Male Tuberculosis Patients Research Articles

Transmission dynamics of tuberculosis in a high-burden area of China: An 8-year population-based study using whole genome sequencing

ObjectivesThis study investigated the transmission patterns of tuberculosis (TB) and its associated risk factors in Hunan province to inform the development of prevention and control strategies in the region. MethodsAn 8-year retrospective population-based genomic epidemiological study was conducted. Genomic clusters were defined using distance thresholds of 12-single-nucletide-polymorphisms. Risk factors associated with TB transmission were analyzed using logistic regression model. Kernel Density analysis was used to locate hotspots where transmission occurred. ResultsAmong 2649 TB cases included in this study, 275 clusters were identified, with an overall clustering rate of 24.7% (654/2649). Nearly 95% (620/654) of clustered strains were isolated from the same county. Of the 275 clusters, 23 (8.4%, 23/275) had differences in drug-resistant profiles, with FQs resistance mutations occurring most frequently (52.2%, 12/23). Multivariate analysis identified male TB patients, those aged 30-60 years, ethnic minorities, nonfarmers, retreated TB patients, and individuals infected with MDR/RR-TB as independent risk factors for TB transmission (P < 0.05). Kernel density analysis showed that among the 5 drug-resistant surveillance sites, Leiyang had the highest clustering rate, followed by Yongshun, Qidong, Hecheng, and Taojiang. ConclusionRecent transmission in the region is predominantly occurring within counties. The risk factors related to TB transmission and the hotspots where transmission occurs can provide a scientific basis for the formulation of targeted TB prevention and control strategies.

Immuno-Hematological and Biochemical Changes in Patients with Tuberculosis in Dessie Comprehensive Specialized Hospital, Dessie, Ethiopia.

Tuberculosis (TB) is a serious worldwide health issue, particularly in developing nations like Ethiopia. Patients with tuberculosis experience a range of hematological, immunological, and biochemical alterations. The purpose of this study was to evaluate immunological, hematological, and biochemical alterations of newly diagnosed TB patients at Dessie comprehensive specialized hospital, Dessie, Ethiopia. A comparative, cross-sectional study was carried out to evaluate the immuno-hematological and biochemical changes in patients with tuberculosis at Dessie comprehensive specialized hospital from January to July 2018. One hundred sixty-four (164) newly diagnosed TB patients, and 80 apparently healthy controls were included consecutively. The variables were expressed in frequency, percentage, and mean ± SD. To compare mean ± SD of the groups or within the groups, we used an independent sample t-test. Statistical significance was defined as a P value less than 0.05. Male TB patients had significantly high mean absolute WBC count, neutrophil count, lymphocyte, platelet count, and systemic immune-inflammation compared with male healthy controls (P=0.001, P=0.011 P=0.021, P=0.001, and P=0.018, respectively). The mean platelet count of female TB patients was significantly higher than that of the female control group (P=0.015). However, mean RBC counts, Hgb, HCT, and MPV of TB patients were significantly lower than those of male (p<0.001) and female healthy controls (P=0.022, 0.015, and 0.001, respectively). The TB patients had developed anemia (23.8%), WBC abnormalities (29.3%), thrombocytosis (11.6%), and thrombocytopenia (9.8%). The cases had significantly higher mean alanine amino transferase, total bilirubin, and glucose level, but the mean total protein, alkaline phosphatase, and total cholesterol of cases were significantly lower than healthy control groups. TB patients in this study showed significant alterations in a number of hematological and biochemical profiles. This indicates that hematological and biochemical profiles should be monitored and properly interpreted for the differential diagnosis of tuberculosis and evaluation of response to treatment.

Assessment of gender differences in some inflammatory cytokines of tuberculosis patients before and during treatment.

Gender variation is a feature of many physiological parameters including inflammatory cytokines. Inflammation is an obvious feature of Tuberculosis (TB) infection with changes in pro and anti-inflammatory cytokines. To compare the levels of inflammatory cytokines between male and female TB patients before treatment, after 2-months and after 6-months anti-tuberculosis treatment. A total of 35 males and 25 females TB subjects were enlisted before initiation of therapy and followed up after 2-months and 6 months treatment and samples collected and analysed. Tumour necrosis factor-alpha (TNF-α), Interleukin 10 (IL-10, Interleukin -6 (IL-6), Interleukin-2 (IL-2), transforming growth factor-beta (TGF-β) were assayed by ELISA method. Before treatment, the median level of IL-6 (pg/ml) was significantly higher in males compared to female TB patients (P=0.046). While after 2-months treatment, TNF-α (pg/ml) and IL-10 (pg/ml) was significantly higher in males compared with females (P=0.008 and 0.045 respectively). Conversely, the median IL-6 (pg/ml) was significantly higher in female TB patients compared to the males (P=0.042). No significant differences were observed after 6-months treatment. Gender differences exist in IL-6 before treatment and in IL-6, TNF-α and IL-10 at two months treatment. Thus, TB treatment contributes differentially to levels of inflammatory cytokines in male and female TB patients.

Sex-dependent regulation of interferon-γ receptor expression in pulmonary tuberculosis

Interferon-γ (IFN-γ) is an essential pro-inflammatory cytokine against tuberculosis (TB). To initiate immune response, IFN-γ binds to its receptor complex which consists of two subunits IFN-γ receptor 1 (IFN-γR1) and IFN-γ receptor 2 (IFN-γR2). The deficiency in either receptor subunit can alter IFN-γ signalling thus influencing host susceptibility to TB. In the present study IFN-γ receptor expression at transcriptional and translational level was analysed in pulmonary TB patients from North India. A total of 46 pulmonary TB patients (at 0 day of anti-tuberculosis therapy) and 48 healthy controls (HCs) were recruited. It was found that the mRNA expression of IFN-γR1 was decreased in male TB patients (p = 0.003). The surface expression of IFN-γR1 (p = 0.0005) and IFN-γR2 (p = 0.024) was also found to be decreased in male TB patients. In conclusion, we found sex-dependent regulation of IFN-γR1 and IFN-γR2 expression in pulmonary TB patients of studied population.

A social networks-driven approach to understand the unique alcohol mixing patterns of tuberculosis patients: reporting methods and findings from a high TB-burden setting

Individuals who consume alcohol have a higher chance of contracting tuberculosis (TB) due to their social mixing patterns. We aimed to study the social mixing patterns of TB patients who consume alcohol on a regular basis using a quantitative social network approach. In a high-TB prevalence context in India, a social network survey of 300 newly diagnosed pulmonary drug-sensitive TB patients was done. The survey found 52 (17%) male TB patients who shared alcohol on a regular basis with 106 (4%) of their first-degree social contacts. Alcohol sharing happened in 16 neighborhood venues. When compared to contacts who did not use alcohol, a higher proportion of contacts with regular alcohol use were diagnosed with TB (12.3%; 95% CI: 6.6–20.00 vs. 3.5%; 95% CI: 2.8–4.3). Social network analysis showed that the network consisting of patients and contacts was less dense and less connected (with density ratio of 0.009, and degree centrality of 1.3, and betweenness centrality of 0.5), indicating weaker transmission potential of the network. Comparatively the network consisting of patients, contacts and their alcohol sharing venues was more dense and more connected (with density ratio of 0.018, higher degree centrality of 3.1 and betweenness centrality of 154.2) indicating stronger transmission potential of the network. Regular alcohol sharing in four venues created a giant network component, that linked a higher proportion of contacts without TB (72.3%) to a higher proportion of TB patients (67.3%) and their contacts with TB (38.4%). When examined from a network perspective, the pooled TB transmission exposure of contacts with regular alcohol use grew by a factor of 10, which helped explain the unfavorable social mixing of patients and contacts with regular alcohol use.

Clinical, Socio-Demographic Characteristics and Gender Disparity in Patients with Tuberculosis Infection in Pakistan

Objectives: To assess the clinical, environmental, and socio-demographic characteristics leading to gender disparity in tuberculosis in Pakistan.&#x0D; Study Design: Prospective Comparative study.&#x0D; Study Setting and Duration: The Indus Hospital, Karachi Pakistan, from Jul 2020 to Dec 2020.&#x0D; Methodology: A sample of 200 patients with diagnosed tuberculosis (detected on an acid-fast bacillus (AFB) smear with radiographic abnormalities) irrespective of gender, sensitivity, or site of tuberculosis, were included in the study. Data of gender, personal history, substance abuse history, and dietary habits was documented. &#x0D; Results: Pulmonary tuberculosis was significantly more common in female patients than in males (p&lt;0.001). The mean age of male patients was 30.16 ± 9.47 years. Male patients were significantly older than their female counterparts (p=0.003). The diabetes mellitus in male patients was significantly higher than in female patients with TB (p=0.01). Similarly, substance abuse history was more frequently positive in male patients as compared to female patients, 28 (40.60%) vs 9 (6.70%); p-value &lt;0.001. There was no significant difference in the occurrence of drug-resistance tuberculosis between the two genders. However, pulmonary tuberculosis was significantly more common in female patients than in males (p&lt;0.001).&#x0D; Conclusion: We reported some distinctive differences between male and female tuberculosis patients. Young females had more predilections toward tuberculosis as compared to men. Diabetes mellitus and substance abuse history were more common in male tuberculosis patients than in females.

The Spatial-Temporal Epidemiology Analysis of Tuberculosis Disease in Pakistan

In spite of significant progress, Tuberculosis (TB) remains a severe national health issue in Pakistan. However, very few studies have been done on the spatial-temporal appraisal of tuberculosis in Pakistan. The current research is based on the TB disease dataset obtained from the Pakistan Bureau of Statistics from 2015 to 2019. The study has focused on assessing Spatial epidemiology statistics and spatial autocorrelation to detect the cluster of TB disease incidence rate (IR) for New, Male, Female and total TB patients at the provincial and territorial levels in Pakistan. The spatial epidemiology statistics and spatial autocorrelation have been measured the temporal trends of TB IR as per 100,000 population. The global and local spatial autocorrelation of TB IR has been analyzed by the global Moran's I and Anselin's Local Moran's using GeoDa software and ArcGIS tool. Results show that the IR in Pakistan exhibited a progressive decrease from 2015 to 2018 but showed an unexpected increase in 2019. It is also critically analyzed that the Punjab, Sindh, Khyber Pakhtunkhwa, and Azad Jammu Kashmir provinces and territories (Federally Administered Tribal Areas (FATA) were at high risk with a higher rate of IR. Despite this, the fact is that the global spatial autocorrelation has not been identified across provincial and territorial levels in Pakistan. In the five-year study, datasets have been observed the individual provinces and territories that indicate negative local spatial autocorrelation of Low-high provinces and territories, such as Balochistan and Islamabad Capital Territory (ICT).

Possibilities of Therapeutic and Prophylactic Tactics in Management of Benign Prostatic Hyperplasia in Tuberculosis Patients

The objective: to assess the severity of symptoms of urinary dysfunction in tuberculosis patients with benign prostatic hyperplasia (BPH) and determine the effectiveness of comprehensive therapeutic and preventive measures aimed at their elimination as well as the possibility of their combination with anti-tuberculosis therapy.Subjects and Methods. 447 men with various localizations of tuberculosis at the age from 20 to 96 years old were examined. The questionnaire we used included questions regarding lower urinary tract symptoms, urinary tract infection, involuntary urination, and male genital disorders. The assessment involved comprehensive clinical and laboratory evaluation, including objective examination, laboratory and echographic tests of genitourinary organs.Results. According to assessment results, among 447 male tuberculosis patients, 88 (19.7%) were diagnosed with benign prostatic hyperplasia which indicated a large proportion of older men with various forms of tuberculosis. Analysis of the structure of tuberculosis clinical forms showed the highest frequency of benign prostatic hyperplasia in patients with infiltrative pulmonary tuberculosis (51.1%) and bone and joint tuberculosis (26.1%). Medical treatment (tamsulosin 0.4 mg once a day for 3 months) in 66 patients was highly effective – up to 80.3%.

PERILAKU MEROKOK PADA PASIEN TUBERKULOSIS LAKI-LAKI DI KECAMATAN BANYUWANGI, KABUPATEN BANYUWANGI

An increasing number of smokers is associated with an increased risk of tuberculosis (TB). The risk of TB can be reduced by two thirds if someone stops smoking. The purpose of this study was to determine smoking behavior in TB patients in three puskesmas in Banyuwangi District (Puskesmas Sobo, Puskesmas Kertosari, and Puskesmas Singotrunan). This research is a descriptive study with a cross-sectional approach, which was conducted for 6 (six) months, June to December 2017. This study used data from a study entitled "nutrition status, social support, and health-related quality of life in tuberculosis patients at the center Banyuwangi health services ". Data were collected by conducting a survey using a questionnaire to 71 TB patients, but only male TB patients (56.3%) were further investigated. The results of this study showed 15% of male TB patients continued to smoke, 7.5% smoked daily and 7.5% smoked occasionally. Of the male TB patients who do not currently smoke, 73% smoked daily, and 9% smoked occasionally. As many as 85% of male TB patients have smoked, 4% smoked 5 minutes after waking up, and 21% smoked 6 to 30 minutes after waking up. As many as 11% of male TB patients who smoke spend more than 31 cigarettes, and 14% use 21 to 30 cigarettes. It can be concluded that there are still male TB patients who continue to smoke. The results of this study indicate that the need for empowerment of the PMO (Drugs Supervisor) to monitor smoking behavior in TB patients, counseling in TB patients should be able to detect the existence of addiction to smoking and consultation efforts to stop smoking.

Factors Contributing to TB at Primary Health Center in Sidoarjo - Indonesia

Introduction: Tuberculosis (TB) is caused by Mycobacterium tuberculosis, and remains a burden in Indonesia. Many factors contribute to the TB prevalence, including age, sex, body mass index, sputum smear conversion, HIV infection, and Diabetes Mellitus. The objective of this study is to identify factors contributing to TB prevalency at the primary health center.Methods: This research used as a cross-sectional study and was conducted in March 2020. The population of this study was TB patients at Porong Primary Health Center in Sidoarjo, East Java Province, Indonesia. Samples were all TB patients who registered in Porong Primary Health Center and were taken by total sampling. The sample size was 51 TB patients. There were no inclusion and exclusion samples criteria implemented. Data were collected that used the secondary data of TB Patients Registration, between 1st – 31st March April 2020. Data were analyzed using frequency distribution with SPSS Version 21.Results: Result shows there were 30 (58.80%) male TB patients, 34(66.70%) TB patients were adults, 48 (94.10%) TB patients had sputum smear conversion from positive to negative after two months DOTS therapy, there were 48 (94,10%) TB patients not infected by HIV Virus, and there were 36 (70,60%) TB patients had a history of Diabetes Mellitus.Conclusion: Factors contributing to TB prevalence are many, including age, sex, body mass index, sputum smear conversion, HIV infected, and Diabetes Mellitus. To improve care of TB patients requires integration and comprehension of care at the primary health center.

Predictors of Loss to Follow-Up among Men with Tuberculosis in Puducherry and Tamil Nadu, India.

.Identifying predictors of loss to follow-up (LTFU; treatment lapse ≥ 2 months) among people with tuberculosis (TB) may assist programmatic efforts in controlling the spread of TB. Newly diagnosed smear-positive TB patients were enrolled in the Regional Prospective Observational Research for TB study in Puducherry and Tamil Nadu, India. Treatment records were used to identify LTFU of those who were enrolled from May 2014 through December 2017. This nested case–control study evaluated male TB patients. Predictors were assessed using multivariable logistic regression. Of 425 men with TB, 82 (19%) were LTFU. In the adjusted analyses of males, divorced/separated marital status (adjusted odds ratio [aOR] 3.80; 95% CI: 1.39–10.38) and at-risk alcohol use (aOR 1.92; 95% CI: 1.12–3.27) were significant predictors for increased risk of LTFU, and diabetes was a significant predictor for decreased risk of LTFU (aOR 0.52; 95% CI: 0.29–0.92). Of 53 men with recorded date of last treatment visit, 23 (43%) and 43 (81%) had LTFU within the first 2 and first 4 months of treatment, respectively. Addressing at-risk alcohol use and providing more intensive follow-up could lead to improved treatment completion.

Parametric Survival Modeling of Tuberculosis Data- A Case Study of Federal Medical Centre, Bida, Nigeria

The research performed parametric survival analysis of Tuberculosis (TB) data (covering 2010 to 2016) collected from the Federal Medical Centre, Bida, Niger State, Nigeria. Three parametric survival models (Exponential, Weibull and Log-logistic) were fitted. The outcome variable was time to recovery from TB infection and four covariates being age, gender, TB type and occupation were involved. Models were estimated by maximum likelihood method and model selection criterion used was the Akaike Information Criterion (AIC). The exponential and log-logistic models found all covariates statistically insignificant while Weibull found all covariates but TB type significant at 5% level. Based on AIC, Weibull model with AIC of 163.5731 performed best, followed by log-logistic model with AIC of 191.419 and exponential model performed worst, with AIC of 517.9652. The best of fitted models being Weibull suggested that older patients had higher hazards than younger ones, older patients hence, had lower survival times, holding other covariates constant. That is, the older the TB patient, the lower was the time to recovery from TB. Males had higher hazards and hence, lower survival times compared to females. That is, male TB patients recovered faster than the females. Pulmonary TB patients had lower (insignificant) hazards and hence, higher survival times than Respiratory TB patients. TB patients on technical occupation had lower hazards than others and hence, had higher survival times than those whose occupations were considered not technical. The research concluded that age, gender and occupation were the major determinants of recovery period of TB patients. It was recommended that the Management of Federal Medical Centre, Bida, and other organizations involved in TB management could make use of the Weibull model to fit and predict both the survival and hazard rates of TB patients.

The risk of multidrug- or rifampicin-resistance in males versus females with tuberculosis.

Males are at an increased risk of tuberculosis (TB) disease compared to females. Additionally, several risk factors for multidrug-resistant (MDR) or rifampicin-resistant (RR) TB disease are more common in males, hence male TB patients may have a higher relative risk of MDR/RR-TB than female TB patients.We used sex-disaggregated data of TB patients reported to the World Health Organization for 106 countries to calculate male-to-female (M:F) risk ratios of having MDR/RR-TB.There was no evidence of either sex being more at risk of MDR/RR-TB in 81% (86 out of 106) of countries, with an overall random-effects weighted M:F risk ratio of 1.04 (95% CI 0.97-1.11). In 12% (13 out of 106) of countries there was evidence that males were more at risk, while in 7% (seven out of 106), females were more at risk. The risk of having TB that was MDR/RR increased for males compared to females as MDR/RR-TB incidence increased, and was higher for males than females in the former Soviet Union, where the risk ratio was 1.16 (1.06-1.28). Conversely, the risk increased for females compared to males as gross domestic product purchase power parity increased, and was higher for females than males in countries where the majority of TB burden was found in the foreign-born population, where the risk ratio was 0.84 (0.75-0.94).In general, the risk of MDR/RR-TB, among those with TB, is the same for males as for females. However, males in higher MDR/RR-TB burden countries, particularly the former Soviet Union, face an increased risk that their infection is MDR/RR-TB, highlighting the need for a sex-differentiated approach to TB case-finding and care.

Arrack shops as probable hot spots of tuberculosis transmission in urban Puducherry, South India: An exploratory study

Background: Alcohol use is common among male tuberculosis (TB) patients of Puducherry, particularly from lower socioeconomic strata who consume liquor from local arrack shops. These shops could be hot spots for the transmission of infection. Hence, this study aimed to explore whether arrack shops could be probable hot spots for the transmission of infection. Materials and Methods: An exploratory, descriptive study was conducted at three primary health-care centers in Puducherry, among male pulmonary TB patients using a pretested semistructured questionnaire. Home visits and visit to the arrack shop were made to assess for factors conducive to the transmission of TB. Results: Most of the patients belonged to lower socioeconomic status and consumed alcohol, mostly from arrack shops. The arrack shops had poor sanitation, were overcrowded, and multiple persons with TB visited the shop. Many had the behavior of spending more than an hour at the arrack shops. Conclusion: There is a possibility of TB transmission of at the arrack shops. Active case finding in the arrack shop may be beneficial.

Nutritional intakes and associated factors among tuberculosis patients: a cross-sectional study in China

BackgroundThe objectives of this study were to examine nutrient intakes of tuberculosis (TB) patients and to identify their associated factors.MethodsIn this cross-sectional study, 300 adult TB patients were surveyed in two impoverished counties in China. Nutrient intakes were evaluated through two consecutive 24-h dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs) 2013. The potential socio-demographic and behavioral factors were analyzed using multivariate logistic model to identify strong influential factors.ResultsWe found that mean daily energy intake was 1655.0 kcal (SD: 619.3 kcal) and 1360.3 kcal (SD: 552.1 kcal) for male and female patients, respectively. The mean daily energy intake was significantly lower than that has been recommended by DRI (i.e., 2250 and 1800 kcal for males and females, respectively), with 87.4% of the male patients and 59.9% of female patients failed to consume adequate energy. The protein intakes were 44.6 g (SD: 18.2 g) and 35.9 g (SD: 12.3 g) for male and female patients, respectively, which were lower than the recommended values by DRI (i.e., 65 and 55 g for males and females, respectively). Most male (90.8%) and female (58.4%) TB patients had insufficient daily protein intake. Further analyses suggested that mean daily intakes of many micronutrients, were insufficient, while for most of patients, intakes of vitamin E and sodium were sufficient. We identified that unemployment was a risk factor for low energy intake (p < 0.05) and out-home-eating was a protective factor for low protein intake (p < 0.01).ConclusionsIn impoverished areas in China, intakes of macronutrients and most micronutrients in TB patients were inadequate compared with DRIs, especially for unemployed patients and patients eating at home. These findings suggested that public health actions are needed to promote education on TB patients about significance of nutritional support, and, further interventions in TB patients’ nutritional intakes are also required.

Effect of Protein and Vitamin C Supplementation with Lifestyle Modification Counselling on Biochemical Parameters of Male Tuberculosis Patients

Effect of Protein and Vitamin C Supplementation with Lifestyle Modification Counselling on Biochemical Parameters of Male Tuberculosis Patients

Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis

BackgroundWorldwide tuberculosis (TB) reports show a male bias in morbidity; however, the differences in pathogenesis between men and women with TB, as well as the mechanisms associated with such differences, are poorly investigated. We hypothesized that comparison of the degree of lung injury and clinical indices of well-matched men and women with newly diagnosed TB, and statistical analysis of the correlation between these indices and the extent of lung lesions, can provide insights into the mechanism of gender bias in TB.MethodsWe evaluated the acid-fast bacilli grading of sputum samples and compiled computed tomography (CT) data of the age-matched, newly diagnosed male and female TB patients without history of smoking or comorbidities. Inflammatory biomarker levels and routine haematological and coagulation-associated parameters were compared. Binary logistic regression analysis was used to define the association between the indices and lung lesions, and the influence of sex adjustment.ResultsWomen with TB have a longer delay in seeking healthcare than men after onset of the TB-associated symptoms. Men with TB have significantly more severe lung lesions (cavities and healing-associated features) and higher bacterial counts compared to women with TB. Scoring of the CT images before and after anti-TB treatment showed a faster response to therapy in women than in men. Coagulation- and platelet-associated indices were in models from multivariate regression analysis with groups of males or females with TB or in combination. In univariate regression analysis, lower lymphocyte counts were associated with both cavity and more bacterial counts, independent of sex, age and BMI. The association of international normalized ratios (INR), prothrombin times (PTs), mean platelet volumes (MPVs) and fibrinogen (FIB) level with lung lesions was mostly influenced by sex adjustment.ConclusionsSex influences the association between haemostasis and extent of TB lung lesions, which may be one mechanism involved in sex bias in TB pathogenesis.

Prevalence of diabetes mellitus amongst hospitalized tuberculosis patients at an Indian tertiary care center: A descriptive analysis

BackgroundIndia has a high prevalence of tuberculosis (TB) as well as diabetes mellitus (DM). DM is a chronic disease caused by deficiency of insulin production by the pancreas. The risk of TB amongst DM patients is three times higher than those without. The estimated national prevalence of DM is 7.3%. Despite the growing burden of DM, there are limited studies describing the prevalence of TB-DM in India.ObjectiveOur study estimated the prevalence of DM amongst adult hospitalized TB patients at Kasturba Hospital, Manipal and determined factors associated with the likelihood of DM-TB co-prevalence.MethodsWe conducted a retrospective cohort study at Kasturba Hospital, Manipal Academy of Higher Education. All hospitalized adult patients diagnosed with pulmonary TB (PTB) and extrapulmonary TB (EPTB) between June 1st 2015 and June 30th 2016 were eligible for inclusion. Pediatric and pregnant TB patients were excluded from our study. Data were extracted from medical charts. Descriptive and multivariate analyses were performed in R. Multivariate analysis adjusted for age, gender, type of TB, history of TB, and nutrition (body mass index (BMI)) status.ResultsA total of 728 patients met the eligibility criteria, 517 (71%) were male, 210 (29%) female, 406 (56%) had PTB and 322 (44%) had EPTB. Amongst those with a nutritional status, 36 (30%) patients were underweight (BMI <18.4 kg/m2), 73 (40%) had a normal BMI (18.5kg/m2–24.9 kg/m2), 15 (8%) were overweight (BMI 25.0 kg/m2–29.9 kg/m2) and 9 (5%) were obese (BMI >30.0 kg/m2). A total of 720 (98.9%) of TB patients had at least one blood sugar test result. The overall prevalence of DM (n = 184) amongst TB patients was 25.3% (95% CI 22.2%, 28.6%). When stratified, it was 35.0% (30.4%, 39.9%) and 13.0% (9.7%, 17.3%) amongst PTB and EPTB patients respectively. TB patients aged 41–60 years had 3.51 times higher odds (aOR 3.51 (2.08, 6.07)) of having DM than patients 40 years or younger. Patients aged 60 years or older had 2.49 times higher odds (aOR 2.49 (1.28, 4.85)) of having DM than younger patients (<40 years). Females had lower odds (aOR 0.80 (0.46, 1.37)) of developing DM than male TB patients and patients with a history of TB had lower odds (aOR 0.73 (0.39, 1.32)) than newly diagnosed TB patients. Additionally, EPTB patients had significantly lower odds (aOR 0.26 (0.15, 0.43)) compared to PTB patients. Underweight patients also had significantly lower odds (aOR 0.25 (0.14, 0.42)) of having DM than normal weight patients.ConclusionOur study found a higher prevalence of TB-DM than the national average. TB-DM co-prevalence was significantly associated with age, type of TB and undernutrition. As India’s DM prevalence is expected to rise, TB-DM will become an increasingly important part of the TB epidemic requiring specialized study and care.

Prevalence of Human Immune Deficiency among Registered Tuberculosis Patients across Pakistan during 2013-2015&amp;lt;br/&amp;gt;—Prevalence of TB-HIV Co-Infection in Pakistan

The problem of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) co-infection becomes vital when it is seen in the context of under developed countries like Pakistan. Pakistan ranks 5th high burden countries for drug-susceptible and 6th among drug-resistant TB patients [1]. Objectives of the study were to assess the prevalence of TB-HIV Co-infection at the designated Sentinel Sites across Pakistan. A cross-sectional study is based on retrospective record review of routinely maintained TB program data at all 17 designated sentinel sites of TB Control Program from 2013-15. Among the screened TB patients 145 (0.66%) were found HIV reactive. The prevalence of HIV was higher (1.02%) in extra-pulmonary and male TB patients (1.23 %) as compared to pulmonary (0.55%) and female patients (0.09%). Scale up TB surveillance activities, integrating TB-HIV care services, active case finding among key affected populations will have a positive impact on TB-HIV co-infection and disease control.

Prevalence of Tuberculosis in Gambella Regional Hospital, Southwest Ethiopia: A Retrospective Study to Assess the Progress towards Millennium Development Goals for Tuberculosis (2006-2015)

A retrospective study was carried out to evaluate the progress towards millennium development goals and to generate preliminary epidemiological information on tuberculosis (TB) in Gambella town hospital and its surroundings in Southwestern Ethiopia. The medical records of all TB patients registered from 2009 to 2014 were assessed retrospectively. A total of 2519 TB patients were registered for the last 6 years and treated in Gambella Regional Hospital. The sex proportion of male TB patients was 60.18 % (1516/2519). The mean and the standard deviation of age was 23.8±13.18. The age group between 15-44 years in both sexes was most frequently affected with both forms of TB (pulmonary tuberculosis and extra pulmonary tuberculosis), 1660 (65.9%) followed by 0-14 years of age 508 (20.2%). Of 2519 tuberculosis cases registered in the last 6 years, 637(25.3%) of them were extra pulmonary tuberculosis cases and the rest 1884 (74.79%) were pulmonary tuberculosis cases. Out of 2519 TB cases registered during the six years, 1516 (60.18%) were males, and higher tuberculosis cases were registered (χ2 =4.191; p=0.022). The annual trends of TB for both sexes were gradually declined in the last six years. In conclusion, the retrospective study showed that although there was reduction in the number of both pulmonary and extra-pulmonary tuberculosis cases in the study area, what should not be undermined is the importance of regular prognostic evaluation among tuberculosis cases. Hence, we re-emphasize that Tuberculosis Control Program should give attention to control of tuberculosis and HIV-TB co-infection in Gambella Region.