Distribution Of Pulmonary Tuberculosis Research Articles

Determinants, risk factors and spatial analysis of multi-drug resistant pulmonary tuberculosis in Jodhpur, India

This study was planned to estimate the proportion of confirmed multi-drug resistance pulmonary tuberculosis (TB) cases out of the presumptive cases referred to DTC (District Tuberculosis Center) Jodhpur for diagnosis; to identify clinical and socio-demographic risk factors associated with the multidrug-resistant pulmonary TB and to assess the spatial distribution to find out clustering and pattern in the distribution of pulmonary TB with the help of Geographic Information System (GIS). In the Jodhpur district, 150 confirmed pulmonary multi-drug resistant tuberculosis (MDR-TB) cases, diagnosed by probe-based molecular drug susceptibility testing method and categorized as MDR in DTC's register (District Tuberculosis Center), were taken. Simultaneously, 300 control of confirmed non-MDR or drug-sensitive pulmonary TB patients were taken. Statistical analysis was done with logistic regression. In addition, for spatial analysis, secondary data from 2013-17 was analyzed using Global Moran's I and Getis and Ordi (Gi*) statistics. In 2012-18, a total of 12563 CBNAAT (Cartridge-based nucleic acid amplification test) were performed. 2898 (23%) showed M. TB positive but rifampicin sensitive, and 590 (4.7%) showed rifampicin resistant. Independent risk factors for MDR TB were ≤60 years age (AOR 3.0, CI 1.3-7.1); male gender (AOR 3.4, CI 1.8-6.7); overcrowding (AOR 1.6, CI 1.0-2.7); using chulha (smoke appliance) for cooking (AOR 2.5, CI 1.2-4.9), past TB treatment (AOR 5.7, CI 2.9-11.3) and past contact with MDR patient (AOR 10.7, CI 3.7-31.2). All four urban TUs (Tuberculosis Units) had the highest proportion of drug-resistant pulmonary TB. There was no statistically significant clustering, and the pattern of cases was primarily random. Most of the hotspots generated were present near the administrative boundaries of TUs, and the new ones mostly appeared in the area near the previous hotspots. A random pattern seen in cluster analysis supports the universal drug testing policy of India. Hotspot analysis helps cross administrative border initiatives with targeted active case finding and proper follow-up.

Assessment of Strategies and Epidemiological Characteristics of Tuberculosis in Henan Province, China: Observational Study.

BackgroundIn 2005, China established an internet-based Tuberculosis Information Management System (TBIMS) to monitor changes in tuberculosis (TB). Many scholars have conducted epidemiological research using TBIMS; however, few studies assessing control strategies have been performed based on this platform data. Henan province is a high TB incidence area in China where, in addition to following the nationwide TB strategies, a series of local intervention combinations have been implemented.ObjectiveOur study aims to evaluate the impact of nationwide TB intervention combinations on epidemiological changes and determine whether Henan province can achieve the World Health Organization’s (WHO) goal of reducing TB incidence by 50% and TB mortality by 75% by the year 2025.MethodsWe used descriptive statistical methods to show the spatial and temporal distribution of pulmonary tuberculosis (PTB) reported to the TBIMS database from 2005 to 2018, and logistic regression analysis was performed to identify the risk factors of bacteriological-positive TB. The dynamic compartmental model and Bayesian melding approach was adopted to estimate the burden of TB under the impact of different TB control policies.ResultsIn total, 976,526 PTB cases were notified to the TBIMS in Henan in a period of 14 years. Although the overall incidence of PTB declined from 91.4/105 to 58.5/105, and the overall incidence of bacteriological-positive PTB declined from 44.5/105 to 14.7/105, the WHO’s 2025 goal could not be met. The distribution of high incidence and poverty-stricken counties were basically overlapped. Men, farmers and herdsmen (in rural areas), and subjects aged ≥60 years were more likely to develop bacteriological-positive PTB. The increasing treatment success for drug-susceptible tuberculosis and multidrug-resistant tuberculosis has not provided the desired reduction in incidence and mortality.ConclusionsTo achieve the targeted goal, while improving the cure rate of TB, new active (rather than passive) detection and intervention strategies should be formulated based on epidemiological characteristics in Henan province.

Impact of Meteorological Parameters on Distribution of Pulmonary Tuberculosis in the City of Yaoundé, Centre Region of Cameroon

Tuberculosis remains a major health problem and particularly in the Centre Region of Cameroon where prevalence is still high in the city of Yaounde. Climate has been proved to have impact on tuberculosis distribution. This study aimed at assessing possible association of TB notifications with some meteorological parameters. Daily, weekly, monthly and quaterly aggregates of tuberculosis diagnosis results for consecutive tuberculosis patients tested over one year (April 2010 until March 2011) at Jamot Hospital of Yaounde were analysed (Microsoft excel and SPSS). A total of 665 tuberculosis patients were enrolled at the Jamot Hospital of Yaounde during the study period. Weekly mean humidity and temperature were related to tuberculosis cases with respectively Pearson correlation coefficients of 0.291 and -0.342 even though the relation was weak. For the relationship magnitude 8.5% and 11.7% of the variance in tuberculosis cases were explained by weekly mean humidity and temperature respectively. A Poisson regression predicted more tuberculosis cases following weekly increase of humidity, a statistically significant result with p ˂ 0.001. There was 12.1% decrease in the number of tuberculosis cases for each decrease of temperature per week. However, rainfall had no impact on tuberculosis notifications even though most cases were recorded in rainy season while seasonal index changed over time. In short, tuberculosis notifications showed to be associated to two meteorological parameters: mean ambient temperature and relative mean humidity. The highest peak was in the month of June during the rainy season. Data from this work may contribute to the National Tuberculosis Control Program to model tuberculosis variation from recorded tuberculosis notifications since years in order to find an indicator for better intervention strategies for disease control.

Distribution of pulmonary tuberculosis in Rio de Janeiro (Brazil): a spatial analysis

The aim of this study was to analyze the spatial distribution of the tuberculosis endemic in Rio de Janeiro State from 2002 to 2011. A retrospective study was conducted in the state of Rio de Janeiro from 2002 to 2011. Spatial analysis techniques were used to describe the distribution of tuberculosis incidence in the state. Multilevel Poisson regression model was used to access the relationship of tuberculosis and the following factors: "sex", "age-group" and "diagnostic year" (individual-level factors). Demographic density and municipality were also included in the model as contextual-level factors. A reduction in endemic tuberculosis was observed over the years. The highest incidence rates were concentrated on the south coast of the state, covering Rio de Janeiro City (capital) and neighboring cities. We detected a significant clustering of high TB incidence rates on the south coast of the state and a cluster of low incidence in the northeastern region of state. The risk of tuberculosis was higher in early 2000s, in males and in 40-59 age group. Metropolitan regions are important risk areas for the spread of tuberculosis. These findings could be used to plan control measures according to the characteristics of each region.

Spatial-temporal analysis of pulmonary tuberculosis in the northeast of the Yunnan province, People\u2019s Republic of China

BackgroundThe number of pulmonary tuberculosis (PTB) cases in China ranks third in the world. A continuous increase in cases has recently been recorded in Zhaotong prefecture-level city, which is located in the northeastern part of Yunnan province. This study explored the space-time dynamics of PTB cases in Zhaotong to provide useful information that will help guide policymakers to formulate effective regional prevention and control strategies.MethodsThe data on PTB cases were extracted from the nationwide tuberculosis online registration system. Time series and spatial cluster analyses were applied to detect PTB temporal trends and spatial patterns at the town level between 2011 and 2015 in Zhaotong. Three indicators of PTB treatment registration history were used: initial treatment registration rate, re-treatment registration rate, and total PTB registration rate.ResultsSeasonal trends were detected with an apparent symptom onset peak during the winter season and a registration peak during the spring season. A most likely cluster and six secondary clusters were identified for the total PTB registration rate, one most likely cluster and five secondary clusters for the initial treatment registration rate, and one most likely cluster for the re-treatment registration rate. The most likely cluster of the three indicators had a similar spatial distribution and size in Zhenxiong County, which is characterised by a poor socio-economic level and the largest population in Yunnan.ConclusionThis study identified temporal and spatial distribution of PTB in a high PTB burden area using existing health data. The results of the study provide useful information on the prevailing epidemiological situation of PTB in Zhaotong and could be used to develop strategies for more effective PTB control at the town level. The cluster that overlapped the three PTB indicators falls within the geographic areas where PTB control efforts should be prioritised.

Cystic Pulmonary Tuberculoma

Pulmonary tuberculosis (TB) is a medical and social problem, particularly in developing countries. Early diagnosis and treatment is important. Chest radiography is usually the first diagnostic tool when there is a suspicion of pulmonary TB. A computed tomography (CT) scan provides more accurate information on the extent and distribution of pulmonary TB. We present here a young, immunocompetent male patient with unusual imaging findings for pulmonary TB. We discuss the clinical presentation and management.

Mild and severe forms of tuberculosis in diabetic and non‐diabetic patients

The aim of the present study was to compare the frequency of pleural tuberculosis in patients with and without diabetes mellitus (DM). Three hundred consecutive patients who were smear positive for pulmonary tuberculosis or isolated pleural tuberculosis were enrolled in the study. Patients' age and smoking status (pack-years) were recorded. Patients were divided into two groups: those with and without DM. All patients enrolled in the study were male. Mean (± SD) patient age was 42.4 ± 15.9 years. Of the 300 patients in the study, 48 had DM. There was no significant difference in the distribution of pulmonary tuberculosis and isolated pleural tuberculosis between patients with and without DM (P > 0.05). However, there was a significant difference in mean pack-years of smoking between patients with pulmonary tuberculosis and those with isolated pleural tuberculosis for all patients; patients with isolated pleural tuberculosis had a significantly lower number of pack-years of smoking (P < 0.05). Severe pulmonary involvement in DM patients may be due to smoking status.

Distribution of Pulmonary Tuberculosis and TB Drug Resistance in a Hospital Setting in Papua New Guinea

Distribution of Pulmonary Tuberculosis and TB Drug Resistance in a Hospital Setting in Papua New Guinea

Increasing burden of pulmonary tuberculosis in young women

The epidemic is best described as ‘explosive’ and occurs disproportionately among young women, with more than 60% of infections occurring in the 20 - 30-year age group. 2 As the epidemic matures there has been an increase in young adult morbidity and mortality that mirrors the observed HIV infection patterns. 3 The objective of this study was to investigate the temporal trends of pulmonary tuberculosis (PTB) at the Prince Cyril Zulu Communicable Diseases Clinic (CDC), an urban outpatient specialist TB facility in central Durban, KwaZulu-Natal. Data were extracted from the clinic’s computerised register. The chi-square test for linear trend assessed changes in the distribution of PTB from 1998 to 2004. Data on age were categorised as 0 - 19 years, 20 - 39 years, and ≥ 40 years, and the effect of gender was examined separately for each age group because of the differential impact of the HIV infection by gender and age. 2 The total number of new TB cases increased from 1998 to 2004, with an average annual increase of 13.3% per year (Table I). The total number of patient visits increased substantially, with an average annual increase of 15.2% per year (p < 0.001). Significantly more patients were either self-referred ( p < 0.001) or referred from hospitals (p < 0.001). There was a downward trend in the rate per year of PTB cases, which proportionally decreased from 70% in 1998 to 53% in 2004 (p < 0.001). While more men than women were diagnosed with PTB, the proportion of men decreased from 68% in 1998 to 60% in 2004, while the proportion of women increased from 32% in 1998 to 40% in 2004 (p < 0.001). Of note is the difference in the proportion of PTB between men and women by age (Fig. 1); in the 20 - 39-year age group the proportion of women

Correlation of immunologic status with high-resolution CT and distributions of pulmonary tuberculosis.

To investigate the correlation of cluster of differentiation (CD)4 lymphocyte counts with high-resolution CT (HRCT) findings and distribution of pulmonary tuberculosis. Thirty-seven bacteriologically proven pulmonary tuberculosis, clinically non-AIDS, patients underwent HRCT and CD4 lymphocyte counts in peripheral blood cells were obtained within 3 days after the CT examinations. Patients were categorized into four groups according to CD4 lymphocyte counts (A >800; B 800-500; C 500-200; D <200). HRCT findings analyzed were as follows: typical, atypical, and mixed findings of post-primary tuberculosis, common, uncommon, and mixed distribution, and number of lobes involved. CD4 lymphocyte counts correlated with the degree of the mixture of atypical CT findings (rho=0.565, p<0.001) and the degree of the mixture of uncommon distribution (rho=0.431, p<0.01). Number of involved lobes showed no statistically significant correlation (rho=0.209, p=0.21). In patients with low CD4 levels, atypical HRCT findings co-exist with typical findings, and uncommon sites are involved in addition to common sites.

An investigation into the distribution of pulmonary tuberculosis and other respiratory diseases in the west riding of yorkshire

An investigation into the distribution of pulmonary tuberculosis and other respiratory diseases in the west riding of yorkshire

Studies in National Degeneration

THE several aspects of study which the statistics deal with in this memoir are chiefly parental and fraternal heredity, the fertility of tuberculous stocks, and the distribution of pulmonary tuberculosis in tubercular families. Prof. Pearson's observations are admittedly, from a numerical standpoint, wholly insufficient, but if his deductions are thereby rendered inconclusive, he has pointed the way and laid the foundation for further study of an all-important subject.