New Cases Of Pulmonary Tuberculosis Research Articles

Interaction between air pollutants and meteorological factors on pulmonary tuberculosis in northwest China: A case study of eight districts in Urumqi.

Meteorological factors and air pollutants are associated with the spread of pulmonary tuberculosis (PTB), but few studies have examined the effects of their interactions on PTB. Therefore, this study investigated the impact of meteorological factors and air pollutants and their interactions on the risk of PTB in Urumqi, a city with a high prevalence of PTB and a high level of air pollution. The number of new PTB cases in eight districts of Urumqi from 2014 to 2019 was collected, along with data on meteorological factors and air pollutants for the same period. A generalized additive model was applied to explore the effects of meteorological factors and air pollutants and their interactions on the risk of PTB incidence. Segmented linear regression was used to estimate the nonlinear characteristics of the impact of meteorological factors on PTB. During 2014-2019, a total of 14,402 new cases of PTB were reported in eight districts, with March to May being the months of high PTB incidence. The exposure-response curves for temperature (Temp), relative humidity (RH), wind speed (WS), air pressure (AP), and diurnal temperature difference (DTR) were generally inverted "U" shaped, with the corresponding threshold values of - 5.411 °C, 52.118%, 3.513m/s, 1021.625hPa, and 8.161 °C, respectively. The effects of air pollutants on PTB were linear and lagged. All air pollutants were positively associated with PTB, except for O3, which was not associated with PTB, and the ER values for the effects on PTB were as follows: 0.931 (0.255, 1.612) for PM2.5, 1.028 (0.301, 1.760) for PM10, 5.061 (0.387, 9.952) for SO2, 2.830 (0.512, 5.200) for NO2, and 5.789 (1.508, 10.251) for CO. Meteorological factors and air pollutants have an interactive effect on PTB. The risk of PTB incidence was higher when in high Temp-high air pollutant, high RH-high air pollutant, high WS-high air pollutant, lowAP-high air pollutant, and high DTR-high air pollutant. In conclusion, both meteorological and pollutant factors had an influence on PTB, and the influence on PTB may have an interaction.

Vitamin D as Supplementary Treatment for Newly Diagnosed Pulmonary Tuberculosis patients

Objective: To compare vitamin D with placebo in patients with pulmonary tuberculosis in terms of clinical improvement and sputum conversion. Materials And Methods: This is a prospective randomized, double blind, placebo controlled comparative study conducted for a period of 12 weeks in a tertiary care centre in south India. Total Subjects were 60 new cases of pulmonary tuberculosis who are getting TB treatment initiation, Subjects were randomly allocated into two groups, group A and group B comprising of 30 patients in each group. Group A received vitamin D and group B received placebo. Dosage of vitamin D was 0.25mg/day, given in initial six weeks of antituberculosis drug therapy. Serum level of 25-hydroxyvitamin D was measured at time of diagnosis and at 8 weeks of anti-tuberculous therapy. Measurements of haemoglobin, leukocyte count and serum calcium were done at beginning and repeated at 6th, 8th and 12 weeks. Acid fast bacilli were examined at beginning and on 6th, 8thand 12 weeks. Primary outcome was evaluation of conversion time of sputum smear; secondary outcome was clinical improvement as assessed by TB score. Results: There is no significant difference in mean values of age, haemoglobin level, calcium level,serum Vitamin D, TB score and total lymphocyte count in both groups at start of study.There was no statistical difference in serum calcium level, haemoglobin level and total lymphocyte level at end of study. Mean serum vitamin D level at 8th week of treatment was 27.83±7.09ng/dl in group A and 18.83±2.27 in group B, there was statistically significant difference between two groups. Sixth week sputum conversion in 30 subjects of vitamin D group is 100% and in placebo group, it is 76.7%, which was statistically significant. Conclusion: Supplementary vitamin D when added to first line anti-tuberculous drugs results in shorter conversion time and less severe TB clinical manifestation without any manifestations of hypercalcemia. Therefore, it is recommended to add vitamin D as supplementary treatment to first-line anti-tuberculous drugs in treatment course of active pulmonary TB.

Keterkaitan Pengaruh Iklim Terhadap Angka Kejadian Tuberkulosis Berbasis Web Gis

Management of pulmonary tuberculosis (TB) in Bogor City is still a priority in health care. The high number of TB cases in the Lawang Gintung Health Center area in the 2017-2019 period reached 126 new cases. Where the most new cases were in the Muarasari Village with a total of 52 new cases of TB. This research method uses the spatial interpolation method to determine the distribution of climate and its association with the incidence of new cases of pulmonary TB. Through the development of spatial interpolation GIS, it is known that the pattern of distribution of cases per month in the area of ??the Public Health Center in terms of the relationship between climate and the development of new cases of TB in the area of ??the Lawang Gintung public Health center. Incidence Rate in the region public Health center Lawang Gintung per month during 2017-2019 was highest in February with an IR value of 8.7 per 10,000 people/population. The increase in the IR value in each month is accompanied by an increase in the average value of rainfall (mm²), air temperature (°C), and humidity (%). Where in January the IR value was 2.2, increasing in February to 8.7 with an average rainfall value per month of January 15.4 mm² and in February it increased to 25.3 mm². Followed by increasing the value of air temperature and humidity. Correlation of climate to the incidence of new cases of pulmonary TB in the region public Health center Lawang Gintung is known that rainfall is positive with an R² value of 0.50. Air temperature is negative where R² is 0.01 and humidity is positive with R² value is 0.17.

Sex-differences in socioeconomic status and health-seeking behaviour among tuberculosis patients in transitional Albania in 2012-2013

Aim: There is little scientific evidence about the main determinants of sex discrepancies in tuberculosis rates in Albania. The aim of this study was to assess the sex-differences in socioeconomic characteristics, knowledge and attitudes about tuberculosis and access to health care among tuberculosis patients in Albania, a transitional country in the Western Balkans.
 Methods: Our analysis involved all the new cases of pulmonary tuberculosis diagnosed in Albania during the period June 2012 – June 2013 (N=197; 69% males; overall mean age: 44±19 years). The recording and reporting system of tuberculosis cases was performed according to the WHO and EuroTB Surveillance guidelines. Information on socioeconomic characteristics of the patients, knowledge and attitudes about tuberculosis and access to health care was also collected. Logistic regression was used to assess the correlates of sex-differences among tuberculosis patients.
 Results: In multivariable-adjusted models, female sex was positively related to unemployment (OR=3.7, 95%CI=1.8-7.7), bad living conditions (OR=3.0, 95%CI=1.4-6.5), a longer distance to health care facility (OR=3.0, 95%CI=1.4-6.3), a lower level of knowledge about tuberculosis (OR=3.1, 95%CI=1.3-7.1) and a higher level of stigma against tuberculosis (OR=3.6, 95%CI=1.6-7.9).
 Conclusion: Our study informs about selected correlates of sex-differences in tuberculosis rates in post-communist Albania. Future studies should more vigorously explore determinants of sex-differences in tuberculosis rates in countries of the Western Balkans.

High Pretreatment Level of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio and Other Factors Associated with Delayed Sputum Conversion in Patients with Pulmonary Tuberculosis.

IntroductionPatients with delayed intensive phase sputum conversion have a higher risk of multidrug resistant-tuberculosis (MDR-TB) and poorer treatment outcomes. Both, host (immune response and comorbidity) and pathogen factors play important roles in determining sputum conversion after treatment initiation. Impaired host immune response, especially the cellular components, as defined by the increased pre-treatment level of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and other additional factors, were associated with severe active TB.PurposeTo evaluate whether impaired immune responses (high pre-treatment level of NLR and MLR) and other factors associate with delayed sputum conversion at the end of the intensive phase treatment.Patients and MethodsThis was a case–control study from 2016 to 2020, which retrospectively analyzed the pre-treatment level of NLR, MLR and other factors among patients with new cases of pulmonary tuberculosis (PTB).ResultsA total of 62 patients (31 cases and 31 control). The cut-off value of high pretreatment level of NLR and MLR was 5.065 and 0.585, respectively. Bivariate analysis showed that pretreatment NLR ≥5.065 (OR 8.23, CI 95% 2.48–27.32, p < 0.001), MLR ≥0.585 (OR 10.18, 95% CI 3.13–33.18, p < 0.001) and BMI <18.5 (OR 2.91, 95% CI 1.03–8.20, p = 0.041) were associated with an increased risk of delayed sputum conversion. Multivariate analysis, however, showed that pretreatment NLR ≥5.065 was not significantly associated with delayed sputum conversion (AOR 3.370, 95% CI 0.71–15.91, p value 0.125). A high pretreatment of MLR (AOR 30.802, 95% CI 3.22–287.55, p value 0.003) and lower BMI (AOR 10.942, 95% CI 1.121–98.563, p value 0.033) were significantly associated with an increased risk of delayed intensive phase sputum conversion.ConclusionHigh MLR pretreatment and a low BMI were significantly associated with an increased risk of delayed sputum conversion at the end of the PTB intensive phase treatment. High NLR pretreatment, smoking, diabetes, and HIV were not associated with sputum conversion.

COMPARATIVE STUDY OF CLINICO-RADIOLOGICAL AND MYCOBACTERIAL PROFILE OF PULMONARY TB IN DIABETIC VS. NON DIABETIC PATIENTS AT TERTIARY CARE HOSPITAL

Background: Tuberculosis (TB) is a disease most commonly affecting the lungs caused by mycobacterium tuberculosis, may also affect any parts of the body. Diabetes mellitus (DM) is recognized as a major risk factor for the progression of active pulmonary tuberculosis (PTB). The prole of pulmonary tuberculosis is variable in diabetic vs non diabetic patients .There is scarcity of published comparative literature, therefore this study carried out. This is hospital based prospective observational and comparative study was conducted in admitted patients of MahatmaMethod: Gandhi Medical College &amp; Hospital, Jaipur. All the new cases of pulmonary tuberculosis diagnosed on the basis of clinic-radiological and mycobacterial. All the tuberculosis patients were also screened for diabetes as per criteria and divided in 2 groups PTB-DM &amp; PTB-NDM respectively. Total number of cases of pulmonary tuberculosis in the study was 150, out of which 50 cases with diabetic and 100 casesResults: without diabetic. Male's predominance was in both the groups (70%vs78%). Maximum cases of PTB were in middle age (41-60 years) in both the groups (54% vs51%). There was no signicant difference in respiratory symptoms, mycobacterial positivity and various type parenchymal lesions. However there was signicantly more grade 3 positivity on Z.N staining, lower zone predominance, multiple cavitations and far advance disease in diabetic PTB patients Diabetes is a risk factor &amp; potentially may affect serious implications in management of tuberculosis and TB. Conclusion: control program. Therefore, early detection of diabetes in suspect cases of pulmonary tuberculosis &amp;vice-versa is important in clinical practice &amp; TB control program.

Correlation between serum IL-17 levels with Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) levels of new cases of pulmonary tuberculosis at Sanglah Central General Hospital, Bali, Indonesia

Background: Tuberculosis (TB) is a mycobacterial infection that usually attacks the lungs and triggers lung damage and dysfunction related to the reléase of IL-17, Erythrocyte Sedimentation Rate (ESR), and C-Reactive Protein (CRP). This study aims to evaluate the correlation between serum IL-17 levels with ESR and CRP levels in new cases of pulmonary tuberculosis at Sanglah Central General Hospital, Bali, Indonesia. Methods: A cross-sectional study was conducted among 56 TB patients treated as new pulmonary TB cases in Outpatient and Inpatient Internal Medicine at Sanglah Hospital, Bali, Indonesia. IL-17 levels in this study were the results of IL-17 examination from patient serum using the ELISA method from R&amp;Dsystems with units of pg/mL. The Erythrocyte Sedimentation Rate (ESR) in this study is the rate of blood deposition in mm/hour using a Westergreen tube. Meanwhile, the C-Reactive Protein (CRP) examination was carried out using a Roche 6000 analyzer in mg/dL. Data were analyzed with SPSS version 16 for Windows. Results: Most respondents are female (75.0%) and the 30-34 years old group (26.8%). The mean value of ESR is 40.39±25.86 mm/hour, followed by CRP (9.95±10.01 mg/dL), and IL-17 (15.21±1.20 pg/mL). There is no significant correlation between ESR to CRP (r=0.069; p=0.613) and IL-17 (r=0.135; p=0.323). In addition, there is no significant correlation between CRP and IL-17 (r=0.168; p=0.215). Conclusion: This study's results indicate no significant correlation between IL-17 levels with CRP and ESR or between CRP and ESR.

Integrating landmark modeling framework and machine learning algorithms for dynamic prediction of tuberculosis treatment outcomes.

This study aims to establish an informative dynamic prediction model of treatment outcomes using follow-up records of tuberculosis (TB) patients, which can timely detect cases when the current treatment plan may not be effective. We used 122267 follow-up records from 17958 new cases of pulmonary TB in the Republic of Moldova. A dynamic prediction framework integrating landmark modeling and machine learning algorithms was designed to predict patient outcomes during the course of treatment. Sensitivity and positive predictive value (PPV) were calculated to evaluate performance of the model at critical time points. New measures were defined to determine when follow-up laboratory tests should be conducted to obtain most informative results. The random-forest algorithm performed better than support vector machine and penalized multinomial logistic regression models for predicting TB treatment outcomes. For all 3 outcome classes (ie, cured, not cured, and died after 24 months following treatment initiation), sensitivity and PPV of prediction models improved as more follow-up information was collected. Specifically, sensitivity and PPV increased from 0.55 to 0.84 and from 0.32 to 0.88, respectively, for the not cured class. The dynamic prediction framework utilizes longitudinal laboratory test results to predict patient outcomes at various landmarks. Sputum culture and smear results are among the important variables for prediction; however, the most recent sputum result is not always the most informative one. This framework can potentially facilitate a more effective treatment monitoring program and provide insights for policymakers toward improved guidelines on follow-up tests.

Application of Bottle SOSA And Promotions To Reduce The Risk Of Transmission Of Pulmonary TB In Men's Prison, Deli Serdang District

Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis. A report from the Ministry of Law and Human Rights of North Sumatra Province stated that during the period 2009-2011, new cases of pulmonary TB in prison / remand centers tended to increase every year, the increase was an average of 7.2%. Based on the above background, dedication needs to be done to apply the SOSA bottle along with the promotion of prevention of pulmonary TB transmission in an effort to reduce the incidence of pulmonary TB in assisted residents in the Male Prison, Deli Serdang Regency. Community service activities have been carried out with the socialization of the SOSA bottle application method which is carried out by the method of providing counseling videos and training for the introduction of SOSA bottles as a promotional medium in reducing the risk of pulmonary TB transmission. The WBP was recruited to attend training and become a Training of Trainer (TOT) by forming a peer group of 10 small groups in each prison. It is hoped that the service activities can continue with good cooperation with partners.

The evaluation of sensitive pulmonary tuberculosis deaths

The data of 112 patients who died of tuberculosis during 3 years (2018-2020) in the Municipal Hospital of Phthisiopneumology in Chisinau were studied. The died patients were divided into two groups: 1 group — 73(65,9%) new cases of pulmonary tuberculosis and 2 group — 39(34,8%) re-treatment cases. It was found that 55(75,5%) patients in 1 group and 22(56,4%) from 2 group died from the TB progression and its complications. in the 1 group from other diseases 18(24,7%) patients died and from 2 group — 17(45,6%) cases. in both groups, the age between 41 and more than 60 years predominated, the unemployed, singular status, people with severe forms of tuberculosis (generalized, caseous pneumonia), homeless were 36(32,1%), TB / HIV co-infection 26(23,21%), alcoholism — 58(51,8%) patients. in serious condition from general hospital — 107 (95,5%) patients were transfered and death occurred in 2/3 cases in the first month after admission.

Individual and public health consequences associated with a missed diagnosis of pulmonary tuberculosis in the emergency department: A retrospective cohort study.

To determine: i) the emergency department (ED) utilization history of pulmonary tuberculosis (PTB) patients, and ii) the potential individual and public health consequences of a missed diagnosis of PTB in this setting. Retrospective observational cohort study. Patients with PTB aged >16 years diagnosed between April 1, 2010 and December 31, 2016 in the Province of Alberta, Canada. We identified valid new cases of PTB from a provincial registry and linked them to ED attendees in administrative databases. Visits are considered 'PTB', pulmonary 'other', and non-pulmonary based on the most responsible discharge diagnosis. Individual consequences of a missed diagnosis included health system delay and PTB-related death; public health consequences included nosocomial ED exposure time and secondary cases. Of 711 PTB patients, 378 (53%) made 845 ED visits in the six months immediately preceding the date of diagnosis. The most responsible ED discharge diagnosis was PTB in 92 (10.9%), pulmonary 'other' in 273 (32%) and non-pulmonary in 480 (56.8%). ED attendees had a median (IQR) health system delay of 27 (7,180) days and, compared to non-ED attendees were more likely to die a TB-related death 5.9% vs 1.2%, p = 0.001. Emergency attendees generated 3812 hours of ED nosocomial exposure time, and 31 secondary cases (60.8% of all secondary cases reported). Mycobacterium tuberculosis isolates from ED-attendees were more likely than non-attendees to be clustered-i.e., have an identical DNA fingerprint with another isolate (27% vs. 21%, p = 0.037). ED utilization by PTB patients, and related consequences, are substantial. EDs are a potential resource for earlier PTB diagnosis.

Profile of Adenosine Deaminase (ADA) Level in Active Pulmonary Tuberculosis Patients

Background: Pulmonary tuberculosis (TB) has a risk of increasing the transmission of infection and death may occur if diagnosis is delayed due to limited testing. Faster, more accurate, inexpensive new methods with easy-to-obtain samples, such as serum levels of Adenosine deaminase (ADA), need to be applied. This study aims to compare serum ADA levels in new cases of pulmonary TB patients and in healthy individuals, and to examine the potential of serum ADA to diagnose pulmonary TB. Methods: This study was an observational analytic study conducted at the Outpatient Clinic of TB/TB-MDR-DOTS, Dr. Soetomo Hospital, Surabaya, Indonesia, from August to December 2019. The subjects were new cases of pulmonary TB patients and healthy individuals. Serum ADA levels were analyzed using the enzymatic colorimetric method, using Erba XL 600. Results: A total of 60 patients were divided into 34 new cases of pulmonary TB patients and 26 healthy individuals. Serum ADA levels in new cases of pulmonary TB patients were significantly higher compared to those in healthy individuals (P<0.001). The cut-off value of serum ADA levels was 11.4 U/L with a sensitivity of 85.3% and specificity of 84.6%. Conclusion: ADA serum levels are increased in patients with new cases of pulmonary TB. ADA serum can be used to assist the diagnosis of tuberculosis.

Type 2 Diabetes Mellitus And Hemoptisis Risk Factor In Lung Tuberculosis : A Case Control Study

Background: Diabetes mellitus (DM) is a risk factor for tuberculosis (TB) morbidity and mortality. Increasing cases of type 2 DM in the world increases the risk of developing TB. The frequency of DM in TB patients was reported to be around 10-15% and the prevalence of this infectious disease was 2-5 times higher in diabetic patients compared to non-diabetics. Hemoptysis is a respiratory symptom which can be life threatening. Tuberculosis and bronchiectasis are the two most common ethology of hemoptysis, while TB with DM are the cause of recurrent hemoptysis.&#x0D; Methods: This was case control study which used the medical records data of diabetic patients infected with TB who experienced hemoptysis and no hemoptysis, treated at Fatmawati General Hospital during 2017. Sampling method was total sampling.&#x0D; Results: There were 12 hemoptysis patients with DM comorbidity and 31 patients without DM comorbidity. As many as 58% of patients with DM had new cases of pulmonary TB and 42% had history of treatment completion. The correlation between hemoptysis of TB patients with DM compared to without DM obtained a relative risk of 1.535 (95% CI=0.677-2.618)&#x0D; Conclusion: The proportion of hemoptysis in TB patients with DM comorbidity was 10.3%. Diabetes Mellitus was a risk factor for hemoptysis 1.535 times higher compared to TB patients without DM but statistically not significant. (J Respir Indo. 2020; 40(3): 144-9)

Comparison of the effectiveness of treatment of patients with pulmonary tuberculosis in conditions of TB system restructuring

Objective — to study the dynamics of the effectiveness of the treatment of patients with pulmonary tuberculosis in the Sumy region for 2011—2018.Materials and methods. The authors analyzed the effectiveness of the treatment of two groups of patients. Group I included 2973 patients with new cases of pulmonary tuberculosis with bacterial excretion, which was confirmed by microscopy of sputum smear or by bacteriological method. The second group consisted of 998 patients with relapses of pulmonary tuberculosis with bacterial excretion, which was confirmed by microscopy of sputum smear or bacteriological method. Each group has divided into subgroups «a», which includes patients registered during 2011—2014 and subgroup «b» registered during 2015—2018.Results and discussion. Over the past eight years, the effectiveness of treating patients with the first diagnosed bacillary tuberculosis has decreased from 72.3 % in 2011 to 58.1 % in 2018. Among the patients of the Ia subgroup died 75 (5.5 %) patients, which is less than 1.2 times than in the Ib subgroup — 106 (6.5 %) — (p &gt; 0.05). Unsuccessful treatments (by smear or clinical and radiological findings) in patients with Ia and Ib subgroups were 8.7 and 8.9 % respectively (p &gt; 0.05). The percentage of first identified patients transferred to category 4 increased from 6.5 % in 2011 to 25.7 % in 2018 (p &lt; 0.05). Among 432 patients with recurrent bacillary tuberculosis of the IIa subgroup, effective treatment had recorded in 169 (39.1 %) people. In the studied group IIb, the effectiveness of treatment had established in 198 (35.0 %) (p &gt; 0.05). Unsuccessful treatment (according to microbiological and clinical, radiological studies) among patients of IIa and IIb subgroups had recorded in 9.7 and 6.7 %, respectively (p &gt; 0.05). In the IIa subgroup, 128 (29.6 %) patients had transferred to 4 categories, and four years later, 270 (47.7 %) in the IIb subgroup (p &lt; 0.001).Conclusions. The effectiveness of the treatment of the first detected bacillary patients with pulmonary tuberculosis in the Sumy region in 8 years decreased by 1.2 times. The effectiveness of the treatment of patients with recurrent bacterial pulmonary tuberculosis has fluctuated within 40 % over the last decade. In the structure of «effective treatment» of patients with newly diagnosed tuberculosis and relapse of tuberculosis, the results of «treatment completed» prevail every year, which means that patients are transferred to category 5.1 only because they have just received all doses of drugs. Due to the increase of Mycobacterium tuberculosis resistance to anti tuberculosis drugs, patients are transferred to 4 categories of observation four times more often with the first detected tuberculosis, with recurrent — 1.9 times.It is evidence of a decrease in the effectiveness of the treatment of patients with newly discovered and recurrent bacillary tuberculosis in recent years.

Relationship between multimorbidity and the outcome of the treatment for pulmonary tuberculosis.

To analyze the influence of multimorbidity on the treatment outcome of new cases of pulmonary tuberculosis. A population-based analytical study, using secondary data, collected from the database of the Notification Disease Information System, of new cases of pulmonary tuberculosis in the state of Rio Grande do Sul between 2013 and 2016. The relationship between multimorbidity and the outcome was analyzed with Multinomial Logistic Regression. Multimorbidity was present in 37.0% of the cases. Of these, the Relative Risk (RR) was 1.7 for treatment abandonment and 2.9 for death. HIV had an RR of 2.1 for dropout and of 3.9 for death. The higher the number of comorbidities, the higher the RR for unfavorable outcomes. Multimorbidity influences on unfavorable outcomes of the treatment for tuberculosis.

Changes of serum adenosine deaminase level in new cases of pulmonary tuberculosis before and after intensive phase treatment.

Background and Objectives:Tuberculosis (TB) continues to be a public health crisis with an estimated 10 million people developing TB disease in 2017. Adenosine deaminase (ADA) level in serum and pleural fluid as a biomarker may be used to diagnose pulmonary TB (PTB), but it is not always easy to obtain those samples at the end of treatment. This study was conducted to analyze the changes of serum ADA level in the new case of PTB patients with acid-fast bacilli (AFB) smear-positive sputum and sputum conversion status as treatment monitoring in PTB patients.Materials and Methods:This was a prospective observational analytic study conducted in Dr. Soetomo General Hospital, Surabaya, from January 2018 to May 2018. Participants were all new cases of PTB patients with AFB smear-positive sputum, and a positive rapid molecular test for Mycobacterium tuberculosis. Blood serums were taken at the same time on the 1st day of TB treatment and also taken at the end of intensive phase treatment to analyze the changes of serum ADA level.Results:There were 26 TB patients and 26 healthy control people. Serum ADA level at the beginning of TB treatment was higher than the level at the end of intensive phase treatment. There was a significant difference between serum ADA level before and after the intensive phase of TB treatment (P < 0.001).Conclusions:The examination of serum ADA levels can be used to evaluate the PTB treatment response.

Primary drug resistance in pulmonary tuberculosis cases by standard proportion method and BACTEC radiometric method

OBJECTIVE: The objective was to study anti-tubercular drug susceptibility level among 'newly diagnosed' pulmonary tuberculosis (TB) cases by two methods of drug sensitivity testing i.e., standard proportion method (SPM) and BACTEC radiometric method. MATERIALS AND METHODS: Sputum samples from fifty new cases of pulmonary TB were cultured and subjected to antitubercular drug susceptibility testing by using conventional SPM and radiometric method (BACTEC 460 TB system) and compared. RESULTS: Monoresistance was found to be 2%, 8%, 0% and 2% for Streptomycin (S), Isoniazid (H), Rifampicin® and Ethambutol (E), respectively. Any resistance (with or without resistance to other drugs) was 4%, 28%, 10% and 16% for S, H, R and E, respectively. Primary multidrug resistance was 10% (5/50) namely H + R, 6% (3/50); H + R + E, 2% (1/50); H + R + S, 0% (0/50) and H + R + E + S, 2% (1/50). H + E resistance was found in 10% (5/50) of isolates. CONCLUSION: Comparing with other studies, the levels of H, R and multi drug resistance (MDR) were within the expected levels in our study. However, more number of similar studies on drug resistance need to be undertaken regularly to assess the changing trends.

Fungal isolates findings of sputum samples in new and previously treated cases of pulmonary tuberculosis in dr. soetomo hospital surabaya, Indonesia.

Fungal infections generally occur in immunosuppressive patients. Long-term tuberculosis (TB) treatment facilitates the occurrence of fungal infections, such as long-term antibiotics administration which is immunosuppressive agents and increases the opportunity of infections. Other factors may be correlated with fungal infection such as age, sex, malnutrition, smoking, diabetes mellitus, lung lesion severity, and the presence of multidrug-resistant TB. This study aims to identify and analyze the proportion of fungal isolates findings in the sputum of new and previously treated cases of pulmonary TB patients. This was an observational analytic study with a cross-sectional design of all pulmonary TB patients who were hospitalized in Dr. Soetomo Hospital Surabaya. Sputum samples were inoculated on Sabouraud's dextrose agar medium. The growth of visible colonies was identified by Lactophenol Cotton Blue staining using direct microscopy. Fungal isolates were found in 148/193 (77%) pulmonary TB patients. Candida species was found 99% among 148 fungal positive culture. Candida albicans was the most common found fungal species (54.05%), followed by Candida sp (26.35%), Candida glabrata (10.13%), Candida krusei (5.4%), and Candida tropicalis (1.35%). Previously treated cases, sex, malnutrition, and smoking were variables correlated with fungal isolates finding with P value of 0.015, 0.006, 0.010, and <0.001, respectively. The proportion of fungal positive cultures in previously treated cases was higher than in new cases. C. albicans was the most common fungal species both in previously treated cases and new cases of pulmonary TB.

Pulmonary tuberculosis in healthcare workers of the North-West Federal District

The purpose of this study was to investigate trends of morbidity and course of pulmonary tuberculosis in healthcare workers at the North-West Federal District during the period of 2000 – 2017. Methods . This is a retrospective study. Medical records of North-West Federal Research Center of Hygiene and Public Health from the years 2000 – 2017 were analyzed. Results . Cases of pulmonary tuberculosis in healthcare workers were included in the analysis. The highest morbidity of pulmonary tuberculosis was registered in 2006 (19%), 2007 (16%) and 2010 (21%). Information on habitation of tuberculosis patients was of particular interest. Physicians (34%), nurses (54%), cleaning personnel (7%) and technicians (5%) were among healthcare workers with pulmonary tuberculosis. Tuberculosis was diagnosed during preventive examination in 48% and at presentation in 52% of cases. Conclusion . Majority of new cases of pulmonary tuberculosis in healthcare workers were diagnosed at presentation with advanced clinical symptoms. This situation is associated with an increased risk of the infection spread. Preventive measures should be developed in order to diagnose tuberculosis in an earlier stage.

Physical Environmental Factors and Its Association with the Existence of Mycobacterium Tuberculosis: A Study in The Working Region of Perak Timur Public Health Center

In 2017, Surabaya District Health Office reported an increasing number of new cases of pulmonary tuberculosis in the working region of of East Perak Surabaya Public Health Center (Puskesmas) and was reported as the highest rates of tuberculosis cases in Surabaya. Pulmonary tuberculosis can be transmitted through ambient air contamination initiated by the presence of Mycobacterium tuberculosis. This study aims to determine the association of physical environmental factors (temperature, humidity, lighting, ventilations’ size, floor materials, walls, ceilings, and density) in the presence of Mycobacterium tuberculosis in the air. This research is an observational analytic study with case control study design. The study sample consisted of 21 households/realtives of patients diagnosed with Pulmonary TB positive. The data was obtained from completed questionnaires by respondents, direct observation and laboratory examination of the presence of Mycobacterium tuberculosis in the air. Data analysis was conducted by Chi-square test supported by Fisher's Exact Test test. The results showed that the significant association between physical environment variables of temperature variables (p-value= 0,000), humidity (p-value= 0,000), lighting (p = 0,000), with the existence of mycobacterium tuberculosis inside of the room. While insignificant association was detected for the variables of ventilation (p = 0.397), floor materials (p = 0.229), the walls materials (p = 0.338), the ceiling condition (p = 0.331), and the dwellers density (p = 0.611), with the presence of Mycobacterium tuberculosis in the air of the common room this current study concludes that there is a significant association between temperature, humidity, and illumination with the presence of Mycobacterium tuberculosis in ambient of common room. Transmission of tuberculosis can be eliminated by using face masks, Despite the previous satisfied level of knowledge, the family behavior and practices when in contact with patients were insufficient to prevent pulmonary TB transmission.