Positive Tuberculosis Patients Research Articles

Association of Sociodemographic Factors in Affecting the Knowledge, Attitude, and Behaviour of Tuberculosis and HIV in Malang: A Community-Based Study in Rural Area

Background: Tuberculosis is the leading cause of death among people with HIV. In Indonesia, the Tuberculosis prevalence in 2021 stood at 969,000 cases with an average of 354 cases per 100,000 people. Nevertheless, tuberculosis is often neglected by many people, whereas in fact, it is a preventable and curable disease. This study aims to assess the knowledge, perception, behaviour, and screening for tuberculosis and their association with sociodemographic factors in a rural area of Malang, Indonesia. Method: A cross-sectional community-based study was conducted. The subjects of this study were adults (≥18 years old) who could comprehend the Indonesian language. We included 462 individuals who were chosen randomly by a multistage stratified sampling technique in rural areas of Malang, Indonesia. A validated questionnaire was asked to be filled in by participants, which were selected randomly using a multistage stratified sampling technique. Collected data were analyzed on SPSS for Windows version 25.0 Results: This study found that most (59.77%) of adults from the study area are still unaware of tuberculosis infection, transmission, prevention, and its risk factors. Only 1.2% were aware of the importance of screening if they had contact with positive tuberculosis patients. Participants in the age groups of 61 to 70 and over 70 years old were 5.5 and 4.0 times more likely to exhibit unsatisfactory behaviour compared to those in the 27 to 30 age group. Conclusion: This study shows that knowledge, perceptions, behaviours and tuberculosis screening toward tuberculosis are still lacking in rural communities in Malang and showed that participant on younger age and higher educational subjects has better knowledge, behaviour, perception and screening towards Tuberculosis and HIV.

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity

Background Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

Assessment of treatment outcome among HIV positive tuberculosis patients in Visakhapatnam

In March 2016, RNTCP revised its technical and operational guidelines. One of the major additions was introduction of Daily Regimen in the treatment of Drug sensitive TB, started initially among TB-HIV co-infected patients in 2017. The present study was taken up to assess the treatment outcomes of Tuberculosis among TB-HIV co-infected patients and certain factors related to the poorer outcome of the treatment.An Observational Longitudinal study conducted at an ART centre, attached to King George Hospital in Visakhapatnam District, Andhra Pradesh, among all TB-HIV co-infected patients newly diagnosed with Drug Susceptible Tuberculosis, aged above 18years, at the selected ART centre, from the month of June 2018 to December 2018. The sample size calculated was 88 with an absolute precision of 10. Ethical clearance from Institutional Ethics Committee, Andhra Medical College; Written informed consent from all the study participants were taken prior to start of study. Confidentiality of the study participants was maintained Qualitative variables were presented as proportions. Analytical statistics include chi-square test and regression analysis. 74% of the patients had a favourable treatment outcome, 15% of the patients died and 11% of the patients were lost to follow up. Occupational status of the study participant, Socio- economic class, tobacco using habit and their CD4 counts had a statistically significant impact on their TB treatment outcome.CD4 count below 200cells/mm, Tobacco use, Diabetes Mellitus- factors responsible for unfavourable treatment outcome of Tuberculosis treatment Case-specific approaches among LFUs may be carried out to bring improvements in the strategies which are already existing or framing new strategies.

Tuberculosis prevalence and rifampicin resistance among presumptive patients in Nasarawa State: A three-year retrospective study

Objective: To investigate the prevalence and rifampicin resistance of tuberculosis among presumptive patients in Nasarawa state, Nigeria. Methods: Patient data collected from January 2019 to December 2021 were retrospectively computed from the register at the tuberculosis laboratory of Dalhatu Araf Specialist Hospital, Lafia. A total of 91884 patient records were analyzed to determine tuberculosis prevalence, rifampicin resistance, and patients’ characteristics using Chi-squared test. Results: An overall prevalence of 8.0% was recorded among presumptive patients over the three-year period with a decreasing trend in prevalence from 10.0% (2019) to 6.5% (2021), though the number of samples progressively increased each year and more than doubled in 2021. Most of the patients tested for tuberculosis were females (52.6%) and were mostly older than 15 years (84.1%). Conversely, a higher resistance to rifampicin was observed among tuberculosis positive male patients (55.6%) than in females (44.4%). Similarly, tuberculosis positive patients older than 15 years (84.6%) showed greater resistance to rifampicin than those younger than 15 years (15.4%). Statistically, no relationship was established among age, sex, year of sampling and tuberculosis prevalence or rifampicin resistance rate. Conclusions: Despite the downward trends in tuberculosis prevalence and rifampicin resistance rate observed in this study, measures at maintaining the gains achieved in the fight against tuberculosis must remain paramount as the race towards reducing tuberculosis incidence and mortality by 2025 continues.

Strain structure analysis of Mycobacterium tuberculosis circulating among HIV negative, positive and drug resistant TB patients attending chest clinics in Western Kenya

BackgroundDespite global tuberculosis (TB) interventions, the disease remains one of the major public health concerns. Kenya is ranked 15th among 22 high burden TB countries globally.MethodsA cross-sectional study was conducted in Western Kenya, which comprises 10 counties. A multistage sampling method was used where a single sub-county was randomly selected followed by sampling two high volume health facility from each sub-county. Identification of spoligotype profiles and their family distribution and lineage level were achieved by comparison with SITVIT database.ResultsLineage distribution pattern revealed that the most predominant lineage was CAS 220 (39.8%) followed by Beijing 128 (23.1%). The other lineages identified were T, LAM, H, X, S and MANU which were quantified as 87 (15.7%), 67 (12.1%), 16 (2.8%), 10 (1.8%), 8 (1.4%) and 5 (0.9%) respectively. CAS and Beijing strains were the most predominant lineage in both HIV negative and positive TB patients. The Beijing lineage was also the most predominant in resistant M. tuberculosis strains as compared to wild type. A total of 12 (2.0%) were orphaned M. tuberculosis strains which were spread across all the 10 counties of the study site. In multivariate logistic regression adjusting for potential cofounders three potential risk factors were significant. HIV status (OR = 1.52, CI = 0.29–3.68 and P value of 0.001), Alcohol use (OR = 0.59, CI = 0.43–3.12 and P-value =0.001) and cross border travel (OR = 0.61, CI = 0.49–3.87 and P value = 0.026). Most M. tuberculosis clinical isolates showed genetic clustering with multivariate logistic regression indicating three potential risk factors to clustering. HIV status (OR = 1.52, CI = 0.29–3.68 and P value of 0.001), Alcohol use (OR = 0.59, CI = 0.43–3.12 and P-value =0.001) and cross border travel (OR = 0.61, CI = 0.49–3.87 and P value = 0.026).ConclusionThere exist diverse strains of M. tuberculosis across the 10 counties of Western Kenya. Predominant distribution of clustered genotype points to the fact that most TB cases in this region are as a result of resent transmission other than activation of latent TB.

Assessment of drug-susceptible and multidrug-resistant tuberculosis (MDR-TB) in the Central Region of Somalia: A 3-year retrospective study.

Multidrug-resistant tuberculosis (MDR-TB) remains a public health emergency and a threat globally. Although increasing MDR-TB cases have been recently reported in Somalia, limited information is known. This study aims to determine the prevalence of drug-susceptible and MDR-TB in suspected patients referred to the TB Department in Mudug Hospital, Galkayo, Somalia, and identify potential factors associated with MDR-TB. A 3-year hospital laboratory-based retrospective study was conducted by manually reviewing laboratory records of Mycobacterium tuberculosis specimens and GeneXpert MTB/RIF results from January 2019 to December 2021 at the reference mycobacteria laboratory department in Mudug Hospital. A total of 714 positive GeneXpert-MTB results were identified: 619 (86.7%) were drug susceptible (no Rifampin resistance [RR] detected) and 95 (13.3%) with RR detected or defined as MDR-TB. Most of the MDR-TB patients were males (71.6%, 68/95) and between the ages of 15 to 24 (31.6%, 30/95). Most isolates were collected in 2021 (43.2%, 41/95). Multivariate analyses show no significant difference between patients having MDR-TB and/or drug-susceptible TB for all variables. This study showed an alarming frequency of MDR-TB cases among M. tuberculosis-positive patients at a regional TB reference laboratory in central Somalia.

Assessment of Family Tuberculosis Contact Screening Practice and its Associated Factors Among Pulmonary Tuberculosis Positive Patients in South Wollo Zone, Amhara Region, Ethiopia.

Objectives: The objective of this study was to assess the prevalence and the associated factors of family contact screening practice. Methods: An institution-based cross-sectional study was conducted among 403 randomly selected pulmonary tuberculosis index cases from 1st May to 30th June 2020. Data were collected through a face-to-face interviewer-administered questionnaire. Multivariable logistic regression was performed. Results: The prevalence of family contact screening was 55.3%, (CI: 60-50). Having family support for care and treatment (AOR = 2.21, 95% CI: 1.16-4.21), waiting time of less than 60min (AOR = 2.03, 95% CI: 1.28-3.21), receiving health education on TB prevention and treatment (AOR = 1.86), 95% CI: 1.05-3.29), and having good knowledge about TB prevention (AOR = 2.76, 95% CI: 1.77-4.294) were factors associated with family TB contact screening practice. Conclusion: This study revealed that the prevalence of family contact screening was low as compared to national and global targets. Factors associated with family contact screening practice were: the presence of family support, shorter waiting time, health education offered by healthcare workers, and a good level of knowledge of the index cases.

Simultaneous Bilateral Spontaneous Pneumothorax in an HIV Positive Tuberculosis Patient

Background: Even though tuberculosis has been linked to pneumothorax for a long time and has caused significant morbidity and mortality in some patients, it has been the topic of few publications and analyses, thus very little study has been done to evaluate and review on this matter.Case: In this article, we reported a 39-year-old male, presented to the ER with breathlessness for the last 3 days accompanied by increased sputum productivity. The patient had an active pulmonary tuberculosis taht was under treatment, as well as HIV. Physical examination showed low chest expansion, weakened breathing sounds on both lungs, and the use of accessory breathing muscles. The chest X-ray showed bilateral pneumothorax. The patient underwent emergency chest decompression with a 16-gauge needle on both sides, followed by the insertion of an IPC and chest tube. The patient's breathlessness got significantly better, and after 35 days, the IPC was removed.Discussion: Pneumothorax is a frequent complication in Tuberculosis with HIV, with a prevalence of 6.8% compared to 0.95-1.4% in Tuberculosis without HIV. The progression of breathlessness in bilateral pneumothorax on HIV positive Tuberculosis patient is slower, up to 3 days since onset, compared to pneumothorax occured in other etiologies. Secondary pneumothorax usually occurs after extensive destruction of the lungs, leaving a little functionality and lower cardiopulmonary reserve, thus requiring prompt evaluation and more aggresive lifesaving treatment.Conclusion: Based on this case, bilateral pneumothorax found in HIV-associated TB patients comes with an insidious onset but warrants immediate evaluation and aggressive treatment or surgery if necessary.

Determination Image Quality on Thorax COVID-19 and Tuberculosis Using Optical Density Image Analysis

Covid-19 is a type of pneumonia disease currently affecting people around the world. Covid-19 and tuberculosis are lung diseases that are dangerous and spread quickly to other humans. Chest radiography is one of the main modalities in the management of suspected COVID-19 and tuberculosis patients as it provides radiological information on lung infections that can be used as diagnostic guidelines and patient care. This study aims to determine the differences in optical density and contrast in Covid-19 and pneumonia tuberculosis cases in order to find the specific characteristics of Covid-19 and tuberculosis. This research processed secondary data from Covid-19 and tuberculosis positive patients using image-J software that can be easily obtained and operated by anyone. After processing, the density and contrast were analyzed, particularly for the lungs. Based on image processing results, the average density for Cnovid-19 radiographs is 1,066, while for Tuberculosis radiograph is 1,519. The average contrast values for Covid-19 and tuberculosis radiographs are 0.37 and 1.03. Thus, it can be concluded that the contrast of the Covid-19 radiograph is lower than the tuberculosis radiograph. The difference in optical density on the tuberculosis and Covid-19 cases is 0.5 as the opacity on the chest radiographs of Covid-19 patients is evenly distributed over the entire lung surface.

Screening for Latent and Active Tuberculosis in Paediatric Contacts of Tuberculosis Patients: A Cross-sectional Study

Introduction: Globally, World Health Organisation (WHO) estimate suggests that, one million cases of Tuberculosis (TB) occur among children (approximate 10% of the total 9.6 million TB cases). As per Revised National Tuberculosis Control Programme (RNTCP), high importance and priority is given to the household contacts and paediatric age group (especially <6 years). Since, transmission can happen at any time from index case to the contact (before diagnosis or during treatment), all contacts of TB patients should be screened. Aim: To focus on the screening of paediatric contacts of TB positive patients by Mantoux test and to find out active and latent TB. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. The duration of the study was 16 months, from February 2020 to June 2021. Participants, who were proven cases, either sputum positive or clinically diagnosed and were less than 18 years of age were included. Contacts in whom Isoniazid Preventive Therapy (IPT) had been started were excluded. The candidates who tested Mantoux positive and had symptoms of TB were further screened by following test chest X-ray, Ultrasonography (USG) abdomen, Microscopy for Acid Fast Bacilli (AFB), Cartridge Based Nucliec Acid Amplification Test (CBNAAT), Cerebrospinal Fluid (CSF) analysis and contrast Magnetic Resonance Imaging (MRI). The data collected was analysed statistically with Statistical Package for Social Sciences (SPSS) version 26.0 and the level of significance was determined p-value <0.05 as insignificant, p-value >0.05 as significant and p-value <0.001 as highly significant. Results: A total of 82 contacts were included. Out of these, 60 children had no organ system involvement, whilst 11 had lymphadenopathy, five had respiratory involvement and six had abdominal involvement. Out of 82 contacts, 23 children tested Mantoux positive and 59 tested negative. Out of 23 Mantoux positive contacts 16 (19.51%) had latent TB and only 1 (2.44%) had active TB. Conclusion: A significant number of children in contact with TB positive patients were found to have latent TB, and it is possible that, there can be activation from latent to active TB later on in these children.

Diabetes Mellitus and its Association with Body Mass Index in Sputum Positive Tuberculosis Patients in a Tertiary Health Care Centre

Background: Tuberculosis is a chronic infectious disease that causes pulmonary tuberculosis and also affectsother tissues of the body. People with diabetes mellitus and those who are underweight have an increased risk ofgetting active tuberculosis. The objectives of the study were to estimate the prevalence of diabetes mellitus and todetermine its association with Body Mass Index in tuberculosis patients.Methods: In the present record-based cross-sectional study, 100 sputum smear positive tuberculosis patients 18years and older who attended the out-patient department of Pulmonary Medicine from 1/6/2020 to 31/12/2022were included and sputum smear negative patients were excluded. Data entry and analysis was done in MicrosoftExcel. Percentages were calculated and association between diabetes mellitus and Body Mass Index of the studypopulation was assessed by chi square test.Conclusion: The prevalence of diabetes mellitus in tuberculosis patients was almost double than that of thegeneral population of India and its association with underweight was found to be statistically significant. Soproper screening of all patients of tuberculosis for diabetes mellitus is necessary for early diagnosis and treatment.Health education and counselling are equally important

Correlation Between CD4, Hemoglobin, and Body Mass Index Levels on The Success of Intensive Phase Therapy among Positive Bacteriological Tuberculosis Patients with Human Immunodeficiency Virus Co-infection

Background: Tuberculosis and HIV infections are still a combination of diseases with high mortality rates. The success of intensive phase therapy of positive bacteriological TB patients with HIV co-infection can reduce morbidity and mortality rates. This study aims to determine the relationship between CD4 levels, HB, and BMI on the success of intensive phase therapy among positive bacteriological TB patients with HIV co-infection. Method: This research was an observational analytic study using a retrospective cohort study design conducted in Bali over 5 years (January 2016 to December 2021). Of 120 subjects, 118 subjects met the research requirements. The data was analyzed by Univariate analysis, Bivariate analysis was carried out using Chi-Square, and multivariate analysis was performed using multiple logistic regression. Results: a significant correlation was found between CD4 levels (RR=3,03, p= 0,004), HB (RR= 1,92, p= 0,006), BMI (RR= 5,91 p< 0,001) with successful intensive phase therapy in Bacteriologically Confirmed TB patients with HIV co-infection. All independent variables simultaneously affected sputum conversion (p<0,001; R Square = 0,479; CI: 95%). This study also found that BMI was the dominant predictor that affected the success of intensive phase therapy in Bacteriologically Confirmed TB patients with HIV co-infection (p<0,001; OR: 5,193; CI 95%). Conclusion: CD4, HB, and BMI levels are significantly related to the success of intensive phase therapy in Bacteriologically Confirmed TB patients with HIV co-infection.

Risk And Prevalence of Latent Tuberculosis Infection Among Healthcare Workers of Tertiary Care Hospital in Karachi Pakistan

More than 10 million people fall sick due to TB annually; Pakistan ranks 5th for highest tuberculosis (TB) burden globally. Latent tuberculosis infection (LTBI) is asymptomatic TB infection that can reactivate later on, causing transmission and disease. Health care workers dealing with positive Mycobacterium Tuberculosis (MTB) samples and patients are at high risk of TB infection. In this study, we investigated the frequency of LTBI in health care workers as well as a comparative group of patients suspected to have LTBI by their physicians. A total of 77 healthy healthcare workers (including phlebotomists, medical technologists, nurses, doctors, and faculty members working closely with TB samples or patients) and 104 patients diagnosed with TB were recruited in our study after institutional ethical approval. 3ml of whole blood was collected from study participants and was dispensed into three specific QFT tubes. (NIL, TB, Mitogen). Samples were investigated for interferon specifically released against TB according to the manufacturer’s protocol by using QuantiFERON TB Gold assay kit. Out of 77 healthcare workers, 16.8% (n=13) were positive for LTBI; these included microbiologists, technicians, phlebotomists, and housekeeping staff. However, none of the doctors and medical technologists tested positive. On the other hand, out of 104 patients, 23.1 % (n=24) were found to be positive, 10.5% (n=11) were indeterminate and 65.3% (n=68) were negative for LTB. The one-tail chi-square test revealed 35.14% risk to the highly exposed HCWs with the overall estimated risk of 42.54%. This study reports a high prevalence of LTBI in HCWs. Among the HCWs, microbiologists and technicians were the most affected. Housekeeping staff was also found to have LTBI. This study also found a higher risk for LTBI in technicians, medical technologists, microbiologists, and phlebotomist as compared to doctors and interns. This highlights the importance of regular screening of all HCWs, including housekeeping staff, in order to control and prevent the spread of this disease.

Household symptomatic contact screening of sputum smear positive tuberculosis patients at the DOTS clinic of SGT hospital, Gurugram

Background: Contact screening was conducted under ICMR (REFERENCE ID: 2019-07811) programme in villages near SGT hospital, Gurugram. Objective: To evaluate risk factors, extent of spread of tuberculosis among household contacts of tuberculosis cases and to create awareness. Methods and Material: Address of TB cases were taken from RNTCP register at DOTS clinic, SGT medical college. Then all household contacts of positive cases were screened, counselled and advised to approach ASHA Workers if such symptoms appear. Data was analysed using appropriate statistical methods. Results:21 Index cases along with 94 household contacts were screened. 61.90% families still use chullahs for cooking. 76.1% families have overcrowding. 3) 61.90% families had inadequate ventilation 4) 19.05%families were aware about the spread of this disease. 5)Only 23.80% families practised adequate sanitation methods and precautions6) 42.8% Index cases had a history of smoking. 7) 44.4% 4 continue to smoke with infection. The association of adequate sanitation with presence of awareness was found to be statistically significant. (p-value<0.05). Other factors were not significantly associated with level of awareness regarding prevention of tuberculosis spread among study participants. Conclusions: Contact screening is an effective tool and it gives the real-time picture of TB in India.

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity

Background: Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods: In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results: A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions: Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

Determinants of unsuccessful tuberculosis treatment outcome in Northern Red Sea region, Eritrea.

BackgroundEritrea has achieved the global target (90%) for tuberculosis (TB) treatment success rate. Though, events of unsuccessful TB treatment outcomes (death, treatment failure, lost to follow up and not evaluated) could lead to further TB transmission and the development of resistant strains. Hence, factors related to these events should be explored and addressed. This study aims to fill the gap in evidence by identifying the determinants of unsuccessful TB treatment outcomes in Eritrea’s Northern Red Sea region.MethodsA retrospective cohort study was conducted in Eritrea’s Northern Red Sea region. Data collected using a data extraction tool was analyzed using Stata version 13. Frequencies, proportions, median and standard deviations were used to describe the data. Furthermore, univariable and multivariable logistic regression analysis were performed to determine the risk factors for unsuccessful TB treatment outcomes. Crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence interval (CI) presented and p-value < 0.05 was considered statistically significant.ResultsAmong 1227 TB patients included in this study, 9.6% had unsuccessful TB treatment outcomes. In multivariable logistic regression analysis, TB cases 55–64 years old (AOR: 2.75[CI: 1.21–6.32], p = 0.016) and those ≥ 65 years old (AOR: 4.02[CI: 1.72–9.45], p = 0.001) had 2.7 and 4 times higher likelihood of unsuccessful TB treatment outcome respectively. In addition, HIV positive TB patients (AOR: 5.13[CI: 1.87–14.06], p = 0.002) were 5 times more likely to have unsuccessful TB treatment outcome. TB treatment in Ghindae Regional Referral Hospital (AOR: 5.01[2.61–9.61], p < 0.001), Massawa Hospital (AOR: 4.35[2.28–8.30], p< 0.001) and Nakfa Hospital (AOR: 2.53[1.15–5.53], p = 0.021) was associated with 5, 4 and 2.5 higher odds of unsuccessful TB treatment outcome respectively.ConclusionIn this setting, old age, HIV co-infection and health facility were the independent predictors of unsuccessful TB treatment outcome.

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity.

Background: Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods: In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results: A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions: Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

Effects of Anti-Tuberculosis Drugs on Lipid Profile in Pulmonary Tuberculosis Patients

Objective: To determine the anti-tuberculosis drugs effect on the lipid profile parameters in pulmonary tuberculosis (TB) patients.Methods: A prospective cross-sectional study was conducted at Tehsil Headquarter Hospital, Taunsa Sharif and District Headquarter Teaching Hospital, Dera Ghazi Khan from December 2020 to May 2021. The blood samples from 84 positive pulmonary TB patients were collected in three different intervals of the study, before the start of the treatment, and after the use of first four baseline drugs isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), and ethambutol (EMB) respectively to check out the variation in lipid profile parameters such as total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG) and very low density lipoprotein (VLDL). Results: Of 84 pulmonary TB patients, the mean age was 38.1 ± 19.8 years. There were 44 (52.4%) males and 40 (47.6%) females. The mean difference of cholesterol level significantly increases from baseline to 6th and 10th week, (p-value &lt;0.001). Similarly, HDL (p-value &lt;0.001) and LDL (p-value &lt;0.001) also increases significantly from baseline to 6th week and 10th week. However, no significant difference of TG (p-value 0.908) and VLDL (p-value 0.367) was observed from baseline to 6th and 10th week.Conclusion: Patients with pulmonary TB showed low lipid profile in our cohort. This shows that pulmonary TB may be a causative agent of low lipid profile. After anti-TB therapy, cholesterol, HDL, and LDL levels seem to be increased.

A study to assess the prevalence of Tuberculosis to review “TB free status” in Nashik district, Maharashtra, India

Tuberculosis (TB) is an infectious disease that is a significant cause of ill health and one of the leading causes of death worldwide. The prevalence of tuberculosis varies significantly across the country. Recent sub-national surveys have revealed wide geographical variation and discordance with corresponding annual notification rates. Present study aimed to estimate the prevalence of TB in 2022 to review the TB-free status of Nashik Districts. Methods: We conducted community-based crosssectional household survey between Jan 2021- March 2021. The district was divided into 15 survey units based on the number of TB units. We selected one village/ward from each survey unit using probability proportional to sampling. The estimated sample size was 30 bacteriologically positive TB patients using inverse sampling method. The prevalence of TB in 2020 was estimated by two methods- direct and indirect. Besides, proportionate decline, numbers needed to test and TB score were also estimated. Along with this, the prevalence was also estimated by drug consumption. Results:The TB prevalence was estimated as 60, 43 and 40 per 100,000 using direct estimate, indirect estimate, and drug consumption methods, respectively. There was a significant reduction in TB prevalence from the baseline year 2015 to more than 40 percent (62 %, 46%, and 64 % according to indirect estimate, direct estimate, and drug consumption, respectively). Conclusion: The study reported reduction of the prevalence of TB in Nashik district in 2020 as compared to 2015. Thus there is need of strategic execution of planned strategies to achieve the goal or TB elimination

Prevalence of diabetes mellitus among newly detected sputum positive pulmonary tuberculosis patients and associated risk factors: A cross-sectional study

Background: Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods: In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results: A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (&gt;46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions: Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.