Family History Of Tuberculosis Research Articles

Prevalence and associated risk factors for tuberculosis among people living with HIV in Nepal.

BackgroundWorldwide tuberculosis (TB) takes more lives than any other infectious diseases. WHO estimates around 68,000 incident TB cases in Nepal. However, in 2018 only around 27,232 new TB cases were reported in the national system, resulting around 40,768 incident TB cases missing every year in Nepal. National Tuberculosis Control Center carried out this study in anti-retroviral therapy (ART) sites to estimate the prevalence of TB and identify the associated risk factors for TB among the people living with Human Immunodeficiency Virus (PLHIVs) in Nepal.MethodsIt was a cross-sectional institution-based study conducted between March and August 2018. Six ART sites with high caseloads of PLHIVs were selected. PLHIVs who were equal or above 18 years of age and were in ART program at the selected study sites were considered eligible for the study. Diagnosis of tuberculosis among PLHIVs who agreed to participate in the study was carried out as per the National Tuberculosis Management Guideline of National Tuberculosis Program of Nepal.ResultsAmong 403 PLHIVs, tuberculosis was diagnosed in 40 (9.9%) individuals. Median age of the participants was 36 (30–43) years. Prevalence of TB was significantly higher among male PLHIVs than female PLHIVs (13.6% Vs 5.8%; P = 0.02) and Dalit ethnic group compared to Brahmin/Chettri (22.0%Vs5.9%, P = 0.01). The risk of developing TB was found significant among those with HIV stage progressed to WHO stage 3 and 4 (OR = 4.85, P<0.001) and with the family history of TB (OR = 4.50, P = 0.002).ConclusionsPrevalence of TB among PLHIVs in Nepal was found 9.9%. Risk of developing TB was higher among PLHIVs who were male, Dalit, with HIV stage progressed to WHO stage 3 and 4 and with family history of TB. Hence, targeted interventions are needed to prevent the risk of developing TB among PLHIVs. Similarly, integrated, and comprehensive TB and HIV diagnosis and treatment services are needed for the management of TB/HIV co-infection in Nepal.

COMPLETUDE DOS REGISTROS DE ENFERMEIROS NO CUIDADO À PESSOA COM TUBERCULOSE: ESTUDO DE TENDÊNCIA

ABSTRACT Objective: to assess the completeness and tendency of non-completeness of the records of nurses in the care of people with tuberculosis followed up in Primary Health Care. Method: this is a descriptive, documentary, retrospective study, with quantitative approach, developed in family health units of a municipality in the state of Paraíba. It took place between July and September 2020. A sample of 190 medical records was delineated, selected by sampling in two stages: proportionality and systematic probabilistics. The collected data were analyzed using the R software, assuming a significance level of 5%. Descriptive statistics, Pareto Chart and trend analysis were used. Results: completeness classification was predominantly “very bad” (76.9%), with a higher percentage of non-completion for the indicators: prejudice (91.1%), preliminary findings (85.2%), absenteeism in consultations (80.8%), family history of tuberculosis (74.7%) and psychosocial aspects. They showed a trend of significant non-completion ascending: lifestyle and conditions of life (p=0.0088) and physical examination (p=0.0352). The only indicator with a trend of significant non-completion descending was Prejudice (p=0.0077). Conclusion: unsatisfactory completeness and a predominantly ascending trend towards non-completion of records was found, indicating points to be prioritized in public health interventions due to their importance in the production of indicators in tuberculosis management in Primary Health Care that can influence decision-making.

1403. Tuberculous sacroiliitis: Clinical and Imaging Characteristics

BackgroundOsteoarticular tuberculosis remains a common disease among which the spine is the most affected site. Less frequently, sacroiliac joint is involved. Its diagnosis is often delayed due to misleading and varied symptoms. The aim of this work was to study the clinical features and the contribution of imaging results in the diagnosis of tuberculous sacroiliitis.MethodsWe conducted a retrospective study including all patients hospitalized in the infectious disease department for tuberculous sacroiliitis. The diagnosis was based on clinical, laboratory and radiological features.ResultsIn total, we encountered 12 women with a median age of 51 [39-63] years. Three patients had a family history of tuberculosis (25%). The median diagnostic delay was 155 [48-331] days. The revealing symptoms were lower back pain (75%) and hip pain (25%) associated with fever (83.3%) and weight loss (75%). Reduced mobility was noted in 3 cases (25%). Pulmonary tuberculosis and tuberculous spondylodiscitis were associated with tuberculous sacroiliitis in 5 cases (41.7%) and 4 cases (33.3%), respectively. Tuberculin skin test was positive in 6 cases (50%). Laboratory investigations revealed elevated C-reactive protein levels in 11 cases (91.6%) and accelerated erythrocyte sedimentation rates in 9 cases (75%). Needle biopsy of the sacroiliac joint (41.7%) and soft tissues abscess puncture (16.6%) were performed. Computed tomography scan revealed joint space widening (83.3%), peripheral joint erosions (83.3%) and osteolysis (58.3%). Soft tissue abscesses were noted in 66.7% of the cases. Magnetic resonance imaging was performed in 4 cases (33.3%). Sacroiliac joint was hypointense in T1-weighted images (75%), hyperintense in T2 weighted images (50%) and in STIR images (50%). Bone scintigraphy, performed in 5 cases, revealed hyperfixation of the sacroiliac area (100%). All patients received antitubercular therapy. Percutaneous abscess drainage was indicated in 4 cases (33.3%).ConclusionBecause of its deep localization, the diagnosis of tuberculous sacroiliitis is mainly based on imaging results associated with epidemiological, clinical and laboratory features. Antitubercular therapy initiated promptly leads to recovery.Disclosures All Authors: No reported disclosures

INCIDENCE OF ABDOMINAL TUBERCULOSIS IN PATIENT PRESENTING WITH PAIN IN RIGHT ILIAC FOSSA: A PROSPECTIVE STUDY IN GRMC, GWALIOR.

Introduction: Abdominal tuberculosis is sixth most common type of extrapulmonary tuberculosis. It may mimics other gastrointestinal lesions like inammatory bowel disease, malignancies. The diagnosis is usually delayed due to non specic symptoms and signs.5-6We observed the various presentations of abdominal tuberculosis in our hospital and analyzed the pathology in present scenario. Aim: To evaluate the incidence of Abdominal tuberculosis in patient presenting Right iliac fossa pain and its association with pulmonary tuberculosis and role of Anti tubercular therapy (ATT) to minimize the further complications. Method And Materials:The study was carried out as a prospective study in the Department of General Surgery at Gajra Raja Medical College and Jayarogya group of Hospitals, Gwalior (M.P.) for 1½ year from January 2020 to June 2021. Atotal of 50 patients with pain in right iliac fossa were admitted and studied. The study was approved by the ethical committee of the hospital. Results: In our study out of 50 cases with pain in right iliac fossa 15 cases were diagnosed with abdominal tuberculosis with slight female predominance. maximum number of cases present between 20-39 years of age. 2 out of 15 had the past history of pulmonary Tuberculosis while 3 having family history of Tuberculosis. Out of 15 abdominal T.B. patients 5 patients underwent for surgery and 10 were managed conservatively &amp; ATT started from which 4 patients responded well to ATT and 6 developed complications and presents in emergencyemergency, Out of them 4 having SAIO, 1 having distal ileal perforation and 1 with enterocutaneous stula. Conclusion: From the observation and result of my study most of patient Presented with chronic pain in Right iliac fossa has been diagnosed with ileocecal TB. Study show that 40% patients respond well to ATT and 60% develop complication with symptoms of obstruction and perforation during follow up that underwent for Surgery later on.

Tuberculous pleural effusion in a patient with sympathetic ophthalmia on immunosuppression:\xa0a case report

BackgroundTuberculous pleural effusion (TPE) is paucibacillary, making its diagnosis difficult based on laboratory investigations alone. We present a case of a patient with a TPE who was initially misdiagnosed to have azathioprine-induced lung injury. The diagnosis of TPE was arrived at with the help of clinical assessment, laboratory and radiological investigations.Case presentationA 25-year-old chronic smoker with sympathetic ophthalmia on long-term immunosuppression, latent tuberculosis infection and a significant family history of tuberculosis presented with a three-week history of productive cough, low-grade fever, night sweats and weight loss. Examination of the lungs showed reduced breath sounds at the right lower zone. Chest x-ray showed minimal right pleural effusion with a small area of right upper lobe consolidation. The pleural fluid was exudative with predominant mononuclear leukocytes. Direct smears of sputum and pleural fluid; polymerase chain reaction of pleural fluid; and sputum, pleural fluid and blood cultures were negative for M. tuberculosis (MTB) and other organisms. As he did not respond to a course of broad-spectrum antibiotics, he was then treated as a case of azathioprine-induced lung injury. However, his condition did not improve despite the cessation of azathioprine. A contrast-enhanced computed tomography of the thorax showed right upper lobe consolidation with tree-in-bud changes, bilateral lung atelectasis, subpleural nodule, mild right pleural effusion and mediastinal lymphadenopathy. Bronchoalveolar lavage was negative for malignant cells and microorganisms including, MTB. However, no pleural biopsy was done. He was empirically treated with anti-tubercular therapy for 9 months duration and showed complete recovery.ConclusionA high index of suspicion for TPE is required in individuals with immunosuppression living in regions endemic to tuberculosis. Targeted investigations and sound clinical judgement allow early diagnosis and prompt treatment initiation to prevent morbidity and mortality.

Pattern of drug resistance among patients of pulmonary tuberculosis

BackgroundDrug resistant tuberculosis (DR-TB), particularly multidrug resistance (MDR-TB) and extensive drug resistance (XDR-TB) pose a serious threat to public health. This study aimed to identify drug resistance in pulmonary tuberculosis patients and to see their association with diabetes, human immunodeficiency virus (HIV), previous history of tuberculosis (TB) and family history of TB. MethodSputum specimens obtained from 11,874 pulmonary tuberculosis patients were subjected to smear microscopy, cartridge based nucleic acid amplification test (CBNAAT) and liquid culture (LC). Smear positive isolates were subjected to first line Line probe assay (FL-LPA) for isoniazid and rifampicin resistance. FL- LPA positive isolates were subjected to second line Line probe assay (SL-LPA) for fluoroquinolones and second line injectable drug resistance. ResultOut of 11,874 microbiologically confirmed cases of pulmonary tuberculosis, 976 (8.2%) had a drug resistant tuberculosis. Five patterns of drug resistance were identified monoisoniazid; 394 (3.32%), rifampicin; 461 (3.88%) (monorifampicin; 383 (3.22%)), multidrug; 73 (0.61), extensivedrug; 11 (0.09) and others; 37 (0.31). Previous history of tuberculosis was significantly associated with rifampicin resistance and MDR-TB. Family history of tuberculosis contact was strongly associated with rifampicin resistance, MDR-TB and XDR-TB. ConclusionThere has been an increasing trend in drug resistance in the recent years, particularly in retreatment cases. This study highlights the pattern of drug resistance and need to detect resistance among all tuberculosis cases, in order to interrupt transmission and control this emerging epidemic.

What should be the place of the tuberculinic chronic reactive mode in 21 st century homeopathic practice?

In the early 20 th century Antoine Nebel developed a new chronic reactive mode (CRM), tuberculinism, in addition to the three diatheses already described by Samuel Hahnemann: psora, sycosis and syphilis. Today, what is the exact place of tuberculinism within the three other CRM? To provide the diagnostic elements to identify the tuberculinic MRC of a patient. To locate this CRM among the 3 previous ones. To suggest the most effective therapeutic strategy. By comparing the writings of the authors of the twentieth century with our clinical experience, we will identify the essential characteristics and the pathognomonic tuberculinism as well as its treatment. Tuberculinism is an inherited or acquired CRM, very common in children and adolescents. It often occurs when there is a family history of tuberculosis or following BCG vaccination or repeated antibiotic therapy for recurrent ENT disorders. It evolves in two stages, acceleration of cell metabolism then progressive exhaustion. Individuals with a phosphoric constitution are more affected. Morbid manifestations mainly evoke psora but also sycosis. The recognition and management of the tuberculinic CRM make it possible to effectively treat recurrent and chronic respiratory diseases, which are very debilitating for children as well as for their parents.

Quelle place pour le mode réactionnel chronique tuberculinique dans la pratique de l’homéopathie au XXIème siècle ?

ContextIn the early 20 th century, Antoine Nebel developed a new chronic reactive mode (CRM), tuberculinism, in addition to the three “miasms” already described by Hahnemann: psora, sycosis and syphilis. How does tuberculinism fit in within the three other CRMs today? GoalTo provide diagnostic elements so as to identify the tuberculinic CRM of a patient. To suggest the most effective therapeutic strategy. MethodBy comparing the writings of twentieth century authors with our clinical experience, we will offer the essential features and pathognomonic of tuberculinism as well as its treatment. ResultsTuberculinism is an inherited or acquired CRM, very common in children and adolescents. It often occurs when there is a family history of tuberculosis or following BCG vaccination or repeated antibiotic therapy for recurrent ENT disorders. It evolves in two stages, acceleration of cellular metabolism then progressive exhaustion. Individuals with a phosphoric constitution are more affected. Morbid manifestations mainly evoke psora but also sycosis. ConclusionThe recognition and management of the tuberculinic CRM make it possible to effectively treat recurrent and chronic respiratory diseases, which are very debilitating for children as well as for their parents.

Risk Factors for Tuberculosis in an Urban Setting in Indonesia: A Case-control Study in Umbulharjo I, Yogyakarta.

The rate of incidence of Tuberculosis (TB) in Indonesia is the ninth highest in the world. Poor environmental conditions, mainly related to air circulation and improper behaviour, were recognized as the risk factors in this country. A case-control study of 69 participants was conducted in the Umbulharjo I Public Health Centre of Yogyakarta during January-August 2019. Data collection was conducted using a tested questionnaire. Analysis was performed using Chi-square and Logistic regression. Three variables were identified as potential risk factors for TB: family history of TB, smoking behaviour, and ventilation condition. The results of the logistic regression test revealed that people who smoke have the greatest risk of TB infection. Health promotion needs to be enforced to educate both patients and their family to prevent the transmission of TB.

Female Genital Tuberculosis, a Rare Lesion Mimicking Ovarian Carcinoma, with Granulosa Cell Tumor: A Case Report

Introduction: Tuberculosis (TB) of the upper genital tract is a rare disease worldwide. TB should be always considered in the differential diagnosis of a pelvic or adnexal mass as it may diagnosed as ovarian carcinoma but both have completely different treatment. Therefore, recognition of TB is important for surgeons and histopathologists, in order to set a proper plan for management and avoid unnecessary extensive therapy. Granulosa cell tumor of the ovary is a rare type of ovarian cancer that accounts for approximately 2% of all ovarian tumors. This type of tumor is known as a sex cord-stromal tumor and usually occurs in adults. Thorough search in English literature revealed only 2 case reports showed combination between genital TB and granulosa cell tumor. Case summary: A 68 years old female patient complained of vaginal bleeding for four months. She had no personal or family history of TB. An ultrasound study showed a 2x1.5 cm mixed echogenic mass in the right adnexa. Based on her clinical and imaging findings which suggestive of ovarian cancer, the patient underwent panhystrectomy and bilateral salpingoophrectomy. The gross examination of the specimen revealed distended and coiled tubes with right adnexal mass measured 2x1.5 cm and dissection of the uterus revealed erythematous endometrium with yellowish secretions. The histopathologic assessment of right adnexal mass revealed malignant neoplasm *Granulosa cell tumor* formed of short polygonal cells arranged in diffuse sheets with patternless pattern. The malignant cells showed nuclear grooving. There was no necrosis or other ovarian neoplastic element. The histopathologic assessment of both tubes and endometrium revealed infiltration by multiple nodular granulomas. Each granuloma was formed of multinucleated giant cells and epithelioid cells rimmed by lymphocytes with occasional central caseation *genital tuberculosis*. Conclusion: The conclusion of this case report is to stress upon keeping genital TB in mind as a potential differential diagnosis for ovarian carcinoma.

Rate of History of Tuberculosis Among Healthcare Workers in Turkey: A Cross-Sectional Study.

Healthcare workers (HCWs) possess a high risk for both latent tuberculosis infection (LTBI) and active disease. This study aimed to investigate tuberculosis (TB) disease history in hospital staff working in healthcare institutions in the Eastern Black Sea Region of Turkey. This study included 460 HCWs employed in 5 hospitals in the Eastern Black Sea Region of Turkey. Between May 01 and July 31, 2016, the participants were asked to answer a questionnaire, including data about TB history. The data about family TB history, Bacilli Calmette-Guerin (BCG) vaccination, or tuberculin skin test (TST) application before starting work were also evaluated. Of the 460 participants, 69.3% were women (n=319) and 30.7% (n=141) were men. The mean age was 32 (17-63) years. A total of 8 participants (1.7 %) had TB history. There was no statistically significant relationship between TB history and age, sex, body mass index (BMI), smoking habits, or presence of comorbidities (p>0.05 for all variables); family history of TB (p<0.001) and TST positivity (p<0.001) were significantly higher in participants with a TB history. Each participant was checked for the presence of both BCG scar and TST positivity. No difference was noted between positive TB history and negative HCWs (p>0.05). The duration of work (years) was higher in participants with a TB history. The p value was very close but did not reach the limits of significance (p=0.059). In this study, the rate of TB among HCWs was 1.7% (8 of 460 HCWs). Family history of TB and TST positivity are strong predictors of TB in HCWs.

Clinical pattern of cutaneous tuberculosis in paediatric age group

Tuberculosis (TB) is one of the major public health problem in developing country like India. Cutaneous tuberculosis which is only 1-1.5% of all cases of extra pulmonary TB, is mostly common in the paediatric age group as compared to adults. A rising incidence of cutaneous tuberculosis is seen as a marker of active transmission of the disease in the community. The present study was done on paediatric age group children (upto 13 years) attending Dermatology OPD of Silchar Medical College and Hospital, Assam to report the clinical pattern and types of cutaneous tuberculosis, and atypical presentations if any, for a period of one year. Material and Methods: All the clinically suspected cutaneous tuberculosis in paediatric patients up to 13 years of age attending the Dermatology OPD of Silchar Medical College and Hospital in one year duration were studied to find out the clinical pattern of cutaneous tuberculosis. Selected cases have been subjected to various investigations including histopathological study. Results: A total of 11 cases were selected after fulfilling inclusion and exclusion criteria. Male to female ratio was 4.5:1. Commonest type was scrofuloderma (54.55%), followed by lupus vulgaris (36.36%), and tuberculosis verrucosa cutis (9.09%). In this study most of cases were in the age group 11-13 years, the youngest was 4 year old boy. Lower limb involvement was the commonest presentation, followed by involvement of neck. Only two of the cases had family history of TB. All the cases responded well to standard directly observed treatment short course (DOTS) anti-tubercular treatment. Conclusion: Cutaneous tuberculosis continues to be a significant medical problem even with the advent of highly effective anti-tubercular drugs because it has varied clinical presentations. Therefore high clinical suspicion is required to diagnose the case. Proper and meticulous clinical evaluation with relevant investigation aids early diagnosis and successful ther

1641. A Comparative Analysis Of Lymph Node Tuberculosis Between Children And Adults

BackgroundLymph node tuberculosis (LNTB) represents the most common site of extrapulmonary tuberculosis. Among children, due to non-specific clinical features, the diagnosis is often delayed. We aimed to compare the clinical, therapeutic and evolutionary features of LNTB between adults and children.MethodsWe conducted a retrospective study including patients hospitalized for LNTB in the infectious diseases and pediatric department between 1993 and 2018. Children aged ≤18 years were included.ResultsOverall, we encountered 231 cases of LNTB. There were 40 children (17.3%) with a mean age of 11±4 years and 191 adults (82.7%) with a mean age of 42±16 years. As to gender, females were more affected (adults: 67% vs children: 70%), with no significant difference (p >0.05). A family history of tuberculosis was significantly more frequent among children (20% vs 6.3%; p=0.01). Raw milk consumption (38.2% vs 30%; p >0.05) and close contact with animals (29.8% vs 35%; p >0.05) were noted among both adults and children. Fever (53.4% vs 32.5%; p=0.01), night sweats (35.8% vs 10%; p=0.001), loss of appetite (38.2% vs 17.5%; p=0.01) and weight loss (35.1% vs 15%; p=0.01) were significantly more frequent among adults. Tuberculin skin test was positive in 75.8% of the cases among adults and in 86.2% of the cases among children (p >0.05). Multifocal tuberculosis was significantly more frequent among adults (23.8% vs 5.7%; p=0.01). Antitubercular therapy was prescribed for a mean duration of 10±4 months among adults and for 9±3 months among children, with no significant difference (p >0.05). Side effects of antitubercular drugs were more frequent among adults (33% vs 10.3%), with a significant difference (p=0.004). Comparison of the disease evolution showed no significant difference between adults and children, regarding recovery (94.8% vs 90%), relapse (5.2% vs 5%) and death (0.5% vs 2.5%).ConclusionThe clinical presentation of LNTB among children was less common and misleading. A family history of tuberculosis and a high index of suspicion might shorten the diagnostic delay.Disclosures All Authors: No reported disclosures

1647. Breast Tuberculosis: A Diagnostic Challenge

BackgroundBreast tuberculosis is a rare disease accounting for less than 0.1% in developed countries and 3-4% in high incidence regions. Its diagnosis remains challenging as it closely mimics breast cancer and abscess. We aimed to study the epidemiological, clinical and therapeutic features of breast tuberculosis.MethodsWe conducted a retrospective study including all patients hospitalized in the infectious diseases department for breast tuberculosis between 2000 and 2018.ResultsWe enrolled 17 women with a mean age of 40 ±12 years. Nine patients came from rural area (52.9%). Two patients (11.7%) had a history of tuberculosis. None of our patients had a family history of tuberculosis, nor breast cancer. The duration of symptoms varied from one month to a year. At the time of diagnosis, three patients were pregnant (17.6%) and one patient (5.8%) was lactating. The most common clinical symptoms were mastalgia (88.2%), palpable breast lump (88.2%) and fever (76.5%). The average size of the breast lump was 5 ±2 cm. Eight patients (47%) had associated signs of inflammation, 11 patients had axillary lymphadenopathy (64.7%) and four patients had nipple discharge (23.5%). The diagnosis was confirmed by histopathological proof in 14 cases (82.4%) and bacteriological proof in three cases (17.6%). The tuberculin skin test was positive in 10 cases (58.8%). The mean duration of antitubercular therapy was 10 ±1 months. Excision of the mass were indicated in 10 cases (58.8%) and a mastectomy in 2 cases (11.7%). Two cases of relapse were noted (11.7%).ConclusionBreast tuberculosis should be suspected in front of breast abscess or inflammation with poor response to antibiotic treatment, especially in patients from endemic countries.Disclosures All Authors: No reported disclosures

The group process in school-age children for tuberculosis prevention behaviour

Background: Tuberculosis (TB) attacks various ages, including school-age children. TB in children can make them lose more time in school and their growth and development are disrupted. Hence it is important to prevent TB in school-age children. Objectives: This research assesses the effect of group process on behaviour, knowledge, attitudes, and skills prevention of TB in school-age children. Method: This study used a quasi-experimental design, pre-post-test with a control group. It used multistage sampling, involving 63 children in the intervention group and 64 in the control group. Results: In the intervention group, most children were 10 years old, male, with no family history of TB. Parental educational level was mainly junior high school and parental income level ≥ Regional minimum wage. In the control group, most children were 11 years old, male, with no family history of TB. Parental educational level was mainly elementary school and parental income level ≥ Regional minimum wage. There was a statistically significant effect of group process on behaviour, knowledge, attitudes and skills prevention of TB in school-age children (p Conclusions: Group process affected behaviour, knowledge, attitudes and prevention skills of TB in school-age children significantly. Sri Lanka Journal of Child Health, 2020; 49(3): 235-239

Epidemiological, clinical characteristics and drug resistance situation of culture-confirmed children TBM in southwest of China: a 6-year retrospective study

BackgroundSichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB). This study aimed to analyze the epidemiological and clinical characteristics, as well as drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China.MethodsWe performed a retrospective study on children (< 14 years old) with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Mycobacterium tuberculosis (MTB) drug sensitivity testing (DST) was performed using the MicroDST™ method. The age, gender, family history of tuberculosis, status of Bacillus Calmette–Guérin (BCG) vaccination, residential areas information, clinical, laboratory, and radiological features were recorded. Data were analyzed using SPSS Statistics Client 25.0, and the change in drug resistance rate was examined using the Cruskal-Wallis test.ResultsAmong 319 patients clinically diagnosed with TBM, 42 (13.2%) were Mycobacterial culture positive. Their median age was nine years, and the distribution was equal among female and male patients. Among 42 patients who were enrolled in the study, 1/42 (2.38%) passed away. Children with TBM were concentrated in the minority areas of western Sichuan, where 34/42 (81.0%) patients with TBM belonged to ethnic minorities, and only 2/42 (4.76%) received BCG vaccination in the past. Chest X-rays changes were observed in all patients. Fever and headache were the most common presenting symptom. Thirty-five (83.3%) patients suffered from neck stiffness, and 30/42 (71.4%) had high CSF pressure. DST results showed that the resistance rate was high; resistance to any anti-tuberculosis drug (ATD) was observed in 13 (31.0%) patient isolates, while multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were found in 2 (4.8%) and 1 (2.4%) patients, respectively.ConclusionsTBM among children in Southwest China was mainly concentrated in the minority areas of western Sichuan and more than 95% of patients did not receive BCG vaccination at birth. The most common symptoms were fever, headache, and neck stiffness and all patients had positive chest X-ray findings. In addition, high rates of drug resistance were found.

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

BackgroundDespite the availability of effective drugs, tuberculosis remains a major public health problem that predominantly affects low- and middle-income countries. This study aimed to assess tuberculosis treatment outcomes among patients treated at one of the primary health care levels in Addis Ababa, Ethiopia.MethodsAn institutional-based retrospective cross-sectional study was conducted at a tuberculosis clinic in public primary healthcare facility. The study populations were all patients with tuberculosis who had been completed their treatment course in the center from July 2014 to July 2018. After getting Ethical clearance and permission from the health center, trained data collectors working in the center were recruited. The collected data were checked for completeness every day by the principal investigators. Data were edited, cleaned, and analyzed using SPSS version 25. Descriptive statistics were used to summarize the data while multinomial logistic regression was employed to explore associations among variables of interest, and p < 0.05 was considered as statistically significant.ResultsA total of 352 patients with tuberculosis were included for the study with a median age of 25 years which ranged from 1 to79 year. Most (36.4%) participants were in the age group of 15 to 24 years. The majority (38.8%) of patients had extrapulmonary tuberculosis, 11.9% of them were HIV positive and only two had family history of tuberculosis. Regarding treatment outcome, 238(67.6%) completed the treatment, 95(27%) cured and the rest were unsuccessful treatment outcomes 19(5.4%) either died, defaulted or treatment failed. The odds ratio for cured in relation to unsuccessful treatment outcome was found to be significantly higher in HIV negative patients (AOR = 6.1; 95%CI 2.1–13.9) compared with those patients tested positive for HIV. While patients with smear-positive pulmonary tuberculosis (AOR = 10.5, 95% CI 5.36–16.31) were significantly associated with the odds of having complete treatment cure as compared to patients with extrapulmonary tuberculosis. Similarly being HIV positive and extrapulmonary tuberculosis were predicting factors for unsuccessful treatment compared with their counterparts.ConclusionsThe finding of the present study showed that successful tuberculosis treatment outcome was found to be optimal.

Prevalence and Associated Factors of Tuberculosis among Adult Household Contacts of Smear Positive Pulmonary Tuberculosis Patients Treated in Public Health Facilities of Haramaya District, Oromia Region, Eastern Ethiopia.

Background Tuberculosis is an infectious airborne disease caused by Mycobacterium tuberculosis. It still remains a major public health problem which affects all age groups. Risk of exposure is higher in household contact than members of the general population. Objective The aim of this study was to assess the prevalence and associated factors of tuberculosis among adult household contacts of smear positive pulmonary tuberculosis in Haramaya district, Oromia Region, Eastern Ethiopia from February to March, 2019. Method A community based cross-sectional study design was conducted. A total of 454 study participants were selected using systematic sampling method from all adult household contacts of smear positive pulmonary tuberculosis patients treated from July 2017 to December 2018. Data were collected using a pretested and structured questionnaire; and laboratory examination was processed using fluorescent smear microscope. Logistic regression analysis was used to identify the factors associated with the infection of pulmonary tuberculosis and a statistically significant association was declared at P-value < 0.05. Result The overall prevalence of pulmonary tuberculosis among adult household contacts was 7.8% (95% CI: 5.8–10.0). The risk factors for tuberculosis infection among household contacts were eating meals less than three times per day (AOR = 4.31; 95% CI: 1.61, 11.55), drinking raw milk (AOR = 4.12; 95% CI: 1.43, 11.90), having family history of tuberculosis with more than one index case (AOR = 2.7; 95% CI: 1.02, 6.92), living in poor ventilated houses (AOR = 4.02; 95% CI: 1.38, 11.76), and living in inadequate size of living room (AOR = 3.4; 95% CI: 1.30, 8.86). Conclusion In this study, the prevalence of tuberculosis among adult household contacts of smear positive pulmonary tuberculosis is high. Eating meals less than three times per day, drinking raw milk, living in poor ventilated houses, and inadequate sizes of the rooms were identified as contributing factors. Therefore, we recommend that the transmission of tuberculosis can potentially be reduced by a better contact tracing and treatment strategies along with appropriate health education.

Haematological Indices and Predisposing Factors Associated with Tuberculosis at Federal Medical Center Owerri, Imo State, Nigeria

Introduction: Tuberculosis (TB) is a chronic infectious disease caused by bacterium “Mycobacterium tuberculosis”. It is a systemic infection and has deleterious effect on both circulatory and respiratory systems, and thrives more in a society with little knowledge of its predisposing factors.&#x0D; Aim of the Study: This study was carried out to identify the predisposing factors of tuberculosis and its effects on haematological indices of the positive patients at the Federal Medical Center, Owerri, Imo state, Nigeria.&#x0D; Materials and Methods: The blood samples were analyzed manually for the indices while predisposing factors of Tuberculosis were obtained with the aid of a structured self-administered questionnair,these were administered simultaneously while the blood samples were been collected.&#x0D; Results and Discussion: Results were considered to be statistically signifificant (P&lt;0.05), (OR&gt;1). Simple frequencies were also computed. The results revealed that Haemoglobin (P=0.001); Erythrocyte sedimentation rate (P=0.020); Neutrophils (P=0.002); Eosinophils (P=0.000); Monocytes (P=0.000); Platelets (P=0.001) of the Tuberculosis positive patients when compared with the controls, showed, statistically (P&lt;0.05) significant haematological abnormalities. History of Tuberculosis in family (Odd ratio=9.3) and Alcoholism (OR=6.0) were significant predisposing factors of Tuberculosis. Other predisposing factors; smoking habits (OR=2.7), Educational status (OR=2.2), marital status (OR=1.3) were also associated with Tuberculosis infection, while employment status (OR=1.0) and socio-economic status (OR=0.1) were not. Tuberculosis infection in this study adversely affected Haemoglobin, Platelets, Erythrocyte sedimentation rate, Neutrophil, Eosinophil and Monocyte values, while family history of Tuberculosis and Alcoholism were significantly associated with the infection.&#x0D; Conclusion: Quarrantine of Tuberculosis patients and creating more awareness on the predisposing factors of tuberculosis will help towards preventing, reducing and eliminating the disease.

Tobacco smoking as a risk factor for tuberculous pleural effusion: a case-control study.

This study assessed the tobacco smoking-associated risk for tuberculous pleural effusion (TPE) in India. Ninety-two patients with TPE and 184 controls were randomly selected and assessed regarding their tobacco-smoking status and type, quantity and duration of tobacco used. Odds ratios (ORs) for the association of smoking cigarette, beedi and cigarette or beedi with TPE were 19.22 (p < 0.0001), 2.89 (p = 0.0006) and 4.57 (p < 0.0001) respectively. ORs for developing TPE increased with an increase in beedi/cigarette consumption, duration and pack years of smoking (p < 0.001 each). TPE was significantly associated with confounding risk factors viz., regular alcohol use (OR = 1.89, p = 0.019), history of contact with tuberculosis (TB) patient (OR = 8.07, p < 0.0001), past history of TB (OR = 22.31, p < 0.0001), family history of TB (OR = 9.05, p = 0.0002) and underweight (OR = 3.73, p = 0.0009). Smoking (OR = 3.07, p < 0.001), regular alcohol use (OR = 2.10, p = 0.018), history of contact with TB patient (OR = 4.01, p = 0.040), family history of TB (OR = 10.80, p = 0.001) and underweight (OR = 5.04, p < 0.001) were independently associated with TPE. Thus, both cigarette- and beedi-smoking have a significant association with TPE. The risk for TPE in tobacco smokers is dose- and duration-dependent.