Cases Of Sputum-positive Tuberculosis Research Articles

A Retrospective Study of Seasonal Variation in the Number of Cases Diagnosed at a Tertiary Care Tuberculosis Hospital

To study the seasonality of tuberculosis (TB) in a tertiary care tuberculosis and respiratory hospital in Delhi. Data from a tertiary care respiratory hospital in south Delhi over a six years period from April 2002 to March 2008 were analysed. Symptomatics: A total of 192,863 patients were registered newly in the hospital during this period. Maximum number of symptomatic patients reported to the out-patient department during April-June and the minimum during October-December. An increase of about 25% in symptomatics was observed (p < 0.05) in the period from April to June in comparison to October to December. The amplitude of seasonal variation was estimated as 11% of the annual mean symptomatics. Tuberculosis cases: The maximum sputum-positive TB cases were diagnosed during the period from April to June and the number was least during October to December. There was an increase of about 34% in sputum-positive cases (p < 0.001) during the period from April to June against October to December. The amplitude of seasonal variation was estimated as 14.4% of the annual mean smear-positives per quarter. The extra-pulmonary TB (EPTB) cases were the maximum during April-June. Chest symptomatics of all types of TB cases were the lowest in January. A seasonal pattern of TB was observed for pulmonary TB and EPTB cases. This information would be useful for administration and managers to take extra care to arrange and provide extra facilities during the peak seasons.

The effectiveness of individualized treatment regimen on smear-positive retreatment pulmonary tuberculosis with mono- and poly-drug resistance

Objective: To analyze and evaluate the effectiveness of individualized treatment regimen in the therapy of smear-positive retreatment pulmonary tuberculosis with mono-and poly-drug resistance, and therefor to provide information on how to develop rational individualized regimen for retreatment tuberculosis cases with drug resistance. Methods: This was a multi-centered, prospective cohort study. Totally 254 cases of sputum positive tuberculosis with previous treatment history during the period from July 1, 2009 to August 30, 2016 were included in the analysis. All the cases were randomly divided into 3 groups and received therapy after randomization into treatment groups. After 3 months, cases with multidrug resistant tuberculosis, extensively drug-resistant tuberculosis, non-tuberculosis mycobacterial infection and those with smear-positive but culture-negative tuberculosis were excluded according to result of sputum culture and drug susceptibility test (DST). In treatment group A (individualized treatment group), 86 cases with an average age of (42.1±13.7) years for men and (38.5±12.8) years for women, were treated with individualized regimen, which allowed drug replacement on the basis of standard regimen (2SHRZE/6HRE) according to DST result. Treatment duration was recalculated after drug replacement and the total length should be 12 months or more. If the DST result did not show drug resistance, the patients would continue the 8 months' standard treatment. In treatment group B (intensified retreatment regimen group), 86 cases with an average age of (43.2±14.2) years for man and (37.9±14.1) years for women, received intensified retreatment regimen (2HL(2)EZS/2HL(2)EZS(3)/4HL(2)E). The dose for H was 0.3 g/d for patients with body weight <50 kg, and 0.4~0.5 g/d for higher body weight (≥50 kg); The doses for L(2,)E and Z were 0.6 g, 2/w; 0.75, 1/d and 0.5g, 3/d. In treatment group C (standard treatment group), 82 cases with an average of (42.5±11.9) years for man and (38.6±12.8) years for women, were treated with standardized regimen recommended by national tuberculosis program (2HREZS/6HRE). In both group B and C, the total treatment duration was 8 months and the drugs were not replaced for mono-and poly-drug resistance. Treatment outcomes of the 3 groups were analyzed, the status of drug replacement in group A was analyzed, and the adjustment of dose of H and R according to patients' body weight was observed. SPSS 19.0 was used for data analysis. Results: The treatment cure rates for group A, B and C were 73.3%(63/86), 76.7%(66/86) and 50%(41/82), and the treatment success rates were 80.2%(69/86), 84.9%(73/86) and 62.2%(51/82) respectively. Treatment failure was 8.1%(7/86), 4.7%(4/86) and 19.5%(16/82) in 3 groups. There were significant differences in the above indicators for group A and B in comparison with group C(χ(2)=13.127, P=0.001). However, there was no difference observed between group A and B(χ(2)=0.646, P=0.422). In group A, tuberculosis specialized hospitals using regular doses for R was only 38.7%(12/31). After 3 years' follow-up, no-relapse-success for group A was 66.7% (10/15). Conclusions: Inappropriate individualized treatment would increase treatment failure for retreatment tuberculosis. Higher doses of H and R and prolonged extensive therapy phase could contribute to increased treatment success.

Aspergilloma in Active Tuberculosis: A Case Report

Pulmonary Aspergilloma is a saprophytic colonization of a lung cavity by Aspergillus spp most often by Aspergillus fumigatus. It is usually secondary i.e. it occurs in a pre-existing cavity often as a result of old healed pulmonary tuberculosis. Pulmonary Aspergilloma complicating active tuberculosis is rare. We report a case of sputum positive tuberculosis complicated by pulmonary Aspergilloma.

Active Case Finding of Pulmonary Tuberculosis among Prison Inmates in Aba Federal Prison, Abia State, Nigeria

Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding general population. However, in many developing countries with high TB burden, passive case-finding remains the usual approach to case detection of TB in prisons. On this premise, the Abia State TB Control Programme conducted a pilot study to assess the contribu- tion of active case finding to tuberculosis control in Aba Federal Prison. Methods: The inmates were clinically screened and those with symptoms suggestive of TB cases were tested by sputum smear microscopy. Results: Out of the total number of 477 prison inmates present in the prison at the time of study, 449 (94.1%) were clinically screened for history of cough of 2 weeks' duration; 52 (10.42%) met the inclusion criteria for sputum smear microscopy. Eleven of the 52 (21.15%) tested for acid fast bacilli (AFB) by direct smear light microscopy were positive for AFB. One in- mate was on anti-tuberculosis therapy; this with the 11 cases detected in the course of this study gave a total of 12 inmates of Aba prison with active pulmonary tuberculosis at the time of this study. This gives a minimum point prevalence rate of 2405 cases per 100,000 prison inmates. Four of the 11 prison cells had at least one smear positive case with 7 of the 11 cases concentrated in two cells. The age group of 25 - 34 years had the highest number of sputum positive cases. Conclu- sion: Active case-finding resulted in detection of 11 new cases of sputum positive tuberculosis (an increase in detection rate of 1100%) and the prevalence of sputum positive TB is very high (2405 cases per 100,000 prison inmates) in Aba prison. There is an urgent need to institute more effec- tive TB case-finding and control in the prison. * Corresponding author.

Trend of tuberculosis and performance evaluation of new sputum positive tuberculosis from Satara district, India

Background: Tuberculosis (TB) has remained a major public health threat worldwide and considering this, Govt. of India declared TB as notifiable disease in year 2012. Objectives: To assess the trend of TB in Satara district, India and to evaluate outcome of new sputum positive TB cases registered under district Revised National Tuberculosis Control Programme (RNTCP). Materials and Methods: A retrospective record based cross-sectional study was conducted in District Tuberculosis Centre (DTC), Satara district, Maharashtra, India during March 2013. All Registered TB cases under DTC from the year 2002 to 2012 were included as study subjects. The district RNTCP records since the year 2002-2012, for all TB cases were viewed and analyzed by investigator according to RNTCP outcome evaluation indicators. The trend of TB was statistically analyzed for the period of eleven years by using chi-square trend test.Results: Annual the total TB case detection rate was 117.94/ lakh for year 2002 which decreased to 98.30 / lakh for year 2012. The proportions of pulmonary TB cases decreased from 92.23% to 81.0% since year 2002 to 2012 whereas proportions of HIV-reactive TB cases increased from 3.11% to 25.3% since year 2009 to 2011.Proportions of male TB cases were almost the double of females; however child TB cases increased continuously with maximum TB cases belonged to pulmonary type. The proportional trend of New Sputum Positive (NSP) cases showed periodic fluctuations ranging from 34% to 50% since year 2002 to 2012. The performance of outcome evaluation indicators of NSP cases during evaluation period as viz., cure rate ranging from 79.91% to 87.02% with periodic fluctuations, sputum conversion rate continuously increased from 78.5% to 93.5%,treatment success rate ranging from 82.7% to 90% with apparent difference, whereas defaulter rate decreased from 7.5% to 3.8% by year 2011, treatment failure rate continuously decreased to 2.1% whereas Death rate ranging from 5.2% to 10.4%. The proportional trends of outcome evaluation indicators of NSP-TB cases showed statistically significant difference over period of year 2002 to 2012.Conclusion: Data indicates that TB is still big problem in rural area of western Maharashtra, India and need to strengthen the awareness programme about TB and involvement of private health sector to control the burden of TB. DOI: http://dx.doi.org/10.3126/ajms.v6i4.11112 Asian Journal of Medical Sciences Vol.6(4) 2015 30-35

Prevalence of Multidrug-resistant Tuberculosis Among Newly Diagnosed Cases of Sputum-positive Pulmonary Tuberculosis from MGM Hospital Warangal

In spite of availability of effective chemotherapy and Bacille-Calmette-Guerian (BCG) vaccine, tuberculosis remains a leading infectious killer worldwide. Tuberculosis (TB) is presently recognized as one of the most common opportunistic infections seen in HIV seropositive patients, mostly presenting in the form of pulmonary and extrapulmonary infections. The prevalence of multidrug-resistant tuberculosis (MDRTB) is increasing throughout the world. Although previous treatment for TB is the most important risk factor for development of MDR-TB, A total of 100 clinically diagnosed and radiologically evident cases suggestive of pulmonary tuberculosis were selected for study. A total of 27 samples were found to be culture positive and 73 were culture negative, of these 26 stains were identified as Mycobacterium tuberculosis, one was identified as M.avium complex (MAC). All sputum-positive TB cases were subjected to mycobacterial culture and first-line drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. All the 27 isolates were concurrently subjected for minimal inhibitory concentration (MIC), Proportion method and BACTEC. Out of 27 cultures tested by the MIC methods, resistance was observed in 99.9 percent at MIC of 128 mg/l. In proportion method five isolate were shown resistance to Isoniazid (H); Rifampicin (R); but shown sensitive to other drugs Ethambutol (E); Pyrazinamide and Streptomycin.

AB 19. Contact tracing of a sputum posistive tuberculosis case in a daycare employee

Background In June 2012 a case of sputum-positive tuberculosis was detected in an employee of a daycare center and contact tracing was performed in the children and other employees.