Percentage Of Tuberculosis Research Articles

TREATMENT OUTCOME OF CHEMOTHERAPY AND ANTIRETROVIRAL THERAPY AND COTRIMOXAZOLE PREVENTIVE THERAPY IN TUBERCULOSIS PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS COINFECTION

Objective: In developing countries like India, the fatality rate of tuberculosis (TB) coinfected with human immunodeficiency virus (HIV) is still at high rate and imposes significant challenge among the physicians. The present study was conducted to evaluate management outcomes of combined antiretroviral therapy (ART) and chemotherapy or cotrimoxazole preventive therapy (CPT) in TB/HIV co-infected patients. Methods: The study was conducted on 3512 confirmed TB patients who were treated with ART and CPT therapy. Out of these, HIV positive was 58 cases and HIV negative was 3414 cases. HIV cases the algorithm KHB- Statpak- Unigold were used. Patient started CPT. Results: Percentage of TB and HIV coinfection was 58 and the coinfection was greater in 20–40-year age groups and 2 times higher in PTB sputum-positive cases. Among the extrapulmonary TB cases, 76% took CPT + ART. The treatment success was 86%. Conclusion: Thus, CPT therapy must be established in all centers and compulsory HIV screening must be implicated throughout the country.

Respiratory symptoms in people attended in health facilities of the Ministry of Health in Lima, Peru

The aim of this study was to determine the percentage of symptomatic respiratory (SR) cases, according to the programmatic definition, among people who attend medical offices at first-level health facilities of the Ministry of Health in Lima under normal circumstances. The study also aims at identifying the percentage of patients with tuberculosis among the RS and among coughers over seven days. Cross-sectional study of patients attending consultations at 57 health centers. Patients with cough and phlegm lasting more than seven days and RS were identified and a sputum sample was taken to rule out tuberculosis by smear and culture. A total of 10,421 people was surveyed. A 2.7% had cough with phlegm for ≥7 days and only 1.1% were SR; 215 patients were screened for tuberculosis. Seven (5.9%) of the RS and eight (4.8%) of the patients with a 7-14-day cough had tuberculosis. The percentage of RS in the Ministry of Health's health facilities in Lima was less than the expected 5%, ranging from 0.8% in Callao to 1.5% in Lima City. The percentage of tuberculosis among coughers (lasting 7-14 days) and RS is consistent with the findings of other local studies. Consideration should be given to lowering the RS target to less than 5% and expanding tuberculosis screening to patients with cough ≥7 days at the Health Divisions with high tuberculosis incidence.

Quality Improvement of Tuberculosis Screening in Foreign-Born Patients

In the United States, a disproportionate percentage of tuberculosis (TB) cases occur in foreign-born persons. We implemented a performance improvement project to improve rates of screening for latent tuberculosis infection in a medical clinic. A questionnaire was developed to identify patients for tuberculosis screening, which was performed as a Tuberculin Skin Test (TST). Patients with positive skin tests underwent further testing. One hundred and sixty-five patients were screened, with 58 TSTs ordered and 36 placed. Twenty-seven patients returned to have the TST read with 12 positive. Eleven of these patients had chest X-rays, 2 revealing findings suggestive of active TB. This project identifies the importance of a standardized TB screening process for high-risk patients and identifies barriers to such a process.

Influence of immigration on tuberculosis transmission patterns in Castellón, Spain (2004-2007)

BACKGROUND This study aimed to identify tuberculosis transmission patterns in Castellon in a period of major demographic changes. METHODS A prospective study of patients with positive culture in the province of Castellon over a 4-year period (2004-2007) was carried out. Cases were described by year and nationality and were compared with those reported to the Department of Public Health. We studied the population with available molecular patterns, identified through restriction fragment length polymorphism (RFLP) and analyzed the variables from patient clusters, based on data collected in surveys of the Department of Health and the Laboratory Management Program. RESULTS According to data from the Department of Public Health, the overall rate of tuberculosis per 100,000 inhabitants in the province of Castellon was 15.7 in 2004, 19.9 in 2005, 18.2 in 2006 and 17.5 in 2007. In our laboratory, strains were identified from 301 patients, representing 77% (301/390) of reported cases and 94% (301/321) of reported cases with a positive culture. The percentage of tuberculosis among foreigners increased with age, exceeding 50% in 2007. Molecular studies were available in 95% of patients (286); 58% were Spanish and 42% were foreigners, of whom 54% were Romanians. The cluster percentage was 40%, with 30% of mixed clusters. According to conventional contact studies, 85% of patients in clusters had been considered isolated cases. CONCLUSIONS The increased rate of tuberculosis in Castellon was mainly due to the increasing number of cases among foreigners, mostly Romanians. The availability of molecular studies in all patients with a positive culture allowed us to analyze how and where tuberculosis is transmitted in our province. Forty percent of the patients were grouped into clusters; of these, mixed clusters accounted for one third, indicating the high integration of immigrants in our area.

Influencia de la inmigración en los patrones de transmisión de la tuberculosis en Castellón (2004–2007)

Background This study aimed to identify tuberculosis transmission patterns in Castellón in a period of major demographic changes. Methods A prospective study of patients with positive culture in the province of Castellon over a 4-year period (2004–2007) was carried out. Cases were described by year and nationality and were compared with those reported to the Department of Public Health. We studied the population with available molecular patterns, identified through restriction fragment length polymorphism (RFLP) and analyzed the variables from patient clusters, based on data collected in surveys of the Department of Health and the Laboratory Management Program. Results According to data from the Department of Public Health, the overall rate of tuberculosis per 100,000 inhabitants in the province of Castellón was 15.7 in 2004, 19.9 in 2005, 18.2 in 2006 and 17.5 in 2007. In our laboratory, strains were identified from 301 patients, representing 77% (301/390) of reported cases and 94% (301/321) of reported cases with a positive culture. The percentage of tuberculosis among foreigners increased with age, exceeding 50% in 2007. Molecular studies were available in 95% of patients (286); 58% were Spanish and 42% were foreigners, of whom 54% were Romanians. The cluster percentage was 40%, with 30% of mixed clusters. According to conventional contact studies, 85% of patients in clusters had been considered isolated cases. Conclusions The increased rate of tuberculosis in Castellón was mainly due to the increasing number of cases among foreigners, mostly Romanians. The availability of molecular studies in all patients with a positive culture allowed us to analyze how and where tuberculosis is transmitted in our province. Forty percent of the patients were grouped into clusters; of these, mixed clusters accounted for one third, indicating the high integration of immigrants in our area.

A proposal for applying molecular markers as an aid to identifying potential cases of imported tuberculosis in immigrants

In recent years, the percentage of tuberculosis (TB) cases in immigrants in Spain has increased markedly. In this context, discrimination between cases with potentially imported TB and cases likely to have acquired it by recent transmission after arrival is a basic issue. In this study, we evaluated molecular markers to obtain information on the geographic origin of Mycobacterium tuberculosis (MTB) strains and to determine whether they could help to identify imported TB cases. We analyzed the pks15/1 gene, spoligotype, and MIRU locus 24 in 168 MTB isolates from immigrants of 32 nationalities and from a selection of autochthonous cases. In non-Asian immigrants we could not detect major differences with the autochthonous cases. For the Asian cases, we found some specific features for these markers. pks15/1 was intact in 69% of the Asian patients, but this gene had a 7-bp deletion in all non-Asian and Spanish (non-Beijing) cases. The spoligotype-defined lineages EAI and CAS, and the allele with two repetitions in MIRU locus 24 was found exclusively among Asian immigrants. The analysis of certain bacterial molecular markers could help to discriminate between potentially imported TB cases and those more probably acquired in the host country.

New Route of Importation ofMycobacterium tuberculosisBeijing Genotype

New Route of Importation of<i>Mycobacterium tuberculosis</i>Beijing Genotype

Medical and Social Reality in Chile

732 Extracts from: Allende S, La Realidad Medico-Social Chilena, Santiago, Chile. Ministerio de Salubridad, 1939. Translated by Bruna Galobardes, Department of Social Medicine, University of Bristol, Bristol, UK. Despite every effort to trace and contact copyright holders prior to publication, this has not been possible. If notified we will be pleased to rectify any errors or omissions at the earliest opportunity. from rickets, etc. He also discussed children born in similar circumstances, but brought up in child institutions with hygienic rooms and good diet. The detailed results of this survey are shown in Table 2. Despite the difficulties of observing its full impact, salary, as a determinant of the worker’s life circumstances, clearly has an influence on morbidity. It has an effect on all morbid states that arise from insufficient or deficient nutrition, the development of infectious diseases, cold-related diseases, etc. especially tuberculosis, which is well known as the disease that most seriously affects the working class. Dr Cruz says in this respect, ‘When the conditions of the people are flowering, and housing, nutrition and culture are above the required threshold needed to express its vital characteristics, tuberculosis develops in an endemic form and with low mortality: 7 to 12 per ten thousand inhabitants. On the other hand, when the above conditions are not met, the environment is such that infection progresses, developing and acquiring an epidemic form that brings mortality up to 60 per ten thousand’. ‘In Chile, the big differences in morbidity among workers with adequate pay (less than 1% of secondary school teachers, as reported in Professor Saye’s surveys), those receiving low salaries (4%–5% of workers in industries and farmers, as reported in “Seguro Obrero” the Workers Social Security’s survey) and, to a greater extent, the relatives that do not belong to an association (10%, based on Dr Saye’s survey), clearly show the excess rate of disease.’ Drs A de Paula and E de Benedetti in their work entitled ‘The tuberculosis’ clinics (dispensarios) and their current direction’ reach the same conclusions with respect to the difference between mortality for tuberculosis among the rich and the working classes. They highlight the fact that general measures towards social improvement automatically lead to a decrease in mortality for tuberculosis. Dr Manuel De Viado shows mortality rates for tuberculosis among ‘Caja de Seguro obrero’ (manual workers), the ‘Empleados Particulares’ (self-employed workers), and those of the ‘La Caja de Empleados Publicos y Periodistas’ (civil servant and journalists). The percentage of tuberculosis is much higher among the workers than the employees (among other advantages, employees have a minimum wage fixed by the government, while workers do not have legal protection for Second part. Life circumstances in the working class I. Wages

Pulmonary tuberculosis after gastric resection

Reviewing the charts of tuberculosis patients during a span of seventeen years, we found a large number of gastrectomized patients. In our general hospital population, the incidence of tuberculosis was 3.2 per cent. Among the gastrectomized patients, the percentage of tuberculosis was 6.3 per cent. Of our tuberculosis patients 1.9 per cent had gastrectomy, whereas of our general population 0.67 per cent had gastrectomy. We were unable to arrive at any definite conclusions regarding the causative relationship between gastrectomy and tuberculosis. It is a retrospective study with all the fallacies, but the data do show an extremely significant difference between the incidence of gastrectomy in the general hospital population and the incidence of gastrectomy in histories of patients admitted with tuberculosis. It appears that a patient having gastrectomy runs a considerably greater risk of having tuberculosis in later life than a patient admitted for other reasons. Clinically, we were impressed with the widespread character of the disease in association with the poor nutritional status in the majority of the patients. We, therefore, could not avoid associating the loss of stomach substance with its nutritional function and the development of tuberculosis. As a consequence, we recommend a purified protein derivative test for all patients undergoing gastric surgery. If the test proves to be positive, it is suggested the patient be given a course of isoniazid for one year. In the face of negative purified protein derivative test, we repeat the test at six month intervals. Should a conversion of the purified protein derivative occur, the patient is started on the course of isoniazid therapy. Our current belief is that more conservative methods of gastric surgery, that is, pyloroplasty, vagotomy, or antrectomy, should be substituted for gastrectomy in the treatment of duodenal ulcer disease to preserve a more normal gastric physiologic structure.

Polish Medical Science

THE medical issue of "Polish Science and Learning" (London: Oxford University Press, 1944. 2s. 6d.), which is one of a series of booklets edited by the Association of Polish University Professors and Lecturers in Great Britain, is, its editors state, an attempt to lay a foundation for the future in collaboration with the scientific workers of other nations. The creation of the Polish Medical School and of the Paderewski Hospital in Edinburgh is, as Prof. Jurasz says in his article about them, a symbolic act, a practical demonstration of the determination of the Polish people to continue their national life in spite of all the sufferings of their country; and it demonstrates the existence of practical collaboration between two very different nations. It is perhaps difficult for some Englishmen to realize what hope and encouragement the creation of these two medical centres has meant to the Polish people. Already fifty-three students have graduated from the Polish Medical School. Many civilian students who are unfit for the Polish armed forces have joined it after leaving their schools in Great Britain, and others have got leave from the Army to continue their studies interrupted by the War, while some have gone there from the U.S.S.R. or after their escape from German prison camps. The Paderewski Hospital is devoted entirely to Polish patients and to the training of medical students and graduates. In addition to this hospital provision, valuable work has been done by a Polish sanatorium for tuberculous cases in Great Britain. Established at the end of 1942 at Gallowhill Hall, this sanatorium has now a capacity of one hundred beds and can carry out the best treatment. The majority of Polish cases of tuberculosis are, however, still distributed throughout British hospitals and Polish military hospitals. The percentage of tuberculosis, says Dr. Spitzer, is higher now among Poles in exile than it was in Poland before the War, so that there is urgent need of the developments which are contemplated.

The Tuberculosis Problem in the Mobilization of Military and Naval Personnel

This problem consists very simply of rejecting for military and naval service all those, first, who have tuberculosis in any active form, second, those who have tuberculosis in an inactive form which has any slight likelihood of being reactivated by the exercise and exhaustion concomitant with service in active warfare and, third, those in whom there will be too large a percentage of tuberculosis develop even though perfectly normal at the time of examination. The Government has half solved the first group, that of the active tuberculous, by decreeing that every candidate for the honor of defending his Country have an x-ray examination of the chest, but no provision has been made for x-ray survey of the men now in the services. Bringing in recruits who have been carefully selected and surveyed for tuberculosis elimination, and then mixing them with the unsurveyed group now in the Army and Navy service, is like sorting apples at great expense and upon completion of the procedure, mixing the sound apples with other apples, some of which are rotten. Persistance in such procedure will entitle our Democracy to bear, without complaint, some of the charges of futility made by Totalitarians. X-ray of all Service men, new and old, should eliminate most immediately infectious cases, providing x-ray of known value and not new experimental methods, are used. The only methods that have had any extensive use, and with which any considerable numbers of interpreters of x-ray films have had any experience, are the 14x17 gelatine and paper films. Both are adequate, and only they are proven adequate, for this huge and tremendously important task. E. L. Cooper (Brit. M. J., 2: 245, Aug. 24, 1940), reporting a survey of 9000 Australian Cadets by the 35 mm. film, makes what are apparently contradictory statements. He