newly-developed method for detection of AFB utilizing magnetic beads. We evaluated the quality of this method in comparison with the centrifuge method, focusing on the results of smear and culture tests. This evaluation study was conducted using both 5 positive and 5 negative sputum samples. The sensitivity of TB-beads for fluorescent smear tests, conducted using "Acri-stain," was almost the same as that of the centrifuge method. One advantage of TB-beads, however, was that it was very convenient to practice microscopic observation due to the clear background of the smeared glass slides. The comparison of the contamination rates between the two methods showed that TB-beads suggested significantly lower contamination rates. The centrifuge method resulted in 50% and 60% of contamination rates for HK Semisolid Isolation Medium and BacT/ALERT MP, respectively. On the other hand, the contamination rates of TB-beads for both of the culture methods were only 10%. With regard to the 5 positive sputum samples, the comparison of the detection rates between the centrifuge and TB-Beads method was made utilizing Myco Acid, Ogawa K, and BacT/ALERT MP. The TB-Beads method suggested higher detection rates for Myco Acid and Ogawa K, while there were no significant differences between the two methods for BacT/ALERT MP (16-23 days). TB-beads is an easy method that allows to simplify the process of smear tests, and contributes to significantly reducing the contamination rate of culture

  7. Litigation as TB Rights Advocacy: A New Delhi Case Study.

    Science.gov (United States)

    McBroom, Kerry

    2016-06-01

    One thousand people die every day in India as a result of TB, a preventable and treatable disease, even though the Constitution of India, government schemes, and international law guarantee available, accessible, acceptable, quality health care. Failure to address the spread of TB and to provide quality treatment to all affected populations constitutes a public health and human rights emergency that demands action and accountability. As part of a broader strategy, health activists in India employ Public Interest Litigation (PIL) to hold the state accountable for rights violations and to demand new legislation, standards for patient care, accountability for under-spending, improvements in services at individual facilities, and access to government entitlements in marginalized communities. Taking inspiration from right to health PIL cases (PILs), lawyers in a New Delhi-based rights organization used desk research, fact-findings, and the Right To Information Act to build a TB PIL for the Delhi High Court, Sanjai Sharma v. NCT of Delhi and Others (2015). The case argues that inadequate implementation of government TB schemes violates the Constitutional rights to life, health, food, and equality. Although PILs face substantial challenges, this paper concludes that litigation can be a crucial advocacy and accountability tool for people living with TB and their allies.

  8. Solution growth of Tb doped Gd_2O_3 film

    International Nuclear Information System (INIS)

    Ghosh, M.; Pitale, S.; Desai, D.G.; Patra, G.D.; Sen, S.; Gadkari, S.C.

    2016-01-01

    Nanomaterials of Gd_2O_3 have proven applications in medical imaging and cancer therapy due to the presence of element Gd. Also Gd_2O_3 films have been grown by vapor phase method as well as self assembly in solution and studied as a high-k dielectric and efficient luminescence material. Here, we report a method to obtain Tb doped Gd_2O_3 film by solution growth method followed by suitable heat treatment. Uniform films of Tb doped Gadolinium hydroxycarbonate have been deposited on fused quartz substrates kept inside a solution containing gadolinium nitrate, terbium nitrate and Urea maintained at 90°C. Gadolinium hydroxy-carbonate films are then treated at 800°C for 2 hour to obtain Tb doped cubic Gd_2O_3 as confirmed by X-ray diffraction measurement. The photoluminescence spectra display characteristic Tb emission at 544 nm when excited at 285 nm. The lifetime of Tb emission is found to be of the order of few microseconds. (author)

  9. EXAFS study of Tb-doped silica xerogels

    International Nuclear Information System (INIS)

    Rocca, F.; Monti, F.; Kuzmin, A.; Dalmaso, A.; Pasqualini, D.

    1999-01-01

    The modification of the local environment of Tb 3+ ions in optically active silica xerogels as a function of concentration (from 400 ppm to 40000 ppm) and thermal treatment (which induces densification) was studied by x-ray absorption spectroscopy at the Tb L 3 edge. Quantitative analysis of the first Tb-O coordination shell was performed using the experimental signal from Tb 3+ ions in water solution as a reference. The radial distribution functions (RDF) of the non-thermally treated (NT) gels are characterised by a nearly gaussian shape, as for the reference sample. On the contrary, the RDF of the densified gels (T) are asymmetric having the main peak at a shorter distance, with a reduced coordination number (N=4-5) and a secondary peak, with N=1-2, at a longer distance. The local environment of Tb in the low concentration sample (400 ppm) is different from that at higher concentrations, both in the NT- and in the T-gels. (au)

  10. EXAFS study of Tb-doped silica xerogels

    Energy Technology Data Exchange (ETDEWEB)

    Rocca, F. [CeFsa - Centro CNR-ITC de Fisica degli Stati Aggregati, Povo (Italy); Monti, F. [Univ. de Verona, Facolta di Scienze (Italy); Kuzmin, A. [Inst. of Solid State Physics, Riga (Latvia); Dalmaso, A.; Pasqualini, D. [Univ. di Trento, INFM - Dipartimento di Fisica (Italy)

    1999-11-01

    The modification of the local environment of Tb{sup 3+} ions in optically active silica xerogels as a function of concentration (from 400 ppm to 40000 ppm) and thermal treatment (which induces densification) was studied by x-ray absorption spectroscopy at the Tb L{sub 3} edge. Quantitative analysis of the first Tb-O coordination shell was performed using the experimental signal from Tb{sup 3+} ions in water solution as a reference. The radial distribution functions (RDF) of the non-thermally treated (NT) gels are characterised by a nearly gaussian shape, as for the reference sample. On the contrary, the RDF of the densified gels (T) are asymmetric having the main peak at a shorter distance, with a reduced coordination number (N=4-5) and a secondary peak, with N=1-2, at a longer distance. The local environment of Tb in the low concentration sample (400 ppm) is different from that at higher concentrations, both in the NT- and in the T-gels. (au) 15 refs.

  11. EXAFS study of Tb-doped silica xerogels

    CERN Document Server

    Rocca, F; Kuzmin, A; Dalmaso, A; Pasqualini, D

    1999-01-01

    The modification of the local environment of Tb/sup 3+/ ions in optically active silica xerogels as a function of concentration (from 400 ppm to 40000 ppm) and thermal treatment (which induces densification) was studied by X-ray absorption spectroscopy at the Tb L/sub 3/ edge. Quantitative analysis of the first Tb-O coordination shell was performed using the experimental signal from Tb/sup 3+/ ions in water solution as a reference. The radial distribution functions (RDF) of the non-thermally treated (NT) gels are characterized by a nearly Gaussian shape, as for the reference sample. On the contrary, the RDF of the densified gels (T) are asymmetric having the main peak at a shorter distance, with a reduced coordination number (N=4-5) and a secondary peak, with N=1-2, at a longer distance. The local environment of Tb in the low concentration sample (400 ppm) is different from that at higher concentrations, both in the NT- and in the T-gels. (15 refs).

  12. Magnetic Interactions in Tb and Tb-10% Ho from Inelastic Neutron Scattering

    DEFF Research Database (Denmark)

    Bjerrum Møller, Hans; Houmann, Jens Christian Gylden; Mackintosh, A.R.

    1968-01-01

    The magnon dispersion relations and lifetimes have been measured in Tb and a Tb‐10% Ho alloy by inelastic neutron scattering, in regions of both ferromagnetic and spiral ordering. In the ferromagnetic phase, the magnon energy is generally finite at zero wavevector and rises quadratically at low q....... The magnon energies scale approximately with the magnetization. In the spiral phase the magnon energy rises linearly from zero at low q. The Fourier‐transformed exchange parameter J(q) has pronounced peaks in the c direction, which are ascribed to transitions between states close to the Fermi surface....... These peaks are less pronounced in the ferromagnetic phase. The primary mechanism limiting the magnon lifetimes appears to be interaction with the conduction electrons. In the alloy, the lifetime for magnons propagating in the c direction in the ferromagnetic phase falls abruptly at about q  =  0.35 Å−1...

  13. Outcomes and Impact of HIV Prevention, ART and TB Programs in Swaziland – Early Evidence from Public Health Triangulation

    Science.gov (United States)

    van Schalkwyk, Cari; Mndzebele, Sibongile; Hlophe, Thabo; Garcia Calleja, Jesus Maria; Korenromp, Eline L.; Stoneburner, Rand; Pervilhac, Cyril

    2013-01-01

    Introduction Swaziland’s severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment (ART) program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling (HTC), tuberculosis (TB) and prevention of mother to child transmission (PMTCT). Methods Data triangulated include intervention coverage and outcomes according to program registries (2001-2010), hospital admissions and deaths disaggregated by age and sex (2001-2010) and population mortality estimates from the 1997 and 2007 censuses and the 2007 demographic and health survey. Results By 2010, ART reached 70% of the estimated number of people living with HIV/AIDS with CD4<350/mm3, with progressively improving patient retention and survival. As of 2010, 88% of health facilities providing antenatal care offered comprehensive PMTCT services. The HTC program recorded a halving in the proportion of adults tested who were HIV-infected; similarly HIV infection rates among HIV-exposed babies halved from 2007 to 2010. Case fatality rates among hospital patients diagnosed with HIV/AIDS started to decrease from 2005–6 in adults and especially in children, contrasting with stable case fatality for other causes including TB. All-cause child in-patient case fatality rates started to decrease from 2005–6. TB case notifications as well as rates of HIV/TB co-infection among notified TB patients continued a steady increase through 2010, while coverage of HIV testing and CPT for co-infected patients increased to above 80%. Conclusion Against a background of high, but stable HIV prevalence and decreasing HIV incidence, we documented early evidence of a mortality decline associated with the expanded national HIV response since 2004. Attribution of impact to specific interventions (versus natural epidemic dynamics) will require additional data from future

  14. State of affairs of tuberculosis in prison facilities: a systematic review of screening practices and recommendations for best TB control

    NARCIS (Netherlands)

    Vinkeles Melchers, Natalie V. S.; van Elsland, Sabine L.; Lange, Joep M. A.; Borgdorff, Martien W.; van den Hombergh, Jan

    2013-01-01

    Prisoners are at high risk of developing tuberculosis (TB), causing morbidity and mortality. Prison facilities encounter many challenges in TB screening procedures and TB control. This review explores screening practices for detection of TB and describes limitations of TB control in prison

  15. Active Sputum Monitoring Detects Substantial Rate of Multi-Drug Resistant Tuberculosis (MDR-TB) in an HIV-Infected Population in South Africa

    Science.gov (United States)

    Hassim, Shaheen; Shaw, Pamela A.; Sangweni, Phumelele; Malan, Lizette; Ntshani, Ella; Mathibedi, Monkwe Jethro; Stubbs, Nomso; Metcalf, Julia A; Eckes, Risa; Masur, Henry; Komati, Stephanus

    2010-01-01

    Background Tuberculosis (TB) co-infection with HIV is a substantial problem in South Africa. There has been a presumption that drug resistant strains of TB are common in South Africa, but few studies have documented this impression. Methods In Phidisa, a joint observational and randomized HIV treatment study for South African National Defence Force members and dependents, an initiative obtained microbiologic TB testing in subjects who appeared to be at high risk. We report results for HIV-infected subjects. Results TB was identified by culture in 116/584 (19.9%) of patients selected for sputum examination on the basis of suggestive symptoms. Smear was an insensitive technique for confirming the diagnosis: only 33% of culture-positive patients were identified by smear, with a 0.2% false positive rate. Of the 107 culture-positive individuals with susceptibility testing, 22 (20.6%) were identified to be MDR and 4 (3.7%) became extremely drug resistant tuberculosis (XDR) while under observation. Culture-positive cases with a history of TB treatment had more than twice the rate of MDR than those without, 27.1% vs. 11.9% (p=0.05). Conclusions TB is common in this cohort of HIV-infected patients. Smear was not a sensitive technique for identifying culture-positive cases in this health system. Drug susceptibility testing is essential to proper patient management because MDR was present in 20.6% of culture-positive patients. Better management strategies are needed to reduce the development of MDR-TB since so many such patients had received prior antituberculous therapy that was presumably not curative. PMID:20196651

  16. Difference in TB10.4 T-cell epitope recognition following immunization with recombinant TB10.4, BCG or infection with Mycobacterium tuberculosis

    DEFF Research Database (Denmark)

    Billeskov, Rolf; Grandal, Michael V; Poulsen, Christian

    2010-01-01

    vaccine Ag, TB10.4, in a recombinant form, or when expressed by the pathogen Mycobacterium tuberculosis (M.tb), or by the current anti-tuberculosis vaccine, Mycobacterium bovis BCG. We showed that BCG and M.tb induced a similar CD4(+) T-cell specific TB10.4 epitope-pattern, which differed completely from...... that induced by recombinant TB10.4. This difference was not due to post-translational modifications of TB10.4 or because TB10.4 is secreted from BCG and M.tb as a complex with Rv0287. In addition, BCG and TB10.4/CAF01 were both taken up by DC and macrophages in vivo, and in vitro uptake experiments revealed...... that both TB10.4 and BCG were transported to Lamp(+)-compartments. BCG and TB10.4 however, were directed to different types of Lamp(+)-compartments in the same APC, which may lead to different epitope recognition patterns. In conclusion, we show that different vectors can induce completely different...

  17. Preparation and characterization of Tb3+ and Tb(sal)3.nH2O doped PC:PMMA blend

    International Nuclear Information System (INIS)

    Dwivedi, Y.; Singh, A.K.; Prakash, Rajiv; Rai, S.B.

    2011-01-01

    Tb doped polycarbonate:poly(methyl methacrylate) (Tb-PC:PMMA) blend was prepared with varying proportions of PC and PMMA. Thermal and spectroscopic properties of the doped polymer have been investigated employing Fourier Transform Infrared (FTIR) absorption and differential scanning calorimetric (DSC) techniques. PC:PMMA blend (with 10 wt% PC and 90 wt% PMMA) shows better miscibility. Optical properties of the dopant Tb 3+ ions have been investigated using UV-vis absorption and fluorescence excited by 355 nm radiation. It is seen that luminescence intensity of Tb 3+ ion depends on PC:PMMA ratio and on Tb 3+ ion concentration. Concentration quenching is seen for TbCl 3 .6H 2 O concentration larger than 4 wt%. Addition of salicylic acid to the polymer blend increases the luminescence from Tb 3+ ions. Luminescence decay curve analysis affirms the non-radiative energy transfer from salicylic acid to Tb 3+ ions, which is identified as the reason behind this enhancement. - Highlights: → Blend formation is confirmed at PC/90PMMA, using FTIR and DSC techniques. → Absorption and bandgap studies of blend and parent components were studied. → Optical properties of Tb and Tb(sal) 3 .nH 2 O complex have been studied in PC/PMMA blend. → Luminescence decay curves confirm non-radiative energy transfer from Sal to Tb 3+ ions.

  18. KEMANDIRIAN MASYARAKAT DALAM PERILAKU PENCEGAHAN PENULARAN PENYAKIT TB PARU

    Directory of Open Access Journals (Sweden)

    Niniek Lely Pratiwi

    2013-03-01

    Full Text Available ABSTRACT Background: Prevention of tuberculosis, particularly pulmonary tuberculosis in lndonesia was started in 1969, but the number of pulmonary TB patients is increasing. Methods:Ethnographic qualitative study aims to assess the independence of the community effort in preventing pulmonary TB disease transmission. Methods: of data collection participatory observation, in-depth interviews with informants pulmonary TB patients and families. Research sites in the city of Pariaman, West Lombok district and the district Rote Ndao NTT. Results:The analysis of four independent indicators of the knowledge society is stilllow considering that most of the informants consider pulmonary TB disease as a hereditary disease, and infectious diseases as the people in the district Hossa Rote Ndao. Illness perceptions of people in the city of Pariaman, pulmonary TB disease as a disease because "ismeken", due to use-for others who are not happy ln the town of West Lombok fear of stigma, shame as people with TB, so there are many people who call it the perception of illness as a disease of old cough, dry cough of 40 days, and asthma. Confidence/trust society still depends on health workers, yet there are cadres who provide direct counseling on prevention of transmission. Capability community is lacking, people still believe in the health care workers to provide counseling. Selection of the PMO staff (Supervisors taking medication were not appropriate to the social structures that exist in society Lobar districts with 'sasak' social structure, then the host teacher, 'Kyai' can be as social support surrounding communities. 'Kyai' expected to affect the mindset of people, motivate people to air PHBs. Rote Ndao district as a social support from church leaders as well as the city of Pariaman, a descendant of the king, can motivate people. Participatory community by providing prevention counseling in a variety of pulmonary TB disease or group of containers carried on a

  19. Fusion cross sections measurement for 6Li + 159Tb

    International Nuclear Information System (INIS)

    Pradhan, M.K.; Mukherjee, A.; Kshetri, R.; Roy, Subinit; Basu, P.; Goswami, A.; Saha Sarkar, M.; Ray, M.; Parkar, V.; Santra, S.; Kailas, S.; Palit, R.

    2009-01-01

    In order to investigate the effect of projectile breakup threshold energy on fusion in mass region around A∼170, we have carried out a systematic investigation of the fusion (both CF and ICF) cross sections for the systems 11 B, 10 B + 159 Tb and 7 Li + 159 Tb at energies near and close to the barrier where 11 B was considered to be a strongly bound nucleus. The nucleus 10 B has a α-separation energy of 4.5 MeV. The measurements show that the extent of suppression of CF cross sections is correlated with the α-separation energies of the projectiles. As a further continuation of this work, we have recently carried out fusion excitation function measurement for the system 6 Li + 159 Tb (Coulomb barrier 27 MeV) at energies near and close to the barrier

  20. Inhibition of placenta growth factor with TB-403

    DEFF Research Database (Denmark)

    Nielsen, Dorte Lisbet; Sengeløv, Lisa

    2012-01-01

    INTRODUCTION: There is clinical evidence that therapies targeting the vascular endothelial growth factor pathway are effective in delaying cancer progression. However, tumors may be either intrinsically resistant or evolve resistance to such therapies. Hence, there is a need for new therapies...... targeting angiogenesis. AREAS COVERED: The data are obtained by searching in the PubMed database. The search terms used included antiangiogenic therapy, TB-403 (RO5323441), placenta growth factor (PlGF) and VEGFR-1 (Flt-1). We review preclinical data concerning the function and inhibition of Pl......GF and summarize data on expression of PlGF in cancer patients. Data from early-phase clinical trials of TB-403 (RO5323441), a monoclonal antibody inhibiting PlGF, are discussed. Future development strategies, therapeutic potentials and limitations of TB-403 are further evaluated. EXPERT OPINION: There are some...

  1. [The clinical application of quantiferon TB-2G: its usefulness and limitations].

    Science.gov (United States)

    Sato, Shigeki; Nagai, Hideaki

    2011-02-01

    under exceptional circumstances. (1) How do we manage kidney transplant recipients with latent tuberculosis infection?: Norihiko GOTO (Transplant Surgery, Nagoya Daini Red Cross Hospital) It is unclear whether QuantiFERON-second generation (QFT-2G) is useful for diagnostic screening and follow up of latent tuberculosis infection (LTBI) in immunosuppressed kidney transplant (KTx) recipients. The QFT-2G assay that included response to mitogen stimulation was performed before and 6 months after KTx. Non responder was 0 (0%) at baseline, 3 (3%) at 6 months. Response to mitogen stimulation was 9.7 +/- 5.3 IU/mL at baseline vs. 10.4 +/- 5.0 IU/mL at 6 months after KTx (p = 0.29). QFT-2G is a useful screening test for LTBI and active tuberculosis (TB) even during maintenance of immunosuppression of KTx. (2) QuantiFERON-TB Gold in Japanese rheumatoid arthritis patients for assessing latent tuberculosis infection prior treatment of anti-tumor necrosis factor antibody: Shogo BANNO (Division of Rheumatology and Nephrology, Department of Internal Medicine, Aichi Medical School of Medicine) To determine the positive rate of LTBI in RA patients using the QFT-2G test, we divided RA patients into two groups: with or without old TB findings by chest CT. With a cutoff level set at 0.35 IU/ml, the positive rate of QFT-2G in LTBI was detected only 5.8%, when setting cutoff at 0.1 IU/ml (lower cutoff level), 23.1% was detected in LTBI patients. The positive TST results were significantly increased in non-LTBI patients compared than in LTBI patients. The QFT-2G test was not affected by the treatment of MTX, and the incidence of indeterminate result was low. The QFT-2G was useful compared to TST before administration of TNF inhibitors in RA patients, because of superior specificity of QFT-2G. (3) Clinical parameters that influence the sensitivity of T-cell assays: Haruyuki ARIGA (National Hospital Organization Tokyo National Hospital) The detection of tuberculosis (TB) infection in

  2. MDR-TB Outbreak among HIV-Negative Tunisian Patients followed during 11 Years.

    Directory of Open Access Journals (Sweden)

    Naira Dekhil

    Full Text Available Multidrug-resistant tuberculosis (MDR-TB outbreaks that evolve, from the outset, in a context strictly negative for HIV infection deserve special consideration since they reflect the true intrinsic epidemic potential of the causative strain. To our knowledge, the long-term evolution of such exceptional outbreaks and the treatment outcomes for the involved patients has never been reported hitherto. Here we provide a thorough description, over an 11-year period, of an MDR-TB outbreak that emerged and expanded in an HIV-negative context, Northern Tunisia.From October 2001 to June 2011, the MDR-TB outbreak involved 48 HIV-negative individuals that are mainly young (mean age 31.09 yrs; 89.6% male and noninstitutionalized. Drug susceptibility testing coupled to mutational analysis revealed that initial transmission involved an isolate that was simultaneously resistant to isoniazid, rifampicin, ethambutol, and streptomycin. The causative Haarlem3-ST50 outbreak strain expanded mainly as an 11-banded IS6110 RFLP profile (77.1%, from which a 12-banded subclone evolved. After undergoing a 2-year treatment with second-line drugs, 22 (45.8% patients were cured and 3 (6.2% completed treatment, thus yielding an overall treatment success rate of 52.1%. Among the patients that experienced unfavorable treatment outcomes, 10 (20.8% failed treatment, 3 (6.2% were lost to follow-up, 5 (10.4% died, and 5 (10.4% could not be evaluated. Poor adherence to treatment was found to be the main independent predictor of unfavorable outcomes (HR: 9.15; 95% CI 1.72-48.73; P = 0.014. Intriguingly, the evolved 12-banded subclone proved significantly associated with unfavorable outcomes (HR: 4.90; 95% CI 1.04-23.04, P = 0.044. High rate of fatality and relapse was further demonstrated at the long-term, since 70% of those whose treatment failed have died, and 24% among those deemed successfully treated have relapsed.Taken together, the data obtained in this study indicate that MDR-TB

  3. Diagnostic value of T-Spot TB combined with INF-γ and IL-27 in tuberculous pleurisy.

    Science.gov (United States)

    Zhang, Meng; Xiong, Dedong; Li, Hongxia; Wang, Zonglan; Li, Renzhe

    2018-02-01

    The purpose of the present study was to investigate the diagnostic value of T cells spot test (T-Spot TB) combined with interferon-γ (INF-γ) and interleukin-27 (IL-27) in tuberculous pleurisy. Sixty patients with tuberculous pleurisy (observation group) and 60 patients with non-tuberculous pleurisy (control group) were enrolled in this study. T-Spot TB was performed to detect the pleural effusion of two groups of patients. Levels of IFN-γ and IL-27 in serum and pleural effusion were detected by enzyme-linked immunosorbent assay (ELISA). Relative expression of IFN-γ mRNA and IL-27 mRNA in peripheral blood mononuclear cells were detected by RT-PCR. Positive rate of T-Spot TB in observation group was 96.7% (58 cases), which was significantly higher than that in control group (pSpot TB with INF-γ and IL-27 has significant application value in the clinical diagnosis of tuberculous pleurisy, and should be popularized.

  4. Reaching out to take on TB in Somalia.

    Science.gov (United States)

    Moore, David A J; Granat, Simo M

    2014-01-01

    Among the many challenges facing populations disrupted by complex emergencies, personal security and food security rank much higher than access to healthcare. However, over time health needs assume increasing importance. Many complex crises occur in settings where the background incidence of TB is already high; social and economic conditions in crises are then highly conducive to amplification of the existing TB problem. Innovative approaches to delivery of diagnostic and treatment services, transition planning and integration with other healthcare providers and services are vital. In the extremely challenging environment of Somalia, multiple partners are making headway though collaboration and innovation.

  5. Analysis of the fourth spectrum of terbium (Tb IV)

    International Nuclear Information System (INIS)

    Spector, N.; Sugar, J.

    1976-01-01

    The low-energy level structure of Tb 3+ has been derived from spectra obtained with a sliding spark light source. The 7 F ground term of the 4f 8 configuration was found as well as all levels of the configurations 4f 7 5d, 6s, and 6p built on the 8 S 7 / 2 core state of 4f 7 . Of the possible 51 lines connecting these levels, 48 were observed. Optimized radial parameters are given for the observed configurations. A value for the ionization energy of 39.37(0.10) eV is derived for Tb 3+

  6. Optimal treatment interruptions control of TB transmission model

    Science.gov (United States)

    Nainggolan, Jonner; Suparwati, Titik; Kawuwung, Westy B.

    2018-03-01

    A tuberculosis model which incorporates treatment interruptions of infectives is established. Optimal control of individuals infected with active TB is given in the model. It is obtained that the control reproduction numbers is smaller than the reproduction number, this means treatment controls could optimize the decrease in the spread of active TB. For this model, controls on treatment of infection individuals to reduce the actively infected individual populations, by application the Pontryagins Maximum Principle for optimal control. The result further emphasized the importance of controlling disease relapse in reducing the number of actively infected and treatment interruptions individuals with tuberculosis.

  7. Random anisotropy studies in amorphous Co-Tb ribbons

    International Nuclear Information System (INIS)

    Hassanain, N.; Berrada, A.; Lassri, H.; Krishnan, R.

    1995-01-01

    Amorphous Co 1-x Tb x ribbons with x=0.45, 0.55 and 0.65 have been prepared by melt spinning technique. Magnetization measurements were carried out at 4.2 K, under magnetic fields up to 150 kOe. The Co moment is found to be very small and the Tb moment is 7.15μ B at 4.2 K, which indicates a speromagnetic spin structure. Using Chudnovsky's theory we have extracted some fundamental magnetic parameters. ((orig.))

  8. Random anisotropy studies in amorphous CoTb ribbons

    Science.gov (United States)

    Hassanain, N.; Berrada, A.; Lassri, H.; Krishnan, R.

    1995-02-01

    Amorphous Co 1- xTb x ribbons with x = 0.45, 0.55 and 0.65 have been prepared by melt spinning technique. Magnetization measurements were carried out at 4.2 K, under magnetic fields up to 150 kOe. The Co moment is found to be very small and the Tb moment is 7.15 μB at 4.2 K, which indicates a speromagnetic spin structure. Using Chudnovsky's theory we have extracted some fundamental magnetic parameters.

  9. Decay out of superdeformed bands in Tb isotopes

    International Nuclear Information System (INIS)

    Petrache, C.M.; Beck, F.A.; Flibotte, S.; France, G. de; Theisen, C.; Vivien, J.P.

    1995-01-01

    Excited states in the 150,151,152 Tb isotopes have been investigated using the 130 Te( 27 Al, xn) reaction and the EUROGAM array. The theoretical interpretation of the level schemes has been performed in the framework of the deformed independent particle model. The feeding patterns of the normal-deformed states by the superdeformed bands in 150,151 Tb istopes have also been established. The results indicate that the decay-out mechanism of the bands is not of purely statistical nature, but depends on the configurations of both normal- and superdeformed states. (orig.)

  10. Divergent Small Tim Homologues Are Associated with TbTim17 and Critical for the Biogenesis of TbTim17 Protein Complexes in Trypanosoma brucei

    Science.gov (United States)

    Smith, Joseph T.; Singha, Ujjal K.; Misra, Smita

    2018-01-01

    ABSTRACT The small Tim proteins belong to a group of mitochondrial intermembrane space chaperones that aid in the import of mitochondrial inner membrane proteins with internal targeting signals. Trypanosoma brucei, the protozoan parasite that causes African trypanosomiasis, possesses multiple small Tim proteins that include homologues of T. brucei Tim9 (TbTim9) and Tim10 (TbTim10) and a unique small Tim that shares homology with both Tim8 and Tim13 (TbTim8/13). Here, we found that these three small TbTims are expressed as soluble mitochondrial intermembrane space proteins. Coimmunoprecipitation and mass spectrometry analysis showed that the small TbTims stably associated with each other and with TbTim17, the major component of the mitochondrial inner membrane translocase in T. brucei. Yeast two-hybrid analysis indicated direct interactions among the small TbTims; however, their interaction patterns appeared to be different from those of their counterparts in yeast and humans. Knockdown of the small TbTims reduced cell growth and decreased the steady-state level of TbTim17 and T. brucei ADP/ATP carrier (TbAAC), two polytopic mitochondrial inner membrane proteins. Knockdown of small TbTims also reduced the matured complexes of TbTim17 in mitochondria. Depletion of any of the small TbTims reduced TbTim17 import moderately but greatly hampered the stability of the TbTim17 complexes in T. brucei. Altogether, our results revealed that TbTim9, TbTim10, and TbTim8/13 interact with each other, associate with TbTim17, and play a crucial role in the integrity and maintenance of the levels of TbTim17 complexes. IMPORTANCE Trypanosoma brucei is the causative agent of African sleeping sickness. The parasite’s mitochondrion represents a useful source for potential chemotherapeutic targets. Similarly to yeast and humans, mitochondrial functions depend on the import of proteins that are encoded in the nucleus and made in the cytosol. Even though the machinery involved in this

  11. Oxidative Stress Markers in Tuberculosis and HIV/TB Co-Infection.

    Science.gov (United States)

    Rajopadhye, Shreewardhan Haribhau; Mukherjee, Sandeepan R; Chowdhary, Abhay S; Dandekar, Sucheta P

    2017-08-01

    Dysfunction of redox homeostasis has been implicated in many pathological conditions. An imbalance of pro- and anti-oxidants have been observed in Tuberculosis (TB) and its co-morbidities especially HIV/AIDS. The pro inflammatory milieu in either condition aggravates the physiological balance of the redox mechanisms. The present study therefore focuses on assessing the redox status of patients suffering from TB and HIV-TB co-infection. To assess the oxidative stress markers in the HIV-TB and TB study cohort. The current prospective study was conducted in Haffkine Institute, Parel, Maharashtra, India, during January 2013 to December 2015. Blood samples from 50 patients each suffering from active TB and HIV-TB co-infection were collected from Seth G.S.Medical College and KEM Hospital Mumbai and Group of Tuberculosis Hospital, Sewree Mumbai. Samples were processed and the experiments were carried out at the Department of Biochemistry, Haffkine Institute. Samples from 50 healthy volunteers were used as controls. Serum was assessed for pro-oxidant markers such as Nitric Oxide (NO), Thiobarbituric Acid Reactive Species (TBARS), C-Reactive Protein (CRP), superoxide anion. Antioxidant markers such as catalase and Superoxide Dismutase (SOD) were assessed. Total serum protein, was also assessed. Among the pro-oxidants, serum NO levels were decreased in TB group while no change was seen in HIV-TB group. TBARS and CRP levels showed significant increase in both groups; superoxide anion increased significantly in HIV-TB group. Catalase levels showed decreased activities in TB group. SOD activity significantly increased in HIV-TB but not in TB group. The total serum proteins were significantly increased in HIV-TB and TB groups. The values of Control cohort were with the normal reference ranges. In the present study, we found the presence of oxidative stress to be profound in the TB and HIV-TB co-infection population.

  12. Usefulness of the mycobacterium tuberculosis direct assay in early diagnosis of extrapulmonary TB

    Directory of Open Access Journals (Sweden)

    Zhang Hui-Zhang

    2014-01-01

    Full Text Available The aim of this study was to evaluate the in situ detection of living mycobacterium TB rRNA by the mycobacterium TB direct assay (MTD and its clinical significance in the early diagnosis of extrapulmonary TB. Eighty-six patients were recruited from the Shanghai Public Health Clinical Center from June to November in 2010, having been diagnosed with extrapulmonary TB, including tuberculous peritonitis (n=22, lymphatic TB (n=21, tuberculous meningitis (n=15, HIV-associated TB (n=13, nephroTB (n=9, spinal TB (n=2, cutaneous TB (n=13, parotid TB (n=1, chest wall TB (n=1, intestinal TB (n=1. One hundred and five extrapulmonary specimens, including CSF, puncture fluid, drainage, pleural fluid, urine, secretion, ascites, lymphatic tissue and marrow were collected from the patients. The samples were examined using acid-fast stain, solid culture, liquid culture and MTD in parallel. In MTD, the target segments of MTB rRNA in either cultures or clinical specimens were amplified prior to being qualitatively detected with the hybridization protection assay (HPA. The sensitivities of MTD and acid-fast staining in liquid and solid cultures were 48.6%, 41.9%, 20.0% and 14.3%, respectively. MTD sensitivity was higher than that of the others and its specificity was 100%. We concluded that MTD rRNA detection is an effective, rapid, convenient, sensitive and reliable method for the early diagnosis of extrapulmonary TB.

  13. The isothermal section at 500 deg. C of the Gd-Tb-Ga ternary system

    International Nuclear Information System (INIS)

    Li, J.Q.; Jian, Y.X.; Ao, W.Q.; Zhuang, Y.H.; He, W.

    2006-01-01

    Phase equilibria in the Gd-Tb-Ga ternary system at 500 deg. C were investigated by X-ray powder diffraction and differential scanning calorimetry. The binary compounds, Gd 5 Ga 3 , Gd 3 Ga 2 , GdGa, GdGa 2 , Tb 5 Ga 3 , TbGa, TbGa 2 and TbGa 3 have been confirmed at 500 deg. C. No ternary compound was found in this system. The isothermal section of this system at 500 deg. C was constructed. It is composed of 7 single-phase regions, 8 two-phase regions and 2 three-phase regions. Four ternary continuous solid solutions (Gd, Tb), (Gd, Tb) 5 Ga 3 , (Gd, Tb)Ga, (Gd, Tb)Ga 2 were formed in this isothermal section. The maximum solid solubilities of Ga in (Gd, Tb) at 500 deg. C is 5.0 at.%. The homogeneity range of (Gd, Tb)Ga 2 is from 20 to 33.3 at.% Ga in Gd-Ga side but limited in Tb-Ga side. The solid solubilities of Ga in the other phases cannot be detected. The Curie temperatures of the Gd 0.6 Tb 0.4-x Ga x alloys increase from 270 to 298 K as x increases from 0 to 0.03

  14. Operational challenges in diagnosing multi-drug resistant TB and initiating treatment in Andhra Pradesh, India.

    Directory of Open Access Journals (Sweden)

    Sarabjit S Chadha

    Full Text Available BACKGROUND: Revised National TB Control Programme (RNTCP, Andhra Pradesh, India. There is limited information on whether MDR-TB suspects are identified, undergo diagnostic assessment and are initiated on treatment according to the programme guidelines. OBJECTIVES: To assess i using the programme definition, the number and proportion of MDR-TB suspects in a large cohort of TB patients on first-line treatment under RNTCP ii the proportion of these MDR-TB suspects who underwent diagnosis for MDR-TB and iii the number and proportion of those diagnosed as MDR-TB who were successfully initiated on treatment. METHODS: A retrospective cohort analysis, by reviewing RNTCP records and reports, was conducted in four districts of Andhra Pradesh, India, among patients registered for first line treatment during October 2008 to December 2009. RESULTS: Among 23,999 TB patients registered for treatment there were 559 (2% MDR-TB suspects (according to programme definition of which 307 (55% underwent diagnosis and amongst these 169 (55% were found to be MDR-TB. Of the MDR-TB patients, 112 (66% were successfully initiated on treatment. Amongst those eligible for MDR-TB services, significant proportions are lost during the diagnostic and treatment initiation pathway due to a variety of operational challenges. The programme needs to urgently address these challenges for effective delivery and utilisation of the MDR-TB services.

  15. Development and optimization of an ESAT6-ELISA-based detection system of Mycobacterium tuberculosis complex, suitable for bovine TB eradication

    Directory of Open Access Journals (Sweden)

    Rouhollah Keshavarz

    2015-01-01

    Conclusion: Performing the ELISA test based on ESAT-6 antigen shows that this test can be a suitable way for screening beside the tuberculin test for accurate detection. It is noticed that the specificity of the ELISA test was determined more than the tuberculin test, especially since the culture and PCR are gold standards. Therefore, incorrect sampling can change the specificity of the tuberculin test. The results of this kit can encourage designing of an ELISA kit for the detection of human TB.

  16. Direct two-photon excitation of Sm3+, Eu3+, Tb3+, Tb.DOTA-, and Tb.propargylDO3A in solution

    Science.gov (United States)

    Sørensen, Thomas Just; Blackburn, Octavia A.; Tropiano, Manuel; Faulkner, Stephen

    2012-07-01

    We have observed direct two-photon excitation of samarium, europium and terbium ions in solution upon near IR excitation using a tuneable pulsed light source, and have also studied two-photon processes in a pair of related terbium complexes, namely [Tb.DOTA]- and Tb.propargylDO3A. Direct two-photon excitation of lanthanides is observed in simple systems in the absence of sensitizing chromophores. Where even simple chromophores such as a triple bond are present in the complex, then single and two-photon excitation of chromophore excited states competes with direct two-photon excitation of the ions and is the dominant pathway for sensitizing formation of the lanthanide excited state.

  17. Booster phenomenon of QuantiFERON-TB Gold after prior intradermal PPD injection.

    Science.gov (United States)

    Igari, H; Watanabe, A; Sato, T

    2007-07-01

    University medical school in Japan. To clarify the influence of prior intradermal purified protein derivative (PPD) injection on QuantiFERON-TB Gold (QFT-G). Ninety-seven sixth-year university medical students aged 20-29 years concurrently underwent QFT-G and tuberculin skin test (TST). The first negative QFT-G and the first TST boost QFT-G. Further studies of the diagnostic significance and immunological mechanisms of this phenomenon are needed. For clinical application, especially during contact screening, QFT-G should be evaluated while keeping in mind the possible influence of prior PPD intradermal injection.

  18. Investigation of luminescence properties in SiO2: Tb, Yb upconversion inverse opal

    International Nuclear Information System (INIS)

    Yang Zhengwen; Yan Dong; Song Zhiguo; Zhou Dacheng; Yu Xue; Yang Yong; Yin Zhaoyi; Yan Lei; Wang Rongfei; Wu Hangjun; Qiu Jianbei

    2012-01-01

    The SiO 2 : Tb, Yb inverse opals with photonic band gap at 465 or 543 nm were prepared, and an effect of photonic band gap on upconversion spontaneous emission from Tb 3+ was investigated. The results show that the photonic band gap has a significant influence on the upconversion emission of the SiO 2 : Tb, Yb inverse opals. The upconversion luminescence of the Tb 3+ ions is suppressed in the inverse opal compared with the luminescence of that of the reference sample. - Highlights: ► Upconversion emission from Tb 3+ was observed in the SiO 2 : Tb, Yb inverse opal. ► UC emission of Tb 3+ was modulated by controlling the structure of inverse opal. ► UC emission of Tb 3+ was depressed in the inverse opal.

  19. What are the reasons for patients not adhering to their anti-TB ...

    African Journals Online (AJOL)

    2008-11-13

    Nov 13, 2008 ... patients started their anti-TB treatment, according to the known factors that influence TB adherence. The patients .... Inadequate relationship between health care provider and patient ..... on the Internet] [cited 2009 Jan. 12].

  20. Dosimetric characterization of KMgF{sub 3}:Tb+PTFE; Caracterizacion dosimetrica de KMgF{sub 3}:Tb+PTFE

    Energy Technology Data Exchange (ETDEWEB)

    Ramirez R, M. I.; Garcia S, L.; Villicana M, M.; Huirache A, R.; Apolinar C, J. [Universidad Michoacana de San Nicolas de Hidalgo, Facultad de Ingenieria Quimica, Francisco J. Mujica s/n, Ciudad Universitaria, Col. Felicitas del Rio, 58030 Morelia, Michoacan (Mexico); Gonzalez M, P. R., E-mail: itcraf_15@hotmail.com [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2017-10-15

    In this work the results obtained from the dosimetric characterization of the new radiation detectors of KMgF{sub 3}:Tb+PTFE are presented. The host salt was obtained by means of the microwave technique, with the polycrystalline powder obtained, dosimeters were made in tablet form, using as Ptfe binder. The thermoluminescent response of these new detectors presented a linear behavior, in the dose range between 1 and 1000 Gy of {sup 60}Co gamma radiation, the reproducibility test in the measurements, during ten cycles of heat treatment, irradiation and reading presented ± 3.7% Ds, in the stability test of thermoluminescent signal, during two months showed that the fading is practically null. Due to the results obtained, this new detector could be very useful for the dosimetry of ionizing radiation in different clinical applications. (Author)

  1. TB or not TB?’ Problems of differential diagnosis of cutaneous mycobacteriosis and tuberculosis – A Case Study and interdisciplinary discussion

    Directory of Open Access Journals (Sweden)

    Katarzyna Szmygin-Milanowska

    2015-12-01

    Full Text Available The diagnosis of cutaneous tuberculosis poses a serious challenge due to many skin diseases of different etiology resembling the lesions caused by the TB (tuberculosis bacillus, and difficulties in confirming the disease. The presented case concerns skin lesions in a hobby aquarist stung in the finger of the left hand by a fish. The resulting inflammatory infiltration was to be cutaneous tuberculosis or mycobacteriosis caused by MOTT (Mycobacterium other than tuberculosis. Laboratory, pathomorphologic, genetic and microbiologic tests of samples obtained from the patient, fish and water in the aquarium gave ambiguous results. A multidisciplinary discussion is presented on the difficulties in the differential diagnosis, problems with a clear interpretation of the results of various conducted tests, and possible ways of transmission of the infection, relevant to the described example.

  2. Evaluation of the CervidTB STAT-PAK for the Detection of Mycobacterium bovis Infection in Wild Deer in Great Britain▿

    Science.gov (United States)

    Gowtage-Sequeira, S.; Paterson, A.; Lyashchenko, K. P.; Lesellier, S.; Chambers, M. A.

    2009-01-01

    Deer are acknowledged as hosts of Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB), and determining the prevalence of infection in deer species is one of the key steps in understanding the epidemiological role played by cervids in the transmission and maintenance of bTB in the United Kingdom. This study evaluated a rapid lateral-flow test for the detection of bTB in samples from wild deer species in the United Kingdom. Fallow deer (Dama dama), roe deer (Capreolus capreolus), and red deer (Cervus elaphus) from areas in Wales, the Cotswolds, and southwestern England were necropsied for a bTB survey. Serum samples from individual deer were tested with the CervidTB STAT-PAK, and the results were evaluated against the culture of M. bovis from tissues (n = 432). Sensitivity and specificity were 85.7% (95% confidence interval [CI], 42.1 to 99.6%) and 94.8% (95% CI, 92.3 to 96.7%), respectively, with an odds ratio of 109.9 (95% CI, 12.7 to 953.6%) for a positive STAT-PAK result among culture-positive deer. The low prevalence of infection (3.8%, n = 860) affected the confidence of the sensitivity estimate of the test, but all culture-positive fallow deer (n = 6) were detected by the test. In addition, antibodies to M. bovis could be detected in poor-quality serum samples. The results suggest that the CervidTB STAT-PAK could be deployed as a field test for further evaluation. PMID:19656989

  3. Evaluation of the CervidTB STAT-PAK for the detection of Mycobacterium bovis infection in wild deer in Great Britain.

    Science.gov (United States)

    Gowtage-Sequeira, S; Paterson, A; Lyashchenko, K P; Lesellier, S; Chambers, M A

    2009-10-01

    Deer are acknowledged as hosts of Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB), and determining the prevalence of infection in deer species is one of the key steps in understanding the epidemiological role played by cervids in the transmission and maintenance of bTB in the United Kingdom. This study evaluated a rapid lateral-flow test for the detection of bTB in samples from wild deer species in the United Kingdom. Fallow deer (Dama dama), roe deer (Capreolus capreolus), and red deer (Cervus elaphus) from areas in Wales, the Cotswolds, and southwestern England were necropsied for a bTB survey. Serum samples from individual deer were tested with the CervidTB STAT-PAK, and the results were evaluated against the culture of M. bovis from tissues (n = 432). Sensitivity and specificity were 85.7% (95% confidence interval [CI], 42.1 to 99.6%) and 94.8% (95% CI, 92.3 to 96.7%), respectively, with an odds ratio of 109.9 (95% CI, 12.7 to 953.6%) for a positive STAT-PAK result among culture-positive deer. The low prevalence of infection (3.8%, n = 860) affected the confidence of the sensitivity estimate of the test, but all culture-positive fallow deer (n = 6) were detected by the test. In addition, antibodies to M. bovis could be detected in poor-quality serum samples. The results suggest that the CervidTB STAT-PAK could be deployed as a field test for further evaluation.

  4. A model of population dynamics of TB in a prison system and application to South Africa

    OpenAIRE

    Witbooi, Peter; Vyambwera, Sibaliwe Maku

    2017-01-01

    Background Tuberculosis (TB) continues to spread in South African prisons in particular, as prisons are over-capacitated and have poor ventilation. The awaiting trial detainees are not screened on admission and are at high risk of getting infected with TB. Results We propose a compartmental model to describe the population dynamics of TB disease in prisons. Our model considers the inflow of susceptible, exposed and TB infectives into the prison population. Removal of individuals out of the pr...

  5. Tb3+ and Eu3+ luminescence in imidazolium ionic liquids

    International Nuclear Information System (INIS)

    Hopkins, Todd; Goldey, Matt

    2009-01-01

    The luminescence properties of Tb 3+ and Eu 3+ dissolved in ionic liquids are studied. Solutes in this study include simple lanthanide compounds (e.g., EuBr 3 , TbCl 3 ) and lanthanide complexes (e.g., Eu(dpa) 3 3- where dpa = 2,6 pyridine dicarboxylate dianion) dissolved in a 1-butyl-3-methylimidazolium bromide(BMIBr)/water mixture. Emission, excitation, and time-resolved emission measurements are utilized to characterize the spectroscopic properties. It is well established in the literature that the solubility and spectroscopic properties of lanthanides in ionic liquids are highly dependent upon environmental factors including purity, and water content [K. Binnemans, Chemical Reviews (2007); I. Billard, S. Mekki, C. Gaillard, P. Hesemann, C. Mariet, G. Moutiers, A. Labet, J.-C.G. Buenzli, European Journal of Inorganic Chemistry 6 (2004) 1190-1197; S. Samikkanu, K. Mellem, M. Berry, P.S. May, Inorganic Chemistry 46 (2007) 7121-7128]. The water in this ionic liquid system acts as a co-solvent to facilitate solubility of Tb 3+ and Eu 3+ compounds. The observed spectroscopic properties of Eu 3+ and Tb 3+ salts are expectedly impacted by the high water content, but unexpectedly impacted by the BMIBr ionic liquid. However, the spectroscopy of Eu(dpa) 3 3- is unaffected by the presence of BMIBr.

  6. When students become patients: TB disease among medical ...

    African Journals Online (AJOL)

    A self-administered questionnaire was distributed via email and social media to current medical students and recently graduated ... of stigma will be reported in a separate article. ... help was 3.2 weeks (range 0 - 16 weeks, SD 4.6); the mean diagnostic ... students' health-seeking behaviour and delayed TB diagnosis:.

  7. The effects of Tb 3+ doping concentration on luminescence ...

    Indian Academy of Sciences (India)

    BaF2 phosphor; crystal structure; luminescence properties; X-ray diffraction; concentration quenching. 1. Introduction ... reported that the particle size, shape, crystallinity, etc., sig- nificantly ... Figure 3 shows the excitation and emission spectra of sam- ple with 4 ... gies obtained earlier.9,10 The ground term of the Tb3+ ion is.

  8. EDITORIAL South Africa and national TB control: Are we making ...

    African Journals Online (AJOL)

    accounting for 7.2% of deaths, followed by diabetes mellitus with 5.4% of deaths. Although tuberculosis has maintained its position ... and indirect costs before, during, and after a TB diagnosis. The largest costs these patients incur are for hospitalization, medication, transportation, and treatment or care in the private sector.

  9. Design of a 1 Tb/s superchannel coherent receiver

    NARCIS (Netherlands)

    Millar, D.S.; Maher, R.; Lavery, D.; Koike-Akino, T.; Pajovic, M.; Alvarado, A.; Paskov, M.; Kojima, K.; Parsons, K.; Thomsen, B.C.; Savory, S.J.; Bayvel, P.

    2016-01-01

    We describe the design of a trained and pilot-aided digital coherent receiver, capable of detecting a 1 Tb/s superchannel with a single optical front-end. Algorithms for receiver training are described, which calculate the equalizer coefficients, subchannel SNRs, and centroids of the transmitted

  10. Deexcitation of superdeformed bands in the nucleus Tb-151

    NARCIS (Netherlands)

    Finck, C; Appelbe, D; Beck, FA; Byrski, T; Cullen, D; Curien, D; deFrance, G; Duchene, G; Erturk, S; Haas, B; Khadiri, N; Kharraja, B; Prevost, D; Rigollet, C; Stezowski, O; Twin, P; Vivien, JP; Zuber, K

    1997-01-01

    The aim of this work is to get more informations about the decay-out of superdeformed bands. One of the best candidates in the mass A similar or equal to 150 region for that kind of research is the nucleus Tb-151. From previous works, it has been established that the first excited band goes lower in

  11. RESEARCH Diagnosing Xpert MTB/RIF-negative TB: Impact and ...

    African Journals Online (AJOL)

    Health Economics and Epidemiology Research O ce, Department of Internal ... have a positive culture result, accounting for only 10% of all TB ... information and patient follow-up systems, results may only reach ..... Raviglione M, Zumla A, Marais B, Horton R, Motsoaledi A. A sustainable agenda for tuberculosis control.

  12. Spin dynamics in Tb studied by critical neutron scattering

    DEFF Research Database (Denmark)

    Dietrich, O. W.; Als-Nielsen, Jens Aage

    1971-01-01

    The inelasticity of the critical neutron scattering in Tb was measured at and above the Neel temperature. In the hydrodynamic region the line width Gamma (q=0, kappa 1)=C kappa z1, with z=1.4+or-0.1 and c=4.3+or-0.3 meVAAz. This result deviates from the conventional theory, which predicts...

  13. Predicting Efficient Antenna Ligands for Tb(III) Emission

    Energy Technology Data Exchange (ETDEWEB)

    Samuel, Amanda P.S.; Xu, Jide; Raymond, Kenneth

    2008-10-06

    A series of highly luminescent Tb(III) complexes of para-substituted 2-hydroxyisophthalamide ligands (5LI-IAM-X) has been prepared (X = H, CH{sub 3}, (C=O)NHCH{sub 3}, SO{sub 3}{sup -}, NO{sub 2}, OCH{sub 3}, F, Cl, Br) to probe the effect of substituting the isophthalamide ring on ligand and Tb(III) emission in order to establish a method for predicting the effects of chromophore modification on Tb(III) luminescence. The energies of the ligand singlet and triplet excited states are found to increase linearly with the {pi}-withdrawing ability of the substituent. The experimental results are supported by time-dependent density functional theory (TD-DFT) calculations performed on model systems, which predict ligand singlet and triplet energies within {approx}5% of the experimental values. The quantum yield ({Phi}) values of the Tb(III) complex increases with the triplet energy of the ligand, which is in part due to the decreased non-radiative deactivation caused by thermal repopulation of the triplet. Together, the experimental and theoretical results serve as a predictive tool that can be used to guide the synthesis of ligands used to sensitize lanthanide luminescence.

  14. EDITORIAL Multi-drug-resistant tuberculosis (MDR-TB): Current ...

    African Journals Online (AJOL)

    A South African Health Systems Trust report indicated that despite a global ... less financial resources performed better. ... Healthcare providers need to be better trained at our various nursing colleges and medical schools on how to manage TB, with regular and intense follow-up in-service training sessions. In addition ...

  15. H+ searches in ATLAS (II): H+ to tb

    CERN Document Server

    Mir, Lluisa-Maria; The ATLAS collaboration

    2016-01-01

    A search for charged Higgs bosons heavier than the top quark and decaying via to tb is presented. The analysis uses 13.2 ifb of pp collision data at a centre-of-mass energy of sqrt(s) = 13 TeV collected with the ATLAS detector at the Large Hadron Collider. The production of a charged Higgs boson in association with a top quark and a bottom quark, pp to tbH+-, is explored in the mass range 300 to 1000 GeV using multi-jet final states with one electron or muon from the top-quark decay. Events are categorised according to the multiplicity of jets and b-tagged jets. Multivariate techniques are used to discriminate between signal and background events. No significant excess above the background-only hypothesis is observed and upper limits are set on the tbH+- production cross section times the branching fraction BR(H+- to tb), together with their interpretation in benchmark scenarios of the Minimal Supersymmetric Standard Model.

  16. Autopsy case of pulmonary aspergilloma. [After long chemotherapy for TB

    Energy Technology Data Exchange (ETDEWEB)

    II, Yohei; Akizuki, S

    1973-01-01

    A 73-year-old female received anti-TB chemotherapy for pulmonary tuberculosis for a long period and died from severe hemoptysis which suddenly developed after recovery from the disease. Autopsy showed a large aspergilloma in the upper lobe of the right lung. This case is reported along with a review of the literature on aspergillosis. (30 refs) (DLC)

  17. Five years retrospective cohort analysis of treatment outcomes of TB ...

    African Journals Online (AJOL)

    Background: Human immunodeficiency virus (HIV) associated tuberculosis (TB) remains a major global public health chal- lenge, with an estimated 1.4 .... completed treatment and who is smear negative at the end of 6th or 7th month of treat- ..... the course of management of the dual disease entity. Conclusion. This study ...

  18. Five years retrospective cohort analysis of treatment outcomes of TB ...

    African Journals Online (AJOL)

    Background: Human immunodeficiency virus (HIV) associated tuberculosis (TB) remains a major global public health challenge, with an estimated 1.4 million patients worldwide. Co-infection with HIV leads to challenges in the diagnosis and treatment of patients. Objectives: The aim of this study was to assess treatment ...

  19. Community-based directly observed treatment for TB patients to improve HIV services: a cross-sectional study in a South African province.

    Science.gov (United States)

    Howell, Embry M; Kigozi, N Gladys; Heunis, J Christo

    2018-04-07

    There is uncertainty about how directly observed treatment (DOT) support for tuberculosis (TB) can be delivered most effectively and how DOT support can simultaneously be used to strengthen human immunodeficiency virus (HIV) prevention and control among TB patients. This study describes how DOT support by community health workers (CHWs) was used in four municipalities in the Free State province - a high TB/HIV burden, poorly-resourced setting - to provide HIV outreach, referrals, and health education for TB patients. The study was part of a larger cross-sectional study of HIV counselling and testing (HCT) among 1101 randomly-selected TB patients registered at 40 primary health care (PHC) facilities (clinics and community health centres) across small town/rural and large town/urban settings. Univariate analysis of percentages, chi-square tests and t-tests for difference in means were used to describe differences between the types of TB treatment support and patient characteristics, as well as the types of - and patient satisfaction with - HIV information and referrals received from various types of treatment supporters including home-based DOT supporters, clinic-based DOT supporters or support from family/friends/employers. Multivariate logistic regression was used to predict the likelihood of not having receiving home-based DOT and of never having received HIV counselling. The independent variables include poverty-related health and socio-economic risk factors for poor outcomes. Statistical significance is shown using a 95% confidence interval and a 0.05 p-value. Despite the fact that DOT support for all TB patients was the goal of South African health policy at the time (2012), most TB patients were not receiving formal DOT support. Only 155 (14.1%) were receiving home-based DOT, while 114 (10.4%) received clinic-based DOT. TB patients receiving home-based DOT reported higher rates of HIV counselling than other patients. Public health providers should train DOT

  20. Microstructural and photoluminescence properties of sol–gel derived Tb3+ doped ZnO nanocrystals

    CSIR Research Space (South Africa)

    Kabongo, GL

    2014-04-01

    Full Text Available Un-doped and Tb(Sup3+) doped ZnO nanocrystals with different concentrations of Tb(Sup3+) were synthesized by a sol–gel method and their photoluminescence (PL) properties were investigated. The successful incorporation of Tb(sup3+) ions...

  1. RESEARCH Improving access and quality of care in a TB control ...

    African Journals Online (AJOL)

    or treatment. Improving access and quality of care in a. TB control programme. Vera Scott, Virginia Azevedo, Judy Caldwell. Objectives. To use a quality improvement approach to improve access to and quality of tuberculosis (TB) diagnosis and care in. Cape Town. Methods. Five HIV/AIDS/sexually transmitted infections/TB.

  2. A review of the literature on the economics of vaccination against TB

    NARCIS (Netherlands)

    Tu, H.A.; Vu, H.D.; Rozenbaum, M.H.; Woerdenbag, H.J.; Postma, M.J.

    The BCG vaccine was introduced in 1921 and remains the only licensed vaccine for the prevention of TB worldwide. Despite its extensive use, the BCG vaccine lacks the ability to fully control the TB-endemic and -pandemic situations. The BCG vaccine is most effective in preventing pediatric TB, in

  3. The progression of tb diagnosis in the hiv era: from microscopes to ...

    African Journals Online (AJOL)

    smear-negative pulmonary TB, hospitalised. HIV-infected patients with advanced and disseminated disease, young children and patients with extrapulmonary forms of TB, clinical case definitions and algorithms can be beneficial for guiding the empiric use of anti-TB treatment. Multiple clinical case definitions and algorithms ...

  4. TB truths : Patients’ experience with tuberculosis and healthcare in sub-Saharan Africa

    NARCIS (Netherlands)

    Cremers, A.L.

    2018-01-01

    TB remains one of the most alarming global health threats of this age. Despite the often available TB medication for free, rates are not being significantly reduced or in some areas even going up. TB epidemiology have become more complex, due to the HIV epidemic and development of drug-resistance.

  5. The time delay of patients presenting with symptoms of TB at TC ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is a major health problem in South Africa. The early detection and treatment of TB cases are essential. The impression of senior staff working at the TC Newman Community Health Centre (TCN), Paarl was that there often is an unnecessary time delay between the presentation of TB symptoms and the ...

  6. Medicinal plants used to treat TB in Ghana.

    Science.gov (United States)

    Nguta, Joseph Mwanzia; Appiah-Opong, Regina; Nyarko, Alexander K; Yeboah-Manu, Dorothy; Addo, Phyllis G A

    2015-06-01

    The current study was designed to document medicinal plant species that are traditionally used to treat tuberculosis (TB) by Ghanaian communities. The medicinal plants used against TB or its signs and symptoms were selected using library and online published data searches. A guided questionnaire interview was also conducted with a botanist involved in plant collection at the Centre for Scientific Research into Plant Medicine (CSRPM) at Mampong. Data obtained were entered in Excel and summarized into means and frequencies using SPSS 12.0.1 for windows, and expressed as tables and bar graphs. A total of 15 medicinal plant species distributed between 13 genera and 13 families were documented. The following medicinal plant species were found to be used against TB in Greater Accra and Eastern parts of Ghana: Azadirachta indica A. Juss. Stem bark (Meliaceae), Hygrophila auriculata Heine, whole plant (Acanthaceae), Chenopodium ambrosioides L. leaves (Amaranthaceae), Coix lacryma-jobi L. glumes (Poaceae), Solanum torvum Sw. unripe fruits (Solanaceae), Solanum torvum Sw. leaves (Solanaceae), Bidens pilosa L. whole plant (Asteraceae), Phyllanthus fraternus G.L. Webster leaves (Phyllanthaceae), Dissotis rotundifolia (Sm.) Triana, leaves (Melastomataceae), Cymbopogon giganteus Chiov. Leaves (Poaceae), Cyperus articulatus L. roots (Cyperaceae), Allium sativum L. bulb (Amaryllidaceae), Zingiber officinale Roscoe, rhizomes (Zingiberaceae), Allium cepa L. bulbs (Amaryllidaceae), Allium cepa L. leaves (Amaryllidaceae), Aloe vera var. barbadensis aqueous extract from leaves (Xanthorrhoeaceae), Aloe vera var. barbadensis organic extract from leaves (Xanthorrhoeaceae), Cocos nucifera Linn, water (Arecaceae) and Cocos nucifera Linn. Husk (Arecaceae). The collected plant species could be a source of a new class of drugs against TB. Bioactivity guided fractionation is recommended to identify lead compounds for antimycobacterial activity. The current paper documents for the first time

  7. Luminescence and Tb3+-Ce3+-Eu3+ ion energy transfer in single-crystalline films of Tb3Al5O12:Ce,Eu garnet

    International Nuclear Information System (INIS)

    Zorenko, Y.; Gorbenko, V.; Voznyak, T.; Batentschuk, M.; Osvet, A.; Winnacker, A.

    2008-01-01

    The paper is devoted to investigation of the processes of excitation energy transfer between the host cations (Tb 3+ ions) and the activators (Ce 3+ and Eu 3+ ions) in single-crystalline films of Tb 3 Al 5 O 12 :Ce,Eu (TbAG:Ce,Eu) garnet which is considered as a promising luminescent material for the conversion of LED's radiation. The cascade process of excitation energy transfer is shown to be realized in TbAG:Ce,Eu: (i) from Tb 3+ ions to Ce 3+ and Eu 3+ ions; (ii) from Ce 3+ ions to Eu 3+ ions by means of dipole-dipole interaction and through Tb 3+ ion sublattice

  8. Community-based MDR-TB care project improves treatment initiation in patients diagnosed with MDR-TB in Myanmar.

    Science.gov (United States)

    Wai, Pyae Phyo; Shewade, Hemant Deepak; Kyaw, Nang Thu Thu; Thein, Saw; Si Thu, Aung; Kyaw, Khine Wut Yee; Aye, Nyein Nyein; Phyo, Aye Mon; Maung, Htet Myet Win; Soe, Kyaw Thu; Aung, Si Thu

    2018-01-01

    The Union in collaboration with national TB programme (NTP) started the community-based MDR-TB care (CBMDR-TBC) project in 33 townships of upper Myanmar to improve treatment initiation and treatment adherence. Patients with MDR-TB diagnosed/registered under NTP received support through the project staff, in addition to the routine domiciliary care provided by NTP staff. Each township had a project nurse exclusively for MDR-TB and 30 USD per month (max. for 4 months) were provided to the patient as a pre-treatment support. To assess whether CBMDR-TBC project's support improved treatment initiation. In this cohort study (involving record review) of all diagnosed MDR-TB between January 2015 and June 2016 in project townships, CBMDR-TBC status was categorized as "receiving support" if date of project initiation in patient's township was before the date of diagnosis and "not receiving support", if otherwise. Cox proportional hazards regression (censored on 31 Dec 2016) was done to identify predictors of treatment initiation. Of 456 patients, 57% initiated treatment: 64% and 56% among patients "receiving support (n = 208)" and "not receiving support (n = 228)" respectively (CBMDR-TBC status was not known in 20 (4%) patients due to missing diagnosis dates). Among those initiated on treatment (n = 261), median (IQR) time to initiate treatment was 38 (20, 76) days: 31 (18, 50) among patients "receiving support" and 50 (26,101) among patients "not receiving support". After adjusting other potential confounders (age, sex, region, HIV, past history of TB treatment), patients "receiving support" had 80% higher chance of initiating treatment [aHR (0.95 CI): 1.8 (1.3, 2.3)] when compared to patients "not receiving support". In addition, age 15-54 years, previous history of TB and being HIV negative were independent predictors of treatment initiation. Receiving support under CBMDR-TBC project improved treatment initiation: it not only improved the proportion initiated but also

  9. A novel automatic molecular test for detection of multidrug resistance tuberculosis in sputum specimen: A case control study.

    Science.gov (United States)

    Li, Qiang; Ou, Xi C; Pang, Yu; Xia, Hui; Huang, Hai R; Zhao, Bing; Wang, Sheng F; Zhao, Yan L

    2017-07-01

    MiniLab tuberculosis (ML TB) assay is a new automatic diagnostic tool for diagnosis of multidrug resistance tuberculosis (MDR-TB). This study was conducted with aims to know the performance of this assay. Sputum sample from 224 TB suspects was collected from tuberculosis suspects seeking medical care at Beijing Chest hospital. The sputum samples were directly used for smear and ML TB test. The left sputum sample was used to conduct Xpert MTB/RIF, Bactec MGIT culture and drug susceptibility test (DST). All discrepancies between the results from DST, molecular and phenotypic methods were confirmed by DNA Sequencing. The sensitivity and specificity of ML TB test for detecting MTBC from TB suspects were 95.1% and 88.9%, respectively. The sensitivity for smear negative TB suspects was 64.3%. For detection of RIF resistance, the sensitivity and specificity of ML TB test were 89.2% and 95.7%, respectively. For detection of INH resistance, the sensitivity and specificity of ML TB test were 78.3% and 98.1%, respectively. ML TB test showed similar performance to Xpert MTB/RIF for detection of MTBC and RIF resistance. In addition, ML TB also had good performance for INH resistance detection. Copyright © 2017. Published by Elsevier Ltd.

  10. Thermoelectric properties of TbFe{sub 2} and TbCo{sub 2} in C15- laves phase: Spin-polarized DFT+U approach

    Energy Technology Data Exchange (ETDEWEB)

    Reshak, A.H., E-mail: maalidph@yahoo.co.uk [New Technologies - Research Centre, University of West Bohemia, Univerzitni 8, Pilsen 306 14 (Czech Republic); School of Material Engineering, University Malaysia Perlis, Kangar, Perlis 01007 (Malaysia)

    2017-01-15

    Thermoelectric properties of materials are intimately related to their electronic band structure. Combining first- and second-principles calculations, we have obtained the transport properties for the spin-up and spin-down electrons of the laves phase TbFe{sub 2} and TbCo{sub 2} compounds. The unique band structure feature and the density of states at Fermi level (E{sub F}) promote the E{sub F} to a point where carriers are in energetic proximity to these features. The non-zero density of states at E{sub F} for the spin-up (↑) and spin-down (↓) electrons leads to unusual transport properties because both the (↑) and (↓) densities contributes to the states at E{sub F}. The parabolic bands in the vicinity of E{sub F} enhance the carriers mobility and hence the transport properties of TbFe{sub 2} and TbCo{sub 2}. Calculations show that the spin-up/down transport coefficients are temperature-dependent. It has been found that TbCo{sub 2} possess larger Seebeck coefficient than that of TbFe{sub 2} and hence the power factor. The calculated Seebeck coefficient of TbCo{sub 2} agree well with the available experimental data. - Highlights: • The transport properties of TbFe{sub 2} and TbCo{sub 2} are obtained. • The non-zero density of states at E{sub F} leads to unusual transport properties. • Spin-up/down transport coefficients are temperature-dependent. • The calculated Seebeck coefficient of TbCo{sub 2} agree with the experimental data. • TbCo{sub 2} possesses larger Seebeck coefficient than that of TbFe{sub 2}.

  11. When students become patients: TB disease among medical undergraduates in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Helene-Mari van der Westhuizen

    2017-06-01

    Full Text Available Background. Medical students acquire latent tuberculosis (TB infection at a rate of 23 cases/100 person-years. The frequency and impact of occupational TB disease in this population are unknown. Methods. A self-administered questionnaire was distributed via email and social media to current medical students and recently graduated doctors (2010 - 2015 at two medical schools in Cape Town. Individuals who had developed TB disease as undergraduate students were eligible to participate. Quantitative and qualitative data collected from the questionnaire and semi-structured interviews were analysed with descriptive statistics and a framework approach to identify emerging themes. Results. Twelve individuals (10 female reported a diagnosis of TB: pulmonary TB (n=6, pleural TB (n=3, TB lymphadenitis (n=2 and TB spine (n=1; 2/12 (17% had drug-resistant disease (DR-TB. Mean diagnostic delay post consultation was 8.1 weeks, with only 42% of initial diagnoses being correct. Most consulted private healthcare providers (general practitioners (n=7; pulmonologists (n=4, and nine underwent invasive procedures (bronchoscopy, pleural fluid aspiration and tissue biopsy. Substantial healthcare costs were incurred (mean ZAR25 000 for drug-sensitive TB, up to ZAR104 000 for DR-TB. Students struggled to obtain treatment, incurred high transport costs and missed academic time. Students with DR-TB interrupted their studies and experienced severe side-effects (hepatotoxicity, depression and permanent ototoxicity. Most participants cited poor TB infection-control practices at their training hospitals as a major risk factor for occupational TB. Conclusions. Undergraduate medical students in Cape Town are at high risk of occupationally acquired TB, with an unmet need for comprehensive occupational health services and support.

  12. Does the integration of TB medical services in the general hospital improve the quality of TB care? Evidence from a case study in China.

    Science.gov (United States)

    Sun, Qiang; Yin, Jia; Yin, Xiao; Zou, Guanyang; Liang, Mingli; Zhong, Jieming; Walley, John; Wei, Xiaolin

    2013-06-01

    Moving the clinical services from tuberculosis (TB) dispensary to the integrated county hospital (called integrated approach) has been practiced in China; however, it is unknown the quality of TB care in the integrated approach and in the dispensary approach. A total of 202 new TB patients were investigated using structured questionnaires in three counties implementing the integrated approach and one county implementing the dispensary approach. The quality of TB care is measured based on success rate of treatment, medical expenditure, health system delay and second-line drug use. The integrated approach showed a high success treatment rate. The medical expenditure in the integrated approach was USD 432, significantly lower than that in the dispensary approach (Z = -5.771, P < 0.001). The integrated approach had a shorter health system delay (5 days) than the dispensary approach (32 days). Twenty-six percent of patients in integrated hospitals were prescribed with second-line TB drugs, significantly lower than that in the TB dispensary (47%, χ(2) = 7.452, P = 0.006). However, the medical expenditure, use of second-line anti-TB drug and liver-protection drugs indeed varied greatly across the three integrated hospitals. The integrated approach showed better quality of TB care, but the performance of the integrated hospitals varied greatly. A method to standardize TB treatment and management of this approach is urgent.

  13. Fabrication and properties of highly luminescent materials from Tb(OH)3-SiO2 and Tb(OH)3-SiO2:Eu3+ nanotubes

    International Nuclear Information System (INIS)

    Tran Thu Huong; Tran Kim Anh; Le Quoc Minh

    2009-01-01

    Luminescent nanomaterials with one-dimensional (1D) structures have attracted much attention due to their unique properties and potential applications in nanophotonics and nanobiophotonics. In this paper, we report a synthesis of terbium - hydroxide - at - silica Tb(OH) 3 -SiO 2 and Tb(OH) 3 -SiO 2 :Eu 3+ nanotubes. Terbium - hydroxide tubes were synthesized by soft template method. The size of the tubes can be controlled precisely and have outer diameters ranging from 80 to 120 nm, wall thickness of about 30 nm, and lengths ranging from 300 to 800 nm. To fabricate core/shell materials, the seed growth method is used. FESEM, X-ray diffraction, Raman spectra of Tb(OH) 3 and Tb(OH) 3 -SiO 2 nanotubes were investigated. The photoluminescence (PL) spectrum of Tb(OH) 3 under 325 nm excitation consists of four main peaks at 488, 542, 582, and 618 nm. Furthermore, a preliminary suggestion for the mechanism of growth of the Tb(OH) 3 nanotubes using the soft - template synthesis technique has been proposed. The PL intensity from Tb(OH) 3 -SiO 2 or Tb(OH) 3 -SiO 2 :Eu 3+ nanotubes is much stronger than that of Tb(OH) 3 .

  14. Definition of drug resistance of Mycobacterium tuberculosis to antituberculosis drugs in patients with multidrugresistant tuberculosis and TB with extremely drug resistant depending on the case of the disease

    Directory of Open Access Journals (Sweden)

    Kryzhanovsky D.G.

    2014-11-01

    Full Text Available There was studied the profile of drug resistance to the main (I line and reserve (II line antituberculosis drugs in patients with MDR and XDR tuberculosis, depending of the case of the disease. According to the randomized retrospective research 200 patients with MDR and XDR tuberculosis, who received treatment in the clinic of hospital Municipal institution «Dnipropetrovsk rigional clinical association «Phthisiology» Dnipropetrovsk regional Council» during the period 2010 – 2012 were involved. Data about patients contained the data on a case of the disease and the results of the test of drug sensitivity to MBT. XDR – TB was revealed in 7.5% of patients with MDR tuberculosis. In patients with MDR tuberculosis as compared with patients with XDR tuberculosis «new cases» were diagnosed in 19.5% against 18.5% (p <0.05. In patients with MDR tuberculosis and with XDR tuberculosis resistance to the antituberculosis drug more commonly developed to S - 88.5%, E - 55% and Z - 24%. The presence of MDR-TB and XDR-TB prevails in patients, who underwent previous courses of treatment with anti-TB drugs in case history as compared with patients with «new cases» of treatment. The development of resistance to anti-TB drugs depends on the availability of these drugs in the previous treatment regimens.

  15. TB Risk Perceptions among Medical Residents at a Tertiary Care Center in India

    Directory of Open Access Journals (Sweden)

    Geeta S. Pardeshi

    2017-01-01

    Full Text Available Setting. Government tertiary health care center in India. Objective. To understand the perceptions of medical residents about their risk of developing TB in the workplace. Design. Cross-sectional study in which a semistructured questionnaire which included an open-ended question to assess their main concerns regarding TB in workplace was used to collect data. Results. Out of 305 resident doctors approached, 263 (94% completed a structured questionnaire and 200 of these responded to an open-ended question. Daily exposure to TB was reported by 141 (64% residents, 13 (5% reported a prior history of TB, and 175 (69% respondents were aware of TB infection control guidelines. A majority reported concerns about acquiring TB (78% and drug-resistant TB (88%. The key themes identified were concerns about developing drug-resistant TB (n=100; 50%; disease and its clinical consequences (n=39; 20%; social and professional consequences (n=37; 19%; exposure to TB patients (n=32; 16%; poor infection control measures (n=27; 14%; and high workload and its health consequences (n=16; 8%. Conclusion. Though many resident doctors were aware of TB infection control guidelines, only few expressed concern about lack of TB infection control measures. Doctors need to be convinced of the importance of these measures which should be implemented urgently.

  16. Access to and affordability of healthcare for TB patients in China: issues and challenges.

    Science.gov (United States)

    Tang, Shenglan; Wang, Lixia; Wang, Hong; Chin, Daniel P

    2016-01-29

    This paper introduces the background, aim and objectives of the project entitled "China-the Gates Foundation Collaboration on TB Control in China" that has been underway for many years. It also summarizes the key findings of the nine papers included in this special issue, which used data from the baseline survey of Phase II of the project. Data were collected from the survey of TB and MDR-TB patients, from designated hospitals, health insurance agencies and the routine health information systems, as well as key informant interviews and focus group discussions with relevant key stakeholders. Key issues discussed in this series of papers include the uses of TB services and anti-TB medicines and their determining factors related to socio-economic and health systems development; expenditures on TB care and the financial burden incurred on TB patients; and the impact of health insurance schemes implemented in China on financial protection.

  17. National HIV Testing Day

    Centers for Disease Control (CDC) Podcasts

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses National HIV Testing Day, an annual observance which raises awareness of the importance of knowing one's HIV status and encourages at-risk individuals to get an HIV test.

  18. A deadly combination of AIDS, TB and cardiac tumour.

    Science.gov (United States)

    Sahasrabudhe, Tushar Ramesh

    2013-05-22

    Immunocompromised status in AIDS makes differential diagnosis of any symptom very difficult for a clinician. Sharp clinical judgement and plenty of investigations may be needed to reach the diagnosis, as in this case. We hereby present a case of AIDS and active tuberculosis (TB) under treatment. The patient developed acute onset multifocal neurological symptoms following an episode of fever and diarrhoea. The MRI scan revealed numerous large cerebral infarcts. On investigations to evaluate brain infarcts, we made a diagnosis of left atrial cardiac tumour. Association of cardiac tumours with AIDS has only been rarely reported. It is uncertain if these can be opportunistic tumours in AIDS. The patient successfully came out of this deadly combination of diseases, viz AIDS, TB and large brain infarcts due to atrial tumour; with almost complete recovery.

  19. Synchrotron diffraction characterization of nanostructured KY3F10:Tb

    International Nuclear Information System (INIS)

    Ichikawa, Rodrigo U.; Teixeira, Maria I.; Ranieri, Izilda M.; Martinez, Luis G.; Linhares, Horacio M.S.M.D.; Turrillas, Xavier

    2015-01-01

    Nanostructured rare-earth fluorides materials are being intensively studied recently due to their potential applications in high-dose dosimetry. Particularly, nanostructured Tb-doped KY 3 F 10 has shown satisfactory results to be used in this area. In the present work, the structure and microstructure of KY 3 F 10 :Tb was investigated by means of X-ray synchrotron diffraction. One of the samples was analyzed as synthesized and another after a heat treatment. Rietveld refinement of synchrotron diffraction data was applied to obtain cell parameters, atomic positions and atomic displacement factors and the results were compared to values found in literature. X-ray line profile analysis methods were applied to determine mean crystallite sizes and their distribution. (author)

  20. Advocacy, partnership and political commitment for TB vaccine research.

    Science.gov (United States)

    Olesen, Ole F; Chan, Sharon; Chappell, Janice; Guo, Yan; Leite, Luciana C C

    2016-08-01

    The 4th Global Forum on TB Vaccines, convened in Shanghai, China, from 21 - 24 April 2015, brought together a wide and diverse community involved in tuberculosis vaccine research and development to discuss the current status of, and future directions for this critical effort. This paper summarizes the sessions on Advancing the Pipeline: A Vision for the Next Decade, Engaging the BRICS: Basic Research to Manufacturing, and Regulatory and Access Issues for New TB Vaccines. Summaries of all sessions from the 4th Global Forum are compiled in a special supplement of Tuberculosis. [August 2016, Vol 99, Supp S1, S1-S30]. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Danielle Taubman

    2013-12-01

    Conclusions: Compliance for latent TB screening is low among HCWs in northeastern Israel. Providing detailed information about latent TB was not associated with increased test compliance. Understanding existing disparities in screening rates and potential barriers to latent TB screening among HCWs is important in order to move forward and successfully increase screening rates.

  2. Experimental animal modelling for TB vaccine development

    Directory of Open Access Journals (Sweden)

    Pere-Joan Cardona

    2017-03-01

    Full Text Available Research for a novel vaccine to prevent tuberculosis is an urgent medical need. The current vaccine, BCG, has demonstrated a non-homogenous efficacy in humans, but still is the gold standard to be improved upon. In general, the main indicator for testing the potency of new candidates in animal models is the reduction of the bacillary load in the lungs at the acute phase of the infection. Usually, this reduction is similar to that induced by BCG, although in some cases a weak but significant improvement can be detected, but none of candidates are able to prevent establishment of infection. The main characteristics of several laboratory animals are reviewed, reflecting that none are able to simulate the whole characteristics of human tuberculosis. As, so far, no surrogate of protection has been found, it is important to test new candidates in several models in order to generate convincing evidence of efficacy that might be better than that of BCG in humans. It is also important to investigate the use of “in silico” and “ex vivo” models to better understand experimental data and also to try to replace, or at least reduce and refine experimental models in animals.

  3. Toward a Generation Free of Tuberculosis: TB Disease and Infection in Individuals of College Age in the United States

    Science.gov (United States)

    Shah, N. S.; Flood-Bryzman, A.; Jeffries, C.; Scott, J.

    2018-01-01

    Objectives: To assess the magnitude of active TB disease and latent TB infection (LTBI) in young adults of college age. Participants: Individuals who were aged 18-24 years in 2011 were used as a proxy for college students. Methods: Active TB cases reported to the 2011 US National TB Surveillance System (NTSS) were included. LTBI prevalence was…

  4. A deadly combination of AIDS, TB and cardiac tumour

    OpenAIRE

    Sahasrabudhe, Tushar Ramesh

    2013-01-01

    Immunocompromised status in AIDS makes differential diagnosis of any symptom very difficult for a clinician. Sharp clinical judgement and plenty of investigations may be needed to reach the diagnosis, as in this case. We hereby present a case of AIDS and active tuberculosis (TB) under treatment. The patient developed acute onset multifocal neurological symptoms following an episode of fever and diarrhoea. The MRI scan revealed numerous large cerebral infarcts. On investigations to evaluate br...

  5. Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India

    Science.gov (United States)

    Sharma, Surendra K.; Ryan, H.; Khaparde, Sunil; Sachdeva, K. S.; Singh, Achintya D.; Mohan, Alladi; Sarin, Rohit; Paramasivan, C N; Kumar, Prahlad; Nischal, Neeraj; Khatiwada, Saurav; Garner, Paul; Tharyan, Prathap

    2017-01-01

    Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research. PMID:28862176

  6. Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India

    Directory of Open Access Journals (Sweden)

    Surendra K Sharma

    2017-01-01

    Full Text Available Extrapulmonary tuberculosis (EPTB is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i use of Xpert MTB/RIF in diagnosis, (ii use of adjunct corticosteroids in treatment, and (iii duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.

  7. Major Challenges in Clinical Management of TB/HIV Coinfected Patients in Eastern Europe Compared with Western Europe and Latin America

    DEFF Research Database (Denmark)

    Efsen, Anne Marie W; Schultze, Anna; Post, Frank A

    2015-01-01

    OBJECTIVES: Rates of TB/HIV coinfection and multi-drug resistant (MDR)-TB are increasing in Eastern Europe (EE). We aimed to study clinical characteristics, factors associated with MDR-TB and predicted activity of empiric anti-TB treatment at time of TB diagnosis among TB/HIV coinfected patients......% of participants in EE compared with 90-96% in other regions (pmanagement of TB/HIV patients in EE requires...... better access to TB diagnostics including DSTs, empiric anti-TB therapy directed at both susceptible and MDR-TB, and more widespread use of cART....

  8. PolyTB: A genomic variation map for Mycobacterium tuberculosis

    KAUST Repository

    Coll, Francesc

    2014-02-15

    Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) is the second major cause of death from an infectious disease worldwide. Recent advances in DNA sequencing are leading to the ability to generate whole genome information in clinical isolates of M. tuberculosis complex (MTBC). The identification of informative genetic variants such as phylogenetic markers and those associated with drug resistance or virulence will help barcode Mtb in the context of epidemiological, diagnostic and clinical studies. Mtb genomic datasets are increasingly available as raw sequences, which are potentially difficult and computer intensive to process, and compare across studies. Here we have processed the raw sequence data (>1500 isolates, eight studies) to compile a catalogue of SNPs (n = 74,039, 63% non-synonymous, 51.1% in more than one isolate, i.e. non-private), small indels (n = 4810) and larger structural variants (n = 800). We have developed the PolyTB web-based tool (http://pathogenseq.lshtm.ac.uk/polytb) to visualise the resulting variation and important meta-data (e.g. in silico inferred strain-types, location) within geographical map and phylogenetic views. This resource will allow researchers to identify polymorphisms within candidate genes of interest, as well as examine the genomic diversity and distribution of strains. PolyTB source code is freely available to researchers wishing to develop similar tools for their pathogen of interest. 2014 Elsevier Ltd. All rights reserved.

  9. HIV-associated TB syndemic: A growing clinical challenge worldwide

    Directory of Open Access Journals (Sweden)

    Maria Theresa Montales

    2015-12-01

    Full Text Available The association of tuberculosis (TB with human immunodeficiency virus (HIV infection and acquired immune deficiency syndrome (AIDS over the past several years has become an emerging syndemic. Approximately 10% of people living with HIV (PLHIV with latent TB infection will develop active TB disease each year. In this review, we highlight that this phenomenon is not limited to high endemic regions like Afro-Asian nations, but globalization/migration is causing increased case detection even in developed nations such as the United States (US. Active screening should be performed for tuberculosis in PLHIV. A high degree of clinical suspicion for tuberculosis is warranted in PLHIV presenting with fever, cough and unintentional weight loss. HIV-Mycobacterium tuberculosis (MTB coinfection is often paucibacillary, precluding diagnosis by conventional diagnostics and/or smear-microscopy/culture. Improved detection of pulmonary and extrapulmonary tuberculosis is now possible by incorporation of the GeneXPERT MTB/RIF assay (Cepheid Inc, Sunnyvale, USA. The World Health Organization (WHO recommends instituting immediate therapy for Mycobacterium tuberculosis, in conjunction with ongoing or newly introduced antiretroviral therapy (ART. Vigilance is required to detect drug-induced organ injuries, and early-treatment induced immune reconstitution inflammatory syndrome (IRIS. Collaborating MTB and HIV activities in concentrated HIV epidemic settings should become a high public health priority.

  10. Magnetoelastic coupling in TbFe2 (110) thin films

    International Nuclear Information System (INIS)

    Ciria, M.; Arnaudas, J.I.; Dufour, C.; Oderno, V.; Dumesnil, K.; del Moral, A.

    1997-01-01

    We have determined the rhombohedral magnetoelastic stress of a Laves phase TbFe 2 (110) single-crystal film, grown by molecular-beam epitaxy. The film thickness was 1300 Angstrom. The magnetoelastic stress was directly measured by using a low-temperature cantilever capacitive method, between 300 and 10 K. The isotherms clearly display the coercive field but, unlike bulk alloy behavior, do not saturate even at the maximum field of 12 T. The determined rhombohedral magnetoelastic parameter of the film is B ε,2 =-0.43 GPa, at 0 K and 12 T, which is 0.67 times the value for bulk TbFe 2 . B ε,2 follows a power m 3 of the reduced magnetization m, indicating a single-ion volume origin for the rhombohedral magnetoelastic stress of this film. Measurements performed in a 300 Angstrom TbFe 2 (110) film deposited onto a YFe 2 buffer show that the coercive field is drastically lowered and that the magnetoelastic distortion is negligible. copyright 1997 American Institute of Physics

  11. ASSESSMENT OF EFFECTIVENESS OF TB POSTING DURING THE COMPULSORY ROTATORY RESIDENTIAL INTERNSHIP (CRRI PROGRAMME

    Directory of Open Access Journals (Sweden)

    Pradeep Aggarwal

    2011-12-01

    Full Text Available Research Question: What is the effectiveness of TB posting during the Compulsory Rotatory Residential Internship (CRRI programme? Objectives: To assess the effectiveness of TB posting during the CRRI programme. To find out the need of making Tuberculosis & Respiratory Diseases Department posting mandatory during CRRI Programme. Study Design: Cross Sectional study. Study Duration: 12 months i.e. 01st April 2009 till 31st March 2010 Participants: 90 students who joined the CRRI programme formed the study group. Out of these 90 interns only 57 (64% of them joined their two months Compulsory Rotatory Internship in the Department of Community Medicine and these were posted in Tuberculosis & Respiratory Diseases Department for 15 days. Methodology: A pre-designed pre-tested self-administered questionnaire was administered to the participants on the first day and last day of their posting in Tuberculosis & Respiratory Diseases Department. The results were analysed by using suitable statistical package. Results: The mean pre-test score was 28 (49.6% and the mean post-test score was 38 (61.5%. It was observed that there was a 27% improvement in the knowledge of the participants when the question about the year of launching of RNTCP programme in India was asked. A remarkable improvement (46% was found in the difference between pre and post-test knowledge of the participants when the questions like “Who are the DOTS providers” and “What is the colour coding of boxes for different categories of patients” were asked. A significant difference in the knowledge was found in the pre and post-test assessment in reference to Tuberculosis and its National Programm

  12. Patient satisfaction with TB care clinical consultations in Kampala: a cross sectional study.

    Science.gov (United States)

    Ssengooba, Willy; Kirenga, Bruce; Muwonge, Catherine; Kyaligonza, Steven; Kasozi, Samuel; Mugabe, Frank; Boeree, Martin; Joloba, Moses; Okwera, Alphonse

    2016-12-01

    Patient satisfaction towards care during encounter with clinicians is key for better treatment outcomes. We assessed patient satisfaction with TB clinical care consultations in Kampala, Uganda. This was a facility-based cross sectional study done between September 2012 and February 2013 using qualitative method of data collection. Participants consecutively completed a pre-tested structured satisfaction questionnaire. A criteria of the rating as good; >75% was considered acceptable, (50-75%) as more effort is needed and patient satisfaction, were: time spent with clinician (85.4%), explanation of what was done (87.6%), technical skills (91.6%), personal manner of the clinician seen (91.6%). Factors for low satisfaction were; waiting time before getting an appointment (61.8%), convenience of location of consultation office (53.4%), getting through to the office by phone (21.3%) and length of time waiting at the office (61.2%). Tuberculosis patients in Kampala are satisfied with TB clinical care consultations. Addressing factors with low patient satisfaction may significantly impact on treatment outcome.

  13. Impact of ART on TB case fatality stratified by CD4 count for HIV-positive TB patients in Cape Town, South Africa (2009-2011).

    Science.gov (United States)

    Kaplan, Richard; Caldwell, Judy; Middelkoop, Keren; Bekker, Linda-Gail; Wood, Robin

    2014-08-15

    To identify determinants of tuberculosis (TB) case fatality including the impact of antiretroviral therapy (ART) at different CD4 thresholds for HIV-positive adult and adolescent TB patients. Through a retrospective analysis of the electronic TB database, we identified the HIV status of newly registered patients aged ≥15 years. Multivariable Cox proportional hazard models were used to determine the risk factors for TB case fatality in these patients. In 2009, 2010, and 2011, 25,841, 26,104, and 25,554 newly registered adult TB patients were treated in primary health care clinics in Cape Town, of whom 49.7%, 50.4%, and 50.9% were HIV positive. ART uptake increased over 3 years from 43% to 64.9%, and case fatality of the HIV-positive patients decreased from 7.0% to 5.8% (P ART had a substantial decrease in case fatality. The difference in case fatality between patients on ART and not on ART was most pronounced at low CD4 counts with the positive influence of ART noted up to a CD4 count threshold of 350 cells per cubic millimeter (P ART uptake, in 2011, 21% of the patients with CD4 counts ART during TB treatment. This study showed a relatively poor uptake of ART among severely immune-compromised TB patients. Patients with CD4 counts ART during TB treatment, and ART initiation should be prioritized for this category of patients.

  14. Understanding Market Size and Reporting Gaps for Paediatric TB in Indonesia, Nigeria and Pakistan: Supporting Improved Treatment of Childhood TB in the Advent of New Medicines.

    Science.gov (United States)

    Coghlan, Renia; Gardiner, Elizabeth; Amanullah, Farhana; Ihekweazu, Chikwe; Triasih, Rina; Grzemska, Malgorzata; Sismanidis, Charalambos

    2015-01-01

    We sought to understand gaps in reporting childhood TB cases among public and private sector health facilities (dubbed "non-NTP" facilities) outside the network of national TB control programmes, and the resulting impact of under-reporting on estimates of paediatric disease burden and market demand for new medicines. Exploratory assessments were carried out in Indonesia, Nigeria and Pakistan, reaching a range of facility types in two selected areas of each country. Record reviews and interviews of healthcare providers were carried out to assess numbers of unreported paediatric TB cases, diagnostic pathways followed and treatment regimens prescribed. A total of 985 unreported diagnosed paediatric TB cases were identified over a three month period in 2013 in Indonesia from 64 facilities, 463 in Pakistan from 35 facilities and 24 in Nigeria from 20 facilities. These represent an absolute additional annualised yield to 2013 notifications reported to WHO of 15% for Indonesia, 2% for Nigeria and 7% for Pakistan. Only 12% of all facilities provided age and sex-disaggregated data. Findings highlight the challenges of confirming childhood TB. Diagnosis patterns in Nigeria highlight a very low suspicion for childhood TB. Providers note the need for paediatric medicines aligned to WHO recommendations. This study emphasises the impact of incomplete reporting on the estimation of disease burden and potential market size of paediatric TB medicines. Further studies on "hubs" (facilities treating large numbers of childhood TB cases) will improve our understanding of the epidemic, support introduction efforts for new treatments and better measure markets for new paediatric medicines.

  15. Integration of HIV and TB Services Results in Improved TB Treatment Outcomes and Earlier Prioritized ART Initiation in a Large Urban HIV Clinic in Uganda

    NARCIS (Netherlands)

    Hermans, Sabine M.; Castelnuovo, Barbara; Katabira, Catherine; Mbidde, Peter; Lange, Joep M. A.; Hoepelman, Andy I. M.; Coutinho, Alex; Manabe, Yukari C.

    2012-01-01

    Background: The World Health Organization recommends that treatment of tuberculosis (TB) in HIV-infected patients should be integrated with HIV care. In December 2008, a separate outdoor-integrated TB/HIV clinic was instituted for attendees of a large urban HIV clinic in Uganda. We sought to

  16. Lithium-aluminum-zinc phosphate glasses activated with Tb3+ and Tb3+/Eu3+ for green laser medium, reddish-orange and white phosphor applications

    Science.gov (United States)

    Francisco-Rodriguez, H. I.; Lira, A.; Soriano-Romero, O.; Meza-Rocha, A. N.; Bordignon, S.; Speghini, A.; Lozada-Morales, R.; Caldiño, U.

    2018-05-01

    A spectroscopic analysis of Tb3+ and Tb3+/Eu3+ doped lithium-aluminum-zinc phosphate glasses is performed through their absorbance and photoluminescence spectra, and decay time profiles. Laser parameter values (stimulated emission cross section, effective bandwidth, gain bandwidth and optical gain) were obtained for the terbium 5D4 → 7F5 green emission from the Tb3+ singly-doped glass (LAZT) excited at 350 nm to judge the suitability of the glass phosphor for fiber lasers. A quantum yield of (47.68 ± 0.49)% was measured for the 5D4 level luminescence. Upon 350 nm excitation the LAZT glass phosphor emits green light with a color purity of 65.6% and chromaticity coordinates (0.285, 0.585) very close to those (0.29, 0.60) of European Broadcasting Union illuminant green. The Tb3+/Eu3+codoped glass emission color can be tuned from reddish-orange of 1865 K upon 318 nm excitation to warm white of 3599 K and neutral white of 4049 K upon 359 and 340 nm excitations, respectively. Upon Tb3+ excitation at 340 nm Eu3+ is sensitized by Tb3+ through a non-radiative energy transfer with an efficiency of 0.23-0.26. An electric dipole-dipole interaction might be the dominant mechanism in the Tb3+ to Eu3+ energy transfer taking place into Tb3+ - Eu3+ clusters.

  17. Estimating the effect of lay knowledge and prior contact with pulmonary TB patients, on health-belief model in a high-risk pulmonary TB transmission population.

    Science.gov (United States)

    Zein, Rizqy Amelia; Suhariadi, Fendy; Hendriani, Wiwin

    2017-01-01

    The research aimed to investigate the effect of lay knowledge of pulmonary tuberculosis (TB) and prior contact with pulmonary TB patients on a health-belief model (HBM) as well as to identify the social determinants that affect lay knowledge. Survey research design was conducted, where participants were required to fill in a questionnaire, which measured HBM and lay knowledge of pulmonary TB. Research participants were 500 residents of Semampir, Asemrowo, Bubutan, Pabean Cantian, and Simokerto districts, where the risk of pulmonary TB transmission is higher than other districts in Surabaya. Being a female, older in age, and having prior contact with pulmonary TB patients significantly increase the likelihood of having a higher level of lay knowledge. Lay knowledge is a substantial determinant to estimate belief in the effectiveness of health behavior and personal health threat. Prior contact with pulmonary TB patients is able to explain the belief in the effectiveness of a health behavior, yet fails to estimate participants' belief in the personal health threat. Health authorities should prioritize males and young people as their main target groups in a pulmonary TB awareness campaign. The campaign should be able to reconstruct people's misconception about pulmonary TB, thereby bringing around the health-risk perception so that it is not solely focused on improving lay knowledge.

  18. First reported case of fulminant TB with progression of infection from lungs to the genitourinary region

    Directory of Open Access Journals (Sweden)

    Tatjana Adzic-Vukicevic

    Full Text Available ABSTRACT Although tuberculosis (TB is a curable disease, it continues to be one of the leading infections associated with death in the world. Extra-pulmonary TB (EPTB occurs in approximately 10% of the total cases, presenting with lymph nodes, pleura, bone and genitourinary tract as the most common locations. Genitourinary tuberculosis, the second most common EPTB, is very difficult to diagnose unless there is a high index of suspicion. Isolated TB orchitis or prostatitis without clinical evidence of renal involvement is a rare entity among genitourinary tuberculosis. We presented the first reported case of TB prostatitis and orchitis associated with pulmonary TB and the presence of an acute massive caseous pneumonia in an immunocompetent man. Despite the anti-TB therapy, the patient presented a rapid progression of disease and deterioration of general conditions taking to death, which occurred four days after TB treatment had started. Disseminated TB is a relatively uncommon cause of acute massive caseous pneumonia; however, there should always be suspicion of the disease, since it is a potentially treatable cause. This rare case supports the assertion that TB should be considered as an important differential diagnosis of genitourinary tumors irrespective of evidence of active TB elsewhere in the body.

  19. Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013

    Science.gov (United States)

    Sandy, Charles; Masuka, Nyasha; Hazangwe, Patrick; Choto, Regis C.; Mutasa-Apollo, Tsitsi; Nkomo, Brilliant; Sibanda, Edwin; Mugurungi, Owen; Siziba, Nicholas

    2017-01-01

    Background. In 2013, the tuberculosis (TB) mortality rate was highest in southern Zimbabwe at 16%. We therefore sought to determine factors associated with mortality among registered TB patients in this region. Methodology. This was a retrospective record review of registered patients receiving anti-TB treatment in 2013. Results. Of 1,971 registered TB patients, 1,653 (84%) were new cases compared with 314 (16%) retreatment cases. There were 1,538 (78%) TB/human immunodeficiency virus (HIV) coinfected patients, of whom 1,399 (91%) were on antiretroviral therapy (ART) with median pre-ART CD4 count of 133 cells/uL (IQR, 46–282). Overall, 428 (22%) TB patients died. Factors associated with increased mortality included being ≥65 years old [adjusted relative risk (ARR) = 2.48 (95% CI 1.35–4.55)], a retreatment TB case [ARR = 1.34 (95% CI, 1.10–1.63)], and being HIV-positive [ARR = 1.87 (95% CI, 1.44–2.42)] whilst ART initiation was protective [ARR = 0.25 (95% CI, 0.22–0.29)]. Cumulative mortality rates were 10%, 14%, and 21% at one, two, and six months, respectively, after starting TB treatment. Conclusion. There was high mortality especially in the first two months of anti-TB treatment, with risk factors being recurrent TB and being HIV-infected, despite a high uptake of ART. PMID:28352474

  20. Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013

    Directory of Open Access Journals (Sweden)

    Kudakwashe C. Takarinda

    2017-01-01

    Full Text Available Background. In 2013, the tuberculosis (TB mortality rate was highest in southern Zimbabwe at 16%. We therefore sought to determine factors associated with mortality among registered TB patients in this region. Methodology. This was a retrospective record review of registered patients receiving anti-TB treatment in 2013. Results. Of 1,971 registered TB patients, 1,653 (84% were new cases compared with 314 (16% retreatment cases. There were 1,538 (78% TB/human immunodeficiency virus (HIV coinfected patients, of whom 1,399 (91% were on antiretroviral therapy (ART with median pre-ART CD4 count of 133 cells/uL (IQR, 46–282. Overall, 428 (22% TB patients died. Factors associated with increased mortality included being ≥65 years old [adjusted relative risk (ARR = 2.48 (95% CI 1.35–4.55], a retreatment TB case [ARR = 1.34 (95% CI, 1.10–1.63], and being HIV-positive [ARR = 1.87 (95% CI, 1.44–2.42] whilst ART initiation was protective [ARR = 0.25 (95% CI, 0.22–0.29]. Cumulative mortality rates were 10%, 14%, and 21% at one, two, and six months, respectively, after starting TB treatment. Conclusion. There was high mortality especially in the first two months of anti-TB treatment, with risk factors being recurrent TB and being HIV-infected, despite a high uptake of ART.

  1. The 500 deg. C isothermal section of the Gd-Tb-Co ternary system

    International Nuclear Information System (INIS)

    Zhou, K.W.; Zhuang, Y.H.; Li, J.Q.; Zhu, Q.M.; Deng, J.Q.

    2006-01-01

    The isothermal section of the phase diagram of the Gd-Tb-Co ternary system at 500 deg. C was investigated by X-ray powder diffraction, differential thermal analysis and metallographic analysis techniques. In this isothermal section, there are nine single-phase regions, eight two-phase regions and none three-phase region. No ternary compound was found. The compounds Gd 2 Co 17 and Tb 2 Co 17 , Gd 2 Co 7 and Tb 2 Co 7 , GdCo 3 and TbCo 3 , GdCo 2 and TbCo 2 , Gd 4 Co 3 and Tb 4 Co 3 , Gd 12 Co 7 and Tb 12 Co 7 , Gd 3 Co and Tb 3 Co, Gd and Tb form a continuous series of solid solutions. In addition, we experimentally determined the vertical section of pseudobinary system and the Curie temperature of Gd 1-x Tb x Co 2 (x from 0 to 1) series alloys

  2. Rapid Screening of MDR-TB in Cases of Extra Pulmonary Tuberculosis Using Geno Type MTBDRplus.

    Directory of Open Access Journals (Sweden)

    Richa Kumari

    Full Text Available Drug resistance in tuberculosis is a major public health challenge in developing countries. The limited data available on drug resistance in extra pulmonary tuberculosis stimulated us to design our study on anti-tuberculosis drug resistance pattern in cases of extra pulmonary tuberculosis in a tertiary referral hospital of North India. We performed Geno Type MTBDRplus assay in comparison with conventional drug susceptibility testing by proportion method to study the mutation patterns in rpoB, katG and inhA genes.A total of 510 extra pulmonary samples were included in this study. After the smear microscopy, all the specimens were subjected for culture on Lowenstein Jensen (LJ media. Phenotypic drug susceptibility testing (DST was performed on LJ media for all the MTB isolates and compared with the results of Geno Type MTBDRplus assay which was performed with the DNA isolated from the culture by conventional method.Of 510 specimens cultured, the total culture positivity obtained was 11.8% (60 encompassing 54 (10.6% Mycobacterium tuberculosis and 6 (1.2% non-tubercular mycobacteria (NTM. DST results by Geno Type MTBDRplus assay and solid culture methods were compared in 51 MTB isolates excluding the two Rif indeterminate and one invalid test. Geno Type MTBDRplus accurately identified 13 of 14 rifampicin-resistant strains, 14 of 15 isoniazid-resistant strains and 13 of 14 as multi drug resistant tuberculosis (MDR-TB in comparison with conventional method. Sensitivity and specificity were 92.86% and 97.30% respectively for detection of RIF resistance, 93.33% and 94.44% respectively for detection of INH resistance, 92.86% and 97.30% respectively for detection of MDR-TB, while the overall concordance of Geno Type MTBDRplus assay with conventional DST was 94.11%. The turn-around time for performing Geno Type MTBDRplus assay test was 48 hours.The problem of MDR in extra pulmonary tuberculosis (EPTB cannot be overlooked and due attention on patients

  3. TbRGG2 facilitates kinetoplastid RNA editing initiation and progression past intrinsic pause sites.

    Science.gov (United States)

    Ammerman, Michelle L; Presnyak, Vladimir; Fisk, John C; Foda, Bardees M; Read, Laurie K

    2010-11-01

    TbRGG2 is an essential kinetoplastid RNA editing accessory factor that acts specifically on pan-edited RNAs. To understand the mechanism of TbRGG2 action, we undertook an in-depth analysis of edited RNA populations in TbRGG2 knockdown cells and an in vitro examination of the biochemical activities of the protein. We demonstrate that TbRGG2 down-regulation more severely impacts editing at the 5' ends of pan-edited RNAs than at their 3' ends. The initiation of editing is reduced to some extent in TbRGG2 knockdown cells. In addition, TbRGG2 plays a post-initiation role as editing becomes stalled in TbRGG2-depleted cells, resulting in an overall decrease in the 3' to 5' progression of editing. Detailed analyses of edited RNAs from wild-type and TbRGG2-depleted cells reveal that TbRGG2 facilitates progression of editing past intrinsic pause sites that often correspond to the 3' ends of cognate guide RNAs (gRNAs). In addition, noncanonically edited junction regions are either absent or significantly shortened in TbRGG2-depleted cells, consistent with impaired gRNA transitions. Sequence analysis further suggests that TbRGG2 facilitates complete utilization of certain gRNAs. In vitro RNA annealing and in vivo RNA unwinding assays demonstrate that TbRGG2 can modulate RNA-RNA interactions. Collectively, these data are consistent with a model in which TbRGG2 facilitates initiation and 3' to 5' progression of editing through its ability to affect gRNA utilization, both during the transition between specific gRNAs and during usage of certain gRNAs.

  4. Processing of metacaspase 2 from Trypanosoma brucei (TbMCA2) broadens its substrate specificity.

    Science.gov (United States)

    Gilio, Joyce M; Marcondes, Marcelo F; Ferrari, Débora; Juliano, Maria A; Juliano, Luiz; Oliveira, Vitor; Machado, Maurício F M

    2017-04-01

    Metacaspases are members of the cysteine peptidase family and may be implicated in programmed cell death in plants and lower eukaryotes. These proteases exhibit calcium-dependent activity and specificity for arginine residues at P 1 . In contrast to caspases, they do not require processing or dimerization for activity. Indeed, unprocessed metacaspase-2 of Trypanosoma brucei (TbMCA2) is active; however, it has been shown that cleavages at Lys 55 and Lys 268 increase TbMCA2 hydrolytic activity on synthetic substrates. The processed TbMCA2 comprises 3 polypeptide chains that remain attached by non-covalent bonds. Replacement of Lys 55 and Lys 268 with Gly via site-directed mutagenesis results in non-processed but enzymatically active mutant, TbMCA2 K55/268G. To investigate the importance of this processing for the activity and specificity of TbMCA2, we performed activity assays comparing the non-processed mutant (TbMCA2 K55/268G) with the processed TbMCA2 form. Significant differences between TbMCA2 WT (processed form) and TbMCA2 K55/268G (non-processed form) were observed. Specifically, we verified that although non-processed TbMCA2 is active when assayed with small synthetic substrates, the TbMCA2 form does not exhibit hydrolytic activity on large substrates such as azocasein, while processed TbMCA2 is able to readily digest this protein. Such differences can be relevant for understanding the physiological regulation and function of TbMCA2. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. TB infection prevention and control experiences of South African nurses - a phenomenological study

    Science.gov (United States)

    2011-01-01

    Background The tuberculosis (TB) epidemic in South Africa is characterised by one of the highest levels of TB/HIV co-infection and growing multidrug-resistant TB worldwide. Hospitals play a central role in the management of TB. We investigated nurses' experiences of factors influencing TB infection prevention and control (IPC) practices to identify risks associated with potential nosocomial transmission. Methods The qualitative study employed a phenomenological approach, using semi-structured interviews with a quota sample of 20 nurses in a large tertiary academic hospital in Cape Town, South Africa. The data was subjected to thematic analysis. Results Nurses expressed concerns about the possible risk of TB transmission to both patients and staff. Factors influencing TB-IPC, and increasing the potential risk of nosocomial transmission, emerged in interconnected overarching themes. Influences related to the healthcare system included suboptimal IPC provision such as the lack of isolation facilities and personal protective equipment, and the lack of a TB-IPC policy. Further influences included inadequate TB training for staff and patients, communication barriers owing to cultural and linguistic differences between staff and patients, the excessive workload of nurses, and a sense of duty of care. Influences related to wider contextual conditions included TB concerns and stigma, and the role of traditional healers. Influences related to patient behaviour included late uptake of hospital care owing to poverty and the use of traditional medicine, and poor adherence to IPC measures by patients, family members and carers. Conclusions Several interconnected influences related to the healthcare system, wider contextual conditions and patient behavior could increase the potential risk of nosocomial TB transmission at hospital level. There is an urgent need for the implementation and evaluation of a comprehensive contextually appropriate TB IPC policy with the setting and

  6. Test

    DEFF Research Database (Denmark)

    Bendixen, Carsten

    2014-01-01

    Bidrag med en kortfattet, introducerende, perspektiverende og begrebsafklarende fremstilling af begrebet test i det pædagogiske univers.......Bidrag med en kortfattet, introducerende, perspektiverende og begrebsafklarende fremstilling af begrebet test i det pædagogiske univers....

  7. Patient reported delays in seeking treatment for Tuberculosis (TB among adult and pediatric TB patients and TB patients co-infected with HIV in Lima, Peru: a qualitative study

    Directory of Open Access Journals (Sweden)

    Valerie A Paz-Soldan

    2014-12-01

    Full Text Available Abstract: Tuberculosis (TB remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness. Objectives: The objective was to understand the complex factors that can impact TB patient health seeking behavior. Methods: In-depth interviews were conducted with adult and parents of pediatric patients receiving TB treatment (n=43, within that group a sub-group was also co-infected with HIV (n=11. Results: Almost all of the study participants recognized delays in seeking either their child’s or their own diagnosis of their TB symptoms. The principal reasons for treatment-seeking delays were lack of knowledge and confusion of tuberculosis symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention.Conclusions: Health promotion activities that target patient delays have the potential to improve individual patient outcomes and mitigate the spread of TB at a community level.

  8. Incremental Yield of Including Determine-TB LAM Assay in Diagnostic Algorithms for Hospitalized and Ambulatory HIV-Positive Patients in Kenya.

    Science.gov (United States)

    Huerga, Helena; Ferlazzo, Gabriella; Bevilacqua, Paolo; Kirubi, Beatrice; Ardizzoni, Elisa; Wanjala, Stephen; Sitienei, Joseph; Bonnet, Maryline

    2017-01-01

    Determine-TB LAM assay is a urine point-of-care test useful for TB diagnosis in HIV-positive patients. We assessed the incremental diagnostic yield of adding LAM to algorithms based on clinical signs, sputum smear-microscopy, chest X-ray and Xpert MTB/RIF in HIV-positive patients with symptoms of pulmonary TB (PTB). Prospective observational cohort of ambulatory (either severely ill or CD4<200cells/μl or with Body Mass Index<17Kg/m2) and hospitalized symptomatic HIV-positive adults in Kenya. Incremental diagnostic yield of adding LAM was the difference in the proportion of confirmed TB patients (positive Xpert or MTB culture) diagnosed by the algorithm with LAM compared to the algorithm without LAM. The multivariable mortality model was adjusted for age, sex, clinical severity, BMI, CD4, ART initiation, LAM result and TB confirmation. Among 474 patients included, 44.1% were severely ill, 69.6% had CD4<200cells/μl, 59.9% had initiated ART, 23.2% could not produce sputum. LAM, smear-microscopy, Xpert and culture in sputum were positive in 39.0% (185/474), 21.6% (76/352), 29.1% (102/350) and 39.7% (92/232) of the patients tested, respectively. Of 156 patients with confirmed TB, 65.4% were LAM positive. Of those classified as non-TB, 84.0% were LAM negative. Adding LAM increased the diagnostic yield of the algorithms by 36.6%, from 47.4% (95%CI:39.4-55.6) to 84.0% (95%CI:77.3-89.4%), when using clinical signs and X-ray; by 19.9%, from 62.2% (95%CI:54.1-69.8) to 82.1% (95%CI:75.1-87.7), when using clinical signs and microscopy; and by 13.4%, from 74.4% (95%CI:66.8-81.0) to 87.8% (95%CI:81.6-92.5), when using clinical signs and Xpert. LAM positive patients had an increased risk of 2-months mortality (aOR:2.7; 95%CI:1.5-4.9). LAM should be included in TB diagnostic algorithms in parallel to microscopy or Xpert request for HIV-positive patients either ambulatory (severely ill or CD4<200cells/μl) or hospitalized. LAM allows same day treatment initiation in patients at

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Evaluation of a diagnostic flow chart applying medical thoracoscopy, adenosine deaminase and T-SPOT.TB in diagnosis of tuberculous pleural effusion.

    Science.gov (United States)

    He, Y; Zhang, W; Huang, T; Wang, X; Wang, M

    2015-10-01

    To evaluate a diagnostic flow chart applying medical thoracoscoy (MT), adenosine deaminase (ADA) and T-SPOT.TB in diagnosis of tuberculous pleural effusion (TPE) at a high TB burden country. 136 patients with pleural effusion (PE) were enrolled and divided into TPE and Non-TPE group. MT (histology), PE ADA and T-SPOT.TB were conducted on all patients. ROC analysis was performed for the best cut-off value of PE ADA in detection of TPE. The diagnostic flow chart applying MT, ADA and T-SPOT.TB was evaluated for improving the limitations of each diagnostic method. ROC analysis showed that the best cut-off value of PE ADA was 30U/L. The sensitivity and specificity of these tests were calculated respectively to be: 71.4% (58.5%-81.6%) and 100% (95.4-100.0%) for MT, 92.9% (83.0-97.2%) and 68.8% (57.9-77.9%) for T-SPOT.TB, and 80.0% (69.6-88.1%) and 92.9% (82.7-98.0%) for PE ADA. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive value of the diagnostic flow chart were 96.4% (87.9-99.0%), 96.3% (89.6-98.7%), 25.714, 0.037, 97.4 and 94.9, respectively. The diagnostic flow chart applying MT, ADA and T-SPOT.TB is an accurate and rapid diagnostic method in detection of TPE.

  11. Local level epidemiological analysis of TB in people from a high incidence country of birth

    Directory of Open Access Journals (Sweden)

    Massey Peter D

    2013-01-01

    Full Text Available Abstract Background The setting for this analysis is the low tuberculosis (TB incidence state of New South Wales (NSW, Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas’ country of birth profiles. Methods TB notification data for the three year period 2006–2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder. Results During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5–19

  12. Local level epidemiological analysis of TB in people from a high incidence country of birth.

    Science.gov (United States)

    Massey, Peter D; Durrheim, David N; Stephens, Nicola; Christensen, Amanda

    2013-01-22

    The setting for this analysis is the low tuberculosis (TB) incidence state of New South Wales (NSW), Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC) in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas' country of birth profiles. TB notification data for the three year period 2006-2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder. During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA) in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5-19 years age group. Analysing local area TB rates and possible

  13. Coercivity enhancement of sintered Nd-Fe-B magnets by chemical bath deposition of TbCl{sub 3}

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Shuai, E-mail: gshuai@nimte.ac.cn; Zhang, Xiaofeng; Ding, Guangfei; Chen, Renjie; Yan, Aru [Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Material Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201 (China); Zhejiang Province Key Laboratory of Magnetic Materials and Application Technology, Ningbo Institute of Material Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201 (China); Lee, Don [Key Laboratory of Magnetic Materials and Devices, Ningbo Institute of Material Technology and Engineering, Chinese Academy of Sciences, Ningbo 315201 (China); University of Dayton, Dayton, Ohio 45469 (United States)

    2014-05-07

    The chemical bath deposition (CBD) and the grain boundary diffusion method were combined to diffuse the heavy rare earth for obtain the thick magnets with high coercivity and low heavy rare earth. The jet mill powders were soaked into the alcohol solution of 0.2 wt. % TbCl{sub 3}. A thin layer of TbCl{sub 3} was wrapped to the surface of (PrNd){sub 2}Fe{sub 14}B powder particles. The coercivity of magnet is increased from 11.89 kOe to 14.72 kOe without significant reduction of remanence after grain boundary diffusion in the sintering and the annealing processes. The temperature coefficients of the remanence and the coercivity are improved by the substitution of PrNd by Tb in the surface of grains. The highly accelerated temperature/humidity stress test (HAST) results indicate that the CBD magnet has poor corrosion resistance, attributing to the present of Cl atoms in the grain boundaries.

  14. Global evidence directing regional preventive strategies in Southeast Asia for fighting TB/HIV.

    Science.gov (United States)

    Aung, Myo Nyein; Moolphate, Saiyud; Paudel, Damodar; Jayathunge Ph, Mangalasiri; Duangrithi, Duangjai; Wangdi, Kinley; Aung, Thin Nyein Nyein; Lorga, Thaworn; Higuchi, Kazue

    2013-03-14

    Tuberculosis (TB) and human immunodeficiency virus (HIV) co-epidemics form a huge burden of disease in the Southeast Asia region. Five out of eleven nations in this region are high TB/HIV burden countries: Myanmar, Thailand, India, Indonesia and Nepal. The trends of TB incidence in these countries have been rising in recent years, in contrast to a falling global trend. Experts in the field of TB control and health service providers have been perplexed by the association of TB and HIV infections which causes a mosaic clinical presentation, a unique course with poor treatment outcomes including death. We conducted a review of contemporary evidence relating to TB/HIV control with the aims of assisting integrated health system responses in Southeast Asia and demystifying current evidence to facilitate translating it into practice.

  15. Dr Mario Raviglione, director of the Stop TB Department World Health Organization. Interview by Christo Hall.

    Science.gov (United States)

    Raviglione, Mario

    2012-03-01

    Tuberculosis (TB) is a very global disease; there are over 9 million new incidences of TB every year with the vast majority of cases emerging in the developing world. As one of three major diseases associated with poverty it affects the areas where poverty is most prevalent, notably Asia and Africa. While the incidence rate has been slowly declining in the developed world it continues to pose a major health threat to even the most developed nations. To demonstrate the global, and persistent, nature of TB we asked Dr Mario Raviglione, Director of the World Health Organization's Stop TB Department to provide an analysis on the current TB situation in the United Kingdom and comment on what measures should be taken to alleviate the issue of TB in one of the world's richest countries.

  16. Immunoendocrine Interactions during HIV-TB Coinfection: Implications for the Design of New Adjuvant Therapies

    Directory of Open Access Journals (Sweden)

    Guadalupe Veronica Suarez

    2015-01-01

    Full Text Available Worldwide, around 14 million individuals are coinfected with both tuberculosis (TB and human immunodeficiency virus (HIV. In coinfected individuals, both pathogens weaken immunological system synergistically through mechanisms that are not fully understood. During both HIV and TB infections, there is a chronic state of inflammation associated to dramatic changes in immune cytokine and endocrine hormone levels. Despite this, the relevance of immunoendocrine interaction on both the orchestration of an effective immune response against both pathogens and the control of the chronic inflammation induced during HIV, TB, or both infections is still controversial. The present study reviews immunoendocrine interactions occurring during HIV and TB infections. We also expose our own findings on immunoendocrine cross talk in HIV-TB coinfection. Finally, we evaluate the use of adrenal hormones and their derivatives in immune-therapy and discuss the use of some of these compounds like the adjuvant for the prevention and treatment of TB in HIV patients.

  17. Should all suspected tuberculosis cases in high income countries be tested with GeneXpert?

    Science.gov (United States)

    Vella, Venanzio; Broda, Agnieszka; Drobniewski, Francis

    2018-05-01

    In countries with a low incidence of multidrug-resistant tuberculosis (MDR-TB), universal testing with GeneXpert might not be always cost-effective. This study provides hospital managers in low MDR-TB incidence countries with criteria on when decentralised universal GeneXpert testing would make sense. The alternatives taken into consideration include: universal microbiological culture and drug susceptibility testing (DST) only (comparator); as above but with concurrent centralized GeneXpert in a referral laboratory vs a decentralized GeneXpert system in every hospital to test smear-positive cases only; as above but testing all samples with GeneXpert regardless of smear status. The parameters were from the national TB statistics for England and from a systematic review. Decentralised GeneXpert to test any suspected TB case was the most cost-effective option when 6% or more TB patients belonged to the high-risk group, defined as previous TB diagnosis and or being born in countries with a high MDR-TB incidence. Hospital managers in England and other low MDR-TB incidence countries could use these findings to decide when to invest in GeneXpert or other molecular diagnostics with similar performance criteria for TB diagnostics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. HIV and intestinal parasites in adult TB patients in a teaching hospital in Northwest Ethiopia.

    Science.gov (United States)

    Kassu, Afework; Mengistu, Getahun; Ayele, Belete; Diro, Ermias; Mekonnen, Firew; Ketema, Dereje; Moges, Feleke; Mesfin, Tsehay; Getachew, Assefa; Ergicho, Bahiru; Elias, Daniel; Wondmikun, Yared; Aseffa, Abraham; Ota, Fusao

    2007-10-01

    The level of HIV infection and intestinal parasitoses among TB patients was assessed in a hospital-based cross-sectional study involving 257 patients in Gondar, Ethiopia. In TB patients, our study reported co-infection with HIV (52.1%) and intestinal parasites (40.9%) The high prevalence of HIV and intestinal parasites indicates an increased morbidity inTB patients and emphasized the importance of continued HIV sero-surveillance, stool analysis and treatment.

  19. Age-specific mortality among TB patients in Denmark 1998-2010

    DEFF Research Database (Denmark)

    Fløe, Andreas; Løkke, Anders; Ibsen, Rikke

    Objective: To evaluate the age-specific mortality in a national TB cohort, and to estimate relative age-specific mortality compared with matched controls, in a retrospective case-control study. Methods: Using Danish National Patient Registry, we retrospectively identified TB-patients between 1998...... to matched controls. While the difference in survival is substantial among elderly patients, a high relative risk of dying is particularly of concern among young and middle-aged adult TB patients....

  20. Team approach to manage difficult-to-treat TB cases: Experiences in Europe and beyond

    Directory of Open Access Journals (Sweden)

    L. D’Ambrosio

    2018-03-01

    Full Text Available As recommended by the World Health Organization (WHO, optimal management of MDR-TB cases can be ensured by a multi-speciality consultation body known as ‘TB Consilium’. This body usually includes different medical specialities, competences and perspectives (e.g., clinical expertise both for adults and children; surgical, radiological and public health expertise; psychological background and nursing experience, among others, thus lowering the risk of making mistakes – or managing the patients inappropriately, in order to improve their clinical outcomes.At present, several high MDR-TB burden countries in the different WHO regions (and beyond have introduced TB Consilium-like bodies at the national or subnational level to reach consensus on the best treatment approach for their patients affected by TB.In addition, in countries/settings where a formal system of consultation does not exist, specialized staff from MDR-TB reference centres or international organizations usually spend a considerable amount of their working time responding to phone or e-mail clinical queries on how to manage M/XDR-TB cases.The aim of this manuscript is to describe the different experiences with the TB Consilia both at the international level (European Respiratory Society – ERS/WHO TB Consilium and in some of the countries where this experience operates successfully in Europe and beyond. The Consilium experiences are described around the following topics: (1 history, aims and focus; (2 management and funding; (3 technical functioning and structure; (4 results achieved.In addition a comparative analysis of the TB Consilia in the different countries has been performed. Keywords: MDR-TB, XDR-TB, Clinical management, Drug resistance, Prevention, Consilium

  1. HoTbTi2O7, the mixtures of spin ice and spin liquid

    International Nuclear Information System (INIS)

    Chang, L.J.; Terashita, H.; Schweika, W.; Chen, Y.Y.; Gardner, J.S.

    2007-01-01

    Polycrystalline samples of Ho 2- x Tb x Ti 2 O 7 (x=0.5, 1, and 1.5) have been prepared and characterized. No long-range order is observed for HoTbTi 2 O 7 in magnetization and specific heat measurements down to 2 K. The low-energy magnetic excitation measurements suggests that HoTbTi 2 O 7 possesses both characteristics of spin ice and spin liquid in the ground state

  2. Analysis of host responses to Mycobacterium tuberculosis antigens in a multi-site study of subjects with different TB and HIV infection states in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Jayne S Sutherland

    Full Text Available Tuberculosis (TB remains a global health threat with 9 million new cases and 1.4 million deaths per year. In order to develop a protective vaccine, we need to define the antigens expressed by Mycobacterium tuberculosis (Mtb, which are relevant to protective immunity in high-endemic areas.We analysed responses to 23 Mtb antigens in a total of 1247 subjects with different HIV and TB status across 5 geographically diverse sites in Africa (South Africa, The Gambia, Ethiopia, Malawi and Uganda. We used a 7-day whole blood assay followed by IFN-γ ELISA on the supernatants. Antigens included PPD, ESAT-6 and Ag85B (dominant antigens together with novel resuscitation-promoting factors (rpf, reactivation proteins, latency (Mtb DosR regulon-encoded antigens, starvation-induced antigens and secreted antigens.There was variation between sites in responses to the antigens, presumably due to underlying genetic and environmental differences. When results from all sites were combined, HIV- subjects with active TB showed significantly lower responses compared to both TST(- and TST(+ contacts to latency antigens (Rv0569, Rv1733, Rv1735, Rv1737 and the rpf Rv0867; whilst responses to ESAT-6/CFP-10 fusion protein (EC, PPD, Rv2029, TB10.3, and TB10.4 were significantly higher in TST(+ contacts (LTBI compared to TB and TST(- contacts fewer differences were seen in subjects with HIV co-infection, with responses to the mitogen PHA significantly lower in subjects with active TB compared to those with LTBI and no difference with any antigen.Our multi-site study design for testing novel Mtb antigens revealed promising antigens for future vaccine development. The IFN-γ ELISA is a cheap and useful tool for screening potential antigenicity in subjects with different ethnic backgrounds and across a spectrum of TB and HIV infection states. Analysis of cytokines other than IFN-γ is currently on-going to determine correlates of protection, which may be useful for vaccine

  3. Intraclonal genome diversity of Pseudomonas aeruginosa clones CHA and TB

    Science.gov (United States)

    2013-01-01

    Background Adaptation of Pseudomonas aeruginosa to different living conditions is accompanied by microevolution resulting in genomic diversity between strains of the same clonal lineage. In order to detect the impact of colonized habitats on P. aeruginosa microevolution we determined the genomic diversity between the highly virulent cystic fibrosis (CF) isolate CHA and two temporally and geographically unrelated clonal variants. The outcome was compared with the intraclonal genome diversity between three more closely related isolates of another clonal complex. Results The three clone CHA isolates differed in their core genome in several dozen strain specific nucleotide exchanges and small deletions from each other. Loss of function mutations and non-conservative amino acid replacements affected several habitat- and lifestyle-associated traits, for example, the key regulator GacS of the switch between acute and chronic disease phenotypes was disrupted in strain CHA. Intraclonal genome diversity manifested in an individual composition of the respective accessory genome whereby the highest number of accessory DNA elements was observed for isolate PT22 from a polluted aquatic habitat. Little intraclonal diversity was observed between three spatiotemporally related outbreak isolates of clone TB. Although phenotypically different, only a few individual SNPs and deletions were detected in the clone TB isolates. Their accessory genome mainly differed in prophage-like DNA elements taken up by one of the strains. Conclusions The higher geographical and temporal distance of the clone CHA isolates was associated with an increased intraclonal genome diversity compared to the more closely related clone TB isolates derived from a common source demonstrating the impact of habitat adaptation on the microevolution of P. aeruginosa. However, even short-term habitat differentiation can cause major phenotypic diversification driven by single genomic variation events and uptake of phage

  4. Current integration of tuberculosis (TB and HIV services in South Africa, 2011.

    Directory of Open Access Journals (Sweden)

    Joel C Chehab

    Full Text Available SETTING: Public Health Facilities in South Africa. OBJECTIVE: To assess the current integration of TB and HIV services in South Africa, 2011. DESIGN: Cross-sectional study of 49 randomly selected health facilities in South Africa. Trained interviewers administered a standardized questionnaire to one staff member responsible for TB and HIV in each facility on aspects of TB/HIV policy, integration and recording and reporting. We calculated and compared descriptive statistics by province and facility type. RESULTS: Of the 49 health facilities 35 (71% provided isoniazid preventive therapy (IPT and 35 (71% offered antiretroviral therapy (ART. Among assessed sites in February 2011, 2,512 patients were newly diagnosed with HIV infection, of whom 1,913 (76% were screened for TB symptoms, and 616 of 1,332 (46% of those screened negative for TB were initiated on IPT. Of 1,072 patients newly registered with TB in February 2011, 144 (13% were already on ART prior to Tb clinical diagnosis, and 451 (42% were newly diagnosed with HIV infection. Of those, 84 (19% were initiated on ART. Primary health clinics were less likely to offer ART compared to district hospitals or community health centers (p<0.001. CONCLUSION: As of February 2011, integration of TB and HIV services is taking place in public medical facilities in South Africa. Among these services, IPT in people living with HIV and ART in TB patients are the least available.

  5. Digital health for the End TB Strategy: developing priority products and making them work.

    Science.gov (United States)

    Falzon, Dennis; Timimi, Hazim; Kurosinski, Pascal; Migliori, Giovanni Battista; Van Gemert, Wayne; Denkinger, Claudia; Isaacs, Chris; Story, Alistair; Garfein, Richard S; do Valle Bastos, Luis Gustavo; Yassin, Mohammed A; Rusovich, Valiantsin; Skrahina, Alena; Van Hoi, Le; Broger, Tobias; Abubakar, Ibrahim; Hayward, Andrew; Thomas, Bruce V; Temesgen, Zelalem; Quraishi, Subhi; von Delft, Dalene; Jaramillo, Ernesto; Weyer, Karin; Raviglione, Mario C

    2016-07-01

    In 2014, the World Health Organization (WHO) developed the End TB Strategy in response to a World Health Assembly Resolution requesting Member States to end the worldwide epidemic of tuberculosis (TB) by 2035. For the strategy's objectives to be realised, the next 20 years will need novel solutions to address the challenges posed by TB to health professionals, and to affected people and communities. Information and communication technology presents opportunities for innovative approaches to support TB efforts in patient care, surveillance, programme management and electronic learning. The effective application of digital health products at a large scale and their continued development need the engagement of TB patients and their caregivers, innovators, funders, policy-makers, advocacy groups, and affected communities.In April 2015, WHO established its Global Task Force on Digital Health for TB to advocate and support the development of digital health innovations in global efforts to improve TB care and prevention. We outline the group's approach to stewarding this process in alignment with the three pillars of the End TB Strategy. The supplementary material of this article includes target product profiles, as developed by early 2016, defining nine priority digital health concepts and products that are strategically positioned to enhance TB action at the country level. The content of this work is ©the authors or their employers. Design and branding are ©ERS 2016.

  6. The WHO's new End TB Strategy in the post-2015 era of the Sustainable Development Goals.

    Science.gov (United States)

    Lönnroth, Knut; Raviglione, Mario

    2016-03-01

    The WHO's new End TB Strategy 2016-2035 has evolved from previous global strategies to respond to old and new challenges and take advantage of new opportunities. It frames the global fight against TB as a development, social justice and human rights issue, while re-emphasizing the public health and clinical fundaments of TB care and prevention. In this commentary, we outline how TB prevention, care and control will both benefit from and contribute to the achievement of the new Sustainable Development Goals that were recently adopted at the United Nations. © The author 2016. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.

  7. Evaluation of TB Case Finding through Systematic Contact Investigation, Chhattisgarh, India

    Directory of Open Access Journals (Sweden)

    Kshitij Khaparde

    2015-01-01

    Full Text Available Rationale. Contact investigation is an established tool for early case detection of tuberculosis (TB. In India, contact investigation is not often conducted, despite national policy, and the yield of contact investigation is not well described. Objective. To determine the yield of evaluating household contacts of sputum smear-positive TB cases in Rajnandgaon district, Chhattisgarh, India. Methods. Among 14 public health care facilities with sputum smear microscopy services, home visits were conducted to identify household contacts of all registered sputum smear-positive TB cases. We used a standardized protocol to screen for clinical symptoms suggestive of active TB with additional referral for chest radiograph and sputa collection. Results. From December 2010 to May 2011, 1,556 household contacts of 312 sputum smear-positive TB cases were identified, of which 148 (9.5% were symptomatic. Among these, 109 (73.6% were evaluated by sputum examination resulting in 11 cases (10.1% of sputum smear-positive TB and 4 cases (3.6% of smear-negative TB. Household visits contributed additional 63% TB cases compared to passive case detection alone. Conclusion. A standard procedure for conducting household contact investigation identified additional TB cases in the community and offered an opportunity to initiate isoniazid chemoprophylaxis among children.

  8. Sharing the spotlight in Durban: A report from IAS TB2016 at AIDS2016

    Directory of Open Access Journals (Sweden)

    J.A. Whitaker

    2017-05-01

    Full Text Available Tuberculosis (TB is now recognized as the number one cause of death worldwide due to a single infectious pathogen and is the cause of death in one-third of people living with HIV worldwide. An inaugural pre-conference focused on TB (TB2016 was held at the International AIDS Society Conference AIDS2016. This report focuses on key messages from the TB2016 conference that are important for the medical, public health, activist, and scientific communities. Keywords: Tuberculosis, HIV, Epidemiology, Public health, Treatment, Prevention

  9. Hindered El Transitions in Eu155 and Tb161

    International Nuclear Information System (INIS)

    Malmskog, Sven G.

    1965-02-01

    The absolute E1 transition probabilities from the 3/2 + (411), 5/2 - (532) and 7/2 - (523) single particle levels in Eu 155 and Tb 161 have been measured by the method of delayed coincidences. This gave half lives of T 1/2 1/2 = (1.38 ± 0.06) ns for the 104.4 and 246 keV levels in Eu 155 . T 1/2 = (0.84 ± 0.04) ns and T 1/2 161 . The result has been compared with the calculations of a single particle in a deformed potential made by Nilsson

  10. Polarized neutron study of TbNi2

    International Nuclear Information System (INIS)

    Givord, D.; Givord, F.; Gignoux, D.; Koehler, W.C.; Moon, R.M.

    1976-01-01

    Neutron diffraction experiments have been carried out on a TbNi 2 single crystal. Below the Curie temperature, 42 K, a magnetic contribution is observed only on nuclear scattering peaks. Therefore, the terbium atoms form a ferromagnetic structure. Polarized neutron measurements performed in the paramagnetic state, in an applied magnetic field of 57 kOe, reveal a non-uniform polarization of the conduction band. Within the experimental accuracy, no 3d magnetic moment is observed on nickel atoms. This result is consistent with the assumption of rare earth magnetic ordering occurring through the polarization of conduction electrons. (author)

  11. A superconducting magnet: Tb2Mo3Si4

    International Nuclear Information System (INIS)

    Aliev, F.G.; Pryadun, V.V.; Vieira, S.; Villar, R.; Paredes, J.; Levanyuk, A.P.; Yarovets, V.I.

    1994-01-01

    Measurements of transport properties (resistivity, Seebeck coefficient, thermal conductivity), thermal expansion, heat capacity and magnetic susceptibility of Tb 2 Mo 3 Si 4 samples with different annealing conditions show that in this superconductor (with T c between 0.5 and 1.2 K) a complex magnetic structure exists in the normal state, characterized by transitions at 2.3 K and 19 K. The expected magnetic structures are discussed taking into account the absence of experimental evidence of spontaneous magnetization and the possibility of an antiferromagnetic-structure formation without change of translational geometry. (orig.)

  12. Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients.

    Directory of Open Access Journals (Sweden)

    Anna H Van't Hoog

    Full Text Available The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB, that a quarter of the prevalent cases had not yet sought care, and a low case detection rate.We aimed to identify factors associated with inadequate case finding among adults with PTB in this population by comparing characteristics of 194 PTB patients diagnosed in a health facility after self-report, i.e., through passive case detection, with 88 patients identified through active case detection during the prevalence survey. We examined associations between method of case detection and patient characteristics, including HIV-status, socio-demographic variables and disease severity in univariable and multivariable logistic regression analyses.HIV-infection was associated with faster passive case detection in univariable analysis (crude OR 3.5, 95% confidence interval (CI 2.0-5.9, but in multivariable logistic regression this was largely explained by the presence of cough, illness and clinically diagnosed smear-negative TB (adjusted OR (aOR HIV 1.8, 95% CI 0.85-3.7. Among the HIV-uninfected passive case detection was less successful in older patients aOR 0.76, 95%CI 0.60-0.97 per 10 years increase, and women (aOR 0.27, 95%CI 0.10-0.73. Reported current or past alcohol use reduced passive case detection in both groups (0.42, 95% CI 0.23-0.79. Among smear-positive patients median durations of cough were 4.0 and 6.9 months in HIV-infected and uninfected patients, respectively.HIV-uninfected patients with infectious TB who were older, female, relatively less ill, or had a cough of a shorter duration were less likely found through passive case detection. In addition to intensified case finding in HIV-infected persons, increasing the suspicion of TB among HIV-uninfected women and the elderly are needed to improve TB case

  13. Simulation of the magnetocaloric effect in Tb nanofilms

    Energy Technology Data Exchange (ETDEWEB)

    Anselmo, Dory Hélio A. L., E-mail: doryh@dfte.ufrn.br [Departamento de Física Teórica e Experimental (DFTE), Universidade Federal do Rio Grande do Norte (UFRN), Natal-RN (Brazil); Mello, Vamberto D. [Departamento de Física,Universidade do Estado do Rio Grande do Norte (UERN), Mossoró-RN (Brazil); Vasconcelos, Manoel S. [Escola de Ciência e Tecnologia (ECT), Universidade Federal do Rio Grande do Norte (UFRN), Natal-RN (Brazil)

    2014-03-31

    Rare-earth (RE) metals have different magnetic structures resulting from the competition between the crystal-field and exchange interactions. When a magnetic field is applied it creates a third interaction and the magnetic structures are more complicated. In thin films, it is expected that even the magnetic arrangement itself can be strongly modified. Rare-earth helimagnets such as Terbium (Tb), Holmium (Ho) and Dysprosium (Dy) represent the best candidates to evidence such finite-size effects. This finite-size effect is caused by the reduced number of atoms in the direction perpendicular to the film plane that leads to a decrease of the total magnetic exchange energy. We report this contribution to the investigation of magnetocaloric effect (MCE) of thin Terbium films in the helimagnetic temperature range, from T{sub C} = 219 K to T{sub N} = 231 K, for external fields of the order of 1 kOe. We find that for strong fields, H = 50 kOe, the adiabatic temperature change ΔT near the Néel temperature is around 15 K for any thickness of Tb films. However large thickness effects are found for small values of the magnetic field. For field strength of the order of a few kOe, the thermocaloric efficiency increases significantly for ultrathin (nanomagnetic) films.

  14. The TT, TB, EB and BB correlations in anisotropic inflation

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xingang [Department of Physics, The University of Texas at Dallas, Richardson, TX 75083 (United States); Emami, Razieh [School of Physics, Institute for Research in Fundamental Sciences (IPM), P. O. Box 19395-5531, Tehran (Iran, Islamic Republic of); Firouzjahi, Hassan [School of Astronomy, Institute for Research in Fundamental Sciences (IPM), P. O. Box 19395-5531, Tehran (Iran, Islamic Republic of); Wang, Yi, E-mail: Xingang.Chen@utdallas.edu, E-mail: emami@ipm.ir, E-mail: firouz@ipm.ir, E-mail: yw366@cam.ac.uk [Centre for Theoretical Cosmology, DAMTP, University of Cambridge, Cambridge CB3 0WA (United Kingdom)

    2014-08-01

    The ongoing and future experiments will measure the B-mode from different sky coverage and frequency bands, with the potential to reveal non-trivial features in polarization map. In this work we study the TT, TB, EB and BB correlations associated with the B-mode polarization of CMB map in models of charged anisotropic inflation. The model contains a chaotic-type large field complex inflaton which is charged under the U(1) gauge field. We calculate the statistical anisotropies generated in the power spectra of the curvature perturbation, the tensor perturbation and their cross-correlation. It is shown that the asymmetry in tensor power spectrum is a very sensitive probe of the gauge coupling. While the level of statistical anisotropy in temperature power spectrum can be small and satisfy the observational bounds, the interactions from the gauge coupling can induce large directional dependence in tensor modes. This will leave interesting anisotropic fingerprints in various correlations involving the B-mode polarization such as the TB cross-correlation which may be detected in upcoming Planck polarization data. In addition, the TT correlation receives an anisotropic contribution from the tensor sector which naturally decays after l ∼> 100. We expect that the mechanism of using tensor sector to induce asymmetry at low l to be generic which can also be applied to address other low l CMB anomalies.

  15. Research training needs in Peruvian national TB/HIV programs

    Directory of Open Access Journals (Sweden)

    Gonzalez Elsa

    2010-09-01

    Full Text Available Abstract Background There are few published reports of research training needs assessments and research training programs. In an effort to expand this nascent field of study and to bridge the gap between research and practice, we sought to systematically assess the research training needs of health care professionals working at Peruvian governmental institutions leading HIV and tuberculosis (TB control and among senior stakeholders in the field. Methods Six institutional workshops were conducted with the participation of 161 mid-level health professionals from agencies involved in national HIV and TB control. At each workshop informants completed a structured questionnaire and participated in small and large group discussions. Additional data and institutional commitment was obtained through in-depth interviews from 32 senior managers and researchers from the Ministry of Health, academia and NGOs. Results Participants exhibited an overwhelming receptivity for additional research training, observing a gap between current levels of research training and their perceived importance. Specialized skills in obtaining funding, developing research protocols, particularly in operational, behavioral and prevention research were considered in greatest need. Beyond research training, participants identified broader social, economic and political factors as influential in infectious disease control. Conclusions The needs assessment suggests that future training should focus on operational research techniques, rather than on clinical skill building or program implementation only. Strengthening health systems not only requires additional research training, but also adequate financial resources to implement research findings.

  16. Research training needs in Peruvian national TB/HIV programs.

    Science.gov (United States)

    Garcia, Patricia J; Cotrina, Armando; Gotuzzo, Eduardo; Gonzalez, Elsa; Buffardi, Anne L

    2010-09-28

    There are few published reports of research training needs assessments and research training programs. In an effort to expand this nascent field of study and to bridge the gap between research and practice, we sought to systematically assess the research training needs of health care professionals working at Peruvian governmental institutions leading HIV and tuberculosis (TB) control and among senior stakeholders in the field. Six institutional workshops were conducted with the participation of 161 mid-level health professionals from agencies involved in national HIV and TB control. At each workshop informants completed a structured questionnaire and participated in small and large group discussions. Additional data and institutional commitment was obtained through in-depth interviews from 32 senior managers and researchers from the Ministry of Health, academia and NGOs. Participants exhibited an overwhelming receptivity for additional research training, observing a gap between current levels of research training and their perceived importance. Specialized skills in obtaining funding, developing research protocols, particularly in operational, behavioral and prevention research were considered in greatest need. Beyond research training, participants identified broader social, economic and political factors as influential in infectious disease control. The needs assessment suggests that future training should focus on operational research techniques, rather than on clinical skill building or program implementation only. Strengthening health systems not only requires additional research training, but also adequate financial resources to implement research findings.

  17. Research training needs in Peruvian national TB/HIV programs

    Science.gov (United States)

    2010-01-01

    Background There are few published reports of research training needs assessments and research training programs. In an effort to expand this nascent field of study and to bridge the gap between research and practice, we sought to systematically assess the research training needs of health care professionals working at Peruvian governmental institutions leading HIV and tuberculosis (TB) control and among senior stakeholders in the field. Methods Six institutional workshops were conducted with the participation of 161 mid-level health professionals from agencies involved in national HIV and TB control. At each workshop informants completed a structured questionnaire and participated in small and large group discussions. Additional data and institutional commitment was obtained through in-depth interviews from 32 senior managers and researchers from the Ministry of Health, academia and NGOs. Results Participants exhibited an overwhelming receptivity for additional research training, observing a gap between current levels of research training and their perceived importance. Specialized skills in obtaining funding, developing research protocols, particularly in operational, behavioral and prevention research were considered in greatest need. Beyond research training, participants identified broader social, economic and political factors as influential in infectious disease control. Conclusions The needs assessment suggests that future training should focus on operational research techniques, rather than on clinical skill building or program implementation only. Strengthening health systems not only requires additional research training, but also adequate financial resources to implement research findings. PMID:20875140

  18. Lu{sub 2}O{sub 3}:Tb,Hf storage phosphor

    Energy Technology Data Exchange (ETDEWEB)

    Kulesza, Dagmara; Trojan-Piegza, Joanna [Faculty of Chemistry, University of Wroclaw, 14 F. Joliot-Curie Street, 50-383 Wroclaw (Poland); Zych, Eugeniusz, E-mail: zych@wchuwr.p [Faculty of Chemistry, University of Wroclaw, 14 F. Joliot-Curie Street, 50-383 Wroclaw (Poland)

    2010-03-15

    Lu{sub 2}O{sub 3}:Tb,Hf ceramics containing 0.1% of Tb and 0-1.5% of Hf were prepared in reducing atmosphere at 1700 {sup o}C and their thermoluminescence properties were systematically studied. For comparison Tb,Ca co-doped specimen was also fabricated and investigated. The Tb,Hf ceramics shows basically a single TL band located around 180 {sup o}C as found with heating rate of 15 {sup o}C/min. Ceramics singly doped with Tb show complex TL glow curves indicating the presence of traps of very different depths. On the other hand Tb,Ca co-doping is beneficial for the development of shallow traps with the main TL band around 70 {sup o}C. Hence, the aliovalent impurities, Ca{sup 2+} and Hf{sup 4+}, strongly influenced the traps structure in Lu{sub 2}O{sub 3}:Tb ceramics, each of them in its own specific way. Isothermal decay of Lu{sub 2}O{sub 3}:Tb,Hf at 185 {sup o}C was recorded and its shape suggest that multiple hole trapping occurs in the Lu{sub 2}O{sub 3}:Tb,Hf ceramics. Due to the different traps depths the Lu{sub 2}O{sub 3}:Tb,Hf ceramics possess properties typical for storage phosphors, while Lu{sub 2}O{sub 3}:Tb,Ca is a persistent luminescent material rather.

  19. Convergence of a diabetes mellitus, protein energy malnutrition, and TB epidemic: the neglected elderly population.

    Science.gov (United States)

    Menon, Sonia; Rossi, Rodolfo; Nshimyumukiza, Leon; Wusiman, Aibibula; Zdraveska, Natasha; Eldin, Manal Shams

    2016-07-26

    On a global scale, nearly two billion persons are infected with Mycobacterium tuberculosis. From this vast reservoir of latent tuberculosis (TB) infection, a substantial number will develop active TB during their lifetime, with some being able to transmit TB or Multi-drug- resistant (MDR) TB to others. There is clinical evidence pointing to a higher prevalence of infectious diseases including TB among individuals with Diabetes Mellitus (DM). Furthermore, ageing and diabetes mellitus may further aggravate protein-energy malnutrition (PEM), which in turn impairs T-lymphocyte mediated immunologic defenses, thereby increasing the risk of developing active TB and compromising TB treatment. This article aims to a) highlight synergistic mechanisms associated with immunosenescence, DM and PEM in relation to the development of active TB and b) identify nutritional, clinical and epidemiological research gaps. To explore the synergistic relationship between ageing, DM, tuberculosis and PEM, a comprehensive review was undertaken. The MEDLINE and the Google Scholar databases were searched for articles published from 1990 to March 2015, using different MESH keywords in various combinations. Ageing and DM act synergistically to reduce levels of interferon gamma (IFN- γ), thereby increasing susceptibility to TB, for which cell mediated immunity (CMI) plays an instrumental role. These processes can set in motion a vicious nutritional cycle which can predispose to PEM, further impairing the CMI and consequently limiting host defenses. This ultimately transforms the latent TB infection into active disease. A clinical diagnostic algorithm and clinical guidelines need to be established for this population. Given the increase in ageing population with DM and PEM, especially in resource-poor settings, these synergistic tripartite interactions must be examined if a burgeoning TB epidemic is to be averted. Implementation of a comprehensive, all-encompassing approach to curb transmission

  20. System Tb-Fe-O: thermodynamic properties of ternary oxides using solid-state electrochemical cells

    International Nuclear Information System (INIS)

    Rakshit, S.K.; Parida, S.C.; Dash, S.; Singh, Ziley; Prasad, R.; Venugopal, V.

    2003-01-01

    The standard molar Gibbs free energies of formation of TbFeO 3 (s) and Tb 3 Fe 5 O 12 (s) have been determined using solid-state electrochemical cell employing different solid electrolytes. The reversible emfs of the following solid-state electrochemical cells have been measured in the temperature range 1050≤T/K≤1250. Cell (I):(-)Pt/{TbFeO 3 (s)+Tb 2 O 3 (s)+Fe(s)}//YDT/CSZ//{Fe(s)+Fe 0.95 O(s)}/Pt(+))) (Cell (II):(-)Pt/{Fe(s)+Fe 0.95 O(s)}//CSZ//{TbFeO 3 (s)+Tb 3 Fe 5 O 12 (s)+Fe 3 O 4 (s)}/Pt(+) The oxygen chemical potentials corresponding to the three-phase equilibria involving the ternary oxides have been computed from the emf data. The standard molar Gibbs free energies of formation of solid TbFeO 3 and Tb 3 Fe 5 O 12 calculated by the least-squares regression analysis of the data obtained in the present study are given by {Δ f G compfn m (TbFeO 3 ,s)/(kJ·mol -1 )±3.2}=-1357.5+0.2531·(T/K); (1050≤T/K≤1548);))and({Δ f G compfn m (Tb 3 Fe 5 O 12 ,s)/(kJ·mol -1 )±3.5}=-4901.7+ 0.9997·(T/K); (1050≤T/K≤1250).)) The uncertainty estimates for Δ f G compfn m include the standard deviation in the emf and uncertainty in the data taken from the literature. Based on the thermodynamic information, oxygen potential diagram and chemical potential diagrams were computed for the system Tb-Fe-O at T=1250 K

  1. The association between alcohol use, alcohol use disorders and tuberculosis (TB. A systematic review

    Directory of Open Access Journals (Sweden)

    Room Robin

    2009-12-01

    Full Text Available Abstract Background In 2004, tuberculosis (TB was responsible for 2.5% of global mortality (among men 3.1%; among women 1.8% and 2.2% of global burden of disease (men 2.7%; women 1.7%. The present work portrays accumulated evidence on the association between alcohol consumption and TB with the aim to clarify the nature of the relationship. Methods A systematic review of existing scientific data on the association between alcohol consumption and TB, and on studies relevant for clarification of causality was undertaken. Results There is a strong association between heavy alcohol use/alcohol use disorders (AUD and TB. A meta-analysis on the risk of TB for these factors yielded a pooled relative risk of 2.94 (95% CI: 1.89-4.59. Numerous studies show pathogenic impact of alcohol on the immune system causing susceptibility to TB among heavy drinkers. In addition, there are potential social pathways linking AUD and TB. Heavy alcohol use strongly influences both the incidence and the outcome of the disease and was found to be linked to altered pharmacokinetics of medicines used in treatment of TB, social marginalization and drift, higher rate of re-infection, higher rate of treatment defaults and development of drug-resistant forms of TB. Based on the available data, about 10% of the TB cases globally were estimated to be attributable to alcohol. Conclusion The epidemiological and other evidence presented indicates that heavy alcohol use/AUD constitute a risk factor for incidence and re-infection of TB. Consequences for prevention and clinical interventions are discussed.

  2. Risk factors associated with default among new smear positive TB patients treated under DOTS in India.

    Science.gov (United States)

    Vijay, Sophia; Kumar, Prahlad; Chauhan, Lakbir Singh; Vollepore, Balasangameshwara Hanumanthappa; Kizhakkethil, Unnikrishnan Pallikkara; Rao, Sumathi Govinda

    2010-04-06

    Poor treatment adherence leading to risk of drug resistance, treatment failure, relapse, death and persistent infectiousness remains an impediment to the tuberculosis control programmes. The objective of the study was to identify predictors of default among new smear positive TB patients registered for treatment to suggest possible interventions to set right the problems to sustain and enhance the programme performance. Twenty districts selected from six states were assigned to six strata formed, considering the geographic, socio-cultural and demographic setup of the area. New smear positive patients registered for treatment in two consecutive quarters during III quarter 2004 to III quarter 2005 formed the retrospective study cohort. Case control analysis was done including defaulted patients as "cases" and equal number of age and sex matched patients completing treatment as "controls". The presence and degree of association between default and determinant factors was computed through univariate and multivariate logistic regression analysis. Data collection was through patient interviews using pre-tested semi structured questionnaire and review of treatment related records. Information on a wide range of socio demographic and patient related factors was obtained. Among the 687 defaulted and equal numbers of patients in completed group, 389 and 540 patients respectively were satisfactorily interviewed. In the logistic regression analysis, factors independently associated with default were alcoholism [AOR-1.72 (1.23-2.44)], illiteracy [AOR-1.40 (1.03-1.92)], having other commitments during treatment [AOR-3.22 (1.1-9.09)], inadequate knowledge of TB [AOR-1.88(1.35-2.63)], poor patient provider interaction [AOR-1.72(1.23-2.44)], lack of support from health staff [AOR-1.93(1.41-2.64)], having instances of missed doses [AOR-2.56(1.82-3.57)], side effects to anti TB drugs [AOR-2.55 (1.87-3.47)] and dissatisfaction with services provided [AOR-1.73 (1.14-2.6)]. Majority of

  3. Risk factors associated with default among new smear positive TB patients treated under DOTS in India.

    Directory of Open Access Journals (Sweden)

    Sophia Vijay

    2010-04-01

    Full Text Available Poor treatment adherence leading to risk of drug resistance, treatment failure, relapse, death and persistent infectiousness remains an impediment to the tuberculosis control programmes. The objective of the study was to identify predictors of default among new smear positive TB patients registered for treatment to suggest possible interventions to set right the problems to sustain and enhance the programme performance.Twenty districts selected from six states were assigned to six strata formed, considering the geographic, socio-cultural and demographic setup of the area. New smear positive patients registered for treatment in two consecutive quarters during III quarter 2004 to III quarter 2005 formed the retrospective study cohort. Case control analysis was done including defaulted patients as "cases" and equal number of age and sex matched patients completing treatment as "controls". The presence and degree of association between default and determinant factors was computed through univariate and multivariate logistic regression analysis. Data collection was through patient interviews using pre-tested semi structured questionnaire and review of treatment related records. Information on a wide range of socio demographic and patient related factors was obtained. Among the 687 defaulted and equal numbers of patients in completed group, 389 and 540 patients respectively were satisfactorily interviewed. In the logistic regression analysis, factors independently associated with default were alcoholism [AOR-1.72 (1.23-2.44], illiteracy [AOR-1.40 (1.03-1.92], having other commitments during treatment [AOR-3.22 (1.1-9.09], inadequate knowledge of TB [AOR-1.88(1.35-2.63], poor patient provider interaction [AOR-1.72(1.23-2.44], lack of support from health staff [AOR-1.93(1.41-2.64], having instances of missed doses [AOR-2.56(1.82-3.57], side effects to anti TB drugs [AOR-2.55 (1.87-3.47] and dissatisfaction with services provided [AOR-1.73 (1

  4. Evaluation of accessory cell heterogeneity. I. Differential accessory cell requirement for T helper cell activation and for T-B cooperation.

    Science.gov (United States)

    Ramila, G; Studer, S; Kennedy, M; Sklenar, I; Erb, P

    1985-01-01

    Several Ia+ tumor cell lines and peritoneal exudate macrophages were tested as accessory cells (AC) for the activation of antigen-specific T cells and for T-B cooperation. The macrophages and all the Ia+ tumor lines tested induced the release of lymphokines from T cells in a major histocompatibility complex (MHC)-restricted fashion and reconstituted the antibody responses of AC-depleted spleen cells or of purified T and B cells. However, only the normal macrophages but none of the tumor lines induced carrier-specific T helper (Th) cells which help B cells for specific antihapten antibody responses by linked recognition. For T-B cooperation accessory cells were also required, but in contrast to Th cell activation any type of Ia+ AC (e.g. macrophage or tumor line) was effective. Strong MHC-restriction between the lymphocytes and the AC was seen if antigen-pulsed AC were added into the AC-depleted T-B cooperation cultures. If the AC and antigen were concomitantly added to the AC-depleted T-B cultures, MHC-restriction was less obvious. Concanavalin A supernatant reconstituted the response of AC-depleted T-B cultures provided antigen-specific Th cells and the hapten-carrier conjugate were present. If, however, tumor line-activated T cells were added instead of macrophage-induced Th cells, no cooperation with B cells took place even in the presence of Con A supernatant. The results obtained demonstrate a differential AC requirement for the induction of Th cells depending on the differentiation stage of the Th cells.

  5. High-coercivity Nd-Fe-B magnets obtained with the electrophoretic deposition of submicron TbF3 followed by the grain-boundary diffusion process

    International Nuclear Information System (INIS)

    Soderžnik, Marko; Korent, Matic; Žagar Soderžnik, Kristina; Katter, Matthias; Üstüner, Kaan; Kobe, Spomenka

    2016-01-01

    Using a grain-boundary diffusion process (GBDP) involving the electrophoretic deposition (EPD) of submicron TbF 3 powder, we substantially increased the coercivity of sintered Nd-Fe-B permanent magnets. The experiments used magnets with low heavy-rare-earth (HRE) content (HRE = 1.2 wt%) and a coercivity of 790 kA/m (at 75 °C). After experiencing optimized conditions at 875 °C for 10 h and subsequent annealing at 500 °C for 1 h, the coercivity was increased to 1536 kA/m (at 75 °C). This value is 1.94 times higher than that for a sintered magnet, without post-sintering heat treatment. Furthermore, a vibration test revealed satisfactory adhesion of the TbF 3 powder to the surface of the magnet with no detected reduction in coercivity. Using field emission gun scanning electron microscopy (FEG-SEM) with an energy dispersive spectroscope (EDS), we confirmed the formation of various secondary intergranular phases and the core-shell-type microstructure, which increases the coercivity. The Tb content in the magnet, exposed to the EPD-based GBDP, was controlled by inductively coupled plasma optical electron spectroscopy (ICP-OES). The additional Tb detected in the magnet due to the described technology was only 0.12 wt%.

  6. Syntheses and crystal structures of BaAgTbS{sub 3}, BaCuGdTe{sub 3}, BaCuTbTe{sub 3}, BaAgTbTe{sub 3}, and CsAgUTe{sub 3}

    Energy Technology Data Exchange (ETDEWEB)

    Prakash, Jai; Beard, Jessica C.; Ibers, James A. [Department of Chemistry, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208-3113 (United States); Mesbah, Adel [Department of Chemistry, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208-3113 (United States); ICSM-UMR 5257 CNRS/CEA/UM2/ENSCM, Bat 426, BP 17171, 30207 Bagnols/Ceze (France)

    2015-06-15

    Five new quaternary chalcogenides of the 1113 family, namely BaAgTbS{sub 3}, BaCuGdTe{sub 3}, BaCuTbTe{sub 3}, BaAgTbTe{sub 3}, and CsAgUTe{sub 3}, were synthesized by the reactions of the elements at 1173-1273 K. For CsAgUTe{sub 3} CsCl flux was used. Their crystal structures were determined by single-crystal X-ray diffraction studies. The sulfide BaAgTbS{sub 3} crystallizes in the BaAgErS{sub 3} structure type in the monoclinic space group C{sup 3},{sub 2h}-C2/m, whereas the tellurides BaCuGdTe{sub 3}, BaCuTbTe{sub 3}, BaAgTbTe{sub 3}, and CsAgUTe{sub 3} crystallize in the KCuZrS{sub 3} structure type in the orthorhombic space group D{sup 1},{sub 2}{sup 7},{sub h}-Cmcm. The BaAgTbS{sub 3} structure consists of edge-sharing [TbS{sub 6}{sup 9-}] octahedra and [AgS{sub 5}{sup 9-}] trigonal pyramids. The connectivity of these polyhedra creates channels that are occupied by Ba atoms. The telluride structure features {sup 2}{sub ∞}[MLnTe{sub 3}{sup 2-}] layers for BaCuGdTe{sub 3}, BaCuTbTe{sub 3}, BaAgTbTe{sub 3}, and {sup 2}{sub ∞}[AgUTe{sub 3}{sup 1-}] layers for CsAgUTe{sub 3}. These layers comprise [MTe{sub 4}] tetrahedra and [LnTe{sub 6}] or [UTe{sub 6}] octahedra. Ba or Cs atoms separate these layers. As there are no short Q..Q (Q = S or Te) interactions these compounds achieve charge balance as Ba{sup 2+}M{sup +}Ln{sup 3+}(Q{sup 2-}){sub 3} (Q = S and Te) and Cs{sup +}Ag{sup +}U{sup 4+}(Te{sup 2-}){sub 3}. (Copyright copyright 2015 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  7. The role of variants from the innate immune system genes in tuberculosis and skin test response in a Native American population.

    Science.gov (United States)

    Lindenau, Juliana D; Salzano, Francisco M; Hurtado, Ana M; Hill, Kim R; Hutz, Mara H

    2016-10-01

    Native American populations show higher tuberculosis (TB) mortality and infectivity rates than non-Native populations. Variants in the innate immune system seem to have an important role on TB susceptibility. The role of some innate immune system variants in TB susceptibility and/or skin test response (PPD) were investigated in the Aché, a Native American population. Complement receptor 1 and toll like receptor 9 variants were associated with anergy to PPD and protection to TB, respectively. These findings demonstrate an important role of the innate immune system variants in TB susceptibility. Copyright © 2016 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  8. Antiretroviral Treatment Scale-Up and Tuberculosis Mortality in High TB/HIV Burden Countries: An Econometric Analysis.

    Science.gov (United States)

    Yan, Isabel; Bendavid, Eran; Korenromp, Eline L

    2016-01-01

    Antiretroviral therapy (ART) reduces mortality in patients with active tuberculosis (TB), but the population-level relationship between ART coverage and TB mortality is untested. We estimated the reduction in population-level TB mortality that can be attributed to increasing ART coverage across 41 high HIV-TB burden countries. We compiled TB mortality trends between 1996 and 2011 from two sources: (1) national program-reported TB death notifications, adjusted for annual TB case detection rates, and (2) WHO TB mortality estimates. National coverage with ART, as proportion of HIV-infected people in need, was obtained from UNAIDS. We applied panel linear regressions controlling for HIV prevalence (5-year lagged), coverage of TB interventions (estimated by WHO and UNAIDS), gross domestic product per capita, health spending from domestic sources, urbanization, and country fixed effects. Models suggest that that increasing ART coverage was followed by reduced TB mortality, across multiple specifications. For death notifications at 2 to 5 years following a given ART scale-up, a 1% increase in ART coverage predicted 0.95% faster mortality rate decline (p = 0.002); resulting in 27% fewer TB deaths in 2011 alone than would have occurred without ART. Based on WHO death estimates, a 1% increase in ART predicted a 1.0% reduced TB death rate (peconometric analysis supports a substantial impact of ART on population-level TB mortality realized already within the first decade of ART scale-up, that is apparent despite variable-quality mortality data.

  9. Role of oral candidiasis in TB and HIV co-infection: AIDS Clinical Trial Group Protocol A5253.

    Science.gov (United States)

    Shiboski, C H; Chen, H; Ghannoum, M A; Komarow, L; Evans, S; Mukherjee, P K; Isham, N; Katzenstein, D; Asmelash, A; Omozoarhe, A E; Gengiah, S; Allen, R; Tripathy, S; Swindells, S

    2014-06-01

    To evaluate the association between oral candidiasis and tuberculosis (TB) in human immunodeficiency virus (HIV) infected individuals in sub-Saharan Africa, and to investigate oral candidiasis as a potential tool for TB case finding. Protocol A5253 was a cross-sectional study designed to improve the diagnosis of pulmonary TB in HIV-infected adults in high TB prevalence countries. Participants received an oral examination to detect oral candidiasis. We estimated the association between TB disease and oral candidiasis using logistic regression, and sensitivity, specificity and predictive values. Of 454 participants with TB culture results enrolled in African sites, the median age was 33 years, 71% were female and the median CD4 count was 257 cells/mm(3). Fifty-four (12%) had TB disease; the prevalence of oral candidiasis was significantly higher among TB cases (35%) than among non-TB cases (16%, P oral candidiasis when controlling for CD4 count and antifungals (95%CI 1.2-4.7, P = 0.01). The sensitivity of oral candidiasis as a predictor of TB was 35% (95%CI 22-48) and the specificity 85% (95%CI 81-88). We found a strong association between oral candidiasis and TB disease, independent of CD4 count, suggesting that in resource-limited settings, oral candidiasis may provide clinical evidence for increased risk of TB and contribute to TB case finding.

  10. Cost-effectiveness of initiating antiretroviral therapy at different points in TB treatment in HIV-TB co-infected ambulatory patients in South Africa

    Science.gov (United States)

    Naidoo, Kogieleum; Grobler, Anneke C; Deghaye, Nicola; Reddy, Tarylee; Gengiah, Santhanalakshmi; Gray, Andrew; Karim, Salim Abdool

    2015-01-01

    Objective Initiation of antiretroviral therapy (ART) during tuberculosis (TB) treatment improves survival in TB-HIV co-infected patients. In patients with CD4+ counts benefit of early ART initiation. The purpose of this study was to assess the costs and cost effectiveness of starting ART at various time points during TB treatment in patients with CD4+ counts ≥50cells/mm3. Methods In the SAPiT trial, 642 HIV-TB co-infected patients were randomized to three arms, either receiving ART within 4 weeks of starting TB treatment (early treatment arm; Arm-1), after the intensive phase of TB treatment (late treatment arm; Arm-2), or after completing TB treatment (sequential arm; Arm-3). Direct healthcare costs were measured from a provider perspective using a micro-costing approach. The incremental cost per death averted was calculated using the trial outcomes. Results For patients with CD4+ count≥50cells/mm3, median monthly variable costs per patient were $116, $113 and $102 in Arms-1, -2 and -3, respectively. There were 12 deaths in 177 patients in Arm-1, 8 deaths in 180 patients in the Arm-2 and 19 deaths in 172 patients in Arm-3. While the costs were lower in Arm-3, it had a substantially higher mortality rate. The incremental cost per death averted associated with moving from Arm-3 to Arm-2 was $4199. There was no difference in mortality between Arm-1 and Arm-2, but Arm-1 was slightly more expensive. Conclusions Initiation of ART after the completion of the intensive phase of TB treatment is cost effective for patients with CD4+ counts≥50cells/mm3. PMID:26167618

  11. 46 CFR 35.05-25 - Illness, alcohol, drugs-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Illness, alcohol, drugs-TB/ALL. 35.05-25 Section 35.05-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Officers and Crews § 35.05-25 Illness, alcohol, drugs—TB/ALL. (a) No person, known by the individual in charge of a tank...

  12. Is Chemoprophylaxis for Child Contacts of Drug-Resistant TB Patients Beneficial? A Systematic Review

    Directory of Open Access Journals (Sweden)

    C. Padmapriyadarsini

    2018-01-01

    Full Text Available Background. Preventive therapy for child contacts of multidrug-resistant tuberculosis (MDR-TB patients is poorly studied, and no consensus about the role and the rationale of chemoprophylaxis has been reached. Objective. To conduct systematic review with an aim to determine the effectiveness of TB preventive therapy in reducing the incidence of TB disease in pediatric contacts of MDR-TB patients. Methods. We conducted a literature search for randomized control trials, cohort studies, and case reports of chemoprophylaxis for pediatric contacts of MDR-TB patients in PubMed, EMBASE, Cochrane Databases of Systematic Reviews, metaRegister of Controlled Trials, and other clinical registries through March 2017, using appropriate search strategy. In addition we searched abstracts from international conferences and references of published articles and reviews. Results. Of the 153 references assessed from various databases, seven studies were identified as relevant after adaption of eligibility criteria and assessed for systematic review. Of these, only two studies contributed data for the pooled meta-analysis. Conclusions. Though the available evidences suggest that the chemoprophylaxis for child contacts of MDR-TB patients is beneficial, data to support or reject preventive therapy is very limited. Further clinical research, in Tb endemic settings like India, needs to be performed to prove the beneficial effect of chemoprophylaxis for pediatric contacts of MDR-TB.

  13. XDR TB in South Africa - What lies ahead? | Thaver | South African ...

    African Journals Online (AJOL)

    The emergence of XDR TB coupled with the high prevalence of HIV/AIDS has intensified the need to identify new treatment strategies and accelerate research into antibiotics against XDR TB before the world is faced with a global public health crisis. This article gives a short overview on the important health implications of ...

  14. 46 CFR 32.35-1 - Boilers and machinery-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Boilers and machinery-TB/ALL. 32.35-1 Section 32.35-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Main and Auxiliary Machinery § 32.35-1 Boilers and machinery—TB/ALL. Boilers, main and auxiliary...

  15. 46 CFR 32.75-5 - Hull requirements; general-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Hull requirements; general-TB/ALL. 32.75-5 Section 32.75..., AND HULL REQUIREMENTS Hull Requirements for Wood Hull Tank Vessels Constructed Prior to November 10, 1936 § 32.75-5 Hull requirements; general—TB/ALL. The scantlings, material, and workmanship, and the...

  16. 46 CFR 32.70-5 - Hull requirements; general-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Hull requirements; general-TB/ALL. 32.70-5 Section 32.70..., AND HULL REQUIREMENTS Hull Requirements for Steel Hull Tank Vessels Constructed Prior to November 10, 1936 § 32.70-5 Hull requirements; general—TB/ALL. The scantlings, material, and workmanship, the...

  17. Dipolar and Non-Dipolar Interactions in LiTbF4

    DEFF Research Database (Denmark)

    Holmes, L. M.; Als-Nielsen, Jens Aage; Guggenheim, H. J.

    1975-01-01

    The magnetic interactions in LiTbF4 have been studied in measurements of the quasielastic scattering of neutrons from the paramagnetic crystal. Scattering data have been collected at a temperature T=18.6 K, which is 6.5 times the Curie temperature of LiTbF4, and have been least-squares fitted...

  18. Management of TB/HIV Co-Infection in the Context of the DOTS ...

    African Journals Online (AJOL)

    The reason for this deterioration in both developed and developing countries are mainly due to improper diagnosis and treatment, poor drug compliance, increase travel and migration, multi-resistant TB, increase number of refugee from wars and famine and lately to the pandemic of HIV/AIDS(4). Key Words: TB/HIV, ...

  19. Profile of HIV-1 RNA viral load among HIV-TB co-infected patients in ...

    African Journals Online (AJOL)

    Profile of HIV-1 RNA viral load among HIV-TB co-infected patients in a tertiary health facility in Maiduguri, Northeastern Nigeria. ... This study aims to estimate the HIV-1 RNA viral load and impact of anti TB therapy (ATT) ... HOW TO USE AJOL.

  20. HIV and TB co-infection in South Sudan: a three year retrospective ...

    African Journals Online (AJOL)

    dual HIV/TB co-infection is in Africa in which one-third ... HIV and TB rates. A high commercial sex workers presence in the towns. •. [10]. .... but lower than prevalences found in studies conducted .... A retrospective cohort study in South African.

  1. Assessing the effect of TB-HIV collaborative activities on knowledge ...

    African Journals Online (AJOL)

    Assessing the effect of TB-HIV collaborative activities on knowledge and perception of TB patients ... Tanzania Journal of Health Research ... which requires to be corrected as soon as possible so as to enable patients to undertake active steps ...

  2. Treatment outcome of tb/hiv positive and negative smear positive ...

    African Journals Online (AJOL)

    Background: In our previous study we found that half of the patients treated at the Nylon District Hospital tuberculosis (TB) treatment centre were seropositive. HIV does not only fuel the number of tuberculosis (TB) cases worldwide but it is also at least in part, responsible for the non-achievement of the 85% cure rate target.

  3. Photoluminescence properties of X5SiO4Cl6:Tb (X = Sr, Ba) green ...

    Indian Academy of Sciences (India)

    attracted more attention due to their potential applications ... materials were thoroughly mixed and ground in an agate mortar. ... Figure 2. Excitation spectra of Ba5SiO4Cl6:Tb3+ phosphor. spectrum of Tb3+ singly doped phosphor Ba5SiO4Cl6,.

  4. The normal and inverse magnetocaloric effect in RCu2 (R=Tb, Dy, Ho, Er) compounds

    International Nuclear Information System (INIS)

    Zheng, X.Q.; Xu, Z.Y.; Zhang, B.; Hu, F.X.; Shen, B.G.

    2017-01-01

    Orthorhombic polycrystalline RCu 2 (R=Tb, Dy, Ho and Er) compounds were synthesized and the magnetic properties and magnetocaloric effect (MCE) were investigated in detail. All of the RCu 2 compounds are antiferromagnetic (AFM) ordered. As temperature increases, RCu 2 compounds undergo an AFM to AFM transition at T t and an AFM to paramagnetic (PM) transition at T N . Besides of the normal MCE around T N , large inverse MCE around T t was found in TbCu 2 compound. Under a field change of 0–7 T, the maximal value of inverse MCE is even larger than the value of normal MCE around T N for TbCu 2 compound. Considering of the normal and inverse MCE, TbCu 2 shows the largest refrigerant capacity among the RCu 2 (R=Tb, Dy, Ho and Er) compounds indicating its potential applications in low temperature multistage refrigeration. - Highlights: • Large inverse magnetocaloric effect is observed in TbCu 2 compound. • The AFM to AFM transition is observed in RCu 2 (R=Tb, Dy, Ho, Er) compounds. • The MCE performance of TbCu 2 compound is evaluated in a more comprehensively way.

  5. TB/HIV integration at primary care level: A quantitative assessment ...

    African Journals Online (AJOL)

    2012-09-02

    Sep 2, 2012 ... Public Health Leadership Program, University of North Carolina, Chapel Hill, NC, USA. L Evarts, MPH. WitkoppenHealth ..... for TB symptoms. • 10% of TB suspects assessed by smear microscopy. Percentage of new HIV-positive patients starting. IPT (indicator B.2.1). 100%. 124 059 (12%). • 0% at 2 clinics.

  6. HUBUNGAN ANTARA PERILAKU PENCEGAHAN DAN KEPATUHAN BEROBAT PENDERITA TB DI INDONESIA

    Directory of Open Access Journals (Sweden)

    Noor Edi Widya Sukoco

    2012-11-01

    Full Text Available Background: Indonesia constitutes the third highest of Tuberculosis (TB cases after India and China. One of the problem in TB control is still low of drug treatment compliance of TB patients. The objective of this study was to know the relationship between TB disease prevention behaviors with treatment compliance of TB patients in Indonesia. Methods: Data explored from National Basic Health Survey (Riskesdas 2010. The data is designed to represent provinces. Design of study is cross sectional. The population is all respondents of Riskesdas 2010, while samples were chosen aged > 5 years with Pulmonary TB, particularly the TB patients who was received medication and treated by health facilities. The number of samples are all 968 patients. Interviews were conducted by skilled interviewers. Data were processed by SPSS 15 version. Results: The behavior of respondents drying the wrong mattress have risk non-compliant treatment about 1. 64 compared with the behavior of respondents drying the right mattress (OR = 1. 64; P = 0.001; confidence interval (CI=1. 21-2.22. Likewise, low education has risk non-compliant treatment in the amount of 1.62 compared with highly educated respondents (OR= 1.62; P = 0.005; confidence interval (CI = 1.15-2.27. Conclusion: The updated data signify that analysis of drug adherence TB patients will show significantly in correlation between drug adherence with level of education, and behaviour of dry mattress. Key words: drug compliance, preventive behavior. tuberculosis

  7. History of TB in the Sudan | Zaki | Sudan Journal of Medical Sciences

    African Journals Online (AJOL)

    Introduction: Medical history in Sudan is far from being complete. There are no reliable records. Attempt to write on the projects and development of history of TB in the Sudan is a difficult task. Objective: To study and trace the progress of TB in Sudan during the last century through their historical development. Design: A ...

  8. 46 CFR 30.10-33 - Great Lakes-TB/L.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Great Lakes-TB/L. 30.10-33 Section 30.10-33 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS GENERAL PROVISIONS Definitions § 30.10-33 Great Lakes—TB/L. Under this designation shall be included all tank vessels navigating the Great Lakes. ...

  9. 46 CFR 32.35-5 - Installation of internal combustion engines-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Installation of internal combustion engines-TB/ALL. 32... EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Main and Auxiliary Machinery § 32.35-5 Installation of internal combustion engines—TB/ALL. Each internal combustion engine located on the weather deck shall be provided with...

  10. 46 CFR 31.36-1 - Lifesaving appliances and arrangements-TB/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Lifesaving appliances and arrangements-TB/ALL. 31.36-1... CERTIFICATION Lifesaving Appliances and Arrangements § 31.36-1 Lifesaving appliances and arrangements—TB/ALL. All lifesaving appliances and arrangements on tank vessels must be in accordance with subchapter W...

  11. Pulmonary Immune-Compartment-Specific Interferon Gamma Responses in HIV-Infected Individuals with Active Tuberculosis (TB in an Area of High TB Prevalence

    Directory of Open Access Journals (Sweden)

    S. Buldeo

    2012-01-01

    Full Text Available There is a paucity of data on the pulmonary immune-compartment interferon gamma (IFNγ response to M. tuberculosis, particularly in settings of high tuberculosis (TB prevalence and in HIV-coinfected individuals. This data is necessary to understand the diagnostic potential of commercially available interferon gamma release assays (IGRAs in both the pulmonary immune-compartment and peripheral blood. We used intracellular cytokine staining by flow cytometry to assess the IFNγ response to purified protein derivative (PPD and early secretory antigen 6 (ESAT6 in induced sputa (ISp and blood samples from HIV-infected, smear-negative, TB suspects. We found that individuals with active TB disease produced significantly less IFNγ in response to PPD in their induced sputa samples than individuals with non-active TB (control group. This difference was not reflected in the peripheral blood, even within the CD27− CD4+ memory T lymphocyte population. These findings suggest that progression to active TB disease may be associated with the loss of IFNγ secretion at the site of primary infection. Our findings highlight the importance of studying pulmonary immune-compartment M. tuberculosis specific responses to elucidate IFNγ secretion across the spectrum of TB disease.

  12. Effects of Green - Emitting Phosphor (La,Ce,TbPO_4:Ce:Tb on Luminous Flux and Color Quality of White LED Lamps

    Directory of Open Access Journals (Sweden)

    Nguyen Thi Phuong Thao

    2017-01-01

    Full Text Available In this paper, we present and analyze the influence of (La,Ce,TbPO_4:Ce:Tb green phosphor (LaTb toward the performance of the multi-chip white LED (MCW-LEDs lamps including color uniformity, lumen output, Color Rendering Index (CRI, and Color Quality Scale (CQS. By mixing the LaTb green phosphor and the YAG:Ce yellow phosphor compounding under condition of 7000 K MCW-LEDs, this new approach can produce a huge meaningful change in lumen output and the angular color distribution of MCW-LEDs. We also study the interaction between the concentration and size of the LaTb particles with output flux, color uniformity, CRI, and CQS. The obtained results demonstrate that the higher lumen output, the higher color uniformity enhancement could be attained by adding the LaTb particles with a size range around 6-8 µm and the concentration around 1.5% in phosphor layer. Meanwhile, the decrease of the color rendering value (CRI and the Color Quality Scale (CQS tend to be stable and insignificant. In other words, the obtained results provide a prospective method which plays an important role in the development of MCW-LED manufacturing technology.

  13. Structural and optical properties of Tb and Na-Tb co-doped Ca3V2O8 phosphors prepared by sol-gel process

    Science.gov (United States)

    Parab, Shambhu S.; Salker, A. V.

    2018-01-01

    A malic acid assisted sol-gel route was successfully employed to prepare two distinct series of green emitting Ca3V2O8 phosphors. In the first series, Tb was solely doped whereas in the second series Na and Tb were doped simultaneously in the Ca3V2O8 crystal lattice. X-ray diffraction studies proved the utility of adopted preparative method by confirming the monophasic formation of all compounds from both the series. Spectral analysis like Raman spectroscopy, UV-DRS were undertaken to analyse the local structure, crystallinity and absorptive characteristics. XPS validated the presence of desired oxidation states of all the elements present. Finally, photoluminescence studies were done to elucidate the scope of prepared compounds as green emitting phosphors and also to understand the effect of both doping schemes on the luminescence. Intense green emission was observed in both the cases. Tb concentration of 0.08 was found to be optimum in case of Tb singly doped compounds whereas Tb = 0.12 showed highest intensity among the Na-Tb co-doped samples. Moreover, a red shift in the excitation wavelength was observed after Na doping signifying a change in the local electronic environment which in turn has affected the luminescence pattern. Local crystallinity and vacancy concentrations were found to have a major say on the emission intensities.

  14. Comparative evaluation of GenoType MTBDRplus line probe assay with solid culture method in early diagnosis of multidrug resistant tuberculosis (MDR-TB at a tertiary care centre in India.

    Directory of Open Access Journals (Sweden)

    Raj N Yadav

    Full Text Available The objectives of the study were to compare the performance of line probe assay (GenoType MTBDRplus with solid culture method for an early diagnosis of multidrug resistant tuberculosis (MDR-TB, and to study the mutation patterns associated with rpoB, katG and inhA genes at a tertiary care centre in north India.In this cross-sectional study, 269 previously treated sputum-smear acid-fast bacilli (AFB positive MDR-TB suspects were enrolled from January to September 2012 at the All India Institute of Medical Sciences hospital, New Delhi. Line probe assay (LPA was performed directly on the sputum specimens and the results were compared with that of conventional drug susceptibility testing (DST on solid media [Lowenstein Jensen (LJ method].DST results by LPA and LJ methods were compared in 242 MDR-TB suspects. The LPA detected rifampicin (RIF resistance in 70 of 71 cases, isoniazid (INH resistance in 86 of 93 cases, and MDR-TB in 66 of 68 cases as compared to the conventional method. Overall (rifampicin, isoniazid and MDR-TB concordance of the LPA with the conventional DST was 96%. Sensitivity and specificity were 98% and 99% respectively for detection of RIF resistance; 92% and 99% respectively for detection of INH resistance; 97% and 100% respectively for detection of MDR-TB. Frequencies of katG gene, inhA gene and combined katG and inhA gene mutations conferring all INH resistance were 72/87 (83%, 10/87 (11% and 5/87 (6% respectively. The turnaround time of the LPA test was 48 hours.The LPA test provides an early diagnosis of monoresistance to isoniazid and rifampicin and is highly sensitive and specific for an early diagnosis of MDR-TB. Based on these findings, it is concluded that the LPA test can be useful in early diagnosis of drug resistant TB in high TB burden countries.

  15. Purity-activity relationships of natural products: the case of anti-TB active ursolic acid.

    Science.gov (United States)

    Jaki, Birgit U; Franzblau, Scott G; Chadwick, Lucas R; Lankin, David C; Zhang, Fangqiu; Wang, Yuehong; Pauli, Guido F

    2008-10-01

    The present study explores the variability of biological responses from the perspective of sample purity and introduces the concept of purity-activity relationships (PARs) in natural product research. The abundant plant triterpene ursolic acid (1) was selected as an exemplary natural product due to the overwhelming number yet inconsistent nature of its approximate 120 reported biological activities, which include anti-TB potential. Nine different samples of ursolic acid with purity certifications were obtained, and their purity was independently assessed by means of quantitative 1H NMR (qHNMR). Biological evaluation consisted of determining MICs against two strains of virulent Mycobacterium tuberculosis and IC50 values in Vero cells. Ab initio structure elucidation provided unequivocal structural confirmation and included an extensive 1H NMR spin system analysis, determination of nearly all J couplings and the complete NOE pattern, and led to the revision of earlier reports. As a net result, a sigmoid PAR profile of 1 was obtained, demonstrating the inverse correlation of purity and anti-TB bioactivity. The results imply that synergistic effects of 1 and its varying impurities are the likely cause of previously reported antimycobacterial potential. Generating PARs is a powerful extension of the routinely performed quantitative correlation of structure and activity ([Q]SAR). Advanced by the use of primary analytical methods such as qHNMR, PARs enable the elucidation of cases like 1 when increasing purity voids biological activity. This underlines the potential of PARs as a tool in drug discovery and synergy research and accentuates the need to routinely combine biological testing with purity assessment.

  16. Structural and magnetic properties of Tb implanted ZnO single crystals

    International Nuclear Information System (INIS)

    Zhou Shengqiang; Potzger, K.; Muecklich, A.; Eichhorn, F.; Helm, M.; Skorupa, W.; Fassbender, J.

    2008-01-01

    ZnO single crystals have been implanted with Tb ions. For an atomic concentration of 1.5%, annealing at 823 K leads to an increase of the saturation magnetization per implanted Tb ion up to 1.8 μ B at room temperature. Structural investigations revealed no secondary phase formation, but the out-diffusion of Tb. No significant evidence is found for Tb substituting Zn sites either in the as-implanted or annealed samples. However, indications for the existence of a small amount of Tb nanoclusters however have been found using magnetization versus temperature measurements. The ferromagnetic properties disappear completely upon annealing at 1023 K. This behavior is related to the formation of oxide complexes or nanoparticles

  17. Fusion of 6Li with 159Tb at near-barrier energies

    International Nuclear Information System (INIS)

    Pradhan, M. K.; Mukherjee, A.; Basu, P.; Goswami, A.; Kshetri, R.; Roy, Subinit; Chowdhury, P. Roy; Sarkar, M. Saha; Palit, R.; Parkar, V. V.; Santra, S.; Ray, M.

    2011-01-01

    Complete and incomplete fusion cross sections for 6 Li + 159 Tb have been measured at energies around the Coulomb barrier by the γ-ray method. The measurements show that the complete fusion cross sections at above-barrier energies are suppressed by ∼34% compared to coupled-channel calculations. A comparison of the complete fusion cross sections at above-barrier energies with the existing data for 11,10 B + 159 Tb and 7 Li + 159 Tb shows that the extent of suppression is correlated with the α separation energies of the projectiles. It has been argued that the Dy isotopes produced in the reaction 6 Li + 159 Tb at below-barrier energies are primarily due to the d transfer to unbound states of 159 Tb, while both transfer and incomplete fusion processes contribute at above-barrier energies.

  18. Continuous production of phosphor YAG:Tb nanoparticles by hydrothermal synthesis in supercritical water

    International Nuclear Information System (INIS)

    Hakuta, Yukiya; Haganuma, Tsukasa; Sue, Kiwamu; Adschiri, Tadafumi; Arai, Kunio

    2003-01-01

    Phosphor YAG:Tb ((Y 2.7 Tb 0.3 )Al 5 O 12 ) nano particles were synthesized by a hydrothermal method at supercritical conditions (400 deg. C and 30 MPa) using a flow reactor. Hydroxide sol solutions formed by stoichiometric aluminum nitrate, yttrium nitrate, terbium nitrate and potassium hydroxide solutions. The relationship between particle size and experimental variables including pH, concentration of coexistent ions and hydroxide sol were investigated. Particles were characterized by XRD, TEM and photo-luminescence measurements. Particle size of YAG:Tb became finer as pH was increased or potassium nitrate concentration of the starting metal salt solution was increased. By removing the coexisting ions (NO 3 - , K + ) from the metal salt solution, single phase YAG:Tb particles with 20 nm particle size were obtained. The emission spectra of YAG:Tb particles of 14 nm shows a blue shift

  19. High pressure behaviour of TbN: an X-ray diffraction and computational study

    DEFF Research Database (Denmark)

    Jakobsen, J.M.; Madsen, G.K.H.; Jorgensen, J.E.

    2002-01-01

    In the present work, we report an X-ray powder diffraction study of TbN up to an applied hydrostatic pressure of 43 GPa. TbN was found to be stable in the 131 (NaCl structure) within the examined pressure interval, and the zero pressure bulk modulus was determined to be 176(7) GPa. The electronic...... is greatly improved by introducing an orbital dependent U term into the energy-functional. The 4f electrons in TbN-B1 are atomic like and highly correlated, and ferro-magnetic TbN-B1 is found to be a magnetic half-metal. Calculations find the spindown f-electrons in a hypothetical TbN-B2 (CsCl) structure...

  20. Eu-, Tb-, and Dy-Doped Oxyfluoride Silicate Glasses for LED Applications

    DEFF Research Database (Denmark)

    Zhu, C.F.; Wang, J.; Zhang, M.M.

    2014-01-01

    Luminescence glass is a potential candidate for the light-emitting diodes (LEDs) applications. Here, we study the structural and optical properties of the Eu-, Tb-, and Dy-doped oxyfluoride silicate glasses for LEDs by means of X-ray diffraction, photoluminescence spectra, Commission Internationale...... de L’Eclairage (CIE) chromaticity coordinates, and correlated color temperatures (CCTs). The results show that the white light emission can be achieved in Eu/Tb/Dy codoped oxyfluoride silicate glasses under excitation by near-ultraviolet light due to the simultaneous generation of blue, green, yellow......, and red-light wavelengths from Tb, Dy, and Eu ions. The optical performances can be tuned by varying the glass composition and excitation wavelength. Furthermore, we observed a remarkable emission spectral change for the Tb3+ single-doped oxyfluoride silicate glasses. The 5D3 emission of Tb3+ can...

  1. Na3Tb(PO4)2: Synthesis, crystal structure and greenish emitting properties

    Science.gov (United States)

    Zhao, Dan; Ma, Zhao; Liu, Bao-Zhong; Zhang, Rui-Juan; Wu, Zhi-Qiang; Wang, Jian; Duan, Pei-Gao

    2018-03-01

    A anhydrous orthoborate Na3Tb(PO4)2 has been prepared and its crystal structure was determined by X-Ray diffraction of a non-merohedral twinned single crystal. The results show that the compound crystallizes in monoclinic space group C2/c and the structure features a 3D framework containing PO4, NaO6, NaO7, NaO8 and TbO8 polyhedra. Under near-UV excitation (370 nm), Na3Tb(PO4)2 shows intense characteristic emission bands of Tb3+ (490 nm, 543 nm, 585 nm and 620 nm) with the CIE coordinate of (0.3062, 0.5901), corresponding to greenish color. The excitation spectrum covers a wide range from 340 nm to 390 nm, which indicates that phosphor Na3Tb(PO4)2 can be efficiently activated by near-UV LED ship.

  2. X-ray magnetic absorption in Fe-Tb amorphous thin films

    CERN Document Server

    Kim, Chan Wook; Watanabe, Yasuhiro

    1999-01-01

    In order to investigate the magnetic structure of Fe-Tb amorphous thin films, we have performed magnetic circular dichroism (MCD) measurements by using the circularly polarized X-ray at the Fe K- and the Tb L2,3-edges in Fe sub 8 sub 8 Tb sub 1 sub 2 , Fe sub 8 sub 0 Tb sub 2 sub 0 , and Fe sub 6 sub 2 Tb sub 3 sub 8. In all samples, the spin-dependent absorption effects, DELTA mu t, were observed. Also, elementary information was obtained on the spin polarizations of the p- and the d-projected electrons lying in the unoccupied states near the Fermi levels in the samples.

  3. Solid oxide galvanic cell for determination of Gibbs energy of formation of Tb6UO12(s)

    International Nuclear Information System (INIS)

    Sahu, Manjulata; Dash, Smruti

    2013-01-01

    Citrate-nitrate combustion method was used to synthesise Tb 6 UO 12 (s). Gibbs energy of formation of Tb 6 UO 12 (s) was measured using solid oxide galvanic cell in the temperature range 957-1175 K. (author)

  4. Get Tested. Make it Contagious.

    Centers for Disease Control (CDC) Podcasts

    2010-05-13

    This podcast is part of the "Get Tested. Make it Contagious" campaign, which is designed to raise awareness of sexually transmitted diseases (STDs) and increase testing among college students.  Created: 5/13/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 5/13/2010.

  5. A review of the literature on the economics of vaccination against TB.

    Science.gov (United States)

    Tu, Hong-Anh T; Vu, Hoa D; Rozenbaum, Mark H; Woerdenbag, Herman J; Postma, Maarten J

    2012-03-01

    The BCG vaccine was introduced in 1921 and remains the only licensed vaccine for the prevention of TB worldwide. Despite its extensive use, the BCG vaccine lacks the ability to fully control the TB-endemic and -pandemic situations. The BCG vaccine is most effective in preventing pediatric TB, in particular, miliary TB and tuberculous meningitis. However, it has a limited effect in preventing pulmonary TB, which occurs more frequently in adults. BCG vaccination has now been implemented in more than 157 countries worldwide. For various countries, the benefits of vaccination are only limited and potentially not cost effective. The International Union Against Tuberculosis and Lung Diseases had set the criteria for discontinuation of BCG vaccination in 1994. This decision, however, was not based on economic considerations. Many developed countries have met the criteria set by the International Union Against Tuberculosis and Lung Disease and stopped universal BCG vaccination. For developing countries, the BCG vaccine is still an effective intervention in protecting young children from TB infection. A lot of effort has been spent on R&D of new TB vaccines, the first of which are expected to be available within 5-7 years from now. Novel TB vaccines are expected to be better and more effective than the current BCG vaccine and should provide a viable strategy in controlling TB morbidity and mortality. In this review, the aim is to explore economic evaluations that have been carried out for vaccination against TB worldwide. In addition to epidemiological evidence, economic evidence can play a crucial role in supporting the governments of countries in making proper public health decisions on BCG vaccination policies, in particular, to implement, continue, or discontinue.

  6. FEATURES OF ADOLESCENTS TUBERCULOSIS AT A REFERRAL TB'S HOSPITAL IN TEHRAN, IRAN

    Directory of Open Access Journals (Sweden)

    Ferial Lotfian

    2016-01-01

    Full Text Available Abstract OBJECTIVE: To identify the pattern of the clinical, radiological, diagnostic procedures and loss to follow -up of the diagnosed cases of active tuberculosis (TB adolescents. METHODS: This study was a retrospective analysis of the medical records of 143 adolescents aged 10 to 18 years with tuberculosis who were admitted TB wards of National Research Institute of Tuberculosis and Lung Disease (NRITLD in Tehran, Iran, between March 2006 and March2011. RESULTS: Of the 143 patients identified, 62.9% were females. Median age of the patients was 16 years. The contact source was identified in 47.5%.The most common presenting symptom was cough (86%.Isolated pulmonary TB (PTB was detected in 113 patients (79%, 21 patients (14.7% had extrapulmonary TB(EPTB, and 9 patients (6.3% had PTB and EP TB .The most common site of  EPTB was pleural (14% .The most common radiographic finding was infiltration (61%.Positive acid fast smears were seen in 67.8%.Positive cultures for Mycobacterium tuberculosis(M. TB were seen in 31.6%. Positive PCR results were seen in 60%.The adolescents aged 15 to 18 years were more likely to lose weight (p=0.001, smear positive (p=0.002and have positive PCR results (p=0.009. The type of TB (p=0.017 was a significant factor influencing loss to follow-up. CONCLUSIONS: Adolescents with the high rate of positive sputum smear results and the high treatment default rate are more likely to increase risk for TB transmission to the community. The TB control programs should pay more attention to prevention and treatment of TB in adolescents.     Key words: adolescents, tuberculosis, Lost to follow-up, prevention

  7. Tunable emission and concentration quenching of Tb{sup 3+} in magnesium phosphate lithium

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Mingming; Zhang, Dongyun, E-mail: dyz@sit.edu.cn; Chang, Chengkang

    2015-04-05

    Highlights: • It is very likely the first time to realize tunable emission using Tb{sup 3+} as emitting centers. • Tb{sup 3+}:LiMgPO{sub 4} with colorful emissions are obtained by simply adjusting the Tb concentration. • The energy transfer method is implied by calculating the index of electric multipole interaction. • Either the dipole–dipole or exchange interaction method is proposed for each emission. - Abstract: Tunable photoluminescence of Tb{sup 3+}-doped LiMgPO{sub 4} (Tb{sup 3+}:LiMgPO{sub 4}) phosphors with different Tb{sup 3+} concentrations are successfully synthesized by a high temperature solid-state reaction routine. X-ray diffraction (XRD) and photoluminescent spectroscope (PLS) are employed to characterize the phosphors. It is found that a suitable firing temperature is important for the synthesis of the phosphors, and pure phase material can only be obtained around 900 °C. PL spectra reveals typical {sup 5}D{sub 4} to {sup 7}F{sub j} energy transition of Tb{sup 3+} ions, and the emission colors varied from red to green with Tb{sup 3+} concentration increasing, which is caused by the concentration quenching of Tb{sup 3+} emission centers in the LiMgPO{sub 4} matrix. The emissions peaking at 591, 619 and 695 nm are quenched at concentration of 1.5%, while the emissions at 489 nm and 543 nm are quenched at concentration of 8%. Further analysis of the data reveals two different energy transfer mechanisms for the five emission bands. The dipole–dipole model is proposed for the energy transfer of the red bands peaking at 694 nm, 619 nm and 591 nm, while the exchange interaction model is suggested for that of the green bands (543 nm and 489 nm), due to the different ion separations caused by different Tb concentrations.

  8. Luminescent properties of Al2O3: Tb powders

    International Nuclear Information System (INIS)

    Esparza G, A.E.; Garcia, M.; Falcony, C.; Azorin N, J.

    2000-01-01

    In this work the photo luminescent and cathode luminescent characteristics of aluminium oxide (Al 2 O 3 ) powders impurified with terbium (Tb) were studied for their use in dosimetry. The optical, structural, morphological characteristics of the powders as function of variation in the impurity concentration and the annealing temperature will be presented. As regards the optical properties of powders (photoluminescence and cathode luminescence) it was observed a characteristic emission associated with radiative transitions between electron energy levels of terbium, the spectra associated with this emission consists of several peaks associated with such transitions. In the structural and morphological characterization (X-ray diffraction and scanning electron microscopy) it was appreciated that in accordance the annealing temperature of powders is augmented it is evident the apparition of certain crystalline phases. The results show that this is a promissory material for radiation dosimetry. (Author)

  9. Radiochemical separation of Tb-149 after tandem accelerator production

    International Nuclear Information System (INIS)

    Sarkar, S.R.

    1996-01-01

    Full text: Terbium-149 is produced by the heavy ion induced reaction of the type 142 Nd( 12 C,5n) 149 Dy→ 149 Tb. This work concerns the separation of terbium from neodymium target, and other lanthanides produced by secondary reactions on neodymium target. Firstly, anion-exchange separation is carried out at room temperature using acid-alcohol media (90% methanol-10% 5M nitric acid) as eluent. But the separation is not satisfactory. To achieve satisfactory separation, cation exchange separation is performed under pressure at room temperature using 0.1 6M α-hydroxyisobutyric acid of pH 5 as eluent. The pressure is exerted from a nitrogen gas cylinder. The simplicity and efficacy of this method for the separation of terbium are discussed in comparison with the commercially available high performance liquid chromatography system

  10. Microscopic study of superdeformed rotational bands in {sup 151} Tb

    Energy Technology Data Exchange (ETDEWEB)

    El Aouad, N.; Dudek, J.; Li, X.; Luo, W.D.; Molique, H.; Bouguettoucha, A.; Byrski, TH.; Beck, F.; Finck, C.; Kharraja, B. [Strasbourg-1 Univ., 67 (France). Centre de Recherches Nucleaires; Dobaczewski, J. [Warsaw Univ. (Poland); Kharraja, B. [Notre Dame Univ., IN (United States). Dept. of Physics

    1996-12-31

    Structure of eight superdeformed bands in the nucleus {sup 151}Tb is analyzed using the results of the Hartree-Fock and Woods-Saxon cranking approaches. It is demonstrated that far going similarities between the two approaches exit and predictions related to the structure of rotational bands calculated within the two models are nearly parallel. An interpretation scenario for the structure of the superdeformed bands is presented and predictions related to the exit spins are made. Small but systematic discrepancies between experiment and theory, analyzed in terms of the dynamical moments, J{sup (2)}, are shown to exist. The pairing correlations taken into account by using the particle-number-projection technique are shown to increase the disagreement. Sources of these systematic discrepancies are discussed - they are most likely related to the yet not optimal parametrization of the nuclear interactions used. (authors). 60 refs.

  11. Isomer spectroscopy of neutron-rich 168 Tb 103

    Energy Technology Data Exchange (ETDEWEB)

    Gurgi, L. A.; Regan, P. H.; Söderström, P. -A.; Watanabe, H.; Walker, P. M.; Podolyák, Zs.; Nishimura, S.; Berry, T. A.; Doornenbal, P.; Lorusso, G.; Isobe, T.; Baba, H.; Xu, Z. Y.; Sakurai, H.; Sumikama, T.; Catford, W. N.; Bruce, A. M.; Browne, F.; Lane, G. J.; Kondev, F. G.; Odahara, A.; Wu, J.; Liu, H. L.; Xu, F. R.; Korkulu, Z.; Lee, P.; Liu, J. J.; Phong, V. H.; Yag, A.; Zhang, G. X.; Alharbi, T.; Carroll, R. J.; Chae, K. Y.; Dombradi, Zs.; Estrade, A.; Fukuda, N.; Griffin, C.; Ideguchi, E.; Inabe, N.; Kanaoka, H.; Kojouharov, I.; Kubo, T.; Kubono, S.; Kurz, N.; Kuti, I.; Lalkovski, S.; Lee, E. J.; Lee, C. S.; Lotay, G.; Moon, C. -B.; Nishizuka, I.; Nita, C. R.; Patel, Z.; Roberts, O. J.; Schaffner, H.; Shand, C. M.; Suzuki, H.; Takeda, H.; Terashima, S.; Vajta, Zs.; Yoshida, S.; Valiente-Dòbon, J. J.

    2017-11-01

    In-flight fission of a 345 MeV per nucleon 238U primary beam on a 2 mm thick 9Be target has been used to produce and study the decays of a range of neutron-rich nuclei centred around the doubly mid-shell nucleus 170Dy at the RIBF Facility, RIKEN, Japan. The produced secondary fragments of interest were identified event-by-event using the BigRIPS separator. The fragments were implanted into the WAS3ABI position sensitive silicon active stopper which allowed pixelated correlations between implants and their subsequent β-decay. Discrete γ-ray transitions emitted following decays from either metastable states or excited states populated following beta decay were identified using the 84 coaxial high-purity germanium (HPGe) detectors of the EURICA spectrometer, which was complemented by 18 additional cerium-doped lanthanum bromide (LaBr3) fast-timing scintillation detectors from the FATIMA collaboration. This paper presents the internal decay of a metastable isomeric excited state in the odd-odd nucleus 168Tb, which corresponds to a single proton-neutron hole configuration in the valence maximum nucleus 170Dy. These data represent the first information on excited states in this nucleus, which is the most neutron-rich odd-odd isotope of terbium (Z=65) studied to date. Nilsson configurations associated with an axially symmetric, prolate-deformed nucleus are proposed for the 168Tb ground state the observed isomeric state by comparison with Blocked BCS-Nilsson calculations.

  12. Superdeformation studies in {sup 150}Tb and {sup 153}Ho

    Energy Technology Data Exchange (ETDEWEB)

    Nisius, D.; Janssens, R.V.F.; Crowell, B. [and others

    1995-08-01

    There are now over 40 superdeformed (SD) bands known in the A {approximately} 150 region and in most cases the properties of these bands are understood in terms of single-particle excitations in the absence of pairing. By continuing the search for new SD bands we hope to gain insight into (1) the ordering of the proton and neutron orbitals near the Fermi surface in the SD well, (2) the effects that the alignment of those orbitals has on the moments of inertia, and (3) the collective excitations in the SD well. For {sup 150}Tb, which is one proton and one neutron away from the SD doubly-magic nucleus {sup 152}Dy, it should be possible to study SD bands based on both proton and neutron hole excitations. By adding one proton to the {sup 152}Dy nucleus (i.e. {sup 153}Ho) proton excitations above the Z = 66 shell gap can be studied. These excitations are important as calculations suggested that the proton intruder orbital N = 7 might become occupied. Interactions between this orbital and a N = 5 level may result in softness towards octupole vibrations. High spin states in {sup 150}Th and {sup 153}Ho were populated using the {sup 124}Sn({sup 31}P,5n) and {sup 120}Sn({sup 37}Cl,4n) reactions, respectively. In both cases the early implementation phase of Gammasphere was used to detect the decay gamma rays and over 1 x 10{sup 9} triple and higher fold coincidence events were recorded. In {sup 150}Tb, the data analysis is complete and two new SD bands were identified. The fact that Im{sup (2)} moments of inertia are sensitive to the specific high-N intruder content of the SD bands was used to suggest configurations for the two new bands. A paper reporting these results is being prepared. For {sup 153}Ho, data analysis is still in its early stages.

  13. Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral and Second Line Anti-TB Treatment in Mumbai, India

    Science.gov (United States)

    Isaakidis, Petros; Varghese, Bhanumati; Mansoor, Homa; Cox, Helen S.; Ladomirska, Joanna; Saranchuk, Peter; Da Silva, Esdras; Khan, Samsuddin; Paryani, Roma; Udwadia, Zarir; Migliori, Giovanni Battista; Sotgiu, Giovanni; Reid, Tony

    2012-01-01

    Background Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings. Methods Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE. Results Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen. Conclusions AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays

  14. Determination of activation energies of K2YF5: Tb by the isothermal decay method

    International Nuclear Information System (INIS)

    Gallegos, A.A.; Azorin, J.; Khaidukov, M.

    2007-01-01

    the samples K 2 YF 5 : Tb 0.8% and K 2 YF 5 : Tb 0.99% which were subjected to isothermic decay treatment to temperatures of 373.15 K, 398.15 K and 423.15 K, making registration of the TL glow curve at different times of decay, the curves were studied by the 'phosphorescent' decay method. In this last dosimetric characterization was observed in the TL glow curves a marked one 'competition' among the visible traps, during the heating stage to two different heating ramps (10 C/s), for what became necessary to characterize by another dosimetric test suggested by the McKeever pattern and collaborators: Response to the dose. Of the competition among traps during heating stage Chen and collaborators predict that the response sample to the dose will not be lineal to 'big' absorbed doses (ITL α D 2 ). This charge transfer among traps stimulated during the heating stage can associate to an apparent thermal-transfer among trapper states. (Author)

  15. Temporal trends in TB notification rates during ART scale-up in Cape Town: an ecological analysis

    NARCIS (Netherlands)

    Hermans, Sabine; Boulle, Andrew; Caldwell, Judy; Pienaar, David; Wood, Robin

    2015-01-01

    Although antiretroviral therapy (ART) reduces individual tuberculosis (TB) risk by two-thirds, the population-level impact remains uncertain. Cape Town reports high TB notification rates associated with endemic HIV. We examined population trends in TB notification rates during a 10-year period of

  16. IP-10 measured by Dry Plasma Spots as biomarker for therapy responses in Mycobacterium Tuberculosis infection.

    Science.gov (United States)

    Tonby, Kristian; Ruhwald, Morten; Kvale, Dag; Dyrhol-Riise, Anne Ma

    2015-03-18

    Tuberculosis (TB) has huge impact on human morbidity and mortality and biomarkers to support rapid TB diagnosis and ensure treatment initiation and cure are needed, especially in regions with high prevalence of multi-drug resistant TB. Soluble interferon gamma inducible protein 10 (IP-10) analyzed from dry plasma spots (DPS) has potential as an immunodiagnostic marker in TB infection. We analyzed IP-10 levels in plasma directly and extracted from DPS in parallel by ELISA from 34 clinically well characterized patients with TB disease before and throughout 24 weeks of effective anti-TB chemotherapy. We detected a significant decline of IP-10 levels in both plasma and DPS already after two weeks of therapy with good correlation between the tests. This was observed both in pulmonary and extrapulmonary TB. In conclusion, plasma IP-10 may serve as an early biomarker for anti-TB chemotherapy responses and the IP-10 DPS method has potential to be developed into a point-of care test for use in resource-limited settings. Further studies must be performed to validate the use of IP-10 DPS in TB high endemic countries.

  17. Clinical application of T-spot test of Mycobacterium tuberculosis infection for diagnosis of suspected pulmonary tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Xue-ping SHI

    2017-11-01

    Full Text Available Objective To explore the application value of T-spot test of Mycobacterium tuberculosis infection (T-SPOT.TB on diagnosis and differential diagnosis of pulmonary tuberculosis. Methods From Apr. 2014 to Dec. 2016, 700 patients with suspected pulmonary tuberculosis were collected, venous blood (5ml was drawn off and sputum was collected from each patient separately for T-SPOT.TB and pathogens identification (including TB. Chest CT, bronchoscopy brush or biopsy histopathological examination were followed up, cultivation of My. tuberculosis and of common bacteria with sputum or lavage fluid when needed. T-SPOT.TB test was performed according to the kit instruction operation. 2.5×105 peripheral blood mononuclear cells (PBMCs were added into the pre- coated anti- human γ- interferon antibody, and co-incubated separately with two specific My. tuberculosis antigens, namely early secretory targeting 6 (ESAT-6 and culture filtration protein 10 (CFP-10, and then the spot forming cells (SFCs were counted. The gold standard for present study were set as follows: 1 My. tuberculosis smear positive or culture positive; 2 Clinical diagnosis (meet any one is positive. The efficacy of T-SPOT.TB on diagnosing active TB was observed, and then the optimal critical value for diagnosing active TB was determined. Patients diagnosed as active TB were divided into 4 subgroups: initial treatment group, retreatment group, smear or culture positive group, and smear or culture negative group. T-SPOT.TB was carried out to detect A and B antigen, and the difference of formed SFCs was then compared. The present study was approved by the Ethics Committee of Xinjiang Uygur Autonomous Region Chest Hospital. Results Of 700 cases suspected of pulmonary tuberculosis enrolled in present study, 528 out of 624 definite cases (84.6% were finally diagnosed as active tuberculosis (active TB group and 96 cases (15.4% were as without TB infection (non-TB group. Positive results of T-SPOT.TB

  18. Differential cellular recognition pattern to M. tuberculosis targets defined by IFN-γ and IL-17 production in blood from TB + patients from Honduras as compared to health care workers: TB and immune responses in patients from Honduras.

    Science.gov (United States)

    Alvarez-Corrales, Nancy; Ahmed, Raija K; Rodriguez, Carol A; Balaji, Kithiganahalli N; Rivera, Rebeca; Sompallae, Ramakrishna; Vudattu, Nalini K; Hoffner, Sven E; Zumla, Alimuddin; Pineda-Garcia, Lelany; Maeurer, Markus

    2013-03-06

    A better understanding of the quality of cellular immune responses directed against molecularly defined targets will guide the development of TB diagnostics and identification of molecularly defined, clinically relevant M.tb vaccine candidates. Recombinant proteins (n = 8) and peptide pools (n = 14) from M. tuberculosis (M.tb) targets were used to compare cellular immune responses defined by IFN-γ and IL-17 production using a Whole Blood Assay (WBA) in a cohort of 148 individuals, i.e. patients with TB + (n = 38), TB- individuals with other pulmonary diseases (n = 81) and individuals exposed to TB without evidence of clinical TB (health care workers, n = 29). M.tb antigens Rv2958c (glycosyltransferase), Rv2962c (mycolyltransferase), Rv1886c (Ag85B), Rv3804c (Ag85A), and the PPE family member Rv3347c were frequently recognized, defined by IFN-γ production, in blood from healthy individuals exposed to M.tb (health care workers). A different recognition pattern was found for IL-17 production in blood from M.tb exposed individuals responding to TB10.4 (Rv0288), Ag85B (Rv1886c) and the PPE family members Rv0978c and Rv1917c. The pattern of immune target recognition is different in regard to IFN-γ and IL-17 production to defined molecular M.tb targets in PBMCs from individuals frequently exposed to M.tb. The data represent the first mapping of cellular immune responses against M.tb targets in TB patients from Honduras.

  19. Direct in vitro and in vivo comparison of {sup 161}Tb and {sup 177}Lu using a tumour-targeting folate conjugate

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Cristina; Reber, Josefine; Haller, Stephanie [Paul Scherrer Institute, Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Villigen (Switzerland); Dorrer, Holger; Tuerler, Andreas [Paul Scherrer Institute, Laboratory of Radiochemistry and Environmental Chemistry, Villigen (Switzerland); University of Bern, Laboratory of Radiochemistry and Environmental Chemistry, Department of Chemistry and Biochemistry, Bern (Switzerland); Bernhardt, Peter [The Sahlgrenska Academy, University of Gothenburg, Department of Radiation Physics, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Medical Physics and Medical Bioengeneering, Gothenburg (Sweden); Zhernosekov, Konstantin [Paul Scherrer Institute, Laboratory of Radiochemistry and Environmental Chemistry, Villigen (Switzerland); Schibli, Roger [Paul Scherrer Institute, Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Villigen (Switzerland); ETH Zurich, Department of Chemistry and Applied Biosciences, Zurich (Switzerland)

    2014-03-15

    The radiolanthanide {sup 161}Tb (T{sub 1/2} = 6.90 days, Eβ{sup -}{sub av} = 154 keV) was recently proposed as a potential alternative to {sup 177}Lu (T{sub 1/2} = 6.71 days, Eβ{sup -}{sub av} = 134 keV) due to similar physical decay characteristics but additional conversion and Auger electrons that may enhance the therapeutic efficacy. The goal of this study was to compare {sup 161}Tb and {sup 177}Lu in vitro and in vivo using a tumour-targeted DOTA-folate conjugate (cm09). {sup 161}Tb-cm09 and {sup 177}Lu-cm09 were tested in vitro on folate receptor (FR)-positive KB and IGROV-1 cancer cells using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) viability assay. In vivo {sup 161}Tb-cm09 and {sup 177}Lu-cm09 (10 MBq, 0.5 nmol) were investigated in two different tumour mouse models with regard to the biodistribution, the possibility for single photon emission computed tomography (SPECT) imaging and the antitumour efficacy. Potentially undesired side effects were monitored over 6 months by determination of plasma parameters and examination of kidney function with quantitative SPECT using {sup 99m}Tc-dimercaptosuccinic acid (DMSA). To obtain half-maximal inhibition of tumour cell viability a 4.5-fold (KB) and 1.7-fold (IGROV-1) lower radioactivity concentration was required for {sup 161}Tb-cm09 (IC{sub 50} ∝0.014 MBq/ml and ∝2.53 MBq/ml) compared to {sup 177}Lu-cm09 (IC{sub 50} ∝0.063 MBq/ml and ∝4.52 MBq/ml). SPECT imaging visualized tumours of mice with both radioconjugates. However, in therapy studies {sup 161}Tb-cm09 reduced tumour growth more efficiently than {sup 177}Lu-cm09. These findings were in line with the higher absorbed tumour dose for {sup 161}Tb-cm09 (3.3 Gy/MBq) compared to {sup 177}Lu-cm09 (2.4 Gy/MBq). None of the monitored parameters indicated signs of impaired kidney function over the whole time period of investigation after injection of the radiofolates. Compared to {sup 177}Lu-cm09 we demonstrated equal imaging

  20. Interpretation of the gamma interferon test for diagnosis of subclinical paratuberculosis in cattle

    DEFF Research Database (Denmark)

    Jungersen, Gregers; Huda, A.; Hansen, J.J.

    2002-01-01

    A group of 252 cattle without clinical signs of paratuberculosis (paraTB) in 10 herds infected with paraTB and a group of 117 cattle in 5 herds without paraTB were selected. Whole-blood samples were stimulated with bovine, avian, and johnin purified protein derivative (PPD) and examined for gamma...... interferon (IFN-gamma) release. For diagnosis of paraTB, satisfactory estimated specificities (95 to 99%) could be obtained by johnin PPD stimulation irrespective of interpretation relative to bovine PPD or no-antigen stimulation alone, but numbers of test positives in the infected herds varied from 64...

  1. Synthesis and crystal structure of terbium(III) meta-oxoborate Tb(BO{sub 2}){sub 3} ({identical_to} TbB{sub 3}O{sub 6}); Synthese und Kristallstruktur von Terbium(III)-meta-Oxoborat Tb(BO{sub 2}){sub 3} ({identical_to} TbB{sub 3}O{sub 6})

    Energy Technology Data Exchange (ETDEWEB)

    Nikelski, Tanja; Schleid, Thomas [Institut fuer Anorganische Chemie der Universitaet Stuttgart (Germany)

    2003-06-01

    The terbium meta-oxoborate Tb(BO{sub 2}){sub 3} ({identical_to} TbB{sub 3}O{sub 6}) is obtained as single crystals by the reaction of terbium, Tb{sub 4}O{sub 7} and TbCl{sub 3} with an excess of B{sub 2}O{sub 3} in gastight sealed platinum ampoules at 950 C after three weeks. The compound appears to be air- and water-resistant and crystallizes as long, thin, colourless needles which tend to growth-twinning due to their marked fibrous habit. The crystal structure of Tb(BO{sub 2}){sub 3} (orthorhombic, Pnma; a = 1598.97(9), b = 741.39(4), c = 1229.58(7) pm; Z = 16) contains strongly corrugated oxoborate layers {sub {infinity}}{sup 2}{l_brace}(BO{sub 2}){sup -}{r_brace} built of vertex-linked [BO{sub 4}]{sup 5-} tetrahedra (d(B-O) = 143 - 154 pm, and angsph;(O-B-O) = 102-115 ) which spread out parallel (100). The four crystallographically different Tb{sup 3+} cations all exhibit coordination numbers of eight towards the oxygen atoms (d(Tb-O) = 228-287 pm). The corresponding metal cation polyhedra [TbO{sub 8}]{sup 13+} too convene to layers (composition: {sub {infinity}}{sup 2}{l_brace}(Tb{sub 2}O{sub 11}){sup 16-}{r_brace}) which are likewise oriented parallel to the (100) plane. (Abstract Copyright [2003], Wiley Periodicals, Inc.) [German] Das Terbium-meta-Oxoborat Tb(BO{sub 2}){sub 3} ({identical_to} TbB{sub 3}O{sub 6}) entsteht einkristallin bei der Reaktion von Terbium, Tb{sub 4}O{sub 7} und TbCl{sub 3} mit einem Ueberschuss von B{sub 2}O{sub 3} in gasdicht verschlossenen Platinampullen nach drei Wochen bei 950 C. Die Verbindung ist luft- und wasserstabil und faellt in langen, duennen, farblosen Nadeln an, die aufgrund ihres ausgepraegt faserigen Habitus zur Wachstumsverzwillingung neigen. Die Kristallstruktur von Tb(BO{sub 2}){sub 3} (orthorhombisch, Pnma; a = 1598, 97(9), b = 741, 39(4), c = 1229, 58(7) pm; Z = 16) enthaelt parallel (100) verlaufende, stark gewellte Oxoborat-Schichten {sub {infinity}}{sup 2}{l_brace}(BO{sub 2}){sup -}{r_brace} aus

  2. Nitrofuranyl Methyl Piperazines as New Anti-TB Agents: Identification, Validation, Medicinal Chemistry, and PK Studies

    Science.gov (United States)

    2015-01-01

    Whole-cell screening of 20,000 drug-like small molecules led to the identification of nitrofuranyl methylpiperazines as potent anti-TB agents. In the present study, validation followed by medicinal chemistry has been used to explore the structure–activity relationship. Ten compounds demonstrated potent MIC in the range of 0.17–0.0072 μM against H37Rv Mycobacterium tuberculosis (MTB) and were further investigated against nonreplicating and resistant (RifR and MDR) strains of MTB. These compounds were also tested for cytotoxicity. Among the 10 tested compounds, five showed submicromolar to nanomolar potency against nonreplicating and resistant (RifR and MDR) strains of MTB along with a good safety index. Based on their overall in vitro profiles, the solubility and pharmacokinetic properties of five potent compounds were studied, and two analogues, 14f and 16g, were found to have comparatively better solubility than others tested and acceptable pharmacokinetic properties. This study presents the rediscovery of a nitrofuranyl class of compounds with improved aqueous solubility and acceptable oral PK properties, opening a new direction for further development. PMID:26487909

  3. HIV testing, antiretroviral therapy, and treatment outcomes in new cases of tuberculosis in Brazil, 2011

    Directory of Open Access Journals (Sweden)

    Ana Torrens

    Full Text Available ABSTRACT Objective To assess the implementation of HIV-related interventions for patients with tuberculosis (TB, as well as TB treatment outcomes in patients coinfected with HIV in Brazil in 2011. Methods This was a cross-sectional, operational research study of HIV-related interventions among TB cases and the sociodemographic and clinical characteristics of TB-HIV coinfected patients. It also used a retrospective cohort design to determine the association between antiretroviral therapy (ART and favorable TB treatment outcomes. The source of data was a linkage of 2011 administrative health databases used by the National TB and HIV/AIDS Programs. Results Of 73 741 new cases of TB reported, 63.6% (46 865 patients were tested for HIV; 10.3% were positive. Of patients with HIV, 45.9% or 3 502 were on ART. TB favorable outcome was achieved in 63.1% or 2 205 coinfected patients on ART and in only 35.4% or 1 459 of those not on ART. On multivariate analysis, the relative risk for the association between ART and TB treatment success was 1.72 (95% Confidence Interval = 1.64–1.81. Conclusions The linkage between national TB and HIV datasets has created a convenient baseline for ongoing monitoring of HIV testing, ART use, and TB treatment outcomes among coinfected patients. The low rates of HIV screening and ART use in 2011 need to be improved. The association between ART and treatment success adds to the evidence supporting timely initiation of ART for all patients with TB-HIV coinfection.

  4. Magnetic properties of amorphous Tb-Fe thin films with an artificially layered structure

    International Nuclear Information System (INIS)

    Sato, N.

    1986-01-01

    An alternating terbium-iron (Tb-Fe) multilayer structure artificially made in amorphous Tb-Fe thin films gives rise to excellent magnetic properties of large perpendicular uniaxial anisotropy, large saturation magnetization, and large coercivity over a wide range of Tb composition in the films. The films are superior to amorphous Tb-Fe alloy thin films, especially when they are piled up with a monatomic layer of Tb and several atomic layers of Fe in an alternating fashion. Small-angle x-ray diffraction analysis confirmed the layering of monatomic layers of Tb and Fe, where the periodicity of the layers was found to be about 5.9 A. Direct evidence for an artificially layered structure was obtained by transmission electron microscopic and Auger electron spectroscopic observations. Together with magnetic measurements of hysteresis loops and torque curves, it has been concluded that the most important origin of the large magnetic uniaxial anisotropy can be attributed to the Tb-Fe pairs aligned perpendicular to the films

  5. Expanded polyfunctional T cell response to mycobacterial antigens in TB disease and contraction post-treatment.

    Directory of Open Access Journals (Sweden)

    James M Young

    2010-06-01

    Full Text Available T cells producing multiple factors have been shown to be required for protection from disease progression in HIV but we have recently shown this not to be the case in TB. Subjects with active disease had a greater proportion of polyfunctional cells responding to ESAT-6/CFP-10 stimulation than their infected but non-diseased household contacts (HHC. We therefore wanted to assess this profile in subjects who had successfully completed standard TB chemotherapy.We performed a cross-sectional study using PBMC from TB cases (pre- and post-treatment and HHC. Samples were stimulated overnight with TB antigens (ESAT-6/CFP-10 and PPD and their CD4+ and CD8+ T cells were assessed for production of CD107a, IFN-gamma, IL-2 and TNF-alpha and the complexity of the responses was determined using SPICE and PESTLE software.We found that an increase in complexity (i.e., production of more than 1 factor simultaneously of the T cell profile was associated with TB disease and that this was significantly reduced following TB treatment. This implies that T cells are able to respond adequately to TB antigens with active disease (at least initially but the ability of this response to protect the host from disease progression is hampered, presumably due to immune evasion strategies by the bacteria. These findings have implications for the development of new diagnostics and vaccine strategies.

  6. Fabrication, magnetostriction properties and applications of Tb-Dy-Fe alloys: a review

    Directory of Open Access Journals (Sweden)

    Nai-juan Wang

    2016-03-01

    Full Text Available As an excellent giant-magnetostrictive material, Tb-Dy-Fe alloys (based on Tb0.27-0.30Dy0.73-0.70Fe1.9-2 Laves compound can be applied in many engineering fields, such as sonar transducer systems, sensors, and micro-actuators. However, the cost of the rare earth elements Tb and Dy is too high to be widely applied for the materials. Nowadays, there are two different ways to substitute for these alloying elements. One is to partially replace Tb or Dy by cheaper rare earth elements, such as Pr, Nd, Sm and Ho; and the other is to use non-rare earth elements, such as Co, Al, Mn, Si, Ce, B, Be and C, to substitute Fe to form single MgCu2-type Laves phase and a certain amount of Re-rich phase, which can reduce the brittleness and improve the corrosion resistance of the alloy. This paper systemically introduces the development, the fabrication methods and the corresponding preferred growth directions of Tb-Dy-Fe alloys. In addition, the effects of alloying elements and heat treatment on magnetostrictive and mechanical properties of Tb-Dy-Fe alloys are also reviewed, respectively. Finally, some possible applications of Tb-Dy-Fe alloys are presented.

  7. Social, economic, and psychological impacts of MDR-TB treatment in Tijuana, Mexico: a patient's perspective.

    Science.gov (United States)

    Morris, M D; Quezada, L; Bhat, P; Moser, K; Smith, J; Perez, H; Laniado-Laborin, R; Estrada-Guzman, J; Rodwell, T C

    2013-07-01

    The State of Baja California, Mexico, had the highest prevalence of multidrug-resistant tuberculosis (MDR-TB) in Mexico in 2009. To understand the socio-economic burden of MDR-TB disease and its treatment on patients in Tijuana and Mexicali, Mexico. From July to November 2009, qualitative interviews were conducted with 12 patients enrolled in a US-Mexico binational MDR-TB treatment program, Puentes de Esperanza (Bridges of Hope), which was designed to support MDR-TB patients. In-depth interviews were coded to identify major themes in patient experiences of MDR-TB diagnosis and care. While some patients were able to maintain their pre-MDR-TB lives to a limited extent, most patients reported losing their sense of identity due to their inability to work, social isolation, and stigmatization from family and friends. The majority of participants expressed appreciation for Puentes' role in 'saving their lives'. Being diagnosed with MDR-TB and undergoing treatment imposes significant psychological, social and economic stress on patients. Strong social support elements within Puentes helped alleviate these burdens. Improvements to the program might include peer-support groups for patients undergoing treatment and transitioning back into the community after treatment.

  8. Perception of stigma towards TB among patients on DOTS & patients attending general OPD in Delhi.

    Science.gov (United States)

    Anand, Tanu; Kumar, D Arun; Sharma, Nandini; Saha, Renuka; Krishnamurthy, Laxmi; Singh, S V; Ingle, G K

    2014-01-01

    In India, Tuberculosis (TB) continues to be a public health problem. One of the key reasons for it is the stigma associated with the disease which affects the treatment seeking behaviour and hence the outcome. To assess the perceived and enacted stigma among TB patients and perceptions of other patients related to TB in Central Delhi. A cross-sectional study conducted in urban field practice area of a medical college of Delhi, using a pre-designed questionnaire containing items for assessment of stigma being faced by a TB patient in family, social life and workplace. It also contained questions pertaining to reaction of patients from general OPD to a family member who develops TB. A total of 100 patients on DOTS and 200 patients from general OPD were interviewed. There were 21 patients who reported to have delayed treatment seeking due to stigma. Nearly one third patients (n=34; 34%) noted negative changes in the behaviour of their family members towards them while 40% were isolated on being diagnosed with the disease. Out of the 36 employed TB patients, 65.5% (n=23) experienced negative change in the behaviour of their colleagues. In general OPD patients, significantly higher proportion of female patients said that they would not disclose the disease status of a family member suffering from TB to their neighbours (pstigma like delayed treatment seeking.

  9. Management and treatment outcomes of patients enrolled in MDR-TB treatment in Viet Nam.

    Science.gov (United States)

    Phuong, N T M; Nhung, N V; Hoa, N B; Thuy, H T; Takarinda, K C; Tayler-Smith, K; Harries, A D

    2016-03-21

    The programmatic management of drug-resistant tuberculosis (TB) in Viet Nam has been rapidly scaled up since 2009. To document the annual numbers of patients enrolled for multidrug-resistant tuberculosis (MDR-TB) treatment during 2010-2014 and to determine characteristics and treatment outcomes of patients initiating treatment during 2010-2012. A retrospective cohort study using national reports and data from the national electronic data system for drug-resistant TB. The number of patients enrolled annually for MDR-TB treatment increased from 97 in 2010 to 1522 in 2014. The majority of patients were middle-aged men who had pulmonary disease and had failed a retreatment regimen; 77% had received ⩾2 courses of TB treatment. Favourable outcomes (cured and treatment completed) were attained in 73% of patients. Unfavourable outcomes included loss to follow-up (12.5%), death (8%) and failure (6.3%). Having had ⩾2 previous treatment courses and being human immunodeficiency virus-positive were associated with unfavourable outcomes. Increasing numbers of patients are being treated for MDR-TB each year with good treatment outcomes under national programme management in Viet Nam. However, there is a need to increase case detection-currently at 30% of the estimated 5100 MDR-TB cases per year, reduce adverse outcomes and improve monitoring and evaluation.

  10. Effects of magnetic and structural properties on magnetoresistance in amorphous TbFeCo

    International Nuclear Information System (INIS)

    Yumoto, S.; Hidaka, Y.; Okada, O.

    1990-01-01

    An extraordinary magnetoresistance effect, linearly dependent on the external magnetic field, is observed in amorphous TbFeCo films. The electrical resistance jumps by δρ at magnetization reversal. δρ depends on Tb concentration and it becomes nearly zero at about Tb 26 at. % concentration. To clarify the Tb concentration dependence of δρ, the magnetic properties and the heat treatment effect are examined. It is found that the magnetic anisotropy field (H k ) is maximum at about Tb 26 at. % and the gradient of linear magnetoresistance, δρ/(ρ 0 H c ), is proportional to the -H k + const, where ρ 0 is the electric resistance in zero field, H c is the coercive force, and the constant is about 100 kOe. The structural relaxation, a coercive force change by the heat treatment up to 200 degree C, is examined. It is found that as δρ/(ρ 0 H c ) in the as-sputtered state decreases, the coercive force change by the heat treatment decreases. The coercive force change is minimum at about Tb 26 at. %, where δρ/(ρ 0 H c ) becomes zero. These results mean that linear magnetoresistance is related to structure relaxation by heat treatment. The δρ disappearance at about Tb 26 at. % is based on the stable structure against heat treatment and the largest magnetic anisotropy field

  11. Double Standards in Global Health: Medicine, Human Rights Law and Multidrug-Resistant TB Treatment Policy.

    Science.gov (United States)

    Nicholson, Thomas; Admay, Catherine; Shakow, Aaron; Keshavjee, Salmaan

    2016-06-01

    The human rights arguments that underpinned the fight against HIV over the last three decades were poised, but ultimately failed, to provide a similar foundation for success against multidrug-resistant TB (MDR-TB) and other diseases of the poor. With more than 1.5 million deaths since 2000 attributed to strains of MDR-TB, and with half a million new, and mostly untreated, MDR-TB cases in the world each year, the stakes could not be higher. The World Health Organization (WHO), whose mandate is to champion the attainment by all peoples of the highest possible level of health, recommended unsound medical treatment for MDR-TB patients in resource-poor settings from 1993-2002. Citing cost considerations, WHO did not recommend the available standard of care that had been successfully used to contain and defeat MDR-TB in rich countries. By acting as a strategic gatekeeper in its technical advisory role to donor agencies and countries, it also facilitated the global implementation of a double standard for TB care in low- and middle-income countries (LMICs), upending important legal and scientific priorities. This raises serious questions about whether the organization violated international human rights standards and those established in its own constitution. While calling for additional analysis and discussion on this topic, the authors propose that policymakers should reject double standards of this kind and instead embrace the challenge of implementing the highest standard of care on a global level.

  12. Integrated nanophotonic hubs based on ZnO-Tb(OH3/SiO2 nanocomposites

    Directory of Open Access Journals (Sweden)

    Lin Yu

    2011-01-01

    Full Text Available Abstract Optical integration is essential for practical application, but it remains unexplored for nanoscale devices. A newly designed nanocomposite based on ZnO semiconductor nanowires and Tb(OH3/SiO2 core/shell nanospheres has been synthesized and studied. The unique sea urchin-type morphology, bright and sharply visible emission bands of lanthanide, and large aspect ratio of ZnO crystalline nanotips make this novel composite an excellent signal receiver, waveguide, and emitter. The multifunctional composite of ZnO nanotips and Tb(OH3/SiO2 nanoparticles therefore can serve as an integrated nanophotonics hub. Moreover, the composite of ZnO nanotips deposited on a Tb(OH3/SiO2 photonic crystal can act as a directional light fountain, in which the confined radiation from Tb ions inside the photonic crystal can be well guided and escape through the ZnO nanotips. Therefore, the output emission arising from Tb ions is truly directional, and its intensity can be greatly enhanced. With highly enhanced lasing emissions in ZnO-Tb(OH3/SiO2 as well as SnO2-Tb(OH3/SiO2 nanocomposites, we demonstrate that our approach is extremely beneficial for the creation of low threshold and high-power nanolaser.

  13. HIV, multidrug-resistant TB and depressive symptoms: when three conditions collide.

    Science.gov (United States)

    Das, Mrinalini; Isaakidis, Petros; Van den Bergh, Rafael; Kumar, Ajay M V; Nagaraja, Sharath Burugina; Valikayath, Asmaa; Jha, Santosh; Jadhav, Bindoo; Ladomirska, Joanna

    2014-01-01

    Management of multidrug-resistant TB (MDR-TB) patients co-infected with human immunodeficiency virus (HIV) is highly challenging. Such patients are subject to long and potentially toxic treatments and may develop a number of different psychiatric illnesses such as anxiety and depressive disorders. A mental health assessment before MDR-TB treatment initiation may assist in early diagnosis and better management of psychiatric illnesses in patients already having two stigmatising and debilitating diseases. To address limited evidence on the baseline psychiatric conditions of HIV-infected MDR-TB patients, we aimed to document the levels of depressive symptoms at baseline, and any alteration following individualized clinical and psychological support during MDR-TB therapy, using the Patient Health Questionnaire-9 (PHQ-9) tool, among HIV-infected patients. This was a retrospective review of the medical records of an adult (aged >15 years) HIV/MDR-TB cohort registered for care during the period of August 2012 through to March 2014. A total of 45 HIV/MDR-TB patients underwent baseline assessment using the PHQ-9 tool, and seven (16%) were found to have depressive symptoms. Of these, four patients had moderate to severe depressive symptoms. Individualized psychological and clinical support was administered to these patients. Reassessments were carried out for all patients after 3 months of follow-up, except one, who died during the period. Among these 44 patients, three with baseline depressive symptoms still had depressive symptoms. However, improvements were observed in all but one after 3 months of follow-up. Psychiatric illnesses, including depressive symptoms, during MDR-TB treatment demand attention. Routine administration of baseline mental health assessments by trained staff has the potential to assist in determining appropriate measures for the management of depressive symptoms during MDR-TB treatment, and help in improving overall treatment outcomes. We recommend

  14. A model of population dynamics of TB in a prison system and application to South Africa.

    Science.gov (United States)

    Witbooi, Peter; Vyambwera, Sibaliwe Maku

    2017-11-29

    Tuberculosis (TB) continues to spread in South African prisons in particular, as prisons are over-capacitated and have poor ventilation. The awaiting trial detainees are not screened on admission and are at high risk of getting infected with TB. We propose a compartmental model to describe the population dynamics of TB disease in prisons. Our model considers the inflow of susceptible, exposed and TB infectives into the prison population. Removal of individuals out of the prison population can be either by death or by being released from prison, as compared to a general population in which removal is only by death. We describe conditions, including non-inflow of infectives into the prison, which will ensure that TB can be eradicated from the prison population. The model is calibrated for the South African prison system, by using data in existing literature. The model can be used to make quantitative projections of TB prevalence and to measure the effect of interventions. Illustrative simulations in this regard are presented. The model can be used for other prison populations too, if data is available to calculate the model parameters. Various simulations generated with our model serve to illustrate how it can be utilized in making future projections of the levels of prevalence of TB, and to quantify the effect of interventions such as screening, treatment or reduction of transmission parameter values through improved living conditions for inmates. This makes it particularly useful as there are various targets set by the World Health Organization and by governments, for reduction of TB prevalence and ultimately its eradication. Towards eradication of TB from a prison system, the theorem on global stability of the disease-free state is a useful indicator.

  15. Eu/Tb ions co-doped white light luminescence Y2O3 phosphors

    International Nuclear Information System (INIS)

    Tu Dong; Liang Yujun; Liu Rong; Li Daoyi

    2011-01-01

    Y 2 O 3 :Eu 3+ , Tb 3+ phosphors with white emission are prepared with different doping concentration of Eu 3+ and Tb 3+ ions and synthesizing temperatures from 750 to 950 deg. C by the co-precipitation method. The resulted phosphors were characterized by X-ray diffraction (XRD) and photoluminescence (PL) spectroscopy. The results of XRD indicate that the crystallinity of the synthesized samples increases with enhancing the firing temperature. The photoluminescence spectra indicate the Eu 3+ and Tb 3+ co-doped Y 2 O 3 phosphors show five main emission peaks: three at 590, 611 and 629 nm originate from Eu 3+ and two at 481 and 541 nm originate from Tb 3+ , under excitation of 250-320 nm irradition. The white light luminescence color could be changed by varying the excitation wavelength. Different concentrations of Eu 3+ and Tb 3+ ions were induced into the Y 2 O 3 lattice and the energy transfer from Tb 3+ →Eu 3+ ions in these phosphors was found. The Commission International de l'Eclairage (CIE) chromaticity shows that the Y 2 O 3 :Eu 3+ , Tb 3+ phosphors can obtain an intense white emission. - Highlights: → Novel phosphors Y 2 O 3 :Eu 3+ , Tb 3+ have been synthesized by co-precipitation method. → Samples emit white light with excellent color coordinates under UV excitation. → Luminescence color could be changed by varying the excitation wavelength. → Energy transfer from Tb 3+ →Eu 3+ ions in these phosphors was found.

  16. Effect of structure, particle size and relative concentration of Eu3+ and Tb3+ ions on the luminescence properties of Eu3+ co-doped Y2O3:Tb nanoparticles

    International Nuclear Information System (INIS)

    Mukherjee, S; Sudarsan, V; Vatsa, R K; Tyagi, A K; Godbole, S V; Kadam, R M; Bhatta, U M

    2008-01-01

    Eu 3+ co-doped Y 2 O 3 :Tb nanoparticles were prepared by the combustion method and characterized for their structural and luminescence properties as a function of annealing temperatures and relative concentration of Eu 3+ and Tb 3+ ions. For Y 2 O 3 :Eu,Tb nanoparticles annealed at 600 and 1200 deg. C, variation in the relative intensity of excitation transitions between the 7 F 6 ground state and low spin and high spin 4f 7 5d 1 excited states of Tb 3+ is explained due to the combined effect of distortion around Y 3+ /Tb 3+ in YO 6 /TbO 6 polyhedra and the size of the nanoparticles. Increase in relative intensity of the 285 nm peak (spin-allowed transition denoted as peak B) with respect to the 310 nm peak (spin-forbidden transition denoted as peak A) with decrease of Tb 3+ concentration in the Y 2 O 3 :Eu,Tb nanoparticles heated at 1200 deg. C is explained based on two competing effects, namely energy transfer from Tb 3+ to Eu 3+ ions and quenching among the Tb 3+ ions. Back energy transfer from Tb 3+ to Eu 3+ in these nanoparticles is found to be very poor

  17. Analysis of multi drug resistant tuberculosis (MDR-TB) financial protection policy: MDR-TB health insurance schemes, in Chhattisgarh state, India.

    Science.gov (United States)

    Kundu, Debashish; Sharma, Nandini; Chadha, Sarabjit; Laokri, Samia; Awungafac, George; Jiang, Lai; Asaria, Miqdad

    2018-01-27

    There are significant financial barriers to access treatment for multi drug resistant tuberculosis (MDR-TB) in India. To address these challenges, Chhattisgarh state in India has established a MDR-TB financial protection policy by creating MDR-TB benefit packages as part of the universal health insurance scheme that the state has rolled out in their effort towards attaining Universal Health Coverage for all its residents. In these schemes the state purchases health insurance against set packages of services from third party health insurance agencies on behalf of all its residents. Provider payment reform by strategic purchasing through output based payments (lump sum fee is reimbursed as per the MDR-TB benefit package rates) to the providers - both public and private health facilities empanelled under the insurance scheme was the key intervention. To understand the implementation gap between policy and practice of the benefit packages with respect to equity in utilization of package claims by the poor patients in public and private sector. Data from primary health insurance claims from January 2013 to December 2015, were analysed using an extension of 'Kingdon's multiple streams for policy implementation framework' to explain the implementation gap between policy and practice of the MDR-TB benefit packages. The total number of claims for MDR-TB benefit packages increased over the study period mainly from poor patients treated in public facilities, particularly for the pre-treatment evaluation and hospital stay packages. Variations and inequities in utilizing the packages were observed between poor and non-poor beneficiaries in public and private sector. Private providers participation in the new MDR-TB financial protection mechanism through the universal health insurance scheme was observed to be much lower than might be expected given their share of healthcare provision overall in India. Our findings suggest that there may be an implementation gap due to weak

  18. Spin-wave excitation and Moessbauer spectrometry of amorphous interface in Tb/Fe multilayer

    International Nuclear Information System (INIS)

    El Khiraoui, S.; Sajieddine, M.; Lassri, H.; Sahlaoui, M.

    2009-01-01

    Magnetic properties of Tb(48 A)/Fe(26 A) multilayer were studied with Moessbauer spectrometry at different temperatures before and after isothermal annealing at 673 K. For this last case, a significant perpendicular magnetic anisotropy is induced. This phenomenon is related to the existence of an amorphous and homogenous Tb-Fe alloy, located at the interfaces, which is produced by interdiffusion during the heat processing. The thermal evolution of hyperfine field deduced for interfacial Tb-Fe alloy is found to obey the Bloch law. The spin-wave stiffness constant, the distance between nearest magnetic atoms and the exchange parameter A were calculated from the experimental results

  19. Uncertainty of determination of 158Tb in the RBMK nuclear reactor waste.

    Science.gov (United States)

    Plukis, Artūras; Barkauskas, Vytenis; Druteikienė, Rūta; Duškesas, Grigorijus; Germanas, Darius; Gudelis, Arūnas; Juodis, Laurynas; Lagzdina, Elena; Plukienė, Rita; Remeikis, Vidmantas

    2018-04-01

    The activity of 158 Tb was measured in waste samples from the Ignalina NPP Unit I RBMK-1500 reactor using gamma-ray spectrometry. The origin of 158 Tb and the other observed gamma-ray emitters has been studied by using SCALE 6.1 modeling and comparing radionuclide ratios in the RBMK-1500 radioactive waste. The results of the calculation of the massic activity of gamma-ray emitters were used for interpretation of the total gamma-ray spectrum and the determination of 158 Tb massic activity uncertainty in the waste of RBMK-1500. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Towards the development of new phosphors with reduced content of rare earth elements: Structural and optical characterization of Ce:Tb: Al{sub 2}SiO{sub 5}

    Energy Technology Data Exchange (ETDEWEB)

    Chiriu, D.; Stagi, L.; Carbonaro, C.M.; Corpino, R. [Dipartimento di Fisica, Università degli Studi di Cagliari, S.P.n°8 Km 0, 700, I-09042 Monserrato (Italy); Casula, M.F. [Dipartimento di Scienze Chimiche e Geologiche and INSTM, Università di Cagliari, S.P.n°8 Km 0, 700, I-09042 Monserrato (Italy); Ricci, P.C., E-mail: carlo.ricci@dsf.unica.it [Dipartimento di Fisica, Università degli Studi di Cagliari, S.P.n°8 Km 0, 700, I-09042 Monserrato (Italy)

    2016-05-15

    Highlights: • A new promising inert matrix as host of luminescent ions is proposed. • Al2SiO5 matrix is free from Rare earths (critical raw materials). • Doping the matrix with Ce and Tb we obtain an efficient green emitter. • Cerium acts as sensitizer for Terbium emission. - Abstract: A new promising inert matrix as host of luminescent ions is proposed. Al2SiO5 samples, doped with rare earths (Ce, Tb single doped and co-doped) are proposed as good prospect for the development of new UV–vis converter with reduced content of rare earths elements. Structural characterization by Raman, XRD spectroscopy and TEM imaging reveals the sillimanite phase and nano sized dimension of the investigated powders. Optical characterization by steady time and time resolved emission spectroscopy for the single doped and co-doped samples allows to identify an efficient energy transfer from Ce to Tb ions under near UV excitation wavelength. The intense green emission observed in the Ce:Tb co-doped Al2SiO5 system suggests its potential application as efficient blue pumped green emitter phosphor to be exploited for white LED: to this purpose we tested the compound in combination with a red emitting doping ion recording for Ce:Tb:Cr:ASO system a correlated color temperature of 6720 K.