Largest Number Of Tuberculosis Cases Research Articles

Kajian Perilaku Kepatuhan Medikasi Pasien Tuberculosis Paru di Kabupaten Ngawi: Sebuah Model Matematis

Background: Tuberculosis (TB) is currently still a health issue in Indonesia. Indonesia is the country that contributes the second largest number of tuberculosis cases after India. Ngawi is one of the cities in East Java Province with a large number of tuberculosis cases. In 2022, tuberculosis cases in Ngawi Regency will double from the previous year with the death rate also increasing from the previous year. This shows that tuberculosis control in Ngawi Regency has not been effective. Efforts are needed to increase medication compliance in tuberculosis sufferers so that therapeutic success can be achieved so that the death rate and tuberculosis transmission rate can be reduced.Methods: This research is an analytical observational study with a cross sectional research design which aims to create a mathematical model of medication adherence in pulmonary TB sufferers in Ngawi Regency. This research involved 102 pulmonary TB sufferers at Dr. Soeroto Hospital, Widodo Hospital and Ngawi Regency Health Center. Pulmonary TB sufferers were selected using a purposive sampling technique. Data were analyzed using multiple logistic regression tests.Result: Based on interviews conducted with 102 respondents, the results obtained were that the variables age, length of treatment, motivation to recover, self-perception, knowledge, access to health facilities, medication assistance, family support, drug side effects and health facility administration were candidates for bivariate testing.Conclusion : The variables of self-perception, knowledge, family support and health facility administration are the dominant factors influencing medication compliance in pulmonary TB sufferers in Ngawi Regency in 2023.

Concomitant pulmonary tuberculosis and venous thromboembolism

Abstract Globally, tuberculosis (TB) is a common communicable disease and every year affects millions of people, particularly in developing countries. Venous thromboembolism (VTE) is common in elderly people with higher mortality. TB is also common in old people and is an independent risk factor of VTE. However, the association of VTE and active TB is rare, even in high-prevalence countries like India, and the reason is not known. In developing countries, failure to suspect thrombotic events clinically by those who treat a large number of TB cases in the peripheral health centres may be one of the reasons for underreporting VTE in active TB. In active TB, deep venous thrombosis (DVT) is more frequent than pulmonary thromboembolism (PTE) or VTE. DVT or PTE or VTE may present with TB or develop during treatment for TB, but simultaneous occurrence of active pulmonary TB and VTE is rare. We report concomitant active pulmonary TB with VTE without comorbid illnesses in an elderly man as a rare occurrence.

Myocardial tuberculosis: A rare case report

Tuberculosis (TB) is one of the most common causes of mortality and morbidity globally, with Indian subcontinent having quite a large number of TB cases. TB can involve any organ system in humans; however, the disease affecting the cardiovascular system is rare. On the other hand, myocardial tuberculosis is a serious entity and can, unfortunately, be fatal if the diagnosis is missed or delayed. Therefore, the possibility of TB involving the myocardium should always be considered in areas with a high prevalence of TB, like the Indian subcontinent. Anti-TB therapy (with corticosteroids in some cases), along with early detection and suspicion, is proven to be quite effective in management and cure in most cases. We describe a case of sputum AFB (acid-fast bacilli) positive pulmonary TB with dilated cardiomyopathy, and impaired/decreased left ventricular systolic function, which gradually improved after anti-tubercular decongestive therapy.

Tuberculosis Modeling in East Java Based on Geographically Weighted Regression Approach

Tuberculosis is the 13th trigger of death causes around the world. Even after Covid-19, tuberculosis ranks 2nd as a contagious killer disease. In 2020, Indonesia ranks 2nd out of 8 countries with the highest contributor to tuberculosis sufferers after India. East Java Province is the region with the largest number of tuberculosis cases in order of 8. Tuberculosis cases in East Java in 2020 have decreased, but when viewed from the success rate of treatment of tuberculosis cases per district/city in East Java, it was found that 53% still did not meet the target of 90%. According to (World Health Organization), gender affects the occurrence of tuberculosis disease, where men are more susceptible than women. In finding treatment for all tuberculosis incidents in East Java, the highest patient was male. This study was conducted to model tuberculosis in men in the East Java area. The results of the study prove that the modeling of male tuberculosis in East Java used linear regression and GWR (Geographically Weighted Regression) obtained the best model was GWR with Fixed Gaussian Kernel weighting, CV value of 5.68, and R2 86.47%. Variables that have a significant effect on male tuberculosis in East Java are BCG immunization for male infants, public places meeting health requirements, youth who smoke tobacco every day, sex ratio, and households with access to proper sanitation facilities.

Dynamics of Clinical, Radiological and Laboratory Parameters in Patients with an Infiltrative Form of Firstly Diagnosed Pulmonary Tuberculosis

According to the World Health Organization, each year 10 million people are diagnosed with tuberculosis for the first time and 1.5 million people die from it. The death rate from this disease has increased in the world for the first time in more than ten years. Unfortunately, Ukraine is in the TOP-10 countries with the largest number of tuberculosis cases among population. Only in December 2021, 1,229 cases of tuberculosis were registered in Ukraine. To date, the course of the tuberculosis process has undergone significant changes. The infiltrative form (IF) of pulmonary tuberculosis accounts for the majority of new cases. Standardized treatment (60 doses in the intensive phase and 120 doses in the continuation phase) is not always sufficient for effective recovery and requires prolongation. That is why it is necessary to study the predictors that maximally reflect the need in therapy prolongation. The objective: to analyze the dynamics of clinical, laboratory and radiological parameters in patients with IF of newly diagnosed pulmonary tuberculosis (NDPT) under conditions of varying treatment effectiveness. Materials and methods. 120 men of working age with IF NDPT were examined in KNP of the Kharkiv Regional Council “Regional TB Dispancer N1” during 2019–2021. Patients were divided into two groups: Group 1 (n=89) included patients with positive clinical and radiological dynamics of the tuberculosis process, and as a result of treatment clearing of Mycobacterium tuberculosis (MBT) from the sputum; Group 2 included patients (n=31) with weak positive dynamics, as a result of which IF was extended to 90 doses. Comparison of clinical, laboratory and radiological data at the beginning and end of IF treatment in patients with different therapy efficiency was performed. The study was conducted in accordance with the requirements of good clinical practice, the Declaration of Helsinki of the World Medical Association, and was approved by the local ethic committee of the Kharkiv Medical Academy of Postgraduate Education. Results. An analysis of the dynamics of clinical, radiological and laboratory data showed that the decrease of immuno-inflammatory indicators levels (C-reactive protein, IL-4, IL-10, circulating immune complexes; CD4/CD8 ratio) was more pronounced in the group of patients who did not need treatment prolongation. At the same time this group was also characterized by significant increase in the level of IFN-γ by the end of the IF treatment, which could indicate activation of cellular immunity together with decrease in the levels of IL-4 and IL-10 which indicated the suppression of humoral immunity. Due to the predominance of cellular immunity over humoral, macrophage activation and their phagocytic activity were accelerated, as a result of which the process of MBT elimination was much faster and more efficient in Group 1 patients. Changes in cytokine levels were observed in patients of Group 1, who showed positive dynamics after IF treatment, but not in patients of Group 2, who demonstrated signs of cytokine dysregulation due to continuing specific inflammatory process. Conclusions. Tuberculosis remains one of the global health problems. The general trend in the spread of tuberculosis and mortality from it throughout the world requires urgent efforts to the detection and treatment of this disease. In patients with IF pulmonary TB standard treatment was less effective in case of slow insufficient decrease in the levels of CRP, IL-10, γ-INF, and the CD4/CD8 ratio which was associated with slow cavities healing, continuing spreading of the infiltrative process. These patients needed prolonged treatment regimen.

The Profile of the Patients with Double Infection HIV and TB in South West of Romania.

Background: Co-infection with human immunodeficiency virus (HIV) / tuberculosis (TB) raises important diagnostic and treatment problems as the lung is one of the target organs for HIV. Studies have shown that an HIV patient is 5-15 times more likely to switch from Koch's bacillus-infected status to active tuberculosis. Material and method: Retrospective study on 207 patients with HIV/TB coinfection in the Oltenia area registered in the Regional Center for Monitoring and Evaluation of HIV/AIDS infection in Craiova to define the profile of patients with double TB-HIV infection in southern Romania for cases registered between 2005-2015. Results: 53.14% of patients were females. Most cases were from rural areas (56.10%) Half of them are born between 1988 and 1990 but only 5% graduated university. 66.18% don’t have a job and are supported by state with a monthly minimum income. 29.4% are smokers. More than 60% of cases had pulmonary TB and other 25% had concomitant pulmonary and extrapulmonary TB. TB and HIV have been diagnosed almost at the same time in 25% of cases. At the time of TB diagnosis 75% of patients had CD4+lymphocytes count <200cel/ml. We also noticed the absence of prophylaxis for TB in patients infected with HIV (PIH) and high incidence of hepatitis B (30.43%). Conclusions: Clinical expression, radiological and bacteriological aspects are often atypical in HIV/TB coinfected patients. The lack of TB prophylaxis and TB endemicity in the studied area may justify the large number of TB cases in HIV-infected patients.

Perfil epidemiológico dos casos de tuberculose no estado do Maranhão de 2009 a 2018

Objetivo: Delinear o perfil epidemiológico dos casos de tuberculose notificados no Estado do Maranhão entre os anos de 2009 e 2018. Métodos: Estudo de natureza retrospectiva, descritiva e quantitativa sobre as ocorrências de tuberculose notificadas no estado do Maranhão, delineando seu perfil epidemiológico. Resultados: Os resultados obtidos no estudo revelam que no período de 2009 a 2018 foram registradas 23.120 notificações de caso de Tuberculose no Estado do Maranhão, onde se encontra atualmente em 4º lugar na região Nordeste e em 11º no país. Conclusão: O estudo demonstrou que mesmo com a grande quantidade do número de casos de Tuberculose no Estado do Maranhão, houve uma grande diminuição do número de pessoas infectadas ao longo do período analisado. Foi demonstrado que a doença acomete mais as pessoas do sexo masculino e, entre os 20 aos 39 anos de idade.

PENERAPAN ANALISIS LASSO DAN GROUP LASSO DALAM MENGIDENTIFIKASI FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN TUBERKULOSIS DI JAWA BARAT

Tuberculosis is the deadliest infectious disease in Indonesia, and West Java is a province with the largest number of tuberculosis cases in Indonesia. This research was conducted to identify variables and groups of variables that could explain the number of tuberculosis cases in West Java. The data used has many explanatory variables, and these variables form groups. LASSO and group LASSO analysis can be used for variables selection and handle data that has many explanatory variables, and group LASSO analysis can be used on data with grouped variables. The results of the LASSO analysis, variables that can explain the number of tuberculosis cases in West Java are the number of people with disabilities, the number of pharmacy staff, the number of malnourished people, the number of people working and the number of cities. According to the group LASSO analysis, the variables that can explain the number of tuberculosis cases in West Java are variables in the health and environmental groups. The government can focus on these factors if they want to reduce the number of tuberculosis cases in West Java.

PREDIKSI PENYAKIT TUBERCULOSIS (TBC) MENGGUNAKAN ALGORITMA C4.5

Tuberculosis (TB) is an infectious disease caused by mycobacteria, especially Mycobacterium tuberculosis. TB disease remains one of the threats, especially in a country with low and middle economic levels. According to the World Health Organization (WHO) TB disease became one of the biggest causes of death in the world. Indonesia ranks second with the largest number of TB cases in the world. In addition, there are some symptoms and factors that can cause a person affected by TB disease. For the treatment of TB disease can be done intensively, but it takes a long time. Research in the diagnosis of disease with classification techniques using C4.5 algorithm has been done by several previous researchers and get good results. Therefore, in this research will be predicted TB disease using C4.5 algorithm. The C4.5 algorithm is chosen because it is very easy to interpret, fast, and has high precision accuracy. The results of this study is an application that can help people to make the diagnosis of TB disease from an early age.

Screening for diabetes among tuberculosis patients registered under revised national tuberculosis control program, Bhopal, India.

Context:Tuberculosis (TB) and diabetes mellitus (DM) remain a global public health problem. India has the largest number of TB cases; in 2015, out of total global annual incidence of 9.6 million TB cases, 2.2 million were estimated from India. There are 62.4 million people with type 2 diabetes and 77 million people with prediabetes in India, and these numbers are projected to increase to 101 million by the year 2030. Diabetes and TB affect each other at many levels. Screening for diabetes in patients with TB will not only help in early case detection but also better management of both comorbidities.Aims:(i) To determine the prevalence of diabetes and prediabetes among diagnosed cases of TB registered under RNTCP in Bhopal district. (ii) To determine additional yield of previously unknown DM and the number needed to screen (NNS) to find out a new case of DM. (iii) To find out the factors associated with diabetes among patients diagnosed with TB registered under RNTCP in Bhopal district.Settings and Design:This study was a cross-sectional study conducted on registered patients with TB under RNTCP in two TB units of Bhopal district.Materials and Methods:Participants were contacted and interview was conducted after obtaining consent using predesigned and pretested performa during the period of 1st October 2014 to 30th March 2015 for a period of 6 months.Statistical Analysis Used:Continuous variable were summarized as frequency, mean, and standard deviation. All variables were analyzed using Chi-square test of significance; P < 0.05 was taken as statically significant.Result:Of the total 528 patients with TB, 296 was male and 232 were female. Of the total, 63 (11.9%) patients were diagnosed as diabetic. NNS to diagnose a new case of DM was 22.1. Significant association was found with six variables which are age, sex, body mass index, type of TB, category of TB, and smoking.Conclusion:This study shows feasibility and importance of screening of patients with TB in existing program settings.

Isolated splenic tuberculosis in immunocompetent patient: A rare occurrence

Globally millions of people are affected by tuberculosis (TB) each year and India has the largest number of TB cases both pulmonary and extrapulmonary. Extrapulmonary TB affecting spleen is quite rare and occurs mostly as a part of miliary tuberculosis in immunocompromised patients. In the Immunocompetent patients, isolated splenic tuberculosis is extremely rare. Herein, we present the case of an immunocompetent female with isolated splenic tuberculosis.

Paleomicrobiology of Human Tuberculosis.

Tuberculosis is a significant global disease today, so understanding its origins and history is important. It is primarily a lung infection and is transmitted by infectious aerosols from person to person, so a high population density encourages its spread. The causative organism is Mycobacterium tuberculosis, an obligate pathogen in the M. tuberculosis complex that also contains closely related species, such as Mycobacterium bovis, that primarily infect animals. Typical bone lesions occur in about 5% of untreated infections. These can be recognized in historical and archaeological material, along with nonspecific paleopathology such as new bone formation (periostitis), especially on ribs. Based on such lesions, tuberculosis has been found in ancient Egypt, pre-Columbian America, and Neolithic Europe. The detection of M. tuberculosis ancient DNA (aDNA) by using PCR led to the development of the new field of paleomicrobiology. As a result, a large number of tuberculosis cases were recognized in mummified tissue and bones with nonspecific or no lesions. In parallel with these developments, M. tuberculosis cell wall lipid biomarkers have detected tuberculosis suggested by paleopathology and confirmed aDNA findings. In well-preserved cases, molecular typing has identified M. tuberculosis lineages and genotypes. The current interest in targeted enrichment, shotgun sequencing, and metagenomic analysis reveals ancient mixed infections with different M. tuberculosis strains and other pathogens. Identification of M. tuberculosis lineages from samples of known age enables the date of the emergence of strains and lineages to be calculated directly rather than by making assumptions on the rate of evolutionary change.

Follow-up of chronic coughers improves tuberculosis case finding: results from a community-based cohort study in southern Ethiopia.

BackgroundUntreated smear-positive tuberculosis (TB) patients are the primary source of infection; however, a large number of TB cases have not been identified and are untreated in many sub-Saharan African countries, including Ethiopia. This study determined whether or not a community-based follow-up of chronic coughers improves detection of TB cases and the risk factors for death among such cases.MethodsWe conducted a census in six rural communities in Sidama, southern Ethiopia. Based on interview and sputum investigation, we identified 724 TB smear-negative chronic coughers, and did a cohort study of these chronic coughers and 1448 neighbourhood controls. For both chronic coughers and neighbourhood controls, we conducted a TB screening interview and performed sputum microscopy, as required, at 4, 7 and 10 months. Between September 2011 and June 2012, we followed chronic coughers and neighbourhood controls for 588 and 1,204 person-years of observation, respectively.ResultsOf the chronic coughers, 23 developed smear-positive TB (incidence rate = 3912/105 person-years) compared to three neighbourhood controls who developed smear-positive TB (incidence rate = 249/105 person-years). The male-to-female ratio of smear-positive TB was 1:1. We demonstrated that chronic coughers (adjusted hazards ratio [aHR], 13.5; 95% CI, 4.0–45.7) and the poor (aHR, 2.6; 95% CI, 1.1–5.8) were at high-risk for smear-positive TB. Among the study cohort, 15 chronic coughers and two neighbourhood controls died (aHR, 14.0; 95% CI, 3.2–62.4).ConclusionA community-based follow-up of chronic coughers is helpful in improving smear-positive TB case detection, it benefits socioeconomically disadvantaged people in particular; in rural settings, chronic coughers had a higher risk of death.

Population structure and circulating genotypes of drug-sensitive and drug-resistant Mycobacterium tuberculosis clinical isolates in São Paulo state, Brazil

São Paulo is the most populous Brazilian state and reports the largest number of tuberculosis cases in the country annually (over 18,500). This study included 193 isolates obtained during the 2nd Nationwide Survey on Mycobacterium tuberculosis Drug Resistance that was conducted in São Paulo state and 547 isolates from a laboratory based study of drug resistance that were analyzed by the Mycobacteria Reference Laboratory at the Institute Adolfo Lutz. Both studies were conducted from 2006 to 2008 and sought to determine the genetic diversity and pattern of drug resistance of M. tuberculosis isolates (MTC) circulating in São Paulo. The patterns obtained from the spoligotyping analysis demonstrated that 51/740 (6.9%) of the isolates corresponded to orphan patterns and that 689 (93.1%) of the isolates distributed into 144 shared types, including 119 that matched a preexisting shared type in the SITVIT2 database and 25 that were new isolates. A total of 77/144 patterns corresponded to unique isolates, while the remaining 67 corresponded to clustered patterns (n=612 isolates clustered into groups of 2–84 isolates each). The evolutionarily ancient PGG1 lineages (Beijing, CAS1-DEL, EAI3-IND, and PINI2) were rarely detected in São Paulo and comprised only 13/740, or 1.76%, of the total isolates; all of the remaining 727/740, or 98.24%, of the MTC isolates from São Paulo state were from the recent PGG2/3 evolutionary isolates belonging to the LAM, T, S, X, and Haarlem lineages, i.e., the Euro-American group. This study provides the first overview of circulating genotypes of M. tuberculosis in São Paulo state and demonstrates that the clustered shared types containing seven or more M. tuberculosis isolates that are spread in São Paulo state included both resistant and susceptible isolates.

Nosocomial Tuberculosis in India

Most high-income countries implement tuberculosis (TB) infection control programs to reduce the risk for nosocomial transmission. However, such control programs are not routinely implemented in India, the country that accounts for the largest number of TB cases in the world. Despite the high prevalence of TB in India and the expected high probability of nosocomial transmission, little is known about nosocomial and occupational TB there. The few available studies suggest that nosocomial TB may be a problem. We review the available data on this topic, describe factors that may facilitate nosocomial transmission in Indian healthcare settings, and consider the feasibility and applicability of various recommended infection control interventions in these settings. Finally, we outline the critical information needed to effectively address the problem of nosocomial transmission of TB in India.

Bacillus Calmette–Guerin osteomyelitis in a patient with severe combined immunodeficiency: radiologic appearances of extensive dissemination

Tuberculosis continues to be a grave health problem in developing countries. Africa and Southeast Asia have the largest number of tuberculosis cases and the situation has been worsened by the HIV epidemic. It has regained importance in the west in the last decade because of drug and alcohol abuse, immigration from third-world countries, homelessness, and HIV epidemics. Routine prophylaxis is employed in developing countries by bacillus Calmette–Guerin (BCG), the vaccine administered to prevent human tuberculosis. Results suggest that BCG vaccine may have reduced the incidence of tuberculosis by up to 87.6% (95% confidence interval 55.2-98.5%). Routine prophylaxis poses a problem for patients with immune deficiency, because live-attenuated vaccines may cause widespread disease in such patients. Severe combined immunodeficiency (SCID) is a fatal disease with a fulminant course caused by severe opportunistic infections soon after birth. In these patients, bone-marrow transplantation (BMT), as well as antituberculous medication, is an effective method of treating BCG infection. However, activated immune response and resistance may lead to a severe clinical presentation characterized by disseminated involvement and abcess formation, as described in the following case. Case Report

Global aspects of tuberculosis in children.

Tuberculosis (TB) in children reflects the prevalence of the disease in adults as well as current transmission rates. Africa and South-east Asia have the largest number of tuberculosis cases and the situation there has been worsened by the HIV epidemic. Children born to HIV-infected parents, whether infected or not, are at high risk of developing tuberculosis because of the increased risk of exposure to the disease. Tuberculosis is more common among the disadvantaged and vulnerable groups in each society and the impact of overcrowding, under-nutrition and poverty is particularly severe on children. Recent studies have documented the increase in the occurrence of tuberculosis in children, both in developed and developing countries. The peak age of notification of tuberculosis decreases as the incidence of the disease increases in the region. Tuberculosis infection can progress rapidly to disease, particularly in infancy and early childhood. Most of the morbidity occurs in the first few years after infection. Recently infected children and those with large tuberculin reaction (>18 mm) are at increased risk for progression and should be followed closely. Mortality from tuberculosis is also highest in early childhood, mainly due to disseminated forms like meningeal and miliary tuberculosis. Tuberculosis can be controlled either by preventing the infection from occurring or by treating early infection after it has occurred. An efficient tuberculosis control program with early detection of infectious adults and their cure is the best long-term approach to the reduction of TB disease in children. The DOTS strategy advocated by the WHO has the potential to have a significant impact on the epidemiology of tuberculosis by achieving high cure rates and thereby decreasing community transmission. BCG vaccination, through effective against disseminated forms of the disease in childhood, has very little impact on adult forms of the disease. Chemoprophylaxis or preventive therapy is effective, but difficult to implement on a mass scale and is only recommended for special high-risk groups in developing countries.