Positive Pulmonary Tuberculosis Cases Research Articles

Spatial-temporal distribution characteristics of etiologically positive pulmonary tuberculosis in Jiangsu Province from 2011 to 2021

Objective: To analyze the spatial-temporal distribution of etiologically positive pulmonary tuberculosis (PTB) at the county (city, district) unit in Jiangsu Province from 2011 to 2021 to provide evidence for the implementation and adjustment of prevention and control strategies of PTB in Jiangsu Province. Methods: The registration data of etiologically positive PTB patients in Jiangsu Province from 2011 to 2021 were collected from the Tuberculosis Management Information System in the China Information System of Disease Control and Prevention. Data on the permanent population were from the statistical yearbook of each county (city, district) in Jiangsu Province. Geoda 1.18.0 software was used to analyze the global and local spatial autocorrelation and explore the spatial clustering. SaTScan 10.1 software was used to analyze the spatial-temporal clusters, and ArcGIS 10.7 software was used to visualize the spatial-temporal clusters. Results: A total of 128 240 etiological positive PTB cases were registered in Jiangsu Province from 2011 to 2021, with an average annual registration rate of 13.99/100 000. The registration rate showed an overall upward trend (trend χ2=63.49, P<0.001) after 2017, and the etiologically positive rate showed an overall upward trend (trend χ2=3 710.86, P<0.001). The annual Moran's I values ranged from 0.107 to 0.343, which showed a spatial clustering distribution. The results of local spatial autocorrelation analysis showed that there were "high-high" clustering areas in Jiangsu Province each year, showing a dynamic distribution, and most of the areas were distributed in the central and southern regions of Jiangsu Province, with the largest number (7) in 2015 and the smallest number (1) in 2011. A total of 4 spatial-temporal clustering areas were explored by spatial-temporal scanning analysis (all P<0.001), among which the first-level clustering area covered 3 counties (cities, districts), namely Changshu, Taicang, and Xiangcheng District of Suzhou, and the clustering time was from 2011 to 2015. The secondary clustering areas covered 24 counties (cities, districts), mainly covering Jiangsu's central and northern regions, such as Huai'an, Suqian, and Yancheng. The third-level clustering areas covered 26 counties (cities, districts); the fourth-level clustering area was the Gaochun District of Nanjing, with the clustering period from 2017 to 2021. Conclusions: From 2011 to 2021, the etiologically positive PTB registration rate at the county (city, district) level in Jiangsu Province had obvious spatial-temporal clustering characteristics. The clustering areas included the northern areas with relatively backward economies and the southern areas with better economic development. Multiple measures should be taken to prevent and control PTB according to the specific situation in different regions.

Epidemiology, treatment outcome and resistance profile of pulmonary tuberculosis cases at the Niamey national anti-tuberculosis center in Niger: a retrospective study.

tuberculosis remains a major public health problem, with continuing high levels of prevalence, and mortality. In Niger, the incidence of tuberculosis remains high. This study aims to investigate the epidemiology of pulmonary tuberculosis at the National Anti-Tuberculosis Center of Niamey in Niger. this study used a quantitative approach with a retrospective and descriptive design. Data were obtained from positive pulmonary tuberculosis cases detected by microscopy on Ziehl-Neelsen stained sputum at the National Anti-Tuberculosis Center (NATC) in Niamey, Niger covered the period between June 2017 and January 2020. 955 pulmonary TB patients were recorded whose diagnosis was based either on clinical-radiological arguments (thus negative microscopy) or positive microscopy. This form was used to collect data recorded in the clinical case registers, registers, and Excel files of the GeneXpert platform of the NATC laboratory. eighty-nine-point eleven percent (89.11%) of the patients were microscopy-positive. Among the study population, men were the most affected by tuberculosis with 80.03%. The 25-34 age group, representing 23.77%, was the most affected. 6.93% of patients were co-infected with tuberculosis and HIV. All patients were put on treatment, with a therapeutic success rate of 72.38% and a therapeutic failure rate of 10.95%. Among the cases of therapeutic failure, 80.90% had Mycobacterium tuberculosis complex detected and 27.14% were resistant to Rifampicin. Niger continues to have a tuberculosis epidemic which requires monitoring. Improving the diagnostic system for more effective management of the disease is important for appropriate diagnosis and treatment.

Burden of type 2 diabetes among pulmonary and extra pulmonary tuberculosis patients diagnosed in a tertiary care institute in Puducherry

Background: Most often diabetes and tuberculosis present together and complicate each other at many levels. Studies show people with diabetes were at three times higher risk of developing tuberculosis. Study done in Kerala have reported that the prevalence of diabetes is higher among males and among smear positive pulmonary tuberculosis cases. Objective was to measure the burden of type 2 diabetes mellitus among pulmonary and extra pulmonary tuberculosis patients diagnosed in a tertiary care institute in Puducherry. Methods: Data was obtained from National tuberculosis elimination programme (NTEP) referral register of Pondicherry Institute of Medical Science. All the patients who have diagnosed to have tuberculosis from January 2022 to July 2022 were included. Diabetic status among pulmonary and extrapulmonary tuberculosis patients was also collected. Results: Among the patients with tuberculosis, 67% of patients were males. A total of 38.8% of cases were found to have diabetes and out of these cases, 23.8% of patients were known case of diabetes and 16.4%of cases were patients with newly diagnosed diabetes. It is observed that, among patients with pulmonary tuberculosis, 32.8% of cases and among patients with extrapulmonary tuberculosis 5.9% of cases were found to have diabetes. Conclusions: The present study showed that burden of type 2 diabetes mellitus was more among pulmonary tuberculosis.

Tuberculous Meningitis in Male Child and Cavitary Pulmonary Tuberculosis in Mother: Concurrent Familial Infective Disease as Evidence of Recent Transmission from Mother to Baby!

Tuberculosis (TB) is one of the leading causes of mortality in children worldwide, but there remain significant challenges in diagnosing and treating TB infection and disease. Tuberculous (TB) meningitis is the commonest infectious disease of the central nervous system in paediatric and geriatric cases. Childhood TB is an indication of failing TB control in the community. It allows disease persistence in the population. Tuberculosis can be prevented in children by diagnosing and treating cases of active TB amongst adults, as paediatric cases always acquire it passively from household contact of adults suffering from TB as disease in adults is multibacillary. Although significant data is available for the prevention of childhood extra-pulmonary and disseminated TB, offering Bacillus Calmette-Guerin (BCG) vaccination, it is still not routinely offered during vaccination. In this case report, a two-year child with a history of failure to thrive and constitutional symptoms diagnosed with disseminated extra-pulmonary TB presenting as TB meningitis with a history of contact with the mother suffering from active sputum positive pulmonary TB receiving anti-TB treatment. Child was evaluated with CT brain plain and contrast and documented meningeal enhancement. Cerebrospinal fluid analysis revealed tuberculous etiology in presence of lymphocytic predominance and raised ADA level in fluid. CSF fluid sent for cartridge based nucleic acid amplification test documented MTB genome with rifampicin sensitivity. We retrospectively analysed mothers’ sputum examination and observed higher grades of sputum AFB and her cartridge based nucleic acid amplification test revealed MTB genome with rifampicin sensitivity. Child and mother were treated with standard protocol recommended by NTEP (National Tuberculosis elimination program). In conclusion, we recommend BCG vaccination to all newborns, and tuberculin skin testing and isoniazid prophylaxis to the contact of adults with sputum positive pulmonary TB cases in India to prevent transmission of disease from mother to baby. A high index of suspicion is must while evaluating these cases and all possible measures should be taken to confirm tuberculosis to have successful treatment outcome.

High proportion of RR-TB and mutations conferring RR outside of the RRDR of the rpoB gene detected in GeneXpert MTB/RIF assay positive pulmonary tuberculosis cases, in Addis Ababa, Ethiopia.

Globally, TB is the leading cause of infectious disease morbidity and mortality with many diagnostic uncertainties. Access to affordable and rapid diagnostics remained a major challenge for many developing countries which bear the greatest burden of TB delaying the initiation time to treatment. This study aimed to assess the GeneXpert MTBRIF assay probe utility for the detection of pulmonary TB and Rifampicin-resistant TB cases in Addis Ababa, Ethiopia. A cross-sectional study was performed from October 2019 to July 2020 in Saint Peter TB Specialized Hospital in Addis Ababa metropolitan area, Ethiopia. This study enrolled 216 clinically suspected new presumptive pulmonary TB cases confirmed by GeneXpert MTB/RIF Assay. Sociodemographic and clinical characteristics were captured using a structured tool. Data were entered in Microsoft Excel 2019, checked for inconsistency, cleaned promptly, and exported to IBM SPSS Statistics for Windows, Version 26.0. Armonk, N.Y: IBM Corp, the USA for analysis. Descriptive analysis and binary and multivariate logistics regression were performed and all statistical significance was determined at a 95% confidence level. The majority of the study participants, 55.1% [119/216] were males aged 6-80 years. The prevalence of RR MTB was 11.11% [24/216]. A higher proportion of RR TB was found in female patients [54.2%, 13/24], in patients in the age group of 30-50 years [45.8%, 11/24], in married individuals [62.5%, 15/24], in persons whose residence is urban [79.2%, 19/24], in persons who had a previous history of TB symptoms [100%, 24/24], in persons who had a history of contact with active and LTBI [33.3%, 8/24], and in persons who had a history of HIV and IDUs [41.7%, 10/24]. Occupation (AOR 22.868, 95% CI 1.655-316.022, p = 0.019), history of previous PTB+ (AOR 4.222, 95% CI 1.020-17.47, p = 0.047), and history of HIV and IDUs (AOR 4.733, 95% CI 1.416-15.819, p = 0.012) were independent predictors associated with RR-TB emergence. The commonest mutation 62.5% [15/24] was found in probe E (codons 529-533) region. There was no mutation associated with probe A (codons 507-511), probe B (codons 511-518), and probe C (codons 518-523) regions, as well as no combination of missed probes, was revealed. However, 12.5% [3/24] of RR TB patients were found without unidentified missed probe types detected outside of the RRDR. The delta Ct max was >4.0 and the highest proportion of 35.6% [77/216] RR TB was detected in samples of medium DNA load. The proportion of RR-TB we observed in this study was high. Similarly, a higher proportion of RR TB was detected outside of the RRDR. Moreover, a significant number of the GeneXpert MTB/RIF Assay probes were identified as unhybridized and this critical observation would mean that most of the probes had no or minimal utility in this geographical region. This calls for further studies to uncover mutation in the rpoB gene conferring RR and reshape TB triage and definite diagnostic algorithm in Ethiopia.

Analysis of epidemiological characteristics of pulmonary tuberculosis patients in Fengtai District, Beijing City from 2011 to 2021

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Fengtai District from 2011 to 2021. Methods: A retrospective study was conducted, the data of PTB patients in Fengtai District from 2011 to 2021 were collected in Chinese disease prevention and Control Information System, which included etiological classification, gender, age, occupation, onset time, demographic information etc. the epidemiological characteristics of reported PTB patients was analysis. Results: A total of 10 342 cases of PTB were reported from 2011 to 2021 in Fengtai District, with an average annual reported incidence rate of 42.87/ 100 000. The incidence rate was the highest in 2012(75.89/100 000), and significantly declined from 2013, which declined to 29.70/100 000 in 2017. It showed a slow rise from 2018 to 2021. The difference was statistically significant (χ2=1 471.77,P<0.001).There were 2 975 cases of etiologic positive PTB from 2011 to 2021, and 76 cases of Rifampicin-resistant PTB from 2017 to 2021. The ratio of male cases to female was 1.75, the average annual incidence rate of male (53.94/100 000) was higher, than female(31.57/100 000).(χ2=704.01,P<0.001). Among all age groups, 25-29 years group, 20-24 years group and 30-34 years group had the highest proportion, which were 1 506 cases (14.56%) , 1 292 cases (12.49%) and 1 024 cases (9.90%) respectively. The average annual incidence rate was the lowest in the group less than 10 years old (1.43/100 000), and the highest in the group 85 years old and over (195.20/100 000), the difference was statistically significant(χ2=3164.24, P<0.001). The top occupations from high to low were housework and unemployment (2 917 cases, 28.21%), retirees (2 308 cases, 22.32%), workers (1 047 cases, 10.12%), cadres and staff (950 cases, 9.19%), farmers (860 cases, 8.32%), business services (698 cases, 6.75%), teachers and students (455 cases, 4.40%). Conclusion: From 2011 to 2021, the incidence rate of PTB was decreased from 2012 to 2017, and slowly increased lately in Fengtai District. The epidemiological characteristics of PTB vary in different age and gender.

A STUDY ON PREVALENCE OF ACTIVE PULMONARY TUBERCULOSIS IN NATIONAL CAPITAL REGION (NCR), INDIA.

The objective of this study is to know the prevalence of Pulmonary TB in cases brought to tertiary care hospital with specication of age and gender. Material &amp;Method- Results &amp; Discussion-Sputum acid-fast bacilli (AFB) smear microscopy was done by Ziehl-Neelsen (ZN) method. The study is carried out on 194 total valid samples .5.15% of total samples are found positive for pulmonary TB. 3.22% of male and 8.57% of female are positive. 7.84% out of male patients are positive in the age bracket of 41-60 years where as positive cases are present in all age bracket in female patients. The maximum cases are recorded in female patients in age group of 21-60 years. The pulmonary TB was higher (5.33%) in hospitalised (IPD) patients in comparison to OPD patients (4.54%). Out of IPD cases 4.16% male and 7.40% female patients are found positive. The results of this study depict the maximum share of positive pulmonary TB cases are female patients. The positive cases from the OPD patients are 4.54% which is lesser than IPD cases(5.33%). Female patients in OPD recorded highest 13.33% positive cases. 5.15% samplesConclusion- out of tested samples are found positive . The percentage of positive cases of pulmonary TB out of tested samples in present study is higher than that of national average(4.2%) but lower than state (UP) average (10.8%).Female share of positive cases is 8.57% whereas male positive cases are 3.22%. The male positive patients are only in the age bracket of 41-60 years. Female patients in OPD recorded highest 13.33% positive cases.

Spoligotyping of Clinical Isolates of Mycobacterium tuberculosis Complex Species in the Oromia Region of Ethiopia.

BackgroundTuberculosis (TB) is a leading cause of morbidity and mortality in Ethiopia. Investigation of the Mycobacterium tuberculosis complex (MTBC) species circulating in the Ethiopian population would contribute to the efforts made to control TB in the country. Therefore, this study was conducted to investigate the MTBC species and spoligo patterns in the Oromia region (central) of Ethiopia.MethodsA cross-sectional study design was used to recruit 450 smear positive pulmonary TB (PTB) cases from the Oromia region between September 2017 and August 2018. Mycobacteria were isolated from sputum samples on the Lowenstein Jensen (LJ) medium. Molecular identification of the isolates was performed by spoligotyping. The results of spoligotyping were transferred into a query box in the SITVIT2 database and Run TB-Lineage in the TB Insight website for the identification of spoligo international type (SIT) number and linages of the isolates, respectively. Statistical Product and Service Solutions (SPSS) 20 was applied for statistical analysis.ResultsThree hundred and fifteen isolates were grouped under 181 different spoligotype patterns. The most dominantly isolated spoligotype pattern was SIT149 and it consisted of 23 isolates. The majority of the isolates were grouped under Euro-American (EA), East-African-Indian (EAI), and Indo-Oceanic (IO) lineages. These lineages consisted of 79.4, 9.8, and 9.8% of the isolates, respectively. One hundred and sixty-five of the isolates were classified under 31 clustered spoligotypes whereas the remaining 150 were singleton types. Furthermore, 91.1% of the total isolates were classified as orphan types. Clustering of spoligotypes was associated (p < 0.001) with EAI lineage.ConclusionSIT149 and EA lineage were predominantly isolated from the Oromia region substantiating the findings of the similar studies conducted in other regions of Ethiopia. The observation of significant number of singleton and orphan spoligotypes warrants for additional genetic typing of the isolates using method(s) with a better discriminatory power than spoligotyping.

The Prediction Number of Smear Acid Resistant Bacteria on Positive Pulmonary Tuberculosis Infection Disease at Madiun City in 2021 to 2025

Tuberculosis (TB) is an infectious disease caused by Mycobacterium Tuberculosis Bacillus. The disease spreads in the air when people contract TB bacteria, such as coughing or sneezing. The lack of ability to anticipate the incidence of Acid Resistant Bacteria Positive Pulmonary TB in Madiun City is affected by the time and number of events that have not been appropriately foreseen. There is no map of regional vulnerability based on the time of occurrence. Hence, the incidence of Acid Resistant Bacteria Positive Pulmonary TB in Madiun city increases, determined by the total number of cases in 6 health centers, seven hospitals, and one prison. In 2015, there were 174 cases, then in 2019, 706 cases. The objective of this study is to predict the number of Acid Resistant Bacteria Positive Pulmonary TB suffering in 2021-2025 based on gender, health centers, and prisons in Madiun City and the overall incidence of cases in 2015-2019 is then foreseen in 2021 to 2025. This type of research is descriptive study research by employing Eviews with the ARIMA method. The population and samples in the study were all data of Acid Resistant Bacteria Positive Pulmonary TB case encompassing the sex of patients during 2015-2019 in Madiun City. The study aimed to predict the incidence of Acid Resistant Bacteria Positive Pulmonary TB in 2021-2025. The results of this study revealed the projection of Acid Resistant Bacteria Positive Pulmonary TB cases based on gender, health centers, hospitals, and prisons in Madiun City from 2020-2025, which experienced an increasing trend with the number of 933, 992, 1063, 1120, 1190 incidences respectively. This study is recommended for relevant agencies or health services to perform preventive efforts by involving trained policymakers and Health Cadis, particularly in preventing TB disease and reducing the high rate of predicting positive pulmonary TB smear incidences in the future.

Study of spectrum of fungal isolates in the sputum of newly diagnosed pulmonary tuberculosis patients.

Tuberculosis is a state of immunosupression which exposes the patients to further opportunistic pathogens like fungus. Methods: 102 newly diagnosed sputum positive pulmonary tuberculosis cases were enrolled. Significant fungal isolates were seen in 31/102 (30.4%) patients. Aspergillus spp. were isolated in 13/31(41.9%) of the positive fungal cultures while Candida spp. were isolated in 15/31 (48.4%). Low body mass index, duration of symptoms, haemoptysis, severity of radiological features and IgG Aspergillus antibodies were independent risk factors for positive fungal culture. Significant proportion of patients with PTB have fungal colonisation of their airways which can lead to poor clinical outcomes. Few easily ascertained clinical parameters can help the clinician to determine patients who are at a higher risk of fungal colonisation.

‘Student centered approach’ in implementing community based active case finding for tuberculosis in rural, Puducherry – A qualitative evaluation

BackgroundAs a part of Competency Based Medical Education (CBME) the competencies related to Communication skills, survey technique, can be improvised by exposing the students in community based Active Case Finding for Tuberculosis which helps in sustaining the activity. MethodsCommunity based house-to-house survey using “Student centered approach” was carried out to identify Presumptive TB cases as per the program definition among fourteen villages covered by Thirubhuvanai, Primary Health Centre. The team comprised of trained MBBS student, medical interns supervised by Post graduates, Medical social workers posted at the Department of Community Medicine, of a medical college, Puducherry. After training Mobile based application (Epicollect5) was used for survey. Feedback from students were obtained to explore their experience from ACF. Free listing and pile sorting was done among interns to explore their experience on Epicollect using Visual Anthropic software. ResultsThe major learning of the medical students from ACF activities were communication skills, rapport building with the community people, Screening for TB and their problem. Free listing identified 14 salient variables depending on the cut-off value of 0.083 (Smith's Salience Score) and subjected to pile sorting. Cognitive map identified their experiences into three categories namely knowledge on TB screening, uses of Epicollect and paper-based questionnaire. Totally 19,134 households were screened, among them 77 presumptive TB cases were identified, three positive pulmonary TB cases were detected and linked to TB care pathway. Conclusion“Student centered approach” proved to be effective strategy in ACF for TB from student's reflection. This rigorous ACF outreach activity shares dual benefits individual and community level benefit and also programme level benefits. Implementing this approach of involving MBBS students in ACF activity was successful and it is feasible to continue every year propounded by National TB Elimination Program (NTEP) guidelines.

Time and risk factors for death among smear-positive pulmonary tuberculosis patients in the Health District of commune VI of Bamako, Mali, 2016

BackgroundThe End Tuberculosis (TB) Strategy aims to achieve 90% reduction of deaths due to TB by 2030, compared with 2015. Mortality due to tuberculosis in Mali was 13 per 100,000 inhabitants in 2014 and 11 per 100,000 inhabitants in 2017. Risk factors for death are not known. The objective of this study was to determine the time and risk factors for death in pulmonary TB patients with positive microscopy.MethodsWe conducted a retrospective cohort study from October to December 2016 in Commune VI of Bamako. Smear positive cases pulmonary tuberculosis from 2011 to 2015 were included. We reviewed the treatment registers and collected sociodemographic, clinical, biological and therapeutic data. Median time to death and hazard ratio (HR) were estimated by the Kaplan-Meier method and a Cox regression model, respectively.ResultsIn total, we analysed 1362 smear positive cases of pulmonary TB including 104 (8%) HIV positive and 90 (7%) deaths. The mean age was 36 ± 13 years, the sex ratio of males to females was 2:1. Among the deaths, 48 (53%) occurred during the first 2 months of treatment. Age ≥ 45 years (HR 2.09 95% CI [1.35–3.23]), weight < 40 kg (HR 2.20 95% CI [1.89–5.42]), HIV unknown status (HR 1.96, 95% CI [1.04–3.67]) and HIV-positive (HR 7.10 95% CI [3.53–14.26]) were significantly associated with death.ConclusionsThe median time to death was 2 months from the start of treatment. Independent risk factors for death were age ≥ 45 years, weight < 40 kg, unknown and positive HIV status. We recommend close monitoring of patients over 45 years, HIV testing in those with unknown status, an adequate care for positive HIV status, as well as a nutritional support for those with weight below 40 kg during the intensive phase of TB treatment.

Pattern of chest radiographic abnormalities and co-morbidities in newly detected sputum positive pulmonary tuberculosis cases

Background: Tuberculosis (TB) is an airborne communicable disease which one of the leading causes of morbidity and deaths worldwide (ranking above AIDS).1 Probability of detecting AFB on sputum is greatly associated by the radiological findings.8 Because of the apparent widespread difficulty in recognizing the radiographic manifestations of pulmonary tuberculosis, it will be beneficial to review the spectrum of chest x-ray abnormalities in sputum positive tuberculosis patients. Aim: To study clinical features, radiological features and comorbidities among newly detected sputum positive pulmonary tuberculosis patients. Settings and design: The hospital based cross-sectional study was conducted from the year 2016-2018 at a tertiary care teaching hospital in Mangalore. Methodology: Newly diagnosed smear positive pulmonary tuberculosis aged between 18-70 years attending OPD/IPD of Department of Respiratory Medicine, who fulfilled study eligibility criteria were included. Comprehensive clinical assessment was conducted and information regarding socio-demographic profile, comorbidities were noted. Chest x-ray PA view was performed for all patients. Statistical A nalysis: Data was analyzed in SPSS V:20. Data is presented in frequency, percentages. Chisquare, was applied to test significance of association. Results: A total of 563 (309 elderly and 254 adult) patients participated in study. Male predominance was noted (64.7%). Cough (94.1%) and expectoration (83.8%) were the most common symptoms. High bacillary load (3+) and bilateral lungs involvement were predominant among elderly patients (75.6%). Cavitary lesions were predominant among adults. Infiltration (39.6%), cavitary lesions (37.7%) and consolidation (37.5%) were most common lesions seen in chest x-ray. Cavitary lesions were found in higher percentage among patients with higher bacterial load of 2+and 3+ (36.8% and 33.0% respectively). Bilateral lesions were associated with TB patients with diabetes

Latent tuberculosis infection in children in Bangui: about 524 cases exposed at home to index cases of positive microscopy pulmonary tuberculosis

Introductionmalgré la vaccination par le BCG, le risque de développer la tuberculose chez les jeunes enfants dans les régions endémiques reste plus élevé après exposition au cas de tuberculose chez l´adulte. Le but de cette étude était de réduire le risque de tuberculose active chez les enfants contacts des cas index adultes à domicile.Méthodesune étude transversale multisite (avril 2016-janvier 2019) a été réalisée sur des enfants de 0 à 59 mois, contacts des cas index à domicile, dépistés et suivis au centre pédiatrique de Bangui.Résultatscinq cent vingt- quatre (524) enfants ont été enregistrés. La moyenne d´âge était de 2 ans et 1 mois et le sex ratio garçon/fille de 1,02. Environ quatre-vingt-huit pourcent (88,5%) des contacts étaient vaccinés avec le BCG contre 11,5% non vaccinés. Dans plus de la moitié des cas (52%), les contacts et les cas index ont partagé la même chambre et le temps de contact journalier était supérieur à 12h dans 56% des ménages. Un peu plus de neuf pourcent (9,35%) des contacts avaient une IDR positive. Tous les enfants ont été mis sous chimioprophylaxie à base de Rifampicine + Isoniazide selon les directives nationales et malgré cela, 14 soit 2,67% ont développé une tuberculose active dont 13 formes pulmonaires et une forme ganglionnaire.Conclusionla chimio prophylaxie tuberculeuse a sans doute permis de réduire considérablement le risque de survenue de la tuberculose chez des enfants ayant été en contact avec les cas index à domicile.

Clinico-haematological Profile in Acid Fast Bacilli Positive Pulmonary Tuberculosis Patients at Tertiary Care Centre in Raichur, Karnataka

Introduction: Tuberculosis (TB) is a major public health problem in India and it remains an epidemic, affecting one third of the population. It manifests with diversified haematological manifestations of varying severity like anaemia, leukocytosis, thrombocytosis and raised erythrocyte sedimentation rate levels. Therefore, monitoring clinical and haematological alterations in sputum positive Pulmonary Tuberculosis (PTB) patients necessitates the need for deliberation of supportive care and varied treatment options that would amplify the treatment outcome. This study was carried out to explore the early changes and the relationship between the social risk factors like smoking, alcohol intake and the haematological profile of TB patients which will help in early identification of altered haematological parameters and in minimising the risk of transmission among susceptible population. Aim: To do analysis of various haematological manifestations in sputum positive PTB patients and to evaluate diagnostic and prognostic significance. Materials and Methods: A prospective study was conducted over a period of six months between November 2019 to April 2020 on 50 PTB patients referred by Department of Respiratory Medicine, Navodaya Medical College, Raichur. Patients who were on Anti-Tubercular Treatment (ATT), extra-PTB patients, pregnant women and those with any other major co-morbid condition were excluded from the study. All patients were thoroughly examined clinically and investigated with plain chest x-ray, complete blood count; ESR, PS examination and sputum for acid-fast bacilli stained with Ziehl-Neelsen (Z-N) stain and AFB grading charts were used according to Revised National Tuberculosis Control Programme (RNTCP). Data collected was analysed by SPSS software version 16.0 and Chi-square test was used to calculate the sample size. Results: Of total 50 cases of PTB, there were 30 males and 20 females and mean age of patient was 44 years. Commonest haematological parameters raised were ESR (48 cases; 96%) followed by anaemia (45 cases; 90%), neutrophilia (36 cases; 72%), leukocytosis (24 cases; 48%) and thrombocytosis (12 cases; 24%). The frequent peripheral smear picture was Microcytic Hypochromic Anaemia (MHA) (27 cases; 54%) followed by normocytic normochromic anaemia (21 cases; 42%) and least common was macrocytic anaemia (2 cases; 4%). There was significant improvement in all haematological parameters after three months of treatment, with sputum conversion of PTB cases (75%). Conclusion: TB can lead to heterogenous and diversified haematological abnormalities like anaemia, leukocytosis, neutrophilia, thrombocytosis and raised ESR. These haematological parameters can be a guide to assess the improvement of TB patients after ATT which indirectly speaks about the improvement in immune response.

A study on coverage of isoniazid chemoprophylaxis among the household contacts of smear positive pulmonary tuberculosis cases aged &lt;6 years under Revised National Tuberculosis Control Programme

A study on coverage of isoniazid chemoprophylaxis among the household contacts of smear positive pulmonary tuberculosis cases aged &lt;6 years under Revised National Tuberculosis Control Programme

Electrocardiographic variations in cases with pulmonary tuberculosis related to anti-tuberculosis therapy

Tuberculosis is the major public health concern globally. Cardiovascular involvement was observed in 1-2% of cases with pulmonary tuberculosis. The present study was designed to assess the ECG changes in pulmonary tuberculosis before and after anti-tuberculosis therapy. A total of 90 clinically diagnosed with sputum positive pulmonary tuberculosis cases above 21 years of age were included. Cases with abnormal findings on ECG were advised to echocardiography to detect the exact abnormality / cardiac complication due to pulmonary tuberculosis. Collected data were analysed to compare the ECG changes in pulmonary tuberculosis at the initial diagnosis and follow up for six months. In 60% of cases, the duration of symptoms was less than 6 months and in 40% cases, it was more than 6 months. ECG abnormalities was observed in 65.5% pulmonary tuberculosis cases before commencing anti-tuberculosis therapy, whereas ECG abnormalities were noted in 34.4% of cases after completion of anti-tuberculosis therapy. Sinus tachycardia was observed in pulmonary tuberculosis cases before anti tuberculosis therapy was 42.2% and after 6 months follow up with ATT it was reduced to 11.1%. Sinus tachycardia, QRS axia+900, p wave axis +900, Right side axis deviation and p-pulmonale was the main abnormalities noticed in ECG before the commencement of anti-tuberculosis therapy. The values were reverted back to normal after anti tuberculosis therapy. PT cases with atypical features should be a monitor with echocardiography for early detection of cardiac complications.

Spatial Description of the Distribution Cases of BTA Positive Pulmonary TB in Kota Kupang

Tuberculosis is one of the top 10 leading causes of death in the world. In 2017 an estimated 10.4 million people suffered from TB and 1.3 million people died of the disease. TB is a disease based on the region that has a spatial dependence (correlation between geographic regions), therefore its restraint must also consider the spatial distribution patterns of the case that can be learned through spatial analysis. The purpose of this research was to analyze spatially the distribution of BTA positive pulmonary TB cases based on population density, coverage of healthy houses, altitude, and the number of poor families in Kota Kupang 2018. The type of research used in this study was quantitative descriptive with Geographic Information System (GIS) approach. The sample in this study consisted of all new cases of BTA positive pulmonary TB in 2018 amounted to 451 cases. Spatial analysis showed that the BTA positive pulmonary TB cases distributed to spread the subdistricts in Kota Kupang which was a region of low altitude (&lt;150 masl) with the highest distribution in the areas with high population density, high coverage of the healthy house, and the high number of poor families. It calls for networking between the government and the community in the prevention of BTA positive pulmonary TB.

Case-control study to evaluate the role of smoking, alcohol abuse, intravenous drug abuse, tobacco use and biomass fuel exposure as risk factor in pulmonary tuberculosis

Background: An association between smoking and tuberculosis disease has been shown in various studies, it is less clear to what extent smoking increases the risk of Mycobacterium tuberculosis infection. Therefore the aim of this study is to evaluate the role of smoking, alcohol abuse, intravenous drug abuse, tobacco use and biomass fuel exposure as a risk factor for the development of pulmonary tuberculosis.Methods: This is a case control study and total 200 subjects will be included with 100 sputum smear positive pulmonary tuberculosis cases and 100 age and sex matched healthy subjects as controls. Data collected from both cases and controls using a proforma by enquiring smoking habits, alcohol abuse, intravenous drug abuse, biomass fuel exposure and documenting chest X-ray features.Results: The study showed significant association between tuberculosis and smoking as a risk factor with beedi smoking, early age of starting smoking, increased duration and quantity of smoking increases risk for tuberculosis. There was significant association between intravenous drug abuse, biomass fuel exposure and risk of tuberculosis. There was no significant association in the study between alcohol abuse, tobacco chewing and tuberculosis, but heavy drinking and tuberculosis showed significant association. The study also showed significant association of cavitary lesion with smoking.Conclusions: There is significant association between smoking, intravenous drug abuse, biomass fuel exposure and tuberculosis, since these risk factors impairs host immune defences that allows the development of active tuberculosis.

Study of prevalence Rifampicin and/ or Isoniazid drug resistance among newly diagnosed cases of sputum smear positive pulmonary tuberculosis at tertiary care centre

Worldwide tuberculosis is most common infectious cause of death. India bears one-fourth of the global tuberculosis burden. Despite all national &amp; international efforts to control &amp; eliminate tuberculosis, more than 10 million active tuberculosis cases occur each year. The problem of tuberculosis has been further compounded by the emergence of multi drug resistant (MDR) and extensively drug resistant(XDR) tuberculosis. Previously treated tuberculosis is most important risk factor for drug resistant TB but treatment naïve patients are also at risk due to transmission of drug resistant strain or spontaneous mutation.Study was conducted in Department Of Respiratory Medicine, GMC Nagpur between May 2017 to October 2018.It was prospective observational study. All sputum smear positive cases were subjected to mycobacterial culture and LPA testing in IRL.Total 250 patients whose sputum smear was positive for acid fast bacilli were included in study. Maximum patients were in age group of 18-30 years of age with mean age 36.43+/-14.05.Out of 250 patient 188 were males and 62 were females. Isoniazid monoresistance was found in 6 patients and isoniazid with rifampicin resistance was found in 9 patients. We did not find any case of rifampicin monoresistance in our study.Prevalence of isoniazid monoresistance was 2.4 % in our study while prevalence of isoniazid and rifampicin resistance (MDR TB) was 3.6%. Thus prevalence of drug resistant TB is low amongst newly diagnosed sputum smear positive cases. This shows success of tuberculosis control programme.