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Sample records for tuberculosis patients living

  1. Lived experience of patients on tuberculosis treatment in Tshwane ...

    African Journals Online (AJOL)

    Oluwafunmilayo Olabisi Akeju

    a Adelaide Tambo School of Nursing, Tshwane University of Technology, ... better understanding of being a patient taking tuberculosis treatment and to improve ... tuberculosis treatment, which has contributed to an increase ... own perspective, what has been your lived experience since ... Intention to complete treatment.

  2. Living with Tuberculosis

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2018-04-01

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

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

    Science.gov (United States)

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

    2003-12-01

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

  5. Tuberculosis screening in patients with HIV

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie Mia Katrine; Bonsu, Frank; Hanson-Nortey, Nii Nortey

    2016-01-01

    BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...

  6. Tuberculosis screening in patients with HIV

    DEFF Research Database (Denmark)

    Bjerrrum, Stephanie; Bonsu, Frank; Hanson-Nortey, Nii Nortey

    2016-01-01

    BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...... May and October 2014, before and after a performance feedback intervention in August 2014. The outcomes of interest were overall tuberculosis suspicion rate during consultations and provider adherence to the International Standards for Tuberculosis Care and the World Health Organizations' guidelines...

  7. Tuberculosis treatment among smear positive tuberculosis patients

    International Nuclear Information System (INIS)

    Munir, M.K.; Iqbal, R.; Shabbir, I.; Chaudhry, K

    2012-01-01

    Tuberculosis is a major health problem in many parts of the world. Delay in initiation of the treatment may result in prolonged infectious state, drug resistance, relapse and death. Objectives: To determine the factors responsible for not starting tuberculosis treatment among smear positive tuberculosis patients. Study type, settings and duration: This cross sectional study was done at Pakistan Medical Research Council TB Research Center, King Edward Medical University, Lahore, from fifth March 2010 to fifth December 2010. Patients and Methods: Fifty sputum smear positive patients of tuberculosis who did not register themselves in treatment register and presumably did not initiate anti tuberculosis treatment were contacted using telephone or traced by their home addresses. Once contact was established, they were inquired about the reasons for not starting tuberculosis treatment. Results: Of 50 patients 38(76%)belonged to the lower socio economic class and 12(24%) to the lower middle class. Fourteen patients (28%) were illiterate and 23(46%) had only 8 years of education. Of the 50 cases 41(82%) were taking treatment from traditional healers and 4% did not go back to the DOTS program. Physical condition of the patient, social, domestic and religious issues also played some role in default. Conclusions: Lack of health education and poverty were the main factors responsible for non compliance from treatment. Policy message: Sputum testing sites should have a paramedic who should educate the patients about the benefits of treatment and the dangers of default or partial treatment. (author)

  8. [Increased IL-4 production in response to virulent Mycobacterium tuberculosis in tuberculosis patients with advanced disease].

    Science.gov (United States)

    Ordway, Diane J; Martins, Marta S; Costa, Leonor M; Freire, Mónica S; Arroz, Maria J; Dockrell, Hazel M; Ventura, Fernando A

    2005-01-01

    The study was designed to compare immune responses to Mycobacterium tuberculosis bacilli and antigens in healthy Portuguese subjects and pulmonary tuberculosis patients (TB), and to correlate immune status with clinical severity of tuberculosis disease. PBMC were cultured and stimulated with live and killed M. tuberculosis H37Rv and purified protein derivative (PPD) and lymphoproliferation and production of IFN-gamma and IL-5/IL-4 by these cultures were evaluated by the use of ELISA and multi-parameter flow cytometry. PBMC from 30 tuberculosis patients demonstrated significantly reduced amounts of proliferation and IFN-gamma when stimulated with live M. tuberculosis compared the control group. Of 15 tuberculosis patients tested for intracellular IL-4 following stimulation with M. tuberculosis, 7 showed greatly increased IL-4 production in CD8+ and gammadelta+ T cells. Tuberculosis patients demonstrated an increase of intracellular IL-4 after PBMC were stimulated with live M. tuberculosis in the CD4+ phenotype, but more notably in CD8+ and gammadelta TCR+ subsets. Increased production of IL-4 in tuberculosis patients was primarily in individuals with advanced involvement of lung parenchymal with high bacterial loads in sputum. These results suggest that an alteration in type 1 and type 2 cytokine balance can occur in patients with tuberculosis at an advanced clinical stage of disease.

  9. [Tuberculosis and mycobacteriosis important opportunistic disease in AIDS patients].

    Science.gov (United States)

    Zalewska-Schönthaler, N; Schönthaler-Humiecka, J; Podlasin, R; Cholewińska, G; Rzeszkowicz, T; Mikuła, T; Horban, A

    2001-01-01

    The aim of the search was investigation of tuberculosis in AIDS patients. Each year 8-9 mln people fall ill of tuberculosis and one third of them die. To the infection of tuberculosis and fast development into active state are especially exposed people with AIDS. 696 people were examined on tuberculosis most of which were AIDS patients hospitalized and cured in Hospital of Infection Diseases and Prison Hospital. 159 patients were women and 537 were men. The average age was between 25 and 45 (70%). The investigated population was characterized according to age, social and living conditions, using drugs and former contact with tuberculosis. All patients suspected of tuberculosis had chest X-rayed, sputum, BAL and pleural liquor were taken to bacteriological examination when extrapulmonary tuberculosis was suspected. The material was taken adequately to the disease process: CSF, urine, lymph nodes, peritoneal fluids, blood, stool, swabs and other. Bacteriological investigations have been carried out by fast cultivating method since 1998 and rapid genetic method since 1999. Apart from modern, fast diagnostic methods, routine bacteriological procedures were applied in tuberculosis diagnosis. More than 30% of the examined population were from bad social-living conditions, 78% had risk factors, 65% were drug users. The analysis of the tuberculosis illness from 1997 to July 2001 shows growing tendency. Nowadays it is 20% cases proved by bacteriological diagnosis. The structure of falling ill with tuberculosis has changed. Considerable increase of extrapulmonary tuberculosis was observed, 20 patients died due to tuberculosis and 8 patients due to mycobacteriosis. Resistance of M.tub.complex occurred within the range of 10% cases.

  10. Living with HIV: Patients Perspective

    Centers for Disease Control (CDC) Podcasts

    2009-06-04

    This podcast showcases three people who are living with HIV. The patients share their experiences of being diagnosed with HIV, of the treatments they are undergoing, and on taking responsibility for their health.  Created: 6/4/2009 by Division of HIV and AIDS Prevention (DHAP), National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention ( NCHHSTP).   Date Released: 6/4/2009.

  11. Operating Characteristics of a Tuberculosis Screening Tool for People Living with HIV in Out-Patient HIV Care and Treatment Services, Rwanda.

    Directory of Open Access Journals (Sweden)

    Kenneth Turinawe

    Full Text Available The World Health Organization (WHO 2010 guidelines for intensified tuberculosis (TB case finding (ICF among people living with HIV (PLHIV includes a recommendation that PLHIV receive routine TB screening. Since 2005, the Rwandan Ministry of Health has been using a five-question screening tool. Our study objective was to assess the operating characteristics of the tool designed to identify PLHIV with presumptive TB as measured against a composite reference standard, including bacteriologically confirmed TB.In a cross-sectional study, the TB screening tool was routinely administered at enrolment in outpatient HIV care and treatment services at seven public health facilities. From March to September 2011, study enrollees were examined for TB disease irrespective of TB screening outcome. The examination consisted of a chest radiograph (CXR, three sputum smears (SS, sputum culture (SC and polymerase chain reaction line-probe assay (Hain test. PLHIV were classified as having "laboratory-confirmed TB" with positive results on SS for acid-fast bacilli, SC on Lowenstein-Jensen medium, or a Hain test.Overall, 1,767 patients were enrolled and screened of which; 1,017 (57.6% were female, median age was 33 (IQR, 27-41, and median CD4+ cell count was 385 (IQR, 229-563 cells/mm3. Of the patients screened, 138 (7.8% were diagnosed with TB of which; 125 (90.5% were laboratory-confirmed pulmonary TB. Of 404 (22.9% patients who screened positive and 1,363 (77.1% who screened negative, 79 (19.5% and 59 (4.3%, respectively, were diagnosed with TB. For laboratory-confirmed TB, the tool had a sensitivity of 54.4% (95% CI 45.3-63.3, specificity of 79.5% (95% CI 77.5-81.5, PPV of 16.8% and NPV of 95.8%.TB prevalence among PLHIV newly enrolling into HIV care and treatment was 65 times greater than the overall population prevalence. However, the performance of the tool was poorer than the predicted performance of the WHO recommended TB screening questions.

  12. Tuberculosis Treatment in Patients with Comorbidities

    OpenAIRE

    Kang, Young Ae

    2014-01-01

    Tuberculosis is a significant infectious problem in elderly patients with comorbidities in Korea. The age-associated diseases such as malignancy and diabetes mellitus may increase the risk of tuberculosis in this population. The medication treatments of tuberculosis in patients with comorbidities can cause adverse reactions to antituberculosis drugs and inadequate treatment responses. Thus, clinicians must carefully monitor the toxicity of antituberculosis therapy and the efficacy of treatmen...

  13. Periodontitis in patients with focal tuberculosis

    Directory of Open Access Journals (Sweden)

    Alexandrova Е.А.

    2010-12-01

    Full Text Available The research goal is to investigate the mechanisms of formation and peculiarities of periodontitis in patients with focal tuberculosis. Patients with periodontitis and focal tuberculosis are proved to develop local inflammatory reaction with increased infection and activation of proinflammatory cytokines in parodontal pockets fluid. The main risk factor of frequent and durable recurrence of parodontal pathology in case of focal tuberculosis was the development of pathologic process as a cause of disbalance of lipid peroxidation and antioxidant system, endotoxicosis syndrome

  14. [Treatment of tuberculosis in patients with comorbidities].

    Science.gov (United States)

    Abe, Masahiro; Fujita, Akira

    2013-12-01

    Early detection and appropriate treatment are the keys to tuberculosis control. In particular, providing appropriate treatment for tuberculosis in patients with HIV infection, rheumatoid arthritis (RA), chronic hepatic disease, or renal failure necessitating hemodialysis, and taking appropriate measures against adverse reactions to antituberculosis drugs are issues of critical importance. This mini-symposium, four experts explained the current status of "treatment of tuberculosis in patients with comorbidities" and proposed measures to address these problems. Dr. Aoki talked about "HIV infection complicated by tuberculosis." To the next, Dr. Yoshinaga gave a talk on "treatment of tuberculosis in RA patients receiving biological agents. Further, Dr. Sasaki lectured on "tuberculosis in patients with hepatic disease/impairment". Lastly, Dr. Takamori gave a lecture on "tuberculosis in patients with renal disease and those on hemodialysis. Tuberculosis patients often have some underlying diseases, and adverse reactions caused by antituberculosis drugs, such as hepatic and renal impairments, are matters of concern. I believe that this mini-symposium has provided useful information for physicians engaged in tuberculosis treatment and for many other healthcare professionals as well.

  15. Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Group).

    Science.gov (United States)

    Kim, Jae Kyoung; Jeong, Ina; Lee, Ji Yeon; Kim, Jung Hyun; Han, Ah Yeon; Kim, So Yeon; Joh, Joon Sung

    2018-03-07

    The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

  16. Tuberculosis: Art Therapy with Patients in Isolation.

    Science.gov (United States)

    Rosner-David, Irene; Ilusorio, Shereen

    1995-01-01

    Tuberculosis is reappearing with increasing prevalence and presenting new treatment challenges. Art therapy, which partly originated in a tuberculosis sanatoria, again serves to assist patients in coping with their illness and confinement. Case examples illustrate aspects of the disease and related emotions and highlight the potential for such an…

  17. Microevolution of Mycobacterium tuberculosis in a tuberculosis patient.

    NARCIS (Netherlands)

    Al-Hajoj, S.A.; Akkerman, O.; Parwati, I.; Al-Gamdi, S.; Rahim, Z.; Soolingen, D. van; Ingen, J. van; Supply, P.; Zanden, A.G. van der

    2010-01-01

    Five Mycobacterium tuberculosis isolates were obtained from three body sites from a Dutch patient. The isolates displayed a single genotype by 24-locus MIRU-VNTR typing (except for a single locus not amplified from one isolate) but were differentiated by small variations in IS6110 fingerprints,

  18. Vitamin D Deficiency in Patients with Tuberculosis

    International Nuclear Information System (INIS)

    Iftikhar, R.; Kamran, S. M.; Haider, E.; Qadir, A.; Usman, H. B.

    2013-01-01

    Objective: To determine the frequency and association of Vitamin D deficiency in patients with tuberculosis. Study Design: Case control study. Place and Duration of Study: Medical Department, Combined Military Hospital, Kharian, from July 2010 to June 2012. Methodology: One hundred and five outdoor patients of tuberculosis were selected with 255 gender matched controls. Tuberculosis was diagnosed by presence of acid fast bacilli in sputum smears, positive culture for Mycobacterium tuberculosis or demonstration of chronic caseating granulomatous inflammation in tissue specimens. Controls were drawn randomly from general population. Serum 25 hydroxyvitamin D [25 (OH) D3] levels < 25 ng/ml was considered Vitamin D deficiency. The results were analyzed on SPSS version 17. Results: Mean Vitamin D levels were 23.23 A+- 6.81 ng/ml in cases, 29.27 A+- 8.89 ng/ml in controls (p < 0.0001). Vitamin D deficiency was found in 57% of cases and 33% controls (p < 0.0001). Mean Vitamin D levels were significantly lower in females with tuberculosis (20.84 ng/ml) as compared to males (25.03 ng/ml, p = 0.002). Mean BMI in patients of tuberculosis with Vitamin D deficiency were 19.51 A+- 1.77 kg/m2 and in patients with normal Vitamin D were 21.65 A+- 1.79 kg/m2 (p < 0.0001). Mean Vitamin D levels in patients with multi-drug resistant tuberculosis was lower to a mean of 15.41 A+- 4.67 ng/ml (p < 0.0001). Conclusion: There is significant deficiency of Vitamin D in patients with tuberculosis as compared to controls. This deficiency is more pronounced in females, individuals with low BMI, extra pulmonary and MDR tuberculosis. (author)

  19. Risk assessment of tuberculosis in immunocompromised patients

    DEFF Research Database (Denmark)

    Sester, Martina; van Leth, Frank; Bruchfeld, Judith

    2014-01-01

    RATIONALE: In the absence of active tuberculosis, a positive tuberculin skin test (TST) or interferon-γ release assay (IGRA) result defines latent infection with Mycobacterium tuberculosis, although test results may vary depending on immunodeficiency. OBJECTIVES: This study compared the performance...... of TST and IGRAs in five different groups of immunocompromised patients, and evaluated their ability to identify those at risk for development of tuberculosis. METHODS: Immunocompromised patients with HIV infection, chronic renal failure, rheumatoid arthritis, solid-organ or stem-cell transplantation......, and healthy control subjects were evaluated head-to-head by the TST, QuantiFERON-TB-Gold in-tube test (ELISA), and T-SPOT.TB test (enzyme-linked immunospot) at 17 centers in 11 European countries. Development of tuberculosis was assessed during follow-up. MEASUREMENTS AND MAIN RESULTS: Frequencies of positive...

  20. Miliary tuberculosis: HRCT findings in 14 patients

    International Nuclear Information System (INIS)

    Son, Hyun Ju; Kim, Kun II; Juhng, Dong Hi; Lee, Suk Hong; Kim, Byung Su; Park, Soon Kew

    1994-01-01

    To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significance. We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 - 2 mm in 6 cases, and 3 mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). HRCT findings of miliary tuberculosis are diffusely distributed micro nodules of variable size, less than 5 mm in diameter. The ground-glass opacity can be combined

  1. Tuberculosis.

    Science.gov (United States)

    Tabbara, Khalid F

    2007-11-01

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

  2. Risk Factors of Active Tuberculosis in People Living with HIV/AIDS ...

    African Journals Online (AJOL)

    BACKGROUND: Determinants of active tuberculosis among People Living with HIV/AIDS (PLHA) are not well elucidated in countries with limited resources. The objective of this study was to assess distal and proximate determinants of active tuberculosis among people living with HIV/AIDS in southwest. Ethiopia.

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

    DEFF Research Database (Denmark)

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

    2002-01-01

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

  4. Tuberculosis patients co-infected with Mycobacterium bovis and Mycobacterium tuberculosis in an urban area of Brazil.

    Science.gov (United States)

    Silva, Marcio Roberto; Rocha, Adalgiza da Silva; da Costa, Ronaldo Rodrigues; de Alencar, Andrea Padilha; de Oliveira, Vania Maria; Fonseca Júnior, Antônio Augusto; Sales, Mariana Lázaro; Issa, Marina de Azevedo; Filho, Paulo Martins Soares; Pereira, Omara Tereza Vianello; dos Santos, Eduardo Calazans; Mendes, Rejane Silva; Ferreira, Angela Maria de Jesus; Mota, Pedro Moacyr Pinto Coelho; Suffys, Philip Noel; Guimarães, Mark Drew Crosland

    2013-05-01

    In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.

  5. Tuberculosis patients co-infected with Mycobacterium bovis and Mycobacterium tuberculosis in an urban area of Brazil

    Directory of Open Access Journals (Sweden)

    Marcio Roberto Silva

    2013-05-01

    Full Text Available In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis. Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ and Stonebrink (SB-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks. One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6% of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.

  6. Factors Associated with Prevalent Tuberculosis Among Patients ...

    African Journals Online (AJOL)

    Background: Tuberculosis (TB) causes significant morbidity/mortality among human immunodeficiency virus‑infected individuals in Africa. Reducing TB burden in the era of highly active antiretroviral therapy (HAART) is a public health priority. Aim: We determined the factors associated with prevalent TB among patients ...

  7. Previous treatment, sputum-smear nonconversion, and suburban living: The risk factors of multidrug-resistant tuberculosis among Malaysians.

    Science.gov (United States)

    Mohd Shariff, Noorsuzana; Shah, Shamsul Azhar; Kamaludin, Fadzilah

    2016-03-01

    The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese (odds ratio 3.17, 95% confidence interval 1.04-9.68; and odds ratio 6.23, 95% confidence interval 2.24-17.35, respectively), unmarried (odds ratio 2.58, 95% confidence interval 1.09-6.09), living in suburban areas (odds ratio 2.58, 95% confidence interval 1.08-6.19), are noncompliant (odds ratio 4.50, 95% confidence interval 1.71-11.82), were treated previously (odds ratio 8.91, 95% confidence interval 3.66-21.67), and showed positive sputum smears at the 2nd (odds ratio 7.00, 95% confidence interval 2.46-19.89) and 6th months of treatment (odds ratio 17.96, 95% confidence interval 3.51-91.99). Living in suburban areas, positive sputum smears in the 2nd month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment, have a history of previous

  8. Previous treatment, sputum-smear nonconversion, and suburban living: The risk factors of multidrugresistant tuberculosis among Malaysians

    Directory of Open Access Journals (Sweden)

    Noorsuzana Mohd Shariff

    2016-01-01

    Full Text Available The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese (odds ratio 3.17, 95% confidence interval 1.04–9.68; and odds ratio 6.23, 95% confidence interval 2.24–17.35, respectively, unmarried (odds ratio 2.58, 95% confidence interval 1.09–6.09, living in suburban areas (odds ratio 2.58, 95% confidence interval 1.08–6.19, are noncompliant (odds ratio 4.50, 95% confidence interval 1.71–11.82, were treated previously (odds ratio 8.91, 95% confidence interval 3.66–21.67, and showed positive sputum smears at the 2nd (odds ratio 7.00, 95% confidence interval 2.46–19.89 and 6th months of treatment (odds ratio 17.96, 95% confidence interval 3.51–91.99. Living in suburban areas, positive sputum smears in the 2nd month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment

  9. Tuberculosis

    Directory of Open Access Journals (Sweden)

    Elena Morán López

    2001-04-01

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

  10. Tuberculosis control in people living with HIV/AIDS.

    Science.gov (United States)

    Magnabosco, Gabriela Tavares; Lopes, Lívia Maria; Andrade, Rubia Laine de Paula; Brunello, Maria Eugênia Firmino; Monroe, Aline Aparecida; Villa, Tereza Cristina Scatena

    2016-09-09

    to analyze the offering of health actions and services for the control of tuberculosis for people living with HIV/AIDS being followed up in the Specialized Care Services for HIV/AIDS in Ribeirão Preto, SP, Brazil. quantitative, exploratory survey study. Participated 253 people living with HIV/AIDS followed up by this service, considering as inclusion criteria: individuals older than 18 years living in the city and not inmates. Data collection was conducted from January 2012 to May 2013 through interviews with the support of a specific instrument. Data were analyzed using indicators and a composite index. the offering of services for the control of tuberculosis in people living with HIV/AIDS by municipal services was considered as intermediate, reinforcing the need for better planning for comprehensive assistance, coordination of professionals in teams and among the services network, in addition to professional training and continuing education. it is necessary to implement strategies that promote shared actions between TB and HIV / AIDS programs and between different services in order to strengthen the local care network, aimed at producing an individualized care, comprehensive and responsive. analisar a oferta das ações e serviços de saúde para o controle da tuberculose nas pessoas vivendo com HIV/aids em seguimento pelos Serviços de Atenção Especializada ao HIV/aids de Ribeirão Preto, SP, Brasil. estudo quantitativo, exploratório, do tipo inquérito. Participaram 253 pessoas vivendo com HIV/aids em seguimento nos serviços, considerando os critérios de inclusão: indivíduos maiores de 18 anos, residentes no município e não pertencentes ao sistema prisional. A coleta de dados foi realizada no período de janeiro/2012 a maio/2013, por meio de entrevistas com apoio de um instrumento específico. Os dados foram analisados mediante indicadores e índice composto. a oferta de ações e serviços para o controle da tuberculose nas pessoas vivendo com HIV

  11. Anaemia in patients with HIV-associated tuberculosis in South Africa: predictive/prognostic value, aetiologies and treatment

    NARCIS (Netherlands)

    Kerkhoff, A.D.

    2016-01-01

    Tuberculosis remains the leading cause of death among people living with HIV in sub-Saharan Africa and worldwide. The clinical presentation in such patients is often so non-specific that much tuberculosis remains unsuspected, undiagnosed and is therefore untreated prior to death. Anaemia is one of

  12. Treatment outcomes among pulmonary tuberculosis patients at ...

    African Journals Online (AJOL)

    2009-10-05

    Oct 5, 2009 ... in our environment. Keywords: Pulmonary tuberculosis; treatment centers; treatment outcome. Résumé paramètre: Centres de traitement de la tuberculose en Ibadan, Nigeria objectif: Pour évaluer les résultats de traitement et les déterminants de résultat entre la tuberculose patients. design: A plan d'étude ...

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

    DEFF Research Database (Denmark)

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

    2002-01-01

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

  14. Revaccination of Guinea Pigs With the Live Attenuated Mycobacterium tuberculosis Vaccine MTBVAC Improves BCG's Protection Against Tuberculosis.

    Science.gov (United States)

    Clark, Simon; Lanni, Faye; Marinova, Dessislava; Rayner, Emma; Martin, Carlos; Williams, Ann

    2017-09-01

    The need for an effective vaccine against human tuberculosis has driven the development of different candidates and vaccination strategies. Novel live attenuated vaccines are being developed that promise greater safety and efficacy than BCG against tuberculosis. We combined BCG with the vaccine MTBVAC to evaluate whether the efficacy of either vaccine would be affected upon revaccination. In a well-established guinea pig model of aerosol infection with Mycobacterium tuberculosis, BCG and MTBVAC delivered via various prime-boost combinations or alone were compared. Efficacy was determined by a reduction in bacterial load 4 weeks after challenge. Efficacy data suggests MTBVAC-associated immunity is longer lasting than that of BCG when given as a single dose. Long and short intervals between BCG prime and MTBVAC boost resulted in improved efficacy in lungs, compared with BCG given alone. A shorter interval between MTBVAC prime and BCG boost resulted in improved efficacy in lungs, compared with BCG given alone. A longer interval resulted in protection equivalent to that of BCG given alone. These data indicate that, rather than boosting the waning efficacy of BCG, a vaccination schedule involving a combination of the 2 vaccines yielded stronger immunity to M. tuberculosis infection. This work supports development of MTBVAC use as a revaccination strategy to improve on the effects of BCG in vaccinated people living in tuberculosis-endemic countries. © 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.

  15. Tuberculosis in haemodialysis patients: A single centre experience

    Directory of Open Access Journals (Sweden)

    T Manmadha Rao

    2013-01-01

    Full Text Available We prospectively followed-up new patients of tuberculosis while on maintenance hemodialysis at a State Government-run tertiary care institute. Between 2000 and 2010, 1237 new patients were initiated on maintainence hemodialysis. The number of patients diagnosed with tuberculosis after initiation of hemodialysis was 131 (10.5% of 1237. The age was 46.4 ± 10.4 (range 8-85 years and there were 90 (68.7% males. The number of patients diagnosed with tuberculosis on the basis of organ involvement were: Pulmonary-60, pleural effusion-31, lymph node-21, meningitis-8, pericardial effusion-7, peritoneum-2, latent tuberculosis-2. The incidence of tuberculosis in hemodialysis was found to be 105.9 per 1000 patient years. Male gender, diabetes mellitus, past history of tuberculosis, mining as an occupation, low serum albumin, and duration of hemodialysis more than 24 months, and unemployment were found to be significant risk-factors on univariate analysis.

  16. Tuberculosis case finding in first-degree relative contacts not living with index tuberculosis cases in Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Chheng P

    2015-10-01

    Full Text Available Phalkun Chheng,1,2 Mary Nsereko,2 LaShaunda L Malone,2 Brenda Okware,2 Sarah Zalwango,2 Moses Joloba,2,3 W Henry Boom,2 Ezekiel Mupere,1,2,4 Catherine M Stein1,2 On behalf of the Tuberculosis Research Unit 1Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA; 2Uganda-Case Western Reserve University Research Collaboration, 3Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda; 4Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda Purpose: To assess the prevalence of pulmonary tuberculosis among first-degree relative (FDR contacts not living with tuberculosis (TB cases. Methods: A cross-sectional analysis of household contacts living with an index TB case and FDR contacts living outside of households in Kampala, Uganda, is presented. Results: A total of 177 contacts (52 FDRs and 125 index household contacts of 31 TB cases were examined. Compared with index household contacts, FDR contacts were older, more likely to be TB symptomatic (50% vs 33%, had a higher percentage of abnormal chest X-rays (19% vs 11%, sputum smear positive (15% vs 5%, and many similar epidemiologic risk factors, including HIV infection (13% vs 10%. Contact groups had similar pulmonary tuberculosis prevalence: 9.6% in FDR vs 10.4% in index household contacts and similar Mycobacterium tuberculosis infection: 62% in FDR vs 61% in index households. Conclusion: TB is common among FDR contacts. High TB prevalence justifies targeting FDRs during household contact investigations. Combining TB active-case finding among FDR contacts with household contact investigation in low-income setting is feasible. This should be part of national TB control program strategies for increasing TB case-detection rates and reducing community TB transmission and death. Keywords: prevalence of pulmonary tuberculosis, limited resource setting, contact tracing

  17. Clinical observation of serum tumor necrosis factor in old patients with silicon-tuberculosis

    International Nuclear Information System (INIS)

    Ye Yixiu; Wang Wei; Liu Weimin; Li Hongmin; Yao Hao; Jiang Ping; Chen Dongjin; Feng Bai

    2001-01-01

    To observe the immune condition of old patients with silicon-tuberculosis, serum TNF was detected in 69 old patients with silicon-tuberculosis by RIA and compared with patients with pulmonary tuberculosis and normal old people. Serum TNF in patients with silicon-tuberculosis or pulmonary tuberculosis was significantly lower than that in normal old people (P < 0.01, P < 0.05). There is no significant difference in TNF between silicon-tuberculosis group and pulmonary tuberculosis group. In conclusion, the immunity of old patients with silicon-tuberculosis or pulmonary tuberculosis was poor, they should be given immunomodulator

  18. Chromoblastomycosis due to Fonsecaea monophora misdiagnosed as sporotrichosis and cutaneous tuberculosis in a pulmonary tuberculosis patient

    NARCIS (Netherlands)

    Shi, Dongmei; Zhang, Wei; Lu, Guixia; de Hoog, G Sybren; Liang, Guanzhao; Mei, Huan; Zheng, Hailin; Shen, Yongnian; Liu, Weida

    Chromoblastomycosis is caused by dematiaceous fungi. It develops after inoculation of the organism into the skin. We report a case of chromoblastomycosis in a pulmonary tuberculosis patient without known history of trauma. The lesions were initially diagnosed as sporotrichosis and skin tuberculosis.

  19. Evaluation of vitamin status in patients with pulmonary tuberculosis.

    Science.gov (United States)

    Oh, Jongwon; Choi, Rihwa; Park, Hyung-Doo; Lee, Hyun; Jeong, Byeong-Ho; Park, Hye Yun; Jeon, Kyeongman; Kwon, O Jung; Koh, Won-Jung; Lee, Soo-Youn

    2017-03-01

    Vitamins are known to be associated with immunity and nutrition. Moreover, vitamin deficiency can affect host immunity to various infectious diseases, including tuberculosis. Although patients with tuberculosis often have vitamin D deficiency, little is known about the levels of other vitamins. Here, we aimed to investigate the status of vitamins A, B 12 , D, and E in patients with tuberculosis. We also aimed to investigate the clinical and laboratory variables related to vitamin status in patients with tuberculosis. We performed a case-control study to investigate the serum vitamin concentrations in 152 patients with tuberculosis and 137 control subjects. The concentrations of vitamin A, vitamin D, vitamin E, homocysteine, and methylmalonic acid were measured using high-performance liquid chromatography (HPLC) or HPLC-tandem mass spectrometry. Patient demographic data and other biochemical parameters were also analyzed. The serum concentrations of vitamins A, D, and E were significantly lower in patients with tuberculosis than in control subjects (1.4 vs. 2.0 μmol/L, P vitamin deficiencies were significantly higher in patients with tuberculosis. Moreover, multiple vitamin deficiencies were only observed in patients with tuberculosis (22.4% of all patients with tuberculosis vs. 0% of all control subjects). Positive correlations among vitamin A, D, and E concentrations were observed (vitamins A and D, r = 0.395; vitamins D and E, r = 0.342; and vitamins A and E, r = 0.427, P vitamin A, D, and E concentrations. Vitamin deficiencies are common in patients with tuberculosis. Further research investigating the clinical importance of vitamin and nutritional status in patients with tuberculosis is needed. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  20. [The satisfaction of personal needs in patients with pulmonary tuberculosis].

    Science.gov (United States)

    Sukhova, E V

    2005-01-01

    The founder of humanistic psychology A. Maslow divided the needs of a personality into several levels--from the lowest to the highest ones. Higher-leveled needs rise when the lower-leveled needs are satisfied. A great deal of factors affect the origination and satisfaction of needs, but they are always interrelated with social values. The extent to which personality needs are satisfied in patients with pulmonary tuberculosis has not been studied. A special questionnaire has been drawn up to study the extent to which personality needs are met. Its suitability has been determined, by using a group of patients with bronchial asthma. The extent to which personality needs are satisfied in patients with pulmonary tuberculosis was studied in 178 patients with infiltrative pulmonary tuberculosis and 253 patients with fibrocavernous pulmonary tuberculosis. The results have shown that the extent to which personality needs are satisfied in patients with tuberculosis is lower than that in apparently healthy individuals of the same social status. In females with infiltrative pulmonary tuberculosis, the needs for safety are satisfied to a lesser extent. In those with fibrocavernous pulmonary tuberculosis, the extent to which the physiological, safety, and self-realization needs is decreased. In males with infiltrative pulmonary tuberculosis, the physiological, noetic, and self-realization needs are satisfied to a lesser extent. In those with fibrocavernous pulmonary tuberculosis, the extent to which the physiological, safety, group decision-making, noetic and self-realization needs is decreased.

  1. Tuberculosis

    International Nuclear Information System (INIS)

    Aleksandrova, A.V.

    1983-01-01

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

  2. Thai people living with tuberculosis and how they adhere to treatment: A grounded theory study.

    Science.gov (United States)

    Choowong, Jiraporn; Tillgren, Per; Söderbäck, Maja

    2017-12-01

    To develop a conceptual framework of adherence to treatment among Thai people living with tuberculosis, a grounded theory approach was used. A purposive sample of 20 Thai people living with tuberculosis, aged from 23 to 85 years, was interviewed. From the participants' perspective, a core category of social belonging was highlighted, with three categories of conditions connected: personal barriers, personal resilience, and social facilitation. Personal barriers encompassed fear of stigma, concealing the illness, and lack of knowledge and motivation to complete the treatment regime. Personal resilience encompassed positive thinking and self-awareness. Social facilitation encompassed the ease of access to health services, continuity in the health service's ability to choose a directly-observed therapy observer, and social support. This study contributes a deeper understanding of the perspective of Thai people living with tuberculosis with regards to adherence to tuberculosis treatment. It might improve how local healthcare workers provide tuberculosis care, and inspire them to tailor care to people living with tuberculosis in a local community to increase personal resilience and reduce stigma. © 2017 John Wiley & Sons Australia, Ltd.

  3. Evaluation of Forty-Nine Patients with Abdominal Tuberculosis

    Directory of Open Access Journals (Sweden)

    Murat Kilic

    2014-12-01

    Full Text Available Aim: Abdominal tuberculosis is an uncommon form of extrapulmonary infection. In this study, we aimed to highlight the nonspecific clinical presentations and diagnostic difficulties of abdominal tuberculosis. Material and Method: Clinical features, diagnostic methods, and the therapeutic outcomes of 49 patients diagnosed as abdominal tuberculosis between 2003 and 2014 were retrospectively analyzed. Results: The patients were classified into four subgroups including peritoneal (28, nodal (14, intestinal (5, and solid organ tuberculosis (2. The most frequent symptoms were abdominal pain, abdominal distention and fatique. Ascites appeared to be the most frequent clinical finding. Ascites and enlarged abdominal lymph nodes were the most frequent findings on ultrasonography and tomography. Diagnosis of abdominal tuberculosis was mainly depended on histopathology of ascitic fluid and biopsies from peritoneum, abdominal lymph nodes or colonoscopic materials. Forty patients healed with standart 6-month therapy while extended treatment for 9-12 months was needed in 8 whom had discontinued drug therapy and had persistent symptoms and signs. One patient died within the treatment period due to disseminated infection. Discussion: The diagnosis of abdominal tuberculosis is often difficult due to diverse clinical presentations. The presence of ascites, personal/familial/contact history of tuberculosis, and coexisting active extraabdominal tuberculosis are the most significant marks in diagnosis. Diagnostic laparoscopy and tissue sampling seem to be the best diagnostic approach for abdominal tuberculosis.

  4. Chest wall tuberculosis; CT findings in 14 patients

    Energy Technology Data Exchange (ETDEWEB)

    Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National Univ. School of Medicine, Chonju (Korea, Republic of); Kim, Dong Woo [Daejoen Eulji Hospital, Daejon (Korea, Republic of); Juhng, Seon Kwan [Wonkwang Univ. Medical School, Iksan (Korea, Republic of)

    1996-01-01

    To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis.

  5. Complex sputum microbial composition in patients with pulmonary tuberculosis

    Science.gov (United States)

    2012-01-01

    Background An increasing number of studies have implicated the microbiome in certain diseases, especially chronic diseases. In this study, the bacterial communities in the sputum of pulmonary tuberculosis patients were explored. Total DNA was extracted from sputum samples from 31 pulmonary tuberculosis patients and respiratory secretions of 24 healthy participants. The 16S rRNA V3 hyper-variable regions were amplified using bar-coded primers and pyro-sequenced using Roche 454 FLX. Results The results showed that the microbiota in the sputum of pulmonary tuberculosis patients were more diverse than those of healthy participants (ppulmonary tuberculosis patients and 17 of which were found in healthy participants. Furthermore, many foreign bacteria, such as Stenotrophomonas, Cupriavidus, Pseudomonas, Thermus, Sphingomonas, Methylobacterium, Diaphorobacter, Comamonas, and Mobilicoccus, were unique to pulmonary tuberculosis patients. Conclusions This study concluded that the microbial composition of the respiratory tract of pulmonary tuberculosis patients is more complicated than that of healthy participants, and many foreign bacteria were found in the sputum of pulmonary tuberculosis patients. The roles of these foreign bacteria in the onset or development of pulmonary tuberculosis shoud be considered by clinicians. PMID:23176186

  6. Chest wall tuberculosis; CT findings in 14 patients

    International Nuclear Information System (INIS)

    Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul; Kim, Dong Woo; Juhng, Seon Kwan

    1996-01-01

    To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis

  7. Tuberculosis in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Flávio Jota de Paula

    1987-06-01

    Full Text Available Nine cases of tuberculosis (TB were diagnosed among 800 uremic patients, followed-up during 11 years, a prevalence of 1125%, 2.5 times higher than that in the general population. Six patients (66.7% had lymph node involvement (4 cervical and 2 mediastinal. Three patients (33.3% had pulmonary involvement (2 pleuro-pulmonary and 1 bilateral apical pulmonary. Eight patients were undergoing dialysis and 1 was pre-dialytic. The duration of dialysis ranged from 1 to 60 months. Three patients had previously received immunosuppressive drugs for unsuccessful renal transplantation. Daily fever was present in all but one patient; he was asymptomatic and TB was suspected after routine chest radiography. Biopsy was the diagnostic procedure in 7 patients (77.8%, four by direct cervical lymph node biopsy, 2 by mediastinal, performed by mediastinoscopy and 1 by pleural biopsy. In 2 other patients TB was confirmed by the presence of tubercle bacilli; in sputum (1 patient and in a bronchial flushing specimen (the other patient. Triple therapy was used in all patients (isoniazid and ethambutol in all, plus rifampicin in 8 and streptomycin in 1. One patient had jaundice and another had optical neuritis. Five patients were cured. The other four died during treatment of causes unrelated to TB or its treatment.

  8. determinants of tuberculosis services acceptance among patients

    African Journals Online (AJOL)

    J MUGUMBATE

    stigmatization on acceptance of tuberculosis services in government hospitals in Oyo State, ... tuberculosis. It usually attacks the lungs but can also affect other parts of the .... out that, stigma among Mexican immigrants in Califonia significantly ...

  9. Stigma against Tuberculosis Patients in Addis Ababa, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Sebsibe Tadesse

    Full Text Available Stigma attached to tuberculosis contributes to the limited effectiveness of current TB control approaches. However, there is a dearth of studies that explore the causes of stigma attached to tuberculosis and its effects on patients and tuberculosis control programs in Ethiopia.An institution-based qualitative study was conducted at St. Peter Tuberculosis Specialized Hospital in Addis Ababa, Ethiopia from July to August, 2015. Ten in-depth interviews and 6 key-informant interviews were carried out among tuberculosis patients and healthcare workers, respectively.The Open Code computer software package was used to analyze the data thematically.The study revealed that fear of infection and inappropriate health education messages by media were the main causes of tuberculosis stigma. The patients experienced isolation within their family and community, separation, and financial crisis. The stigma attached to tuberculosis may contribute to delayed healthcare seeking, poor treatment adherence, and poor prognosis.Interventions that reduce the stigma attached to tuberculosis should target on areas, such as creating community awareness, patient counseling on problem-solving and emotional skills, preparing culturally sensitive and scientifically sound media messages, providing financial support for the patients, and enhancing the qualities of the healthcare workers, such as empathy, concern, respect for the patient and cultural sensitivity.

  10. Tuberculosis-related mortality in people living with HIV in Europe and Latin America

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Efsen, Anne Marie Werlinrud; Schultze, Anna

    2016-01-01

    baseline, whichever occurred first. Risk factors for all-cause and tuberculosis-related deaths were assessed using Kaplan-Meier estimates and Cox models. FINDINGS: Of 1406 patients (834 in eastern Europe, 317 in western Europe, and 255 in Latin America), 264 (19%) died within 12 months. 188 (71...... a multiregional (eastern Europe, western Europe, and Latin America) prospective cohort study: the TB:HIV study. METHODS: Consecutive HIV-positive patients aged 16 years or older with a diagnosis of tuberculosis between Jan 1, 2011, and Dec 31, 2013, were enrolled from 62 HIV and tuberculosis clinics in 19...... countries in eastern Europe, western Europe, and Latin America. The primary endpoint was death within 12 months after starting tuberculosis treatment; all deaths were classified according to whether or not they were tuberculosis related. Follow-up was either until death, the final visit, or 12 months after...

  11. Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review

    NARCIS (Netherlands)

    Tiemersma, Edine W.; van der Werf, Marieke J.; Borgdorff, Martien W.; Williams, Brian G.; Nagelkerke, Nico J. D.

    2011-01-01

    Background: The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting

  12. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review

    NARCIS (Netherlands)

    Tiemersma, E.W.; van der Werf, M.J.; Borgdorff, M.W.; Williams, B.G.; Nagelkerke, N.J.D.

    2011-01-01

    Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting

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

    African Journals Online (AJOL)

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

  14. Tuberculosis in patients with systemic lupus erythematosus: Spain's situation.

    Science.gov (United States)

    Arenas Miras, María del Mar; Hidalgo Tenorio, Carmen; Jimenez Alonso, Juan

    2013-01-01

    There has recently been an increase in the incidence of patients with systemic lupus erythematosus (SLE) due mainly to earlier diagnosis, and increased survival. Tuberculosis in our country is one of the most prevalent infectious diseases, and one of the underlying causes would be HIV infection and increased immigration from areas with high tuberculosis prevalence; this phenomenon is truly important in patients with autoimmune diseases, as clinical presentation, severity and prognosis of tuberculosis are often different to that of immunocompetent patients. Studies of tuberculosis in patients with SLE are scarce and inconclusive, with many doubts existing about the performance or non-tuberculous prophylaxis in this population and the absence of a protocol due to lack of conclusive studies. New techniques for diagnosis of tuberculosis (IGRAs) may be useful in this population due to higher sensitivity than Mantoux, helping avoid false negatives. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  15. The Evaluation of Patients with Tuberculosis Treated in Batman Tuberculosis Control Dispensary in 2003 Year

    Directory of Open Access Journals (Sweden)

    Tekin Yıldız

    2007-01-01

    Full Text Available Tuberculosis is a very important problem for public health all around the world. In this study, 168 patients with TB who were treated in Batman Tuberculosis Control Dispensary in 2003 were retrospectively assessed. Ninety six of our cases were male, 72 were female. Eighty one patients who underwent for the tuberculous treatment were with pulmonary tuberculosis and 87 cases were with extrapulmonary tuberculosis. Acid fast bacilli (AFB at sputum was positive in 66.17% of the cavitary pulmonary TB cases before treatment and only one patient’s sputum was positive in pulmonary tuberculosis without cavity. Results of the tuberculosis treatment of cases revealed that one case left the treatment, 3 patients were inharmonious, 3 patients were dead, 161 patients were cured. Success rate of treatment was 95,83% (5 of these cases were cured and 156 patients completed the treatment. These data suggest that in order to increase the rate of the cure, bacteriological examination of the sputum should be considered at the end of the treatment like as the beginning.

  16. Risk factors for multidrug resistant tuberculosis patients in Amhara ...

    African Journals Online (AJOL)

    Risk factors for multidrug resistant tuberculosis patients in Amhara National ... risk factors of MDR-TB patients in Amhara National Regional State, Ethiopia. ... strict adherence to directly observed therapy, appropriate management of TB ...

  17. Alternation of Gut Microbiota in Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Mei Luo

    2017-11-01

    Full Text Available One-third of the world's population has been infected with Mycobacterium tuberculosis (M. tuberculosis, a primary pathogen of the mammalian respiratory system, while about 10% of latent infections progress to active tuberculosis (TB, indicating that host and environmental factors may determine the outcomes such as infection clearance/persistence and treatment prognosis. The gut microbiota is essential for development of host immunity, defense, nutrition and metabolic homeostasis. Thus, the pattern of gut microbiota may contribute to M. tuberculosis infection and prognosis. In current study we characterized the differences in gut bacterial communities in new tuberculosis patients (NTB, recurrent tuberculosis patients (RTB, and healthy control. The abundance-based coverage estimator (ACE showed the diversity index of the gut microbiota in the patients with recurrent tuberculosis was increased significantly compared with healthy controls (p < 0.05. At the phyla level, Actinobacteria and Proteobacteria, which contain many pathogenic species, were significantly enriched in the feces RTB patients. Conversely, phylum Bacteroidetes, containing a variety of beneficial commensal organisms, was reduced in the patients with the recurrent tuberculosis compared to healthy controls. The Gram-negative genus Prevotella of oral origin from phylum of Bacteroidetes and genus Lachnospira from phylum of Firmicutes were significantly decreased in both the new and recurrent TB patient groups, compared with the healthy control group (p < 0.05. We also found that there was a positive correlation between the gut microbiota and peripheral CD4+ T cell counts in the patients. This study, for the first time, showed associations between gut microbiota with tuberculosis and its clinical outcomes. Maintaining eubiosis, namely homeostasis of gut microbiota, may be beneficial for host recovery and prevention of recurrence of M. tuberculosis infection.

  18. The diagnosis of tuberculosis in dialysis patients

    Directory of Open Access Journals (Sweden)

    Hela Jebali

    2017-01-01

    Full Text Available The incidence of tuberculosis (TB is high in patients undergoing chronic dialysis than it is in the general population. The diagnosis of TB is often difficult and extrapulmonary involvement is predominant. This study investigates the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period. TB was diagnosed in 41 patients. Anti-TB drugs, adverse effects of therapy, and outcome were noted. Thirty-eight patients (92.6% were on hemodialysis and three were on peritoneal dialysis (7.3%. The mean age at diagnosis was 50.8 years and the male/female ratio was 1.16. Four patients had a history of pulmonary TB. Extrapulmonary involvement was observed in 32 (78 % patients. The bacteriological confirmation was made in 41.46% and histological confirmation was made in 26.83%, and in the rest, the diagnosis was retained on the criterion presumption. Nineteen patients (46.34% developed adverse effects of antitubercular drugs. Eight patients (19.51% died during the study from TB or adverse effects of treatment. Low urea reduction ratio and female sex were associated with poor prognosis in our study. The clinical manifestations of TB in patients on dialysis are quite nonspecific, making timely diagnosis difficult, and delaying the initiation of curative treatment, which is a major determinant of the outcome.

  19. Testicular tuberculosis in an HIV positive patient mimicking ...

    African Journals Online (AJOL)

    B.A. Ojo

    Abstract. With the upsurge of tuberculosis infection compounded by the pandemic Human Immune Deficiency Virus. (HIV), isolated testicular tuberculosis though a rarity, should be a differential diagnosis especially in the atypical age group of patients presenting with testicular swelling and in areas with high prevalence rate ...

  20. Frequency of otorhinolaryngologies' manifestations in patients with pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Sousa, Renato Telles de

    2010-06-01

    Full Text Available Introduction: The tuberculosis continues being a world problem and in the last years had an increase in his incidence mainly by the growing number of patients with HIV. The tuberculosis has like an etiologic agent the Mycobacterium tuberculosis that possesses a period of latency generally prolonged between the initial infection and the illness. That illness can affect diverse organs and systems. M Method: This study is descriptive, transversal and prospective. Within, patients diagnosed with pulmonary tuberculosis by the service of pneumologia of the outpatient clinic Araújo Lima of the Federal University of the Amazon (UFAM, in Manaus, between the period of July of 2005 and May of 2006 were submitted to otorhinolaryngological exam in search of manifestations of the illness. Objectives: The main objective of the study was estimate the predominance of otorhinolaryngological manifestations in patients with tuberculosis and to describe the frequencies of the different manifestations. Results: They were analyzed 15 cases of pulmonary tuberculosis confirmed by the baciloscopia, being 7 of the female sex and 8 of the male sex. The majority of the patients were young adults between the third and fourth decade of life (46,7%. Only one of the patients had co-infection with the HIV virus. Conclusion: The otorhinolaryngological affection by the tuberculosis was observed in 2 patients corresponding to 13.33% of the sample, being a patient with tubercular medium otitis and a patient with linfoadenopatia cervical.

  1. DETECTION OF MYCOBACTERIUM TUBERCULOSIS IN BLOOD FOR DIAGNOSIS OF GENERALISED TUBERCULOSIS IN HIV-POSITIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    V. N. Zimina

    2017-01-01

    Full Text Available Objective: To study the informative value of the detection of mycobacteria in blood with the cultural method in patients with suspected tuberculous sepsis and to determine the most significant clinical and laboratory criteria for testing. Materials and methods: The investigation to detect M.tuberculosis was fulfilled in 159 HIV-positive patients with suspected tuberculosis sepsis. Blood culture was completed with culture medium Myco/F Lytic Culture Vials and analyzer BACTEC 9050. Results: Mycobacteria were detected in blood of 19 patients (11,9% of all patients: in 18 patients the growth of М. tuberculosis complex was detected (25,3% of all patients with diagnosed tuberculosis and in 1 patient it was Mycobacterium avium complex (0,6% of all patients. It was shown, that the probability of M.tuberculosis detection was especially associated with the severity of the disease, immunosupression (less than 100 cells/mkl, hemoglobin quantity less than 90 g/l (levels were determined through the seeking for the most significant cutoffs. It was not proofed, that meningoencephalitis develops more often in patients with proven bacteremia. There were no evident differences in detection frequency of mycobacteria in sputum between patients with tuberculous sepsis and without it.

  2. Imaging diagnosis of pulmonary tuberculosis in immunocompromised patients

    International Nuclear Information System (INIS)

    Ma Daqing; Zhao Dawei; Pan Keqin

    2000-01-01

    Objective: To evaluate CT and X-ray features of pulmonary tuberculosis in diabetic patients, patients post kidney transplantation, and patients with acquired immunodeficiency syndrome (AIDS). Methods: The authors reviewed CT scans in 20 patients with diabetic patients, X-ray films in 10 cases after kidney transplantation, and CT scans in 2 patients with AIDS. Results: CT features of pulmonary tuberculosis in diabetic diseases included larger confluent consolidation (10 cases ), multiple small cavities within any given lesion (9 cases ) and non-segmental distribution (2 cases). Satellite lesions were found in most films. The X-ray appearances of pulmonary tuberculosis post kidney transplantation included patch and larger confluent consolidation (6 cases), and miliary tuberculosis(4 cases). The CT findings of pulmonary tuberculosis with AIDS were enlarged mediastinal lymph nodes (1 case), pulmonary infiltration (1 case), and extra chest lesions(2 cases) such as enlarged neck lymph nodes and post-peritoneal lymph nodes. Conclusion: The Main radiological findings of pulmonary tuberculosis in immunocompromised patients appear larger confluent consolidation, multiple small cavities within a given lesion, miliary tuberculosis, enlarged mediastinal lymph nodes, and extra chest enlarged lymph nodes

  3. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Myung Jin; Goo, Jin Mo E-mail: jmgoo@plaza.snu.ac.kr; Im, Jung-Gi

    2004-11-01

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia.

  4. Pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis

    International Nuclear Information System (INIS)

    Chung, Myung Jin; Goo, Jin Mo; Im, Jung-Gi

    2004-01-01

    Objectives: Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of pulmonary tuberculosis. However, detecting pulmonary tuberculosis may be difficult due to the underlying fibrosis. The aim of this report is to describe the radiological and clinical findings of pulmonary tuberculosis in patients with idiopathic pulmonary fibrosis. Materials and methods: We reviewed 143 consecutive patients in whom IPF was diagnosed by either the histological or radio-clinical criteria. Among them, nine patients were histologically (n=2) or bacteriologically (n=7) confirmed to have active pulmonary tuberculosis. The location and patterns of pulmonary tuberculosis were examined on a thin section CT scan. Results: The most common thin section CT findings were subpleural nodules (n=6; mean diameter, 3.2 cm) and a lobar or segmental consolidation (n=3). The lesions were located most commonly in the right lower lobe (n=4). The incidence of tuberculosis in patients with idiopathic pulmonary fibrosis was more than five times higher than that of the general population. Conclusion: The atypical manifestation of pulmonary tuberculosis is common in patients with idiopathic pulmonary fibrosis, which may mimic lung cancer or bacterial pneumonia

  5. Point-of-care C-reactive protein-based tuberculosis screening for people living with HIV: a diagnostic accuracy study.

    Science.gov (United States)

    Yoon, Christina; Semitala, Fred C; Atuhumuza, Elly; Katende, Jane; Mwebe, Sandra; Asege, Lucy; Armstrong, Derek T; Andama, Alfred O; Dowdy, David W; Davis, J Luke; Huang, Laurence; Kamya, Moses; Cattamanchi, Adithya

    2017-12-01

    Symptom-based screening for tuberculosis is recommended for all people living with HIV. This recommendation results in unnecessary Xpert MTB/RIF testing in many individuals living in tuberculosis-endemic areas and thus poor implementation of intensified case finding and tuberculosis preventive therapy. Novel approaches to tuberculosis screening are needed to help achieve global targets for tuberculosis elimination. We assessed the performance of C-reactive protein (CRP) measured with a point-of-care assay as a screening tool for active pulmonary tuberculosis. For this prospective study, we enrolled adults (aged ≥18 years) living with HIV with CD4 cell count less than or equal to 350 cells per μL who were initiating antiretroviral therapy (ART) from two HIV/AIDS clinics in Uganda. CRP concentrations were measured at study entry with a point-of-care assay using whole blood obtained by fingerprick (concentration ≥10 mg/L defined as screen positive for tuberculosis). Sputum samples were collected for Xpert MTB/RIF testing and culture. We calculated the sensitivity and specificity of point-of-care CRP and WHO symptom-based screening in reference to culture results. We repeated the sensitivity analysis with Xpert MTB/RIF as the reference standard. Between July 8, 2013, and Dec 15, 2015, 1237 HIV-infected adults were enrolled and underwent point-of-care CRP testing. 60 (5%) patients with incomplete or contaminated cultures were excluded from the analysis. Of the remaining 1177 patients (median CD4 count 165 cells per μL [IQR 75-271]), 163 (14%) had culture-confirmed tuberculosis. Point-of-care CRP testing had 89% sensitivity (145 of 163, 95% CI 83-93) and 72% specificity (731 of 1014, 95% CI 69-75) for culture-confirmed tuberculosis. Compared with WHO symptom-based screening, point-of-care CRP testing had lower sensitivity (difference -7%, 95% CI -12 to -2; p=0·002) but substantially higher specificity (difference 58%, 95% CI 55 to 61; ptuberculosis screening test

  6. Tuberculosis Treatment Adherence of Patients in Kosovo.

    Science.gov (United States)

    Krasniqi, Shaip; Jakupi, Arianit; Daci, Armond; Tigani, Bahri; Jupolli-Krasniqi, Nora; Pira, Mimoza; Zhjeqi, Valbona; Neziri, Burim

    2017-01-01

    The poor patient adherence in tuberculosis (TB) treatment is considered to be one of the most serious challenges which reflect the decrease of treatment success and emerging of the Multidrug Resistance-TB (MDR-TB). To our knowledge, the data about patients' adherence to anti-TB treatment in our country are missing. This study was aimed to investigate the anti-TB treatment adherence rate and to identify factors related to eventual nonadherence among Kosovo TB patients. This study was conducted during 12 months, and the survey was a descriptive study using the standardized questionnaires with total 324 patients. The overall nonadherence for TB patient cohort was 14.5%, 95% CI (0.109-0.188). Age and place of residence are shown to have an effect on treatment adherence. Moreover, the knowledge of the treatment prognosis, daily dosage, side effects, and length of treatment also play a role. This was also reflected in knowledge regarding compliance with regular administration of TB drugs, satisfaction with the treatment, interruption of TB therapy, and the professional monitoring in the administration of TB drugs. The level of nonadherence TB treatment in Kosovar patients is not satisfying, and more health care worker's commitments need to be addressed for improvement.

  7. Tuberculosis in patients with end-stage renal disease

    International Nuclear Information System (INIS)

    Kim, Hyo Cheol; Goo, Jin Mo; Chung, Myung Jin; Moon, Min Hoan; Koh, Young Hwan; Im, Jung Gi

    2001-01-01

    The purpose of our study was to describe the clinical and radiological manifestations of tuberculosis in patients with end-stage renal disease. The medical records, chest radiographs, and CT scans of 42 patients with tuberculosis among 871 consecutive patients with end-stage renal disease were reviewed. Patterns of initial chest radiographs were categorized as primary, postprimary, miliary, or atypical, according to the predominant radiologic findings. Chest radiographs and CT scans revealed pulmonary tuberculosis in 28 patients and extrapulmonary tuberculosis in 15. The pattern of chest radiographs indicative of pulmonary tuberculosis was primary in 12 cases, postprimary in 11, miliary in one, demonstrated atypical infiltrates in three, and was normal in one. Tuberculosis involved the extrathoracic lymph nodes in six cases, the peritoneum in four, the spine in three, and the bone marrow in two. The primary pattern, seen in 12 patients, manifested as pleural effusion or segmental consolidation, and in ten of the twelve the former was dominant. The radiological pattern of pulmonary tuberculosis in end-stage renal disease is often primary, and extrapulmonary involvement is frequent

  8. Tuberculosis Treatment Adherence of Patients in Kosovo

    Directory of Open Access Journals (Sweden)

    Shaip Krasniqi

    2017-01-01

    Full Text Available Setting. The poor patient adherence in tuberculosis (TB treatment is considered to be one of the most serious challenges which reflect the decrease of treatment success and emerging of the Multidrug Resistance-TB (MDR-TB. To our knowledge, the data about patients’ adherence to anti-TB treatment in our country are missing. Objective. This study was aimed to investigate the anti-TB treatment adherence rate and to identify factors related to eventual nonadherence among Kosovo TB patients. Design. This study was conducted during 12 months, and the survey was a descriptive study using the standardized questionnaires with total 324 patients. Results. The overall nonadherence for TB patient cohort was 14.5%, 95% CI (0.109–0.188. Age and place of residence are shown to have an effect on treatment adherence. Moreover, the knowledge of the treatment prognosis, daily dosage, side effects, and length of treatment also play a role. This was also reflected in knowledge regarding compliance with regular administration of TB drugs, satisfaction with the treatment, interruption of TB therapy, and the professional monitoring in the administration of TB drugs. Conclusion. The level of nonadherence TB treatment in Kosovar patients is not satisfying, and more health care worker’s commitments need to be addressed for improvement.

  9. Analysis of peculiarities of identification, diagnostics and course of tuberculosis in patients with tuberculosis/HIV co-infection

    Directory of Open Access Journals (Sweden)

    V. P. Melnyk

    2017-10-01

    Full Text Available Objective – to analyse dynamics of detection of tuberculosis and HIV/AIDS in tuberculosis/HIV co-infection, to identify the main clinical forms of tuberculosis, the type of tuberculosis process and the structure of incidence of tuberculosis, to analyse dependence of a clinical form of tuberculosis on quantity of CD4 cells. Materials and methods. 155 patients with tuberculosis/HIV co-infection and 155 patients with tuberculosis without HIV infection were examined. All patients underwent general clinical examination, laboratory tests, X-ray, microbiological, histological studies (with extrapulmonary tuberculosis. Results. In all patients, co-infection was detected mainly by respiratory tuberculosis (in 73 % of HIV-positive and 89 % of HIV-negative patients. In HIV-positive patients, tuberculosis was more often detected by the passive way (81 %, and in HIV-negative patients – by the active way (78 %. 66.5 % of patients had HIV infection first, 21.3 % had the first tuberculosis, and 12.2 % had HIV infection and tuberculosis at the same time. In clinical forms in patients with HIV-infection, infiltrative and disseminated tuberculosis prevailed. Pulmonary tuberculosis was diagnosed in 70.3 % of patients, extrapulmonary – in 11 %, pulmonary and extrapulmonary tuberculosis – in 18.7 %. In 28.4 % of patients, immunodeficiency was detected with CD4 cells less than 100 in 1mm3, in 22.6 % of patients – 101–200 CD4 cells in 1 mm3, in 10.3 % in 201–300 CD4 in 1 mm3, in 14.8 % of patients – 301–500 CD4 in 1 mm3 and in 23.9 % ≥ 500 CD4 in 1 mm3. In 56.1 % of patients, first diagnosed tuberculosis was detected, 28.4 % had the relapse of tuberculosis, 7.7 % had tuberculosis after a previous ineffective treatment, 7.7 % had tuberculosis with treatment after the break. Bacterial excretion (by the scopic method was detected in 42.6 % of patients, by the bacteriological method – in 73.9 %, by the molecular-genetic method – in 93.2 %, typical

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

    Science.gov (United States)

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

    2016-01-01

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

  11. DIFFERENTIAL DIAGNOSTICS OF TUBERCULOSIS AND MYCOBACTERIOSIS IN HIV PATIENTS

    Directory of Open Access Journals (Sweden)

    A. M. Panteleev

    2017-01-01

    Full Text Available The article analyzes the differences in clinical and laboratory manifestations of tuberculosis and mycobacteriosis in HIV patients. It was found out that mycobacteriosis developed mostly in the socially well patients at the advanced stages of HIV infection. In case of mycobacteriosis, lesions were mostly located in the abdomen with limited inflammation in the chest, while in case of tuberculosis pulmonary lesions dominated. A negative result of sputum PCR assays for tuberculosis mycobacteria with a positive result of the test for AFB is an important sign for differential diagnostics. The obtained results allow performing differential diagnostics of these diseases in those HIV infected.

  12. Delays and care seeking behavior among tuberculosis patients in ...

    African Journals Online (AJOL)

    Delays and care seeking behavior among tuberculosis patients in Tigray of Northern Ethiopia. Mengiste M Mesfin, Tesfay W Tasew, Israel G Tareke, Yohannes T Kifle, Witten H Karen, Madeley J Richard ...

  13. 17 Smear positive pulmonary tuberculosis among HIV patients ...

    African Journals Online (AJOL)

    conducted in February 2009 to assess the effect of the level of CD4 lymphocyte ... development of smear positive pulmonary TB (PTB) among HIV patients before ..... (2000) Impact of combination antiretroviral therapy on the risk of tuberculosis.

  14. Patients with secondary amenorrhea due to tuberculosis ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is a disease which can affect various organs, including human's genital organs such as the endometrium. Tuberculosis endometritis can cause clinical symptoms of secondary amenorrhea and infertility. Infertility in genital TB caused by the involvement of the endometrium. The case presentation is ...

  15. Prevalence of Tuberculosis among patients attending two ...

    African Journals Online (AJOL)

    boaz

    l'infection à Mycobacteriumtuberculosis. Mais il y avait une différence significative entre l'ESR et la tuberculose. INTRODUCTION. Tuberculosis (TB) is an infectious disease caused by the bacterium. Mycobacterium tuberculosis. It was first described in 1882 by Robert Koch, who won the. Nobel Prize in Physiology/ Medicine ...

  16. Tuberculosis

    OpenAIRE

    C. Robert Horsburgh, Jr

    2014-01-01

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

  17. Tuberculosis

    OpenAIRE

    Mochammad, Hatta

    2008-01-01

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

  18. Living with HIV: Patients Perspective

    Centers for Disease Control (CDC) Podcasts

    This podcast showcases three people who are living with HIV. The patients share their experiences of being diagnosed with HIV, of the treatments they are undergoing, and on taking responsibility for their health.

  19. Tuberculosis

    International Nuclear Information System (INIS)

    Latorre Tortello, Pablo

    1998-01-01

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

  20. [Function in patients with chronic fibrocavernous tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2008-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, residual volume (RV), R(aw), R(in), R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 62 patients with chronic fibrocavernous tuberculosis. Lung dysfunctions were detected in 96.8% of the patients. Changes in lung volumes and capacities were found in 90.3%, impaired bronchial patency was in 90.3%, and pulmonary gas exchange dysfunction was in 79.0%. The lung volume and capacity changes appeared as decreased VC and FVC, decreased and increased TLC, TGV, RV; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, and FEV1/VC%; and increased R(aw), R(in), R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, PaO2, and decreased and increased PaCO2. The magnitude of the observed functional changes ranges from slight to significant and drastic with a predominance of considerable and drastic changes in lung volumes and capacities and mild impairments of bronchial patency and pulmonary gas exchange function.

  1. Endocrine dysfunction among adult patients with tuberculosis: An African experience

    Directory of Open Access Journals (Sweden)

    Davis Kibirige

    2014-01-01

    Full Text Available A broad spectrum of endocrine conditions has been reported among adult patients with tuberculosis in Africa. This review aims to describe the magnitude and pathogenesis of the following endocrinopathies among patients with tuberculosis in Africa: adrenal insufficiency, diabetes mellitus, disorders of calcium and vitamin D metabolism, thyroid dysfunction and hypogonadism. PubMed database and Google scholar were used to search for the relevant published English language studies and case reports relating to endocrine abnormalities and tuberculosis in Africa up to July 2013. The search terms used were endocrine dysfunction, endocrine abnormalities, adrenal insufficiency, diabetes mellitus, thyroid dysfunction, hypogonadism, disorders of calcium and vitamin D metabolism, tuberculosis, Africa. Reference lists of the identified articles were further used to identify other studies. Adrenal insufficiency, diabetes mellitus and calcium-vitamin D abnormalities were the most prevalent and frequently reported endocrine disorders among adult patients with tuberculosis in Africa. A meticulous endocrine evaluation among tuberculosis patients with suspected endocrine abnormalities should be encouraged in Africa and other high TB endemic regions. Treatment of these endocrine disorders has generally been shown to improve quality of life and reduce mortality.

  2. Smoking prolongs the infectivity of patients with tuberculosis.

    LENUS (Irish Health Repository)

    Siddiqui, U A

    2010-10-01

    We sought to establish if smokers on anti-tuberculosis treatment are more likely to have a prolonged period of infectivity, compared to non-smoking tuberculosis patients, in a low tuberculosis prevalence country. We conducted a cross-sectional, retrospective study in Ireland that recruited 53 microbiologically confirmed cases of pulmonary tuberculosis (PTB). The age-sex adjusted odds ratios (AOR) suggest that the infectivity status of PTB on treatment was four times more likely to be prolonged beyond 6-8 weeks, if the cases had a smoking history (AOR: 4.42; 95% CI: 1.23; 15.9). Smoking was associated with delayed sputum smear conversion in PTB patients on treatment.

  3. Factors associated with mortality in tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Roya Alavi-Naini

    2013-01-01

    Full Text Available Background: Tuberculosis (TB is one of the main causes of morbidity and mortality in different societies. Understanding factors leading to death following diagnosis of TB is important to predict prognosis in TB patients. The aim of this study was to identify common risk factors associated with death in patients with an in-hospital diagnosis of TB, in a city in Iran with the highest prevalence and incidence of TB in the country. Materials and Methods: A retrospective study was conducted at a university-affiliated hospital, Zahedan, in the south-east of Iran, which is a referral center for TB. To identify factors leading to death, medical records of 715 patients ≥15 years old with pulmonary TB from February 2002 to February 2011 have been evaluated. Registered factors included smoking, human immune deficiency virus (HIV infection, using drugs, lung cancer, drug hepatitis following anti-TB medications, diabetes mellitus, previous TB treatment, anemia; and results of sputum smears. Univariate comparison and multiple logistic regression were performed to identify factors associated with mortality in TB patients. Results: Among 715 registered TB patients, 375 (52.5% patients were male; among those, 334 (53% were in the alive group and 41 (54% in the death group. Seventy-five (10.5% of the total number of TB patients died during TB treatment. The multivariate model showed that anemia (AOR: 19.8, 95% CI: 5.6-35.5, positive sputum smear (AOR: 13.4, 95% CI: 6.8-33.6, smoking (AOR: 12.9, 95% CI: 3.9-27.3, drug hepatitis (AOR: 12.3, 95% CI: 6.7-24.7, diabetes mellitus (AOR: 9.7, 95% CI: 2.9-32.0, drug use (AOR: 7.8, 95% CI: 2.4-25.5, and history of previous TB (AOR: 6.8, 95% CI: 2.2-21.3 were major risk factors for death in TB patients. Conclusion: Monitoring co-morbid conditions like diabetes mellitus and anemia are important to reduce death rate in TB patients. Preventive measures for smoking and drug addiction also play an important role to decrease

  4. Management of multidrug-resistant tuberculosis in human immunodeficiency virus patients

    Science.gov (United States)

    Jamil, K. F.

    2018-03-01

    Tuberculosis (TB) is a chronic infectious disease mainly caused by Mycobacterium tuberculosis(MTB). 10.4 million new TB cases will appear in 2015 worldwide. There were an estimated 1.4 million TB deaths in 2015, and an additional 0.4 million deaths resulting from TB disease among people living with human immunodeficiency virus (HIV). Multidrug- resistant and extensively drug-resistant tuberculosis (MDR and XDR-TB) are major public health concerns worldwide. 480.000 new cases of MDR-TB will appear in 2015 and an additional 100,000 people with rifampicin-resistant TB (RR-TB) who were also newly eligible for MDR-TB treatment. Their association with HIV infection has contributed to the slowing down of TB incidence decline over the last two decades, therefore representing one important barrier to reach TB elimination. Patients infected with MDR-TB require more expensive treatment regimens than drug-susceptible TB, with poor treatment.Patients with multidrug- resistant tuberculosis do not receive rifampin; drug interactions risk is markedly reduced. However, overlapping toxicities may limit options for co-treatment of HIV and multidrug- resistant tuberculosis.

  5. Spoligotyping of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mumbai, India.

    Science.gov (United States)

    Kulkarni, Savita; Sola, Christophe; Filliol, Ingrid; Rastogi, Nalin; Kadival, Gururaj

    2005-05-01

    Tuberculosis remains a major health problem in India, with 2 million new cases and 421,000 deaths each year. In this paper, we describe the spoligotyping results of 216 Mycobacterium tuberculosis culture isolates from patients with pulmonary tuberculosis in Mumbai, India. As spoligotyping data from India have rarely been described until now, and as there is limited information on the major circulating clades of M. tuberculosis, the data obtained were also compared to an international spoligotype database (SpolDB4) that contained patterns from 22,546 isolates from more than 100 countries. Eighty-four (39%) of the isolates were definitively marked as orphan strains, indicating the paucity of such data from India. The remaining 132 isolates clustered among 59 shared types; among these, 42 shared types were already present in the database, 17 were newly created, and 5 of them were specifically reported from Mumbai. A total of 9 major types in this study clustered 32% of the isolates. At the phylogenetic level, 30% of the isolates belonged to the Central Asian families CAS1 and CAS2, of the major genetic group (MGG) 1, 29% to MGG 2 and 3 families (spacers 33-36 missing) and 17% to the ancestral East African Indian (EAI) family. Finally, nearly 10% of the isolates belonged to the W-Beijing family in a broad sense, also in the MGG 1 group. In conclusion, historic clones of the MGG 1 group of M. tuberculosis are responsible for roughly 60% of all tuberculosis cases in Mumbai. Together with the fact that organisms presumably of European descent (such as the Haarlem family) were only rarely found, our observations suggest that tuberculosis in Mumbai, India is essentially caused by historical clones of tubercle bacilli undergoing active circulation due to uncontrolled demography, high prevalence of the disease, and a paucity of resources.

  6. Mycobacterium tuberculosis strains of the Beijing genotype are rarely observed in tuberculosis patients in South America.

    Science.gov (United States)

    Ritacco, Viviana; López, Beatriz; Cafrune, Patricia I; Ferrazoli, Lucilaine; Suffys, Philip N; Candia, Norma; Vásquez, Lucy; Realpe, Teresa; Fernández, Jorge; Lima, Karla V; Zurita, Jeannete; Robledo, Jaime; Rossetti, Maria L; Kritski, Afranio L; Telles, Maria A; Palomino, Juan C; Heersma, Herre; van Soolingen, Dick; Kremer, Kristin; Barrera, Lucía

    2008-08-01

    The frequency of the Beijing genotype of Mycobacterium tuberculosis as a cause of tuberculosis (TB) in South America was determined by analyzing genotypes of strains isolated from patients that had been diagnosed with the disease between 1997 and 2003 in seven countries of the subcontinent. In total, 19 of the 1,202 (1.6%) TB cases carried Beijing isolates, including 11 of the 185 patients from Peru (5.9%), five of the 512 patients from Argentina (1.0%), two of the 252 Brazilian cases (0.8%), one of the 166 patients from Paraguay (0.6%) and none of the samples obtained from Chile (35), Colombia (36) and Ecuador (16). Except for two patients that were East Asian immigrants, all cases with Beijing strains were native South Americans. No association was found between carrying a strain with the Beijing genotype and having drug or multi-drug resistant disease. Our data show that presently transmission of M. tuberculosis strains of the Beijing genotype is not frequent in Latin America. In addition, the lack of association of drug resistant TB and infection with M. tuberculosis of the Beijing genotype observed presently demands efforts to define better the contribution of the virulence and lack of response to treatment to the growing spread of Beijing strains observed in other parts of the world.

  7. Mycobacterium tuberculosis strains of the Beijing genotype are rarely observed in tuberculosis patients in South America

    Directory of Open Access Journals (Sweden)

    Viviana Ritacco

    2008-08-01

    Full Text Available The frequency of the Beijing genotype of Mycobacterium tuberculosis as a cause of tuberculosis (TB in South America was determined by analyzing genotypes of strains isolated from patients that had been diagnosed with the disease between 1997 and 2003 in seven countries of the subcontinent. In total, 19 of the 1,202 (1.6% TB cases carried Beijing isolates, including 11 of the 185 patients from Peru (5.9%, five of the 512 patients from Argentina (1.0%, two of the 252 Brazilian cases (0.8%, one of the 166 patients from Paraguay (0.6% and none of the samples obtained from Chile (35, Colombia (36 and Ecuador (16. Except for two patients that were East Asian immigrants, all cases with Beijing strains were native South Americans. No association was found between carrying a strain with the Beijing genotype and having drug or multi-drug resistant disease. Our data show that presently transmission of M. tuberculosis strains of the Beijing genotype is not frequent in Latin America. In addition, the lack of association of drug resistant TB and infection with M. tuberculosis of the Beijing genotype observed presently demands efforts to define better the contribution of the virulence and lack of response to treatment to the growing spread of Beijing strains observed in other parts of the world.

  8. Tuberculosis risk factors among tuberculosis patients in Kampala, Uganda: implications for tuberculosis control

    NARCIS (Netherlands)

    Kirenga, Bruce J.; Ssengooba, Willy; Muwonge, Catherine; Nakiyingi, Lydia; Kyaligonza, Stephen; Kasozi, Samuel; Mugabe, Frank; Boeree, Martin; Joloba, Moses; Okwera, Alphonse

    2015-01-01

    Slow decline in the incidence of tuberculosis (TB) has been observed in most high TB burden countries. Knowledge of the prevalence of different TB risk factors can help expand TB control strategies. However with the exception of Human Immunodeficiency Virus (HIV) the prevalence of the other TB risk

  9. Factors influencing quality of life in patients with active tuberculosis.

    Science.gov (United States)

    Marra, Carlo A; Marra, Fawziah; Cox, Victoria C; Palepu, Anita; Fitzgerald, J Mark

    2004-10-20

    With effective treatment strategies, the focus of tuberculosis (TB) management has shifted from the prevention of mortality to the avoidance of morbidity. As such, there should be an increased focus on quality of life (QoL) experienced by individuals being treated for TB. The objective of our study was to identify areas of QoL that are affected by active TB using focus groups and individual interviews. English, Cantonese, and Punjabi-speaking subjects with active TB who were receiving treatment were eligible for recruitment into the study. Gender-based focus group sessions were conducted for the inner city participants but individual interviews were conducted for those who came to the main TB clinic or were hospitalized. Facilitators used open-ended questions and participants were asked to discuss their experiences of being diagnosed with tuberculosis, what impact it had on their lives, issues around adherence to anti-TB medications and information pertaining to their experience with side effects to these medications. All data were audio-recorded, transcribed verbatim, and analyzed using constant comparative analysis. 39 patients with active TB participated. The mean age was 46.2 years (SD 18.4) and 62% were male. Most were Canadian-born being either Caucasian or Aboriginal. Four themes emerged from the focus groups and interviews. The first describes issues related to the diagnosis of tuberculosis and sub-themes were identified as 'symptoms', 'health care provision', and 'emotional impact'. The second theme discusses TB medication factors and the sub-themes identified were 'adverse effects', 'ease of administration', and 'adherence'. The third theme describes social support and functioning issues for the individuals with TB. The fourth theme describes health behavior issues for the individuals with TB and the identified sub-themes were "behavior modification" and "TB knowledge." Despite the ability to cure TB, there remains a significant impact on QOL. Since much

  10. Factors influencing quality of life in patients with active tuberculosis

    Directory of Open Access Journals (Sweden)

    Cox Victoria C

    2004-10-01

    Full Text Available Abstract Background With effective treatment strategies, the focus of tuberculosis (TB management has shifted from the prevention of mortality to the avoidance of morbidity. As such, there should be an increased focus on quality of life (QoL experienced by individuals being treated for TB. The objective of our study was to identify areas of QoL that are affected by active TB using focus groups and individual interviews. Methods English, Cantonese, and Punjabi-speaking subjects with active TB who were receiving treatment were eligible for recruitment into the study. Gender-based focus group sessions were conducted for the inner city participants but individual interviews were conducted for those who came to the main TB clinic or were hospitalized. Facilitators used open-ended questions and participants were asked to discuss their experiences of being diagnosed with tuberculosis, what impact it had on their lives, issues around adherence to anti-TB medications and information pertaining to their experience with side effects to these medications. All data were audio-recorded, transcribed verbatim, and analyzed using constant comparative analysis. Results 39 patients with active TB participated. The mean age was 46.2 years (SD 18.4 and 62% were male. Most were Canadian-born being either Caucasian or Aboriginal. Four themes emerged from the focus groups and interviews. The first describes issues related to the diagnosis of tuberculosis and sub-themes were identified as 'symptoms', 'health care provision', and 'emotional impact'. The second theme discusses TB medication factors and the sub-themes identified were 'adverse effects', 'ease of administration', and 'adherence'. The third theme describes social support and functioning issues for the individuals with TB. The fourth theme describes health behavior issues for the individuals with TB and the identified sub-themes were "behavior modification" and "TB knowledge." Conclusion Despite the ability to

  11. MULTIDISCIPLINARY APPROACH TO SUPPORTING TREATMENT COMPLIANCE IN TUBERCULOSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    T. V. Sherstneva

    2017-01-01

    Full Text Available The article presents the algorithm for working with tuberculosis patients in TB hospital, providing implementation of multidisciplinary patient-centered activities for early diagnostics of psychiatric and social disorders, therapy and rehabilitation of concurrent psychiatric disorders and addictions. Multidisciplinary approach to activities within TB unit is aimed at improvement of treatment compliance of tuberculosis patients. The training programme has been developed in order to improve competency of medical personnel on the issue of treatment interruption prevention and motivating patients to undergo the continuous treatment.

  12. Pleurisy in tuberculosis and HIV-infected patients

    Directory of Open Access Journals (Sweden)

    A. K. Ivanov

    2014-01-01

    Full Text Available A clinical and epidemiological study for 14 years was conducted. Among TB patients, the percentage of persons with mixed infection (TB+HIV infection increased during the observation period from 10 up to 64%. About one third of them had a pleura reaction with an accumulation of fluid between pleura’s petals. Pleuritis in patients with mixed infection were characterized by special features: pleurisy complicated another form of tuberculosis more often, in one-third of patients (29,8% pleural liquid had hemorrhagic type, Mycobacterium tuberculosis in the pleural fluid was detected six times more often. The level of activity of adenosine deaminase and neopterin in the exudate of patients with tuberculosis and HIV infection remained significantly higher than in the control group of persons. These data can be useful in the diagnostics of specific diseases in HIV-infected patients.

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

    Science.gov (United States)

    Siahaan, W. P.; Ginting, F.

    2018-03-01

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

  14. Tuberculosis and Histoplasmosis Co-Infection in AIDS Patients

    Science.gov (United States)

    Agudelo, Carlos A.; Restrepo, Carlos A.; Molina, Diego A.; Tobón, Angela M.; Kauffman, Carol A.; Murillo, Carolina; Restrepo, Angela

    2012-01-01

    Coinfection with tuberculosis in some countries occurs in 8–15% of human immunodeficiency virus (HIV) -infected patients who have histoplasmosis. This coinfection interferes with prompt diagnosis, and treatment is difficult because of drug interactions. We retrospectively reviewed the cases of 14 HIV-infected patients who had concomitant tuberculosis and histoplasmosis. The most frequent clinical manifestations were weight loss (85.7%), asthenia (78.5%), and fever (64.2%). The diagnosis of histoplasmosis was made primarily by histopathology (71.4%), and the diagnosis of tuberculosis was made by means of direct microscopic examination (71.4%). Death occurred in two patients, and relapse of both infections occurred in one patient. Moxifloxacin was substituted for rifampicin in six patients, with good outcomes noted for both infections. The clinical presentation does not readily identify acquired immunodeficiency syndrome (AIDS) patients who have tuberculosis and histoplasmosis. The use of a fluoroquinolone as an alternative agent in place of rifampicin for tuberculosis allows effective therapy with itraconazole for histoplasmosis. PMID:23128292

  15. TUBERCULOSIS

    OpenAIRE

    Tarik Bajrović; Mahmud Nurkić; Šukrija Zvizdić

    2013-01-01

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

  16. Chromoblastomycosis due to Fonsecaea monophora misdiagnosed as sporotrichosis and cutaneous tuberculosis in a pulmonary tuberculosis patient.

    Science.gov (United States)

    Shi, Dongmei; Zhang, Wei; Lu, Guixia; de Hoog, G Sybren; Liang, Guanzhao; Mei, Huan; Zheng, Hailin; Shen, Yongnian; Liu, Weida

    2016-03-01

    Chromoblastomycosis is caused by dematiaceous fungi. It develops after inoculation of the organism into the skin. We report a case of chromoblastomycosis in a pulmonary tuberculosis patient without known history of trauma. The lesions were initially diagnosed as sporotrichosis and skin tuberculosis. Histopathology of scales and skin biopsy specimen revealed sclerotic bodies, the hallmark of chromoblastomycosis. The causative organism was identified as Fonsecaea monophora by rDNA ITS sequencing. The lesions recovered markedly after two month treatment with oral terbinafine 250 mg daily according to drug sensitive test in vitro in combination with local thermotherapy.

  17. Illness perceptions and quality of life among tuberculosis patients in ...

    African Journals Online (AJOL)

    Conclusion: The illness perceptions of the TB patients might influence their adherence to treatment. The poor quality of life of the TB patients in the different areas of quality of life such as daily activities and work, calls for programmes to strengthen TB information, education and counselling. Key words: Tuberculosis, patients, ...

  18. Conjoint alcohol and tobacco use among tuberculosis patients in ...

    African Journals Online (AJOL)

    Objective. To determine the prevalence of, and factors associated with conjoint alcohol and tobacco use among tuberculosis (TB) patients in South Africa (SA). Methods. In a cross-sectional survey, 4 900 (54.5% men, 45.5% women) consecutively selected TB patients (including new TB and new TB retreatment patients) ...

  19. HIV infection among tuberculosis patients in Vietnam: prevalence and impact on tuberculosis notification rates

    NARCIS (Netherlands)

    Thanh, D. H.; Sy, D. N.; Linh, N. D.; Hoan, T. M.; Dien, H. T.; Thuy, T. B.; Hoa, N. P.; Tung, L. B.; Cobelens, F.

    2010-01-01

    Vietnam has an emerging human immunodeficiency virus (HIV) epidemic (estimated population prevalence 0.5%), but valid data on HIV prevalence among tuberculosis (TB) patients are limited. Recent increases in TB notification rates among young adults may be related to HIV. To assess the prevalence of

  20. Tuberculosis (TB): Treatment

    Science.gov (United States)

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

  1. Drug resistance pattern of M. tuberculosis in category II treatment failure pulmonary tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Fahmida Rahman

    2013-01-01

    Full Text Available This study was designed to determine the extent of drug resistance of M. tuberculosis (MTB isolated from category II treatment failure pulmonary tuberculosis (PTB patients. A total of 100 Ziehl-Neelsen (Z-N smear positive category II failure PTB patients were included in this study. Sputum culture was done in Lowenstein-Jensen (L-J media. Conventional proportion method on Lowenstein-Jensen (L-J media was used to determine the drug susceptibility of M. tuberculosis to isoniazid (INH, rifampicin (RMP, ofloxacin (OFX and kanamycin (KA. Out of 100 sputum samples, a total of 87 samples were positive by culture. Drug susceptibility test (DST revealed that 82 (94.25% isolates were resistant to one or more anti -TB drugs. Resistance to isoniazide (INH, rifampicin (RMP, ofloxacin (OFX and kanamycin (KA was 94.25%, 82.75%, 29.90% and 3.45% respectively. Among these isolates, 79.31% and 3.45% isolates were multi-drug resistant (MDR and extended drug resistant (XDR M. tuberculosis respectively. High rate of anti-tubercular drug resistance was observed among the category II treatment failure TB patients. Ibrahim Med. Coll. J. 2013; 7(1: 9-11

  2. [Optimization of parodontitis treatment of patients with tuberculosis].

    Science.gov (United States)

    Aleksandrova, E A; Lepilin, A V; Kazimirova, N E; Shul'diakov, A A

    2010-01-01

    For the purpose to determine the clinic-pathogenetic efficacy of Cycloferon liniment in the combined therapy of parodontitis of patients with focal tuberculosis medical examination and treatment of 40 patients is carried out. It is established, that use of liniment Cycloferon in the combined treatment of patients with focal tuberculosis allows to accelerate process of normalization of lipid peroxidation parameters and antioxidant potential of blood, to decrease infection load (Herpes symplex virus I, Candida albicans, Staphylococcus aureus) in parodontal recess and evidence of local inflammation with reduction of activity of the tumours necrosis factor and interleukin 1beta, that provides acceleration of recuperation processes, lowering the frequency of parodontitis relapses.

  3. Time of default in tuberculosis patients on directly observed treatment.

    Science.gov (United States)

    Pardeshi, Geeta S

    2010-09-01

    Default remains an important challenge for the Revised National Tuberculosis Control Programme, which has achieved improved cure rates. This study describes the pattern of time of default in patients on DOTS. Tuberculosis Unit in District Tuberculosis Centre, Yavatmal, India; Retrospective cohort study. This analysis was done among the cohort of patients of registered at the Tuberculosis Unit during the year 2004. The time of default was assessed from the tuberculosis register. The sputum smear conversion and treatment outcome were also assessed. Kaplan-Meier plots and log rank tests. Overall, the default rate amongst the 716 patients registered at the Tuberculosis Unit was 10.33%. There was a significant difference in the default rate over time between the three DOTS categories (log rank statistic= 15.49, P=0.0004). Amongst the 331 smear-positive patients, the cumulative default rates at the end of intensive phase were 4% and 16%; while by end of treatment period, the default rates were 6% and 31% in category I and category II, respectively. A majority of the smear-positive patients in category II belonged to the group 'treatment after default' (56/95), and 30% of them defaulted during re-treatment. The sputum smear conversion rate at the end of intensive phase was 84%. Amongst 36 patients without smear conversion at the end of intensive phase, 55% had treatment failure. Patients defaulting in intensive phase of treatment and without smear conversion at the end of intensive phase should be retrieved on a priority basis. Default constitutes not only a major reason for patients needing re-treatment but also a risk for repeated default.

  4. Patients at high risk of tuberculosis recurrence

    Directory of Open Access Journals (Sweden)

    Mehdi Mirsaeidi

    2018-01-01

    Full Text Available Recurrent tuberculosis (TB continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  5. Patients at high risk of tuberculosis recurrence.

    Science.gov (United States)

    Mirsaeidi, Mehdi; Sadikot, Ruxana T

    2018-01-01

    Recurrent tuberculosis (TB) continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  6. Risk assessment of hepatotoxicity among tuberculosis and human immunodeficiency virus/AIDS-coinfected patients under tuberculosis treatment

    OpenAIRE

    Williams Ngouleun; Prosper Cabral Biapa Nya; Anatole Constant Pieme; Phelix Bruno Telefo

    2016-01-01

    Objective/background: Tuberculosis (TB) is a worldwide public health problem. It is a contagious and grave disease caused by Mycobacterium tuberculosis. Current drugs such as isoniazid, pyrazinamide, and rifampicin used for the treatment of tuberculosis are potentially hepatotoxic and can lead to drug hepatitis. In order to improve the follow-up of TB patients in Cameroon, we carried out a study which aimed to evaluate the hepatotoxicity risk factors associated with anti-TB drugs. Methods:...

  7. Tuberculosis

    NARCIS (Netherlands)

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

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

  8. The material consumptive: domesticating the tuberculosis patient in Edwardian England

    Science.gov (United States)

    Mooney, Graham

    2013-01-01

    The proliferation of general and specialist hospitals, lunatic asylums, and workhouse infirmaries in the nineteenth century challenged the popular perception of the home as a suitable site of health care. Amidst the emergence of yet another type of institution, the tuberculosis sanatorium, tuberculosis control in the Edwardian period was re-sited and re-scaled to accommodate what might be termed a ‘preventive therapy’ of domestic space. Three interlinked perspectives demonstrate why and how this happened. First, I explore the role of the national and local state in legitimating domestic space as a scale and a site for the regulation of tuberculosis patients and prevention of the disease. Second, I investigate how tuberculosis self-help manuals promoted a technology of the self that was founded largely on the principles of sanatorium therapy but was necessarily reconfigured to reflect the social relations of domestic space. Third, I assess the marketing of consumer goods to the domiciled tuberculosis sufferer through the pages of the British Journal of Tuberculosis. It is suggested that a common tubercular ‘language’ of material consumption was fashioned in order to normalise the accumulation of possessions for use in the home. These arguments are situated in relation to recent historical research on material culture and identity at the turn of the twentieth century, which has stressed the cultivation of individuality and that the right sort of possessions appropriately arranged in domestic space signified well-regulated morality. PMID:24882921

  9. Tuberculosis

    Science.gov (United States)

    Friend, Milton

    1999-01-01

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

  10. Pharmacokinetics of first-line tuberculosis drugs in tanzanian patients

    NARCIS (Netherlands)

    Tostmann, A.; Mtabho, C.M.; Semvua, H.H.; Boogaard, J. van den; Kibiki, G.S.; Boeree, M.J.; Aarnoutse, R.E.

    2013-01-01

    East Africa has a high tuberculosis (TB) incidence and mortality, yet there are very limited data on exposure to TB drugs in patients from this region. We therefore determined the pharmacokinetic characteristics of first-line TB drugs in Tanzanian patients using intensive pharmacokinetic sampling.

  11. Risk factors for mortality among tuberculosis patients on treatment at ...

    African Journals Online (AJOL)

    Background: Tuberculosis (TB) is still an important cause of morbidity and mortality worldwide. Though it can effectively be treated, still a significant proportion of patients die on the course of their treatment. The objective of this study was to determine the outcome and risk factors of mortality among patients diagnosed with ...

  12. HIV and parasitic co-infections in tuberculosis patients

    DEFF Research Database (Denmark)

    Range, N.; Magnussen, Pascal; Mugomela, A.

    2007-01-01

    A cross-sectional study was conducted in Mwanza, Tanzania, to determine the burden of HIV and parasitic co-infections among patients who were confirmed or suspected cases of pulmonary tuberculosis (PTB). Of the 655 patients investigated, 532 (81.2%) had been confirmed as PTB cases, by microscopy...

  13. Factors Associated with Prevalent Tuberculosis Among Patients ...

    African Journals Online (AJOL)

    E‑mail: mikezindu@yahoo.com ... California, San Francisco, USA, 6Department of Clinical Sciences, Institute of ... Background: Tuberculosis (TB) causes significant morbidity/mortality among .... obtained information on health behavior such as current alcohol use (yes or no) and cigarette smoking (ever smoked or never.

  14. Prevalence of nutritional deficiency in patients with pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Silvana Gomes Nunes Piva

    2013-06-01

    Full Text Available OBJECTIVE: To determine the prevalence of nutritional deficiency among patients with pulmonary tuberculosis. METHODS: This was a cross-sectional study using data obtained from the Brazilian Case Registry Database and from the medical records of patients diagnosed with pulmonary tuberculosis (15-59 years of age residing in one of the municipalities that make up the 16th Regional Health District of the state of Bahia. We calculated the incidence, lethality, and mortality rates, as well as the prevalence of nutritional deficiency, as evaluated by body mass index. Demographic, social, clinical, and epidemiological data were collected. RESULTS: Of the 72 confirmed cases of tuberculosis, 59 (81.9% were in males, and 21 (29.2% of the patients were in the 40-49 year age bracket. The majority (85.3% described themselves as Mulatto or Black; 55.2% reported using alcohol; and approximately 90% were treated as outpatients. In the district and age bracket studied, the incidence of pulmonary tuberculosis was 30.6/100,000 population. Among the 72 patients, data regarding nutritional status was available for 34. Of those, 50% and 25%, respectively, presented nutritional deficiency at the beginning and at the end of treatment. No statistically significant differences were found between normal-weight and malnourished patients regarding the characteristics studied. CONCLUSIONS: The prevalence of nutritional deficiency was high among our sample of patients with pulmonary tuberculosis. This underscores the importance of nutritional follow-up for the assessment of tuberculosis treatment in the decision-making process regarding therapeutic interventions.

  15. Spoligotyping of Mycobacterium tuberculosis isolates from tuberculosis diagnosed patients at Dilla University Referral Hospital and other private clinics, Southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Gebremedhin Gebrezgabiher

    2015-04-01

    Full Text Available Objective: To assess Mycobacterium tuberculosis (M. tuberculosis strains exsisting in Gedeo zone and the surrounding areas of the Southern Ethiopia using spoligotyping. Methods: A cross sectional study was carried out from February, 2012 to June, 2013 and 97 (76 sputum and 21 fine needle aspirate samples were taken from tuberculosis diagnosed patients at Dilla University Referral Hospital and other private clinics. Culturing, region of difference (RD9 deletion typing and spoligotyping techniques were employed to isolate M. tuberculosis strains. Results: Growth of mycobacteria was observed in 35.1% (34/97. Speciation of isolates showed that 91.2% (31/34 of the isolates were M. tuberculosis. Further characterization led to the identification of 23 different spoligotype patterns of M. tuberculosis of which 61% and 39% displayed unique and cluster patterns, respectively. The most dominant shared type was spoligotype international type 53. Of the 23 strains, 12 have not been registered in the international spoligotyping database (SpolDB4. Seventy one percent of the strains belonged to the Euro-American lineage. Conclusions: This study revealed the existence of both genetically diverse and clustered M. tuberculosis strains from tuberculosis patients in the area, suggesting reactivation of infection and recent transmission, respectively. Molecular epidemiology of M. tuberculosis should be done nationwide in order to set appropriate control measures.

  16. Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review

    Science.gov (United States)

    Tiemersma, Edine W.; van der Werf, Marieke J.; Borgdorff, Martien W.; Williams, Brian G.; Nagelkerke, Nico J. D.

    2011-01-01

    Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting epidemiological data. Methodology and Principal Findings To estimate the duration and case fatality of untreated pulmonary tuberculosis in HIV negative patients we reviewed studies from the pre-chemotherapy era. Untreated smear-positive tuberculosis among HIV negative individuals has a 10-year case fatality variously reported between 53% and 86%, with a weighted mean of 70%. Ten-year case fatality of culture-positive smear-negative tuberculosis was nowhere reported directly but can be indirectly estimated to be approximately 20%. The duration of tuberculosis from onset to cure or death is approximately 3 years and appears to be similar for smear-positive and smear-negative tuberculosis. Conclusions Current models of untreated tuberculosis that assume a total duration of 2 years until self-cure or death underestimate the duration of disease by about one year, but their case fatality estimates of 70% for smear-positive and 20% for culture-positive smear-negative tuberculosis appear to be satisfactory. PMID:21483732

  17. Tuberculosis Patients Admitted with High Fever and Hilar Mass

    Directory of Open Access Journals (Sweden)

    Yusuf Aydemir

    2014-08-01

    Full Text Available Tuberculosis may occur with very different clinical and radiological features. Therefore, can be difficulties from time to time in the differential diagnosis. 22-year-old male patient with a history of drug use, presenting with high fever was admitted to the Infectious Diseases Clinic. Patient who fail to respond to empiric antibiotic therapy was transferred to our clinic due to the radiologically mass in the lung. Acid-fast bacilli were negative in sputum and bronchial lavage, tuberculosis was diagnosed with excision of the axillary lymphadenomegaly. Fever fell down with antituberculosis treatment and clinical improvement was observed. We present the case of tuberculosis which have with different clinical and radiological findings, in order to always keep in mind.

  18. Opportunistic microorganisms in patients undergoing antibiotic therapy for pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Silvia Maria Rodrigues Querido

    2011-12-01

    Full Text Available Antimicrobial therapy may cause changes in the resident oral microbiota, with the increase of opportunistic pathogens. The aim of this study was to compare the prevalence of Candida, Staphylococcus, Pseudomonas and Enterobacteriaceae in the oral cavity of fifty patients undergoing antibiotic therapy for pulmonary tuberculosis and systemically healthy controls. Oral rinsing and subgingival samples were obtained, plated in Sabouraud dextrose agar with chloramphenicol, mannitol agar and MacConkey agar, and incubated for 48 h at 37ºC. Candida spp. and coagulase-positive staphylococci were identified by phenotypic tests, C. dubliniensis, by multiplex PCR, and coagulase-negative staphylococci, Enterobacteriaceae and Pseudomonas spp., by the API systems. The number of Candida spp. was significantly higher in tuberculosis patients, and C. albicans was the most prevalent specie. No significant differences in the prevalence of other microorganisms were observed. In conclusion, the antimicrobial therapy for pulmonary tuberculosis induced significant increase only in the amounts of Candida spp.

  19. Finding the Missing Patients With Tuberculosis: Lessons Learned From Patient-Pathway Analyses in 5 Countries.

    Science.gov (United States)

    Hanson, Christy; Osberg, Mike; Brown, Jessie; Durham, George; Chin, Daniel P

    2017-11-06

    Despite significant progress in diagnosis and treatment of tuberculosis over the past 2 decades, millions of patients with tuberculosis go unreported every year. The patient-pathway analysis (PPA) is designed to assess the alignment between tuberculosis care-seeking patterns and the availability of tuberculosis services. The PPA can help programs understand where they might find the missing patients with tuberculosis. This analysis aggregates and compares the PPAs from case studies in Kenya, Ethiopia, Indonesia, the Philippines, and Pakistan. Across the 5 countries, 24% of patients with tuberculosis initiated care seeking in a facility with tuberculosis diagnostic capacity. Forty-two percent of patients sought care at level 0 facilities, where there was generally no tuberculosis diagnostic capacity; another 42% of patients sought care at level 1 facilities, of which 39% had diagnostic capacity. Sixty-six percent of patients initially sought care in private facilities, which had considerably less tuberculosis diagnostic capacity than public facilities; only 7% of notified cases were from the private sector. The GeneXpert system was available in 14%-41% of level 2 facilities in the 3 countries for which there were data. Tuberculosis treatment capacity tracked closely with the availability of diagnostic capacity. There were substantial subnational differences in care-seeking patterns and service availability. The PPA can be a valuable planning and programming tool to ensure that diagnostic and treatment services are available to patients where they seek care. Patient-centered care will require closing the diagnostic gap and engaging the private sector. Extensive subnational differences in patient pathways to care call for differentiated approaches to patient-centered care. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Tarik Bajrović

    2013-10-01

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

  1. Circulating microRNAs in patients with active pulmonary tuberculosis.

    Science.gov (United States)

    Fu, Yurong; Yi, Zhengjun; Wu, Xiaoyan; Li, Jianhua; Xu, Fuliang

    2011-12-01

    Emerging evidence shows that microRNAs (miRNAs) play an important role in pathogen-host interactions. Circulating miRNAs have been repeatedly and stably detected in blood and hold promise to serve as molecular markers for diverse physiological and pathological conditions. To date, the relationship between circulating miRNAs and active pulmonary tuberculosis (TB) has not been reported. Using microarray-based expression profiling followed by real-time quantitative PCR validation, the levels of circulating miRNAs were compared between patients with active pulmonary tuberculosis and matched healthy controls. The receiver operating characteristic curve was used to evaluate the diagnostic effect of selected miRNA. Bioinformatic analysis was used to explore the potential roles of these circulating miRNAs in active pulmonary tuberculosis infection. Among 92 miRNAs significantly detected, 59 miRNAs were downregulated and 33 miRNAs were upregulated in the TB serum compared to their levels in the control serum. Interestingly, only two differentially expressed miRNAs were increased not only in the serum but also in the sputum of patients with active pulmonary tuberculosis compared to the levels for the healthy controls. Upregulated miR-29a could discriminate TB patients from healthy controls with reasonable sensitivity and specificity. A number of significantly enriched pathways regulated by these circulating miRNAs were predicted, and most of them were involved in acute-phase response, inflammatory response, and the regulation of the cytoskeleton. In all, for the first time our results revealed that a number of miRNAs were differentially expressed during active pulmonary tuberculosis infection, and circulating miR-29a has great potential to serve as a marker for the detection of active pulmonary tuberculosis infection.

  2. Delayed culture conversion due to cigarette smoking in active pulmonary tuberculosis patients

    NARCIS (Netherlands)

    Nijenbandring de Boer, Renee; Oliveira e Souza Filho, João Baptista de; Cobelens, Frank; Ramalho, Daniela de Paula; Campino Miranda, Pryscilla Fernandes; Logo, Karina de; Oliveira, Hedi; Mesquita, Eliene; Oliveira, Martha Maria; Kritski, Afrânio

    2014-01-01

    Although many studies have assessed factors affecting culture conversion during tuberculosis treatment, few have looked into the effect of tobacco smoking. This study included 89 active pulmonary tuberculosis patients with positive sputum culture upon presentation and collected information regarding

  3. Demographic and clinical characteristics in relation to patient and health system delays in a tuberculosis low-incidence country

    DEFF Research Database (Denmark)

    Leutscher, Peter; Madsen, Gitte; Erlandsen, Mogens

    2012-01-01

    Background: Delays in the diagnosis and treatment of tuberculosis (TB) are commonly encountered. Methods: A study was undertaken among pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) patients in a Danish university hospital to describe demographic and clinical characteristics...

  4. Computed tomography of the adrenals in patients with tuberculosis

    International Nuclear Information System (INIS)

    Yamashita, Seizo; Machado, Jussara Marcondes; Morceli, Jose

    2004-01-01

    We evaluated the adrenals of individuals without tuberculosis (group 1 - G1) and with tuberculosis (group 2 - G2) using computed tomography. The antero-posterior length, the thickness, and the longitudinal length of the adrenals were compared in G1 and G2. The duration of the disease, the occurrence of morphologic abnormalities in G2, the distribution according to sex, age and skin color were also studied. There was difference in the antero-posterior length and thickness of right adrenal between G1 and G2. A higher prevalence of white skin male individuals was observed in G2. There was no association between duration of the disease and the occurrence of morphologic abnormalities in G2. A higher occurrence of adrenal enlargement was observed in G2. The main computed tomography findings in patients with tuberculosis were enlargement of the adrenal without calcification, enlargement of the adrenal with punctiform calcifications, and residual calcification of the adrenal. (author)

  5. Cost effectiveness of Tuberculosis Treatment from the Patients ...

    African Journals Online (AJOL)

    ... Directly Observed Treatment Short course is more cost effective from the patients' point of view. DOTS needs to be re-focused out of the hospitals and clinics and made community based in view of the increasing TB caseload occasioned by HI V/AIDS. Key Words: Cost effectiveness, Tuberculosis treatment, personal cost, ...

  6. Cost of Care Among Patients With Pulmonary Tuberculosis in Lagos ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is a global health challenge. Currently it is the 7th leading cause of death worldwide, and Nigeria ranks fourth amongst 22 high-burden countries for the disease. This study sought to appraise the direct and indirect costs borne by TB patients attending the Chest Clinics at the Lagos State University ...

  7. Profile and treatment outcomes of patients with tuberculosis in ...

    African Journals Online (AJOL)

    Background: Data on the epidemiology of tuberculosis and its treatment outcomes were incomplete in the study area and this study was done to fill this gap. Methods: Institution based cross sectional study was conducted from January 2011 to December 2014. A total of 949 TB patients who were on treatment in North ...

  8. Obstructive pulmonary disease in patients with previous tuberculosis ...

    African Journals Online (AJOL)

    Obstructive pulmonary disease in patients with previous tuberculosis: Pathophysiology of a community-based cohort. B.W. Allwood, R Gillespie, M Galperin-Aizenberg, M Bateman, H Olckers, L Taborda-Barata, G.L. Calligaro, Q Said-Hartley, R van Zyl-Smit, C.B. Cooper, E van Rikxoort, J Goldin, N Beyers, E.D. Bateman ...

  9. Diabetes mellitus among tuberculosis patients: a cross sectional ...

    African Journals Online (AJOL)

    Background: The co-occurrence of diabetes mellitus (DM) and tuberculosis (TB) is largely associated with high frequency of morbidity. Objective: To determine the prevalence of DM among TB patients and describe the socio-demographic and behavioral factors associated with TB-DM co-occurrence . Methods: We enrolled ...

  10. Prevalence of Tuberculosis and Treatment Outcomes of Patients ...

    African Journals Online (AJOL)

    2018-05-01

    May 1, 2018 ... Yonas A. et al. ... North Shoa Ethiopia. Ethiop J Health Sci.2017;28(3):347. ... Berihun, et al . This is an ... RESULTS: A total of 162 patients with tuberculosis were registered ..... Ribeiro ML, Reis-Santos B, Riley LW, Maciel. EL.

  11. [Treatment of bronchial obstruction in patients with pulmonary tuberculosis].

    Science.gov (United States)

    Shmelev, E I; Kuklina, G M; Kalinina, E E

    2004-01-01

    Whether the main points of treatment for bronchial obstructive syndrome (BOS) in chronic obstructive lung disease (COLD) can be adapted for patients with pulmonary tuberculosis (PT) was studied. For this purpose, 435 patients with PT with signs of BOS (forced expiratory volume at 1 second (FEV1) 70% of the normal values; 2) 229 patients with FEV1 69-50%; 3) 102 patients with FEV1 bronchial obstructive syndrome in patients with pulmonary tuberculosis was highly effective, promotes the amelioration of the degree of respiratory symptoms in patients with IPT by 2 to 8 times, in those with FCPT by more than 2-3 times, and in those with PS by 1.45-10 times. The differences in the efficiency of bronchodilator therapy depend on the baseline level of bronchial obstruction. In patients with pulmonary tuberculosis concurrent with BO, the use of current inhalation bronchodilator therapy results in a substantial increase in FEV1, which differentiates BOS in PT from COLD. The use of the proposed therapy in the multimodality treatment of patients with pulmonary tuberculosis showed no statistically significant differences in the changes in the degree of X-ray symptoms while this therapy permits acceleration of abacillation in patients with IPT by 16.8% and in those with FCPT by 14.8%. Effective bronchodilator therapy considerably enhances life quality in patients. Thus, early systematic and long-term performance of the bronchodilator therapy, based on the principles of bronchodilator therapy for COLD, in patients with PT concurrent with BOS may substantially enhance the efficiency of treatment in this category of patients.

  12. CT findings of pulmonary tuberculosis in diabetic and immunocompromised patients

    International Nuclear Information System (INIS)

    Takeuchi, Noriyuki; Ikezoe, Junpei; Johkoh, Tsuyoshi

    1992-01-01

    To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients, we reviewed CT of the chest in 42 adult patients with active pulmonary tuberculosis. Forty-two had some underlying diseases or immunocompromised conditions (31 diabetes mellitus, 6 malignancies, 2 long-term steroid therapy, 2 pneumoconiosis, and one anorexia nervosa). In diabetic or immunocompromised patients, a high incidence of non-segmental distribution (27%) and multiple small cavities in a cavitary lesion (45%) was observed. Unusual localization of the lesions such as lower lung field disease was observed in 18% of cases (the incidence of unusual localization in patients with no underlying disease was equal to diabetic or immunocompromised patients). (author)

  13. CT findings of pulmonary tuberculosis in diabetic and immunocompromised patients

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Noriyuki; Ikezoe, Junpei; Johkoh, Tsuyoshi (Osaka Univ. (Japan). Faculty of Medicine) (and others)

    1992-01-01

    To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients, we reviewed CT of the chest in 42 adult patients with active pulmonary tuberculosis. Forty-two had some underlying diseases or immunocompromised conditions (31 diabetes mellitus, 6 malignancies, 2 long-term steroid therapy, 2 pneumoconiosis, and one anorexia nervosa). In diabetic or immunocompromised patients, a high incidence of non-segmental distribution (27%) and multiple small cavities in a cavitary lesion (45%) was observed. Unusual localization of the lesions such as lower lung field disease was observed in 18% of cases (the incidence of unusual localization in patients with no underlying disease was equal to diabetic or immunocompromised patients). (author).

  14. Inflammation responses in patients with pulmonary tuberculosis in an intensive care unit

    Science.gov (United States)

    Liu, Qiu-Yue; Han, Fen; Pan, Li-Ping; Jia, Hong-Yan; Li, Qi; Zhang, Zong-De

    2018-01-01

    Pulmonary tuberculosis caused by Mycobacterium tuberculosis remains a global problem. Inflammatory responses are the primary characteristics of patients with pulmonary tuberculosis in intensive care units (ICU). The aim of the present study was to investigate the clinical importance of inflammatory cells and factors for patients with pulmonary tuberculosis in ICU. A total of 124 patients with pulmonary tuberculosis in ICU were recruited for the present study. The inflammatory responses in patients with pulmonary tuberculosis in ICU were examined by changes in inflammatory cells and factors in the serum. The results indicated that serum levels of lymphocytes, plasma cells, granulocytes and monocytes were increased in patients with pulmonary tuberculosis in ICU compared with healthy controls. The serum levels of inflammatory factors interleukin (IL)-1, IL-6, IL-10, IL-12, and IL-4 were upregulated in patients with pulmonary tuberculosis in ICU. Lower plasma concentrations of IL-2, IL-15 and interferon-γ were detected in patients with pulmonary tuberculosis compared with healthy controls. It was demonstrated that high mobility group box-1 protein expression levels were higher in the serum of patients with pulmonary tuberculosis compared with healthy controls. Notably, an imbalance of T-helper cell (Th)1/Th2 cytokines was observed in patients with pulmonary tuberculosis. Pulmonary tuberculosis caused by M. tuberculosis also upregulated expression of matrix metalloproteinase (MMP)-1 and MMP-9 in hPMCs. In conclusion, these outcomes demonstrated that inflammatory responses and inflammatory factors are associated with the progression of pulmonary tuberculosis, suggesting that inhibition of inflammatory responses and inflammatory factors may be beneficial for the treatment of patients with pulmonary tuberculosis in ICU. PMID:29456674

  15. Attitudes towards tuberculosis and sources of tuberculosis-related information: study on patients in outpatient settings in Split, Croatia.

    Science.gov (United States)

    Jurcev-Savicević, Anamarija

    2011-03-01

    Attitudes towards tuberculosis may have severe impact on individuals and their families as well as on the effectiveness of tuberculosis control programs. The purpose of this study was to describe these attitudes and explore the sources of tuberculosis information available to the general population in Croatia through a cross-sectional survey based on structured questionnaire using convenience sampling among 386 subjects aged 18 years and over. Data were stratified by sex, age groups, educational background, personal monthly income and contact with tuberculosis patient. Being near to a tuberculosis patient would be uncomfortable for 39.9% of respondents and 26.4% of subjects would avoid any contact. If they were sick of tuberculosis, 9.6% of respondents would keep it from the society. Less than 10% of study subjects would be ashamed of their own or potential tuberculosis in their family. Almost twice less subjects with high education would hide the disease (P=0.049), or be ashamed if sick in comparison with less educated respondents (P=0.036). The subjects who were not in contact were less likely to feel uncomfortable about being near to a tuberculosis patient (P=0.042). As the source of tuberculosis information, 61% of the subjects reported TV, radio and journals. Internet was the least used source (13.2%). The subjects in contact received information from the family or friends (P=0.025), while those without contact were informed through mass media (P<0.001). Study results revealed high stigma-generating attitudes towards tuberculosis. The strong potential of mass media capable of reaching different population groups should be used as part of the stigma-reduction strategies.

  16. Tuberculosis

    OpenAIRE

    Latorre Tortello, Pablo

    2011-01-01

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

  17. Tuberculosis

    Directory of Open Access Journals (Sweden)

    Pablo Latorre Tortello

    1998-10-01

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

  18. Tuberculosis

    OpenAIRE

    Pablo Latorre Tortello

    1998-01-01

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

  19. DOTS Compliance by Tuberculosis Patients in District Raipur (Chhattisgarh

    Directory of Open Access Journals (Sweden)

    Teeku Sinha

    2010-10-01

    Full Text Available Background: Compliance to therapy is one of the important factors that affect the outcome. Non-compliance to self administered multi drug tuberculosis treatment regimens is an important cause of failure of initial therapy and relapse as well as acquired drug resistance, requiring more prolonged and expensive therapy. Objective: To know the compliance of DOTS therapy in TB patients in District Raipur and to find out the reasons of non-compliance of DOTS therapy among the patients. Study Design: Cross sectional observational community based study. Study Setting: Microscopic Centers in District Raipur. Participants: 695 patients of Tuberculosis. Result: Study revealed that 65.93% patients had complied with the DOTS therapy and 33.38% were non compliant. Conclusion: Most of the reasons of non-Compliance can be averted by proper counseling of target group. Hence to achieve the goal of RNTCP, proper counseling of target group must be given top priority.

  20. Impaired CXCR1-dependent oxidative defence in active tuberculosis patients.

    Science.gov (United States)

    Alaridah, Nader; Winqvist, Niclas; Håkansson, Gisela; Tenland, Erik; Rönnholm, Anna; Sturegård, Erik; Björkman, Per; Godaly, Gabriela

    2015-12-01

    Much of the pronounced host inflammatory response that occurs in tuberculosis (TB) is related to failed immunity against the invading pathogen. The G-protein coupled receptors CXCR1 and CXCR2 are implicated in important signal transduction pathways in lung inflammatory responses. We investigated the expression and function of these receptors in a simple whole blood model from 24 patients with pulmonary TB and in subjects with latent TB infection (LTBI). Healthy controls were recruited from close contacts to the pulmonary index patients. We found that pulmonary TB patients had significantly increased CXCR1 expression on blood cells compared to LTBI subjects and controls (p microRNA-223 was increased in pulmonary TB patients compared to LTBI (p tuberculosis (Mtb). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Diagnostic Performance of Tuberculosis-Specific IgG Antibody Profiles in Patients with Presumptive Tuberculosis from Two Continents.

    Science.gov (United States)

    Broger, Tobias; Basu Roy, Robindra; Filomena, Angela; Greef, Charles H; Rimmele, Stefanie; Havumaki, Joshua; Danks, David; Schneiderhan-Marra, Nicole; Gray, Christen M; Singh, Mahavir; Rosenkrands, Ida; Andersen, Peter; Husar, Gregory M; Joos, Thomas O; Gennaro, Maria L; Lochhead, Michael J; Denkinger, Claudia M; Perkins, Mark D

    2017-04-01

    Development of rapid diagnostic tests for tuberculosis is a global priority. A whole proteome screen identified Mycobacterium tuberculosis antigens associated with serological responses in tuberculosis patients. We used World Health Organization (WHO) target product profile (TPP) criteria for a detection test and triage test to evaluate these antigens. Consecutive patients presenting to microscopy centers and district hospitals in Peru and to outpatient clinics at a tuberculosis reference center in Vietnam were recruited. We tested blood samples from 755 HIV-uninfected adults with presumptive pulmonary tuberculosis to measure IgG antibody responses to 57 M. tuberculosis antigens using a field-based multiplexed serological assay and a 132-antigen bead-based reference assay. We evaluated single antigen performance and models of all possible 3-antigen combinations and multiantigen combinations. Three-antigen and multiantigen models performed similarly and were superior to single antigens. With specificity set at 90% for a detection test, the best sensitivity of a 3-antigen model was 35% (95% confidence interval [CI], 31-40). With sensitivity set at 85% for a triage test, the specificity of the best 3-antigen model was 34% (95% CI, 29-40). The reference assay also did not meet study targets. Antigen performance differed significantly between the study sites for 7/22 of the best-performing antigens. Although M. tuberculosis antigens were recognized by the IgG response during tuberculosis, no single antigen or multiantigen set performance approached WHO TPP criteria for clinical utility among HIV-uninfected adults with presumed tuberculosis in high-volume, urban settings in tuberculosis-endemic countries. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  2. Tumoral calcinosis, calciphylaxis, hyperparathyroidism and tuberculosis in a dialysis patient

    Directory of Open Access Journals (Sweden)

    Khawla Kammoun

    2011-01-01

    Full Text Available Tumoral calcinosis and calciphylaxis are uncommon but severe complications in ure-mic patients. They occur generally after long-term hemodialysis (HD treatment explained by ad-vanced secondary hyperparathyroidism and longstanding high calcium phosphorus product (Ca × P. Other factors such granulomatous diseases may worsen the calcium phosphate homeostasis alterations. We report a young male patient treated by HD for 6 years who developed tuberculosis in addition to tumoral calcinosis and calciphylaxis.

  3. HIV-infected presumptive tuberculosis patients without tuberculosis: How many are eligible for antiretroviral therapy in Karnataka, India?

    Directory of Open Access Journals (Sweden)

    Ajay M.V. Kumar

    2017-03-01

    Full Text Available For certain subgroups within people living with the human immunodeficiency virus (HIV [active tuberculosis (TB, pregnant women, children <5 years old, and serodiscordant couples], the World Health Organization recommends antiretroviral therapy (ART irrespective of CD4 count. Another subgroup which has received increased attention is “HIV-infected presumptive TB patients without TB”. In this study, we assess the proportion of HIV-infected presumptive TB patients eligible for ART in Karnataka State (population 60 million, India. This was a cross-sectional analysis of data of HIV-infected presumptive TB patients diagnosed in May 2015 abstracted from national TB and HIV program records. Of 42,585 presumptive TB patients, 28,964 (68% were tested for HIV and 2262 (8% were HIV positive. Of the latter, 377 (17% had active TB. Of 1885 “presumptive TB patients without active TB”, 1100 (58% were already receiving ART. Of the remaining 785 who were not receiving ART, 617 (79% were assessed for ART eligibility and of those, 548 (89% were eligible for ART. About 90% of “HIV-infected presumptive TB patients without TB” were eligible for ART. This evidence supports a public health approach of starting all “HIV-infected presumptive TB patients without TB” on ART irrespective of CD4 count in line with global thinking about ‘test and treat’.

  4. IFNG-mediated immune responses enhance autophagy against Mycobacterium tuberculosis antigens in patients with active tuberculosis

    Science.gov (United States)

    Rovetta, Ana I; Peña, Delfina; Hernández Del Pino, Rodrigo E; Recalde, Gabriela M; Pellegrini, Joaquín; Bigi, Fabiana; Musella, Rosa M; Palmero, Domingo J; Gutierrez, Marisa; Colombo, María I; García, Verónica E

    2015-01-01

    Protective immunity against Mycobacterium tuberculosis (Mtb) requires IFNG. Besides, IFNG-mediated induction of autophagy suppresses survival of virulent Mtb in macrophage cell lines. We investigated the contribution of autophagy to the defense against Mtb antigen (Mtb-Ag) in cells from tuberculosis patients and healthy donors (HD). Patients were classified as high responders (HR) if their T cells produced significant IFNG against Mtb-Ag; and low responders (LR) when patients showed weak or no T cell responses to Mtb-Ag. The highest autophagy levels were detected in HD cells whereas the lowest quantities were observed in LR patients. Interestingly, upon Mtb-Ag stimulation, we detected a positive correlation between IFNG and MAP1LC3B-II/LC3-II levels. Actually, blockage of Mtb-Ag-induced IFNG markedly reduced autophagy in HR patients whereas addition of limited amounts of IFNG significantly increased autophagy in LR patients. Therefore, autophagy collaborates with human immune responses against Mtb in close association with specific IFNG secreted against the pathogen. PMID:25426782

  5. Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil.

    Science.gov (United States)

    Jones-López, Edward C; Acuña-Villaorduña, Carlos; Fregona, Geisa; Marques-Rodrigues, Patricia; White, Laura F; Hadad, David Jamil; Dutra-Molina, Lucilia Pereira; Vinhas, Solange; McIntosh, Avery I; Gaeddert, Mary; Ribeiro-Rodrigues, Rodrigo; Salgame, Padmini; Palaci, Moises; Alland, David; Ellner, Jerrold J; Dietze, Reynaldo

    2017-08-18

    In household contact investigations of tuberculosis (TB), a second tuberculin skin test (TST) obtained several weeks after a first negative result consistently identifies individuals that undergo TST conversion. It remains unclear whether this delay in M. tuberculosis infection is related to differences in the infectious exposure, TST boosting, partial host resistance, or some other factor. We conducted a household contact study Vitória, Brazil. Between 2008 and 2013, we identified culture-positive pulmonary TB patients and evaluated their household contacts with both a TST and interferon gamma release assay (IGRA), and identified TST converters at 8-12 weeks post study enrollment. Contacts were classified as TST-positive (≥10 mm) at baseline, TST converters, or persistently TST-negative. We compared TST converters to TST-positive and to TST-negative contacts separately, using generalized estimating equations. We enrolled 160 index patients and 838 contacts; 523 (62.4%) were TST+, 62 (7.4%) TST converters, and 253 (30.2%) TST-. TST converters were frequently IGRA- at 8-12 weeks. In adjusted analyses, characteristics distinguishing TST converters from TST+ contacts (no contact with another TB patient and residence ownership) were different than those differentiating them from TST- contacts (stronger cough in index patient and contact BCG scar). The individual risk and timing of M. tuberculosis infection within households is variable and dependent on index patient, contact and environmental factors within the household, and the surrounding community. Our findings suggest a threshold effect in the risk of infection in humans.

  6. Tuberculosis

    OpenAIRE

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

    2013-01-01

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

  7. Diminished Adherence and/or Ingestion of Virulent Mycobacterium tuberculosis by Monocyte-Derived Macrophages from Patients with Tuberculosis

    Science.gov (United States)

    Zabaleta, J.; Arias, M.; Maya, J. R.; García, L. F.

    1998-01-01

    The interaction between the macrophage and Mycobacterium tuberculosis is mediated by a variety of macrophage membrane-associated proteins. Complement receptors have been implicated in the adherence of M. tuberculosis to macrophages. In the present work, the adherence and/or ingestion of M. tuberculosis H37Rv to human monocyte-derived macrophages (MDM) from patients with tuberculosis (TB) and healthy controls was measured by microscopical examination, [3H]uracil incorporation, and CFU. The adherence and/or ingestion was enhanced by fresh serum and inhibited by heat inactivation, EDTA treatment, and anti-CR1 and anti-CR3 antibodies. Comparison of MDM from TB patients and healthy controls showed that the former exhibited a significantly decreased capacity to adhere and/or ingest M. tuberculosis, as determined by the number of CFU and 3H incorporation. The expression of CR1 (CD35) and CR3 (CD11b/CD18) on MDM from TB patients and healthy controls, as determined by flow cytometry, did not show significant differences. These results suggest that the lower ingestion of M. tuberculosis by MDM from TB patients is not due to defects in complement receptors, and therefore, there might be other molecules involved in the adherence and/or ingestion process that render MDM from TB patients ingest less mycobacteria than those from healthy controls. PMID:9729537

  8. CT findings of pulmonary tuberculosis in adult patients with no underlying disease

    International Nuclear Information System (INIS)

    Ikezoe, Junpei; Takeuchi, Noriyuki; Johkoh, Tsuyoshi

    1992-01-01

    To evaluate the CT spectrum of pulmonary tuberculosis, we reviewed CT of the chest in 80 adult patients with active pulmonary tuberculosis who had not been treated for tuberculosis. Main patterns seen in patients with active tuberculosis were: (1) nodular shadow (56%), (2) confluent consolidation (15%), and (3) round consolidation (16%). Other CT patterns were: (1) miliary tuberculosis (n=4), (2) pleural effusion only (n=4), and (3) normal chest (n=2). Major features seen at CT included segmental distribution (97%), satellite lesions (86%), single cavity in each cavitary lesion (95%), ectatic change of the bronchi, tendency of distortion or contraction. (author)

  9. The radiological spectrum of pulmonary multidrug-resistant tuberculosis: in HIV-Negative patients

    International Nuclear Information System (INIS)

    Zahirifard, S.; Amiri, M.V.; Bakhshayesh Karam, M.; Mirsaeidi, S.M.; Ehsanpour, A.; Masjedi, M.R.

    2003-01-01

    Background: Multidrug-resistant tuberculosis is a major worldwide health problem. In countries where tuberculosis is of moderate to high prevalence, the issue of Multidrug-resistant tuberculosis carries significant importance. Multidrug-resistant tuberculosis, similar to drug-sensitive tuberculosis, is contagious. Meanwhile its treatment is not only more difficult but also more expensive with lower success rates. Regarding clinical findings, there is no significant difference between Multidrug-resistant tuberculosis and drug-sensitive tuberculosis. Therefore determination of characteristic radiological findings in cases of Multidrug-resistant tuberculosis might be of help in early detection, and hence appropriate management of this disease condition. Objective: To explain the radiological spectrum of pulmonary Multidrug-resistant tuberculosis. Patients and methods: We retrospectively evaluated the radiographic images of 35 patients with clinically-and microbiologically- proven Multidrug-resistant tuberculosis admitted to our tertiary-care tuberculosis unit over a period of 13 months. The latest chest x-ray of all patients and the conventional chest CT scan without contrast of 15 patients were reviewed by three expert radiologists who rendered consensus opinion. Results: Of the 35 patients with imaging studies, 23 (66%) were male and 12 (34%) were female. The mean±SD age of participants was 38.2±17.3 (range: 16-20) years. 33 patients were known as secondary and only 2 had primary Multidrug-resistant tuberculosis. Chest radiography revealed cavitary lesion in 80% pulmonary infiltration in 89% and nodules in 80% of the cases. Pleurisy was the rarest finding observed in only 5 (14%) patients. All of 15 chest CT scans revealed cavitation, 93% of which were bilateral and multiple. Pleural involvement was seen in 93% of patients. Conclusion: Presence of multiple cavities, especially in both lungs, nodular and infiltrative lesions, and pleural effusion are main features

  10. T-cell recognition of Mycobacterium tuberculosis culture filtrate fractions in tuberculosis patients and their household contacts

    DEFF Research Database (Denmark)

    Demissie, A; Ravn, P; Olobo, J

    1999-01-01

    We examined the immune responses of patients with active pulmonary tuberculosis (TB) and their healthy household contacts to short-term culture filtrate (ST-CF) of Mycobacterium tuberculosis or molecular mass fractions derived from it. Our goal was to identify fractions strongly recognized......, to secreted mycobacterial antigens is suggestive of an early stage of infection by M. tuberculosis, which could in time result in overt disease or containment of the infection. This possibility is currently being investigated by follow-up studies of the household contacts....

  11. [Patient-centered medicine for tuberculosis medical services].

    Science.gov (United States)

    Fujita, Akira; Narita, Tomoyo

    2012-12-01

    The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other

  12. Intestinal helminth co-infection and associated factors among tuberculosis patients in Arba Minch, Ethiopia.

    Science.gov (United States)

    Alemu, Getaneh; Mama, Mohammedaman

    2017-01-13

    Helminths affect the outcome of tuberculosis by shifting cell mediated immune response to humoral and by total suppression of the host immune system. On the reverse, Mycobacterium infection favors immune escape of helminths. Therefore assessing helminth co-infection rate and predisposing factors in tuberculosis patients is mandatory to set strategies for better case management. Facility based cross-sectional study was conducted in Arba Minch to assess the prevalence and associated factors of intestinal helminths among pulmonary tuberculosis patients from January to August, 2016. A structured questionnaire was used to capture data about socio-demographic characteristics, clinical history and possible risk factors for intestinal helminth infections. Height and weight were measured to calculate body-mass index. Appropriate amount of stool was collected and processed by direct saline and formol-ether concentration techniques following standard protocols. All the data were analyzed using SPSS version 20.0. A total of 213 (57.3% male and 42.7% female) pulmonary tuberculosis patients were participated in the study. The overall co-infection rate of intestinal parasites was 26.3%. The infection rate of intestinal helminths account 24.4% and that of intestinal protozoa was 6.1%. Ascaris lumbricoides accounted the highest frequency of 11.3%. Living in rural residence (AOR = 3.175, 95% CI: 1.102-9.153, p = 0.032), Eating vegetables/ fruits without washing or peeling off (AOR = 2.208, 95% CI: 1.030-4.733, p = 0.042) and having body-mass index intestinal helminth infection. The infection rate by intestinal helminths was 24.4%. Ascaris lumbricoides was the most prevalent helminth. Residence, habit of washing vegetables/fruits before use and body-mass index were associated factors with intestinal helminthiasis. Therefore health care providers should screen and treat TB patients for intestinal helminthiasis in order to ensure good prognosis.

  13. Bronchoscopic techniques in the management of patients with tuberculosis

    Directory of Open Access Journals (Sweden)

    Michele Mondoni

    2017-11-01

    Full Text Available Tuberculosis (TB is one of the leading causes of morbidity and mortality worldwide. Early diagnosis and treatment are key to prevent Mycobacterium tuberculosis transmission. Bronchoscopy can play a primary role in pulmonary TB diagnosis, particularly for suspected patients with scarce sputum or sputum smear negativity, and with endobronchial disease. Bronchoscopic needle aspiration techniques are accurate and safe means adopted to investigate hilar and mediastinal lymph nodes in cases of suspected TB lymphadenopathy. Tracheobronchial stenosis represents the worst complication of endobronchial tuberculosis. Bronchoscopic procedures are less invasive therapeutic strategies than conventional surgery to be adopted in the management of TB-related stenosis.We conducted a non-systematic review aimed at describing the scientific literature on the role of bronchoscopic techniques in the diagnosis and therapy of patients with TB.We focused on three main areas of interventions: bronchoscopic diagnosis of smear negative/sputum scarce TB patients, endobronchial TB diagnosis and treatment and needle aspiration techniques for intrathoracic TB lymphadenopathy. We described experiences on bronchoalveolar lavage, bronchial washing, and biopsy techniques for the diagnosis of patients with tracheobronchial and pulmonary TB; furthermore, we described the role played by conventional and ultrasound-guided transbronchial needle aspiration in the diagnosis of suspected hilar and mediastinal TB adenopathy. Finally, we assessed the role of the bronchoscopic therapy in the treatment of endobronchial TB and its complications, focusing on dilation techniques (such as balloon dilation and airway stenting and ablative procedures (both heat and cold therapies. Keywords: Bronchoscopy, Tuberculosis, Endoscopic ultrasound-guided fine needle aspiration, Tracheobronchial stenosis

  14. Tuberculosis outbreaks predicted by characteristics of first patients in a DNA fingerprint cluster.

    Science.gov (United States)

    Kik, Sandra V; Verver, Suzanne; van Soolingen, Dick; de Haas, Petra E W; Cobelens, Frank G; Kremer, Kristin; van Deutekom, Henk; Borgdorff, Martien W

    2008-07-01

    Some clusters of patients who have Mycobacterium tuberculosis isolates with identical DNA fingerprint patterns grow faster than others. It is unclear what predictors determine cluster growth. To assess whether the development of a tuberculosis (TB) outbreak can be predicted by the characteristics of its first two patients. Demographic and clinical data of all culture-confirmed patients with TB in the Netherlands from 1993 through 2004 were combined with DNA fingerprint data. Clusters were restricted to cluster episodes of 2 years to only detect newly arising clusters. Characteristics of the first two patients were compared between small (2-4 cases) and large (5 or more cases) cluster episodes. Of 5,454 clustered cases, 1,756 (32%) were part of a cluster episode of 2 years. Of 622 cluster episodes, 54 (9%) were large and 568 (91%) were small episodes. Independent predictors for large cluster episodes were as follows: less than 3 months' time between the diagnosis of the first two patients, one or both patients were young (<35 yr), both patients lived in an urban area, and both patients came from sub-Saharan Africa. In the Netherlands, patients in new cluster episodes should be screened for these risk factors. When the risk pattern applies, targeted interventions (e.g., intensified contact investigation) should be considered to prevent further cluster expansion.

  15. Tuberculosis-Diagnostic Expert System: an architecture for translating patients information from the web for use in tuberculosis diagnosis.

    Science.gov (United States)

    Osamor, Victor C; Azeta, Ambrose A; Ajulo, Oluseyi O

    2014-12-01

    Over 1.5-2 million tuberculosis deaths occur annually. Medical professionals are faced with a lot of challenges in delivering good health-care with unassisted automation in hospitals where there are several patients who need the doctor's attention. To automate the pre-laboratory screening process against tuberculosis infection to aid diagnosis and make it fast and accessible to the public via the Internet. The expert system we have built is designed to also take care of people who do not have access to medical experts, but would want to check their medical status. A rule-based approach has been used, and unified modeling language and the client-server architecture technique were applied to model the system and to develop it as a web-based expert system for tuberculosis diagnosis. Algorithmic rules in the Tuberculosis-Diagnosis Expert System necessitate decision coverage where tuberculosis is either suspected or not suspected. The architecture consists of a rule base, knowledge base, and patient database. These units interact with the inference engine, which receives patient' data through the Internet via a user interface. We present the architecture of the Tuberculosis-Diagnosis Expert System and its implementation. We evaluated it for usability to determine the level of effectiveness, efficiency and user satisfaction. The result of the usability evaluation reveals that the system has a usability of 4.08 out of a scale of 5. This is an indication of a more-than-average system performance. Several existing expert systems have been developed for the purpose of supporting different medical diagnoses, but none is designed to translate tuberculosis patients' symptomatic data for online pre-laboratory screening. Our Tuberculosis-Diagnosis Expert System is an effective solution for the implementation of the needed web-based expert system diagnosis. © The Author(s) 2013.

  16. HIV infection among tuberculosis patients in Vietnam: prevalence and impact on tuberculosis notification rates.

    Science.gov (United States)

    Thanh, D H; Sy, D N; Linh, N D; Hoan, T M; Dien, H T; Thuy, T B; Hoa, N P; Tung, L B; Cobelens, F

    2010-08-01

    Vietnam has an emerging human immunodeficiency virus (HIV) epidemic (estimated population prevalence 0.5%), but valid data on HIV prevalence among tuberculosis (TB) patients are limited. Recent increases in TB notification rates among young adults may be related to HIV. To assess the prevalence of HIV infection among smear-positive TB patients in six provinces with relatively high HIV population prevalence in Vietnam. All patients who registered for treatment of smear-positive TB during the fourth quarter of 2005 were offered HIV testing. Of the 1217 TB patients included in the study, 100 (8.2%) tested HIV-positive. HIV prevalence varied between 2% and 17% in the provinces, and was strongly associated with age Vietnam, HIV infection is concentrated in drug users, as well as in specific geographic areas where it has considerable impact on TB notification rates among men aged 15-34 years.

  17. Plasma Indoleamine 2, 3-Dioxygenase, a Biomarker for Tuberculosis in Human Immunodeficiency Virus-Infected Patients.

    Science.gov (United States)

    Adu-Gyamfi, Clement G; Snyman, Tracy; Hoffmann, Christopher J; Martinson, Neil A; Chaisson, Richard E; George, Jaya A; Suchard, Melinda S

    2017-10-15

    There is no biomarker for diagnosing active tuberculosis in patients with human immunodeficiency virus (HIV) infection. Indoleamine 2, 3-dioxygenase (IDO) is an immunoregulatory enzyme that breaks down tryptophan (Trp) to metabolites known as kynurenines (Kyns). We investigated whether IDO activity, as measured by the ratio of Kyn to Trp, could be used to diagnose or predict active tuberculosis disease in HIV-infected adults. Kyn and Trp concentrations were measured using ultraperformance liquid chromatography mass spectrometry in plasma samples from 32 HIV-infected patients in whom active tuberculosis developed and who were followed up prospectively. We compared to 70 HIV-infected control subjects from the same cohort in whom tuberculosis did not develop, matched by age, sex, and CD4 cell count, and 37 unmatched HIV-infected patients with a diagnosis of pneumonia. Clinical parameters, including body mass index, CD4 cell count, HIV load, and C-reactive protein levels were analyzed. At the time of tuberculosis diagnosis, IDO activity was significantly higher in patients with tuberculosis than in controls (P tuberculosis diagnosis, IDO activity was significantly higher in all patients who later developed tuberculosis (P tuberculosis treatment, IDO activity in patients with tuberculosis declined to levels similar to those in controls. IDO activity was 4-fold higher in patients with tuberculosis than in those with pneumonia, and could be used to distinguish them. With a receiver operating characteristic curve, IDO activity had a sensitivity of 97%, a specificity of 99%, and positive and negative predictive values of 89% and 100% for detecting active tuberculosis disease. Plasma IDO activity is suitable as a biomarker of active tuberculosis in HIV-positive patients. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  18. Sputum is a surrogate for bronchoalveolar lavage for monitoring Mycobacterium tuberculosis transcriptional profiles in TB patients.

    Science.gov (United States)

    Garcia, Benjamin J; Loxton, Andre G; Dolganov, Gregory M; Van, Tran T; Davis, J Lucian; de Jong, Bouke C; Voskuil, Martin I; Leach, Sonia M; Schoolnik, Gary K; Walzl, Gerhard; Strong, Michael; Walter, Nicholas D

    2016-09-01

    Pathogen-targeted transcriptional profiling in human sputum may elucidate the physiologic state of Mycobacterium tuberculosis (M. tuberculosis) during infection and treatment. However, whether M. tuberculosis transcription in sputum recapitulates transcription in the lung is uncertain. We therefore compared M. tuberculosis transcription in human sputum and bronchoalveolar lavage (BAL) samples from 11 HIV-negative South African patients with pulmonary tuberculosis. We additionally compared these clinical samples with in vitro log phase aerobic growth and hypoxic non-replicating persistence (NRP-2). Of 2179 M. tuberculosis transcripts assayed in sputum and BAL via multiplex RT-PCR, 194 (8.9%) had a p-value <0.05, but none were significant after correction for multiple testing. Categorical enrichment analysis indicated that expression of the hypoxia-responsive DosR regulon was higher in BAL than in sputum. M. tuberculosis transcription in BAL and sputum was distinct from both aerobic growth and NRP-2, with a range of 396-1020 transcripts significantly differentially expressed after multiple testing correction. Collectively, our results indicate that M. tuberculosis transcription in sputum approximates M. tuberculosis transcription in the lung. Minor differences between M. tuberculosis transcription in BAL and sputum suggested lower oxygen concentrations or higher nitric oxide concentrations in BAL. M. tuberculosis-targeted transcriptional profiling of sputa may be a powerful tool for understanding M. tuberculosis pathogenesis and monitoring treatment responses in vivo. Published by Elsevier Ltd.

  19. Imaging of tuberculosis - experience from 503 patients. 1. Tuberculosis of the chest

    International Nuclear Information System (INIS)

    Nyman, R.S.; Brismar, J.; Hugosson, C.; Larsson, S.G.; Lundstedt, C.

    1996-01-01

    Purpose: To give an overview of 503 patients with tuberculosis (TB) and to describe the radiologic findings of chest TB. Material and Methods: A total of 503 patients with proven TB were reviewed; 266 had chest involvement. Results: Lung lesions were demonstrated in 214 patients. Infiltrates in the basal parts of the lungs or pleural effusion were often primarily mistaken for viral or bacterial infections. Consolidations within the lungs and pleural thickening were sometimes indistinguishable from malignancy. Positive culture of the sputum without lung lesions was encountered in 12 cases. Enlarged mediastinal lymph nodes were demonstrated in 67 cases, 35 without lesions in the lungs. The lymphadenopathy could be extensive, and both clinically and radiologically indistinguishable from lymphoma. Conclusion: Due to the present increase in incidence of TB and the fact that TB can mimic many other conditions, it is important that both clinicians and radiologists have TB high on the list for differential diagnoses. (orig.)

  20. Detection of mutation in isoniazid-resistant Mycobacterium tuberculosis isolates from tuberculosis patients in Belarus

    Directory of Open Access Journals (Sweden)

    Bostanabad S

    2008-01-01

    Full Text Available The aim of this study was to investigate the frequency, location and type of katG mutations in Mycobacterium tuberculosis strains isolated from patients in Belarus. Forty two isoniazid-resistant isolates were identified from sputum of 163 patients with active pulmonary tuberculosis. Drug susceptibility testing was determined by using CDC standard conventional proportional method and BACTEC system. Standard PCR method for detection of isoniazid resistance associated mutations was performed by katG gene amplification and DNA sequencing. Most mutations were found in katG gene codons 315, 316 and 309. Four types of mutations were identified in codon 315: AGC→ACC ( n = 36 85%, AGC→AGG ( n = 1 2.3%, AGC→AAC ( n = 2 4.7%, AGC→GGC ( n = 1 2.3%. One type of mutation was found in codon 316: GGC→AGC ( n = 1841.4%, four types of mutations were detected in codon 309: GGT→GGT ( n = 716.1%, GGT→GCT ( n = 49.2%, GGT→GTC ( n = 36.9%, GGT→GGG ( n = 12.7%. The highest frequency of mutations sharing between primary and secondary infections was found in codon 315.

  1. Description of polymerase chain reaction and sequencing DNA Mycobacterium tuberculosis from specimen sputum of tuberculosis patients in Medan

    Science.gov (United States)

    Lily; Siregar, Y.; Ilyas, S.

    2018-03-01

    This study purposed to describe the product Polymerase Chain Reaction (PCR) and sequencing of DNA Mycobacterium (M.) tuberculosis from sputum of tuberculosis (TB) patients in Medan. Sputum was collected from patients that diagnosed with pulmonary TB by a physician. Specimen processed by PCR method of Li et al. and sequencing at Macrogen Laboratory. All of 12 product PCR were showed brightness bands at 126 base pair (bp). These results indicated similarity to the study of Li et al. Sequencing analysis showed the presence of a mutation and non-mutation groups of M. tuberculosis. The reference and outcome berange of the mutation and non-mutation of M. tuberculosis were 56-107, 59-85, 60-120 and 63-94, respectively. The percentage bp difference between the outcome and references for mutation and non-mutation were 3.448-6.569and 3.278-7.428%, respectively. In conclusion, the successful amplification of PCR products in a 1.5% agarose gel electrophoresis where all 12 sputa contained rpoB-positive M. tuberculosis and 0.644% difference was found between the outcome with reference bp of the mutation and non-mutation M. tuberculosis groups.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  3. Tuberculosis screening among homeless persons with AIDS living in single-room-occupancy hotels.

    Science.gov (United States)

    Layton, M C; Cantwell, M F; Dorsinville, G J; Valway, S E; Onorato, I M; Frieden, T R

    1995-11-01

    Congregate facilities for homeless persons with the acquired immunodeficiency syndrome (AIDS) are often endemic for tuberculosis. We evaluated tuberculosis screening methods at single-room-occupancy hotels housing persons with AIDS. Residents were screened by cross matching the New York City Tuberculosis Registry, interviewing for tuberculosis history, skin testing, and chest radiography. Cases were classified as either previously or newly diagnosed. Among the 106 participants, 16 (15%) previously diagnosed tuberculosis cases were identified. Participants' tuberculosis histories were identified by the questionnaire (100%) or by registry match (69%). Eight participants (50%) were noncompliant with therapy. These findings prompted the establishment of a directly observed therapy program on site.

  4. Tuberculosis

    OpenAIRE

    Juan Carlos Rodríguez, D.

    2014-01-01

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

  5. Utility of CT in the evaluation of pulmonary tuberculosis in patients without Aids

    International Nuclear Information System (INIS)

    Lee, K.S.; Hwang, J.W.; Chung, M.P.

    1997-01-01

    Objective. To assess the utility of CT in the evaluation of pulmonary tuberculosis in patients without AIDS. Patients and methods. Thin-section CT scans for suspicion of pulmonary tuberculosis were obtained from 226 patients. A total of 38 patients were excluded; the reasons were unavailability of final results (n=18), patient unavailability for follow-up (n=13), and coexistence of tuberculosis and aspergilloma (n=7). The results from 188 patients were used for this study. After assessing the patterns of parenchymal lesion, involved segments, and presence of cavity, bronchiectases, and bronchogenic spread of the lesion with CT, tentative diagnosis and disease activity were recorded. Results. With CT, 133 of 146 patients (91%) with tuberculosis were correctly diagnosed as having pulmonary tuberculosis whereas 32 of 42 patients (76%) without tuberculosis were correctly excluded. CT diagnosis of lung cancer (n=8), bacterial pneumonia (n=2), pulmonary metastasis (n=1), chronic hypersensitivity pneumonia (n=1) and diffuse pan-bronchiolitis (n=1) turned out to be tuberculosis. Conversely CT diagnoses of tuberculosis appeared pathologically as lung cancer (n=5), bacterial pneumonia 71/89, 80%) and inactive state (51/57, 89%) of disease respectively could be correctly differentiated by CT. Conclusion. CT can be helpful in the diagnosis of pulmonary tuberculosis in most cases. On the basis of CT findings, distinction of active from inactive disease can be made in most cases. (authors)

  6. [Clinical analysis of patients with tuberculosis admitted on an emergency cases].

    Science.gov (United States)

    Okada, Toru; Shibuya, Yasuhiro; Saito, Hitoshi; Enomoto, Tatsuji; Nakamura, Seiichi

    2008-08-01

    A retrospective study was made of 75 patients with tuberculosis and tuberculous pleurisy who received medical care in our hospital from 2002 through 2006. Of the 75 patients, 9 were admitted as tertiary emergency cases, and 12 patients were admitted by ambulance as secondary emergency cases. We studied the reason for their emergency medical admission, and the process of diagnosing 21 patients as tuberculosis. In some cases, the reasons for emergency admission were cardiorespiratory arrest, loss of consciousness, and injury resulting from a traffic accident, not common symptoms of tuberculosis such as dyspnea, hemoptysis and bloody sputum. Chest radiographic findings of most patients showed tuberculosis, and other cases were likely to be diagnosed as tuberculosis from their medical history or back-ground such as being homeless, previous tuberculosis, and receiving for therapy of tuberculosis. It was not so difficult to diagnose our cases as tuberculosis, nevertheless we may have an unconscious patient with normal chest radiograph. These data suggest that any patients visiting the emergency room may possibly have tuberculosis even if they are without respiratory symptoms.

  7. [Rd7 genotyping of M. tuberculosis strains isolated from patients with lung tuberculosis in different areas of Kazakhstan].

    Science.gov (United States)

    Demkin, V V; Korneva, I N; Riazanova, Iu A; Muminov, T A; Beĭsembaeva, Sh A; Zhakipbaeva, B T; Shopaeva, G A; Dauletbakova, A M

    2008-01-01

    A three-primer PCR assay was designed for detection of possible deletions in the RD7 region of the Mycobacterium tuberculosis complex chromosome. The assay produced amplicons of different size depending on the presence or absence of the deletions. The PCR assay was applied to 176 isolates from patients with lung tuberculosis collected in different areas of Kazakhstan in summer 2004. The isolates were initially characterized by culture and biochemical tests. The RD7 genotyping results demonstrated no polymorphism and the absence of deletions in the RD7 genome region. Some strains were additionally characterized using PCR-RFLP analysis of gyrB and hsp64 genes. The RFLP-patterns obtained corresponded to the M. tuberculosis genotypes. The results of this work are consistent with certain previous studies, indicating population stability of the RD7 region in M. tuberculosis strains. Species characterization of the isolates shows that M. tuberculosis sensu stricto is the principal causative agent of human lung tuberculosis in Kazakhstan.

  8. Shortening Isolation of Patients With Suspected Tuberculosis by Using Polymerase Chain Reaction Analysis

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Thomsen, Vibeke Østergaard

    2015-01-01

    Background. Isolation of patients suspected for pulmonary tuberculosis is guided by serial sputum smears. This can result in isolation for days for patients with noncontagious tuberculosis. To determine whether a single sample negative for Mycobacterium tuberculosis complex at polymerase chain...... reaction (PCR) can guide isolation. Methods. We retrospectively evaluated sputum samples analyzed for M. tuberculosis complex at the International Reference Laboratory of Mycobacteriology, Copenhagen, Denmark in 2002–2011. We selected culture-confirmed tuberculosis cases with ≥3 samples within 14 days...... before or after the initial culture-positive sample. We repeated the process for those with ≥2 samples within 28 days. The primary outcome was PCR-negative, smear-positive patients. Results. We included 53 533 sputum samples from 20 928 individuals; 1636 had culture-confirmed tuberculosis. Of these, 856...

  9. Use of the VNTR typing technique to determine the origin of Mycobacterium tuberculosis strains isolated from Filipino patients in Korea.

    Science.gov (United States)

    Lee, Jihye; Tupasi, Thelma E; Park, Young Kil

    2014-05-01

    With increasing international interchange of personnel, international monitoring is necessary to decrease tuberculosis incidence in the world. This study aims to develop a new tool to determine origin of Mycobacterium tuberculosis strains isolated from Filipino patients living in Korea. Thirty-two variable number tandem repeat (VNTR) loci were used for discrimination of 50 Filipino M. tuberculosis strains isolated in the Philippines, 317 Korean strains isolated in Korea, and 8 Filipino strains isolated in Korea. We found that the VNTR loci 0580, 0960, 2531, 2687, 2996, 0802, 2461, 2163a, 4052, 0424, 1955, 2074, 2347, 2401, 3171, 3690, 2372, 3232, and 4156 had different mode among copy numbers or exclusively distinct copy number in VNTR typing between Filipino and Korean M. tuberculosis strains. When these differences of the VNTR loci were applied to 8 Filipino M. tuberculosis strains isolated in Korea, 6 of them revealed Filipino type while 2 of them had Korean type. Using the differences of mode or repeated number of VNTR loci were very useful in distinguishing the Filipino strain from Korean strain.

  10. Diagnostic accuracy and optimal use of three tests for tuberculosis in live badgers.

    Directory of Open Access Journals (Sweden)

    Julian A Drewe

    Full Text Available BACKGROUND: Accurate diagnosis of tuberculosis (TB due to infection with Mycobacterium bovis is notoriously difficult in live animals, yet important if we are to understand the epidemiology of TB and devise effective strategies to limit its spread. Currently available tests for diagnosing TB in live Eurasian badgers (Meles meles remain unvalidated against a reliable gold standard. The aim of the present study was to evaluate the diagnostic accuracy and optimal use of three tests for TB in badgers in the absence of a gold standard. METHODOLOGY/PRINCIPAL FINDINGS: A Bayesian approach was used to evaluate the diagnostic accuracy and optimal use of mycobacterial culture, gamma-interferon assay and a commercially available serological test using multiple samples collected from 305 live wild badgers. Although no single test was judged to be sufficiently sensitive and specific to be used as a sole diagnostic method, selective combined use of the three tests allowed guidelines to be formulated that allow a diagnosis to be made for individual animals with an estimated overall accuracy of 93% (range: 75% to 97%. Employing this approach in the study population of badgers resulted in approximately 13 out of 14 animals having their true infection status correctly classified from samples collected on a single capture. CONCLUSIONS/SIGNIFICANCE: This method of interpretation represents a marked improvement on the current procedure for diagnosing M. bovis infection in live badgers. The results should be of use to inform future test and intervention strategies with the aim of reducing the incidence of TB in free-living wild badger populations.

  11. Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands

    NARCIS (Netherlands)

    Tostmann, Alma; Kik, Sandra V.; Kalisvaart, Nico A.; Sebek, Maruschka M.; Verver, Suzanne; Boeree, Martin J.; van Soolingen, Dick

    2008-01-01

    Background. Sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). Although patients with sputum smear-negative TB are less infectious than patients with smear-positive TB, they also contribute to TB transmission. The objective of this study was to determine the proportion of TB

  12. Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands.

    NARCIS (Netherlands)

    Tostmann, A.; Kik, S.V.; Kalisvaart, N.A.; Sebek, M.M.; Verver, S.; Boeree, M.J.; Soolingen, D. van

    2008-01-01

    BACKGROUND: Sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). Although patients with sputum smear-negative TB are less infectious than patients with smear-positive TB, they also contribute to TB transmission. The objective of this study was to determine the proportion of TB

  13. Comparison of Serum Leptin Levels in Pulmonary Tuberculosis Patients with Acute Pneumonia Patients and Healthy Individuals

    Directory of Open Access Journals (Sweden)

    M. Naderi

    2017-10-01

    Full Text Available Aims: Leptin is one of the most important fat-derived hormones. Several studies have shown that serum leptin levels in systemic inflammatory diseases are reduced. The aim of this study was to evaluate the serum leptin levels in three groups: patients with active pulmonary tuberculosis (TB, patients with non-pulmonary infections (acute pneumonia and normal people. Materials & Methods: In this cross-sectional study, in 2010, 40 patients with active pulmonary TB (case group and 40 patients with non-pulmonary infections (positive control group admitted to Boo-Ali hospital in Zahedan and 40 healthy subjects (negative control group were selected using easy access and serum leptin levels were evaluated by ELISA. Data were analyzed by SPSS 18 software and one-way ANOVA. Findings: The mean of serum leptin levels in patients with non-pulmonary infections (p=0.030 and in patients with active pulmonary TB (p=0.004 were significantly lower than normal group, but the mean of serum leptin levels in patients with active pulmonary TB and patients with non-pulmonary infections were not significantly different (p=0.555. Conclusion: Serum leptin levels are lower in patients with active pulmonary tuberculosis and in patients with non-pulmonary infections than in normal people, but there is no difference between patients with active pulmonary tuberculosis and patients with non-pulmonary infections. Therefore, serum leptin levels are not an appropriate marker for the differentiation of active pulmonary tuberculosis from pulmonary infections (acute pneumonia.

  14. Patients' perception regarding the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment: a qualitative study.

    Science.gov (United States)

    da Silva, Rosiane Davina; de Luna, Fernanda Darliane Tavares; de Araújo, Aguinaldo José; Camêlo, Edwirde Luiz Silva; Bertolozzi, Maria Rita; Hino, Paula; Lacerda, Sheylla Nadjane Batista; Fook, Sayonara Maria Lia; de Figueiredo, Tânia Maria Ribeiro Monteiro

    2017-09-19

    Tuberculosis remains an important disease which mainly affects the majority of vulnerable individuals in society, who are subjected to poor living conditions and difficulties to access the services of public health. Under these circumstances, the present study aims to understand patients' perception in relation to the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment. A qualitative descriptive cross sectional study was conducted in one large municipality at the state of Paraíba, Northeast of Brazil. The study subjects, who were residents of the study site, covered all tuberculosis cases diagnosed between March and June 2015. The sample was defined by the criteria of response saturation. All interviews were audio recorded, and data analysis was developed through the hermeneutic dialectic method and the theory of Generative Route Sense. The project was approved by the Research Ethics Committee of the University of São Paulo (USP). A total of 13 individuals were interviewed and the responses were identified into two analytical categories: the difficulties they had and the enabling factors they could mention during their tuberculosis treatment. Patients brought up social exclusion as an obstacle to treatment adherence, which, along with stigmatization, weakened their link with family members and health professionals. Moreover, economic precariousness was a major hindrance to the maintenance of a proper diet and transportation access to health centers. However, social support and directly observed treatment helped to break down barriers of prejudice and to promote individual and family empowerment. Finally, patients also reported that their will to live and faith gave them the strength to continue with the treatment. According to patients in this study, social support and the strengthening of links with family members and health professionals may reduce social exclusion and other difficulties they face, thus encouraging them

  15. Tobacco Smoking and Tuberculosis among Men Living with HIV in Johannesburg, South Africa: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Liza Bronner Murrison

    Full Text Available Although there is ample evidence that smoking increases the risk of tuberculosis (TB, the magnitude of impact on TB risk among HIV-infected persons is poorly described. Given that a high proportion of patients with TB are co-infected with HIV in South Africa, the risks arising from the intersection of smoking, TB, and HIV/AIDS have key relevance for tobacco control policies.To evaluate the association of pulmonary tuberculosis (PTB with current tobacco smoking among men with HIV in South Africa.Case-control study of antiretroviral therapy naïve men with confirmed HIV-infection in Johannesburg. Cases had laboratory-confirmed PTB and controls had no evidence of active TB. Participants were interviewed to collect detailed smoking histories.We enrolled 146 men diagnosed with PTB and 133 controls. Overall, 33% of participants were currently smoking, defined as smoking a cigarette within 2 months (34% cases vs. 32% controls, p = 0.27. Median CD4 count was lower (60 vs. 81 cells/mm3, P = 0.03 and median viral load was higher (173 vs. 67 copies/ul per thousand, P<0.001 among cases versus controls. In adjusted analyses, current smoking tripled the odds of PTB (aOR 3.2; 95%CI: 1.3-7.9, P = 0.01 and former smoking nearly doubled the odds of PTB (aOR 1.8; 95%CI 0.8-4.4, P = 0.18 compared to never smoking.Males with HIV that smoke are at greater odds for developing PTB than non-smokers. Extensive smoking cessation programs are needed to reduce odds of TB and promote health among adults living with HIV.

  16. Tuberculosis Fluoroscopy

    Science.gov (United States)

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

  17. Evaluation of electrolyte imbalance among tuberculosis patients ...

    African Journals Online (AJOL)

    Adebimpe Wasiu Olalekan

    2015-02-24

    Feb 24, 2015 ... a Department of Community Medicine, College of Health Sciences, Osun State University Osogbo, ... trolyte imbalance among TB patients receiving treatments. ... mental organizations whose presence could be felt in the areas ... anti tuberculous drugs with 11 males and 09 females. ... workers in the facility.

  18. Free tuberculosis diagnosis and treatment are not enough: patient cost evidence from three continents

    NARCIS (Netherlands)

    Mauch, V.; Bonsu, F.; Gyapong, M.; Awini, E.; Suarez, P.; Marcelino, B.; Melgen, R. E.; Lönnroth, K.; Nhung, N. V.; Hoa, N. B.; Klinkenberg, E.

    2013-01-01

    The National Tuberculosis Programs of Ghana, Viet Nam and the Dominican Republic. To assess the direct and indirect costs of tuberculosis (TB) diagnosis and treatment for patients and households. Each country translated and adapted a structured questionnaire, the Tool to Estimate Patients' Costs. A

  19. Electronic-nose technology using sputum samples in diagnosis of patients with tuberculosis

    NARCIS (Netherlands)

    Kolk, A.; Hoelscher, M.; Maboko, L.; Jung, J.; Kuijper, S.; Cauchi, M.; Bessant, C.; van Beers, S.; Dutta, R.; Gibson, T.; Reither, K.

    2010-01-01

    We investigated the potential of two different electronic noses (EN; code named "Rob" and "Walter") to differentiate between sputum headspace samples from tuberculosis (TB) patients and non-TB patients. Only samples from Ziehl-Neelsen stain (ZN)- and Mycobacterium tuberculosis culture-positive

  20. Long-term mortality in patients with pulmonary and extrapulmonary tuberculosis

    DEFF Research Database (Denmark)

    Christensen, Anne-Sophie Halkjær; Roed, Casper; Andersen, Peter H

    2014-01-01

    BACKGROUND: Long-term mortality and causes of death in patients with pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) are poorly documented. In this study, long-term mortality and causes of death in PTB and EPTB patients were compared with the background population...

  1. Evaluation of disease patterns, treatment and prognosis of tuberculosis in AIDS patient

    Directory of Open Access Journals (Sweden)

    Atomiya Angela Naomi

    2002-01-01

    Full Text Available Patterns of disease, diagnosis, treatment and prognosis of tuberculosis in 100 patients co-infected with AIDS at Casa da AIDS clinic was studied. Demographic characteristics were as follows: 76 male patients, 24 female patients, 67 caucasian, average 35.8 years-old (SD ± 8.5. Sexual transmission of HIV was reported in 68 patients. Pulmonary tuberculosis was seen in 40 patients, extrapulmonary in 11, and combined in 49 patients. In 63 patients, TCD4+ counts were below 200/mm³ when tuberculosis was diagnosed. Fifty-five patients had their diagnoses confirmed by bacteriological identification of Mycobacterium; either through direct observation and/or culture. Tuberculosis was treated with rifampin, isoniazid and pyrazinamide in 60 patients, reinforced treatment in 14 and alternative treatment in the other 13 patients. Tuberculosis therapy lasted up to 9 months in 66% of the patients. Fifty-four patients were treated with a two-drug antiretroviral regimen and the remaining 46 patients received a triple regimen, which included a protease inhibitor. Among the latter, 35 patients were co-treated with rifampin. The occurrence of hepatic liver enzyme abnormalities was statistically related to alternative antiretroviral regimens (p = 0.01 and to the co-administration of rifampin and protease inhibitor (p = 0.019. Clinical resolution of tuberculosis was obtained in 74 patients. Twelve patients died during tuberculosis treatment. Resolution of tuberculosis was statistically significant related to antituberculosis treatment adherence (p = 0.001. The risk of no response to the treatment was 1.84 times more frequent among patients treated with alternative regimens regardless of the duration of the therapy. We conclude that the characteristics of tuberculosis in HIV infected patients requires that special attention be directed to the types and duration of both antiretroviral and anti-TB therapy in order to achieve the highest level of care.

  2. Factors associated with sputum culture conversion in patients with pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Greta Musteikienė

    Full Text Available Objective: The aim of this study was to determine what factors are associated with sputum culture conversion after 1 month of tuberculosis (TB treatment. Materials and methods: A total of 52 patients with new drug susceptible pulmonary TB were included in the study. Patients completed St. George respiratory questionnaire (SGRQ, they were asked about smoking, alcohol use, living conditions and education. Body mass index (BMI measurements, laboratory tests (C reactive protein [CRP], vitamin D, albumin were performed, and chest X-ray was done. After 1 month of treatment sputum culture was repeated. Results: Culture conversion after 1 month of treatment was found in 38.5% cases. None of investigated social factors appeared to have an effect on conversion, but worse overall health status (as reported in SGRQ and longer duration of tobacco smoking were detected in the “no conversion” group. Concentrations of albumin, CRP, X-ray score and the time it took Mycobacterium tuberculosis culture to grow also differed. Patients who scored 30 or more on SGRQ were more than 7 times as likely to have no conversion. However, the most important factor predicting sputum culture conversion was sputum smear grade at the beginning of treatment: patients with grade of 2+ or more had more than 20-fold higher relative risk for no conversion. Using receiver operating characteristic curve analysis, we also developed a risk score for no conversion. Conclusions: The most important factors in predicting sputum culture conversion after 1 month of treatment were grades of acid-fast bacilli in sputum smears at time of diagnosis and scores of SGRQ. Keywords: Smoking, Smear grade, St. George respiratory questionnaire, Tuberculosis, Culture conversion

  3. Adverse Reactions to Antituberculosis Drugs in Iranian Tuberculosis Patients

    Directory of Open Access Journals (Sweden)

    Aliasghar Farazi

    2014-01-01

    Full Text Available Background. Antituberculosis multidrug regimens have been associated with increased incidence of adverse drug reactions (ADRs. This study aimed to determine the incidence and associated factors of ADRs due to antituberculosis therapy. Methods. This is a retrospective cross-sectional study on tuberculosis patients who were treated in tuberculosis clinics in Markazi province in Iran. The information contained in the medical files was extracted and entered into the questionnaire. Data was descriptively analyzed by using statistical package for social sciences (SPSS 18. Results. A total of 940 TB patients of 1240 patients’ medical records available in 10 medical offices were included in this study. Of the 563 ADRs found in this study, 82.4% were considered minor reactions and 17.6% were major reactions. No death from antituberculosis ADR was observed. We found that the risk of major ADRs was higher in females (P  value=0.0241, age >50 y (P  value=0.0223, coinfection with HIV (P  value=0.0323, smoking (P  value=0.002, retreatment TB (P  value=0.0203, and comorbidities (P  value=0.0005. Conclusions. This study showed that severe side effects of anti-TB drugs are common in patients who have risk factors of ADRs and they should be followed up by close monitoring.

  4. Imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    Song Wenyan; Zhao Zuqi; Zhao Dawei; Jia Cuiyu; Zhang Ruichi; Liu JinXin; Guan Wanhua; Liang Yi

    2013-01-01

    Objective: To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS). Methods: X-ray and multi-slice CT (MSCT) data from 33 AIDS patients with disseminated pulmonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively. Results: Thirty patients underwent initial chest radiography examination, 29 patients showed abnormal appearances, including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients. All patients underwent MSCT examination, 26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations. The abnormal pulmonary appearances included nodule (n = 25), miliary nodule (n = 22), air-space consolidation (n = 22), cavity (n = 11), fibrosis (n = 7), ground-glass opacity (n = 7), pneumatocele (n = 4), calcification (n = 2). There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances. The extra-pulmonary tuberculosis included pleural effusion (n = 33), lymphadenopathy (n = 30), intestinal tuberculosis (n = 3), splenic tuberculosis (n = 1) and cerebral tuberculosis (n = 1). Conclusion: Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules, miliary nodules, air-space consolidations or multiple cavities, accompanied with pleural effusion and lymphadenopathy. (authors)

  5. Evidence for chronic lung impairment in patients treated for pulmonary tuberculosis.

    Science.gov (United States)

    Vecino, Mauricio; Pasipanodya, Jotam G; Slocum, Philip; Bae, Sejong; Munguia, Guadalupe; Miller, Thaddeus; Fernandez, Michel; Drewyer, Gerry; Weis, Stephen E

    2011-11-01

    Patients with pulmonary tuberculosis are likely to develop pulmonary impairment after tuberculosis (PIAT). The stability of PIAT and the relationship of PIAT to the duration of delay in tuberculosis diagnosis and treatment have not been fully characterized. We performed serial pulmonary function tests (PFTs) in a cohort treated for pulmonary tuberculosis after 20 weeks of tuberculosis therapy and again on or after treatment completion to determine the stability of PIAT. PFTs were compared with the duration of delay in tuberculosis diagnosis and treatment, as well as other demographic variables. The median duration between the first and second tests was 15 (interquartile range 9-34) weeks. The mean change in FVC was -0.02l (95% confidence interval [CI] -0.09, 0.06), and the % predicted was -0.02 (95% CI -2.17, 2.12). FEV1 changes were 0l (95% CI -0.05, 0.06), and the % predicted was -0.11 (95% CI -1.82, 1.60). PIAT was not related to the duration of delay in tuberculosis diagnosis or treatment, age or smoking. PIAT was not associated with the duration of delay in tuberculosis diagnosis and treatment and did not significantly change during follow-up. These data demonstrate that, for many individuals, the completion of tuberculosis treatment is the beginning, not the end, of their tuberculosis illness. Published by Elsevier Ltd.

  6. [Clinical evaluation on causes of death in patients with active pulmonary tuberculosis].

    Science.gov (United States)

    Kuba, M; Nakasone, K; Miyagi, S; Kyan, K; Shinzato, T; Kohagura, N; Futenma, M; Genka, K

    1996-04-01

    Seventy one patients with active pulmonary tuberculosis who died during the past 5 years (1989 to 1993) were evaluated on their causes of death. Twenty two patients (31%) died directly of tuberculosis, and among them, 18 patients (81%) of 22 patients who died of tuberculosis) had very advanced tuberculosis. The majority of them (64%) were old age over 70 years and were bedridden due mostly to cerebrovascular injuries. The serum level of albumin was low in all 17 patients in whom it was measured. Establishment of diagnosis of tuberculosis was delayed over one month after the onset of symptoms in 59% of patients who died of severe disease. Sixty one percent (11/18) of patients died within the first month after the initiation of chemotherapy and about 90% (16/18) died within 3 months. Two patients died from massive hemoptysis and other patients died of either respiratory failure or tuberculosis meningitis. From these observations it was found that very advanced tuberculosis was the major cause of death in patients who died of tuberculosis and that the advanced disease was chiefly caused by the delay on the establishment of diagnosis, and it was most important to detect tuberculosis as early as possible, with regular check up of chest X-ray and frequent examination for AFB (acid-fast bacilli) for tuberculosis suspected patients. On the other hand, the majority of patients (49/71) died of complicating medical problem unrelated to tuberculosis. Seventeen patients died from malignancy (seven lung cancer, four lymphoma, two laryngeal cancer, etc). Ten deaths were the result of bacterial superinfection. Other patients died from respiratory failure due to COPD, arteiosclerotic heart disease, or cerebrovascular injuries, etc. Two patients of old age died of hepatic failure possibly caused by adverse reaction of TB chemotherapy. It was found that diseases unrelated to tuberculosis were the cause of death in approximately 70% of patients with active tuberculosis, and it should

  7. Effect of isoniazid preventive therapy on tuberculosis incidence in people living with HIV-AIDS at Hasan Sadikin hospital

    Science.gov (United States)

    Satiavan, I.; Hartantri, Y.; Werry, B.; Nababan, Y.; Wisaksana, R.; Alisjahban, B.

    2018-03-01

    Indonesia is the second largest number of tuberculosis (TB) in the world. Isoniazid Preventive Therapy (IPT) as one of the three I’s TB-HIV collaboration to manage TB in people living with HIV / AIDS (PLHIV) has not been fully performed. It is related to doubt to get rid of TB in PLHIV. This study aims to see the effect of IPT on the incidence of TB in PLHIV. This issue is a retrospective cohort study based on medical record data in HIV clinic. Inclusion criteria are PLHIV ≥ 15 years of age who were registered to visit the CST service and obtain IPT with good adherence if they were receiving ART. Of 462 patients, HIV- infected patients receiving IPT were 154 (33.3%). IPT administration has a protective effect on PLHIV where the rate of TB incidence in PLHIV who received IPT were 0.21 times lower than those who did not receive IPT (IRR = 0.21, 95% CI 0.023-0.881, p 0.008). In this population, IPT administration reduces 79% risk of PLHIV to suffer TB.IPT administration reduces the incidence of TB.

  8. Epidemiology of tuberculosis in HIV-infected patients in Denmark

    DEFF Research Database (Denmark)

    Dragsted, Ulrik Bak; Bauer, J; Poulsen, S

    1999-01-01

    increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from......Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has...... HIV-TB co-infected patients identified in the national registers of TB and AIDS from 1992-95 were collected retrospectively from medical records. Restriction fragment length polymorphism (RFLP) analyses of TB isolates from co-infected patients were compared with all patterns registered...

  9. Comparison of antigen-specific T-cell responses of tuberculosis patients using complex or single antigens of Mycobacterium tuberculosis

    DEFF Research Database (Denmark)

    Mustafa, A S; Amoudy, H A; Wiker, H G

    1998-01-01

    We have screened peripheral blood mononuclear cells (PBMC) from tuberculosis (TB) patients for proliferative reactivity and interferon-gamma (IFN-gamma) secretion against a panel of purified recombinant (r) and natural (n) culture filtrate (rESAT-6, nMPT59, nMPT64 and nMPB70) and somatic-derived (r......GroES, rPstS, rGroEL and rDnaK) antigens of Mycobacterium tuberculosis. The responses of PBMC to these defined antigens were compared with the corresponding results obtained with complex antigens, such as whole-cell M. tuberculosis, M. tuberculosis culture filtrate (MT-CF) and cell wall antigens, as well...... as the vaccine strain, Mycobacterium bovis bacillus Calmette-Guerin (BCG). In addition, M. tuberculosis and MT-CF-induced T-cell lines were tested in the same assays against the panel of purified and complex antigens. The compiled data from PBMC and T-cell lines tested for antigen-induced proliferation and IFN...

  10. Integration of PET/CT in Current Diagnostic and Response Evaluation Methods in Patients with Tuberculosis

    International Nuclear Information System (INIS)

    Oezmen, Oelem; Goekcek, Atila; Tatci, Ebru; Biner, Inci; Akkalyoncu, Behiye

    2014-01-01

    Tuberculosis is a systemic disease that still affects many people. While pleural involvement is frequently observed in extrapulmonary tuberculosis, multiple skeletal system and articular involvements are quite rare. FDG PET imaging could be a promising diagnostic and treatment monitoring method, especially in complicated cases and if the other methods are inadequate. In this case study, we report a patient who was admitted with suspected malignancy and then diagnosed with tuberculosis pleuritis, lymphadenitis, spondylodiscitis, and sacroiliitis with specific symptoms; the response to anti-tuberculosis therapy was shown using FDG PET/CT

  11. Integration of PET/CT in Current Diagnostic and Response Evaluation Methods in Patients with Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Oezmen, Oelem; Goekcek, Atila; Tatci, Ebru; Biner, Inci; Akkalyoncu, Behiye [Atatuerk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara (Turkmenistan)

    2014-03-15

    Tuberculosis is a systemic disease that still affects many people. While pleural involvement is frequently observed in extrapulmonary tuberculosis, multiple skeletal system and articular involvements are quite rare. FDG PET imaging could be a promising diagnostic and treatment monitoring method, especially in complicated cases and if the other methods are inadequate. In this case study, we report a patient who was admitted with suspected malignancy and then diagnosed with tuberculosis pleuritis, lymphadenitis, spondylodiscitis, and sacroiliitis with specific symptoms; the response to anti-tuberculosis therapy was shown using FDG PET/CT.

  12. Comparison of antigen-specific T-cell responses of tuberculosis patients using complex or single antigens of Mycobacterium tuberculosis

    DEFF Research Database (Denmark)

    Mustafa, A S; Amoudy, H A; Wiker, H G

    1998-01-01

    We have screened peripheral blood mononuclear cells (PBMC) from tuberculosis (TB) patients for proliferative reactivity and interferon-gamma (IFN-gamma) secretion against a panel of purified recombinant (r) and natural (n) culture filtrate (rESAT-6, nMPT59, nMPT64 and nMPB70) and somatic-derived ...

  13. Impact of tuberculosis treatment on CD4 cell count, HIV RNA, and p24 antigen in patients with HIV and tuberculosis

    DEFF Research Database (Denmark)

    Wejse, Christian; Furtado, A.; Camara, C.

    2013-01-01

    To describe HIV RNA levels during tuberculosis (TB) infection in patients co-infected with TB and HIV. Moreover, to examine the p24 antigen profile during TB treatment.......To describe HIV RNA levels during tuberculosis (TB) infection in patients co-infected with TB and HIV. Moreover, to examine the p24 antigen profile during TB treatment....

  14. Cytokine Gene Polymorphisms across Tuberculosis Clinical Spectrum in Pakistani Patients

    Science.gov (United States)

    Ansari, Ambreen; Talat, Najeeha; Jamil, Bushra; Hasan, Zahra; Razzaki, Tashmeem; Dawood, Ghaffar; Hussain, Rabia

    2009-01-01

    Background Pakistan ranks 7th globally in terms of tuberculosis (TB) disease burden (incidence 181/100000 pop./yr; prevalence of 329/pop./yr). Reports from different populations show variable associations of TB susceptibility and severity with cytokine gene polymorphisms. Tuberculosis clinical severity is multi-factorial and cytokines play a pivotal role in the modulation of disease severity. We have recently reported that the ratio of two key cytokines (IFNγ and IL10) show significant correlation with the severity spectrum of tuberculosis. The objective of the current study was to analyze the frequency of cytokine gene polymorphisms linked to high and low responder phenotypes (IFNγ +874 T hi→A lo and IL10 −1082 G lo→A hi) in tuberculosis patients. Methods and Findings Study groups were stratified according to disease site as well as disease severity: Pulmonary N = 111 (Minimal, PMN = 19; Moderate, PMD = 63; Advance, PAD = 29); Extra-pulmonary N = 67 (Disseminated DTB = 20, Localized LTB = 47) and compared with healthy controls (TBNA = 188). Genotype analyses were carried out using amplification refractory mutation system-PCR (ARMS-PCR) and stimulated whole blood (WB) culture assay was used for assessing cytokine profiles. Our results suggest that the IFNγ +874 TT genotype and T allele was overrepresented in PMN (p = 0.01) and PMD (p = 0.02). IFNγ +874 TT in combination with IL10 GG lo genotypes showed the highest association (χ2 = 6.66, OR = 6.06, 95% CI = 1.31–28.07, p = 0.01). IFNγ AA lo on the other hand in combination with IL10 GG lo increased the risk of PAD (OR = 5.26; p = 0.005) and DTB (OR = 3.59; p = 0.045). Conclusion These findings are consistent with the role of IL10 in reducing collateral tissue damage and the protective role of IFNγ in limiting disease in the lung. PMID:19274101

  15. Evaluation of Patient Satisfaction with Tuberculosis Services in Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Ugochukwu U. Onyeonoro

    2015-01-01

    Full Text Available Objective Knowing tuberculosis (TB patients’ satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients’ satisfaction with TB services in southern Nigeria. Materials and Methods A total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38 questionnaire on various aspects of TB services. Factor analysis was used to identify eight factors related to TB patient satisfaction. Test of association was used to study the relation between patient satisfaction scores and patient and health facility characteristics, while multilinear regression analysis was used to identify predictors of patient satisfaction. Results Highest satisfaction was reported for adherence counseling and access to care. Patient characteristics were associated with overall satisfaction, registration, adherence counseling, access to care, amenities, and staff attitude, while health system factors were associated with staff attitude, amenities, and health education. Predictors of satisfaction with TB services included gender, educational status, if tested for HIV, distance, payment for TB services, and level and type of health-care facility. Conclusion Patient- and health system–related factors were found to influence patient satisfaction and, hence, should be taken into consideration in TB service programing.

  16. Evaluation of Patient Satisfaction with Tuberculosis Services in Southern Nigeria

    Science.gov (United States)

    Onyeonoro, Ugochukwu U; Chukwu, Joseph N; Nwafor, Charles C; Meka, Anthony O; Omotowo, Babatunde I; Madichie, Nelson O; Ogbudebe, Chidubem; Ikebudu, Joy N; Oshi, Daniel C; Ekeke, Ngozi; Paul, Nsirimobu I; Duru, Chukwuma B

    2015-01-01

    OBJECTIVE Knowing tuberculosis (TB) patients’ satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients’ satisfaction with TB services in southern Nigeria. MATERIALS AND METHODS A total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38) questionnaire on various aspects of TB services. Factor analysis was used to identify eight factors related to TB patient satisfaction. Test of association was used to study the relation between patient satisfaction scores and patient and health facility characteristics, while multilinear regression analysis was used to identify predictors of patient satisfaction. RESULTS Highest satisfaction was reported for adherence counseling and access to care. Patient characteristics were associated with overall satisfaction, registration, adherence counseling, access to care, amenities, and staff attitude, while health system factors were associated with staff attitude, amenities, and health education. Predictors of satisfaction with TB services included gender, educational status, if tested for HIV, distance, payment for TB services, and level and type of health-care facility. CONCLUSION Patient- and health system–related factors were found to influence patient satisfaction and, hence, should be taken into consideration in TB service programing. PMID:26508872

  17. Altered protein and iron levels of patients with active tuberculosis in ...

    African Journals Online (AJOL)

    Backgound: Tuberculosis as a state of chronic inflammation impacts on haematologic functions of the body. Objectives: This study aimed at assessing iron parameters and serum protein levels of ninety tuberculosis patients aged fifteen to sixty years, enrolled from Dr Lawrence Henshaw Memorial Hospital, Calabar, Nigeria.

  18. A household survey on screening practices of household contacts of smear positive tuberculosis patients in Vietnam

    NARCIS (Netherlands)

    Thanh, Thuy Hoang Thi; Ngoc, Sy Dinh; Viet, Nhung Nguyen; van, Hung Nguyen; Horby, Peter; Cobelens, Frank G. J.; Wertheim, Heiman F. L.

    2014-01-01

    Close contacts of tuberculosis (TB) patients are at increased risk of developing tuberculosis. Although passive contact screening guidelines are incorporated in the national TB control program, currently it is unknown how frequent close contacts are screened for TB in Vietnam. This study assesses

  19. Serum Concentrations of Trace Elements in Patients with Tuberculosis and Its Association with Treatment Outcome

    Directory of Open Access Journals (Sweden)

    Rihwa Choi

    2015-07-01

    Full Text Available Deficiencies in essential trace elements are associated with impaired immunity in tuberculosis infection. However, the trace element concentrations in the serum of Korean patients with tuberculosis have not yet been investigated. This study aimed to compare the serum trace element concentrations of Korean adult patients with tuberculosis with noninfected controls and to assess the impact of serum trace element concentration on clinical outcome after antituberculosis treatment. The serum concentrations of four trace elements in 141 consecutively recruited patients with tuberculosis and 79 controls were analyzed by inductively coupled plasma-mass spectrometry. Demographic characteristics were also analyzed. Serum cobalt and copper concentrations were significantly higher in patients with tuberculosis compared with controls, while zinc and selenium concentrations were significantly lower (p < 0.01. Moreover, serum selenium and zinc concentrations were positively correlated (ρ = 0.41, p < 0.05. A high serum copper concentration was associated with a worse clinical outcome, as assessed after one month of antituberculosis therapy. Specifically, culture-positive patients had higher serum copper concentrations than culture-negative patients (p < 0.05. Patients with tuberculosis had altered serum trace element concentrations. Further research is needed to elucidate the roles of individual trace elements and to determine their clinical impact on patients with tuberculosis.

  20. T-cell recognition of Mycobacterium tuberculosis culture filtrate fractions in tuberculosis patients and their household contacts

    DEFF Research Database (Denmark)

    Demissie, A; Ravn, P; Olobo, J

    1999-01-01

    We examined the immune responses of patients with active pulmonary tuberculosis (TB) and their healthy household contacts to short-term culture filtrate (ST-CF) of Mycobacterium tuberculosis or molecular mass fractions derived from it. Our goal was to identify fractions strongly recognized...... to the antigens between the two groups was also found. In general, while all fractions stimulated immune responses, the highest activity was seen with the low-molecular-mass fractions, which include well-defined TB antigens such as ESAT-6. Leukocytes from contacts of TB patients with severe disease produced...... higher levels of antigen-specific IFN-gamma than those from contacts of patients with minimal disease. Both groups of contacts exhibited higher cell-mediated responses than the patients themselves. The enhanced immune response of healthy contacts, especially those of patients with severe disease...

  1. Clinical characteristics differentiating bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia.

    Science.gov (United States)

    Toyota, M; Yasuda, N; Koda, S; Ohara, H; Enkhbat, S; Tsogt, G

    1998-06-01

    The objective of this study is to clarify clinical characteristics which differentiate bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia. The subjects include 338 patients aged 16 years and older who had undergone bacteriological examinations. Of them, 107 patients (31.7%) were confirmed bacteriologically. The proportion of bacteriological positive results increased significantly among patients who had cavities in the roentgenographic examination, cough at diagnosis and the family history of tuberculosis. Addressing these clinical characteristics will contribute to raising not only the sensitivity of the sputum examination, but also the specificity of the roentgenographic examination in the diagnostic process of tuberculosis.

  2. Frequency of Mycobacterium Tuberculosis Infection among Iranian Patients with HIV/AIDS by PPD Test

    Directory of Open Access Journals (Sweden)

    Fatemeh Fattahi

    2010-02-01

    Full Text Available Persons infected with the Human Immunodeficiency Virus (HIV are particularly susceptible to tuberculosis, either by latent infection reactivation or by a primary infection with rapid progression to active disease. This study was done to determine the frequency of tuberculosis infection among Iranian patients with HIV/AIDS. A total of 262 HIV/AIDS patients attending all three HIV/AIDS health care centers of Tehran, Iran were enrolled in this study. A detailed history and physical examination were obtained from all HIV patients suspected of having pulmonary M. tuberculosis. A positive PPD skin test was used as a diagnostic parameter for probability of TB infection. Out of 262 HIV/AIDS patients, a total of 63 (24% were shown to have the tuberculosis infection based on a positive PPD skin test. Of the patients with positive PPD skin test, 22 (35% had pulmonary Tuberculosis, 2 (3.2% had extrapulmonary tuberculosis, and 39 (53% had no evidence of M. tuberculosis infection (latent infection. Also 8 (12.7% had history of long term residence in a foreign country, 32 (50.8% were exposed to an index case, and 9 (14.3% had past history of pulmonary tuberculosis, while only 33.3% had clinical manifestations of TB (active disease. There was no resistant case of tuberculosis. Our study showed that near 24% of Iranian patients with HIV/AIDS were infected with M. tuberculosis. This finding denotes the need to improve the diagnostic and preventive measures, and also prompt treatment of this type of infection in the HIV infected individuals.

  3. Application of Pulsed Field Gel Electrophoresis for Study of Genetic Diversity in Mycobacterium tuberculosis Strains Isolated From Tuberculosis Patients.

    Science.gov (United States)

    Khosravi, Azar Dokht; Vatani, Shideh; Feizabadi, Mohammad Mehdi; Abasi Montazeri, Effat; Jolodar, Abbas

    2014-05-01

    Mycobacterium tuberculosis genotyping can effectively improve tuberculosis (TB) control programs by controlling disease transmission. Pulsed field gel electrophoresis (PFGE) is a particularly powerful tool for determination of clonal identity of bacteria providing information for understanding and controlling the spread of disease. The aim of present study was to investigate the genetic diversity of M. tuberculosis strains in Khuzestan province by the PFGE technique. In total, 80 M. tuberculosis positive cultures were obtained from tuberculosis patients. PFGE was performed on 60 PCR-confirmed isolates by using DraI and XbaI restriction enzymes according to standard protocols. Plugs containing digested DNA were then loaded on agarose gels and run using contour-clamped homogenous electric fields. Fifty distinct DNA banding patterns were obtained by digestion of DNA with DraI and 38 DNA banding patterns by digestion with XbaI restriction enzymes. The patterns comprised of 17 different clusters in which cluster I was the major one, containing six strains. Three clusters contained three strains each and the 13 remaining clusters comprised of two strains each. Digestion with DraI yielded 15-20 DNA fragments with 50-485 kb size, while digestion by XbaI produced DNA fragments with a size smaller than 50-242 kb. Despite the ability of PFGE for study of genetic diversity of many mycobacterial species and it being considered as a robust and useful tool, in this study we only found a 15% epidemiological relationship amongst the isolates. Thus, for higher discrimination of genotypic clusters among M. tuberculosis clinical isolates, the application of more sophisticated complementary techniques is required.

  4. 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.

  5. Tuberculosis case finding in first-degree relative contacts not living with index tuberculosis cases in Kampala, Uganda

    OpenAIRE

    Chheng P; Nsereko M; Malone LL; Okware B; Zalwango S; Joloba M; Boom WH; Mupere E; Stein CM

    2015-01-01

    Phalkun Chheng,1,2 Mary Nsereko,2 LaShaunda L Malone,2 Brenda Okware,2 Sarah Zalwango,2 Moses Joloba,2,3 W Henry Boom,2 Ezekiel Mupere,1,2,4 Catherine M Stein1,2 On behalf of the Tuberculosis Research Unit 1Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA; 2Uganda-Case Western Reserve University Research Collaboration, 3Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda; 4Department of Pediatric...

  6. [Ivory Coast physician's knowledge and attitudes about smoking in patients with tuberculosis].

    Science.gov (United States)

    Daix, A T J; Bakayoko-Yéo, A S; Koné, Z; Samaké, K; Coulibaly, G; Touhon, O A; Domoua, K M S

    2015-05-01

    Smoking promotes, among other health problems, the development of tuberculosis and the discovery of a case of tuberculosis can therefore be an opportunity for tobacco control interventions. We conducted a prospective study evaluating the knowledge of 37 Ivorian physicians (32 men and 5 women with 5 active smokers) on the relationship between smoking and tuberculosis and their attitudes to smoking tuberculous patients between February and August 2012 using an anonymous self-administered questionnaire. The response rate to the questionnaire was 88.1%. Among them, 70.3% of Ivorian physicians knew that smoking increased the incidence of tuberculosis, 75.7% said that forms of tuberculosis were more severe in smokers and about 27% thought that the cure rate of tuberculosis was lower in smokers. No significant difference was observed according to respondents' smoking status, or gender. Patients' smoking status was always assessed by 64.9% of physicians and by 78.4% in patients with tuberculosis, again not differing by physicians' smoking status or gender. The risks of smoking were always explained to patients with active pulmonary tuberculosis by 43.2% and benefits of stopping smoking ware always described in 35.1%. An intervention for smoking cessation was systematically offered to smokers having tuberculosis by 59.4% of physicians and 8.1% offered medication for smoking cessation. These results strongly support the need to reinforce physician behaviors to address smoking in patients with tuberculosis in Ivory Coast. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  7. Mycothiol acetyltransferase (Rv0819) of Mycobacterium tuberculosis is a potential biomarker for direct diagnosis of tuberculosis using patient serum specimens.

    Science.gov (United States)

    Zeitoun, H; Bahey-El-Din, M; Kassem, M A; Aboushleib, H M

    2017-12-01

    Mycobacterium tuberculosis infection constitutes a global threat that results in significant morbidity and mortality worldwide. Efficient and early diagnosis of tuberculosis (TB) is of paramount importance for successful treatment. The aim of the current study is to investigate the mycobacterial mycothiol acetyltransferase Rv0819 as a potential novel biomarker for the diagnosis of active TB infection. The gene encoding Rv0819 was cloned and successfully expressed in Escherichia coli. The recombinant Rv0819 was purified using metal affinity chromatography and was used to raise murine polyclonal antibodies against Rv0819. The raised antibodies were employed for direct detection of Rv0819 in patient serum samples using dot blot assay and competitive enzyme-linked immunosorbent assay (ELISA). Serum samples were obtained from 68 confirmed new TB patients and 35 healthy volunteers as negative controls. The dot blot assay showed sensitivity of 64·7% and specificity of 100%, whereas the competitive ELISA assay showed lower sensitivity (54·4%) and specificity (88·57%). The overall sensitivity of the combined results of the two tests was found to be 89·7%. Overall, the mycobacterial Rv0819 is a potential TB serum biomarker that can be exploited, in combination with other TB biomarkers, for efficient and reliable diagnosis of active TB infection. The early and accurate diagnosis of tuberculosis infection is of paramount importance for initiating treatment and avoiding clinical complications. Most current diagnostic tests have poor sensitivity and/or specificity and in many cases they are too expensive for routine diagnostic testing in resource-limited settings. In the current study, we examined a novel mycobacterial serum biomarker, namely mycothiol acetyltransferase Rv0819. The antigen was detectable in serum specimens of a significant number of tuberculosis patients. This article proves the importance of Rv0819 and paves the way towards its future use as a useful

  8. Imaging of tuberculosis. Pt. 2. Abdominal manifestations in 112 patients

    Energy Technology Data Exchange (ETDEWEB)

    Lundstedt, C. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Nyman, R. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Brismar, J. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Hugosson, C. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia); Kagevi, I. [Dept. of Diagnostic Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1996-07-01

    Purpose: To describe the radiological findings of tuberculosis (TB) of the abdomen as reflected at our hospital. Material and Methods: The radiological files of 503 patients (referred to our institution mainly because of a clinical suspicion of malignancy, and found to have culture- or biopsy-proven TB) were reviewed in order to analyze the spectrum of the TB manifestations in this group of patients. Results: Abdominal manifestations were found in 112 patients, in 1/3 abdominal disease was the only evidence of TB. More than half of the patients also had chest TB. The most common abdominal TB manifestations were peritonitis and lymph node enlargement, each occurring in about 1/3 of the patients. Also 1/3 had genitourinary TB manifestations. About 1/5 had TB of the liver, spleen or pancreas or in the gastrointestinal tract, respectively. Multiple organ involvement was common. Conclusion: The need to consider TB in the differential diagnosis in patients with obscure abdominal symptoms, especially with multiple organ involvement, is stressed. (orig.).

  9. Imaging of tuberculosis. Pt. 2. Abdominal manifestations in 112 patients

    International Nuclear Information System (INIS)

    Lundstedt, C.; Nyman, R.; Brismar, J.; Hugosson, C.; Kagevi, I.

    1996-01-01

    Purpose: To describe the radiological findings of tuberculosis (TB) of the abdomen as reflected at our hospital. Material and Methods: The radiological files of 503 patients (referred to our institution mainly because of a clinical suspicion of malignancy, and found to have culture- or biopsy-proven TB) were reviewed in order to analyze the spectrum of the TB manifestations in this group of patients. Results: Abdominal manifestations were found in 112 patients, in 1/3 abdominal disease was the only evidence of TB. More than half of the patients also had chest TB. The most common abdominal TB manifestations were peritonitis and lymph node enlargement, each occurring in about 1/3 of the patients. Also 1/3 had genitourinary TB manifestations. About 1/5 had TB of the liver, spleen or pancreas or in the gastrointestinal tract, respectively. Multiple organ involvement was common. Conclusion: The need to consider TB in the differential diagnosis in patients with obscure abdominal symptoms, especially with multiple organ involvement, is stressed. (orig.)

  10. Addressing tuberculosis patients' medical and socio-economic needs: a comprehensive programmatic approach.

    Science.gov (United States)

    Contreras, Carmen C; Millones, Ana K; Santa Cruz, Janeth; Aguilar, Margot; Clendenes, Martin; Toranzo, Miguel; Llaro, Karim; Lecca, Leonid; Becerra, Mercedes C; Yuen, Courtney M

    2017-04-01

    For a cohort of patients with tuberculosis in Carabayllo, Peru, we describe the prevalence of medical comorbidities and socio-economic needs, the efforts required by a comprehensive support programme ('TB Cero') to address them and the success of this programme in linking patients to care. Patients diagnosed with tuberculosis in Carabayllo underwent evaluations for HIV, diabetes, mental health and unmet basic needs. For patients initiating treatment during 14 September, 2015-15 May, 2016, we abstracted data from evaluation forms and a support request system. We calculated the prevalence of medical comorbidities and the need for socio-economic support at the time of tuberculosis diagnosis, as well as the proportion of patients successfully linked to care or support. Of 192 patients, 83 (43%) had at least one medical comorbidity other than tuberculosis. These included eight (4%) patients with HIV, 12 (6%) with diabetes and 62 (32%) deemed at risk for a mental health condition. Of patients who required follow-up for a comorbidity, 100% initiated antiretroviral therapy, 71% attended endocrinology consultations and 66% attended psychology consultations. Of 126 (65%) patients who completed the socio-economic evaluation, 58 (46%) reported already receiving food baskets from the municipality, and 79 (63%) were given additional support, most commonly food vouchers and assistance in accessing health care. Carabayllo tuberculosis patients face many challenges in addition to tuberculosis. A collaborative, comprehensive treatment support programme can achieve high rates of linkage to care for these needs. © 2017 John Wiley & Sons Ltd.

  11. [Excess mortality due to tuberculosis and factors associated to death in and annual cohort of patients diagnosed of tuberculosis].

    Science.gov (United States)

    Pina, J M; Domínguez, A; Alcaide, J; Alvarez, J; Camps, N; Díez, M; Godoy, P; Jansá, J M; Minquell, S; Arias, C

    2006-12-01

    To calculate excess mortality in an annual cohort of tuberculosis patients and study the factors associated with death. Cases of tuberculosis reported in Catalonia (May 1996-April 1997). Patients were classified as completed treatment/cured (compliant), non-compliant, failures, transfers out and deaths. Excess mortality was defined as the ratio actual deaths/expected deaths (according to general mortality figures for Catalonia, May 1996-April 1997). Factors associated with death were determined by a comparative study of variables (demographic, substance abuse, comorbidity, tuberculosis-related disease) in deaths after diagnosis and survivors. Time from diagnosis to death was recorded. Patients included: 2,085. Patients classified as: completed treatment/cured (compliant), 1,406 (67.43 %); noncompliant, 165 (7, 91%); failures, 5 (0.24%); transfers out, 25 (1.21%); deaths, 133 (6.38%), 28 of which occurred before diagnosis and 105 after diagnosis. Insufficient data in medical record for classification, 351 (16.83%) patients. Excess mortality: 5.98 (95% CI: 4.96-7.0). Factors associated with death: treatment with non-standardized guidelines, 46%; OR: 10.3 (6.2-17.4); HIV infection, 40%; OR: 13.0 (6.6-25.8); age greater than 64 years, 40%; OR: 14.6 (3.0-69.8); alcoholism, 25%; OR: 2.0 (1.1-3.6); neoplasm, 16%; OR: 3.9 (1.8-8.6; renal failure, 8%; OR: 10.1 (3.1-32.3). The shortest time from diagnosis to death was in patients with only one risk factor, except for HIV infection, where the time passed was the longest observed. We found substantial excess mortality in tuberculosis patients. Death was associated with the efficacy of treatment, HIV coinfection, advanced age, alcoholism and the coexistence of neoplasms or renal failure.

  12. Coronary to Bronchial Artery Fistula Causing Massive Hemoptysis in Patients with Longstanding Pulmonary Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ji Young; Jeon, Eui Yong; Lee, In Jae; Koh, Sung Hye [Hallym University College of Medicine, Anyang (Korea, Republic of)

    2012-01-15

    We report on three cases of longstanding pulmonary tuberculosis patients with coronary to bronchial artery fistula (CBF) who presented with recurrent massive hemoptysis. The first and second patients died because of decreased functional pulmonary volume plus massive hemoptysis and cannulation failure of CBF due to hypovolemic vasospasm, respectively. When recurrent hemoptysis occurs despite successful embolization treatment, CBF should be considered as a potential bleeding source. Moreover, a coronary angiography should be performed, especially in patients with longstanding cardiopulmonary disease such as pulmonary tuberculosis.

  13. 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.

  14. T-cell recognition of Mycobacterium tuberculosis culture filtrate fractions in tuberculosis patients and their household contacts

    DEFF Research Database (Denmark)

    Demissie, A; Ravn, P; Olobo, J

    1999-01-01

    We examined the immune responses of patients with active pulmonary tuberculosis (TB) and their healthy household contacts to short-term culture filtrate (ST-CF) of Mycobacterium tuberculosis or molecular mass fractions derived from it. Our goal was to identify fractions strongly recognized...... antigens and immune responses were determined. Household contacts produced significantly higher levels of gamma interferon (IFN-gamma) than the TB patients in response to antigens present in ST-CF and the 10 narrow-molecular-mass fractions. A similar difference in leukocyte proliferative responses...... to the antigens between the two groups was also found. In general, while all fractions stimulated immune responses, the highest activity was seen with the low-molecular-mass fractions, which include well-defined TB antigens such as ESAT-6. Leukocytes from contacts of TB patients with severe disease produced...

  15. Imaging of tuberculosis. Pt. 4. Spinal manifestations in 63 patients

    International Nuclear Information System (INIS)

    Lindahl, S.; Nyman, R.S.; Brismar, J.; Hugosson, C.; Lundstedt, C.

    1996-01-01

    Purpose: To describe the radiologic findings in patients with spinal tuberculosis (TB). Material and Methods: Out of a total of 503 patients with TB, 63 (13%) had involvement of the spine. Results: In 40 patients, the spine was the only location; 20 patients had concomitant chest TB. Conventional radiographs gave a good overview, CT visualized the diskovetebral lesions and the paravertebral abscesses, while MR imaging was useful to determine the spread of disease to the soft tissues and the spinal canal. The typical findings were destroyed vertebrae with associated paraspinal soft-tissue mass, with or without abscess formation, sometimes also involving the epidural space together with adjoining disk lesion and focal gibbus formation. Involvement of a single vertebra was a relatively common finding. Large psoas abscesses could occur without any signs of bone involvement. The TB process could sometimes be indistinguishable from malignant processes, and in 3 patients, with multiple lesions in the spine, it mimicked metastatic disease. Conclusion: It is stressed that TB should always be considered in the differential diagnosis when radiologic findings suggest spinal infections or primary or secondary spinal tumors. (orig.)

  16. The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India

    Directory of Open Access Journals (Sweden)

    Jonnalagada Subbanna

    2011-12-01

    Full Text Available Abstract Background India has 2.0 million estimated tuberculosis (TB cases per annum with an estimated 280,000 TB-related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India:- i treatment outcomes including the number who died while on treatment, ii the month of death and iii characteristics associated with "early" death, occurring in the initial 8 weeks of treatment. Methods This was a retrospective study in 16 selected Designated Microscopy Centres (DMCs in Hyderabad, Krishna and Adilabad districts of Andhra Pradesh, South India. A review was performed of treatment cards and medical records of all TB patients (adults and children registered and placed on standardized anti-tuberculosis treatment from January 2005 to September 2009. Results There were 8,240 TB patients (5183 males of whom 492 (6% were known to have died during treatment. Case-fatality was higher in those previously treated (12% and lower in those with extra-pulmonary TB (2%. There was an even distribution of deaths during anti-tuberculosis treatment, with 28% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with "early death". Conclusion In this large cohort of TB patients, deaths occurred with an even frequency throughout anti-TB treatment. Reasons may relate to i the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii co-morbidities, such as HIV/AIDS and diabetes mellitus, which are known to influence mortality. More research in this area from prospective and retrospective studies is needed.

  17. Plasma vitamins and essential trace elements in newly diagnosed pulmonary tuberculosis patients and at different durations of anti-tuberculosis chemotherapy

    Directory of Open Access Journals (Sweden)

    V.F. Edem

    2015-07-01

    This study concluded that there is micronutrient (Fe, Zn, Cu, Vit A, C, D and E malnutrition in tuberculosis patients at diagnosis and throughout the duration (6 months of chemotherapy. Supplementation with vitamins and zinc is advised within the first 4 months of commencing anti-tuberculosis chemotherapy.

  18. Psychiatric morbidity in patients of pulmonary tuberculosis-an observational study

    Directory of Open Access Journals (Sweden)

    Lalit Singh

    2015-01-01

    Full Text Available Background: A lot of stigma and misconceptions about pulmonary tuberculosis still persist, in spite of the advances in treatment. Thus, a mere diagnosis of pulmonary tuberculosis can be a psychological trauma to an individual. The situation has aggravated with the association of tuberculosis with HIV infection. Aim: To study the psychiatric morbidity due to the various psychological stresses faced by a patient of pulmonary tuberculosis. Materials and Methods: The study group consisted of 100 inpatients admitted to pulmonary ward with diagnosis of pulmonary tuberculosis. The control group consisted of 100 inpatients admitted to pulmonary ward with nontuberculous pulmonary diseases. Psychiatric history and mental status were recorded on a specially designed proforma and diagnosis of any psychiatric illness, if present, arrived at as per International Classification of Diseases (ICD-10. The psychiatric tests applied were beck's depression inventory (BDI and Taylor's Manifest Anxiety Scale (TMAS. Results: Of the patients of pulmonary tuberculosis, 24% could be given a diagnostic category, as per ICD-10, as compared to only 8% of the controls (P < 0.005. On BDI, 44% of patients of pulmonary tuberculosis showed depression as compared to 27% of the controls (P < 0.02. On TMAS, 38% of patients of pulmonary tuberculosis showed anxiety as compared to 24% of controls (P < 0.05. A greater incidence of depression (on BDI and anxiety (on TMAS was seen in those with longer duration of illness (P < 0.02 and in those with greater severity of illness (P < 0.02. Conclusion: In view of the high psychiatric morbidity associated with pulmonary tuberculosis, there is enough scope for psychiatric services to be made available to these patients. In addition, personnel involved in the treatment of these patients should be trained for early detection of psychiatric symptoms.

  19. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

    OpenAIRE

    Tegegne, Yalewayker; Wondmagegn, Tadelo; Worku, Ligabaw; Jejaw Zeleke, Ayalew

    2018-01-01

    Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study wa...

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

    Science.gov (United States)

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

    2004-01-01

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

  1. TUBERCULOSIS INFECTION MIGHT INCREASE THE RISK OF INVASIVE CANDIDIASIS IN AN IMMUNOCOMPETENT PATIENT

    Directory of Open Access Journals (Sweden)

    Xiao-Hua CHEN

    2015-06-01

    Full Text Available Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicans and spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient.

  2. Quality of life and health behaviours of patients with tuberculosis - sex differences.

    Science.gov (United States)

    Jankowska-Polanska, Beata Katarzyna; Kamińska, Małgorzata; Uchmanowicz, Izabella; Rycombel, Anna

    2015-01-01

    Despite the introduction of effective antituberculosis drugs, tuberculosis (TB) is still a serious health problem and one of the most significant causes of death among infectious diseases. Current publications indicate an increase of tuberculosis cases among smokers, diabetics, malnurished subjects and those abusing alcohol and drugs. In the literature, there are only few studies raising the topic of the quality of life (QoL), stress management and health behaviour among patients with tuberculosis. The aim of this study was to evaluate QoL of patients with tuberculosis taking into account gender differences. In the study, the analysis of knowledge, health behaviour and stress management among TB patients depending on sex was carried out. The study included 80 subjects diagnosed with TB (including 38 females) who were hospitalised at the Regional Hospital Centre of Kotlina Jeleniogórska, Medical Unit Wysoka Łąka, Pulmonology and Phthisiology Department in Kowary between August 2012 and January 2013. The following questionnaires were used in the study: Mini-COPE - evaluating stress management, WHOQoL - assessing the quality of life of patients, IZZ - assessing health behaviour. A difference with regards to sociodemographic profile between females and males was observed. Half of the women surveyed were working (50% vs 19% of men), whereas half of men were entitled to unemployment benefit (50% vs 18.4% of women). More than half of women lived with their family (55.3%), whereas 47.6% of men lived alone. The majority of the subjects consumed alcohol occasionally (60.2% of women vs 45.2% of men), but as many as 31% of male patients vs 7.9% of females admitted that they consumed alcohol frequently. Among the respondents, people who consumed alcohol occasionally dominated (60.2% women vs. 45.2% of men), but as many as 31% of male patients vs. 7.9% of women admitted to consume alcohol frequently. Quality of life (QoL) assessment has shown no statistically significant

  3. Risk factors for pulmonary cavitation in tuberculosis patients from China.

    Science.gov (United States)

    Zhang, Liqun; Pang, Yu; Yu, Xia; Wang, Yufeng; Lu, Jie; Gao, Mengqiu; Huang, Hairong; Zhao, Yanlin

    2016-10-12

    Pulmonary cavitation is one of the most frequently observed clinical characteristics in tuberculosis (TB). The objective of this study was to investigate the potential risk factors associated with cavitary TB in China. A total of 385 smear-positive patients were enrolled in the study, including 192 (49.9%) patients with cavitation as determined by radiographic findings. Statistical analysis revealed that the distribution of patients with diabetes in the cavitary group was significantly higher than that in the non-cavitary group (adjusted odds ratio (OR) (95% confidence interval (CI)):12.08 (5.75-25.35), Ptuberculosis strains, 330 strains (85.7%) were classified as the Beijing genotype, which included 260 strains that belonged to the modern Beijing sublineage and 70 to the ancient Beijing sublineage. In addition, there were 80 and 31 strains belonging to large and small clusters, respectively. Statistical analysis revealed that cavitary disease was observed more frequently among the large clusters than the small clusters (P=0.037). In conclusion, our findings demonstrate that diabetes and multidrug resistance are risk factors associated with cavitary TB. In addition, there was no significant difference in the cavitary presentation between patients infected with the Beijing genotype strains and those infected with the non-Beijing genotype strains.

  4. Pattern of pulmonary tuberculosis in elderly patients in Sohag Governorate: Hospital based study

    Directory of Open Access Journals (Sweden)

    Mona T. Hussein

    2013-04-01

    Conclusion: This study showed that elderly pulmonary TB patients had higher frequencies of atypically clinical, radiological presentations, co-morbidities, anti-tuberculosis drug adverse reactions and TB related mortality.

  5. Relations in the family of patients with infiltrative pulmonary tuberculosis and recommendations for therapeutic interaction

    Directory of Open Access Journals (Sweden)

    E. V. Sukhova

    2015-01-01

    Full Text Available A family is a social group that satisfies the most important needs and fulfils diverse functions. Patients with infiltrative pulmonary tuberculosis are not emotionally supported by their family members and hence experience anger and exasperation. The functioning of 30 families of patients with infiltrative pulmonary tuberculosis was psychologically studied using the family environment scale. The findings were compared with those of 100 standard families. Six out of 10 items showed significant differences, the other 4 items also displayed dissimilarities, but the latter were insignificant. The families of patients with pulmonary tuberculosis were dysfunctional. The social climate of the family had established well before infiltrative tuberculosis was diagnosed in its member. The dissimilarities from the standard families are due to the social characteristics of family members, such as low income, alcohol abuse, and imprisonment. The specific features of the social climate of a family provide an explanation for no moral support to the patient.

  6. Multi-drug-resistant tuberculosis in HIV positive patients in Eastern Europe

    DEFF Research Database (Denmark)

    Post, Frank A; Grint, Daniel; Efsen, Anne Marie Werlinrud

    2014-01-01

    Observational data from Eastern Europe on the management and outcome of multi-drug-resistant tuberculosis (MDR TB) in HIV positive populations remain sparse in the English-language literature.We compared clinical characteristics and outcomes of 55 patients who were diagnosed with HIV and MDR TB...... in Eastern Europe between 2004 and 2006 to 89 patients whose Mycobacterium tuberculosis isolates were susceptible to isoniazid and rifampicin.Patients with HIV and MDR TB were young and predominantly male with high rates of intravenous drug use, imprisonment and hepatitis C co-infection. Eighty-four per cent...... of patients with MDR TB had no history of previous TB drug exposure suggesting that the majority of MDR TB resulted from transmission of drug-resistant M. tuberculosis. The use of non-standardized tuberculosis treatment was common, and the use of antiretroviral therapy infrequent. Compared to those...

  7. The nutritional status of patients with tuberculosis in comparison with ...

    African Journals Online (AJOL)

    2011-11-21

    Nov 21, 2011 ... rate of 808 per 100 000.2 In 2008, 50 000 new tuberculosis cases ... and matched according to age, gender and race to 43 tuberculosis-free contacts. ... Mid-upper-arm circumference (MUAC) was measured to the nearest.

  8. Neutrophil extracellular traps in patients with pulmonary tuberculosis

    NARCIS (Netherlands)

    van der Meer, Anne Jan; Zeerleder, Sacha; Blok, Dana C.; Kager, Liesbeth M.; Lede, Ivar O.; Rahman, Wahid; Afroz, Rumana; Ghose, Aniruddha; Visser, Caroline E.; Zahed, Abu Shahed Md; Husain, Md Anwar; Alam, Khan Mashrequl; Barua, Pravat Chandra; Hassan, Mahtabuddin; Tayab, Md Abu; Dondorp, Arjen M.; van der Poll, Tom

    2017-01-01

    Tuberculosis is a devastating infectious disease causing many deaths worldwide. Recent investigations have implicated neutrophil extracellular traps (NETs) in the host response to tuberculosis. The aim of the current study was to obtain evidence for NETs release in the circulation during human

  9. Multi-drug-resistant tuberculosis in HIV positive patients in Eastern Europe.

    Science.gov (United States)

    Post, Frank A; Grint, Daniel; Werlinrud, Anne Marie; Panteleev, Alexander; Riekstina, Vieja; Malashenkov, Evgeniy A; Skrahina, Alena; Duiculescu, Dan; Podlekareva, Daria; Karpov, Igor; Bondarenko, Vasiliy; Chentsova, Nelly; Lundgren, Jens; Mocroft, Amanda; Kirk, Ole; Miro, Jose M

    2014-03-01

    Observational data from Eastern Europe on the management and outcome of multi-drug-resistant tuberculosis (MDR TB) in HIV positive populations remain sparse in the English-language literature. We compared clinical characteristics and outcomes of 55 patients who were diagnosed with HIV and MDR TB in Eastern Europe between 2004 and 2006 to 89 patients whose Mycobacterium tuberculosis isolates were susceptible to isoniazid and rifampicin. Patients with HIV and MDR TB were young and predominantly male with high rates of intravenous drug use, imprisonment and hepatitis C co-infection. Eighty-four per cent of patients with MDR TB had no history of previous TB drug exposure suggesting that the majority of MDR TB resulted from transmission of drug-resistant M. tuberculosis. The use of non-standardized tuberculosis treatment was common, and the use of antiretroviral therapy infrequent. Compared to those with susceptible tuberculosis, patients with MDR TB were less likely to achieve cure or complete tuberculosis treatment (21.8% vs. 62.9%, p < 0.0001), and they were more likely to die (65.5% vs. 27.0%, p < 0.0001). Our study documents suboptimal management and poor outcomes in HIV positive patients with MDR TB. Implementation of WHO guidelines, rapid TB diagnostics and TB drug susceptibility testing for all patients remain a priority in this region. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  10. Pattern of Oral Lesions in Tuberculosis Patients: A Cross-sectional Study

    Directory of Open Access Journals (Sweden)

    S C Selvamuthukumar

    2011-01-01

    Conclusion: Apart from the oral lesions that occur in a normal nontuberculosis patient group (the regular lesions lesions peculiar to the tuberculosis group of patients were recorded. They comprised primarily of lip crusting lesions, ulcerations of buccal mucosa and palate. A soft tissue enlargement was found involving the tongue and the floor of the mouth and was diagnosed as ′primary oral tuberculosis.′ Drug eruptions on the lips due to rifampicin were noted.

  11. Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Daniel; Aabye, Martine Grosos; Jensen, Andreas Vestergaard

    2014-01-01

    in diabetes patients and therefore the validity of interferon gamma release assays (IGRA) may be compromised. The aim of the present study was to assess the association between diabetes and Mycobacterium tuberculosis (Mtb) antigen-specific interferon gamma (IFN-γ) release in a TB endemic area among culture......-confirmed TB patients and non-TB controls. Methods: Culture-confirmed pulmonary TB patients (n = 187) and healthy non-TB neighbourhood controls (n = 190) from Mwanza, Tanzania were tested for the presence of circulating T cells recognizing Mtb antigens using an IGRA. The diabetes status of all participants...

  12. Population Structure among Mycobacterium tuberculosis Isolates from Pulmonary Tuberculosis Patients in Colombia

    Science.gov (United States)

    Realpe, Teresa; Correa, Nidia; Rozo, Juan Carlos; Ferro, Beatriz Elena; Gomez, Verónica; Zapata, Elsa; Ribon, Wellman; Puerto, Gloria; Castro, Claudia; Nieto, Luisa María; Diaz, Maria Lilia; Rivera, Oriana; Couvin, David; Rastogi, Nalin; Arbelaez, Maria Patricia; Robledo, Jaime

    2014-01-01

    Background Phylogeographic composition of M. tuberculosis populations reveals associations between lineages and human populations that might have implications for the development of strategies to control the disease. In Latin America, lineage 4 or the Euro-American, is predominant with considerable variations among and within countries. In Colombia, although few studies from specific localities have revealed differences in M. tuberculosis populations, there are still areas of the country where this information is lacking, as is a comparison of Colombian isolates with those from the rest of the world. Principal Findings A total of 414 M. tuberculosis isolates from adult pulmonary tuberculosis cases from three Colombian states were studied. Isolates were genotyped using IS6110-restriction fragment length polymorphism (RFLP), spoligotyping, and 24-locus Mycobacterial interspersed repetitive units variable number tandem repeats (MIRU-VNTRs). SIT42 (LAM9) and SIT62 (H1) represented 53.3% of isolates, followed by 8.21% SIT50 (H3), 5.07% SIT53 (T1), and 3.14% SIT727 (H1). Composite spoligotyping and 24-locus MIRU- VNTR minimum spanning tree analysis suggest a recent expansion of SIT42 and SIT62 evolved originally from SIT53 (T1). The proportion of Haarlem sublineage (44.3%) was significantly higher than that in neighboring countries. Associations were found between M. tuberculosis MDR and SIT45 (H1), as well as HIV-positive serology with SIT727 (H1) and SIT53 (T1). Conclusions This study showed the population structure of M. tuberculosis in several regions from Colombia with a dominance of the LAM and Haarlem sublineages, particularly in two major urban settings (Medellín and Cali). Dominant spoligotypes were LAM9 (SIT 42) and Haarlem (SIT62). The proportion of the Haarlem sublineage was higher in Colombia compared to that in neighboring countries, suggesting particular conditions of co-evolution with the corresponding human population that favor the success of this

  13. Prognostic Factors in Tuberculosis Related Mortalities in Hospitalized Patients

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    Ghazal Haque

    2014-01-01

    Full Text Available Setting. The study was undertaken at the Department of Pulmonology at a public, tertiary care centre in Karachi, Pakistan. Objectives. To evaluate factors concerned with in-hospital deaths in patients admitted with pulmonary tuberculosis (TB. Design. A retrospective case-control audit was performed for 120 patients hospitalised with pulmonary TB. Sixty of those discharged after treatment were compared to sixty who did not survive. Radiological findings, clinical indicators, and laboratory values were compared between the two groups to identify factors related to poor prognosis. Results. Factors concerned with in-hospital mortality listed late presentation of disease (P<0.01, noncompliance to antituberculosis therapy (P<0.01, smoking (P<0.01, longer duration of illness prior to treatment (P<0.01, and low body weight (P<0.01. Most deaths occurred during the first week of admission (P<0.01 indicating late referrals as significant. Immunocompromised status and multi-drug resistance were not implicated in higher mortality. Conclusions. Poor prognosis was associated with noncompliance to therapy resulting in longer duration of illness, late patient referrals to care centres, and development of complications. Early diagnosis, timely referrals, and monitored compliance may help reduce mortality. Adherence to a more radically effective treatment regimen is required to eliminate TB early during disease onset.

  14. Using financial incentives to improve the care of tuberculosis patients.

    Science.gov (United States)

    Lee, Cheng-Yi; Chi, Mei-Ju; Yang, Shiang-Lin; Lo, Hsiu-Yun; Cheng, Shou-Hsia

    2015-01-01

    Tuberculosis (TB) is a serious public health concern, and Taiwan has implemented a pay-for-performance (P4P) program to incentivize healthcare professionals to provide comprehensive care to TB patients. This study aims to examine the effects of the TB P4P program on treatment outcomes and related expenses. A population-based natural experimental design with intervention and comparison groups. Propensity score matching was conducted to increase the comparability between the P4P and non-P4P group. A total of 12,018 subjects were included in the analysis, with 6009 cases in each group. Generalized linear models and multinomial logistic regression were employed to examine the effects of the P4P program. The regression models indicated that patients enrolled in the P4P program had 14% more ambulatory visits than non-P4P patients (P ratio, 1.56; P financial incentives to healthcare institutions could be a feasible model for better TB control.

  15. Can follow-up examination of tuberculosis patients be simplified? A study in Chhattisgarh, India.

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    Debashish Kundu

    Full Text Available BACKGROUND: Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely. OBJECTIVES: To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the Revised National Tuberculosis Control Programme (RNTCP in Chhattisgarh, India. METHODOLOGY: A record review of tuberculosis (TB patients registered in 2009 using a structured proforma from two sources, Tuberculosis and Laboratory Register, was undertaken in the six districts of Chhattisgarh, India. RESULTS: In smear positive cases, of 10,048 follow-up examinations, 45 (0.5% were found to be smear positive only on the second sputum when the result of the first sample was negative. In smear negative pulmonary and extra pulmonary TB patients, of 6,206 follow-up smear examinations, 11(0.2% were found to be smear positive. CONCLUSIONS: The incremental yield of a second smear examination was very low, indicating that examination of one sputum sample is enough during follow-up among TB patients. There is insufficient yield to support sputum smear microscopy for monitoring smear negative pulmonary TB and extra pulmonary TB patients. These results indicate that the follow-up smear microscopy can be substantially simplified with favourable resource implications.

  16. Effects of gender and age on development of concurrent extrapulmonary tuberculosis in patients with pulmonary tuberculosis: a population based study.

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    Lin, Chun-Yu; Chen, Tun-Chieh; Lu, Po-Liang; Lai, Chung-Chih; Yang, Yi-Hsin; Lin, Wei-Ru; Huang, Pei-Ming; Chen, Yen-Hsu

    2013-01-01

    Most cases of adult-onset tuberculosis (TB) result from reactivation of a pre-existing Mycobacterium tuberculosis infection. Mycobacterium tuberculosis usually invades the respiratory tract and most patients develop intrapulmonary TB; however, some patients develop concurrent pulmonary and extra-pulmonary TB. The purpose of the present study was to identify the demographic and clinical factors associated with an increased risk of concurrent extra-pulmonary diseases in patients with pulmonary TB. We compared patients who had isolated pulmonary TB with patients who had concurrent pulmonary and extra-pulmonary TB. We initially analyzed one-million randomly selected subjects from the population-based Taiwan National Health Insurance database. Based on analysis of 5414 pulmonary TB patients in this database, women were more likely than men to have concurrent extra-pulmonary TB (OR: 1.30, p = 0.013). A separate analysis of the Kaohsiung Medical University Hospital database, which relied on sputum culture-proven pulmonary TB, indicated that women were more likely than men to have concurrent extra-pulmonary TB (OR: 1.62, p = 0.039). There was no significant gender difference in extra-pulmonary TB for patients younger than 45 years in either database. However, for patients 45 years and older, women were more likely than men to have concurrent extra-pulmonary TB (insurance database: 9.0% vs. 6.8%, p = 0.016, OR: 1.36; hospital database: 27.3% vs. 16.0%, p = 0.008, OR = 1.98). Our results indicate that among patients who have pulmonary TB, older females have an increased risk for concurrent extra-pulmonary TB.

  17. Determinants of Default from Tuberculosis Treatment among Patients with Drug-Susceptible Tuberculosis in Karachi, Pakistan: A Mixed Methods Study.

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    Chida, Natasha; Ansari, Zara; Hussain, Hamidah; Jaswal, Maria; Symes, Stephen; Khan, Aamir J; Mohammed, Shama

    2015-01-01

    Non-adherence to tuberculosis therapy can lead to drug resistance, prolonged infectiousness, and death; therefore, understanding what causes treatment default is important. Pakistan has one of the highest burdens of tuberculosis in the world, yet there have been no qualitative studies in Pakistan that have specifically examined why default occurs. We conducted a mixed methods study at a tuberculosis clinic in Karachi to understand why patients with drug-susceptible tuberculosis default from treatment, and to identify factors associated with default. Patients attending this clinic pick up medications weekly and undergo family-supported directly observed therapy. In-depth interviews were administered to 21 patients who had defaulted. We also compared patients who defaulted with those who were cured, had completed, or had failed treatment in 2013. Qualitative analyses showed the most common reasons for default were the financial burden of treatment, and medication side effects and beliefs. The influence of finances on other causes of default was also prominent, as was concern about the effect of treatment on family members. In quantitative analysis, of 2120 patients, 301 (14.2%) defaulted. Univariate analysis found that male gender (OR: 1.34, 95% CI: 1.04-1.71), being 35-59 years of age (OR: 1.54, 95% CI: 1.14-2.08), or being 60 years of age or older (OR: 1.84, 95% CI: 1.17-2.88) were associated with default. After adjusting for gender, disease site, and patient category, being 35-59 years of age (aOR: 1.49, 95% CI: 1.10-2.03) or 60 years of age or older (aOR: 1.76, 95% CI: 1.12-2.77) were associated with default. In multivariate analysis age was the only variable associated with default. This lack of identifiable risk factors and our qualitative findings imply that default is complex and often due to extrinsic and medication-related factors. More tolerable medications, improved side effect management, and innovative cost-reduction measures are needed to reduce

  18. Determinants of Default from Tuberculosis Treatment among Patients with Drug-Susceptible Tuberculosis in Karachi, Pakistan: A Mixed Methods Study.

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    Natasha Chida

    Full Text Available Non-adherence to tuberculosis therapy can lead to drug resistance, prolonged infectiousness, and death; therefore, understanding what causes treatment default is important. Pakistan has one of the highest burdens of tuberculosis in the world, yet there have been no qualitative studies in Pakistan that have specifically examined why default occurs. We conducted a mixed methods study at a tuberculosis clinic in Karachi to understand why patients with drug-susceptible tuberculosis default from treatment, and to identify factors associated with default. Patients attending this clinic pick up medications weekly and undergo family-supported directly observed therapy.In-depth interviews were administered to 21 patients who had defaulted. We also compared patients who defaulted with those who were cured, had completed, or had failed treatment in 2013.Qualitative analyses showed the most common reasons for default were the financial burden of treatment, and medication side effects and beliefs. The influence of finances on other causes of default was also prominent, as was concern about the effect of treatment on family members. In quantitative analysis, of 2120 patients, 301 (14.2% defaulted. Univariate analysis found that male gender (OR: 1.34, 95% CI: 1.04-1.71, being 35-59 years of age (OR: 1.54, 95% CI: 1.14-2.08, or being 60 years of age or older (OR: 1.84, 95% CI: 1.17-2.88 were associated with default. After adjusting for gender, disease site, and patient category, being 35-59 years of age (aOR: 1.49, 95% CI: 1.10-2.03 or 60 years of age or older (aOR: 1.76, 95% CI: 1.12-2.77 were associated with default.In multivariate analysis age was the only variable associated with default. This lack of identifiable risk factors and our qualitative findings imply that default is complex and often due to extrinsic and medication-related factors. More tolerable medications, improved side effect management, and innovative cost-reduction measures are needed to

  19. Colorectal tuberculosis

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  20. Increasing Access to Tuberculosis Services in Ethiopia: Findings From a Patient-Pathway Analysis.

    Science.gov (United States)

    Fekadu, Lelisa; Hanson, Christy; Osberg, Mike; Makayova, Julia; Mingkwan, Pia; Chin, Daniel

    2017-11-06

    In Ethiopia, extensive scale-up of the availability of health extension workers (HEWs) at the community level has been credited with increased identification and referral of patients with presumptive tuberculosis, which has contributed to increased tuberculosis case notification and better treatment outcomes. However, nearly 30% of Ethiopia's estimated 191000 patients with tuberculosis remained unnotified in 2015. A better understanding of patient care-seeking practices may inform future government action to reach all patients with tuberculosis. A patient-pathway analysis was completed to assess the alignment between patient care initiation and the availability of diagnostic and treatment services at the national level. More than one third of patients initiated care with HEWs, who refer patients to health centers for diagnosis. An additional one third of patients initiated care at health centers. Of those health centers, >80% had microscopy services, but few had access to Xpert. Despite an extensive microscopy and radiography network at middle levels of the health system, a quarter of all notified patients with tuberculosis had no bacteriological confirmation of disease. While 30% of patients reported receiving some form of care from the private sector, private-sector facilities, especially pharmacies, were not widely accessed for tuberculosis diagnosis. The availability of HEWs can increase access to tuberculosis diagnostic and treatment support services, particularly for rural populations. Continued strengthening of referral systems from HEWs and health posts are needed to enable consistent and timely access to Xpert as an initial diagnostic test and to drug resistance screening. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  1. Manifestations of tuberculosis in HIV/AIDS patients and its relationship with CD4 count

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    Ajay Jaryal

    2011-01-01

    Full Text Available Background: HIV/AIDS pandemic is responsible for the resurgence of TB worldwide, resulting in increased morbidity and mortality. HIV and Mycobacterium tuberculosis have a synergistic interaction; each propagates progression of the other. Coinfection with HIV infection leads to difficulties in both the diagnosis and treatment of tuberculosis, increase risk of death, treatment failure and relapse. Objective: The aim of the present study is to study the clinical, radiological profile of pulmonary and extrapulmonary tuberculosis (EPTB in HIV-seropositive patients and their relationship to CD4 counts. Materials and Methods: It was a prospective study conducted over a period of 1 year in the department of medicine, Indira Gandhi Medical College, Shimla. We examined 87 HIV-infected patients with associated tuberculosis recruited from the department of medicine and antiretroviral center and were subjected to thorough clinical examination, X-ray chest, tuberculin testing and sputum examination for AFB and necessary relevant investigations for EPTB. Results: Most common affected age group was 31-40 years. EPTB is the commonest form of TB in our study detected in 65 patients. Commonest EPTB was CNS tuberculosis. Disseminated tuberculosis was only found in patient with CD4 count less than 200/cmm. Majority of lymph node TB was diagnosed by fine needle aspiration cytology (FNAC examination. All patients with AFB-positive lymph node had CD4 count below 200/cum. Conclusions: The results of this study provide information regarding the various forms of TB and their presentation in HIV-infected persons. Early diagnosis of tuberculosis and prompt institution of antitubercular treatment (ATT reduces mortality and morbidity significantly. In resource-poor areas, the diagnosis can be established with cytological/biochemical analysis of fluid, histopathological examination and ZN staining of tissue coupled with radiological features and response to ATT. Therefore

  2. HLA-class II alleles in patients with drug-resistant pulmonary tuberculosis in Kazakhstan.

    Science.gov (United States)

    Kuranov, A B; Kozhamkulov, U A; Vavilov, M N; Belova, E S; Bismilda, V L; Alenova, A H; Ismailov, S S; Momynaliev, K T

    2014-02-01

    The human leukocyte antigen (HLA) system has a major role in the regulation of the immune response as it is involved in the defense against pathogens. Some studies have reported that HLA class II genes play a strong role in severe cases of pulmonary tuberculosis (PTB) in several populations. Thus the aim of the study was to compare the HLA-class II alleles of patients with drug resistant tuberculosis with those of healthy controls from the same ethnic group in Kazakhstan. The aim of the present study was to evaluate the correlation of HLA-class II alleles by patients with drug resistant tuberculosis and the healthy controls of the same ethnic group in Kazakhstan. The HLA-class II alleles of 76 patients with tuberculosis (TB) and 157 healthy volunteers were investigated using sequence-based typing (SBT)-method. HLA-DQA1*03:02 HLA-DRB1*08:01 and DRB1*08:03 occurred more frequently (P = 0.05) in patients with drug resistant tuberculosis than in controls. We observed a possible association between certain HLA alleles and TB that are specific for the Kazakh population. Further studies are needed to confirm our findings using a larger number of patients with drug resistant tuberculosis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Rhodotorula mucilaginosa Fungemia and Pleural Tuberculosis in an Immunocompetent Patient: An Uncommon Association.

    Science.gov (United States)

    Pereira, Cláudia; Ribeiro, Sofia; Lopes, Virgínia; Mendonça, Teresa

    2016-02-01

    We report an atypical case of Rhodotorula mucilaginosa fungemia coexisting with pleural tuberculosis, in an immunocompetent host. The patient was an inhaled drug abuser and worked in a fruit market. The diagnosis of Rhodotorula mucilaginosa infection was established by the isolation of the yeast in two blood cultures followed by a good response to amphotericin B treatment. Persistent evening fever and pleural effusion led to the second diagnosis-pleural tuberculosis. In the last 5 years, this was the only case of Rhodotorula mucilaginosa fungemia in our hospital and the first case in the literature that documents Rhodotorula mucilaginosa fungemia associated with pleural tuberculosis.

  4. [Pulmonary function in patients with infiltrative pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), R(aw), R(in),, R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 103 patients with infiltrative pulmonary tuberculosis. Pulmonary dysfunction was detected in 83.5% of the patients. Changes were found in lung volumes and capacities in 63.1%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 60.2 and 41.7%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC and FVC, and decreased and increased TGV and TLC; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, FEV1/VC% and increased R(aw) R(in), and R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, and PaO2 and decreased and increased PaCO2. The magnitude of the observed functional changes was generally slight. Significant disorders were observed rarely and very pronounced ones were exceptional.

  5. [Pulmonary function in patients with disseminated pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Shergina, E A; Popova, L A

    2007-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25%, MEF50%, MEF75%, TLS, TGV, pulmonary residual volume (PRV), Raw, Rin, Rex, DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 29 patients with disseminated pulmonary tuberculosis. Pulmonary dysfunction was detected in 93.1% of the patients. Changes were found in lung volumes and capacities in 65.5%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 79.3 and 37.9%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC, FVC, and TLS, decreased and increased TGV; impaired bronchial patency presented as decreased PEF, MEF25%, MEF50%, MEF75%, and FEV1/VC% and increased Raw, Rin, and Rex; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SS and PaO2 and decreased and increased PaCO2. The observed functional changes varied from slight to significant and pronounced with a preponderance of small disorders, a lower detection rate of significant disorders, and rare detection of very pronounced ones.

  6. Molecular diversity of Mycobacterium tuberculosis isolates from patients with tuberculosis in Honduras

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    Ghebremichael Solomon

    2010-08-01

    Full Text Available Abstract Background Tuberculosis persists as a public health problem in Honduras. A better knowledge of the molecular characteristics of Mycobacterium tuberculosis strains will contribute to understand the transmission dynamics of the disease within the country. The aim of this study was to provide an insight of the genetic biodiversity of M. tuberculosis clinical isolates collected in Honduras between 1994 and 2002. Genotyping was performed using spoligotyping and RFLP. The spoligotypes obtained were compared with the SITVIT2 proprietary database of the Pasteur Institute of Guadeloupe. Results Spoligotyping grouped 84% of the isolates into 27 clusters (2 to 43 strains per cluster. Of the 44 shared international types (SITs identified among the Honduran stains, 8 SITs were newly identified either within the present study or after match with an orphan type previously identified in the SITVIT2 database. In addition, 16 patterns corresponded to orphan, previously unreported isolates. The Latin American Mediterranean (LAM lineage was the most common in this study; 55% of the strains belonged to this family. Other genotypes found were Haarlem (16%, T (16%, X-clade (6%, Unknown signature (5% and S (1%. Only one Beijing strain was identified (0.5%. We observed a high degree of diversity after characterizing the 43 isolates belonging to the main spoligotyping cluster (SIT 33, LAM3 with IS6110-RFLP. A total of 35 different RFLP-fingerprints were detected, of which 6 patterns corresponded to the same number of clusters comprising 14 strains. Conclusions The findings obtained in this study show that tuberculosis transmission in Honduras is due to modern M. tuberculosis lineages with high level of biodiversity.

  7. Molecular diversity of Mycobacterium tuberculosis isolates from patients with tuberculosis in Honduras

    Science.gov (United States)

    2010-01-01

    Background Tuberculosis persists as a public health problem in Honduras. A better knowledge of the molecular characteristics of Mycobacterium tuberculosis strains will contribute to understand the transmission dynamics of the disease within the country. The aim of this study was to provide an insight of the genetic biodiversity of M. tuberculosis clinical isolates collected in Honduras between 1994 and 2002. Genotyping was performed using spoligotyping and RFLP. The spoligotypes obtained were compared with the SITVIT2 proprietary database of the Pasteur Institute of Guadeloupe. Results Spoligotyping grouped 84% of the isolates into 27 clusters (2 to 43 strains per cluster). Of the 44 shared international types (SITs) identified among the Honduran stains, 8 SITs were newly identified either within the present study or after match with an orphan type previously identified in the SITVIT2 database. In addition, 16 patterns corresponded to orphan, previously unreported isolates. The Latin American Mediterranean (LAM) lineage was the most common in this study; 55% of the strains belonged to this family. Other genotypes found were Haarlem (16%), T (16%), X-clade (6%), Unknown signature (5%) and S (1%). Only one Beijing strain was identified (0.5%). We observed a high degree of diversity after characterizing the 43 isolates belonging to the main spoligotyping cluster (SIT 33, LAM3) with IS6110-RFLP. A total of 35 different RFLP-fingerprints were detected, of which 6 patterns corresponded to the same number of clusters comprising 14 strains. Conclusions The findings obtained in this study show that tuberculosis transmission in Honduras is due to modern M. tuberculosis lineages with high level of biodiversity. PMID:20678242

  8. Study of adrenal function in patients with tuberculosis.

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    Sarin, Bipan Chander; Sibia, Keerat; Kukreja, Sahiba

    2018-07-01

    Although subclinical adrenal insufficiency has been documented in tuberculosis but it has been neglected in mainstream management of TB due to inconclusive data on its prevalence in TB. The fact that adrenal insufficiency may result not only in poor general condition of the patient but also sudden death due to adrenal crisis, makes it all the more important to address this issue seriously. In this non-randomized interventional study comprising of 100 cases of TB, our aim was to assess the adreno-cortical functions in patients with pulmonary TB (50 cases) and extra-pulmonary TB (50 cases) in an attempt to determine if there is any compromise of adrenal function. In this study, 100 cases of active TB were investigated for adrenal insufficiency by measuring morning fasting basal serum cortisol levels, followed by low dose ACTH stimulation test using 1μg synacthen (synthetic ACTH analog). The post-stimulation serum cortisol levels were estimated. Basal serum cortisol levelsstimulation test serum cortisol level incrementstimulation serum cortisol levelsstimulation test, cortisol response was subnormal in 76% cases. Incidence of adrenal insufficiency in pulmonary TB (74%) and extra-pulmonary TB (78%) were comparable. The number of females having adrenal insufficiency in both the groups was higher than the males (67.3% males and 83.3% females) but the difference was statistically significant only in extra-pulmonary TB group (p=0.011). On analysing the data, the sensitivity of basal serum cortisol level estimation in diagnosing adrenal insufficiency was observed to be 21.05% and its specificity was 100%. Positive predictive value was 100% and negative predictive value was 28.57%. Diagnostic accuracy of basal serum cortisol level estimation was observed to be 40%. The incidence of subclinical adrenal insufficiency in TB cases attending chest department at a tertiary care hospital was significantly high but comparable in both pulmonary and extra-pulmonary type of TB

  9. Clinical application of T-spot test of Mycobacterium tuberculosis infection for diagnosis of suspected pulmonary tuberculosis patients

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    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

  10. Pacientes vivendo com HIV/AIDS e coinfecção tuberculose: dificuldades associadas à adesão ou ao abandono do tratamento Pacientes que viven con el VIH/ SIDA y coinfectados con tuberculosis: las dificultades asociadas con la adhesión o abandono del tratamiento Patients living with HIV/AIDS and co-infection by tuberculosis: difficulties associated with treatment compliance or dropout

    Directory of Open Access Journals (Sweden)

    Manoel Pereira de Sousa Filho

    2012-06-01

    íciles de enfrentar para una adhesión continuada al tratamiento, se hace necesario el rol desempeñado por profesionales de salud, con el apoyo de políticas sociales más resolutivas.Research carried out in Fortaleza- CE, between March and April 2011, with the objective of describing the difficulties that influence non-compliance to tuberculosis treatment or treatment dropout in patients infected with Human Immunodeficiency Virus. Qualitative study with data collected through a semi-structured interview, applied to patients with acquired immunodeficiency syndrome and with co-infection of tuberculosis. The Collective Subject's Speech was used for result analysis. Patients reported difficulties related to socioeconomic aspects, lifestyle and drug use. The consumption of alcohol and illicit drugs were factors that led to the discontinuance of the therapeutic process of the disease. We conclude that the barriers related to social economical aspects and to lifestyle are more difficult to be faced for a continuous compliance to treatment, making the role played by health professionals necessary, supported by more effective public and social policies.

  11. Immunological response to Mycobacterium tuberculosis infection in blood from type 2 diabetes patients.

    Science.gov (United States)

    Raposo-García, Sara; Guerra-Laso, José Manuel; García-García, Silvia; Juan-García, Javier; López-Fidalgo, Eduardo; Diez-Tascón, Cristina; Nebreda-Mayoral, Teresa; López-Medrano, Ramiro; Rivero-Lezcano, Octavio Miguel

    2017-06-01

    The convergence of tuberculosis and diabetes represents a co-epidemic that threatens progress against tuberculosis. We have investigated type 2 diabetes as a risk factor for tuberculosis susceptibility, and have used as experimental model whole blood infected in vitro with Mycobacterium tuberculosis. Blood samples from diabetic patients were found to have a higher absolute neutrophil count that non-diabetic controls, but their immune functionality seemed impaired because they displayed a lower capacity to phagocytose M. tuberculosis, a finding that had been previously reported only for monocytes. In contrast, an increased production of TNFα was detected in infected blood from diabetic patients. Despite the altered phagocytic capacity showed by cells from these patients, the antimicrobial activity measured in both whole blood and monocyte derived macrophages was similar to that of controls. This unexpected result prompts further improvements in the whole blood model to analyze the immune response of diabetes patients to tuberculosis. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  12. Radiographic findings of miliary tuberculosis: difference in patients with and those without associated acute respiratory failure

    International Nuclear Information System (INIS)

    Kim, Min Jeong; Lee, Jin Seong; Ko, Yoon Seok; Lee, In Sun; Seo, Joon Beom; Song, Koun Sick; Lim, Tae Hwan

    2002-01-01

    To determine the differences in the radiography findings of miliary tuberculosis between patients with and without associated acute respiratory failure (ARF). We retrospectively 32 patients in whom miliary tuberculosis had been diagnosed, and assigned them to one of two groups: with ARF (n=10), and without ARF (n=22). Chest radiographic findings such as presence of miliary modules, consolidation, ground-glass opacity (GGO), pleural effusion, small calcified nodules and linear opacities were assessed, the size and profusion of nodules in each of four zones were analyzed and scored using the standard radiographs of the international labor organization, and the extent of consolidation and GGO were scored according to the percentage on involved lung. We compared the radiologic findings between the two groups. Ground-glass opacity, consolidation, and pleural effusion were seen more frequently in miliary tuberculosis patinets with ARF than in those without ARF. Although the size and profusion of nodules were similar in both groups (p>0.05), consolidation and ground-glass opacity in cases of miliary tuberculosis with ARF were significantly more extensive than in those without ARF (p<0.005). GGO and consolidation were more extensive in miliary tuberculosis patients with ARF. A finding of ground-glass opacity in miliary tuberculosis patients might be an early indication of developing ARF

  13. Genital Tuberculosis as the Cause of Tuboovarian Abscess in an Immunosuppressed Patient

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    M. Ilmer

    2009-01-01

    Full Text Available Background. Although tuberculosis (TB is a major health problem worldwide, primary extrapulmonary tuberculosis (EPTB, and in particular female genital tract infection, remains a rare event. Case Report. A 35-year-old human immunodeficiency virus (HIV seropositive woman of African descent with lower abdominal pain and fever of two days duration underwent surgery due to left adnexal mass suggesting pelvic inflammatory disease. The surgical situs showed a four quadrant peritonitis, consistent with the clinical symptoms of the patient, provoked by a tuboovarian abscess (TOA on the left side. All routine diagnostic procedures failed to determine the causative organism/pathogen of the infection. Histopathological evaluation identified a necrotic granulomatous salpingitis and specific PCR analysis corroborated Mycobacterium tuberculosis (M. Tb. Consequently, antituberculotic therapy was provided. Conclusion. In the differential diagnosis of pelvic inflammatory disease, internal genital tuberculosis should be considered. Moreover, physicians should consider tuberculous infections early in the work-up of patients when immunosuppressive conditions are present.

  14. Non‑Adherence of New Pulmonary Tuberculosis Patients to Anti ...

    African Journals Online (AJOL)

    South East Asia Region carries about 40% of the global TB burden. India is the ... DOTS strategy, India's revised national tuberculosis control program (RNTCP) ... such as socio‑cultural, economic background, perceived health benefits and ...

  15. Bloodstream Infections with Mycobacterium tuberculosis among HIV patients

    Centers for Disease Control (CDC) Podcasts

    This podcast looks at bloodstream infections with Mycobacterium tuberculosis and other pathogens among outpatients infected with HIV in Southeast Asia. CDC health scientist Kimberly McCarthy discusses the study and why bloodstream infections occur in HIV-infected populations.

  16. IS6110 restriction fragment length polymorphism of Mycobacterium tuberculosis isolated from patients with pulmonary tuberculosis in Campinas, Brazil: evidence of intercontinental distribution of strains

    Directory of Open Access Journals (Sweden)

    Ana Lucia Roscani Calusni

    2003-07-01

    Full Text Available Tuberculosis (TB is a major concern in developing countries. In Brazil, few genotyping studies have been conducted to verify the number of IS6110 copies present in local prevalent strains of Mycobacterium tuberculosis, the distribution and clustering of strains. IS6110 DNA fingerprinting was performed on a sample of M. tuberculosis isolates from patients with AFB smear-positive pulmonary TB, at a hospital in Brazil. The IS6110 profiles were analyzed and compared to a M. tuberculosis database of the Houston Tuberculosis Initiative, Houston, US. Seventy-six fingerprints were obtained from 98 patients. All M. tuberculosis strains had an IS6110 copy number between 5-21 allowing for differentiation of the isolates. Human immunodeficiency virus infection was confirmed in nearly half the patients of whom data was available. Fifty-eight strains had unique patterns, while 17 strains were grouped in 7 clusters (2 to 6 strains. When compared to the HTI database, 6 strains matched isolates from El Paso, Ciudad de Juarez, Houston, and New York. Recently acquired infections were documented in 19% of cases. The community transmission of infection is intense, since some clustered strains were recovered during the four-year study period. The intercontinental dissemination of M. tuberculosis strains is suspected by demonstration of identical fingerprints in a distant country.

  17. Epidemiology and outcome of tuberculosis in immunocompromised patients.

    Science.gov (United States)

    Metry, Abdul Massiah; Al Salmi, Issa; Al-Abri, Seif; Al Ismaili, Faisal; Al Mahrouqi, Yaqoub; Hola, Alan; Shaheen, Faissal A M

    2017-01-01

    The United States Renal Data System showed 1.2% and 1.6% incidences of tuberculosis (TB) in patients on peritoneal dialysis and hemodialysis (HD), respectively. Kidney transplant (KTX) patients have higher rates. We studied the epidemiology and outcome of TB in patients with kidney dysfunction in a tertiary care hospital in the past decade. We examined data of patients with TB with and without kidney dysfunction from 2006 to 2015 through an electronic system. Statistical analysis was completed using Stata software, Chicago, IL, USA. We found 581 patients with active TB of whom 37 had renal dysfunction including chronic kidney disease, HD, and KTX. No difference was found in the prevalence, age, or gender predilection. The age ranged from 1 to 95 with a mean (standard deviation) of 38.6 (21.1) years. The incidence of TB is 3 per 100,000. The number of patients per year with active TB ranges from 52 to 128 and 3 to 4 in the general population and kidney dysfunction group, respectively. Sixty-five percent of patients with kidney dysfunction had pulmonary TB, 5% had pleurisy, and 30% had extrapulmonary TB. Eighty-four percent of patients with kidney dysfunction completed the course of treatment with 16% treatment failure and 0.4% developed multidrug-resistant TB; 8% were lost to follow-up and 8% died during the treatment period. This study showed no gender predilection for TB in the general population and immunocompromised. Duration of symptoms before diagnosis of TB was shorter in kidney dysfunction patients in comparison to the general population. TB cultures were the most positive tests whereas bronchoalveolar lavage and skin test were the least positive for detecting TB in the kidney dysfunction group. Improvement in registries and screening is required to enhance the capturing rate and detection among this group, as well as providing accurate data to health authorities and the public about the magnitude, future trends, treatments, and outcomes regarding TB in

  18. Epidemiology and outcome of tuberculosis in immunocompromised patients

    Directory of Open Access Journals (Sweden)

    Abdul Massiah Metry

    2017-01-01

    Full Text Available The United States Renal Data System showed 1.2% and 1.6% incidences of tuberculosis (TB in patients on peritoneal dialysis and hemodialysis (HD, respectively. Kidney transplant (KTX patients have higher rates. We studied the epidemiology and outcome of TB in patients with kidney dysfunction in a tertiary care hospital in the past decade. We examined data of patients with TB with and without kidney dysfunction from 2006 to 2015 through an electronic system. Statistical analysis was completed using Stata software, Chicago, IL, USA. We found 581 patients with active TB of whom 37 had renal dysfunction including chronic kidney disease, HD, and KTX. No difference was found in the prevalence, age, or gender predilection. The age ranged from 1 to 95 with a mean (standard deviation of 38.6 (21.1 years. The incidence of TB is 3 per 100,000. The number of patients per year with active TB ranges from 52 to 128 and 3 to 4 in the general population and kidney dysfunction group, respectively. Sixty-five percent of patients with kidney dysfunction had pulmonary TB, 5% had pleurisy, and 30% had extrapulmonary TB. Eighty-four percent of patients with kidney dysfunction completed the course of treatment with 16% treatment failure and 0.4% developed multidrug-resistant TB; 8% were lost to follow-up and 8% died during the treatment period. This study showed no gender predilection for TB in the general population and immunocompromised. Duration of symptoms before diagnosis of TB was shorter in kidney dysfunction patients in comparison to the general population. TB cultures were the most positive tests whereas bronchoalveolar lavage and skin test were the least positive for detecting TB in the kidney dysfunction group. Improvement in registries and screening is required to enhance the capturing rate and detection among this group, as well as providing accurate data to health authorities and the public about the magnitude, future trends, treatments, and outcomes

  19. Life experiences of patients who have completed tuberculosis treatment: a qualitative investigation in southeast Brazil

    Science.gov (United States)

    2013-01-01

    Background Despite being curable, tuberculosis is still a stigmatized disease. Not only is TB patients’ suffering due to its clinical manifestations, but also because of society’s prejudice, embarrassing situations, and even self-discrimination. This study aims to investigate psychosocial experiences of patients who have completed tuberculosis treatment in São Carlos a municipality in the interior of São Paulo State, Brazil. Methods This study, of a clinical-qualitative nature, sought to understand the meanings provided by the participants themselves. Fifteen individuals, who had successfully completed tuberculosis treatment, participated in this research. The sample size was established using the information saturation criterion. Data were collected by means of interviews with in-depth open-ended questions. Data were treated by categorizing and analyzing content according to themes. Results Regardless of all progress, this study found that TB still causes patients to suffer from fear of transmission, social prejudice, and death. Despite the fact that the emotional support provided by families and healthcare professionals is considered essential to treatment adherence and completion, participants in this study reveal that friends and colleagues have distanced themselves from them for fear of contagion and/or prejudice. Ignorance about the disease and its transmission modes can be found in the interviewees’ statements, which seems to indicate that they have become vectors of transmission of stigma themselves. Patients’ medical leave from work during treatment may be due to both their health conditions and their attempt to avoid social/emotional embarrassment. There are accounts that TB has caused psychosocial damage to patients’ lives and that they feel more fatigue and lassitude and have begun to pay more attention to their own health. Conclusions Healthcare workers should be aware of the ways TB treatment affect patients’ psychosocial life and

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

    Science.gov (United States)

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

    2003-02-01

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

  1. Macromodular splenic tuberculosis in a medically-treated AIDS patient: diagnosis and management by CT

    International Nuclear Information System (INIS)

    Galant, J., Marti-Bonmati, L.; Tornero, C.; Ferrer, M.D.

    1995-01-01

    We used computerized tomography (CT) in the study of eight patients with macronodular splenic tuberculosis prior to the microbiological diagnosis. These patients underwent additional CT controls during and after tuberculostatic therapy. All the patients studed presented the acquired immunodeficiency syndrome (AIDS). Splenomegaly and numerosous round, hypodense lesions that showed no contrast uptake were found in all the subjects. Only three patients presented evidence of tuberculosis in plain radiography and/or chest X-ray. Two patients presented abdominal lymph nodes. None of them showed evidence of hepatic lesions or ascites. follow-up CT scans revealed a progressive reduction of the lesions, which eventually disappeared completely, and splenomegaly was considerably reduced. Anthough it is uncommon, we should suspect splenic involvement in tuberculosis if the clinical and radiological contexts are appropriate. CT provides excellent monitoring of the efficacy of treatment in these patients. 17 refs

  2. [Pulmonary function in patients with focal pulmonary tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2008-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), Raw, Rin, Rcx, DLCO-SB, DLCO-SS/VA, PaO2, and PaCO2 were determined in 40 patients with focal pulmonary tuberculosis. Changes were found in lung volumes and capacities in 75%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 57.5 and 25%, respectively. The lung volume and capacity changes appeared mainly as increased TGV and PRV; impaired bronchial patency presented as decreased MEF50, MEF75, and FEV1/VC%; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, PaO2, and PaCO2. The magnitude of the observed functional changes was generally slight. TGV and PRL increased up to 148-187 and 142-223% of the normal values, respectively; MEF50, MEF75, FEV1/VC%, and DLCO decreased to 59-24, 58-26, 78-57, and 78-67% of the normal values and PaO2 and PaCO2 did to 79-69 and 34-30 cm Hg.

  3. Risk assessment of hepatotoxicity among tuberculosis and human immunodeficiency virus/AIDS-coinfected patients under tuberculosis treatment.

    Science.gov (United States)

    Ngouleun, Williams; Biapa Nya, Prosper Cabral; Pieme, Anatole Constant; Telefo, Phelix Bruno

    2016-12-01

    Tuberculosis (TB) is a worldwide public health problem. It is a contagious and grave disease caused by Mycobacterium tuberculosis. Current drugs such as isoniazid, pyrazinamide, and rifampicin used for the treatment of tuberculosis are potentially hepatotoxic and can lead to drug hepatitis. In order to improve the follow-up of TB patients in Cameroon, we carried out a study which aimed to evaluate the hepatotoxicity risk factors associated with anti-TB drugs. The studies were performed on 75 participants who had visited the Loum District Hospital located in the littoral region of Cameroon for their routine consultation. Participants have been selected based on pre-established criteria of inclusion and exclusion. Prior to the informed consent signature, patients were given compelling information about the objective and the result output of the study. They were questioned about antioxidant food and alcohol consumption as well as some clinical signs of hepatotoxicity such as fever, nausea, vomiting, and tiredness. The collected blood was tested for the determination of biochemical markers (transaminases and C-reactive protein) using standard spectrophotometric methods. Biochemical analysis of samples showed a significant increase (pfactors, antioxidant food consumption significantly reduced the liver injury patient percentage for the above parameters, whereas an opposite situation was observed with alcohol consumption between TB-coinfection and TB patients. Regarding the C-reactive protein results, the percentage of positive tests was very high among coinfected patients (40%) compared with the control (15%). The interactions between parameters related to alcohol consumption and intake of antioxidant foods showed a slight decrease in activity compared with interactions without food. The results showed that human immunodeficiency virus status and alcohol consumption constitutes aggravating factors for the occurrence of hepatic toxicity. In addition, the consumption of

  4. HIV status and tuberculosis

    African Journals Online (AJOL)

    User

    Failure to perform mycobacterium culture bacterial blood culture and results of other causes of .... for Identification of Highly Infectious Tuberculosis in People Living with HIV in Southeast Asia. ... Indian Journal of Tuberculosis 58, 108-112.

  5. Renal tuberculosis

    Directory of Open Access Journals (Sweden)

    Džamić Zoran

    2016-01-01

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

  6. Mycobacterium tuberculosis Zinc Metalloprotease-1 Elicits Tuberculosis-specific Humoral Immune Response Independent of Mycobacterial Load in Pulmonary and Extra-Pulmonary Tuberculosis Patients

    Directory of Open Access Journals (Sweden)

    Mani Harika eVemula

    2016-03-01

    Full Text Available Conventionally, facultative intracellular pathogen, Mycobacterium tuberculosis (M.tb, the tuberculosis (TB causing bacilli in human is cleared by cell-mediated immunity (CMI with CD4+ T cells playing instrumental role in protective immunity, while antibody-mediated immunity (AMI is considered non-protective. This longstanding convention has been challenged with recent evidences of increased susceptibility of hosts with compromised AMI and monoclonal antibodies conferring passive protection against TB and other intracellular pathogens. Therefore, novel approaches towards vaccine development include strategies aiming at induction of humoral response along with CMI. This necessitates the identification of mycobacterial proteins with properties of immunomodulation and strong immunogenicity. In this study, we determined the immunogenic potential of M.tb Zinc metalloprotease-1 (Zmp1, a secretory protein essential for intracellular survival and pathogenesis of M.tb. We observed that Zmp1 was secreted by in vitro grown M.tb under granuloma-like stress conditions (acidic, oxidative, iron deficiency and nutrient deprivation and generated Th2 cytokine microenvironment upon exogenous treatment of Peripheral Blood Mononulear Cells (PBMCs with recombinant Zmp1 (rZmp1. This was supported by recording specific and robust humoral response in TB patients in a cohort of 295. The anti-Zmp1 titers were significantly higher in TB patients (n=121 as against healthy control (n=62, household contacts (n=89 and non-specific infection controls (n=23. A significant observation of the study is the presence of equally high titers of anti-Zmp1 antibodies in a range of patients with high bacilli load (sputum bacilli load of 300+ per mL to paucibacillary smear-negative pulmonary tuberculosis (PTB cases. This clearly indicated the potential of Zmp1 to evoke an effective humoral response independent of mycobacterial load. Such mycobacterial proteins can be explored as antigen

  7. Emerging tuberculosis pathogen hijacks social communication behavior in the group-living banded mongoose (Mungos mungo)

    Science.gov (United States)

    Mycobacterium mungi, a novel M. tuberculosis complex pathogen (MtbC), has emerged in wild banded mongoose (Mungos mungo) in Northern Botswana, causing significant mortality. Unlike other members of the MtbC, M. mungi is not transmitted through a primary aerosol route. Rather, pathogen invasion occur...

  8. risk factors of active tuberculosis in people living with hiv/aids in ...

    African Journals Online (AJOL)

    Abrham

    2011-07-02

    Jul 2, 2011 ... R, Lisse I, Samb B et al: Tuberculosis in. Bissau: incidence and risk factors in an urban community in sub-Saharan Africa. Int J. Epidemiol 2004;33(1):163-172. 10. MOH: TB, leprosy and TB/HIV prevention and control program manual. Addis Ababa,. Ethiopia. 2008. 11. Fugnudo Mbeki AG, Kuwala Lube: ...

  9. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in Bale Zone, Southeast Ethiopia

    Directory of Open Access Journals (Sweden)

    Hussen Awol

    2012-06-01

    Full Text Available Abstract Background Tuberculosis (TB is a major public health problem in Africa with Ethiopia being the most affected. Treatment delay is an important indicator of access to TB diagnosis and treatment. However, little is known about factors associated with treatment delay of pulmonary TB among pastoralists. Health facility based cross sectional study was conducted on 129 pulmonary TB patients in pastoralist community. The study was conducted in three health centers and a hospital. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay, and the time between first visits to the professional health care provider to the date of diagnosis (provider's delay were analyzed using SPSS 16.0 statistical software. Findings A total of 129 new smear positive pulmonary TB patients participated in the study. The median total delay was 97 days. The median patient and health provider delays were 63 and 34 days, respectively. Ninety six percent of the patients were delayed for more than the twenty one days cutoff point. Patient delay was positively associated with first visit to traditional healer/private clinic/drug shop, rural residence, being illiterate, living in more than 10 kilometers from health facility; severity of illness at first presentation to health facility. Provider delay was positively associated with rural residence, being illiterate, patient with good functional status, patients in contact with more than two health providers, and place of first visit being traditional healer/private clinic/drug shop. Conclusions This study showed that majority of smear positive patients delayed either for diagnosis or treatment, thus continue to serve as reservoirs of infection. This indicates that there is a need for intervention to decrease patient and provider delays. Effort to reduce delays in pastoralist communities should focus on improving access to services in rural communities, engaging traditional and

  10. Prevalence of Candida co-infection in patients with pulmonary tuberculosis.

    Science.gov (United States)

    Kali, Arunava; Charles, Mv Pravin; Noyal, Mariya Joseph; Sivaraman, Umadevi; Kumar, Shailesh; Easow, Joshy M

    2013-01-01

    Candida species are emerging as a potentially pathogenic fungus in patients with broncho-pulmonary diseases. The synergistic growth promoting association of Candida and Mycobacterium tuberculosis has raised increased concern for studying the various Candida spp . and its significance in pulmonary tuberculosis patients during current years. This study was undertaken with the objective of discovering the prevalence of co-infection caused by different Candida species in patients with pulmonary tuberculosis. A total of 75 patients with pulmonary tuberculosis diagnosed by sputum Ziehl-Neelsen staining were included in the study. Candida co-infection was confirmed using the Kahanpaa et al. criteria. Candida species were identified using gram stain morphology, germ tube formation, morphology on cornmeal agar with Tween-80, sugar fermentation tests and HiCrome Candida Agar. Candida co-infection was observed in 30 (40%) of patients with pulmonary tuberculosis. Candida albicans was the most common isolate observed in 50% of the patients with co-infection, followed by C. tropicalis (20%) and C. glabrata (20%). Candida co-infection was found in 62.5% of female patients, while it was observed in only 29.4% of the male patients (P value 0.0133). Mean ± SD age of the patients with C. glabrata infection was 65.83 ± 3.19, while the mean ± SD age of the patients with other Candida infections was 43.25 ± 20.44 (P value 0.0138). Many patients with pulmonary tuberculosis have co-infection with Candida spp. The prevalence of non-albicans Candida species is increasing and may be associated with inadequate response to anti-tubercular drugs. C. glabrata infection has a strong association with old age.

  11. AN ARTIFICIAL NEURAL NETWORK EVALUATION OF TUBERCULOSIS USING GENETIC AND PHYSIOLOGICAL PATIENT DATA

    International Nuclear Information System (INIS)

    Griffin, William O.; Darsey, Jerry A.; Hanna, Josh; Razorilova, Svetlana; Kitaev, Mikhael; Alisherov, Avtandiil; Tarasenko, Olga

    2010-01-01

    When doctors see more cases of patients with tell-tale symptoms of a disease, it is hoped that they will be able to recognize an infection administer treatment appropriately, thereby speeding up recovery for sick patients. We hope that our studies can aid in the detection of tuberculosis by using a computer model called an artificial neural network. Our model looks at patients with and without tuberculosis (TB). The data that the neural network examined came from the following: patient' age, gender, place, of birth, blood type, Rhesus (Rh) factor, and genes of the human Leukocyte Antigens (HLA) system (9q34.1) present in the Major Histocompatibility Complex. With availability in genetic data and good research, we hope to give them an advantage in the detection of tuberculosis. We try to mimic the doctor's experience with a computer test, which will learn from patient data the factors that contribute to TB.

  12. Lipids and Protein Peroxidation in Children and Teenager Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Yu.V. Poliakova

    2015-09-01

    Full Text Available A review of literature about the study of lipid and protein peroxidation in children and teenagers with pulmonary tuberculosis nowadays was carried out. It was established that there is a great number works dedicated to the lipid peroxidation and antioxidant protective system in various pathological conditions of the respiratory system, including pulmonary tuberculosis in children and teenagers today. Oxidative modification proteins products are the earliest markers of oxidative stress in patients. There is no information on the oxidative modification of proteins in children and teenagers suffering from pulmonary tuberculosis in the literature. The study of oxidative modification of proteins will facilitate the development of more efficient new diagnosis methods and pathogenetic treatment of children and teenagers with pulmonary tuberculosis, that will increase the treatment effectiveness.

  13. Substantially Higher and Earlier Occurrence of Anti-Tuberculosis Drug-Related Adverse Reactions in HIV Coinfected Tuberculosis Patients: A Matched-Cohort Study.

    Science.gov (United States)

    Matono, Takashi; Nishijima, Takeshi; Teruya, Katsuji; Morino, Eriko; Takasaki, Jin; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Kaku, Mitsuo; Oka, Shinichi

    2017-11-01

    Little information exists on the frequency, severity, and timing of first-line anti-tuberculosis drug-related adverse events (TB-AEs) in HIV-tuberculosis coinfected (HIV-TB) patients in the antiretroviral therapy (ART) era. This matched-cohort study included HIV-TB patients as cases and HIV-uninfected tuberculosis (non-HIV-TB) patients as controls. Tuberculosis was culture-confirmed in both groups. Cases were matched to controls in a 1:4 ratio on age, sex, and year of diagnosis. TB-AEs were defined as Grade 2 or higher requiring drug discontinuation/regimen change. From 2003 to 2015, 94 cases and 376 controls were analyzed (95% men, 98% Asians). Standard four-drug combination therapy was initiated in 91% of cases and 89% of controls (p = 0.45). Cases had a higher frequency of TB-AE [51% (48/94) vs. 10% (39/376), p tuberculosis treatment. HIV infection was an independent risk factor for TB-AEs in the multivariate Cox analysis [adjusted HR (aHR): 6.96; 95% confidence interval: 3.93-12.3]. TB-AEs occurred more frequently in HIV-TB than in non-HIV-TB patients, and were more severe. The majority of TB-AEs occurred within 4 weeks of initiating anti-tuberculosis treatment. Because TB-AEs may delay ART initiation, careful monitoring during this period is warranted in coinfected patients.

  14. Sputum Conversion Among Patients With Smear Positive Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Soudbakhsh A R

    2003-06-01

    Full Text Available Introduction: In the patients with smear-positive pulmonary tuberculosis (TB bacteriologic assessment of sputum for detection of acid bacilli (AFB Has essential role. This evaluation is accomplished by direct sputum smear & sputum culture. These examinations must be done in regular and preferably monthly after beginning of treatment. These tests have two important aims, including, determining of treatment efficacy & duration of isolation."nMethods and Materials: Most of the studies have that classic six month regimen led to sputum smear conversion & negative sputum culture in 85% of patient. This treatment regimen has two phases, including, attack phase and maintenance phase. In the attack phase we use four drugs, including, Isoniazid (INH, Rifampin (RMP, Pyrazinamide (PZA and Ethambutol (EMB for the first 2 months and if necessary until the end of third month. In the maintenance phase we use INH and Rif for the remaining of treatment course. The main objectives of this study were to determine the time needed for smear conversion and assessment of probable factors which may influence the smear conversion until 4 months after beginning of therapy. The factors that were assessed, were, Age, nationality, sex, clinical symptoms, underlying diseases, chest radiography (number of cavities, smoking, drug abuse and concentration of AF13 in the sputum Generally, we did this cross sectional study on the patient's records, who had been observed in Imam Khomeni Hospital, west health service center and masih daneshvary hospital between."nResults: This study showed that from totally 218 patients, 138(74.6% patients had sputum conversion at the first 2 months of treatment and until the end of 3rd & 4th month this rate reached to 83.3% respectively. So in the end of fourth month only 32(14.7% patients did not show sputum smear conversion. On the other hand this study showed that two factors including presence of cavities in chest radiography

  15. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

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

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...... indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case...... of tuberculosis. We suggest that RD1 based tests are evaluated further in immunocompromised patients....

  16. [Computed tomographic semiotics of respiratory tuberculosis in HIV-infected patients].

    Science.gov (United States)

    Gavrilov, P V; Lazareva, A S; Malashenkov, E A

    2013-01-01

    to study the computed tomographic (CT) semiotics of respiratory tuberculosis in HIV-infected patients in relation to the degree of immunosuppression. The study enrolled 74 patients with verified respiratory tuberculosis in the presence of HIV infection. According to the degree of immunosuppression and the Centers for Disease Control (CDC) and Prevention classification (Atlanta, USA, 1993), the patients were divided into 3 groups: (1) CD4 > or = 500 cells/microl (n = 10); 2) CD4 200-499 cells/microl (n = 28); (3) CD4 <200 cells/microl (n = 36). With spiral CT, focal changes with a predominance of clear-cut foci are visualized at a high frequency in the patients with pulmonary tuberculosis in the presence of HIV infection. In progressive immunosuppression, the CT pattern displays atypical syndromes (frosted glass-type foci, interstitial infiltration, and thin-walled cavities) with the lower rate of alveolar infiltration with confluent foci, as well as lung tissue decay. Enlarged intrathoracic lymph nodes are characteristic of 70.0% of the patients with HIV infection and tuberculosis regardless of the level of CD4 cells. As immunosuppression progresses, the CT pattern of respiratory tuberculosis in the presence of HIV infection shows as atypical syndromes (unclearly defined frosted glass-type focal changes, interstitial infiltrations, and thin-walled cavernous masses). A marked polymorphism in changes and a high rate of lymph node involvement are characteristic.

  17. [Disseminated tuberculosis with severe multi- organ failure in a patient with AIDS].

    Science.gov (United States)

    Grigoriu, B-D; Jacobs, F-M; Mas, A-E; Prat, D; Prévot, S; Brivet, F-G

    2008-09-01

    Tuberculosis is the most common infectious complication in HIV infected patients. The incidence of tuberculosis and the proportion of disseminated disease increase with more severe immuno-suppression. Septic shock and multiple organ failure are uncommon but are of markedly bad prognostic significance. A forty-four year old HIV seropositive man was admitted to the intensive care unit (ICU) with acute respiratory distress. The patient had been febrile for the previous two weeks. His thoracic radiograph showed a discrete interstitial infiltrate and at bronchoscopy small whitish granulations were observed in the main bronchi. All bacteriological investigations remained negative at the time of ICU admission. The patient died sixteen hours later due to multiple organ failure. Mycobacteria were identified after patient's death on the smear from BAL, from blood cultures, and in a postmortem liver biopsy. Septic shock is an infrequent complication of disseminated tuberculosis. Mortality is very high. Treatment should be started early in cases with a high diagnostic suspicion.

  18. Determinant factors associated with occurrence of tuberculosis among adult people living with HIV after antiretroviral treatment initiation in Addis Ababa, Ethiopia: a case control study.

    Directory of Open Access Journals (Sweden)

    Kelemu Tilahun Kibret

    Full Text Available INTRODUCTION: Tuberculosis (TB is a leading morbidity and mortality, and the first presenting sign in majority of people living with Human Immune deficiency Virus (PLWH. Determinants of active TB among HIV patients on anti retroviral treatment (ART are not well described in resource limited settings. The aim of this study was to assess determinant factors for the occurrence of TB among people living with HIV after ART initiation in public hospitals and health centers in Addis Ababa, Ethiopia. METHODS AND FINDINGS: A case control study was conducted from December 2011 to February 2012 in 2 public hospitals and 13 health centers in Addis Ababa. The study population consisted of 204 cases and 409 controls. Cases were adult people living with HIV who developed TB after ART initiation and controls were adult people living with HIV who did not develop TB after ART initiation. An interviewer administered structured questionnaire was used to collect information. After adjustment for potential confounders, presence of isoniazid prophylaxis (adjusted odd ratio [AOR] 0.35, 95% confidence interval [CI] 0.125, 0.69 and cotrimoxazole prophylaxis (AOR = 0.19; 95% CI: 0.06, 0.62 had protective benefit against risk of TB. In contrary, bedridden (AOR = 9.36; 95% CI: 3.39, 25.85, having World Health Organization (WHO clinical stage III/IV (AOR = 3.40; 95% CI: 1.69, 6.87 and hemoglobin level <10 mg/dl (AOR = 7.43; 95% CI; 3.04, 18.31 at enrollment to ART care were predictors for increased risk of tuberculosis in PLWH after ART initiation. CONCLUSION: Increasing coverage of isoniazid preventive therapy and cotrimoxazole preventive therapy reduced risk of TB among HIV patients who started treatment. All PLWH should be screened for TB, but for patients who have advanced disease condition (WHO clinical stage III/IV, being bedridden and having hemoglobin level <10 mg/dl intensified screening is highly recommended during treatment follow up.

  19. Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam

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    Lauritsen Jens M

    2011-05-01

    Full Text Available Abstract Background The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Objectives Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. Methods A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007 were obtained for comparison. Results A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively. The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Conclusions Characteristics of patients

  20. Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam.

    Science.gov (United States)

    Hoa, Nguyen B; Wei, Chen; Sokun, Chay; Lauritsen, Jens M; Rieder, Hans L

    2011-05-23

    The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007) were obtained for comparison. A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively.The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Characteristics of patients greatly differed between countries and between patient categories. In Cambodia

  1. Living in a Patient-Centric Universe.

    Science.gov (United States)

    Kraus, Dennis H

    2016-12-01

    Patients with head and neck cancer face a number of challenges in terms of treatment, cure of their underlying malignant condition, and quality of survivorship. This presentation will focus on the patient perception of both the quality of care and the empathy and availability of the head and neck oncology team. It has become evident that the quality of survivorship plays a central role in the patient's decision-making process. The process of decision making by the patient facing head and neck cancer and the impact on treatment choices will be explored. The ability of the patient and her or his support system to navigate through the increasingly complicated health care system will be considered, with an emphasis on strategies for success. Finally, the role of the of the head and neck surgeon, and the need for physician wellness in predicating successful patient outcomes will be considered. The ultimate goal of achieving optimal care, superior patient outcomes, and patient satisfaction is the true objective of the concept of living in a patient-centric universe.

  2. REASONS FOR PATIENT DELAYS & HEALTH SYSTEM DELAYS FOR TUBERCULOSIS IN SOUTH INDIA

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    Kapil Goel

    2011-12-01

    Full Text Available Background: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of tuberculosis treatment is essential for an effective tuberculosis control programme. Objectives: To study the self reported reasons for patient and health system (diagnosis & treatment delays in Tuberculosis patients. Methods: A community based cross sectional study was conducted among 98 new sputum positive TB cases aged > 15 years registered under RNTCP from Oct 2006 to June 2007 & receiving treatment under DOTS in Udupi taluk by interviewing them. Results: Total 98 patients were recruited and 68% were males. Out of 17 patients with patient delays, 82% felt that their symptoms were not severe, 71% felt that patient delay was due to lack of awareness and 71% did not take it seriously. Out of 86 patients with health system delays, 82.6% of patients mentioned that doctor has not advised for sputum examination, 76.7% of patients told that they first consulted a private doctor, 21% of them mentioned that doctor was unaware to diagnose TB. Conclusion: Symptoms not severe is the main reason for the patient delay and doctor didn’t advise for sputum examination is the main reason for health system delays.

  3. Alarming Levels of Drug-Resistant Tuberculosis in HIV-Infected Patients in Metropolitan Mumbai, India

    OpenAIRE

    Isaakidis, Petros; Das, Mrinalini; Kumar, Ajay M V; Peskett, Christopher; Khetarpal, Minni; Bamne, Arun; Adsul, Balkrishna; Manglani, Mamta; Sachdeva, Kuldeep Singh; Parmar, Malik; Kanchar, Avinash; Rewari, B B; Deshpande, Alaka; Rodrigues, Camilla; Shetty, Anjali

    2014-01-01

    BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a looming threat to tuberculosis control in India. However, no countrywide prevalence data are available. The burden of DR-TB in HIV-co-infected patients is likewise unknown. Undiagnosed and untreated DR-TB among HIV-infected patients is a major cause of mortality and morbidity. We aimed to assess the prevalence of DR-TB (defined as resistance to any anti-TB drug) in patients attending public antiretroviral treatment (ART) centers in greater ...

  4. Identifying patients at high risk of tuberculosis recurrence

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    Ruxana T Sadikot

    2016-01-01

    Full Text Available Several studies have been done in relation to recurrence of tuberculosis (TB following completion of treatment. However, recurrence of TB is still a major problem from a public health perspective in high-burden countries, where no special attention is being given to this issue. Disease recurrence is an important indicator of the efficacy of antituberculosis treatment. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 25%. This variability is not only a reflection of regional epidemiology of recurrence but differences in the definitions used by the TB control programs. In addition to treatment failure related to medication adherence, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include: malnutrition; human immunodeficiency virus; substance abuse including tobacco use; comorbidity such as diabetes, renal failure and systemic diseases, especially immunosuppressive states; and environmental exposure such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being discovered. Information on temporal and geographical trends of TB cases as well as genotyping might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and defining host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  5. Identifying patients at high risk of tuberculosis recurrence.

    Science.gov (United States)

    Sadikot, Ruxana T

    2016-12-01

    Several studies have been done in relation to recurrence of tuberculosis (TB) following completion of treatment. However, recurrence of TB is still a major problem from a public health perspective in high-burden countries, where no special attention is being given to this issue. Disease recurrence is an important indicator of the efficacy of antituberculosis treatment. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 25%. This variability is not only a reflection of regional epidemiology of recurrence but differences in the definitions used by the TB control programs. In addition to treatment failure related to medication adherence, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include: malnutrition; human immunodeficiency virus; substance abuse including tobacco use; comorbidity such as diabetes, renal failure and systemic diseases, especially immunosuppressive states; and environmental exposure such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being discovered. Information on temporal and geographical trends of TB cases as well as genotyping might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and defining host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence. Copyright © 2016.

  6. Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a prospective cohort study.

    Science.gov (United States)

    Velásquez, Gustavo E; Cegielski, J Peter; Murray, Megan B; Yagui, Martin J A; Asencios, Luis L; Bayona, Jaime N; Bonilla, César A; Jave, Hector O; Yale, Gloria; Suárez, Carmen Z; Sanchez, Eduardo; Rojas, Christian; Atwood, Sidney S; Contreras, Carmen C; Santa Cruz, Janeth; Shin, Sonya S

    2016-02-01

    Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting. We conducted a prospective cohort study of patients treated for tuberculosis between 2005 and 2008 in two adjacent health regions in Lima, Peru (Lima Ciudad and Lima Este). We constructed a multivariate Cox proportional hazards model to evaluate the effect of HIV status on mortality during tuberculosis treatment. Of 1701 participants treated for tuberculosis, 136 (8.0%) died during tuberculosis treatment. HIV-positive patients constituted 11.0% of the cohort and contributed to 34.6% of all deaths. HIV-positive patients were significantly more likely to die (25.1 vs. 5.9%, P Peru started providing free antiretroviral therapy. As HIV diagnosis and antiretroviral therapy provision are more widely implemented for tuberculosis patients in Peru, future operational research should document the changing profile of HIV-associated tuberculosis mortality.

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

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    Cope GF

    2017-01-01

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

  8. Altered microRNA signatures in sputum of patients with active pulmonary tuberculosis.

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    Zhengjun Yi

    Full Text Available Role of microRNA (miRNA has been highlighted in pathogen-host interactions recently. At present, their role in active pulmonary tuberculosis is unknown. The aim of the study was to delineate miRNA expression in sputum supernatant of patients with active pulmonary tuberculosis. Expression of miRNAs was evaluated by microarray analysis and differentially expressed miRNAs were validated by RT-qPCR. Secreted cytokines TNF-α and IL-6 were measured by ELISA. We found that 95 miRNAs were differentially expressed between tuberculosis group and controls. More miRNAs (52 out of 95 miRNAs were underexpressed than overexpressed during tuberculosis infection. Overexpression of miR-3179, miR-147 and underexpression of miR-19b-2* in TB group compared with controls were confirmed in the validation cohort. TNF-α and IL-6 levels were not significantly altered between TB group and controls. For the first time, differential expression of miRNAs in sputum was found in active pulmonary tuberculosis. The study provides rationale for identifying the role of miRNAs in the pathogenesis of pulmonary tuberculosis and indicates potential for miRNA-based therapeutic strategies.

  9. Altered microRNA signatures in sputum of patients with active pulmonary tuberculosis.

    Science.gov (United States)

    Yi, Zhengjun; Fu, Yurong; Ji, Rui; Li, Ruifang; Guan, Zhiyu

    2012-01-01

    Role of microRNA (miRNA) has been highlighted in pathogen-host interactions recently. At present, their role in active pulmonary tuberculosis is unknown. The aim of the study was to delineate miRNA expression in sputum supernatant of patients with active pulmonary tuberculosis. Expression of miRNAs was evaluated by microarray analysis and differentially expressed miRNAs were validated by RT-qPCR. Secreted cytokines TNF-α and IL-6 were measured by ELISA. We found that 95 miRNAs were differentially expressed between tuberculosis group and controls. More miRNAs (52 out of 95 miRNAs) were underexpressed than overexpressed during tuberculosis infection. Overexpression of miR-3179, miR-147 and underexpression of miR-19b-2* in TB group compared with controls were confirmed in the validation cohort. TNF-α and IL-6 levels were not significantly altered between TB group and controls. For the first time, differential expression of miRNAs in sputum was found in active pulmonary tuberculosis. The study provides rationale for identifying the role of miRNAs in the pathogenesis of pulmonary tuberculosis and indicates potential for miRNA-based therapeutic strategies.

  10. [Prevalence of HIV-Tuberculosis co-infection and HIV impact on patients with tuberculosis in the Lubumbashi Health Zone from 2014 to 2015].

    Science.gov (United States)

    Wa Ilunga, E N; Muya, R K; Kaponda, A A; Kaput, C M A; Kalonji, S M; Chiribagula, V B; Nshikala, B N; N'sasi, A N; Simbi, J-B L

    2018-02-01

    Tuberculosis and HIV/AIDS are a dangerous couple in sub-Saharan Africa. The aim of this paper is to evaluate the prevalence of the co-infection tuberculosis/HIV/AIDS and its impact on issues of tuberculosis patients treated in Lubumbashi Heath Zone (LHZ). A retrospective and transversal study was conducted through the analysis of tuberculosis patients' data admitted in the tuberculosis Health Centers for Diagnosis and treatment (HCDT) in the LHZ from January 2014 to December 2015. TB-HIV co-infection cases will be identified and the outcome will be analyzed. Data of 1368 patients were noted from three HCDT of the TB of the Lubumbashi ZS and among them 334 cases of co-infections were recorded. The most incriminated age range is 40-50 years. The mean of age of our patients is 32.84±15.32 years and the man/women sex ratio is 1.70. The most predominant clinical tuberculosis form is the extra pulmonary [EPT (52.70 %)]. Among co-infected patients, the predominant form is pulmonary (TPM-). Out of the 51 cases of deaths recorded, 23 (45.10 %) also had HIV while 28 (54.90 %) were HIV-negative. There was an increase of 11.6 % in TB-HIV/AIDS co-infection from 2014 to 2015. TB-HIV/AIDS co-infection is a reality in the LHZ, especially in patients with negative bacterial TB (TPM-) and we have to pay a particular attention on the impact of HIV on the death of tuberculosis patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Socio-demographic profile of patients with sarcoidosis vis-à-vis tuberculosis.

    Science.gov (United States)

    Gupta, D; Vinay, N; Agarwal, R; Agarwal, A N

    2013-11-25

    Sarcoidosis and tuberculosis closely resemble each other and Mycobacterium tuberculosis has been implicated as a causative agent for sarcoidosis. Herein we explore the socio-demographic features of patients with sarcoidosis vis-a-vis tuberculosis. In a prospective case-control design, we studied hundred patients each of newly diagnosed sarcoidosis, bacteriologically confirmed pulmonary tuberculosis and healthy controls. Socio-demographic profile was recorded on a standardized questionnaire. Information about tobacco smoking, exposure to environmental tobacco smoke (ETS) and cooking fuels was also collected. Various parameters were compared among the three groups. Compared to tuberculosis, patients with sarcoidosis were elder, had better body mass index (BMI), higher urban residence (OR 2.19, 95% CI: 1.02-4.69), were better educated (ORs 8.50 to 74.25 for different categories), had higher per capita income (OR 13.33; 95% CI: 6.79-26.19) and belonged to better overall socio-economic status (SES) (ORs 8.57-195.0 for different categories). All these differences were also significant when sarcoidosis patients were compared to healthy controls albeit to a lesser degree. Tobacco smoking, ETS exposure and use of fossil/biomass fuels for cooking were more commonly seen in TB patients. In the multivariate analysis, as compared to TB or controls, sarcoidosis patients had higher odds for a better SES after adjusting for age, gender, BMI, religion, smoking, ETS exposure and cooking fuel. Patients with sarcoidosis are likely to be better educated and more affluent compared to those with tuberculosis and healthy controls and this can be useful in clinical differential diagnosis of the two conditions in populations with high prevalence of TB.

  12. Adherence to Tuberculosis Therapy among Patients Receiving Home-Based Directly Observed Treatment: Evidence from the United Republic of Tanzania

    NARCIS (Netherlands)

    Mkopi, Abdallah; Range, Nyagosya; Lwilla, Fred; Egwaga, Saidi; Schulze, Alexander; Geubbels, Eveline; van Leth, Frank

    2012-01-01

    Background: Non-adherence to tuberculosis (TB) treatment is the leading contributor to the selection of drug-resistant strains of Mycobacterium tuberculosis and subsequent treatment failure. Tanzania introduced a TB Patient Centred Treatment (PCT) approach which gives new TB patients the choice

  13. A prevalence study of pulmonary tuberculosis in hospital visited diabetes patients

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    Chung, Ho Keun; Lee, Hang Young; Joo, Kyung Bin [Eui-Ji Hospital, Seoul (Korea, Republic of); Kim, Kun Sang [College of Medicine, Chung Ang University, Seoul (Korea, Republic of)

    1983-12-15

    We reviewed the records of randomly selected 320 diabetic out-patients at EuiJi Hospital from April 1981 through March 1983. Fasting blood sugar (FBS) of 140 mg/dl or more was taken as a criteria of diabetes according to the report of National Diabetes Data Group. The results are as follows: 1. Mean age of study group was 50.8 years-old and the FBS mean value was 222.4 mg/dl. 2. There was no significant difference of FBS values of tuberculosis and non-tuberculosis patients. 3. Prevalence of pulmonary tuberculosis evaluated by chest films was 13.4 percent in diabetes patients. This value is lower than those of other studies but higher than that of urban population in Korea (p<0.05)

  14. Analysis on misdiagnosis of 35 patients with pulmonary tuberculosis on CT films

    International Nuclear Information System (INIS)

    Li Tieyi; Ji Jingling; Ge Li

    2000-01-01

    Objective: To investigate CT characteristics of pulmonary tuberculosis by analyzing the reasons of misdiagnosis in 35 patients with pulmonary tuberculosis. Methods: The patients in this study included 19 men and 16 women, with ages ranging from 18 to 79 years old. Chest CT scans were performed in all patients. The CT films were reviewed retrospectively by two senior radiologists and were correlated with pathologic findings. The misdiagnosing reasons were analyzed. Results: Misdiagnoses as lung cancer were made in 29 cases, pneumonia in 4 cases, and other diseases in 2 cases. The lesions on CT films appeared as nodules and masses in 14 cases, pulmonary segmental and lobar shadows in 19 cases, and hilar and mediastinal masses in 2 cases. Conclusion: The main causes of misdiagnosis for pulmonary tuberculosis are atypical radiological appearance on CT films, inadequate visualized lesions, and lacking of combination of CT findings with that of chest radiography

  15. Complement, circulating immine complexes and cenral hemodynamics in patients with pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Ershov, A.I.; Fedoseeva, V.N.; Mol'kov, Yu.N.; Evstaf'ev, Yu.A.; Bochkarev, E.G.; Shcheglova, V.T.

    1987-01-01

    By means of radiocardiography and radiometry central hemodynamic parameters were measured, using 131 I-labelled human serum albumin, pulmonary-artery systolic pressure (PASP) was assessed indirectly, and serum complement and circulating immune complexes (CIC) were measured before 48 hours after subcutaneous administration of 20 TU tuberculin in 65 patients with active pulmonary tuberculosis, 25 clinically-cured tuberculosis patients and 16 patients with chronic nonspecific pulmonary diseases (CNPD). A potent direct correlation was demonstrated between the CIC level and PASP elevation. It is suggested that close correlation between CIC and PASP elevation may be evidence of their pathogenetic involvement in chronic pulmonary heart, as well as the fact that prolonged and effective chemotherapy weakens adverse cardiovascular effects of immunologic factors, which can however persist in some individuals even after they are apparently cured from tuberculosis

  16. A prevalence study of pulmonary tuberculosis in hospital visited diabetes patients

    International Nuclear Information System (INIS)

    Chung, Ho Keun; Lee, Hang Young; Joo, Kyung Bin; Kim, Kun Sang

    1983-01-01

    We reviewed the records of randomly selected 320 diabetic out-patients at EuiJi Hospital from April 1981 through March 1983. Fasting blood sugar (FBS) of 140 mg/dl or more was taken as a criteria of diabetes according to the report of National Diabetes Data Group. The results are as follows: 1. Mean age of study group was 50.8 years-old and the FBS mean value was 222.4 mg/dl. 2. There was no significant difference of FBS values of tuberculosis and non-tuberculosis patients. 3. Prevalence of pulmonary tuberculosis evaluated by chest films was 13.4 percent in diabetes patients. This value is lower than those of other studies but higher than that of urban population in Korea (p<0.05)

  17. Assessment of Cardiovascular Fitness of Patients with Pulmonary Tuberculosis Using Six Minute Walk Test

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    Taofeek Oluwole Awotidebe

    2010-04-01

    Full Text Available AIM: Patients with pulmonary tuberculosis (TB tends to have limited exercise tolerance and a significant disability affecting their activities of daily living. The importance of exercise in the management of these patients has not been well investigated. This study was designed to assess the cardiovascular fitness of patients with pulmonary TB using the six-minute walk test (6-MWT. METHOD: Sixty five consented patients with Pulmonary TB were consecutively recruited into the study. The patients performed 6-MWT over a 30 meter course on a level walkway at a speed as fast as they could. Data were obtained on participants’ physical characteristics, pre and post exercise blood pressure and heart rate, and maximum oxygen consumption. Data were analyzed using descriptive statistics of mean and standard deviation and paired t-test. RESULTS: The post walk test cardiovascular parameters were significantly higher than the resting cardiovascular parameters. The mean VO2 max and MET of the participants were 11.7±0.97 (ml O2kg -1min-1 and 3.35±0.28 (mL/Kg respectively. The means 6-MWT distance for male and female participants were 502.0±43.0m 481.7±68.3m respectively. CONCLUSION: The result implies that the 6-MWT is capable of evoking a significant cardiovascular change among patients with pulmonary TB. The 6-MWT may be useful in the assessment of functional capacity of patients with pulmonary TB. [TAF Prev Med Bull 2010; 9(2.000: 99-106

  18. Ex vivo expansion of alveolar macrophages with Mycobacterium tuberculosis from the resected lungs of patients with pulmonary tuberculosis

    Science.gov (United States)

    Petrunina, Ekaterina; Umpeleva, Tatiana; Karskanova, Svetlana; Bayborodin, Sergey; Vakhrusheva, Diana; Kravchenko, Marionella; Skornyakov, Sergey

    2018-01-01

    Tuberculosis (TB), with the Mycobacterium tuberculosis (Mtb) as the causative agent, remains to be a serious world health problem. Traditional methods used for the study of Mtb in the lungs of TB patients do not provide information about the number and functional status of Mtb, especially if Mtb are located in alveolar macrophages. We have developed a technique to produce ex vivo cultures of cells from different parts of lung tissues surgically removed from patients with pulmonary TB and compared data on the number of cells with Mtb inferred by the proposed technique to the results of bacteriological and histological analyses used for examination of the resected lungs. The ex vivo cultures of cells obtained from the resected lungs of all patients were largely composed of CD14-positive alveolar macrophages, foamy or not, with or without Mtb. Lymphocytes, fibroblasts, neutrophils, and multinucleate Langhans giant cells were also observed. We found alveolar macrophages with Mtb in the ex vivo cultures of cells from the resected lungs of even those TB patients, whose sputum smears and lung tissues did not contain acid-fast Mtb or reveal growing Mtb colonies on dense medium. The detection of alveolar macrophages with Mtb in ex vivo culture as soon as 16–18 h after isolation of cells from the resected lungs of all TB patients suggests that the technique proposed for assessing the level of infection in alveolar macrophages of TB patients has higher sensitivity than do prolonged bacteriological or pathomorphological methods. The proposed technique allowed us to rapidly (in two days after surgery) determine the level of infection with Mtb in the cells of the resected lungs of TB patients and, by the presence or absence of Mtb colonies, including those with cording morphology, the functional status of the TB agent at the time of surgery. PMID:29401466

  19. "Rigor mortis" in a live patient.

    Science.gov (United States)

    Chakravarthy, Murali

    2010-03-01

    Rigor mortis is conventionally a postmortem change. Its occurrence suggests that death has occurred at least a few hours ago. The authors report a case of "Rigor Mortis" in a live patient after cardiac surgery. The likely factors that may have predisposed such premortem muscle stiffening in the reported patient are, intense low cardiac output status, use of unusually high dose of inotropic and vasopressor agents and likely sepsis. Such an event may be of importance while determining the time of death in individuals such as described in the report. It may also suggest requirement of careful examination of patients with muscle stiffening prior to declaration of death. This report is being published to point out the likely controversies that might arise out of muscle stiffening, which should not always be termed rigor mortis and/ or postmortem.

  20. Care seeking behaviour and various delays in tuberculosis patients registered under RNTCP in Pune city

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    Jayashree Sachin Gothankar

    2016-03-01

    Full Text Available Introduction: Case finding in tuberculosis is known to be influenced by factors such as patient motivation, care seeking, the degree of diagnostic suspicion by health care provider which could result in a delayed diagnosis.Objective: To determine care seeking behaviour and delay in diagnosis and treatment of new sputum positive tuberculosis patients registered under RNTCP.Material and Methods: Descriptive cross sectional study. 283 new sputum positive tuberculosis patients (≥15 years of age registered during a period of six months at two randomly selected tuberculosis unit of Pune city. Questionnaire by WHO was modified and used. Interviews were conducted in DOT centres. Statistical analysis: Frequency, mean and standard deviation, chi square test.Results: Mean age of patients was 35 (±15 years18% of patients were unemployed and 77% resided in urban slums. The commonest co morbidity in 7.4% and 3.5 % patients was HIV/ AIDS followed by diabetics respectively. Majority of the patients, for the first and second time visited a general practitioner. Median patient, health care system and total delay were 18, 22 and 47 days with mean of 24±21, 32±30 and 56±33 days respectively. Health care system delay was less (p<0.05 in patients who first visited the public health care facility than patients who first visited a private health care provider.Conclusions: General practitioners are preferred first choice of health care provider for tuberculosis patients. Mean health care system delay is more than patient delay.

  1. Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria

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    Adebimpe Wasiu Olalekan

    2015-09-01

    Conclusion: Hyponatraemia, hyperkalaemia, and hypochloremia characterized some of the electrolyte imbalance among TB patients receiving treatments. The raised level of bicarbonate may be attributed to overcorrection of respiratory acidosis often found in patients with tuberculosis. Monitoring electrolytes is therefore an important component of TB management.

  2. Registration and management of community patients with tuberculosis in north-west China

    NARCIS (Netherlands)

    Wang, X.; Cai, J.; Wang, D.; Wang, Q.; Liang, H.; Ma, A.; Schouten, E.G.; Kok, F.J.

    2015-01-01

    OBJECTIVES: To describe the registration, management and characteristics of patients with tuberculosis (TB) in north-west China, and investigate whether patients with TB were diagnosed and treated in a timely manner.STUDY DESIGN: Health-facility-based retrospective data were collected from district

  3. Tuberculosis among HIV-positive patients across Europe: changes over time and risk factors

    NARCIS (Netherlands)

    Kruk, Alexey; Bannister, Wendy; Podlekareva, Daria N.; Chentsova, Nelly P.; Rakhmanova, Aza G.; Horban, Andrzej; Domingo, Perre; Mocroft, Amanda; Lundgren, Jens D.; Kirk, Ole; Losso, M.; Elias, C.; Vetter, N.; Zangerle, R.; Karpov, I.; Vassilenko, A.; Mitsura, V. M.; Suetnov, O.; Clumeck, N.; de Wit, S.; Delforge, M.; Colebunders, R.; Vandekerckhove, L.; Hadziosmanovic, V.; Kostov, K.; Begovac, J.; Machala, L.; Sedlacek, D.; Nielsen, J.; Kronborg, G.; Benfield, T.; Larsen, M.; Gerstoft, J.; Katzenstein, T.; Hansen, A.-B. E.; Skinhøj, P.; Pedersen, C.; Ostergaard, L.; Zilmer, K.; Ristola, M.; Katlama, C.; Viard, J.-P.; Girard, P.-M.; Livrozet, J. M.; Vanhems, P.; Pradier, C.; Dabis, F.; Neau, D.; Rockstroh, J.; Reiss, P.

    2011-01-01

    To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe. Poisson regression models were used to determine temporal changes in incidence rate of TB among 11,952 patients

  4. The socioeconomic impact of multidrug resistant tuberculosis on patients: results from Ethiopia, Indonesia and Kazakhstan

    NARCIS (Netherlands)

    van den Hof, Susan; Collins, David; Hafidz, Firdaus; Beyene, Demissew; Tursynbayeva, Aigul; Tiemersma, Edine

    2016-01-01

    One of the main goals of the post-2015 global tuberculosis (TB) strategy is that no families affected by TB face catastrophic costs. We revised an existing TB patient cost measurement tool to specifically also measure multi-drug resistant (MDR) TB patients' costs and applied it in Ethiopia,

  5. Characteristics of pulmonary tuberculosis patients in Moses Kotane ...

    African Journals Online (AJOL)

    JLM Yoko

    the Southeast Asia, African and Western Pacific region (35%, 30% and 20% ... India, Indonesia, Nigeria, Pakistan, China and South Africa.2. Tuberculosis continues ... TB smear/culture in the last month of treatment and on at least one previous ...

  6. Clarithromycin increases linezolid exposure in multidrug-resistant tuberculosis patients

    NARCIS (Netherlands)

    Bolhuis, Mathieu S.; van Altena, Richard; van Soolingen, Dick; de Lange, Wiel C. M.; Uges, Donald R. A.; van der Werf, Tjip S.; Kosterink, Jos G. W.; Alffenaar, Jan-Willem C.

    2013-01-01

    The use of linezolid for the treatment of multidrug-resistant tuberculosis is limited by dose-and time-dependent toxicity. Recently, we reported a case of pharmacokinetic drug drug interaction between linezolid and clarithromycin that resulted in increased linezolid exposure. The aim of this

  7. Perceptions of HIV, AIDS and tuberculosis among patients on ...

    African Journals Online (AJOL)

    The objectives of the research were to explore perceptions of HIV, AIDS and tuberculosis (TB) among individuals enrolled in antiretroviral therapy (ART) at two municipal clinics in Bulawayo, Zimbabwe, and to assess the implications of these perceptions on the provision of HIV and TB care services. Data were collected ...

  8. Health Literacy Amongst Tuberculosis Patient in a General Hospital ...

    African Journals Online (AJOL)

    Background: Healthy literacy has been shown to improve health care access and adherence to Tuberculosis (TB) treatment. Still it remains largely unstudied in many high risks, underserved and low literacy African populations. This study aims to bridge the existing knowledge gap by assessing health literacy among ...

  9. Illness perceptions and quality of life among tuberculosis patients in ...

    African Journals Online (AJOL)

    used to distinguish health effects from other factors in- fluencing a ... A study from India has shown that the ..... Employee. 0.16. 0.26. 0.04. 1.67. Laborer. 0.33. 0.40. 0.07. 2.53. Employer* ..... Tuberculosis stigma and discrimination worldwide:.

  10. Epidemiology of tuberculosis in HIV-infected patients in Denmark

    DEFF Research Database (Denmark)

    Dragsted, Ulrik Bak; Bauer, J; Poulsen, S

    1999-01-01

    Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has...

  11. Quantiferon test for tuberculosis screening in sarcoidosis patients

    DEFF Research Database (Denmark)

    Milman, Nils; Søborg, Bolette; Svendsen, Claus Bo

    2011-01-01

    Tumour necrosis factor-alpha (TNF-α) inhibitors have been introduced in the treatment of refractory sarcoidosis. These biologics may reactivate latent tuberculosis infection (LTBI). Despite its known limitations, the tuberculin skin test (TST) is currently used for the diagnosis of LTBI in Danish...

  12. Bronchoscopy for the diagnosis of pulmonary tuberculosis in patients with negative sputum smear microscopy results.

    Science.gov (United States)

    Jacomelli, Márcia; Silva, Priscila Regina Alves Araújo; Rodrigues, Ascedio Jose; Demarzo, Sergio Eduardo; Seicento, Márcia; Figueiredo, Viviane Rossi

    2012-01-01

    To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to bronchoscopy-BAL and transbronchial biopsy (TBB). The BAL specimens were submitted to direct testing and culture for AFB and fungi, whereas the TBB specimens were submitted to histopathological examination. Of the 286 patients studied, 225 (79%) were diagnosed on the basis of bronchoscopic findings, as follows: pulmonary tuberculosis, in 127 (44%); nonspecific chronic inflammation, in 51 (18%); pneumocystis, fungal infections, or nocardiosis, in 20 (7%); bronchiolitis obliterans organizing pneumonia, alveolites, or pneumoconiosis, in 14 (5%); lung or metastatic neoplasms, in 7 (2%); and nontuberculous mycobacterium infections, in 6 (2%). For the diagnosis of tuberculosis, BAL showed a sensitivity and a specificity of 60% and 100%, respectively. Adding the TBB findings significantly increased this sensitivity (to 84%), as did adding the post-bronchoscopy sputum smear microscopy results (total sensitivity, 94%). Minor post-procedure complications occurred in 5.6% of the cases. Bronchoscopy is a reliable method for the diagnosis of pulmonary tuberculosis, with low complication rates. The combination of TBB and BAL increases the sensitivity of the method and facilitates the differential diagnosis with other diseases.

  13. INFLUENCE OF IMMUNOLOGICAL DISORDERS ON AN OUTCOME FOR THE FIRST TIME DIAGNOSED INFILTRATIVE TUBERCULOSIS IN SOCIALLY SAFE PATIENTS

    Directory of Open Access Journals (Sweden)

    A. V. Mordyk

    2014-01-01

    Full Text Available The assessment of immunological indicators in 76 first time diagnosed infiltrative tuberculosis of lungs in socially safe patients prior to treatment and in 2 months of chemotherapy was carried out. It is revealed that immunological disorders are connected with efficiency of tuberculosis treatment . It can be criterion of quality of provided chemotherapy. The activation of cell immunity, stimulation of phagocytosis activity of neutrophils would contribute for effective treatment of tuberculosis.

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

    Directory of Open Access Journals (Sweden)

    Syed Fawad Mashhadi

    2014-09-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  16. [Expression of high mobility group box-1 in the lung tissue and serum of patients with pulmonary tuberculosis].

    Science.gov (United States)

    Yang, Xiao-min; Yang, Hua

    2013-07-01

    To explore the expression of high mobility group box-1 (HMGB1) in the lung tissue and serum of patients with pulmonary tuberculosis and to explore its relationship with tumor necrosis factor (TNF)-α and interleukin(IL)-1β. Sixty samples of lung tissues were obtained from patients with pulmonary tuberculosis who had underwent pneumonectomy in Department of Chest Surgery, First Affiliated Hospital of Zunyi Medical College from June 2010 to December 2011. At the same period, 40 normal lung samples were also obtained from patients with pulmonary contusion and lung cancer by surgical resections as the control group. The mRNA expressions of HMGB1 was detected by reverse transcription-polymerase chain reaction (RT-PCR), and the protein level of HMGB1 was measured by immunohistochemical staining of tissue microarrays in lung tissue. Blood samples were taken from 89 patients with active pulmonary tuberculosis (pulmonary tuberculosis group), including hematogenous disseminated pulmonary tuberculosis (type II) in 35 cases and secondary pulmonary tuberculosis (type III) in 54 cases, and 50 healthy volunteers (control group). Furthermore, the 54 patients with secondary pulmonary tuberculosis were divided into different subgroups according to cavity formation and the lung fields involved: patients without lung cavity (35 cases) vs those with lung cavity (19 cases), patients with involvement of pulmonary tuberculosis (69 ± 29) was significantly higher than that in normal lung tissue (22 ± 12) (t = 2.389, P pulmonary tuberculosis (786 ± 86) was significantly higher than that in normal lung tissue (202 ± 60) (t = 3.872, P pulmonary tuberculosis group were (5.0 ± 3.2) µg/L, (118 ± 77) ng/L and (33 ± 20) ng/L, respectively, which were significantly higher than those in the control group [(1.7 ± 1.0) µg/L, (40 ± 11) ng/L and (18 ± 12) ng/L, respectively], the respective t values being -0.928, 4.268 and 11.064, all P pulmonary tuberculosis, the serum concentration of HMGB

  17. [Tuberculosis in compromised hosts].

    Science.gov (United States)

    2003-11-01

    among patients with pulmonary tuberculosis was 8.4 percent. The mean age of gastric resection was 50.2 +/- 16.6 years, and the mean interval from gastrectomy to pulmonary tuberculosis was 13.6 +/- 11.0 years. On admission to our hospital, 34 out of 55 cases were smear positive by sputum examination for acid-fast bacilli and 39 cases had cavitary lesions on chest X-ray. Gastrectomy was done due to carcinoma of the stomach in 31 cases, gastric and/or duodenal ulcer in 21 cases, adenomatous polyp in two cases, and accidental injury in one case. 52 patients improved, but three cases died due to pulmonary tuberculosis. No one had recurrence of carcinoma of the stomach. Body weight, Body Mass Index, Prognostic Nutritional Index (PNI; 10x serum albumin concentration +0.005 x peripheral lymphocyte count) which was proposed by Onodera, serum albumin level and serum total cholesterol level were lower in the gastrectomy group than in the non-gastrectomy group. I calculated the odds of tuberculosis among gastrectomy patients to be 3.8 times that of appropriate controls. This study confirms that gastrectomy is one of the risk factor(s) of tuberculosis. However, whether gastrectomy in itself is a risk factor or whether it is secondarily associated with another risk factor such as underweight status and/or inadequate nutrition following surgery remains unclear. 3. Immunodefficiency and tuberculosis in dialysis patients: Hajime INAMOTO (Division of Dialysis, Keio University School of Medicine). The patients who have renal insufficiency is fatal, but they can live much longer by dialysis. The number of lymphocytes of the patients whose serum creatinine was 10 mg/dl or more has decreased to about 50% of the people who have normal kidney. When the lymphocyte was cultured after it was stimulated with PHA, the DNA synthesis of the patients' lymphocyte was much lower than that of the modest people's. In the dialysis food, the nutrient such as vitamins, minerals, etc. were lacked. The density

  18. Improvement of therapy of inflammatory dieseases of parodentium in patients with focal tuberculosis

    Directory of Open Access Journals (Sweden)

    Shuldyakov А.А.

    2011-03-01

    Full Text Available The purpose of the study is to determine clinical and pathogenetic efficacy of cycloferon liniment in the combined therapy of periodontitis of patients with focal tuberculosis. It is proved, that use of liniment Cycloferon in the combined treatment of patients with focal tuberculosis allows to accelerate process of normalization of parameters of lipid per-oxidation and antioxidant potential of blood, to decrease infection (herpes symplex virus I, Candida albicans, staphylo-coccus aureus in parodontal pockets and local inflammation with reduction of activity of factor tumours necrosis and interleukin 1b. It leads to soon recovery and decrease of frequency of parodontitis recurrences

  19. Incidence, risk factors and mortality of tuberculosis in Danish HIV patients 1995-2007

    DEFF Research Database (Denmark)

    Taarnhøj, Gry A.; Engsig, Frederik N; Ravn, Pernille

    2011-01-01

    Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods.......Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods....

  20. IMPACT OF MEDICAL AND SOCIAL FACTORS ON SURGICAL OUTCOMES OF PULMONARY TUBERCULOSIS IN HIV POSITIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    D. V. Аlkаz

    2018-01-01

    Full Text Available The article presents the study of the impact of social and medical factors and bad habits on the outcomes of planned surgery in 95 patients with concurrent respiratory tuberculosis and HIV infection The correlation analysis was performed which discovered the factors providing a positive impact on treatment outcomes The following factors have the strongest association with treatment outcome: patient's regular job, family, no alcohol or nicotine addiction, a form of tuberculosis, and administration of antiretroviral therapy It was noted that surgery outcome could be predicted and potential complications prevented 

  1. Changes of serum HA and LN level in patients with pulmonary tuberculosis after therapy

    International Nuclear Information System (INIS)

    Yu Jing Zhang Hongwei; Li Jie

    2007-01-01

    Objective: To study the serum HA and LN level in patients with pulmonary tuberculosis and their response to therapy. Methods: Serum HA and LN levels were measured with RIA in: (1) 42 patients with active pulmonary tuberculosis both before and after 2 months' therapy, (2) 40 patients with non-active pulmonary TB and 330 controls. Results: The serum HA and LN level in patients with active pulmonary tubemulosis were significantly higher than those in controls (P < 0.01 ), while no significant difference could Be found Between the levels in patients with non-active pulmonary tuberculosis and controls. The serum HA and LN level in patients with active pulmonary tuberculosis dropped after therapy, but were still higher than those in controls. Significant correlation could Be found between HA and LN levels (P<0.01). The HA and LN levels were positively correlated with severity of the disease, ESR and CRP contents. Conclusion: The measurement of serum HA and LN is valuable for early diagnosis, monitoring development and assessment of therapeutic effect in patients with pulmonary tubemulosis. (authors)

  2. A study of the patients suffering from tuberculosis and tuberculosis-diabetes comorbidity in Revised National Tuberculosis Control Program Centers of Northern Madhya Pradesh, India

    Directory of Open Access Journals (Sweden)

    Anil Kumar Agarwal

    2017-01-01

    Full Text Available Background: Diabetes mellitus (DM is recognized as an important risk factor to tuberculosis (TB. India has high TB burden, along with rising DM prevalence. Aim: This study was conducted to document the coexistence of DM and TB in persons with established TB under the Revised National Tuberculosis Control Program. Type of Study: This was a cross-sectional, descriptive observational study conducted at selected Directly Observed Therapy center in Gwalior North Central India. Materials and Methods: A total of 550 patients with confirmed diagnosis of TB and on treatment were recruited. The study participants were screened for DM and diagnoses were made on the basis of the World Health Organization criteria. Clinical parameters were compared between persons with DM and those without DM. Results: DM/TB co-morbidity was noted in 85 individuals and these made up 15.4% of the study population. The mean age was higher in DM patients with TB (43.4 ± 15.4 vs. 33.1 ± 16.2 years, P = 0.000; the mean duration of symptoms of TB with DM was more (124 ± 16.4 vs. 107.49 ± 10.3 days. Multinomial logistic regression analysis showed that increasing age, positive family history of diabetes, sedentary occupation, and presence of pulmonary TB were significantly associated with diabetes among TB patients. Conclusions: Diabetes is an important co-morbid feature to be sought in patients with TB. This study re-echo the need to raise awareness on screening for DM in persons with TB.

  3. T Cell Reactivity against Mycolyl Transferase Antigen 85 of M. tuberculosis in HIV-TB Coinfected Subjects and in AIDS Patients Suffering from Tuberculosis and Nontuberculous Mycobacterial Infections

    Directory of Open Access Journals (Sweden)

    Pascal Launois

    2011-01-01

    Full Text Available The mycolyl transferase antigen 85 complex is a major secreted protein family from mycobacterial culture filtrate, demonstrating powerful T cell stimulatory properties in most HIV-negative, tuberculin-positive volunteers with latent M.tuberculosis infection and only weak responses in HIV-negative tuberculosis patients. Here, we have analyzed T cell reactivity against PPD and Ag85 in HIV-infected individuals, without or with clinical symptoms of tuberculosis, and in AIDS patients with disease caused by nontuberculous mycobacteria. Whereas responses to PPD were not significantly different in HIV-negative and HIV-positive tuberculin-positive volunteers, responses to Ag85 were significantly decreased in the HIV-positive (CDC-A and CDC-B group. Tuberculosis patients demonstrated low T cell reactivity against Ag85, irrespective of HIV infection, and finally AIDS patients suffering from NTM infections were completely nonreactive to Ag85. A one-year follow-up of twelve HIV-positive tuberculin-positive individuals indicated a decreased reactivity against Ag85 in patients developing clinical tuberculosis, highlighting the protective potential of this antigen.

  4. Tuberculosis verrucosa cutis

    Directory of Open Access Journals (Sweden)

    Krishnabharath S

    2017-08-01

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

  5. Delay in DOTS for new pulmonary tuberculosis patient from rural area of Wardha District, India

    Directory of Open Access Journals (Sweden)

    Shilpa Bawankule

    2010-07-01

    Full Text Available Vast majority of active tuberculosis patients seeks treatment, do so promptly, still many patients spend a great deal of time and money “shopping for health” and too often they do not receive either accurate diagnosis or effective treatment, despite spending considerable resources. Objective: To find out the time taken to, for diagnosis of tuberculosis and to put patient on DOTS from the onset of symptoms and pattern of health seeking behavior of new pulmonary tuberculosis patients. A cross-sectional rapid assessment using qualitative (FGD and quantitative (Interview methods conducted at DOTS center of tertiary care hospital from rural Wardha. Participants: 53 pulmonary tuberculosis patients already on DOTS, in intensive phase. Main outcome measure: Delay in initiation of DOTS & health seeking behavior Results: Median total delay for starting DOTS was 111 days, (range: 10 to 321 days. Patient delay was more than provider delay. Patients delay was more in patients above 60 years, illiterate, per-capita income below 650 Rupees and HIV TB co-infection. Pattern of health seeking behavior was complex. Family physician was the preferred health care provider. Patient visited on an average four providers and spent around 1450 rupees (only direct cost before DOTS begin. Time taken from the onset of symptoms and start of DOT is a cause of concern for the tuberculosis control program. Early case detection is important rather than mere achieving target of 70% new case detection. Program manager needs to implement locally relevant & focused strategies for early case detection to improve the treatment success, especially in rural area of India.

  6. THE DIFFERENCE OF MAP1LC3 LEVEL AS MACROPHAGE AUTOPHAGY MARKER BETWEEN RESISTANT AND SENSITIVE TUBERCULOSIS PATIENTS ON RIFAMPICIN

    Directory of Open Access Journals (Sweden)

    Dian novita W

    2018-04-01

    Full Text Available Mycobacterium tuberculosis (MTB is an intracelular bacteria that live in the host macrophage cells. Several organs can be affected by tuberculosis but most major illnesses are lung diseases. Immediately after infection, MTB will be phagocytosed by the alveolar macrophage cells and can survive in the phagosome. The macrophage plays a role in innate immunity towards an infection using autophagy by removing the microbe directly via phagocytosis. When bacteria phagocytosized, vacuole membrane formed double membranes called autophagosome, and followed by degradation by lysosome, which known as autolysosome. Induction of autophagy can be observed on the formation of microtubule-associated proteins 1B lightchain 3B (MAP1LC3B/LC3. MAP1LC3B is protein that have role at autophagic way for selection autophagy substrate and biogenesis. In this study we are used serum from patients TB with rifampicin resistant and rifampicin sensitive as control. Samples were divided using gene expert to differentiate between resistant and sensitive rifampicin.This research aims to compare MAP1LC3B levels in resistant and sensitive rifampicin to study macrophages respond in autophagic way in tuberculosis patients, and give information for define therapy plan to improve therapy for MDR-TB patients. Type of this research is a case control study design with cross sectional research with each groups sample is 19 from age 18-65 years old. Result, MAP1LC3B serum levels on the rifampicin resistant group are lower compared to rifampicin sensitive group. This occur because MTB is able to hide and evade innate immune defense mechanisms. MTB can maintain intracellular growth inside the phagosome by inhibiting phagolysosome formation in autophagy process especially inhibit MAP1LC3B formation by PDIM.

  7. Tuberculosis: Which patients do not identify their contacts?

    Directory of Open Access Journals (Sweden)

    J. Josaphat

    2014-09-01

    Full Text Available Setting: It is not known what the magnitude of non-identified TB contacts is in our country, or the reasons why contacts at risk are not identified. Objective: The purpose of this study was to analyze the determinants associated with non-identification of contacts. Design: This cross-sectional study included all cases of pulmonary tuberculosis diagnosed and treated in the Chest Disease Centre of Vila Nova de Gaia and their contacts, from 1st January to 31st December 2010. It included information collected from patients related to the identification of contacts in risk, and the information collected by the Public Health Unit during home, work and social places visits. Results: During the period of study, 61 cases of pulmonary TB were diagnosed: 41 cases (67.2% identified all their contacts and 20 cases (32.8% did not. 646 contacts were identified: 154 (23.8% were identified only by the Public Health Unit (mean age of 40.67, and 492 (76.2% were identified by the index cases (mean age of 33.25, (p = 0.001. A mean of 10.59 contacts were identified per index case, of which, 83 (19.3% screened positive. From those identified by the Public Health Unit, 10 (9.8% had LTBI and 5 (4.9% had active TB, and by the index case 61 (18.6% had LTBI and 7 (2.1% had active TB (crude OR = 1.52; CI = 0.83–2.79. The multivariate analysis showed that employment (adjusted OR = 4.82; 95%CI = 1.71–13.54 was associated to non-identification of contacts and patients preferably tended to identify relatives and co-habitants (adjusted OR = 0.22; 95%CI = 0.10–0.47. Conclusion: TB patients tend to identify relatives and co-habitant contacts; contact at place of employment was found to be an independent risk factor for not being identified. Resumo: Contexto: Não é conhecida a magnitude dos contactos de TB não identificados no nosso país, nem os motivos porque os contactos em risco não são identificados

  8. Imaging in Tuberculosis abdominal

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  9. IMPACT OF THE FORM OF MEDICATION ON TREATMENT ADHERENCE IN RESPIRATORY TUBERCULOSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    T. E. Tyulkova

    2017-01-01

    Full Text Available The goal of the study: to investigate treatment adherence in respiratory tuberculosis patients depending on the choice of therapy.Subjects and methods: retrospective full-design study. The case histories of adult new tuberculosis cases who were treated in TB Dispensary in 2015 were analyzed. The groups were formed based on the intake of combined drugs with fixed doses (1 tablet contained 60 mg of isoniazid, 120 mg of rifampicin, 300 mg of pyrazinamide, 225 mg of ethambutol, and 20 mg of pyridoxine – Group 1 (n = 38; or separate tablets in the doses as per drug use instructions (isoniazid, rifampicin, pyrazinamide, ethambutol – Group 2 (n = 78. The groups were compatible as per sex, age, and clinical manifestations of tuberculosis. Patients from Group 1 with the weight of 60 kg received 5 tablets and patients from Group 2 received more than 12 tablets. Patients' adherence to treatment was assessed as per regularity of intake and number of doses during the intensive phase of treatment.Results. Patients from Group 1 were regularly taking anti-tuberculosis drugs, while in Group 2 there were interruptions of treatment (7-21 days in 12 (15.4% patients. In Group, the intensive phase increased up to 90.2 ± 30.6 doses and in Group 2 this increase made 131.6 ± 65.4 doses due to late sputum conversion. In Group 1, sputum conversion was achieved during the first month of treatment in 60% of patients; and in Group 2 – in 10% of cases (p = 0.044. The frequency of transaminase elevation as a side effect was higher in Group 1, but it did not result in discontinuation of drugs. Thus, the intake of combined medication with fixed doses improved tuberculosis patients' adherence to treatment.

  10. Type 2 diabetes mellitus and its influence in the development of multidrug resistance tuberculosis in patients from southeastern Mexico.

    Science.gov (United States)

    Pérez-Navarro, Lucia Monserrat; Fuentes-Domínguez, Francisco Javier; Zenteno-Cuevas, Roberto

    2015-01-01

    To determine the factors associated with the presence of pulmonary tuberculosis in patients with type 2 diabetes mellitus and the effect in the development of drug and multi-drug resistance, in a population with tuberculosis from the southeast of Mexico. This is a case-control study including 409 individuals, 146 with the binomial tuberculosis-type 2 diabetes mellitus and 263 individuals with tuberculosis. Demographic, epidemiological and outcome variables were collected. Risks were calculated. The factors associated with the presence of type 2 diabetes mellitus were age ≥35years, (OR=9.7; CI: 5.2-17.8), previous contact with a person infected with tuberculosis (OR=1.7; CI: 1.1-3.1). Body mass index ≥25 kg/m(2) (OR=2.2; CI: 1.1-4.3), and inherited family history of diabetes (OR=5.4; CI: 3.2-9.2). It was also found that patients with tuberculosis-type 2 diabetes mellitus presented a 4.7-fold (CI: 1.4-11.3) and 3.5-fold (CI: 1.1-11.1) higher risk of developing drug- and multidrug resistance tuberculosis, respectively. By last, individuals with tuberculosis-type 2 diabetes had a 2.3-fold (CI: 1.5-4.1) greater chance of persisting as tuberculosis-positive by the second month of treatment, delaying the resolution of the tuberculosis infection. Type 2 diabetes exerts a strong influence on the presentation and evolution of tuberculosis within the analyzed population and displays remarkable particularities, necessitating the development of dedicated tuberculosis-diabetes surveillance systems that consider the particular epidemiological characteristics of the population affected. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Bloodstream Infections with Mycobacterium tuberculosis among HIV patients

    Centers for Disease Control (CDC) Podcasts

    2010-09-23

    This podcast looks at bloodstream infections with Mycobacterium tuberculosis and other pathogens among outpatients infected with HIV in Southeast Asia. CDC health scientist Kimberly McCarthy discusses the study and why bloodstream infections occur in HIV-infected populations.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/23/2010.

  12. Exploratory Study on Plasma Immunomodulator and Antibody Profiles in Tuberculosis Patients

    Science.gov (United States)

    Ravindran, Resmi; Krishnan, Viswanathan V.; Khanum, Azra; Luciw, Paul A.

    2013-01-01

    Host immune responses to Mycobacterium tuberculosis are generally able to contain infection and maintain a delicate balance between protection and immunopathology. A shift in this balance appears to underlie active disease observed in about 10% of infected individuals. Effects of local inflammation, combined with anti-M. tuberculosis systemic immune responses, are directly detectable in peripheral circulation, without ex vivo stimulation of blood cells or biopsy of the affected organs. We studied plasma immunomodulator and antibody biomarkers in patients with active pulmonary tuberculosis (TB) by a combination of multiplex microbead immunoassays and computational tools for data analysis. Plasma profiles of 10 immunomodulators and antibodies against eight M. tuberculosis antigens (previously reported by us) were examined in active pulmonary TB patients in a country where TB is endemic, Pakistan. Multiplex analyses were performed on samples from apparently healthy individuals without active TB from the same community as the TB patients to establish the assay baselines for all analytes. Over 3,000 data points were collected from patients (n = 135) and controls (n = 37). The data were analyzed by multivariate and computer-assisted cluster analyses to reveal patterns of plasma immunomodulators and antibodies. This study shows plasma profiles that in most patients represented either strong antibody or strong immunomodulator biomarkers. Profiling of a combination of both immunomodulators and antibodies described here may be valuable for the analysis of host immune responses in active TB in countries where the disease is endemic. PMID:23761664

  13. A cluster of multidrug-resistant Mycobacterium tuberculosis among patients arriving in Europe from the Horn of Africa: a molecular epidemiological study.

    NARCIS (Netherlands)

    Walker, Timothy M; Merker, Matthias; Knoblauch, Astrid M; Helbling, Peter; Schoch, Otto D; van der Werf, Marieke J; Kranzer, Katharina; Fiebig, Lena; Kröger, Stefan; Haas, Walter; Hoffmann, Harald; Indra, Alexander; Egli, Adrian; Cirillo, Daniela M; Robert, Jérôme; Rogers, Thomas R; Groenheit, Ramona; Mengshoel, Anne T; Mathys, Vanessa; Haanperä, Marjo; Soolingen, Dick van; Niemann, Stefan; Böttger, Erik C; Keller, Peter M

    2018-01-01

    The risk of tuberculosis outbreaks among people fleeing hardship for refuge in Europe is heightened. We describe the cross-border European response to an outbreak of multidrug-resistant tuberculosis among patients from the Horn of Africa and Sudan.

  14. Rationale and design of a randomized controlled trial of the effect of retinol and vitamin D supplementation on treatment in active pulmonary tuberculosis patients with diabetes

    DEFF Research Database (Denmark)

    Wang, Qiuzhen; Ma, Aiguo; Bygbjerg, Ib Christian

    2013-01-01

    The association between pulmonary tuberculosis (PTB) and diabetes mellitus (DM) has been previously attracted much attention. Diabetes alters immunity to tuberculosis, leading to more frequent treatment failure in TB patients with DM. Moreover, TB and DM often coincide with micronutrients...

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

    Science.gov (United States)

    Peltzer, Karl; Louw, Julia

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2013-01-01

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

  17. Platelet–lymphocyte ratios: a potential marker for pulmonary tuberculosis diagnosis in COPD patients

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    Chen G

    2016-11-01

    Full Text Available Guozhong Chen, Chunling Wu, Zhiying Luo, Yiming Teng, Suping Mao Department of Respiratory Medicine, Yiwu Central Hospital, Yiwu, Zhejiang Province, People’s Republic of China Background: In recent decades, morbidity and mortality have been found to be significantly increased in patients with chronic obstructive pulmonary disease (COPD complicated with pulmonary tuberculosis (PTB. Platelet–lymphocyte ratio (PLR is an indicator for inflammatory diseases. This study aims to investigate whether PLR could act as a potential marker for patients with COPD complicated with PTB.Methods: In this retrospective study, laboratory characteristics of 87 COPD patients complicated with PTB (determined by Mycobacterium tuberculosis positive culture from sputum or bronchial lavage fluid and 83 COPD patients (as the control group, determined by M. tuberculosis culture negativity from sputum or bronchial lavage fluid were investigated. Data obtained on the day of admission were analyzed.Results: PLR >216.82 was identified as the optimal cutoff value for discriminating COPD patients with PTB (sensitivity 92.4%, specificity 84.5%, positive-predictive value 91.6%, negative-predictive value 86.2%, and area under the curve [AUC] was 0.87 from patients with COPD alone. The AUC of PLR was significantly greater than that of neutrophil–lymphocyte count ratio (AUC, 0.74; 95% confidence interval, 0.67–0.81; P<0.01.Conclusion: PLR could be developed as a valuable maker for identifying tuberculosis infection in COPD patients. Keywords: platelet to lymphocyte ratio, pulmonary tuberculosis, chronic obstructive pulmonary disease

  18. Tuberculosis patients hospitalized in the Albert Schweitzer Hospital, Lambaréné, Gabon-a retrospective observational study

    NARCIS (Netherlands)

    Stolp, S. M.; Huson, M. A. M.; Janssen, S.; Beyeme, J. O.; Grobusch, M. P.

    2013-01-01

    Epidemiological data on tuberculosis in Central Africa are limited. We performed a retrospective observational study on clinical characteristics of 719 hospitalized tuberculosis patients in Lambaréné, Gabon. Human immunodeficiency virus (HIV) co-infection rate was high (34%) and in-hospital

  19. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

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

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...

  20. Outcomes, infectiousness, and transmission dynamics of patients with extensively drug-resistant tuberculosis and home-discharged patients with programmatically incurable tuberculosis: a prospective cohort study

    KAUST Repository

    Dheda, Keertan; Limberis, Jason D; Pietersen, Elize; Phelan, Jody; Esmail, Aliasgar; Lesosky, Maia; Fennelly, Kevin P; te Riele, Julian; Mastrapa, Barbara; Streicher, Elizabeth M; Dolby, Tania; Abdallah, Abdallah; Ben Rached, Fathia; Simpson, John; Smith, Liezel; Gumbo, Tawanda; van Helden, Paul; Sirgel, Frederick A; McNerney, Ruth; Theron, Grant; Pain, Arnab; Clark, Taane G; Warren, Robin M

    2017-01-01

    Background: The emergence of programmatically incurable tuberculosis threatens to destabilise control efforts. The aim of this study was to collect prospective patient-level data to inform treatment and containment strategies. Methods: In a prospective cohort study, 273 South African patients with extensively drug-resistant tuberculosis, or resistance beyond extensively drug-resistant tuberculosis, were followed up over a period of 6 years. Transmission dynamics, infectiousness, and drug susceptibility were analysed in a subset of patients from the Western Cape using whole-genome sequencing (WGS; n=149), a cough aerosol sampling system (CASS; n=26), and phenotypic testing for 18 drugs (n=179). Findings: Between Oct 1, 2008, and Oct 31, 2012, we enrolled and followed up 273 patients for a median of 20·3 months (IQR 9·6-27·8). 203 (74%) had programmatically incurable tuberculosis and unfavourable outcomes (treatment failure, relapse, default, or death despite treatment with a regimen based on capreomycin, aminosalicylic acid, or both). 172 (63%) patients were discharged home, of whom 104 (60%) had an unfavourable outcome. 54 (31%) home-discharged patients had failed treatment, with a median time to death after discharge of 9·9 months (IQR 4·2-17·4). 35 (20%) home-discharged cases were smear-positive at discharge. Using CASS, six (23%) of 26 home-discharged cases with data available expectorated infectious culture-positive cough aerosols in the respirable range (<5 μm), and most reported inter-person contact with suboptimal protective mask usage. WGS identified 17 (19%) of the 90 patients (with available sequence data) that were discharged home before the diagnosis of 20 downstream cases of extensively drug-resistant tuberculosis with almost identical sequencing profiles suggestive of community-based transmission (five or fewer single nucleotide polymorphisms different and with identical resistance-encoding mutations for 14 drugs). 11 (55%) of these downstream

  1. Outcomes, infectiousness, and transmission dynamics of patients with extensively drug-resistant tuberculosis and home-discharged patients with programmatically incurable tuberculosis: a prospective cohort study

    KAUST Repository

    Dheda, Keertan

    2017-01-19

    Background: The emergence of programmatically incurable tuberculosis threatens to destabilise control efforts. The aim of this study was to collect prospective patient-level data to inform treatment and containment strategies. Methods: In a prospective cohort study, 273 South African patients with extensively drug-resistant tuberculosis, or resistance beyond extensively drug-resistant tuberculosis, were followed up over a period of 6 years. Transmission dynamics, infectiousness, and drug susceptibility were analysed in a subset of patients from the Western Cape using whole-genome sequencing (WGS; n=149), a cough aerosol sampling system (CASS; n=26), and phenotypic testing for 18 drugs (n=179). Findings: Between Oct 1, 2008, and Oct 31, 2012, we enrolled and followed up 273 patients for a median of 20·3 months (IQR 9·6-27·8). 203 (74%) had programmatically incurable tuberculosis and unfavourable outcomes (treatment failure, relapse, default, or death despite treatment with a regimen based on capreomycin, aminosalicylic acid, or both). 172 (63%) patients were discharged home, of whom 104 (60%) had an unfavourable outcome. 54 (31%) home-discharged patients had failed treatment, with a median time to death after discharge of 9·9 months (IQR 4·2-17·4). 35 (20%) home-discharged cases were smear-positive at discharge. Using CASS, six (23%) of 26 home-discharged cases with data available expectorated infectious culture-positive cough aerosols in the respirable range (<5 μm), and most reported inter-person contact with suboptimal protective mask usage. WGS identified 17 (19%) of the 90 patients (with available sequence data) that were discharged home before the diagnosis of 20 downstream cases of extensively drug-resistant tuberculosis with almost identical sequencing profiles suggestive of community-based transmission (five or fewer single nucleotide polymorphisms different and with identical resistance-encoding mutations for 14 drugs). 11 (55%) of these downstream

  2. Successful drug desensitization in patients with delayed-type allergic reactions to anti-tuberculosis drugs

    Directory of Open Access Journals (Sweden)

    Krittaecho Siripassorn

    2018-03-01

    Full Text Available Objective: To evaluate the outcomes of anti-tuberculosis drug desensitization. Methods: This was a retrospective study. Inclusion criteria were as follows: age >18 years, documented tuberculosis infection, a previous cutaneous allergic reaction to anti-tuberculosis drugs, and having undergone drug desensitization between January 2003 and March 2014. The definition of allergic reaction to anti-tuberculosis drugs included (1 a temporal relationship between drug use and the allergic reaction; (2 improvement in the allergic reaction after drug withdrawal; (3 recurrence of the allergic reaction after reintroduction of only the offending drug; and (4 absence of other causes. Results: A total of 19 desensitization procedures were performed. The drugs used for these procedures were isoniazid (n = 7, rifampicin (n = 6, or ethambutol (n = 6. Of note, severe allergic reactions (Stevens–Johnson syndrome (n = 4, erythema multiforme (n = 3, and drug rash with eosinophilia and systemic syndrome (n = 1 were included. All patients underwent resolution of the previous allergic reactions before desensitization. The median duration of desensitization was 18 days. The success rate was 78.9%. The allergic reactions following failed desensitization were not severe; most were maculopapular rashes. Conclusions: The desensitization protocol for anti-tuberculosis drugs was associated with a high success rate, and the individuals who failed desensitization experienced mild allergic reactions. Keywords: Desensitization, Antituberculosis, Steven-Johnson syndrome, Allergic drug reaction, Tolerance induction, Drug allergy

  3. Nontuberculous mycobacterial species and Mycobacterium tuberculosis complex coinfection in patients with pulmonary tuberculosis in Dr. Soetomo Hospital, Surabaya, Indonesia

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    Ni Made Mertaniasih

    2017-01-01

    Full Text Available Objective/Background: The aim of this study was to analyze the detection of nontuberculous mycobacterial (NTM species derived from sputum specimens of pulmonary tuberculosis (TB suspects. Increasing prevalence and incidence of pulmonary infection by NTM species have widely been reported in several countries with geographical variation. Materials and Methods: Between January 2014 and September 2015, sputum specimens from chronic pulmonary TB suspect patients were analyzed. Laboratory examination of mycobacteria was conducted in the TB laboratory, Department of Clinical Microbiology, Dr. Soetomo Hospital, Surabaya. Detection and identification of mycobacteria were performed by the standard culture method using the BACTEC MGIT 960 system (BD and Lowenstein–Jensen medium. Identification of positive Mycobacterium tuberculosis complex (MTBC was based on positive acid-fast bacilli microscopic smear, positive niacin accumulation, and positive TB Ag MPT 64 test results (SD Bioline. If the growth of positive cultures and acid-fast bacilli microscopic smear was positive, but niacin accumulation and TB Ag MPT 64 (SD Bioline results were negative, then the isolates were categorized as NTM species. MTBC isolates were also tested for their sensitivity toward first-line anti-TB drugs, using isoniazid, rifampin, ethambutol, and streptomycin. Results: From 2440 sputum specimens of pulmonary TB suspect patients, 459 isolates (18.81% were detected as MTBC and 141 (5.78% as NTM species. Conclusion: From the analyzed sputum specimens, 18.81% were detected as MTBC and 5.78% as NTM species. Each pulmonary TB suspect patient needed clinical settings to suspect causative agents of MTBC and/or NTM species; clinicians have to understand the local epidemiological data for the evaluation of causes of lung infection to determine appropriate therapy.

  4. Altered microRNA Signatures in Sputum of Patients with Active Pulmonary Tuberculosis

    OpenAIRE

    Yi, Zhengjun; Fu, Yurong; Ji, Rui; Li, Ruifang; Guan, Zhiyu

    2012-01-01

    Role of microRNA (miRNA) has been highlighted in pathogen-host interactions recently. At present, their role in active pulmonary tuberculosis is unknown. The aim of the study was to delineate miRNA expression in sputum supernatant of patients with active pulmonary tuberculosis. Expression of miRNAs was evaluated by microarray analysis and differentially expressed miRNAs were validated by RT-qPCR. Secreted cytokines TNF-α and IL-6 were measured by ELISA. We found that 95 miRNAs were differenti...

  5. An unusual case of foreign body aspiration mimicking cavitary tuberculosis in adolescent patient: Thread aspiration

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    Cakir Erkan

    2012-05-01

    Full Text Available Abstract Foreign body aspiration continues to be a serious problem in childhood and adolescent period with significant rate of morbidity and rarely mortality. Half of the foreign body aspiration cases have no history of aspiration. The main foreign bodies inhaled are food fragments and different kinds of metallic objects. A 12-year-old girl was referred to the pediatric pulmonology department for chronic cough and hemoptysis. She had persistent infiltration and cavitary lesion mimicking cavitary tuberculosis. There was no contact history with tuberculosis in her family and acid resistant bacillus was not found in the sputum examination. Flexible bronchoscopy was performed for persistent infiltration and hemoptysis and inflamed thread was found in right lower lobe bronchus. This is the first case of thread inhalation mimicking cavitary tuberculosis in an adolescent patient.

  6. PREDNISONE THERAPY SAFETY FOR TREATMENT OF PATIENTS WITH MIX OF TUBERCULOSIS AND HIV-INFECTION

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    G. V. Maksimov

    2013-01-01

    Full Text Available Abstract. The study of prednisone safety for treatment of TB mixed with HIV-infection has been conducted. Two groups of patients were compared. The first group was consisted of 88 patients who were treated by prednisone and standard tuberculosis therapy, the second group of patients presented by 45 patients received only tuberculosis medicines. It was demonstrated that in case of prednisone using (1st group the number of CD4 limphocytes increased, intoxication symptoms disappeared fast and recovery process accelerated. Increasing of cases with unfavorable course of TB and HIV-infection in patients of first group was not registered in compare with the second group. Thus, using of prednisone therapy to treat TB mixed with HIV-infection was safe, not lead to unfavorable course of TB or HIV-infection. Such kind of treatment especially important for patients with exudative reactions.

  7. Cytokine Polymorphisms, Their Influence and Levels in Brazilian Patients with Pulmonary Tuberculosis during Antituberculosis Treatment

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    Eliana Peresi

    2013-01-01

    Full Text Available Cytokines play an essential role during active tuberculosis disease and cytokine genes have been described in association with altered cytokine levels. Therefore, the aim of this study was to verify if IFNG, IL12B, TNF, IL17A, IL10, and TGFB1 gene polymorphisms influence the immune response of Brazilian patients with pulmonary tuberculosis (PTB at different time points of antituberculosis treatment (T1, T2, and T3. Our results showed the following associations: IFNG +874 T allele and IFNG +2109 A allele with higher IFN-γ levels; IL12B +1188 C allele with higher IL-12 levels; TNF −308 A allele with higher TNF-α plasma levels in controls and mRNA levels in PTB patients at T1; IL17A A allele at rs7747909 with higher IL-17 levels; IL10 −819 T allele with higher IL-10 levels; and TGFB1 +29 CC genotype higher TGF-β plasma levels in PTB patients at T2. The present study suggests that IFNG +874T/A, IFNG +2109A/G, IL12B +1188A/C, IL10 −819C/T, and TGFB1 +21C/T are associated with differential cytokine levels in pulmonary tuberculosis patients and may play a role in the initiation and maintenance of acquired cellular immunity to tuberculosis and in the outcome of the active disease while on antituberculosis treatment.

  8. Tuberculosis patients in the Dominican Republic face severe direct and indirect costs and need social protection

    NARCIS (Netherlands)

    Mauch, V.M.C.; Melgen, R.; Marcelino, B.; Acosta, I.; Klinkenberg, E.; Suarez, P.

    2013-01-01

    OBJECTIVE: To examine direct and indirect costs incurred by new, retreatment, and multidrug-resistant (MDR) tuberculosis (TB) patients in the Dominican Republic before and during diagnosis, and during treatment, to generate an evidence base and formulate recommendations. METHODS: The "Tool to

  9. Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil

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    Liberato Isabella Ramos de Oliveira

    2004-01-01

    Full Text Available The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001, showed a higher frequency of weight loss >10 kilos (p <0.001, had a higher rate of non-reaction result to the tuberculin skin test (p <0.001, a higher frequency of negative sputum smear examination for acid-fast bacilli (p = 0.001 and negative sputum culture for Mycobacterium tuberculosis (p = 0.001. Treatment failure was more common in those who were HIV positive (p <0.000. No higher frequency of resistance to antituberculosis drugs was found to be associated with TB/HIV coinfection (p = 0.407. Association between extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis.

  10. Implications of the global increase of diabetes for tuberculosis control and patient care.

    NARCIS (Netherlands)

    Ruslami, R.; Aarnoutse, R.E.; Alisjahbana, B.; Ven, A.J.A.M. van der; Crevel, R. van

    2010-01-01

    OBJECTIVES: To review the current knowledge about tuberculosis (TB) and diabetes, assessing the implication of the global increase of diabetes for TB control and patient care. METHODS: Systematic literature review. RESULTS: Using public databases, it can be estimated that 12.6% (95% CI 9.2-17.3%) of

  11. High prevalence of diabetes and anthropometric heterogeneity among tuberculosis patients in Pakistan

    DEFF Research Database (Denmark)

    Aftab, Huma; Ambreen, Atiqa; Jamil, Mohammad

    2017-01-01

    BACKGROUND: In Pakistan the prevalence of diabetes (DM) among adults is 6.9% and expected to double by 2040. DM may facilitate transmission and halter the elimination of tuberculosis (TB). We aimed to determine the prevalence of DM among TB patients in Pakistan and to investigate anthropometric...

  12. Tuberculosis among HIV-positive patients across Europe: changes over time and risk factors

    DEFF Research Database (Denmark)

    Kruk, Alexey; Bannister, Wendy; Podlekareva, Daria N

    2011-01-01

    OBJECTIVE:: To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe. METHODS:: Poisson regression models were used to determine temporal changes in incidence rate of TB...

  13. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia.

    Science.gov (United States)

    Tegegne, Yalewayker; Wondmagegn, Tadelo; Worku, Ligabaw; Jejaw Zeleke, Ayalew

    2018-01-01

    Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of Intestinal parasites were detected in 50 (19.6%) among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256). Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0%) of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%), followed by Entamoeba histolytica/dispar, 14 (5.46%), and Hookworm, 13 (5.1%). The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable.

  14. Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

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    Yalewayker Tegegne

    2018-01-01

    Full Text Available Introduction. Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective. To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method. Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of <0.05 were considered statistically significant. Results. Intestinal parasites were detected in 50 (19.6% among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256. Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0% of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%, followed by Entamoeba histolytica/dispar, 14 (5.46%, and Hookworm, 13 (5.1%. Conclusion. The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable.

  15. Use of rhu-GM-CSF in pulmonary tuberculosis patients: results of a randomized clinical trial

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    Diana Brasil Pedral-Sampaio

    Full Text Available It has been postulated that deficient or incomplete clinical and/or microbiological response to tuberculosis treatment is associated with cell-mediated immunological dysfunction involving monocytes and macrophages. A phase 2 safety trial was conducted by treating patients with either recombinant human granulocyte-macrophage colony-stimulating factor (rhu-GM-CSF or a placebo, both in combination with anti-tuberculosis chemotherapy. Thirty-one patients with documented pulmonary tuberculosis were treated with rifampin/isoniazid for six months, plus pyrazinamide for the first two months. At the beginning of treatment, rhu-GM-CSF (125µg/M² was randomly assigned to 16 patients and injected subcutaneously twice weekly for four weeks; the other 15 patients received a placebo. The patients were accompanied in the hospital for two weeks, then monthly on an out patient basis, for 12 months. Clinical outcomes were similar in both groups, with no difference in acid-fast bacilli (AFB clearance in sputum at the end of the fourth week of treatment. Nevertheless, a trend to faster conversion to negative was observed in the rhu-GM-CSF group until the eighth week of treatment (p=0.07, after which all patients converted to AFB negative. Adverse events in the rhu-GM-CSF group were local skin inflammation and an increase in the leukocyte count after each injection, returning to normal 72 hours after rhu-GM-CSF injection. Three patients developed SGOP and SGPT > 2.5 times the normal values. All patients included in the GM-CSF group were culture negative at six months, except one who had primary TB resistance. None of the patients had to discontinue the treatment in either group. We conclude that rhu-GM-CSF adjuvant immunotherapy could be safely explored in a phase 3 trial with patients who have active tuberculosis.

  16. Use of rhu-GM-CSF in pulmonary tuberculosis patients: results of a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Pedral-Sampaio Diana Brasil

    2003-01-01

    Full Text Available It has been postulated that deficient or incomplete clinical and/or microbiological response to tuberculosis treatment is associated with cell-mediated immunological dysfunction involving monocytes and macrophages. A phase 2 safety trial was conducted by treating patients with either recombinant human granulocyte-macrophage colony-stimulating factor (rhu-GM-CSF or a placebo, both in combination with anti-tuberculosis chemotherapy. Thirty-one patients with documented pulmonary tuberculosis were treated with rifampin/isoniazid for six months, plus pyrazinamide for the first two months. At the beginning of treatment, rhu-GM-CSF (125µg/M² was randomly assigned to 16 patients and injected subcutaneously twice weekly for four weeks; the other 15 patients received a placebo. The patients were accompanied in the hospital for two weeks, then monthly on an out patient basis, for 12 months. Clinical outcomes were similar in both groups, with no difference in acid-fast bacilli (AFB clearance in sputum at the end of the fourth week of treatment. Nevertheless, a trend to faster conversion to negative was observed in the rhu-GM-CSF group until the eighth week of treatment (p=0.07, after which all patients converted to AFB negative. Adverse events in the rhu-GM-CSF group were local skin inflammation and an increase in the leukocyte count after each injection, returning to normal 72 hours after rhu-GM-CSF injection. Three patients developed SGOP and SGPT > 2.5 times the normal values. All patients included in the GM-CSF group were culture negative at six months, except one who had primary TB resistance. None of the patients had to discontinue the treatment in either group. We conclude that rhu-GM-CSF adjuvant immunotherapy could be safely explored in a phase 3 trial with patients who have active tuberculosis.

  17. The indirect cost due to pulmonary Tuberculosis in patients receiving treatment in Bauchi State—Nigeria

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    Umar Nisser

    2012-05-01

    Full Text Available Objective To determine the time spent and income lost by patients and their households for seeking tuberculosis diagnosis and treatment in Bauchi State-Nigeria. Method A cross sectional study where 242 TB patients were sampled from 27 out of 67 facilities providing TB services in a north-eastern state of Nigeria. Sampling was stratified based on facility type, patients’ HIV status and gender. Results The income lost among the hospitalized group was estimated at $156/patient and about $114 in the non-hospitalized patients group. Age, gender, facility of diagnosis, level of education and occupation were significant (p-values Conclusion Tuberculosis poses causes tremendous burden in terms of time and productivity lost to both patients and their households in Bauchi State Nigeria.

  18. Chest radiology in HIV-positive patients with tuberculosis - analysis of 104 cases

    International Nuclear Information System (INIS)

    Camara, C.S.; Moraes, A.P.P. de; Silva, W.A.E.; Camisao, C.C.; Basilio de Oliveira, C.A.; Kisckinhevski, W.; Santos, A.A.S. dos

    1990-01-01

    Radiological examinations from 104 patients HIV-positive with tuberculosis were revised at HUGG/Uni-Rio, during the period from June/86 to June/89. From these, 91.4% were male patients, the predominant risk group was homosexual. Among the women, the most affected group was the intravenous drug consumer. The general age group mostly presented was the one from 20 to 39 years. The main tuberculosis confirmation came from the BAAR research in the sputum (57.6%); the necropsy contributed with 13.5% of the patients. The extrathoracic manifestations occurred in 27% of the cases. The most common radiological patterns were interstitial infiltrate 71.2%, bilateral in 48% of the cases, in the alveolar patterns 63.5%, mostly upper lobes, frequently they were simultaneous. Other important findings were: mediastinal lymphatic involvement, pleural effusion, cavity and X-ray without particularities with pulmonary tuberculosis. A comparison study was performed based on literature data and it was observed atypical patterns for the secondary tuberculosis. (author)

  19. Pneumocystis carinii pneumonia, pulmonary tuberculosis and visceral leishmaniasis in an adult HIV negative patient

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Toledo Jr.

    Full Text Available This is a case report of a 29 year old male with pneumocystis pneumonia and tuberculosis, and who was initially suspected of having HIV infection, based on risk factor analyses, but was subsequently shown to be HIV negative. The patient arrived at the hospital with fever, cough, weight loss, loss of appetite, pallor, and arthralgia. In addition, he was jaundiced and had cervical lymphadenopathy and mild heptosplenomegaly. He had interstitial infiltrates of the lung, sputum smears positive for Mycobacterium tuberculosis and Pneumocystis carinii, and stool tests were positive for Strongyloides stercoralis and Schistosoma mansoni. He was diagnosed as having AIDS, and was treated for tuberculosis, pneumocystosis, and strongyloidiasis with a good response. The patient did not receive anti-retroviral therapy, pending outcome of the HIV tests. A month later, he was re-examined and found to have worsening hepatosplenomegaly, pancytopenia, fever, and continued weight loss. At this time, it was determined that his HIV ELISA antibody tests were negative. A bone marrow aspirate was done and revealed amastigotes of leishmania, and a bone marrow culture was positive for Leishmania species. He was treated with pentavalent antimony, 20 mg daily for 20 days, with complete remission of symptoms and weight gain. This case demonstrates that immunosuppression from leishmaniasis and tuberculosis may lead to pneumocystosis, and be misdiagnosed as HIV infection. The occurrence of opportunistic infections in severely ill patients without HIV must always be considered and alternate causes of immunosuppression sought.

  20. Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Arax Hovhannesyan

    2012-06-01

    Full Text Available OBJECTIVE: To characterize time to sputum conversion among patients with multidrug resistant tuberculosis who were enrolled into second-line tuberculosis treatment program; to identify risk factors for delayed sputum conversion. DESIGN: Retrospective cohort study designed to identify the factors associated with sputum conversion. Survival analysis was performed using Kaplan-Meier estimator to compute estimates for median time to sputum conversion and Cox proportional hazards model to compute hazard ratios (HR. RESULTS: Sputum conversion from positive to negative was observed in 134 out of 195 cases (69%. Among these who converted the median time to conversion was 3.7 months. Factors independently associated with time to sputum conversion in the proportional hazards model were: male sex (HR=0.51, 95% CI 0.32-0.81, ofloxacin-resistant tuberculosis (HR = 0.45, 95% CI 0.26-0.78 and first period of recruitment into second-line treatment (HR= 0.69, 95% CI 0.47-1.01. CONCLUSION: Time to sputum conversion in patients with multidrug-resistant tuberculosis in Armenia was 5.8 months (range 0.5-17.0 months. High level of ofloxacin resistance was the main reason for compromised response to treatment. Patients with a poor resistance profile and males should be targeted with more aggressive initial therapy.

  1. Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Arax Hovhannesyan

    2012-01-01

    Full Text Available OBJECTIVE: To characterize time to sputum conversion among patients with multidrug resistant tuberculosis who were enrolled into second-line tuberculosis treatment program; to identify risk factors for delayed sputum conversion. DESIGN: Retrospective cohort study designed to identify the factors associated with sputum conversion. Survival analysis was performed using Kaplan-Meier estimator to compute estimates for median time to sputum conversion and Cox proportional hazards model to compute hazard ratios (HR. RESULTS: Sputum conversion from positive to negative was observed in 134 out of 195 cases (69%. Among these who converted the median time to conversion was 3.7 months. Factors independently associated with time to sputum conversion in the proportional hazards model were: male sex (HR=0.51, 95% CI 0.32-0.81, ofloxacin-resistant tuberculosis (HR = 0.45, 95% CI 0.26-0.78 and first period of recruitment into second-line treatment (HR= 0.69, 95% CI 0.47-1.01. CONCLUSION: Time to sputum conversion in patients with multidrug-resistant tuberculosis in Armenia was 5.8 months (range 0.5- 17.0 months. High level of ofloxacin resistance was the main reason for compromised response to treatment. Patients with a poor resistance profile and males should be targeted with more aggressive initial therapy.

  2. Cardiac tamponade as a manifestation of extrapulmonary tuberculosis in β thalassemia major patient

    Science.gov (United States)

    Harahap, S.; Pramudita, A.; Lusiani

    2018-03-01

    Cardiac tamponade is a medical emergency condition. Rapid diagnosis and determination of the etiology with epidemiologic consideration may lead to earlier treatment and improved survival. Occasionally, the etiology may be clearly related to a recognized underlying disease, but the possibility of unrelated etiologies should be considered. Pericarditis tuberculosis, a rare manifestation of extrapulmonary tuberculosis in a non-HIV patient, has to be deliberate as one of the etiology, especially in the endemic area. Here, we report a case of 28 years old male with β thalassemia major presented with excessive exertion breathlessness progressing to orthopnea. Sign of cardiac tamponade was identified from echocardiography which showed large pericardial effusion with swinging heart and right atrial systolic collapse. Pericardiocentesis was performed immediately, drained 870 ml of hemorrhagic fluid from inserted pigtail. The patient was treated with the anti-tuberculosis regimen and oral corticosteroid after real-time polymerase chain reaction of Mycobacterium tuberculosis positivity in pericardial fluid. MRI T2 confirmed no haemosiderosis in patient’s heart. After treatment, the patient responded well and showed clinical improvement.

  3. Increased level of acute phase reactants in patients infected with modern Mycobacterium tuberculosis genotypes in Mwanza, Tanzania

    DEFF Research Database (Denmark)

    Stavrum, Ruth; PrayGod, George; Range, Nyagosya

    2014-01-01

    a distinct genetic ancestry. This study describes the genetic biodiversity of M. tuberculosis genotypes in Mwanza city, Tanzania and the clinical presentation of the disease caused by isolates of different lineages. METHODS: Two-hundred-fifty-two isolates from pulmonary TB patients in Mwanza, Tanzania were......BACKGROUND: There is increasing evidence to suggest that different Mycobacterium tuberculosis lineages cause variations in the clinical presentation of tuberculosis (TB). Certain M. tuberculosis genotypes/lineages have been shown to be more likely to cause active TB in human populations from....... tuberculosis lineage of the infectious agent for each patient. RESULTS: The most frequent genotype was ST59 (48 out of 248 [19.4%]), belonging to the Euro-American lineage LAM11_ZWE, followed by ST21 (CAS_KILI lineage [44 out of 248 [17.7%]). A low degree of diversity (15.7% [39 different ST's out of 248...

  4. SPECIFIC FEATURES OF ANTI-TUBERCULOSIS CHEMOTHERAPY TOLERANCE IN THE LIGHT OF PSYCHOLOGICAL STATUS OF PATIENTS

    Directory of Open Access Journals (Sweden)

    N. V. Zolotova

    2017-01-01

    Full Text Available Specific features of psychological state were studied in 295 pulmonary tuberculosis patients with satisfactory tolerance to anti-tuberculosis medications and 75 patients poorly tolerating the treatment.Before the treatment start the patients who later demonstrated adverse reactions to treatment were diagnosed with more intense neurotic and hypochondriac personal features, destructive reactions and higher level of emotional tension and frustration – all the above promote dysregulation of the host adaptation. The research demonstrated the need to consider psychological aspects when studying the tolerance to anti-tuberculosis chemotherapy. 

  5. Prevalence of latent tuberculosis and treatment adherence among patients with chronic kidney disease in Campo Grande, State of Mato Grosso do Sul

    Directory of Open Access Journals (Sweden)

    Aucely Corrêa Fernandes Chagas

    2014-04-01

    Full Text Available Introduction The primary strategy for tuberculosis control involves identifying individuals with latent tuberculosis. This study aimed to estimate the prevalence of latent tuberculosis in chronic kidney disease (CKD patients who were undergoing hemodialysis in Campo Grande, State of Mato Grosso do Sul, Brazil, to characterize the sociodemographic and clinical profiles of patients with latent tuberculosis, to verify the association between sociodemographic and clinical characteristics and the occurrence of latent tuberculosis, and to monitor patient adherence to latent tuberculosis treatment. Methods This epidemiological study involved 418 CKD patients who were undergoing hemodialysis and who underwent a tuberculin skin test. Results The prevalence of latent tuberculosis was 10.3%. The mean patient age was 53.43±14.97 years, and the patients were predominantly men (63.9%. The population was primarily Caucasian (58.6%; half (50% were married, and 49.8% had incomplete primary educations. Previous contact with tuberculosis patients was reported by 80% of the participants. Treatment adherence was 97.7%. Conclusions We conclude that the prevalence of latent tuberculosis in our study population was low. Previous contact with patients with active tuberculosis increased the occurrence of latent infection. Although treatment adherence was high in this study, it is crucial to monitor tuberculosis treatment administered to patients in health services to maintain this high rate.

  6. Pulmonary tuberculosis among diabetic patients in internal medicine at point g hospital, bamako - mali.

    Science.gov (United States)

    Sidibé, At; Dembélé, M; Diarra, As; Cissé, I; Bocoum, A; Traoré, Ak; Traoré, Ha

    2005-01-01

    Summary The depression of cellular immunity among diabetic patients exposes them to tuberculosis considered as one of the major diseases of immune-depressive people. The purpose of our study was to evaluate the frequency, gravity, treatment and evolution of pulmonary tuberculosis among our patients affected with diabetes. For that purpose, two descriptive retrospective and prospective studies were undertaken from January 1982 to December 1992 in the Internal Medicine (Internal medicine) department of Hospital of Point G, the national hospital. Thus, 54 diabetics patients hospitalised out of 1 365 had tuberculosis at a frequency rate of 3,95%. The average age of our patients was 49 years +/- 12 and the sex ratio was 2,18 in favour of men. The infection was also more frequent in diabetes type 1 (51,9%) then in type 2 (48,1%), and concerned mainly men (68.51%) who were more than 37 years old (57.41%). Clinically, the common signs to both affections were prevalent namely asthenia: 85,2%, anorexia: 53,7%, weight loss: 66,7%, associated to cough: 81,5% and to dyspnea: 29,6%. However, for a third of the patients (22,2%), tuberculosis was discovered during a systematic check up. All the patients had a glycemia higher than 8mmol/l, with extremes up to 8mmol/l and 32mmol/l, 63% of patient had a febricula. The intradermo cutaneous reaction to tuberculosis (IDR) was negative in 44,4%. The bacilloscopy during direct testing or through the liquid obtained by casing was positive in 64,82%. Tubercular lesions were localised at the top: 91,8%, with an equal attack of the two lungs. During the treatment six products were mainly used comprising Rifampicine (R) isoniazid (INH or H), Streptomycine (S), Ethambutol (E), Thiacetazone (T), and Pyrazinamide (Z). Insulin treatment was done on all patients until tuberculosis was cured. The evolution was favourable after 2 to 3 months of treatment for 48 patients (88,88%) among whom 4: (8,33%) fell sick again. Six patients out of 54 died, i

  7. Tuberculosis among people living with HIV/AIDS in the German ClinSurv HIV Cohort: long-term incidence and risk factors.

    Science.gov (United States)

    Karo, Basel; Haas, Walter; Kollan, Christian; Gunsenheimer-Bartmeyer, Barbara; Hamouda, Osamah; Fiebig, Lena

    2014-03-19

    Tuberculosis (TB) still presents a leading cause of morbidity and mortality among people living with HIV/AIDS (PLWHA), including those on antiretroviral therapy. In this study, we aimed to determine the long-term incidence density rate (IDR) of TB and risk factors among PLWHA in relation to combination antiretroviral therapy (cART)-status. Data of PLWHA enrolled from 2001 through 2011 in the German ClinSurv HIV Cohort were investigated using survival analysis and Cox regression. TB was diagnosed in 233/11,693 PLWHA either at enrollment (N = 62) or during follow-up (N = 171). The TB IDR during follow-up was 0.37 cases per 100 person-years (PY) overall [95% CI, 0.32-0.43], and was higher among patients who never started cART and among patients originating from Sub-Saharan Africa (1.23 and 1.20 per 100PY, respectively). In two multivariable analyses, both patients (I) who never started cART and (II) those on cART shared the same risk factors for TB, namely: originating from Sub-Saharan Africa compared to Germany (I, hazard ratio (HR); [95% CI]) 4.05; [1.87-8.78] and II, HR 5.15 [2.76-9.60], CD4+ cell count 5 log10 copies/ml (I, HR 2.51 [1.33-4.75] and II, HR 1.77 [1.11-2.82]). Gender, age or HIV-transmission risk group were not independently associated with TB. In the German ClinSurv HIV cohort, patients originating from Sub-Saharan Africa, with low CD4+ cell count or high viral load at enrollment were at increased risk of TB even after cART initiation. As patients might be latently infected with Mycobacterium tuberculosis complex, early screening for latent TB infection and implementing isoniazid preventive therapy in line with available recommendations is crucial.

  8. Analysis of the economic burden of diagnosis and treatment of tuberculosis patients in rural China.

    Science.gov (United States)

    Pan, H-Q; Bele, S; Feng, Y; Qiu, S-S; Lü, J-Q; Tang, S-W; Shen, H-B; Wang, J-M; Zhu, L-M

    2013-12-01

    A county in Jiangsu Province, China. To estimate the costs of the diagnosis and treatment of tuberculosis (TB) from the patient's perspective and to identify determinants of the patient's financial burden. In a cross-sectional survey, we interviewed 316 patients diagnosed from January 2010 to May 2011 who had already completed their anti-tuberculosis treatment. The financial burden on TB patients included out-of-pocket costs and productivity losses. The average per capita total out-of-pocket cost was 3024.0 Chinese yuan (CNY), with a median cost of 1086 CNY (interquartile range [IQR] 480-2456). Mean out-of-pocket medical and non-medical costs were respectively 2565.7 CNY and 458.3 CNY. Productivity lost by patients and family members was 2615.2 CNY (median 500, IQR 250-2025). Factors associated with out-of-pocket costs and productivity losses included hospitalisation, adverse drug reactions, cost of drugs to 'protect' the liver, cost of second-line anti-tuberculosis drugs and diagnostic delay. Although the government of China has implemented a 'free TB service policy', the economic burden on patients is still heavy. More patient-centred interventions are essential to reduce the financial burden on patients.

  9. Delivering Patient-Centered Care in a Fragile State: Using Patient-Pathway Analysis to Understand Tuberculosis-Related Care Seeking in Pakistan.

    Science.gov (United States)

    Fatima, Razia; Haq, Mahboob Ul; Yaqoob, Aashifa; Mahmood, Nasir; Ahmad, Khawaja Laeeq; Osberg, Mike; Makayova, Julia; Hymoff, Aaron; Hanson, Christy

    2017-11-06

    Pakistan has the sixth largest population in the world and boasts the fifth greatest burden of tuberculosis. The Government of Pakistan has set the ambitious goal of zero deaths due to tuberculosis and universal access to tuberculosis care by 2020. Successfully reaching these goals is dependent on the country's capacity to diagnose and successfully treat an estimated 200000 unnotified or missing patients with tuberculosis. A patient-pathway analysis (PPA) was conducted at the national level, as well as for each of the 4 provinces, to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services. Almost 90% of patients initiated care in the private sector, which accounts for only 15% of facilities with the capacity for tuberculosis diagnosis and treatment. Across the country, nearly 50% of tuberculosis microscopy laboratories were located in public-sector-basic health units and regional health centers. However, very few patients initiated care in these facilities. Overall, tuberculosis case detection was high given the low likelihood of patients reaching facilities with the capacity for tuberculosis service delivery during their first visit. Improving the engagement of the informal sector and lower-level clinicians will improve the efficiency and timeliness of tuberculosis diagnosis for patients in Pakistan. Concurrently, the apparent strength of the referral networks connecting community-level workers and private clinicians to the public sector for tuberculosis diagnosis and treatment suggests that strengthening the capacity of the public sector could be valuable. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  10. risk factors of active tuberculosis in people living with hiv/aids

    African Journals Online (AJOL)

    Abrham

    2011-07-02

    Jul 2, 2011 ... The objective of this study was to assess distal ... KEYWORDS: Active TB, HIV, risk factors, case control study, Southwest Ethiopia ... and Khat (stimulant plant from Chata Edulis), .... to live in a house made of a cement floor.

  11. Surgery as an Adjunctive Treatment for Multidrug-Resistant Tuberculosis: An Individual Patient Data Metaanalysis.

    Science.gov (United States)

    Fox, Gregory J; Mitnick, Carole D; Benedetti, Andrea; Chan, Edward D; Becerra, Mercedes; Chiang, Chen-Yuan; Keshavjee, Salmaan; Koh, Won-Jung; Shiraishi, Yuji; Viiklepp, Piret; Yim, Jae-Joon; Pasvol, Geoffrey; Robert, Jerome; Shim, Tae Sun; Shin, Sonya S; Menzies, Dick; Ahuja, S; Ashkin, D; Avendaño, M; Banerjee, R; Bauer, M; Burgos, M; Centis, R; Cobelens, F; Cox, H; D'Ambrosio, L; de Lange, W C M; DeRiemer, K; Enarson, D; Falzon, D; Flanagan, K; Flood, J; Gandhi, N; Garcia-Garcia, L; Granich, R M; Hollm-Delgado, M G; Holtz, T H; Hopewell, P; Iseman, M; Jarlsberg, L G; Kim, H R; Lancaster, J; Lange, C; Leimane, V; Leung, C C; Li, J; Menzies, D; Migliori, G B; Narita, M; Nathanson, E; Odendaal, R; O'Riordan, P; Pai, M; Palmero, D; Park, S K; Pena, J; Pérez-Guzmán, C; Ponce-de-Leon, A; Quelapio, M I D; Quy, H T; Riekstina, V; Royce, S; Salim, M; Schaaf, H S; Seung, K J; Shah, L; Shean, K; Sifuentes-Osornio, J; Sotgiu, G; Strand, M J; Sung, S W; Tabarsi, P; Tupasi, T E; Vargas, M H; van Altena, R; van der Walt, M; van der Werf, T S; Westenhouse, J; Yew, W W

    2016-04-01

    Medical treatment for multidrug-resistant (MDR)-tuberculosis is complex, toxic, and associated with poor outcomes. Surgical lung resection may be used as an adjunct to medical therapy, with the intent of reducing bacterial burden and improving cure rates. We conducted an individual patient data metaanalysis to evaluate the effectiveness of surgery as adjunctive therapy for MDR-tuberculosis. Individual patient data, was obtained from the authors of 26 cohort studies, identified from 3 systematic reviews of MDR-tuberculosis treatment. Data included the clinical characteristics and medical and surgical therapy of each patient. Primary analyses compared treatment success (cure and completion) to a combined outcome of failure, relapse, or death. The effects of all forms of resection surgery, pneumonectomy, and partial lung resection were evaluated. A total of 4238 patients from 18 surgical studies and 2193 patients from 8 nonsurgical studies were included. Pulmonary resection surgery was performed on 478 patients. Partial lung resection surgery was associated with improved treatment success (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.5-5.9; I(2)R, 11.8%), but pneumonectomy was not (aOR, 1.1; 95% CI, .6-2.3; I(2)R, 13.2%). Treatment success was more likely when surgery was performed after culture conversion than before conversion (aOR, 2.6; 95% CI, 0.9-7.1; I(2)R, 0.2%). Partial lung resection, but not pneumonectomy, was associated with improved treatment success among patients with MDR-tuberculosis. Although improved outcomes may reflect patient selection, partial lung resection surgery after culture conversion may improve treatment outcomes in patients who receive optimal medical therapy. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  12. Clinico-pathological profile and treatment outcome in smear negative pulmonary tuberculosis patients at a teaching hospital

    International Nuclear Information System (INIS)

    Shabir, I.; Iqbal, R.; Khan, S.U.; Munir, K.; Nazir, A.

    2010-01-01

    Tuberculosis remains the single highest contributor to the world's morbidity and mortality. Early diagnosis and prompt treatment is essential to prevent its transmission. To see the treatment response of anti tuberculosis drugs in smear negative patients and study the predictors of culture positive among smear negative tuberculosis patients. Ninety four sputum smear negative patients clinically and radiologically suggestive of tuberculosis were selected. These patients were put on anti tuberculosis drugs without waiting for their culture results. They were then followed for 8 months to see their treatment outcome. A total of 94 smear negative patients were selected and given anti tuberculosis treatment. Of these 37(39%) were culture positive and 57(61%) were culture negative. Of the 37 culture positive patients 36(97%) showed clinical or radiological improvement as compared to 46(81%) out of 57 in culture negative cases. Symptoms of cough with sputum production was significantly associated with culture positivity. On x-ray chest moderate lesion with diffuse infiltration was more common finding in 64% while extensive and cavitatory lesion was seen in 24% of all cases. Association of extensive and cavitatory lesion were seen in culture positive group. Response to anti tuberculosis drugs in sputum smear negative tubercolosis suspects was found to be effective in majority of the patients. Cough, sputum and extensive cavitatory lung lesion were the predictors of culture positive cases. There is need to train physicians on the use of anti tuberculosis therapy in smear negative suspected pulmonary tuberculosis cases, especially if they have productive cough and cavitatory lung lesions. (author)

  13. Experience with mesodiencephalic modulation in the combination treatment of patients with tuberculosis

    Directory of Open Access Journals (Sweden)

    S. V. Kornienko

    2015-01-01

    Full Text Available To study the clinical efficiency of using mesodiencephalic modulation (MDM as therapy in the combination treatment of patients with pulmonary tuberculosis, the authors examined two groups: 1 the patients who received a MDM cycle in combination with chemotherapy regimens (a study group; 2 those treated using standard chemotherapy regimens (a control group. By the end of one-month therapy, the study group ceased bacterial excretion twice more often than the control group that exhibited the similar results only by the end of three-month treatment. MDM as therapy produced positive X-ray changes in 76.0% of the cases in the study group and in 44.4% in the control one. MDM used in the combination treatment of patients with tuberculosis makes it possible to reduce the length of hospital stay, the number of round-the-clock beds, and the cost of treating these patients.

  14. Treatment compliance and challenges among tuberculosis patients across selected health facilities in Osun State Nigeria.

    Science.gov (United States)

    Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O

    2014-12-01

    Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.

  15. A New Method to Directly Observe Tuberculosis Treatment: Skype Observed Therapy, a Patient-Centered Approach.

    Science.gov (United States)

    Buchman, Tavora; Cabello, Celina

    Tuberculosis (TB) treatment completion is in part determined by patient's adherence to long-term drug regimens. To best ensure compliance, directly observed therapy (DOT) is considered the standard of practice. Nassau County Department of Health TB Control is responsible for providing DOT to patients with TB. Tuberculosis Control sought to use and evaluate Skype Observed Therapy (SOT) as an alternative to DOT for eligible patients. The evaluation included analysis of patient's acceptance and adherence to drug regimen using SOT. Tuberculosis Control assessed staff efficiency and cost savings for this program. Percentages of SOT of patients and successful SOT visits, mileage, and travel time savings. Twenty percent of the caseload used SOT and 100% of patients who were eligible opted in. Average SOT success was 79%. Total mileage savings and time saved were $9,929.07 and 614 hours. Because SOT saves cost and time and is a suitable alternative to DOT for patients, it should be considered as part of new policies and practices in TB control programs.

  16. Molecular Identification of Mycobacterium Tuberculosis and Analysis of Its Resistance to Rifampin in Sputa from Tuberculosis Suspected Patients

    International Nuclear Information System (INIS)

    Syaifudin, M.

    2010-01-01

    An accurate identification of different species of Mycobacterium provides to allow appropriate treatment for Mycobacterium tuberculosis infection. Beside that, drug resistance of M. tuberculosis strains to rifampin is not clearly understood in contributing to the spread of tuberculosis in Indonesia. To assess the molecular mechanism of rifampin resistance, a number of clinical specimens of M. tuberculosis were analyzed their molecular nature of a part of the rpoB gene using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) methods. DNA's extracted from sputum samples were amplified and 32 P-labeled by PCR with the specific primers and the product was analyzed their mutation conferring resistance by MDE gel electrophoresis. Of the 70 specimens tested, 57 specimens were positive for M. tuberculosis organism only, three specimens contained a mixture of M. tuberculosis and non tuberculosis mycobacteria (NTM), and 10 specimens were negative approved by Duplex PCR. Of these sixty DNA positive samples (thus the sensitivity of PCR was 85.71%), 5 (8.3%) of them suspected to contain mutations in rpoB which were associated with rifampin resistance. Even though the frequency of mutation was low, the results from our study clearly indicate that the molecular mechanism of rifampin resistance in M. tuberculosis isolates from Indonesia involves alterations in the rpoB gene. Molecular diagnosis by PCR which is fast and easy to perform is useful for early and rapid detection of TB in sputum specimen. (author)

  17. Gastrointestinal tuberculosis.

    Science.gov (United States)

    Galloway, D J; Scott, R N

    1986-10-01

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

  18. Latent tuberculosis infection screening prior to biological treatment in Tunisian patients.

    Science.gov (United States)

    Slouma, Marwa; Mahmoud, Ines; Saidane, Olfa; Bouden, Selma; Abdelmoula, Leila

    2017-10-01

    The screening of latent tuberculosis infection (LTBI) is necessary to prevent infection in patients with chronic inflammatory disease (CID) undergoing biological treatment. We aimed to assess the efficacy of LTBI screening prior to biological treatment in Tunisia, considered as a high-incidence area of active TB disease. We conducted a retrospective study over a period of 8 years [2007-2014] including patients with chronic inflammatory rheumatism receiving biologic agents since at least 6 months. The screening of LTBI was performed according to national Tunisian guidelines. There were 35 men and 78 women. The mean age was 47.67±13.50 years. Rheumatoid arthritis (70.8%) was the most common cause of CID. The diagnosis of LTBI was established in 23 cases. Among these 23 patients, 12 patients had negative tuberculin skin test (TST) associated with positive QuantiFERON-TB Gold (QFT-G), 10 had TST more than 10mm, one patient had a TST between 5 and 10mm associated with positive QFT-G and one patient had a history of tuberculosis inadequately treated. Preventive anti-tuberculous therapy was prescribed before biological therapy initiation in cases of LTBI. During the follow-up period (3.91 years), no case of tuberculosis reactivation has been reported among patients diagnosed with LTBI. However, 2 cases of active pulmonary tuberculosis were reported in patients with initially negative TST and QFT-G. Our study showed that the Tunisian recommendations allowed detecting a LTBI in 20% of biologic therapy candidates. Preventive measures including screening of LTBI and eventually a prophylactic treatment improve the safety of biological treatments. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  19. KNOWLEDGE AND MISCONCEPTIONS OF PULMONARY TUBERCULOSIS PATIENTS AT DOTS CENTRE, URBAN MEERUT.

    Directory of Open Access Journals (Sweden)

    R Bansal

    2013-06-01

    Full Text Available Background: India is the second most populated country in the world; it has more new TB cases annually than any other country. In 2008, 1.98 million were estimated to have occurred in India, of whom 0.87 million were infectious cases, thus amounting to a fifth of the global burden of TB.With the entire country geographically covered under the DOTS program, research into socioeconomic impact of TB on patients and their households is crucial for providing comprehensive patient-friendly TB services and to document the benefits of DOTS. Objective: The present study was undertaken with the following objectives: (1 To determine the socio-demographic variables of registered patients for DOTS Treatment at Urban Health Training center Meerut. (2 To assess knowledge, awareness and attitude regarding Pulmonary Tuberculosis and its treatment among the patients. Materials and Methods: A cross-sectional study of 200 TB patients was done using a pre-tested semi-quantitative questionnaire in UHTC Meerut Period of Study: During 2010-2012. Results: Knowledge and awareness regarding Pulmonary Tuberculosis in patients at DOTS centre, Urban Meerut was very poor. There is a great need to educate the people about misconceptions like food and utensils as mode of transmission. BCC using the person to person contact in community , at health center and awareness campaigns are crucial in educating the ignorance seen in our field practice area. Conclusion: Poor knowledge and misconceptions concerning tuberculosis was quite concern in the patients. TB control program will remain ineffective unless myths and fears of TB patients are addressed related to causation of tuberculosis, mode of spread, and methods of prevention.

  20. KNOWLEDGE AND MISCONCEPTIONS OF PULMONARY TUBERCULOSIS PATIENTS AT DOTS CENTRE, URBAN MEERUT.

    Directory of Open Access Journals (Sweden)

    R Bansal

    2013-08-01

    Full Text Available Background: India is the second most populated country in the world; it has more new TB cases annually than any other country. In 2008, 1.98 million were estimated to have occurred in India, of whom 0.87 million were infectious cases, thus amounting to a fifth of the global burden of TB.With the entire country geographically covered under the DOTS program, research into socioeconomic impact of TB on patients and their households is crucial for providing comprehensive patient-friendly TB services and to document the benefits of DOTS. Objective: The present study was undertaken with the following objectives: (1 To determine the socio-demographic variables of registered patients for DOTS Treatment at Urban Health Training center Meerut. (2 To assess knowledge, awareness and attitude regarding Pulmonary Tuberculosis and its treatment among the patients. Materials and Methods: A cross-sectional study of 200 TB patients was done using a pre-tested semi-quantitative questionnaire in UHTC Meerut Period of Study: During 2010-2012. Results: Knowledge and awareness regarding Pulmonary Tuberculosis in patients at DOTS centre, Urban Meerut was very poor. There is a great need to educate the people about misconceptions like food and utensils as mode of transmission. BCC using the person to person contact in community , at health center and awareness campaigns are crucial in educating the ignorance seen in our field practice area. Conclusion: Poor knowledge and misconceptions concerning tuberculosis was quite concern in the patients. TB control program will remain ineffective unless myths and fears of TB patients are addressed related to causation of tuberculosis, mode of spread, and methods of prevention.

  1. Drug-resistant tuberculosis--current dilemmas, unanswered questions, challenges, and priority needs.

    Science.gov (United States)

    Zumla, Alimuddin; Abubakar, Ibrahim; Raviglione, Mario; Hoelscher, Michael; Ditiu, Lucica; McHugh, Timothy D; Squire, S Bertel; Cox, Helen; Ford, Nathan; McNerney, Ruth; Marais, Ben; Grobusch, Martin; Lawn, Stephen D; Migliori, Giovanni-Battista; Mwaba, Peter; O'Grady, Justin; Pletschette, Michel; Ramsay, Andrew; Chakaya, Jeremiah; Schito, Marco; Swaminathan, Soumya; Memish, Ziad; Maeurer, Markus; Atun, Rifat

    2012-05-15

    Tuberculosis was declared a global emergency by the World Health Organization (WHO) in 1993. Following the declaration and the promotion in 1995 of directly observed treatment short course (DOTS), a cost-effective strategy to contain the tuberculosis epidemic, nearly 7 million lives have been saved compared with the pre-DOTS era, high cure rates have been achieved in most countries worldwide, and the global incidence of tuberculosis has been in a slow decline since the early 2000s. However, the emergence and spread of multidrug-resistant (MDR) tuberculosis, extensively drug-resistant (XDR) tuberculosis, and more recently, totally drug-resistant tuberculosis pose a threat to global tuberculosis control. Multidrug-resistant tuberculosis is a man-made problem. Laboratory facilities for drug susceptibility testing are inadequate in most tuberculosis-endemic countries, especially in Africa; thus diagnosis is missed, routine surveillance is not implemented, and the actual numbers of global drug-resistant tuberculosis cases have yet to be estimated. This exposes an ominous situation and reveals an urgent need for commitment by national programs to health system improvement because the response to MDR tuberculosis requires strong health services in general. Multidrug-resistant tuberculosis and XDR tuberculosis greatly complicate patient management within resource-poor national tuberculosis programs, reducing treatment efficacy and increasing the cost of treatment to the extent that it could bankrupt healthcare financing in tuberculosis-endemic areas. Why, despite nearly 20 years of WHO-promoted activity and >12 years of MDR tuberculosis-specific activity, has the country response to the drug-resistant tuberculosis epidemic been so ineffectual? The current dilemmas, unanswered questions, operational issues, challenges, and priority needs for global drug resistance screening and surveillance, improved treatment regimens, and management of outcomes and prevention of DR

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

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    Bianca Barone

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

  3. Play the Tuberculosis Game

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    ... Questionnaire Tuberculosis Play Tuberculosis Experiments & Discoveries About the game Discover and experience some of the classic methods ... last will in Paris. Play the Blood Typing Game Try to save some patients and learn about ...

  4. Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study

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    Mupere Ezekiel

    2012-12-01

    Full Text Available Abstract Background Information regarding dietary nutrient intake during tuberculosis disease is lacking. We established the relationship between disease severity or wasting during pulmonary tuberculosis and nutrient intake. Methods In a cross-sectional study of 131 adults with or without pulmonary tuberculosis were screened for human immune-deficiency virus (HIV, wasting, disease severity using 13 item validated clinical TBscore, and 24-hour dietary intake recall. Results Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following nutrients: energy, protein, total fat, carbohydrate, calcium, vitamin A, and folate were low among patients with severe tuberculosis disease. Patients with moderate-to-severe clinical TBscore had lower average energy intake than patients with mild TBscores (6.11 vs. 9.27 MJ, respectively (p Conclusions Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake. Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.

  5. Efavirenz, tenofovir and emtricitabine combined with first-line tuberculosis treatment in tuberculosis-HIV-coinfected Tanzanian patients: a pharmacokinetic and safety study

    NARCIS (Netherlands)

    Semvua, H.H.; Mtabho, C.M.; Fillekes, Q.; Boogaard, J. van den; Kisonga, R.M.; Mleoh, L.; Ndaro, A.; Kisanga, E.R.; Ven, A. van der; Aarnoutse, R.E.; Kibiki, G.S.; Boeree, M.J.; Burger, D.M.

    2013-01-01

    BACKGROUND: To evaluate the effect of rifampicin-based tuberculosis (TB) treatment on the pharmacokinetics of efavirenz/tenofovir/emtricitabine in a fixed-dose combination tablet, and vice versa, in Tanzanian TB-HIV-coinfected patients. METHODS: This was a Phase II open-label multiple dose

  6. Changes in avidity and level of immunoglobulin G antibodies to Mycobacterium tuberculosis in sera of patients undergoing treatment for pulmonary tuberculosis

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    Arias-Bouda, Lenka M. Pereira; Kuijper, Sjoukje; van der Werf, Anouk; Nguyen, Lan N.; Jansen, Henk M.; Kolk, Arend H. J.

    2003-01-01

    Much is known about specific antibodies and their titers in patients with tuberculosis. However, little is known about the avidity of these antibodies or whether changes in avidity occur during the progression of the disease or during treatment. The aims of this study were to determine the avidity

  7. Consultations of health service providers amongst patients of pulmonary tuberculosis from an urban area

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    Geeta S. Pardeshi

    2008-11-01

    Full Text Available Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC, Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analysis: Logistic regression analysis and transcripts of interviews. Results and Conclusions A total of 55 patients were studied in whom median duration between first consultation to treatment initiation was 15 days. A majority of cases (87.27% had first consulted a private practitioner. A total of 32 patients reported more than two consultations and 19 had consulted more than two private health service providers. Amongst the movements between consultations, a majority were from private to government. Only four patients had come to DTC without any prior consultation. Many patients came to government health service provider on their own when the symptomatic treatment prescribed by the private practitioners did not relieve their symptoms.

  8. Use of standardised patients to assess quality of tuberculosis care: a pilot, cross-sectional study.

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    Das, Jishnu; Kwan, Ada; Daniels, Benjamin; Satyanarayana, Srinath; Subbaraman, Ramnath; Bergkvist, Sofi; Das, Ranendra K; Das, Veena; Pai, Madhukar

    2015-11-01

    Existing studies of the quality of tuberculosis care have relied on recall-based patient surveys, questionnaire surveys of knowledge, and prescription or medical record analysis, and the results mostly show the health-care provider's knowledge rather than actual practice. No study has used standardised patients to assess clinical practice. Therefore we aimed to assess quality of care for tuberculosis using such patients. We did a pilot, cross-sectional validation study of a convenience sample of consenting private health-care providers in low-income and middle-income areas of Delhi, India. We recruited standardised patients in apparently good health from the local community to present four cases (two of presumed tuberculosis and one each of confirmed tuberculosis and suspected multidrug-resistant tuberculosis) to a randomly allocated health-care provider. The key objective was to validate the standardised-patient method using three criteria: negligible risk and ability to avoid adverse events for providers and standardised patients, low detection rates of standardised patients by providers, and data accuracy across standardised patients and audio verification of standardised-patient recall. We also used medical vignettes to assess providers' knowledge of presumed tuberculosis. Correct case management was benchmarked using Standards for Tuberculosis Care in India (STCI). Between Feb 2, and March 28, 2014, we recruited and trained 17 standardised patients who had 250 interactions with 100 health-care providers, 29 of whom were qualified in allopathic medicine (ie, they had a Bachelor of Medicine & Surgery [MBBS] degree), 40 of whom practised alternative medicine, and 31 of whom were informal health-care providers with few or no qualifications. The interactions took place between April 1, and April 23, 2014. The proportion of detected standardised patients was low (11 [5%] detected out of 232 interactions among providers who completed the follow-up survey), and

  9. Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic

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    Sinem İliaz

    2016-08-01

    Full Text Available Objective: Inelaborate use of new quinolones with strong anti-tuberculosis (TB activity leads to difficulty in diagnosis and more importantly, quinolone-resistant Mycobacterium tuberculosis. We aimed to determine the frequency of quinolone use in patients who were referred to our hospital for suspected TB and to evaluate the association between quinolone use and different clinical laboratory parameters. Methods: Between November 15 and December 15, 2013, all patients who were admitted to the TB outpatient clinic with no previous diagnosis of TB were included in this study. Demographic and clinical laboratory findings and history of antibiotic use were recorded. Patients’ quinolone use were questioned by showing fluoroquinolone antibiotic boxes’ photographs available on the market. The departments of the doctors who prescribed quinolones were recorded. Results: The mean age of 179 patients included in the study was 37±16 (15–89 years. Among these, 113 patients (63.1% were male. Seventy five patients (41.9% were diagnosed as tuberculosis according to the clinical-radiological and/or bacteriological findings. Of 179 patients, 58.1% (n=104 had been prescribed antibiotics for current complaints before referral to our clinic. Sixteen patients (15% had been recommended fluoroquinolones. Fluoroquinolones were prescribed by seven internal medicine specialists, five pulmonologists, three emergency medicine specialists, and one family medicine practitioner. Among 16 fluoroquinolones prescribed, nine were moxifloxacin, four were levofloxacin, and three were gemifloxacin. Quinolone use revealed a significant inverse relationship only with the presence of hemoptysis (p=0.04. Conclusion: Besides increased educational activities regarding the rational use of antibiotics in recent years, the quinolone group of antibiotics is still prescribed for suspected TB cases. To avoid quinolone-resistant M. tuberculosis strains, further education is required.

  10. Reactivation of tuberculosis during immunosuppressive treatment in a patient with a positive QuantiFERON-RD1 test

    DEFF Research Database (Denmark)

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

    2004-01-01

    A patient with polymyositis developed tuberculosis during immunosuppressive treatment. Tuberculin Skin Test and chest X-ray failed to demonstrate latent tuberculosis, whereas a blood sample that was tested with a modified QuantiFERON-TB-assay, using the recombinant ESAT-6 and CFP-10, was positive...... indicating that this patient was latently infected before immunosuppressive therapy. This case indicates the risk of progressing from latent to active tuberculosis given that the subject is RD1 responsive, and we believe that preventive anti-tuberculous treatment could have prevented this case...

  11. Prevalence and Impact of Diabetes Mellitus Among Patients with Active Pulmonary Tuberculosis in South Korea.

    Science.gov (United States)

    Lee, Eun Hye; Lee, Jung Mo; Kang, Young Ae; Leem, Ah Young; Kim, Eun Young; Jung, Ji Ye; Park, Moo Suk; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Kim, Song Yee

    2017-04-01

    South Korea has an increasing prevalence of diabetes and a relatively high burden of tuberculosis. We aimed to determine the prevalence of diabetes in patients with active pulmonary tuberculosis (PTB) and examine the effect of diabetes on tuberculosis treatment outcomes. Data from patients ≥30 years diagnosed with and treated for PTB between January 2010 and December 2012 at Severance Hospital, a 2000-bed tertiary referral hospital in Seoul, South Korea, were analyzed and compared with data from a contemporaneous general population sample extracted from KNHANES V. Diabetes prevalence was 24.2% (252/1044) among patients with PTB and 11.6% (1700/14,655) among controls. Diabetes [odds ratios (OR) 2.56, 95% confidence interval (CI) 1.56-4.21, P Diabetes was the only factor associated with unsuccessful treatment outcomes (OR 1.67, 95% CI 1.03-2.70, P = 0.039). The prevalence of diabetes was markedly higher in patients with PTB than in a sample of the general South Korean population. Diabetes may delay sputum conversion and adversely affect treatment outcomes; detection and management of diabetes in patients with PTB is crucial.

  12. Atypical extraspinal musculoskeletal tuberculosis in immunocompetent patients: Part II, tuberculous myositis, tuberculous bursitis, and tuberculous tenosynovites

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    Abdelwahab, I.F. [Coney Island Hospital, Brooklyn, New York (United States); Bianchi, S. [Clinique et Fondation des Grangettes, Geneva (Switzerland)]. E-mail: stefanobianchi@bluewin.ch; Martinoli, C. [Universita di Genova, Cattedra di Radiologia, DICMI, Genoa (Italy); Klein, M. [Univ. of Alabama School of Medicine, Dept. of Pathology, Birmingham, Alabama (United States); Hermann, G. [Mount Sinai Medical Center, Dept. of Radiology, New York, New York (United States)

    2006-12-15

    Tuberculosis involving the soft tissue from adjacent bone or joint is well recognized. However, primary tuberculous pyomyositis, tuberculous bursitis, and tuberculous tenosynovitis are rare entities constituting 1% of skeletal tuberculosis. Tuberculosis tenosynovitis involves most commonly the tendon sheaths of the hand and wrist, and tuberculous bursitis occurs most commonly around the hip. The greater trochanteric bursa and the greater trochanter are the most frequent sites of tuberculous bursitis. Cases of primary tuberculous pyomyositis and tenosynovitis of the tendons of the ankle and foot are seldom reported in the radiology literature. All imaging modalities - plain radiography, bone scan, computed tomography, and magnetic resonance imaging (MRI) - provide information that is helpful in determining therapy. MRI in particular, with its multiplanar capabilities and superb contrast of soft tissue, can demonstrate the extent of the soft tissue mass and access the adjacent bones and joints. However, MRI has no diagnostic specificity in regard to tuberculosis, and in nonendemic areas, biopsy is strongly recommended. All patients in this review were permanent residents of North America or Western Europe and were immunocompetent. Examples of atypical presentations of the above entities are demonstrated. (author)

  13. Atypical extraspinal musculoskeletal tuberculosis in immunocompetent patients: Part II, tuberculous myositis, tuberculous bursitis, and tuberculous tenosynovites

    International Nuclear Information System (INIS)

    Abdelwahab, I.F.; Bianchi, S.; Martinoli, C.; Klein, M.; Hermann, G.

    2006-01-01

    Tuberculosis involving the soft tissue from adjacent bone or joint is well recognized. However, primary tuberculous pyomyositis, tuberculous bursitis, and tuberculous tenosynovitis are rare entities constituting 1% of skeletal tuberculosis. Tuberculosis tenosynovitis involves most commonly the tendon sheaths of the hand and wrist, and tuberculous bursitis occurs most commonly around the hip. The greater trochanteric bursa and the greater trochanter are the most frequent sites of tuberculous bursitis. Cases of primary tuberculous pyomyositis and tenosynovitis of the tendons of the ankle and foot are seldom reported in the radiology literature. All imaging modalities - plain radiography, bone scan, computed tomography, and magnetic resonance imaging (MRI) - provide information that is helpful in determining therapy. MRI in particular, with its multiplanar capabilities and superb contrast of soft tissue, can demonstrate the extent of the soft tissue mass and access the adjacent bones and joints. However, MRI has no diagnostic specificity in regard to tuberculosis, and in nonendemic areas, biopsy is strongly recommended. All patients in this review were permanent residents of North America or Western Europe and were immunocompetent. Examples of atypical presentations of the above entities are demonstrated. (author)

  14. Patients' willingness to talk to others about living kidney donation.

    Science.gov (United States)

    Rodrigue, James R; Cornell, Danielle L; Kaplan, Bruce; Howard, Richard J

    2008-03-01

    Living donor kidney transplantation has several advantages for patients with end-stage renal disease. However, many patients are reluctant to pursue this treatment option, preferring instead to wait for a deceased donor organ. To examine predictors of patients' willingness to talk to others about living kidney donation. One hundred thirty-two adult patients awaiting kidney transplantation who were enrolled in a randomized trial examining the effectiveness of education on rates of live donor kidney transplantation completed a baseline rating of their willingness to talk to others about living kidney donation. Also, patients completed measures of knowledge and concerns about living donation and a rating of perceived health. Slightly more than half the patients (56.1%) had low willingness to talk to others about living donation. The following variables were associated with higher willingness to talk to others: white race (odds ratio, 3.31; confidence interval, 1.7-7.4), college education (odds ratio, 3.43, confidence interval, 2.0-5.6), fewer concerns about living donor kidney transplantation (odds ratio, 0.31; confidence interval, 0.2-0.6), and less favorable perceptions of their current health status (odds ratio, 4.31; confidence interval, 2.6-7.6). White race, more education, less concern about living donor kidney transplantation, and poorer perceived health are associated with greater willingness to talk to others about living kidney donation. These findings have important implications for educating patients about living donor kidney transplantation.

  15. Clinical, diagnostic and therapeutic management of patients with breast tuberculosis: Analysis of 46 Cases

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    Murat Ozgur Kilic

    2016-01-01

    Full Text Available Breast tuberculosis is a rare form of extrapulmonary tubercular infection. Our aim is to highlight the nonspecific clinical presentations, diagnostic difficulties and therapeutic approaches of mammarian tuberculosis. Forty-six patients diagnosed with breast tuberculosis between 2005 and 2015 were reviewed retrospectively. Clinical features, all diagnostic methods, and the outcomes of treatment were analysed. All cases were female with a mean age of 36.4 years. Breast mass and pain were the most common complaints. While 34.8% of the cases had a physical examination with suspicions for malignancy, 43.5% of the patients had Breast Imaging Reporting and Data System (BI-RADS 4 or 5 lesions suggested malignancy radiologically. Definitive diagnosis was based on histopathologic examination through core needle biopsy (n = 29, excisional biopsy (n = 12, and open biopsy (n = 5 taken from the abscess wall during drainage. Standard antiTB therapy for 6 months was given to all cases. Thirty-three patients recovered with standard 6-month therapy while extended treatment for 9–12 months was needed in 13 (28.2% cases. Surgery was carried out in 17 cases. Two patients developed recurrence. Breast tuberculosis can be easily confused with breast cancer, suppurative abscess, and other causes of granulomatous mastitis, both clinically and radiologically. A multidisciplinary approach is required to prevent diagnostic delays and unnecessary surgical interventions. Although antiTB therapy is the mainstay treatment of breast TB, surgery is usually indicated in patients refractory to medical treatment.

  16. Risk factors for treatment default among re-treatment tuberculosis patients in India, 2006.

    Science.gov (United States)

    Jha, Ugra Mohan; Satyanarayana, Srinath; Dewan, Puneet K; Chadha, Sarabjit; Wares, Fraser; Sahu, Suvanand; Gupta, Devesh; Chauhan, L S

    2010-01-25

    Under India's Revised National Tuberculosis Control Programme (RNTCP), >15% of previously-treated patients in the reported 2006 patient cohort defaulted from anti-tuberculosis treatment. To assess the timing, characteristics, and risk factors for default amongst re-treatment TB patients. For this case-control study, in 90 randomly-selected programme units treatment records were abstracted from all 2006 defaulters from the RNTCP re-treatment regimen (cases), with one consecutively-selected non-defaulter per case. Patients who interrupted anti-tuberculosis treatment for >2 months were classified as defaulters. 1,141 defaulters and 1,189 non-defaulters were included. The median duration of treatment prior to default was 81 days (25%-75% interquartile range 44-117 days) and documented retrieval efforts after treatment interruption were inadequate. Defaulters were more likely to have been male (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.2-1.7), have previously defaulted anti-tuberculosis treatment (aOR 1.3 95%CI 1.1-1.6], have previous treatment from non-RNTCP providers (AOR 1.3, 95%CI 1.0-1.6], or have public health facility-based treatment observation (aOR 1.3, 95%CI 1.1-1.6). Amongst the large number of re-treatment patients in India, default occurs early and often. Improved pre-treatment counseling and community-based treatment provision may reduce default rates. Efforts to retrieve treatment interrupters prior to default require strengthening.

  17. Using Patient-Pathway Analysis to Inform a Differentiated Program Response to Tuberculosis: The Case of Kenya.

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    Masini, Enos; Hanson, Christy; Ogoro, Jeremiah; Brown, Jessie; Ngari, Faith; Mingkwan, Pia; Makayova, Julia; Osberg, Mike

    2017-11-06

    A recent tuberculosis prevalence survey in Kenya found that the country is home to nearly twice as many patients with tuberculosis as previously estimated. Kenya has prioritized identifying and treating the unnotified or missing cases of tuberculosis. This requires a better understanding of patient care seeking and system weaknesses. A patient-pathway analysis (PPA) was completed to assess the alignment between patient care seeking and the availability of tuberculosis diagnostic and treatment services at the national level and for all 47 counties at the subnational level in Kenya. It was estimated that more than half of patients initiate care in the public sector. Nationally, just under half of patients encountered tuberculosis diagnostic and treatment capacity where they initiated care. Overall, there was distinct variation in diagnostic and treatment availability across counties and facility levels. The PPA results emphasized the need for a differentiated approach to tuberculosis care, by county, and the distinct need for better referral systems. The majority of Kenyans actively sought care; improving diagnostic and treatment capacity in the formal and informal private sector, as well as in the public sector, could help identify the majority of missing cases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  18. Diagnostic utility of neuron specific enolase (NSE) in serum and pleural fluids from patients with lung cancer and tuberculosis

    International Nuclear Information System (INIS)

    Alam, J.M.; Baig, J.A.; Asghar, S.S.; Mahmood, S.R.; Ansari, M.A.; Jamil, S.

    2010-01-01

    Several past and recent investigations have focused on the determination of tumor markers in pleural fluids to assess their Usefulness as less invasive replacement method of diagnosis. In this regard, few studies have dealt with the determination of the tumor marker, neuron specific enolase (NSE), in pleural fluids of patients suffering from both benign and malignant diseases such as non small cell lung carcinoma( NSCLC), small cell lung carcinoma( SCLC) and tuberculosis. Therefore, the present study was undertaken to establish the diagnostic utility of NSE in malignant condition by assessing levels in serum and pleural fluids of patients with lung cancer and by comparing it with a benign pulmonary disease of tuberculosis. Pleural fluids were obtained from 22 patients with carcinomatous pleurisy due to SCLC, 11 patients with carcinomatous pleurisy due to non-small cell lung cancer, and 30 patients with tuberculosis pleurisy for comparison purpose. Determination of NSE levels was performed by ECL technology according to the manufacturer's instructions. NSE levels of pleural fluids from SCLC patients were significantly elevated( P<0.0001) when compared with pleural fluids from NSCLC and tuberculosis patients. Moreover, pleural fluids of all 30 tuberculosis patients and 11 NSCLC patients showed moderate significance ( P< O.05 and P < 0.01, respectively) when compared with each other. In addition, cumulative results of NSE levels from SCLC and NSCLC combined also showed high significance (P<0.001) as compared to pleural fluids of tuberculosis patients and moderate significance (P<0.01) when compared with serum levels of both malignant and benign groups. It is concluded that determination of NSE levels in pleural fluids of lung cancer patients noted to be an effective diagnostic tool to differentiate carcinomatous pleurisy due to SCLC from those occurring due to NSCLC and tuberculosis. Further studies with larger group of patients are under progress to further establish

  19. X-ray and CT signs of connective tissue dysplasia in patients with primarily diagnosed infiltrative pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Sukhanova, L.A.; Sharmazanova, O.P.

    2009-01-01

    The x-ray signs of connective tissue systemic dysplasia (CTSD) in patients with primarily diagnosed pulmonary tuberculosis was investigated. Fifty-four patients (28 med and 26 women aged 18-70) with primarily diagnosed infiltrative pulmonary tuberculosis underwent x-ray study. In patients with infiltration pulmonary tuberculosis CTSD in the lungs manifests by their diminishing, deformity of the lung pattern, high position of the diaphragm cupola, mediastinum shift to the side of the pathology, which is better seen on CT. The degree of CTSD x-ray signs in the lungs depends on the number of phenotypical signs that is the degree of the disease manifestation. CT allows more accurate determining of the signs of connective tissue dysplasia in which tuberculosis develops

  20. The Poor Survival among Pulmonary Tuberculosis Patients in Chiapas, Mexico: The Case of Los Altos Region

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    Nájera-Ortiz, J. C.; Sánchez-Pérez, H. J.; Ochoa-Díaz-López, H.; Leal-Fernández, G.; Navarro-Giné, A.

    2012-01-01

    Objective. To analyse survival in patients with pulmonary tuberculosis (PTB) and factors associated with such survival. Design. Study of a cohort of patients aged over 14 years diagnosed with PTB from January 1, 1998 to July 31, 2005. During 2004–2006 a home visit was made to each patient and, during 2008-2009, they were visited again. During these visits a follow-up interview was administered; when the patient had died, a verbal autopsy was conducted with family members. Statistical analysis...

  1. Diabetes mellitus in patients with pulmonary tuberculosis in an aging population in Shanghai, China: Prevalence, clinical characteristics and outcomes.

    Science.gov (United States)

    Wu, Zheyuan; Guo, Juntao; Huang, Ying; Cai, Enmao; Zhang, Xia; Pan, Qichao; Yuan, Zheng'an; Shen, Xin

    2016-03-01

    To determine the prevalence of diabetes mellitus among pulmonary tuberculosis patients and the difference of clinical characteristics and outcomes between pulmonary tuberculosis patients with and without diabetes mellitus in an aging population in Shanghai, China. This is a retrospective population-based study. 201 newly diagnosed pulmonary tuberculosis patients in Changning District, Shanghai during 2007-2008 were included. Clinical characteristics and outcomes were collected. Determination of diabetes mellitus was based on the medical records before pulmonary tuberculosis was diagnosed. The prevalence of diabetes mellitus among pulmonary tuberculosis patients was 19.9% (40/201). Pulmonary tuberculosis patients with diabetes mellitus were more likely to be old (≥50, OR=5.23, 95% CI=2.07-13.25), to have pulmonary cavities (OR=3.02, 95% CI=1.31-6.98), to be sputum smear positive (OR=2.90, 95% CI=1.12-7.51), and to have extension of anti-tuberculosis treatment duration (OR=2.68, 95% CI 1.17-6.14). Besides, they had a higher 2nd month sputum smear positive proportion (OR=2.97, 95% CI 1.22-7.22) and a higher 5-year recurrence rate (OR=5.87, 95% CI 1.26-27.40). High prevalence, severe clinical characteristics and poor outcomes of pulmonary tuberculosis patients with diabetes mellitus highlight the necessity of early bi-directional screening and co-management of these two diseases in Shanghai, China. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Comparison of antigen-specific T-cell responses of tuberculosis patients using complex or single antigens of Mycobacterium tuberculosis

    DEFF Research Database (Denmark)

    Mustafa, A S; Amoudy, H A; Wiker, H G

    1998-01-01

    GroES, rPstS, rGroEL and rDnaK) antigens of Mycobacterium tuberculosis. The responses of PBMC to these defined antigens were compared with the corresponding results obtained with complex antigens, such as whole-cell M. tuberculosis, M. tuberculosis culture filtrate (MT-CF) and cell wall antigens, as well...... as the vaccine strain, Mycobacterium bovis bacillus Calmette-Guerin (BCG). In addition, M. tuberculosis and MT-CF-induced T-cell lines were tested in the same assays against the panel of purified and complex antigens. The compiled data from PBMC and T-cell lines tested for antigen-induced proliferation and IFN...

  3. Latent and subclinical tuberculosis in HIV infected patients: a cross-sectional study

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    Kall Meaghan M

    2012-05-01

    Full Text Available Abstract Background HIV and tuberculosis (TB are commonly associated. Identifying latent and asymptomatic tuberculosis infection in HIV-positive patients is important in preventing death and morbidity associated with active TB. Methods Cross-sectional study of one time use of an interferon-gamma release assay (T-SPOT.TB - immunospot to detect tuberculosis infection in patients in a UK inner city HIV clinic with a large sub-Saharan population. Results 542 patient samples from 520 patients who disclosed their symptoms of TB were tested. Median follow-up was 35 months (range 27-69. More than half (55% originated from countries with medium or high tuberculosis burden and 57% were women. Antiretroviral therapy was used by 67%; median CD4 count at test was 458 cells/μl. A negative test was found in 452 samples and an indeterminate results in 40 (7.4% but neither were associated with a low CD4 count. A positive test was found in 10% (50/502 individuals. All patients with positive tests were referred to the TB specialist, 47 (94% had a chest radiograph and 46 (92% attended the TB clinic. Two had culture-positive TB and a third individual with features of active TB was treated. 40 started and 38 completed preventive treatment. One patient who completed preventive treatment with isoniazid monotherapy subsequently developed isoniazid-resistant pulmonary tuberculosis. No patient with a negative test has developed TB. Conclusions We found an overall prevalence of latent TB infection of 10% through screening for TB in those with HIV infection and without symptoms, and a further 1% with active disease, a yield greater than typically found in contact tracing. Acceptability of preventive treatment was high with 85% of those with latent TB infection eventually completing their TB chemotherapy regimens. IGRA-based TB screening among HIV-infected individuals was feasible in the clinical setting and assisted with appropriate management (including preventive

  4. Immunological Roles of Elevated Plasma Levels of Matricellular Proteins in Japanese Patients with Pulmonary Tuberculosis

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    Beata Shiratori

    2016-12-01

    Full Text Available Elevated matricellular proteins (MCPs, including osteopontin (OPN and galectin-9 (Gal-9, were observed in the plasma of patients with Manila-type tuberculosis (TB previously. Here, we quantified plasma OPN, Gal-9, and soluble CD44 (sCD44 by enzyme-linked immunosorbent assay (ELISA, and another 29 cytokines by Luminex assay in 36 patients with pulmonary TB, six subjects with latent tuberculosis (LTBI, and 19 healthy controls (HCs from Japan for a better understanding of the roles of MCPs in TB. All TB subjects showed positive results of enzyme-linked immunospot assays (ELISPOTs. Spoligotyping showed that 20 out of 36 Mycobacterium tuberculosis (MTB strains belong to the Beijing type. The levels of OPN, Gal-9, and sCD44 were higher in TB (positivity of 61.1%, 66.7%, and 63.9%, respectively than in the HCs. Positive correlations between OPN and Gal-9, between OPN and sCD44, and negative correlation between OPN and ESAT-6-ELISPOT response, between chest X-ray severity score of cavitary TB and ESAT-6-ELISPOT response were observed. Instead of OPN, Gal-9, and sCD44, cytokines G-CSF, GM-CSF, IFN-α, IFN-γ, IL-12p70, and IL-1RA levels were higher in Beijing MTB-infected patients. These findings suggest immunoregulatory, rather than inflammatory, effect of MCPs and can advance the understanding of the roles of MCPs in the context of TB pathology.

  5. Pneumoconiosis and liver cirrhosis are not risk factors for tuberculosis in patients with pulmonary infection

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    Wu, H.P.; Pan, Y.H.; Hua, C.C.; Shieh, H.B.; Jiang, B.Y.; Yu, T.J. [Chang Gung Memorial Hospital, Chilung (Taiwan)

    2007-05-15

    It is unclear whether patients with liver cirrhosis and coal miners with pneumoconiosis are at increased risk of developing pulmonary tuberculosis (TB). Furthermore, little is known of the likelihood of pneumonia in patients with bronchiectasis, haemodialysis, diabetes mellitus or advanced lung cancer being due to TB. To answer these questions, patients with these clinical comorbidities were analysed. The study was retrospective and included 264 TB patients, 478 non-TB pneumonia patients, and as negative controls, 438 subjects without pneumonia. The parameters analysed were age, gender and the presence of pneumoconiosis, bronchiectasis, liver cirrhosis, haemodialysis, diabetes mellitus and advanced lung cancer. Male gender was the only significant factor increasing the risk of pulmonary TB. When compared with non-TB pneumonia and control patients, the odds ratios were 1.862 and 2.182, respectively. Patients with liver cirrhosis did not show an increased risk of pulmonary TB after regression analysis. Pneumoconiosis resulted in a 2.260 (P = 0.003) odds ratio for pulmonary TB, compared with the controls. However, there was no difference in pneurmoconiosis between TB and non-TB pneumonia patients. Patients with bronchiectasis, lung cancer and those receiving haemodialysis had a lower risk for pulmonary TB in lower respiratory tract infection, with odds ratios of 0.342, 0.311 and 0.182, respectively. Physicians should first consider non-TB bacterial infection rather than Mycobacterium tuberculosis infection in pneumonia in patients with bronchiectasis, lung cancer or those receiving haemodialysis.

  6. Secondary renal amyloidosis in a patient of pulmonary tuberculosis and common variable immunodeficiency

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    Balwani Manish R

    2015-04-01

    Full Text Available Common variable immunodeficiency (CVID usually manifests in the second or third decade of life with recurrent bacterial infections and hypoglobulinemia. Secondary renal amyloidosis with history of pulmonary tuberculosis is rare in CVID, although T cell dysfunction has been reported in few CVID patients. A 40-year-old male was admitted to our hospital with a 3-month history of recurrent respiratory infections and persistent pitting pedal edema. His past history revealed 3 to 5 episodes of recurrent respiratory tract infections and diarrhoea each year since last 20 years. He had been successfully treated for sputum positive pulmonary tuberculosis 8 years back. Laboratory studies disclosed high erythrocyte sedimentation rate (ESR, hypoalbuminemia and nephrotic range proteinuria. Serum immunoglobulin levels were low. CD4/CD8 ratio and CD3 level was normal. C3 and C4 complement levels were normal. Biopsy revealed amyloid A (AA positive secondary renal amyloidosis. Glomeruli showed variable widening of mesangial regions with deposition of periodic schiff stain (PAS pale positive of pink matrix showing apple green birefringence on Congo-red staining. Immunohistochemistry was AA stain positive. Immunofluorescence microscopy revealed no staining with anti-human IgG, IgM, IgA, C3, C1q, kappa and lambda light chains antisera. Patient was treated symptomatically for respiratory tract infection and was discharged with low dose angiotensin receptor blocker. An old treated tuberculosis and chronic inflammation due to recurrent respiratory tract infections were thought to be responsible for AA amyloidosis. Thus pulmonary tuberculosis should be considered in differential diagnosis of secondary causes of AA renal amyloidosis in patients of CVID especially in endemic settings.

  7. Surgical Face Masks Worn by Patients with Multidrug-Resistant Tuberculosis

    Science.gov (United States)

    Mphahlele, Matsie; Stoltz, Anton; Venter, Kobus; Mathebula, Rirhandzu; Masotla, Thabiso; Lubbe, Willem; Pagano, Marcello; First, Melvin; Jensen, Paul A.; van der Walt, Martie; Nardell, Edward A.

    2012-01-01

    Rationale: Drug-resistant tuberculosis transmission in hospitals threatens staff and patient health. Surgical face masks used by patients with tuberculosis (TB) are believed to reduce transmission but have not been rigorously tested. Objectives: We sought to quantify the efficacy of surgical face masks when worn by patients with multidrug-resistant TB (MDR-TB). Methods: Over 3 months, 17 patients with pulmonary MDR-TB occupied an MDR-TB ward in South Africa and wore face masks on alternate days. Ward air was exhausted to two identical chambers, each housing 90 pathogen-free guinea pigs that breathed ward air either when patients wore surgical face masks (intervention group) or when patients did not wear masks (control group). Efficacy was based on differences in guinea pig infections in each chamber. Measurements and Main Results: Sixty-nine of 90 control guinea pigs (76.6%; 95% confidence interval [CI], 68–85%) became infected, compared with 36 of 90 intervention guinea pigs (40%; 95% CI, 31–51%), representing a 56% (95% CI, 33–70.5%) decreased risk of TB transmission when patients used masks. Conclusions: Surgical face masks on patients with MDR-TB significantly reduced transmission and offer an adjunct measure for reducing TB transmission from infectious patients. PMID:22323300

  8. Investment in paediatric tuberculosis prevention in Pakistan: Loss or gain

    International Nuclear Information System (INIS)

    Siddiqui, E.U.; Ejaz, K.; Lone, S.; Raza, S.J.

    2010-01-01

    Objective: To assess the effectiveness of paediatric tuberculosis prevention, by reevaluation factors in children exposed to tuberculosis from less privileged strata of Pakistan. Methods: This cross sectional descriptive study was conducted at National Institute of Child Health, from January 2004 to December 2005. Paediatric patients under 15 years of either gender, diagnosed with active tuberculosis were enrolled. Interviews were conducted with parents regarding common preventive measures and factors advocating tuberculosis spread. Later factors leading to non-compliance to safety recommendations were also evaluated. Results: Fifty five (70%) children younger than 5 years, had index cases in direct contact within their own house. Fifteen (14%) patients contracted the infection from neighbours, with 11 being older than 5 years. There were 82 (51%) cases with Protein Calorie Malnutrition (PCM). Total of 66(41%) cases of PCM were <5 years age (p <0.005). Data showed 123(77%) children living in a family with 5 or more members. Sixty eight (55%) children of these large families had to live in a single room house. Conclusion: There is a high frequency of direct contact tuberculosis in children belonging to the lower socioeconomic class. This is attributed to poor housing condition and over crowding. The current paediatric tuberculosis prevention strategies as adapted from World Health Organizations' Millennium Development Goals are ineffectual to make changes in children exposed to tuberculosis from less privileged strata of Pakistan. Our societal and demographic factors remain static, continually exposing our children to higher risk of tuberculosis exposure. (author)

  9. Serum 25-hydroxyvitamin D in a West African population of tuberculosis patients and unmatched healthy controls

    DEFF Research Database (Denmark)

    Wejse, Christian; Olesen, Rikke; Rabna, Paulo

    2007-01-01

    BACKGROUND: Little is known regarding vitamin D deficiency (VDD) in African populations and in tuberculosis (TB) patients. VDD has been shown to be associated with TB. OBJECTIVE: We aimed to compare the degree of vitamin D insufficiency (VDI) and VDD in TB patients and healthy adult controls...... in a West African population. DESIGN: An unmatched case-control study was performed at a Demographic Surveillance Site in Guinea-Bissau. Serum 25-hydroxyvitamin D(3) [25(OH)D(3)] concentrations were measured in 362 TB patients and in 494 controls. RESULTS: Hypovitaminosis D [25(OH)D(3) Udgivelsesdato: 2007...

  10. 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),...

  11. 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...

  12. Grupos de Convivência: contribuições para uma proposta educativa em Tuberculose Grupos de Convivencia: contribuciones para un propuesta educativa en Tuberculosis Living Groups: contributions for an educational proposal for Tuberculosis

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    Sabrina da Silva de Souza

    2007-10-01

    Full Text Available Trata-se de um relatório de prática assistencial que teve como objetivo desenvolver uma proposta de educação em saúde com grupo de pessoas com tuberculose, visando a efetivação do tratamento. Os dados foram obtidos através de uma proposta de educação em saúde, desenvolvida em um grupo de convivência. Decorrentes do processo de análise foram identificados dois temas que estavam interligados: a percepção da tuberculose e seus cuidados e tratamentos e o isolamento social ,que representam os elementos que influenciam na educação em saúde das pessoas com tuberculose e o significado que a mesma traz para essas pessoas.Se trata de um retatorio de practica asistencial que teivo como objetivo desenvolver uma propuesta de educación em salud com um grupo de personas com tuberculosis, visando que el tratamiento se a mas efectivo. Los datos fueram obtenidos atravéz de una propuesta de educación en salud, desenvolvida en un grupo de convivencia. Decorrentes del proceso de análisis fueram identificados dos temas que estavam interligados: la percepción de la tuberculosis, sus cuidados y tratamiento y el aislamiento social, que representam los elementos que influenciam en la educación in salud de las personas con tuberculosis e el significado que la misma trae para estas personas.This study is a report on care practice. Its objective was to develop a proposal for education in health care from a group of people with tuberculosis, seeking to increase the effectiveness of their treatment. The data was obtained through a proposal for education in health care, developed through a living group. Two interrelated themes resulted from the process of analyzing the data: the perception of tuberculosis and its care and treatment, and social isolation. These represent the elements that influence education in health care for people with tuberculosis, as well as the meaning that such a situation has to these people.

  13. Cellular immune responses to ESAT-6 discriminate between patients with pulmonary disease due to Mycobacterium avium complex and those with pulmonary disease due to Mycobacterium tuberculosis

    DEFF Research Database (Denmark)

    Lein, A D; von Reyn, C F; Ravn, P

    1999-01-01

    ESAT-6 (for 6-kDa early secreted antigenic target) is a secreted antigen found almost exclusively in organisms of the Mycobacterium tuberculosis complex. We compared in vitro gamma interferon (IFN-gamma) responses by peripheral blood mononuclear cells to this antigen in patients with pulmonary...... disease due to either Mycobacterium avium complex (MAC) or Mycobacterium tuberculosis with those in healthy, skin test-negative, control subjects. Significant IFN-gamma responses to ESAT-6 were detected in 16 (59%) of 27 M. tuberculosis pulmonary disease patients, 0 (0%) of 8 MAC disease patients, and 0...... (0%) of 8 controls. Significant IFN-gamma responses to M. tuberculosis purified protein derivative were detected in 23 (85%) of 27 M. tuberculosis disease patients, 2 (25%) of 8 MAC disease patients, and 5 (63%) of 8 healthy controls. M. avium sensitin was recognized in 24 (89%) of 27 M. tuberculosis...

  14. False positive seroreactivity to brucellosis in tuberculosis patients: a prevalence study

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    Mojtaba Varshochi

    2011-03-01

    Full Text Available Mojtaba Varshochi1,2, Jafar Majidi2, Marjan Amini1, Kamyar Ghabili3, Mohammadali M Shoja31Department of Infectious Disease, Tabriz University of Medical Sciences, Tabriz, Iran; 2Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: The rising worldwide incidence of tuberculosis (TB increases the demand for knowledge about its potential seroreactivity with other microbial agents. A few reports and the authors’ experiences indicate that tuberculosis may result in a false-positive brucellosis serology. This may cause a diagnostic challenge because of the close clinical resemblance of these two infections.Objective: The aim of the present prevalence study was to elucidate brucellosis seroreactivity in patients with active TB.Methods: Ninety-eight patients with newly diagnosed and active TB were studied using an enzyme-linked immunosorbent assay (ELISA and Wright’s and Coombs–Wright’s tests. Seventy-five healthy individuals were used as controls. The patients showed signs of recovery after starting a standard anti-TB regimen and had no clinical evidence of brucellosis at a subsequent 6-month follow-up. The data were analyzed statistically by Fisher’s exact test using SPSS 11.0.Results: We found that 9.2% of TB patients versus 1.3% of healthy controls had positive results on the anti-Brucella IgG ELISA (P = 0.04. Five TB patients were found to have agglutination on Wright’s tests, while none of the controls showed agglutination.Conclusion: Active TB patients may have some seroreactivity with Brucella antigens, and Brucella IgG ELISA may give a false positive in these patients. Clinicians should consider false positive brucellosis seroreactivity in patients with active TB.Keywords: false positive serology, ELISA, diagnosis

  15. Lung Tissue Concentrations of Pyrazinamide among Patients with Drug-Resistant Pulmonary Tuberculosis

    Science.gov (United States)

    Heinrichs, M. Tobias; Nikolaishvili, Ketino; Sabulua, Irina; Bablishvili, Nino; Gogishvili, Shota; Avaliani, Zaza; Tukvadze, Nestani; Little, Brent; Bernheim, Adam; Read, Timothy D.; Guarner, Jeannette; Derendorf, Hartmut; Peloquin, Charles A.; Blumberg, Henry M.; Vashakidze, Sergo

    2017-01-01

    ABSTRACT Improved knowledge regarding the tissue penetration of antituberculosis drugs may help optimize drug management. Patients with drug-resistant pulmonary tuberculosis undergoing adjunctive surgery were enrolled. Serial serum samples were collected, and microdialysis was performed using ex vivo lung tissue to measure pyrazinamide concentrations. Among 10 patients, the median pyrazinamide dose was 24.7 mg/kg of body weight. Imaging revealed predominant lung lesions as cavitary (n = 6 patients), mass-like (n = 3 patients), or consolidative (n = 1 patient). On histopathology examination, all tissue samples had necrosis; eight had a pH of ≤5.5. Tissue samples from two patients were positive for Mycobacterium tuberculosis by culture (pH 5.5 and 7.2). All 10 patients had maximal serum pyrazinamide concentrations within the recommended range of 20 to 60 μg/ml. The median lung tissue free pyrazinamide concentration was 20.96 μg/ml. The median tissue-to-serum pyrazinamide concentration ratio was 0.77 (range, 0.54 to 0.93). There was a significant inverse correlation between tissue pyrazinamide concentrations and the amounts of necrosis (R = −0.66, P = 0.04) and acid-fast bacilli (R = −0.75, P = 0.01) identified by histopathology. We found good penetration of pyrazinamide into lung tissue among patients with pulmonary tuberculosis with a variety of radiological lesion types. Our tissue pH results revealed that most lesions had a pH conducive to pyrazinamide activity. The tissue penetration of pyrazinamide highlights its importance in both drug-susceptible and drug-resistant antituberculosis treatment regimens. PMID:28373198

  16. Delays in the diagnosis and treatment of tuberculosis patients in Vietnam: a cross-sectional study

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    Khanh Vu T

    2007-06-01

    Full Text Available Abstract Background Treatment delay is an important indicator of access to tuberculosis diagnosis and treatment. Analyses of patient delay (i.e. time interval between onset of symptoms and first consultation of a health care provider and health care delay (i.e. time interval between first consultation and start of treatment can inform policies to improve access. This study assesses the patient, health care provider and total delay in diagnosis and treatment of new smear-positive pulmonary tuberculosis patients, and the risk factors for long delay, in Vietnam. Methods A cross-sectional survey of new patients treated by the National Tuberculosis Control Programme was conducted in 70 randomly selected districts in Vietnam. All consecutively registered patients in one quarter of 2002 were interviewed using a pre-coded structured questionnaire. Results Median (range delay was 4 weeks (1–48 for total, 3 (1–48 weeks for patient and 1 (0–25 week for health care delay. Patients with long total delay (≥ 12 weeks, 15% accounted for 49% of the cumulative number of delay-weeks. Independent risk factors (p 5 km distance from a health facility or in the northern area. For long health care delay (≥ 6 weeks this was urban setting, residence in the central area and initial visit to a communal health post, TB hospital or the private sector. Conclusion Analyses of patient and treatment delays can indicate target groups and areas for health education and strengthening of the referral system, in particular between the private sector and the NTP.

  17. Lung Tissue Concentrations of Pyrazinamide among Patients with Drug-Resistant Pulmonary Tuberculosis.

    Science.gov (United States)

    Kempker, Russell R; Heinrichs, M Tobias; Nikolaishvili, Ketino; Sabulua, Irina; Bablishvili, Nino; Gogishvili, Shota; Avaliani, Zaza; Tukvadze, Nestani; Little, Brent; Bernheim, Adam; Read, Timothy D; Guarner, Jeannette; Derendorf, Hartmut; Peloquin, Charles A; Blumberg, Henry M; Vashakidze, Sergo

    2017-06-01

    Improved knowledge regarding the tissue penetration of antituberculosis drugs may help optimize drug management. Patients with drug-resistant pulmonary tuberculosis undergoing adjunctive surgery were enrolled. Serial serum samples were collected, and microdialysis was performed using ex vivo lung tissue to measure pyrazinamide concentrations. Among 10 patients, the median pyrazinamide dose was 24.7 mg/kg of body weight. Imaging revealed predominant lung lesions as cavitary ( n = 6 patients), mass-like ( n = 3 patients), or consolidative ( n = 1 patient). On histopathology examination, all tissue samples had necrosis; eight had a pH of ≤5.5. Tissue samples from two patients were positive for Mycobacterium tuberculosis by culture (pH 5.5 and 7.2). All 10 patients had maximal serum pyrazinamide concentrations within the recommended range of 20 to 60 μg/ml. The median lung tissue free pyrazinamide concentration was 20.96 μg/ml. The median tissue-to-serum pyrazinamide concentration ratio was 0.77 (range, 0.54 to 0.93). There was a significant inverse correlation between tissue pyrazinamide concentrations and the amounts of necrosis ( R = -0.66, P = 0.04) and acid-fast bacilli ( R = -0.75, P = 0.01) identified by histopathology. We found good penetration of pyrazinamide into lung tissue among patients with pulmonary tuberculosis with a variety of radiological lesion types. Our tissue pH results revealed that most lesions had a pH conducive to pyrazinamide activity. The tissue penetration of pyrazinamide highlights its importance in both drug-susceptible and drug-resistant antituberculosis treatment regimens. Copyright © 2017 American Society for Microbiology.

  18. Tuberculosis and nutrition

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    Gupta Krishna

    2009-01-01

    Full Text Available Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. These two problems tend to interact with each other. Tuberculosis mortality rates in different economic groups in a community tend to vary inversely with their economic levels. Similarly, nutritional status is significantly lower in patients with active tuberculosis compared with healthy controls. Malnutrition can lead to secondary immunodeficiency that increases the host′s susceptibility to infection. In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis. It has been found that malnourished tuberculosis patients have delayed recovery and higher mortality rates than well-nourished patients. Nutritional status of patients improves during tuberculosis chemotherapy. High prevalence of human immunodeficiency (HIV infection in the underdeveloped countries further aggravates the problem of malnutrition and tuberculosis. Effect of malnutrition on childhood tuberculosis and tuberculin skin test are other important considerations. Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world.

  19. Clinical data and molecular analysis of Mycobacterium tuberculosi isolates from drug-resistant tuberculosis patients in Goiás, Brazil

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    Sueli Lemes de Ávila Alves

    2011-09-01

    Full Text Available Drug resistance is one of the major concerns regarding tuberculosis (TB infection worldwide because it hampers control of the disease. Understanding the underlying mechanisms responsible for drug resistance development is of the highest importance. To investigate clinical data from drug-resistant TB patients at the Tropical Diseases Hospital, Goiás (GO, Brazil and to evaluate the molecular basis of rifampin (R and isoniazid (H resistance in Mycobacterium tuberculosis. Drug susceptibility testing was performed on 124 isolates from 100 patients and 24 isolates displayed resistance to R and/or H. Molecular analysis of drug resistance was performed by partial sequencing of the rpoB and katGgenes and analysis of the inhA promoter region. Similarity analysis of isolates was performed by 15 loci mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR typing. The molecular basis of drug resistance among the 24 isolates from 16 patients was confirmed in 18 isolates. Different susceptibility profiles among the isolates from the same individual were observed in five patients; using MIRU-VNTR, we have shown that those isolates were not genetically identical, with differences in one to three loci within the 15 analysed loci. Drug-resistant TB in GO is caused by M. tuberculosis strains with mutations in previously described sites of known genes and some patients harbour a mixed phenotype infection as a consequence of a single infective event; however, further and broader investigations are needed to support our findings.

  20. CT findings of the pulmonary tuberculosis in patients with diabetes mellitus

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    Yang, Chang Kyu; Hong, Deok Hwa; Kim, Yeong Tong; Kim, Hyung Lyul; Lee, Jong Myeong; Kim, Jong Kun; Lee, So Hyun; Jeong, Gun Young [Taejon Sun General Hospital, Taejon (Korea, Republic of)

    1998-07-01

    To evaluate the CT findings of pulmonary tuberculosis in patients with diabetes mellitus (MD),according to the diabetic control state. Materials and Methods: We retrospectively studied 34 cases of pulmonary tuberculosis accompanied by DM. We divided the right lung three lobes and ten segments and the left into two lobes and eight segments and analyzed CT findings of bronchogenic spread, cavitary lesion, ill-defined nodule, lobular consolidation, lobar and segmental consolidation, atelectasis, interlobular septal thickening, fibrotic band, and associated findings such as lymph node enlargement, pleural effusion and empyema. We also tried to determine the typical CT findings of pulmonary tuberculosis according to diabetic duration and controlled state of DM focusing by FBS 160 and HbA1C 8.0. Results: Among 34 CT scans, bronchogenic spread was seen on 29 (85.3%), cavitary lesion on 26 (76.5%), ill-defined nodules on 11 (32.4%), lobular consolidation on 14 (41.2%), lobar and segmental consolidation on 12 (35.3%), atelectasis on four (14.7%), and fibrotic band on eight (23.5%). Multiple cavities were present in 76.9% of total cavitary lesions, and consolidation with bronchogenic spread in 75%; associated findings were as follows: lymph node enlargement (n=1), pleural effusion (n=10), empyema (n=2), and pericardial effusion (n=2). In 46.7% of cases, general tubercular lesions were in an unusual location, but among cases of secondary pulmonary tuberculosis, 73.9% of lesions were in the usual location. More lobular consolidation was seen in patients with less than FBS 160 on admission, and this result was statistically significant (p<0.05); CT findings did not, however, differ according to diabetic duration and HbA1C. Conclusion: In patients with DM,general fubercular lesions were found infrequently, but in secondary tubereulosis, multiple cavitary lesions-in the usual location-were very frequent. In patients with DM, CT findings of pulmonary tuberculosis did not vary

  1. CT findings of the pulmonary tuberculosis in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Yang, Chang Kyu; Hong, Deok Hwa; Kim, Yeong Tong; Kim, Hyung Lyul; Lee, Jong Myeong; Kim, Jong Kun; Lee, So Hyun; Jeong, Gun Young

    1998-01-01

    To evaluate the CT findings of pulmonary tuberculosis in patients with diabetes mellitus (MD),according to the diabetic control state. Materials and Methods: We retrospectively studied 34 cases of pulmonary tuberculosis accompanied by DM. We divided the right lung three lobes and ten segments and the left into two lobes and eight segments and analyzed CT findings of bronchogenic spread, cavitary lesion, ill-defined nodule, lobular consolidation, lobar and segmental consolidation, atelectasis, interlobular septal thickening, fibrotic band, and associated findings such as lymph node enlargement, pleural effusion and empyema. We also tried to determine the typical CT findings of pulmonary tuberculosis according to diabetic duration and controlled state of DM focusing by FBS 160 and HbA1C 8.0. Results: Among 34 CT scans, bronchogenic spread was seen on 29 (85.3%), cavitary lesion on 26 (76.5%), ill-defined nodules on 11 (32.4%), lobular consolidation on 14 (41.2%), lobar and segmental consolidation on 12 (35.3%), atelectasis on four (14.7%), and fibrotic band on eight (23.5%). Multiple cavities were present in 76.9% of total cavitary lesions, and consolidation with bronchogenic spread in 75%; associated findings were as follows: lymph node enlargement (n=1), pleural effusion (n=10), empyema (n=2), and pericardial effusion (n=2). In 46.7% of cases, general tubercular lesions were in an unusual location, but among cases of secondary pulmonary tuberculosis, 73.9% of lesions were in the usual location. More lobular consolidation was seen in patients with less than FBS 160 on admission, and this result was statistically significant (p<0.05); CT findings did not, however, differ according to diabetic duration and HbA1C. Conclusion: In patients with DM,general fubercular lesions were found infrequently, but in secondary tubereulosis, multiple cavitary lesions-in the usual location-were very frequent. In patients with DM, CT findings of pulmonary tuberculosis did not vary

  2. Magnitude and treatment outcomes of pulmonary tuberculosis patients in a poor urban slum of Abia State, Nigeria.

    Science.gov (United States)

    Ogbudebe, Chidubem L; Izuogu, Sam; Abu, Charity E

    2016-06-01

    Tuberculosis (TB) remains one of the deadliest infectious diseases worldwide, with a disproportionate number of those affected living in slum areas. We assessed the magnitude of pulmonary cases among tuberculosis patients in an urban slum in southeast Nigeria, their demographic and clinical characteristics and any associations with treatment outcomes. A retrospective cohort study of patients registered under the National TB Programme (NTP) from 1 January to 31 December 2012 was carried out. Data were extracted from TB treatment cards and registers. Of 647 new TB patients registered, 555 (85.8%) were pulmonary TB (PTB) with a mean age of 34.5years, and a male/female ratio of 1.3. Among these, 468 (84.3%) were smear-positive, while 87 (15.7%) were smear-negative cases. Twenty-one (3.8%) were children younger than 15years old. TB/HIV co-infection rate was 16.9%; 57.4% received antiretroviral therapy (ART) and 88.3% received cotrimoxazole preventive therapy (CPT). Female patients were significantly younger compared to male patients (p=0.003), had higher proportions of smear-negative TB (p=0.001) and HIV-positive status (p⩽0.001). Treatment success rate was 88.5% among smear-positive patients and 79.3% among smear-negative patients. More patients with smear-negative TB were lost to follow up compared with smear-positive TB patients (p<0.02). HIV co-infection was associated with unfavourable treatment outcomes (OR 0.2, CI 0.1-0.4, p⩽0.001). Among them, those who received ART had better outcomes. The study revealed high proportion of PTB, mostly smear-positive TB with HIV-associated outcomes and underlines the need to ensure early TB diagnosis and improved access to HIV care for HIV co-infected patients in this setting. Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

  3. Genotypes of Mycobacterium tuberculosis in patients at risk of drug resistance in Bolivia.

    Science.gov (United States)

    Monteserin, Johana; Camacho, Mirtha; Barrera, Lucía; Palomino, Juan Carlos; Ritacco, Viviana; Martin, Anandi

    2013-07-01

    Bolivia ranks among the 10 Latin American countries with the highest rates of tuberculosis (TB) and multidrug resistant (MDR) TB. In view of this, and of the lacking information on the population structure of Mycobacterium tuberculosis in the country, we explored genotype associations with drug resistance and clustering by analyzing isolates collected in 2010 from 100 consecutive TB patients at risk of drug resistance in seven of the nine departments in which Bolivia is divided. Fourteen isolates were MDR, 29 had other drug resistance profiles, and 57 were pansusceptible. Spoligotype family distribution was: Haarlem 39.4%, LAM 26.3%, T 22.2%, S 2.0%, X 1.0%, orphan 9.1%, with very low intra-family diversity and absence of Beijing genotypes. We found 66 different MIRU-VNTR patterns; the most frequent corresponded to Multiple Locus Variable Analysis (MLVA) MtbC15 patterns 860, 372 and 873. Twelve clusters, each with identical MIRU-VNTR and spoligotypes, gathered 35 patients. We found no association of genotype with drug resistant or MDR-TB. Clustering associated with SIT 50 and the H3 subfamily to which it belongs (pBolivia. However, results should be taken cautiously because the sample is small and includes a particular subset of M. tuberculosis population. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. [Factors associated to pulmonary tuberculosis in patients with diabetes mellitus from Veracruz, México].

    Science.gov (United States)

    Pérez-Navarro, Lucía Montserrat; Fuentes-Domínguez, Francisco; Morales-Romero, Jaime; Zenteno-Cuevas, Roberto

    2011-01-01

    In Mexico, 20% of cases of tuberculosis (TB) are associated with diabetes mellitus (DM). However, the behavior of the factors related to this comorbidity is unknown, so the aim of this study was to estimate the risk factors and outcome for TB-DM in a population from the state of Veracruz, Mexico. We developed a double-design study: cases and controls for the estimation of risk factors, and a retrospective cohort for the outcome factors. The populations surveyed were 67 patients with the comorbidity TB-DB and 109 with TB. The risk factors for tuberculosis in the diabetic population studied were: age ≥ 35 with an OR of 2.5 (95% CI: 1.4-4.3) and IMC ≥ 25 with an OR of 8.5 (95% CI: 3.1-23.3). According to the outcome variables, the patients with TB-DM showed an increased risk of 2.8 (95% CI: 2.2-3.4) for the development of drug resistance against tuberculosis. In conclusion, age and overweight are important risk factors, and drug resistance is an important outcome factor for the binomial TB-DM in the population from Veracruz. This information will have important effects on the development of surveillance programs against TB, with emphasis on the characteristics of the diabetic population.

  5. Spectrum of imaging findings on MDCT enterography in patients with small bowel tuberculosis

    International Nuclear Information System (INIS)

    Kalra, N.; Agrawal, P.; Mittal, V.; Kochhar, R.; Gupta, V.; Nada, R.; Singh, R.; Khandelwal, N.

    2014-01-01

    Abdominal tuberculosis (TB) is the sixth most common extrapulmonary site of involvement. The sites of involvement in abdominal tuberculosis, in descending order of frequency, are lymph nodes, genitourinary tract, peritoneal cavity, and gastrointestinal tract. The radiological armamentarium for evaluating tuberculosis of the small bowel (SBTB) includes barium studies (small bowel follow-through, SBFT), CT (multidetector CT, CT enterography, and CT enteroclysis), ultrasound (sonoenteroclysis), and magnetic resonance imaging (MRI; enterography and enteroclysis). In this review, we illustrate the abnormalities at MDCT enterography in 20 consecutive patients with SB TB and also describe extraluminal findings in these patients. MDCT enterography allows non-invasive good-quality assessment of well-distended bowel loops and the adjacent soft tissues. It displays the thickness and enhancement of the entire bowel wall in all three planes and allows examination of all bowel loops, especially the ileal loops, which are mostly superimposed. The terminal ileum and ileocaecal junction are the most common sites of small bowel involvement in intestinal TB. The most common abnormality is short-segment strictures with symmetrical concentric mural thickening and homogeneous mural enhancement. Other findings include lymphadenopathy, ascites, enteroliths, peritoneal thickening, and enhancement. In conclusion, MDCT enterography is a comprehensive technique for the evaluation of SB TB

  6. An immunocompetent young patient with tuberculosis of the penis: a challenging case.

    Science.gov (United States)

    Rotaru, Maria; Tăban, Sorina; Ţăroi, Mona; Pătraşcu, Virgil; Popa, Florina Ligia

    2015-01-01

    Tuberculous chancre is an extremely rare form of cutaneous tuberculosis. The genital area is a possible site of presentation. We present a case of a young male with a persistent balanopreputial ulceration resembling a luetic chancre with negative serology for syphilis. The diagnosis was based on the specific pathologic features and the positive intradermal reaction to tuberculin. A successful treatment was achieved by combining antituberculosis treatment and surgical approach with circumcision. After six months of antituberculosis treatment, the patient developed paradoxical inguinal lymph node enlargement, which, after surgical excision and biopsy, was not followed by a relapse of the disease and needed no further therapy. Tuberculosis should be considered a potential diagnosis in the case of a persistent genital ulcer.

  7. Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load.

    Directory of Open Access Journals (Sweden)

    Andrew D Kerkhoff

    Full Text Available Increasing evidence suggests that neutrophils play a role in the host response to Mycobacterium tuberculosis. We determined whether neutrophil counts in peripheral blood are associated with tuberculosis (TB and with mycobacterial load in sputum in HIV-infected patients.Adults enrolling in an antiretroviral treatment (ART clinic in a Cape Town township were screened for TB regardless of symptoms. Paired sputum samples were examined using liquid culture, fluorescence microscopy, and the Xpert MTB/RIF assay. Absolute neutrophil counts (ANC were measured in blood samples. Of 602 HIV-infected patients screened, 523 produced one or more sputum samples and had complete results available for analysis. Among these 523 patients, the median CD4 count was 169×10(9/L (IQR, 96-232 and median ANC was 2.6×10(9/L (IQR, 1.9-3.6. Culture-positive pulmonary tuberculosis was diagnosed in 89 patients. Patients with TB had a median ANC of 3.4×10(9/L (IQR, 2.4-5.1 compared to 2.5×10(9/L (IQR, 1.8-3.4 among those who were culture negative (p7.5×10(9/L; p = 0.0005. Patients were then classified into four mutually exclusive groups with increasing sputum mycobacterial load as defined by the results of culture, Xpert MTB/RIF and sputum smear microscopy. Multivariable analyses demonstrated that increasing sputum mycobacterial load was positively associated with blood ANC ≥2.6×10(9/L and with neutrophilia.Increased blood neutrophil counts were independently associated with pulmonary TB and sputum mycobacterial burden in this HIV-infected patient group. This observation supports the growing body of literature regarding the potential role for neutrophils in the host response to TB.

  8. Identification of potential urine proteins and microRNA biomarkers for the diagnosis of pulmonary tuberculosis patients.

    Science.gov (United States)

    Wang, Jieru; Zhu, Xiaojie; Xiong, Xuekai; Ge, Pan; Liu, Han; Ren, Ningning; Khan, Farhan Anwar; Zhou, Xia; Zhang, Li; Yuan, Xu; Chen, Xi; Chen, Yingyu; Hu, Changmin; Robertson, Ian D; Chen, Huanchun; Guo, Aizhen

    2018-04-11

    This study identified urinary biomarkers for tuberculosis (TB) diagnosis. The urine proteomic profiles of 45 pulmonary tuberculosis patients prior to anti-TB treatment and 45 healthy controls were analyzed and compared using two-dimensional electrophoresis with matrix-assisted laser desorption/ionization time of flight mass spectrometry. Nineteen differentially expressed proteins were identified preliminarily, and western blotting and qRT-PCR were performed to confirm these changes at the translational and transcriptional levels, respectively, using samples from 122 additional pulmonary tuberculosis patients and 73 additional healthy controls. Two proteins, mannose-binding lectin 2 and a 35-kDa fragment of inter-α-trypsin inhibitor H4, exhibited the highest differential expression. We constructed a protein-microRNA interaction network that primarily involved complement and inflammatory responses. Eleven microRNAs from microRNA-target protein interactions were screened and validated using qRT-PCR with some of the above samples, including 97 pulmonary tuberculosis patients and 48 healthy controls. Only miR-625-3p exhibited significant differential expression (p tuberculosis diagnosis than individual biomarkers or any two-biomarker combination and generated a diagnostic sensitivity of 85.87% and a specificity of 87.50%. These novel urine biomarkers may significantly improve tuberculosis diagnosis.

  9. Role of PCR method using IS6110 primer in detecting Mycobacterium tuberculosis among the clinically diagnosed childhood tuberculosis patients at an urban hospital in Dhaka, Bangladesh

    Directory of Open Access Journals (Sweden)

    Senjuti Kabir

    2018-03-01

    Full Text Available Objective: Better methods are needed for the accurate detection of child tuberculosis (TB. This study compared different laboratory tests and evaluated IS6110 PCR for the detection of Mycobacterium tuberculosis (MTB among clinically diagnosed child TB patients. Methods: A total of 102 paediatric patients (<15 years old with clinically diagnosed TB were enrolled in this study. The patients were admitted to the icddr,b hospital in Dhaka between 2003 and 2005. Sputum/gastric lavage samples were collected for smear microscopy, culture (solid/Lowenstein–Jensen medium and liquid/MGIT, and IS6110 PCR testing. The sensitivity, specificity, and positive and negative predictive values (PPV, NPV of smear microscopy and PCR were compared to the two culture methods. Results: Three patients were positive on smear microscopy (2.9%. MTB was detected by conventional culture in 15.7% (16/102, liquid culture in 14% (14/100, and IS6110 PCR in 61.8% (63/102. PCR detected an additional 45 patients who were undetected with the three other tests. Compared to conventional and liquid culture, respectively, smear microscopy showed sensitivity of 18.8% and 21.4%, specificity of 100% individually, PPV of 100% individually, and NPV of 86.9% and 88.7%, whereas PCR had sensitivity of 87.5% and 92.9%, specificity of 43% individually, PPV of 22.2% and 21%, and NPV of 94.9% and 97.4%. Conclusions: PCR can be useful compared to smear microscopy and culture methods and is applicable as a rapid screening test for child TB. A larger scale study is required to determine its diagnostic efficacy in improving the detection of child TB in the presence and absence of severe malnutrition. Keywords: Child tuberculosis, Mycobacterium tuberculosis, IS6110 PCR

  10. Do transportation subsidies and living allowances improve tuberculosis control outcomes among internal migrants in urban Shanghai, China?

    Science.gov (United States)

    Lu, Hui; Yan, Fei; Wang, Wei; Wu, Laiwa; Ma, Weiping; Chen, Jing; Shen, Xin; Mei, Jian

    2013-01-01

    Tuberculosis (TB) in internal migrants is one of three threats for TB control in China. To address this threat, a project was launched in eight of the 19 districts of Shanghai in 2007 to provide transportation subsidies and living allowances for all migrant TB cases. This study aims to determine if this project contributed to improved TB control outcomes among migrants in urban Shanghai. This was a community intervention study. The data were derived from the TB Management Information System in three project districts and three non-project districts in Shanghai between 2006 and 2010. The impact of the project was estimated in a difference-in-difference (DID) analysis framework, and a multivariable binary logistic regression analysis. A total of 1872 pulmonary TB (PTB) cases in internal migrants were included in the study. The treatment success rate (TSR) for migrant smear-positive cases in project districts increased from 59.9% in 2006 to 87.6% in 2010 (P < 0.001). The crude DID improvement of TSR was 18.9%. There was an increased probability of TSR in the project group before and after the project intervention period (coefficient = 1.156, odds ratio = 3.178, 95% confidence interval: 1.305-7.736, P = 0.011). The study showed the project could improve treatment success in migrant PTB cases. This was a short-term programme using special financial subsidies for all migrant PTB cases. It is recommended that project funds be continuously invested by governments with particular focus on the more vulnerable PTB cases among migrants.

  11. Do transportation subsidies and living allowances improve tuberculosis control outcomes among internal migrants in urban Shanghai, China?

    Directory of Open Access Journals (Sweden)

    Xin Chen

    2013-03-01

    Full Text Available Introduction: Tuberculosis (TB in internal migrants is one of three threats for TB control in China. To address this threat, a project was launched in eight of the 19 districts of Shanghai in 2007 to provide transportation subsidies and living allowances for all migrant TB cases. This study aims to determine if this project contributed to improved TB control outcomes among migrants in urban Shanghai. Methods: This was a community intervention study. The data were derived from the TB Management Information System in three project districts and three non-project districts in Shanghai between 2006 and 2010. The impact of the project was estimated in a difference-in–difference (DID analysis framework, and a multivariable binary logistic regression analysis. Results: A total of 1872 pulmonary TB (PTB cases in internal migrants were included in the study. The treatment success rate (TSR for migrant smear-positive cases in project districts increased from 59.9% in 2006 to 87.6% in 2010 (P < 0.001. The crude DID improvement of TSR was 18.9%. There was an increased probability of TSR in the project group before and after the project intervention period (coefficient = 1.156, odds ratio = 3.178, 95% confidence interval: 1.305–7.736, P = 0.011. Conclusion: The study showed the project could improve treatment success in migrant PTB cases. This was a short-term programme using special financial subsidies for all migrant PTB cases. It is recommended that project funds be continuously invested by governments with particular focus on the more vulnerable PTB cases among migrants.

  12. Factors Associated with Length of Hospital Stay among HIV Positive and HIV Negative Patients with Tuberculosis in Brazil

    Science.gov (United States)

    Gonçalves, Maria Jacirema Ferreira; Ferreira, Alaidistania A.

    2013-01-01

    Objective Identify and analyze the factors associated to length of hospital stay among HIV positive and HIV negative patients with tuberculosis in Manaus city, state of Amazonas, Brazil, in 2010. Methods Epidemiological study with primary data obtained from monitoring of hospitalized patients with tuberculosis in Manaus. Data were collected by interviewing patients and analyzing medical records, according to the following study variables age, sex, co-morbidities, education, race, income, lifestyle, history of previous treatment or hospitalization due to tuberculosis, treatment regimen, adverse reactions, smear test, clinical form, type of discharge, and length of hospital stay. The associated factors were identified through chi-square or t-Student test at a 5% significance level. Results Income from 1 to 3 minimum wages (P = 0.028), pulmonary tuberculosis form (P = 0.011), negative smear test or no information in this regard (P = 0.014), initial 6-month treatment scheme (P = 0.029), and adverse drug reactions (P = 0.021) were associated to prolonged hospital stay in HIV positive patients. Conclusion We found out that although there were no significant differences in the length of hospital stay in HIV positive patients, all factors significantly associated to prolonged hospital stay occurred in this group of patients. This finding corroborates other studies indicating the severity of tuberculosis in HIV patients, which may also contribute to lengthen their hospital stay. PMID:23593227

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

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-09-01

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

  14. Drug-resistant tuberculosis in HIV-infected patients in a national referral hospital, Phnom Penh, Cambodia.

    Science.gov (United States)

    Walls, Genevieve; Bulifon, Sophie; Breysse, Serge; Daneth, Thol; Bonnet, Maryline; Hurtado, Northan; Molfino, Lucas

    2015-01-01

    There are no recent data on the prevalence of drug-resistant tuberculosis (DR TB) in Cambodia. We aim to describe TB drug resistance amongst adults with pulmonary and extra-pulmonary TB and human immunodeficiency virus (HIV) co-infection in a national referral hospital in Phnom Penh, Cambodia. Between 22 November 2007 and 30 November 2009, clinical specimens from HIV-infected patients suspected of having TB underwent routine microscopy, Mycobacterium tuberculosis culture, and drug susceptibility testing. Laboratory and clinical data were collected for patients with positive M. tuberculosis cultures. M. tuberculosis was cultured from 236 HIV-infected patients. Resistance to any first-line TB drug occurred in 34.7% of patients; 8.1% had multidrug resistant tuberculosis (MDR TB). The proportion of MDR TB amongst new patients and previously treated patients was 3.7 and 28.9%, respectively (pCambodia may be higher than previously recognised, particularly amongst HIV-infected patients. Additional prevalence studies are needed. This study also illustrates the feasibility and utility of analysis of non-respiratory specimens in the diagnosis of TB, even in low-resource settings, and suggests that extra-pulmonary specimens should be included in TB diagnostic algorithms.

  15. Radiographic findings of pulmonary tuberculosis in adult diabetic patients: comparison of diabetics with nondiabetics of no other underlying diseases

    International Nuclear Information System (INIS)

    Park, Hyun Mee; Shin, Cheol Yong; Kim, Tae Hoon; Young Shin So; Lee, Shin Hyung; Lee, Chang Joon; Gang, Hye Jung

    1995-01-01

    The purpose of our study is to evaluate the plain radiographic features of pulmonary tuberculosis in adult diabetic patients compared with those in patients without any underlying diseases. We analyzed the chest PA and lateral views of 100 patients having active pulmonary tuberculosis; 14 patients had diabetes mellitus and 60 patients had no other underlying diseases. Their images were assesed for anatomical distributions, extents of lesions, size and number of cavity and patterns of radiographic findings. Diabetic tuberculosis had higher prevalence and wider involvement of unusual segments for the tuberculosis such as anterior segment, lingular segment of upper lobe and basal segment of the lower lobe, and they showed the tendency of having more cavities than those who had no other underlying diseases, but there were no meaningful differences in the cavity size between the two groups. Pulmonary tuberculosis in diabetic patients tends to have wider extent with unusual segmental involvement and multiple cavities than in the patients who had no other underlying diseases

  16. Chronic obstructive pulmonary disease (COPD): neutrophils, macrophages and lymphocytes in patients with anterior tuberculosis compared to tobacco related COPD.

    Science.gov (United States)

    Guiedem, Elise; Ikomey, George Mondinde; Nkenfou, Céline; Walter, Pefura-Yone Eric; Mesembe, Martha; Chegou, Novel Njweipi; Jacobs, Graeme Brendon; Okomo Assoumou, Marie Claire

    2018-03-27

    The inflammatory profile of chronic obstructive pulmonary disease (COPD) related to tobacco is known in certain studies while that of the post tuberculosis form is not yet known. This study aimed to evaluate the levels of neutrophils, macrophages and lymphocytes cells in sputum of COPD patients with history of smoking or anterior tuberculosis. Enumeration of cells in samples was analyzed using standard microscopy. We enrolled 92 participants, 46 (50%) were COPD subjects comprising 22 (47.83%) smokers and 24 (52.17%) with anterior tuberculosis while 46 (50%) healthy persons constituted the control group. The levels of neutrophils, lymphocytes and monocytes were statistically higher in COPD patients compared to the control group with p-values of 0.0001 respectively. Neutrophils levels were higher in COPD patients with history of tobacco than in COPD patients with anterior tuberculosis with a mean rate of 4.72 × 10 6 /ml and 2.48 × 10 6 /ml respectively (p = 0.04). The monocytes and lymphocytes levels were not statistically different between the two sub-groups of COPD patients with p-value of 0.052 and 0.91 respectively. Neutrophils are the only inflammatory cells that were significantly higher in COPD patients with history of smoking as compared to COPD patients with anterior tuberculosis.

  17. Operational research in malawi: making a difference with cotrimoxazole preventive therapy in patients with tuberculosis and HIV

    Science.gov (United States)

    2011-01-01

    Background In Malawi, high case fatality rates in patients with tuberculosis, who were also co-infected with HIV, and high early death rates in people living with HIV during the initiation of antiretroviral treatment (ART) adversely impacted on treatment outcomes for the national tuberculosis and ART programmes respectively. This article i) discusses the operational research that was conducted in the country on cotrimoxazole preventive therapy, ii) outlines the steps that were taken to translate these findings into national policy and practice, iii) shows how the implementation of cotrimoxazole preventive therapy for both TB patients and HIV-infected patients starting ART was associated with reduced death rates, and iv) highlights lessons that can be learnt for other settings and interventions. Discussion District and facility-based operational research was undertaken between 1999 and 2005 to assess the effectiveness of cotrimoxazole preventive therapy in reducing death rates in TB patients and subsequently in patients starting ART under routine programme conditions. Studies demonstrated significant reductions in case fatality in HIV-infected TB patients receiving cotrimoxazole and in HIV-infected patients about to start ART. Following the completion of research, the findings were rapidly disseminated nationally at stakeholder meetings convened by the Ministry of Health and internationally through conferences and peer-reviewed scientific publications. The Ministry of Health made policy changes based on the available evidence, following which there was countrywide distribution of the updated policy and guidelines. Policy was rapidly moved to practice with the development of monitoring tools, drug procurement and training packages. National programme performance improved which showed a significant decrease in case fatality rates in TB patients as well as a reduction in early death in people with HIV starting ART. Summary Key lessons for moving this research endeavour

  18. Knowledge of Tuberculosis and Self Disclosure amongst Patients ...

    African Journals Online (AJOL)

    adedamla

    willingness to seek and adhere to treatment. ... Assessing knowledge, self disclosure status and perceived stigma among TB patients would help to understand TB-related stigma as a social process and a better understanding of patients.

  19. Risk factors associated with default among tuberculosis patients in Darjeeling district of West Bengal, India.

    Science.gov (United States)

    Roy, Nirmalya; Basu, Mausumi; Das, Sibasis; Mandal, Amitava; Dutt, Debashis; Dasgupta, Samir

    2015-01-01

    The treatment outcome "default" under Revised National Tuberculosis Control Program (RNTCP) is a patient who after treatment initiation has interrupted treatment consecutively for more than 2 months. To assess the timing, characteristics and distribution of the reasons for default with relation to some sociodemographic variables among new sputum-positive (NSP) tuberculosis (TB) patients in Darjeeling District, West Bengal. A case-control study was conducted in three tuberculosis units (TUs) of Darjeeling from August'2011 to December'2011 among NSP TB patients enrolled for treatment in the TB register from 1(st) Qtr'09 to 2(nd) Qtr'10. Patients defaulted from treatment were considered as "cases" and those completed treatment as "controls" (79 cases and 79 controls). The enrolled cases and controls were interviewed by the health workers using a predesigned structured pro-forma. Logistic regression analysis, odds ratios (OR), adjusted odds ratios (AOR). 75% of the default occurred in the intensive phase (IP); 54.24% retrieval action was done within 1 day during IP and 75% within 1 week during continuation phase (CP); cent percent of the documented retrieval actions were undertaken by the contractual TB program staffs. Most commonly cited reasons for default were alcohol consumption (29.11%), adverse effects of drugs (25.32%), and long distance of DOT center (21.52%). In the logistic regression analysis, the factors independently associated were consumption of alcohol, inadequate knowledge about TB, inadequate patient provider interaction, instances of missed doses, adverse reactions of anti-TB drugs, Government Directly Observed Treatment (DOT) provider and smoking. Most defaults occurred in the intensive phase; pre-treatment counseling and initial home visit play very important role in this regard. Proper counseling by health care workers in patient provider meeting is needed.

  20. Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF questionnaire among pulmonary tuberculosis patients in Taiwan

    Directory of Open Access Journals (Sweden)

    Chung Wei-Sheng

    2012-08-01

    Full Text Available Abstract Background Studies on the effects of tuberculosis on a patient’s quality of life (QOL are scant. The objective of this study was to evaluate the psychometric properties of the Taiwan short version of the World Health Organization Quality of Life (WHOQOL-BREF questionnaire using patients with tuberculosis in Taiwan and healthy referents. Methods The Taiwanese short version of the WHOQOL-BREF was administered to patients with tuberculosis undergoing treatment and healthy referents from March 2007 to July 2007. Patients with tuberculosis (n = 140 and healthy referents (n = 130, matched by age, sex, and ethnicity, agreed to an interview. All participants lived in eastern Taiwan. Reliability assessments included internal consistency, whereas validity assessments included construct validity, convergent validity, and discriminant validity. Results More than half of these patients and referents were men (70.7% and 66.2%, respectively, and their average ages were 50.1 and 47.9 years, respectively. Approximately 60% of patients and referents were aboriginal Taiwanese (60.7% and 61.1%, respectively. The proportion with low socioeconomic status was greater for these patients. The internal consistency reliability coefficients were .92 and .93 for the patients and healthy referents, respectively. Exploratory factor analysis on the healthy referents displayed a 4-domain model, which was compatible with the original WHOQOL-BREF 4-domain model. However, for the TB patient group, after deleting 3 items, both exploratory and confirmatory factor analysis revealed a 6-domain model. Conclusion Psychometric evaluation of the Taiwan short version of the WHOQOL-BREF indicates that it has adequate reliability for use in research with TB patients in Taiwan. However, the factor structure generated from this TB patient sample differed from the WHO’s original 4-factor model, which raised a validity concern to apply the Taiwan short version of the WHOQOL

  1. Computer-assisted detection (CAD) methodology for early detection of response to pharmaceutical therapy in tuberculosis patients

    Science.gov (United States)

    Lieberman, Robert; Kwong, Heston; Liu, Brent; Huang, H. K.

    2009-02-01

    The chest x-ray radiological features of tuberculosis patients are well documented, and the radiological features that change in response to successful pharmaceutical therapy can be followed with longitudinal studies over time. The patients can also be classified as either responsive or resistant to pharmaceutical therapy based on clinical improvement. We have retrospectively collected time series chest x-ray images of 200 patients diagnosed with tuberculosis receiving the standard pharmaceutical treatment. Computer algorithms can be created to utilize image texture features to assess the temporal changes in the chest x-rays of the tuberculosis patients. This methodology provides a framework for a computer-assisted detection (CAD) system that may provide physicians with the ability to detect poor treatment response earlier in pharmaceutical therapy. Early detection allows physicians to respond with more timely treatment alternatives and improved outcomes. Such a system has the potential to increase treatment efficacy for millions of patients each year.

  2. Molecular characterization of mutations associated with resistance to second-line tuberculosis drug among multidrug-resistant tuberculosis patients from high prevalence tuberculosis city in Morocco.

    Science.gov (United States)

    Oudghiri, Amal; Karimi, Hind; Chetioui, Fouad; Zakham, Fathiah; Bourkadi, Jamal Eddine; Elmessaoudi, My Driss; Laglaoui, Amin; Chaoui, Imane; El Mzibri, Mohammed

    2018-02-27

    The emergence of extensively drug-resistant tuberculosis (XDR-TB) has raised public health concern for global TB control. Although multi drug-resistant tuberculosis (MDR- TB) prevalence and associated genetic mutations in Morocco are well documented, scarce information on XDR TB is available. Hence, the evaluation of pre-XDR and XDR prevalence, as well as the mutation status of gyrA, gyrB, rrs, tlyA genes and eis promoter region, associated with resistance to second line drugs, is of great value for better management of M/XDR TB in Morocco. To evaluate pre-XDR and XDR prevalence, as well as the mutation status of gyrA, gyrB, rrs, tlyA genes and eis promoter region, associated with resistance to second line drug resistance, in 703 clinical isolates from TB patients recruited in Casablanca, and to assess the usefulness of molecular tools in clinical laboratories for better management of M/XDR TB in Morocco. Drug susceptibility testing (DST) was performed by the proportional method for first line drugs, and then the selected MDR isolates were tested for second line drugs (Ofloxacin, Kanamycin, Amikacin and Capreomycin). Along with DST, all samples were subjected to rpoB, katG and p-inhA mutation analysis by PCR and DNA sequencing. MDR isolates as well as 30 pan-susceptible strains were subjected to PCR and DNA sequencing of gyrA, gyrB, rrs, tlyA genes and eis promoter, associated with resistance to fluoroquinolones and injectable drugs. Among the 703 analysed strains, 12.8% were MDR; Ser531Leu and Ser315Thr being the most common recorded mutations within rpoB and katG genes associated with RIF and INH resistance respectively. Drug susceptibility testing for second line drugs showed that among the 90 MDR strains, 22.2% (20/90) were resistant to OFX, 2.22% (2/90) to KAN, 3.33% (3/90) to AMK and 1.11% (1/90) to CAP. Genotypic analysis revealed that 19 MDR strains harbored mutations in the gyrA gene; the most recorded mutation being Asp91Ala accounting for 47.6% (10

  3. Alarming levels of drug-resistant tuberculosis in HIV-infected patients in metropolitan Mumbai, India.

    Science.gov (United States)

    Isaakidis, Petros; Das, Mrinalini; Kumar, Ajay M V; Peskett, Christopher; Khetarpal, Minni; Bamne, Arun; Adsul, Balkrishna; Manglani, Mamta; Sachdeva, Kuldeep Singh; Parmar, Malik; Kanchar, Avinash; Rewari, B B; Deshpande, Alaka; Rodrigues, Camilla; Shetty, Anjali; Rebello, Lorraine; Saranchuk, Peter

    2014-01-01

    Drug-resistant tuberculosis (DR-TB) is a looming threat to tuberculosis control in India. However, no countrywide prevalence data are available. The burden of DR-TB in HIV-co-infected patients is likewise unknown. Undiagnosed and untreated DR-TB among HIV-infected patients is a major cause of mortality and morbidity. We aimed to assess the prevalence of DR-TB (defined as resistance to any anti-TB drug) in patients attending public antiretroviral treatment (ART) centers in greater metropolitan Mumbai, India. A cross-sectional survey was conducted among adults and children ART-center attendees. Smear microscopy, culture and drug-susceptibility-testing (DST) against all first and second-line TB-drugs using phenotypic liquid culture (MGIT) were conducted on all presumptive tuberculosis patients. Analyses were performed to determine DR-TB prevalence and resistance patterns separately for new and previously treated, culture-positive TB-cases. Between March 2013 and January 2014, ART-center attendees were screened during 14135 visits, of whom 1724 had presumptive TB. Of 1724 attendees, 72 (4%) were smear-positive and 202 (12%) had a positive culture for Mycobacterium tuberculosis. Overall DR-TB was diagnosed in 68 (34%, 95% CI: 27%-40%) TB-patients. The proportions of DR-TB were 25% (29/114) and 44% (39/88) among new and previously treated cases respectively. The patterns of DR-TB were: 21% mono-resistant, 12% poly-resistant, 38% multidrug-resistant (MDR-TB), 21% pre-extensively-drug-resistant (MDR-TB plus resistance to either a fluoroquinolone or second-line injectable), 6% extensively drug-resistant (XDR-TB) and 2% extremely drug-resistant TB (XDR-TB plus resistance to any group-IV/V drug). Only previous history of TB was significantly associated with the diagnosis of DR-TB in multivariate models. The burden of DR-TB among HIV-infected patients attending public ART-centers in Mumbai was alarmingly high, likely representing ongoing transmission in the community and

  4. Alarming levels of drug-resistant tuberculosis in HIV-infected patients in metropolitan Mumbai, India.

    Directory of Open Access Journals (Sweden)

    Petros Isaakidis

    Full Text Available BACKGROUND: Drug-resistant tuberculosis (DR-TB is a looming threat to tuberculosis control in India. However, no countrywide prevalence data are available. The burden of DR-TB in HIV-co-infected patients is likewise unknown. Undiagnosed and untreated DR-TB among HIV-infected patients is a major cause of mortality and morbidity. We aimed to assess the prevalence of DR-TB (defined as resistance to any anti-TB drug in patients attending public antiretroviral treatment (ART centers in greater metropolitan Mumbai, India. METHODS: A cross-sectional survey was conducted among adults and children ART-center attendees. Smear microscopy, culture and drug-susceptibility-testing (DST against all first and second-line TB-drugs using phenotypic liquid culture (MGIT were conducted on all presumptive tuberculosis patients. Analyses were performed to determine DR-TB prevalence and resistance patterns separately for new and previously treated, culture-positive TB-cases. RESULTS: Between March 2013 and January 2014, ART-center attendees were screened during 14135 visits, of whom 1724 had presumptive TB. Of 1724 attendees, 72 (4% were smear-positive and 202 (12% had a positive culture for Mycobacterium tuberculosis. Overall DR-TB was diagnosed in 68 (34%, 95% CI: 27%-40% TB-patients. The proportions of DR-TB were 25% (29/114 and 44% (39/88 among new and previously treated cases respectively. The patterns of DR-TB were: 21% mono-resistant, 12% poly-resistant, 38% multidrug-resistant (MDR-TB, 21% pre-extensively-drug-resistant (MDR-TB plus resistance to either a fluoroquinolone or second-line injectable, 6% extensively drug-resistant (XDR-TB and 2% extremely drug-resistant TB (XDR-TB plus resistance to any group-IV/V drug. Only previous history of TB was significantly associated with the diagnosis of DR-TB in multivariate models. CONCLUSION: The burden of DR-TB among HIV-infected patients attending public ART-centers in Mumbai was alarmingly high, likely representing

  5. CD4 lymphocyte dynamics in Tanzanian pulmonary tuberculosis patients with and without HIV co-infection

    DEFF Research Database (Denmark)

    Andersen, Aase B.; Range, Nyagosya; Changalucha, John

    2012-01-01

    ABSTRACT: BACKGROUND: The interaction of HIV and tuberculosis (TB) on CD4 levels over time has previously been divergently reported and only in small study populations with short or no follow-up. METHODS: CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort...... of pulmonary TB patients with and without HIV co-infection and compared with cross-sectional data on age- and sex-matched non-TB controls from the same area. RESULTS: Of 1605 study participants, 1250 were PTB patients and 355 were non-TB controls. At baseline, HIV was associated with 246 (95% CI: 203; 279...

  6. Factors Associated with Tuberculosis and Rifampicin-Resistant Tuberculosis amongst Symptomatic Patients in India: A Retrospective Analysis.

    Directory of Open Access Journals (Sweden)

    Sreenivas Achuthan Nair

    Full Text Available Tuberculosis remains a major public health challenge for India. Various studies have documented different levels of TB and multi-drug resistant (MDR TB among diverse groups of the population. In view of renewed targets set under the End TB strategy by 2035, there is an urgent need for TB diagnosis to be strengthened. Drawing on data from a recent, multisite study, we address key questions for TB diagnosis amongst symptomatics presenting for care: are there subgroups of patients that are more likely than others, to be positive for TB? In turn, amongst these positive cases, are there factors-apart from treatment history-that may be predictive for multi-drug resistance?We used data from a multi-centric prospective demonstration study, conducted from March 2012 to December 2013 in 18 sub-district level TB programme units (TUs in India and covering a population of 8.8 million. In place of standard diagnostic tests, upfront Xpert MTB/RIF testing was offered to all presumptive TB symptomatics. Here, using data from this study, we used logistic regression to identify association between risk factors and TB and Rifampicin-Resistant TB among symptomatics enrolled in the study.We find that male gender; history of TB treatment; and adult age compared with either children or the elderly are risk factors associated with high TB detection amongst symptomatics, across the TUs. While treatment history is found be a significant risk factor for rifampicin-resistant TB, elderly (65+ yrs people have significantly lower risk than other age groups. However, pediatric TB cases have no less risk of rifampicin resistance as compared with adults (OR 1.23 (95% C.I. 0.85-1.76. Similarly, risk of rifampicin resistance among both the genders was the same. These patterns applied across the study sites involved. Notably in Mumbai, amongst those patients with microbiological confirmation of TB, female patients showed a higher risk of having MDR-TB than male patients.Our results

  7. Yield of facility-based verbal screening amongst household contacts of patients with multi-drug resistant tuberculosis in Pakistan

    Directory of Open Access Journals (Sweden)

    Ejaz Qadeer

    2017-05-01

    Full Text Available Background: Household contacts of multidrug-resistant tuberculosis (MDR-TB patients are at a high risk of getting infected with TB/MDR-TB, therefore symptomatic or vulnerable individuals should be screened and treated early. Methods: A cross-sectional study was conducted among household contacts of MDR-TB patients in three high-burden TB sites in Pakistan from July 2013 to June 2014. MDR-TB index patients were asked to provide a list of all members of their household and were asked whether any of them had TB symptoms such as productive cough, fever, weight loss and night sweat (“facility-based verbal screening”. Symptomatic contacts were defined as presumptive TB cases and were invited for investigations at the facility. Those who did not come were paid a home-visit. Confirmed TB/MDR-TB patients were registered in the nearest treatment facility. Results: Of 209 MDR-TB index patients, 1467 household contacts were identified and screened, 95 of them children < 5 years. Of these 172 (12% were symptomatic. Most common symptoms were cough 157 (91% and fever 107 (62%. 58 (34% presumptive TB contacts were not investigated. Of total contacts, 56 (3.8% were diagnosed with TB, among them 54(96% with MDR-TB and 2(4% with drug-susceptible-TB. The number needed to screen (NNS to identify a new MDR-TB case among adult household contacts was 27 and among presumptive adult and pediatric TB contacts was three. All 56 confirmed patients were registered for treatment. Conclusion: Screening household contacts of MDR-TB index cases may be considered a feasible and high yield option, in high-burden, low-resource settings within Pakistan. The number of presumptive TB contacts required to screen to identify a new MDR-TB case was unusually low, indicating an effective strategy that could easily be scaled-up. The screening and management of vulnerable adults and children living with patients having TB of any form is a major priority in the combined efforts

  8. [Tuberculosis and malaria global prophylaxis in the light of decisions of the Big Eight].

    Science.gov (United States)

    Onishchenko, G G

    2008-01-01

    At the present time about two million people, one third of the Earth's population, are carriers of tuberculosis agent. Though tuberculosis is curable disease, it continues to take away lives of about 4400 persons; most of them are young and are in the most productive age. The most active incidence rate of tuberculosis occurs in the countries of Africa to the south of Sahara (29% of all cases of tuberculosis per head); half of new cases of tuberculosis fall on Asian countries: Bangladesh, China, India, Indonesia, Pakistan, Philippines. The governments of Big Eight maintain activities that have stabilized morbidity of tuberculosis on a world scale. Over 11 years (1995 - 2006) World Health Organization (WHO) implemented the DOTS strategy (Directly Observed Treatment with Short course of chemotherapy) in 183 countries and tested it on 26 millions patients with tuberculosis. Global data acquisition in 2005 found out morbidity of tuberculosis in 59% (the aim is 70%) and successful cure in 84% cases (the aim is 85 %). In 2006 WHO started realization of the Global Plan "Stop tuberculosis" (2006 - 2012). At the present time Global Fund use about 17% its resources to finance programs against tuberculosis. These funds help to reveal 5 millions extra cases of tuberculosis and cure 3 millions patients in the network of DOTS.

  9. Socio-economic status and the duration of pulmonary tuberculosis symptoms in women treated at the Mazovian Treatment Centre of Tuberculosis and Lung Diseases in Otwock.

    Science.gov (United States)

    Błachnio, Maria; Zielonka, Tadeusz M; Błachnio, Antoni; Jagodziński, Jacek

    2014-01-01

    The prevalence of tuberculosis depends on various factors such as migration, homelessness, malnutrition, unemployment, bad life conditions and the aging of a society. The aim of this study was to evaluate tuberculosis in females treated at the Mazovian Treatment Centre of Tuberculosis and Lung Diseases (Mazowieckie Centrum Leczenia Chorób Płuc i Gruźlicy) in Otwock, regarding the context of demographic, social and professional status of female patients. The duration of the illness and the extent of radiographic changes were also taken into consideration. The study was carried out retrospectively. The medical documentation that was evaluated concerned 100 women, aged between 20 and 92, hospitalized at the Mazovian Treatment Centre of Tuberculosis and Lung Diseases in Otwock in the years 2005 and 2006 due to bacteriologically confirmed tuberculosis. Most women with tuberculosis lived in cities (65%), 32% of the evaluated patients lived in villages and 3% were homeless. 1/3 of females were under 40 years of age, and 1/3 were over 60 years of age. Only 29% of the women were professionally active and 25% were unemployed. 60% of women were not married. 35% of women with tuberculosis were bringing up children and 7% had abandoned their offspring. More than 1/3 of women had had tuberculosis symptoms for more than half a year before tuberculosis was diagnosed. 40% of women with tuberculosis had small radiological changes (1 to 2 lung fields); however, 26% of them had extensive changes covering 4 to 6 lung fields. The majority of women with tuberculosis in the Mazovian district are single, over 40 years old, unemployed inhabitants of cities. 30% of women in the study group had had symptoms for more than 6 months before tuberculosis was diagnosed. 40% of women with tuberculosis had very extensive radiological changes covering 4 to 6 lung fields.

  10. First and second line drug resistance among treatment naïve pulmonary tuberculosis patients in a district under Revised National Tuberculosis Control Programme (RNTCP in New Delhi

    Directory of Open Access Journals (Sweden)

    Vithal Prasad Myneedu

    2015-12-01

    Full Text Available There is limited information of level of drug resistance to first-line and second line anti-tuberculosis agents in treatment naïve pulmonary tuberculosis (PTB patients from the Indian region. Therefore, the present prospective study was conducted to determine the antimicrobial susceptibility to first-line and second line anti-TB drug resistance in such patients. Sputum samples from consecutive treatment naïve PTB cases registered in Lala Ram Sarup (LRS district, under RNTCP containing 12 Directly Observed Treatment Centre’s (DOTS, were enrolled using cluster sampling technology. A total of 453 samples were received from July 2011 to June 2012. All samples were cultured on solid medium followed by drug susceptibility to first and second line anti-tubercular drugs as per RNTCP guidelines. Primary multi-drug resistance (MDR was found to be 18/453; (4.0%. Extensively drug resistance (XDR was found in one strain (0.2%, which was found to be resistant to other antibiotics. Data of drug resistant tuberculosis among treatment naïve TB patients are lacking in India. The presence of XDR-TB and high MDR-TB in small population studied, calls for conducting systematic multi-centric surveillance across the country.

  11. Risk factors of treatment default and death among tuberculosis patients in a resource-limited setting.

    Science.gov (United States)

    Alobu, Isaac; Oshi, Sarah N; Oshi, Daniel C; Ukwaja, Kingsley N

    2014-12-01

    To evaluate the rates, timing and determinants of default and death among adult tuberculosis patients in Nigeria. Routine surveillance data were used. A retrospective cohort study of adult tuberculosis patients treated during 2011 and 2012 in two large health facilities in Ebonyi State, Nigeria was conducted. Multivariable logistic regression analyses were used to identify independent predictors for treatment default and death. Of 1 668 treated patients, the default rate was 157 (9.4%), whilst 165 (9.9%) died. Also, 35.7% (56) of the treatment defaults and 151 (91.5%) of deaths occurred during the intensive phase of treatment. Risk of default increased with increasing age (adjusted odds ratio (aOR) 1.2; 95% confidence interval (CI) 1.1-1.9), smear-negative TB case (aOR 2.3; CI 1.5-3.6), extrapulmonary TB case (aOR 2.7; CI 1.3-5.2), and patients who received the longer treatment regimen (aOR 1.6; 1.1-2.2). Risk of death was highest in extrapulmonary TB (aOR 3.0; CI 1.4-6.1) and smear-negative TB cases (aOR 2.4; CI 1.7-3.5), rural residents (aOR 1.7; CI 1.2-2.6), HIV co-infected (aOR 2.5; CI 1.7-3.6), not receiving antiretroviral therapy (aOR 1.6; CI 1.1-2.9), and not receiving cotrimoxazole prophylaxis (aOR 1.7; CI 1.2-2.6). Targeted interventions to improve treatment adherence for patients with the highest risk of default or death are urgently needed. This needs to be urgently addressed by the National Tuberculosis Programme. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  12. Involvement of CD244 in regulating CD4+ T cell immunity in patients with active tuberculosis.

    Directory of Open Access Journals (Sweden)

    Bingfen Yang

    Full Text Available CD244 (2B4 is a member of the signaling lymphocyte activation molecule (SLAM family of immune cell receptors and it plays an important role in modulating NK cell and CD8(+ T cell immunity. In this study, we investigated the expression and function of CD244/2B4 on CD4(+ T cells from active TB patients and latent infection individuals. Active TB patients had significantly elevated CD244/2B4 expression on M. tuberculosis antigen-specific CD4(+ T cells compared with latent infection individuals. The frequencies of CD244/2B4-expressing antigen-specific CD4(+ T cells were significantly higher in retreatment active TB patients than in new active TB patients. Compared with CD244/2B4-dull and -middle CD4(+ T cells, CD244/2B4-bright CD4(+ T cell subset had significantly reduced expression of IFN-γ, suggesting that CD244/2B4 expression may modulate IFN-γ production in M. tuberculosis antigen-responsive CD4(+ T cells. Activation of CD244/2B4 signaling by cross-linking led to significantly decreased production of IFN-γ. Blockage of CD244/2B4 signaling pathway of T cells from patients with active TB resulted in significantly increased production of IFN-γ, compared with isotype antibody control. In conclusion, CD244/2B4 signaling pathway has an inhibitory role on M. tuberculosis antigen-specific CD4(+ T cell function.

  13. A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment

    International Nuclear Information System (INIS)

    Rhee, Chong Heon

    1967-01-01

    In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurement and lung perfusion scans by 131 I-Macroaggregated albumin, lung inhalation scans by colloidal 198 Au and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1) The normal distribution of pulmonary blood flow was found to be 54.5±2.82% to the right lung and 45.5±2.39% to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p 131 I-MAA in patients with pulmonary tuberculosis was as follows: a) In the pretreated minimal pulmonary tuberculosis, the decreased area of pulmonary arterial blood flow was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive than had been expected from the chest roentgenogram in the apparently healed minimal pulmonary tuberculosis. b) In the pretreated moderately advanced pulmonary tuberculosis, the decrease of pulmonary arterial blood flow to the diseased area was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive in the treated moderately advanced pulmonary tuberculosis as in the treated minimal pulmonary tuberculosis. c) Pulmonary arterial blood flow in the patients with far advanced pulmonary tuberculosis both before and after chemotherapy were almost similar to the chest roentgenogram. Especially the decrease of pulmonary arterial blood flow to the cavity was usually greater than had been expected from the chest roentgenogram. 3) Lung inhalation scan by colloidal 198 Au in patients with pulmonary tuberculosis was as follows: a) In the minimal pulmonary tuberculosis, lung inhalation scan showed almost similar decrease of radioactivity corresponding to the chest roentgenogram. b) In the moderately advanced pulmonary tuberculosis the decrease

  14. Diabetes mellitus among tuberculosis patients: a cross sectional ...

    African Journals Online (AJOL)

    We monitored the fasting blood sugar of each patient by using a semi automated clinical chemistry analyzer followed by an HbA1c level check of all ... other hand, diabetic patients have weak cellular immunity, kidney problems and alveolar .... dividuals that may be due to weak immune system along with multiple ailments.

  15. Weight, body composition and handgrip strength among pulmonary tuberculosis patients

    DEFF Research Database (Denmark)

    Praygod, George; Range, Nyagosya; Faurholt-Jepsen, Daniel

    2011-01-01

    This study aimed to estimate deficits in weight, arm fat area (AFA), arm muscle area (AMA) and handgrip strength among smear-positive pulmonary TB (PTB+) patients starting treatment. We conducted a cross-sectional study among PTB+ patients and age- and sex-matched neighborhood controls. HIV statu...

  16. Thyroid function in multidrug-resistant tuberculosis patients with or ...

    African Journals Online (AJOL)

    free triiodothyronine, values are presented in mean ± standard deviation or median (interquartile range). When all the patients were pooled and compared based on gender (males and females), it was observed that the median levels of TSH, T3 and T4 were similar between the 2 groups. However, male patients were found ...

  17. Contribution of spoligotyping and MIRU-VNTRs to characterize prevalent Mycobacterium tuberculosis genotypes infecting tuberculosis patients in Morocco.

    Science.gov (United States)

    Chaoui, Imane; Zozio, Thierry; Lahlou, Ouafae; Sabouni, Radia; Abid, Mohammed; El Aouad, Rajae; Akrim, Mohammed; Amzazi, Said; Rastogi, Nalin; El Mzibri, Mohammed

    2014-01-01

    In the present study, Mycobacterium tuberculosis complex (MTBC) clinical isolates from culture-positive TB patients in Morocco were studied by spoligotyping and 12-loci MIRU-VNTR typing methods to characterize prevalent genotypes (n = 219 isolates from 208 patients). Spoligotyping resulted in 39 unique patterns and 167 strains in 30 clusters (2-50 strains per cluster). Comparison with international database showed that 29 of 39 unique patterns matched existing shared spoligotype international types (SITs). Nine shared types containing 10 strains were newly created (SIT 2891 to SIT 2899); this led to the description of 69 SITs with 206 strains and two orphan patterns. The most prevalent spoligotype was SIT42 (LAM; n = 50 or 24% of isolates). The repartition of strains according to major MTBC clades was as follows LAM (46.1%)> Haarlem (26%) >ill-defined T superfamily (22.6%) and S clade (0.96%). On the other hand, Beijing, CAS (Central Asian) and EAI (East-African Indian) strains were absent in this setting. Subsequent 12-Loci MIRU typing resulted in a total of 25 SIT/MIT clusters (n = 66 isolates, 2-6 isolates per cluster), with a resulting recent transmission rate of 22.3%. The MIRU-VNTR patterns corresponded to 69 MITs for 138 strains and 46 orphan patterns. The most frequent patterns were MIT43 (n = 8), MIT9 (n = 7) and MIT42 (n = 7). HGDI analysis of the 12 MIRU loci showed that loci 10, 23 and 40 were highly discriminative in our setting. The results also underlined the usefulness of spoligotyping and MIRU-VNTR to detect mixed infections among certain of our TB patients. Globally, the results obtained showed that TB is almost exclusively transmitted in Morocco through evolutionary-modern MTBC lineages belonging to principal genetic groups 2/3 strains (Haarlem, LAM, T), with a high level of biodiversity seen by MIRU typing. This study provides with a 1st global snapshot of MTBC population structure in Morocco, and validates the potential use of spoligotyping in

  18. Significance of measurement of serum fibrosis markers (HA, LN, P III P, IV C) in patients with pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Zhou Mingxian

    2006-01-01

    Objective: To study the clinical significance of determination of serum fibrosis markers in patients with pulmonary tuberculosis. Methods: Serum hyaluronic acid (HA), laminin (LN), procollagen III peptide (P III P) and Type IV collagen (IV C) contents were determined with RIA in 128 patients with pulmonary tuberculosis both before and after treatment as well as in 40 controls. Results: Before treatment, the serum contents of the four markers in the patients were significantly higher than those in the controls (P 0.05). Decreases of the levels in treatment failures were not significant and the levels remained significantly higher than those in controls (P<0.01 or P<0.05). Conclusion: Determination of serum fibrosis markers levels in patients with pulmonary tuberculosis is valuable for early diagnosis as well as for evaluation of the effect of chemotherapy. (authors)

  19. Clustering of Mycobacterium tuberculosis strains from foreign-born patients in Korea.

    Science.gov (United States)

    Jeon, Christie Y; Kang, Heeyoon; Kim, Mihye; Murray, Megan B; Kim, Heejin; Cho, Eun Hee; Park, Young Kil

    2011-12-01

    Information on drug resistance and transmission patterns of tuberculosis (TB) in foreign-born patients is lacking in Asia where immigration is increasing. We examined the drug-resistance profiles of 288 Mycobacterium tuberculosis isolates from foreign-born patients in South Korea, and assessed for potential transmission in the host country by analysing their IS6110 genotypes, as well as those of 4780 strains from native Korean TB patients. The prevalence of multidrug-resistant (MDR) TB was 9.7% and 42% among new and previously treated patients, respectively. Chinese nationality was associated with MDR TB (OR(China)=3.0, 95% CI 1.1-9.3). Of the 288 strains, 51 (17.7%) formed 31 clusters, of which 22 were identical to strains from native Koreans. A number of strains belonged to the K family, subtypes known to occur endemically in Korea. MDR TB was common, and clustering patterns showed potential cross-cultural transmission among foreign-born TB patients. Further molecular epidemiological studies of all isolates in the area are needed to determine the extent of international TB transmission in Asia. © 2011 SGM

  20. Feasibility and yield of screening for non-communicable diseases among treated tuberculosis patients in Peru.

    Science.gov (United States)

    Byrne, A L; Marais, B J; Mitnick, C D; Garden, F L; Lecca, L; Contreras, C; Yauri, Y; Garcia, F; Marks, G B

    2018-01-01

    The increasing prevalence of non-communicable diseases (NCDs) poses a major challenge to low- and middle-income countries. Patients' engagement with health services for anti-tuberculosis treatment provides an opportunity for screening for NCDs and for linkage to care. We explored the feasibility and yield of screening for NCDs in patients treated for tuberculosis (TB) in Lima, Peru, as part of a study focused on chronic respiratory sequelae. A representative sample of community controls was recruited from the same geographical area. Screening entailed taking a medical history and performing ambulatory blood pressure measurement and urinalysis. A total of 177 participants with previous TB (33 with multidrug-resistant TB) and 161 community controls were evaluated. There was an almost four-fold increased prevalence of self-reported diabetes mellitus (DM) in the TB group (adjusted prevalence ratio 3.66, 95%CI 1.68-8.01). Among those without self-reported DM, 3.3% had glycosuria, with a number needed to screen (NNS) of 31. The NNS to find one (new) case of hypertension or proteinuria in the TB group was respectively 24 and 5. Patient-centred care that includes pragmatic NCD screening is feasible in TB patients, and the treatment period provides a good opportunity to link patients to ongoing care.

  1. Enteroparasitosis prevalence and parasitism influence in clinical outcomes of tuberculosis patients with or without HIV co-infection in a reference hospital in Rio de Janeiro (2000-2006

    Directory of Open Access Journals (Sweden)

    Luanda M.S. Neto

    Full Text Available Tuberculosis and intestinal parasites affect primarily low social and economic level populations, living clustered in precarious habitational settings. One of the interesting aspects of this interaction is the parasitism influence in cellular response to tuberculosis. In the present study, we evaluated the prevalence of enteroparasitosis in tuberculosis patients, HIV-infected and non HIV infected, and we observed the influence of helminth presence in the response to tuberculin skin test (TST and tuberculosis clinical outcomes. From 607 clinical records reviewed, 327 individuals met the study inclusion criteria and did not present any exclusion criteria. The prevalence of enteroparasites observed was 19.6%. There was no significant association among TST result and the variables related to the presence of: helminthes, protozoa, and stool test for parasites result (p>0.5. Considering the survival of this cohort, we may observe that there is no significant difference (p>0.05 between the survival curves of parasited and non parasited individuals. Solely the variable "eosinophils" presents a statistically significant association (p<0.001 with helminthes, all other associations are considered not significant. Our findings neither show an association between helminthic infection and a favorable tuberculosis outcome, nor between parasitism and TST response, unlike other in vitro studies. Apparently, experimental data do not correspond to the clinical findings.

  2. Cellular Architecture of Spinal Granulomas and the Immunological Response in Tuberculosis Patients Coinfected with HIV.

    Science.gov (United States)

    Bhattacharya, Debapriya; Danaviah, Siva; Muema, Daniel M; Akilimali, Ngomu Akeem; Moodley, Prashini; Ndung'u, Thumbi; Das, Gobardhan

    2017-01-01

    Mycobacterium tuberculosis ( M.tb ) and HIV are individually responsible for the most deaths worldwide among all infectious agents, and coinfection with M.tb and HIV is a significant public health challenge in the developing world. Although the lung is the primary target organ for tuberculosis (TB), M.tb can also cause extrapulmonary tuberculosis (EPTB) such as in the bones and joints. Treatment of EPTB is much more challenging than treatment of pulmonary TB. The hallmark of the host immune response against TB is the formation of organized structures called granulomas that are infiltrated with immune cells and are rich in cytokines and chemokines. Inside granulomas, the host confines the M.tb bacteria to a particular region of the organ and avoids dispersion. In this study, we analyzed immune cells in bone granulomas of patients with EPTB that are also coinfected with HIV. We found that HIV-infected TB patients have dispersed bone granulomas, with reduced T cell numbers and a concomitant increase in plasma cells. Additionally, HIV-infected patients exhibited dramatically increased serum levels of IgM and IgG1 antibodies, which is indicative of T-cell-independent B-cell activation and mucosal T-cell activation, respectively. Interestingly, we also observed that CD29 + stem cells are increased in HIV-TB coinfection, suggesting a link with HIV infection. Therefore, our work provides new insights into the architecture of spinal TB granulomas and the role of B-cells and humoral immunity against a highly infectious intracellular pathogen. We propose that our findings will inform biomarker identification for EPTB and possibly the development of related therapeutics and/or vaccines to protect HIV-infected patients against disseminated TB.

  3. Magnetic resonance imaging findings in spinal tuberculosis: Comparison of HIV positive and negative patients

    Directory of Open Access Journals (Sweden)

    Cameron Michael Anley

    2012-01-01

    Full Text Available Background: There is an increasing incidence of Human immunodeficiency virus (HIV and tuberculosis (TB co-infection. This has led to an increasing number of atypical features on magnetic resonance imaging (MRI. We postulated that the type 4 hypersensitivity response causing granulomatous inflammation may be disrupted by the HIV resulting in less vertebral body destruction. This study compares the MRI features of spinal tuberculosis in HIV positive and negative patients. Materials and Methods: Fifty patients with confirmed spinal tuberculosis, HIV status and available MRI scans at a single institution from 2003-2009 were identified. HIV status was positive in 20 and negative in 30. Females were predominant (34:16. The HIV positive group was younger at 32.4 versus 46 years (P=0.008. Blood parameters (WCC, ESR, Hb, Lymphocyte count were not significantly different between the HIV groups. MRI scans were reviewed by a radiologist who was blinded to the HIV status. Site, extent of disease, body collapse, abscess location and volume, kyphotic deformity and cord signal were reported. Results: There was no difference between the number of vertebral bodies affection with TB involvement, presence of cord signal or incidence of non-contiguous lesions. The HIV negative group had significantly more total vertebral collapse (P=0.036 and greater kyphosis (P=0.002. The HIV positive group had a trend to larger anterior epidural pus collection (P=0.2. Conclusion: HIV negative patients demonstrate greater tuberculous destruction in terms of total percentage body collapse and resultant kyphosis. There is no difference in the incidence of cord signal or presence of non-contiguous lesions. HIV positive patients show a trend to a greater epidural abscess volume. This difference may be explained by the reduced autoimmune response of the type 4 hypersensitivity reaction caused by the HIV infection.

  4. Pitfalls of fluorodeoxyglucose positron-emission tomography-CT in tuberculosis mimicking malignancy in 60 patients

    International Nuclear Information System (INIS)

    Wang Xinlu; Yin Jilin; Zhang Jinhe; Ou Yangxi; Zhou Zheng; Quan Jiangtao; Zhang Weibiao; Zheng Hui

    2013-01-01

    Objective: To analyze the pitfalls of "1"8F fluorodeoxyglucose (FDG) positron emission tomography/computer tomography (PET-CT) scan in the diagnosis of 60 patients of tuberculosis mimicking malignancy. Methods: The study included 60 patients with PET-CT diagnosis of probable malignancy. Fifty patients were proved to be tuberculosis by pathological examinations and 10 were diagnosed by clinical followup. The images of whole body were acquired at 60 min after administration of 222-555 MBq "1"8F-FDG. The PET-CT imaging characteristics and clinical data, including lesion size, distribution, standardized uptake value (SUV) were retrospectively analyzed. After the whole body scan of PET-CT, each patient had a chest spiral CT scan for detailed observation of lung lesions. Contrast enhanced CT (CECT) was performed in 8 patients. Results: (1)Thirty patients were misdiagnosed as lung cancer, 14 patients as malignant lymphoma, 6 patients as malignant mesothelioma, 3 as intestine carcinoma, 2 as bone malignancy, 1 patient as hepatocarcinoma, spleen malignancy, ovarian cancer, laryngocarcinoma and nasopharyngeal carcinoma respectively. (2) 90.9% (20/22) of patients showed normal level of serum CEA and 100% (13/13) of patients showed normal level of CA199. Increasing serum CA125 was found in all patients (6/6) with active TB patients accompanied with ascites, pleural fluid and (or) pericardial effusion. (3) 93.3% (28/30) active tuberculosis showed accumulated "1"8F-FDG which was incorrectly interpreted as malignancy. The most common sites of TB lymphadenopathy were bilateral cervical tissues, which was accounted for 85.7% (12/14). CECT revealed characteristics of peripheral enhancement and central necrosis in tubercular lymphadenopathy, which was 87.5% (7/8). Conclusions: The diverse manifestations of TB on imaging and high uptake of "1"8F-FDG on PET imaging result in misdiagnosis of malignancy. It is important for radiologists and nuclear medicine physicians to identify the

  5. Risk of Development of tuberculosis in HIV-infected patients

    Indian Academy of Sciences (India)

    6.7/100 p-y, 95%CI 2.6–10.8) patients. Trend towards higher mortality in patients who developed TB (10.5/100 p-y, 95%CI 4.8–15.2) compared to those who did not (6.1/100 p-y, 95%CI 3.2–8.8). New TB infections play major role in India?

  6. Study on drug resistance of mycobacterium tuberculosis in patients with pulmonary tuberculosis by drug resistance gene detecting

    International Nuclear Information System (INIS)

    Wang Wei; Li Hongmin; Wu Xueqiong; Wang Ansheng; Ye Yixiu; Wang Zhongyuan; Liu Jinwei; Chen Hongbing; Lin Minggui; Wang Jinhe; Li Sumei; Jiang Ping; Feng Bai; Chen Dongjing

    2004-01-01

    To investigate drug resistance of mycobacterium tuberculosis in different age group, compare detecting effect of two methods and evaluate their the clinical application value, all of the strains of mycobacterium tuberculosis were tested for resistance to RFP, INH SM PZA and EMB by the absolute concentration method on Lowenstein-Jensen medium and the mutation of the rpoB, katG, rpsL, pncA and embB resistance genes in M. tuberculosis was tested by PCR-SSCP. In youth, middle and old age group, the rate of acquired drug resistance was 89.2%, 85.3% and 67.6% respectively, the gene mutation rate was 76.2%, 81.3% and 63.2% respectively. The rate of acquired drug resistance and multiple drug resistance in youth group was much higher than those in other groups. The gene mutation was correlated with drug resistance level of mycobacterium tuberculosis. The gene mutation rate was higher in strains isolated from high concentration resistance than those in strains isolated from low concentration resistance. The more irregular treatment was longer, the rate of drug resistance was higher. Acquired drug resistance varies in different age group. It suggested that surveillance of drug resistence in different age group should be taken seriously, especially in youth group. PCR - SSCP is a sensitive and specific method for rapid detecting rpoB, katG, rpsL, pncA and embB genes mutations of MTB. (authors)

  7. The experiences of patients and carers living.

    Science.gov (United States)

    Leeder, Stephen R; Jowsey, Tanisha; McNab, Justin W

    2018-01-01

    Non-communicable diseases (NCDs) are increasing in prevalence and straining health systems globally. This creates a so-called 'burden of disease', which can be traced in terms of fiscal health system matters and in terms of quality of life and lived experiences of people with NCDs. The United Nations has called for a global agenda to manage NCDs and reduce their burden. The purpose of this article is to summarise key findings from the Serious and Continuing Illness Policy and Practice Study concerning patients’ and carers’ experiences of multimorbid NCDs in Australia. We focus on the relevance of findings for policy and general practitioners in Australia. We suggest that a complex multimorbidity policy is needed to contextualise and guide single-illness NCD policies. Our research suggests that specialist NCD nurses and allied health professionals could have important roles in improving care coordination between general practices and community health centres.  .

  8. Comparison of clinico-radiological features of patients with positive cultures of nontuberculous mycobacteria and patients with tuberculosis

    International Nuclear Information System (INIS)

    Ba-Hammam, Ahmed; Sharif, Yasir; Masood, Mohammad; Isnani, Arthur; Youssef, Ismael; Kambal, Abdelmageed; Shaikh, Shaffi

    2005-01-01

    To identify the clinico-radiological features of patients with positive cultures for nontuberculous mycobacteria (NTM) and compare those to a sample of patients with tuberculosis (MTB). A laboratory database was used to retrieve all specimens submitted to King Khalid University Hospital, Riyadh, mycobacteriology laboratory for mycobacterial smears and cultures during the period from October 1999-April 2002. Using this database, the original records of the mycobacteriology laboratory and a review of the patient's health records, a standard proforma was completed that included demographic, clinical, radiological and laboratory information on patients included in this study. The patients were divided into 2 groups; the NTM group, which included patients with positive cultures for NTM and the MTB group, which included a sample of patients with documented tuberculosis. During the study period, 286 patients had positive mycobacterial cultures. Seventy patients (24.5%) grew NTM and 216 (75.5%) grew MTB. For patients with MTB, 54 patients were included as per the selection protocol of the study. There was no difference between the 2 groups in all measured demographic variables. The presence of weight loss and fever was significantly more in the MTB group. Radiologically, the presence of hilar adenopathy was more significant among patients with MTB than those with NTM (17% versus 4%, p=0.02). However, bronchiectatic changes were seen significantly more among NTM patients compared to patients with MTB (26% versus 11%, p=0.03). The isolation of NTM in the mycobacteriology laboratory is high. The clinico-radiological features were not sufficiently specific to differentiate patients with NTM from patients with MTB. Local studies are needed to explore NTM disease in various developing countries and identify the NTM species causing infections in non-immunosuppressed patients in each locality. (author)

  9. CCR2 V64I polymorphism in rifampicin resistant tuberculosis patients in Moewardi General Hospital Surakarta, Indonesia

    Science.gov (United States)

    Marwoto; Agung Prasetyo, Afiono; Reviono; Suradi

    2018-05-01

    CC chemokine receptor-2 (CCR2) play important roles in inflammation. The CCR2 V64I polymorphism already reported associated with many diseases; however, the association of CCR2 V64I polymorphism with tuberculosis is still unknown. Also, there is no report about the presentation of CCR2 V64I polymorphisms in Indonesian tuberculosis patients with rifampicin-mono resistant status has ever been published, to the best of our knowledge. This study evaluated the presence of CCR2 V64I polymorphisms in Javanese rifampicin-mono resistant tuberculosis patients. In an ongoing molecular epidemiology study of human genomic polymorphisms and infection, 51 Javanese rifampicin-mono resistant tuberculosis patients in Dr. Moewardi General Hospital in Surakarta were enrolled in the study. The blood samples were aliquoted and fractionated. The nucleic acids were extracted from all blood samples and subjected to the CCR2 V64I polymorphisms detection by a polymerase chain reaction-sequence-specific primer (PCR-SSP) technique. PCR products were analyzed in 3% agarose. CCR2 64V and 64I homozygote were found in 23.5% (12/51) and 23.5% (12/51) blood samples, respectively. The CCR2 VI genotype was found in 52.9% (27/51) blood samples. The CCR2 VI genotype was found predominant in Javanese rifampicin-mono resistant tuberculosis patients and may have anassociation with the clinical progression.

  10. Evaluation of treatment outcome of tuberculosis patients in the urban field practice area of D. Y. Patil Medical College, Pimpri, Pune

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    Balkrishan Lanjewar

    2014-09-01

    Full Text Available Background: Tuberculosis (TB bacilli have lived in symbiosis with mankind since time immemorial. RNTCP is the largest and the fastest expanding programme throughout the world as 1.29 million patients in 2005, 1.39 million patients in 2006 and 1.48 million patients in 2007 were enrolled for treatment. In 2008, 1.51 million patients have already been placed on treatment. Treatment success rates have tripled from 25% to 86% & TB death rates have been cut 7 fold from 29% to 4% in comparison to the pre-RNTCP (Revised National Tuberculosis Control Programme era.[1] Objective: To study treatment outcome in the form of cure rate, treatment completion rate, failure rate, death rate in the study area. Method: An ambispective study was done in urban field practice area attached to Padamshree Dr. D.Y. Patil Medical College Pimpri, Pune. The study was carried out during 1st July 2011 - 30th September 2013. Results: A total 429 subjects were enrolled in the study of which, 224(52.24% were successfully completed the treatment, followed by 110(25.54% which were cured, 34(07.92% were defaulted, 28(06.52% were transferred out, 17(03.96% died and 16(03.72% underwent treatment failure during the study period. Conclusion: In spite, of many efforts by RNTCP to treat tuberculosis patients it was found only 50 % of the subjects successfully completed the treatment.

  11. Estrategia de tratamiento acortado y estrictamente supervisado en pacientes con tuberculosis pulmonar confirmada Strategy of strictly monitored and shortened treatment in patients with confirmed pulmonary tuberculosis

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    Luis René Tablada del Risco

    2010-12-01

    Full Text Available Se realizó una investigación descriptiva y transversal para caracterizar a los pacientes con tuberculosis pulmonar, cuyos esputos fueran positivos para bacilos-ácido-alcohol-resistente, en una población abierta del municipio de Santiago de Cuba, desde el 2003 hasta el 2007, los cuales se acogieron a la estrategia de tratamiento acortado estrictamente supervisado. En la casuística predominaron el sexo masculino, los adultos jóvenes, así como los factores de riesgo: hábito tabáquico, alcoholismo y antecedente de contactos con personas afectadas por dicha enfermedad. La atención primaria de salud no cumplió el indicador operacional del diagnóstico de estos pacientes ni el seguimiento baciloscópico mensual. Se recomienda elaborar una estrategia de intervención que contemple un proyecto capacitante, encaminado a elevar la competencia profesional del personal sanitario en relación con la asistencia integral incluida en el Programa Nacional de Control de la Tuberculosis.A cross-sectional and descriptive study was conducted to characterize patients with pulmonary tuberculosis whose sputa were positive for acid-alcohol resistant bacilli, in a general population of Santiago de Cuba municipality, from 2003 to 2007, who opted for the strategy of strictly monitored and shortened treatment. Male sex, young adults as well as risk factors: smoking habit, alcoholism and history of contacts with people affected by this disease prevailed in the case material. Primary health care neither meet the operational indicator of the diagnosis of these patients nor the monthly bacilloscopy. It is recommended to develop an intervention strategy that includes a project aimed at improving the professional competence of health personnel with regard to comprehensive care included in the National Program of Tuberculosis Control.

  12. Structural equation modeling of latent growth curves of weight gain among treated tuberculosis patients.

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    Mahalingam Vasantha

    Full Text Available Tuberculosis still remains a major public health problem even though it is treatable and curable. Weight gain measurement during anti tuberculosis (TB treatment period is an important component to assess the progress of TB patients. In this study, Latent Growth Models (LGMs were implemented in a longitudinal design to predict the change in weight of TB patients who were given three different regimens under randomized controlled clinical trial for anti-TB treatment. Linear and Quadratic LGMs were fitted using Mplus software. The age, sex and treatment response of the TB patients were used as time invariant independent variables of the growth trajectories. The quadratic trend was found to be better in explaining the changes in weight without grouping than the quadratic model for three group comparisons. A significant increase in the change of weight over time was identified while a significant quadratic effect indicated that weights were sustained over time. The growth rate was similar in both the groups. The treatment response had significant association with the growth rate of weight scores of the patients.

  13. Tool for objective quantification of pulmonary sequelae in monitoring of patients with tuberculosis

    International Nuclear Information System (INIS)

    Giacomini, Guilherme; Alvarez, Matheus; Pina, Diana R. de; Bacchim Neto, Fernando A.; Pereira, Paulo C.M.; Ribeiro, Sergio M.; Miranda, Jose Ricardo de A.

    2014-01-01

    Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an ancient infectious disease that remains a global health problem. Chest radiography is the method commonly employed in assessing the evolution of TB. However, lung damage quantification methods are usually performed on a computerized tomography (CT). This objective quantification is important in the radiological monitoring of the patient by assessing the progression and treatment of TB. However, precise quantification is not feasible by the number of CT examinations necessary due to the high dose subjected to the patient and high cost to the institution. The purpose of this work is to develop a tool to quantify pulmonary sequelae caused by TB through chest X-rays. Aiming the proposed objective, a computational algorithm was developed, creating a three-dimensional representation of the lungs, with regions of dilated sequelae inside. It also made the quantification of pulmonary sequelae of these patients through CT scans performed in upcoming dates, minimizing the differences in disease progression. The measurements from the two methods were compared with results suggest that the effectiveness and applicability of the developed tool, allowing lower doses radiological monitoring of the patient during treatment

  14. Challenges in tuberculosis care in Western Uganda: Health care worker and patient perspectives

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    Ashley Wynne

    2014-01-01

    Full Text Available Uganda is one of the high burden countries that contribute 80% of the world’s tuberculosis (TB burden. Health care worker and patient perspectives provide valuable insight into gaps between policy and practice within tuberculosis control program. This study was part of a larger mixed-methods study to explore knowledge and stigma around HIV, TB and TB/HIV co-infection. We conducted a secondary analysis of the qualitative data. Findings related to challenges faced by health care workers and patients. Patient’s identified delays in diagnosis and financial burden associated with TB treatment. Health care workers called for more training on TB and TB/HIV co-infection, and identified poor referral practices between health units and lack of program funding resulting in the abandonment of DOTS programs. Training for health care workers is needed to better manage TB/HIV co-infected patients. Overall health system strengthening is needed, including referral systems tracking patients between health centers.

  15. Elevated OPN, IP-10, and Neutrophilia in Loop-Mediated Isothermal Amplification Confirmed Tuberculosis Patients

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    Beata Shiratori

    2014-01-01

    Full Text Available Tuberculosis (TB is the second most common cause of death from infectious diseases and results in high socioeconomic losses to many countries. Proper diagnosis is the first step in TB eradication. To develop a rapid, simple, and accurate diagnostic TB test and to characterize the prevalence of Mycobacterium tuberculosis (MTB genotypes and immune profiles of TB patients, a total of 37 TB patients and 30 healthy control (HC from Metro Manila were enrolled. Loop-mediated isothermal amplification (LAMP reliably detected MTB infection. Manila genotype was identified by spoligotyping method in all TB patients. Osteopontin (OPN, interferon-γ-induced protein 10 kDa (IP-10, and neutrophil counts were found to reflect the acute stage of MTB infection. The sensitivity and specificity were 94.6% and 93.3%, respectively, for both OPN and IP-10, and they were 83.8% and 78.6%, respectively, for neutrophils. The combination of OPN, IP-10, neutrophil count, IL-6, IL-8, TNF-α, MCP-1, platelets, galectin-9, and leukocyte count correctly identifies all the HC and 96.3% of TB patients. LAMP method may serve as a rapid, supportive method in addition to time-consuming culture methods. OPN, IP-10, and neutrophil counts are useful in detecting MTB infection and may have utility in monitoring the course of the disease.

  16. Role of magnetic resonance diffusion imaging and apparent diffusion coefficient values in the evaluation of spinal tuberculosis in Indian patients

    International Nuclear Information System (INIS)

    Palle, Lalitha; Reddy, MCH Balaji; Reddy, K Jagannath

    2010-01-01

    To define a range of apparent diffusion coefficient values in spinal tuberculosis and to evaluate the sensitivity of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion