Pulmonary Tuberculosis Disease Research Articles

Accuracy of Nasopharyngeal Aspirate GeneXpert Compared to Gastric Aspirate TB Culture and GeneXpert in Diagnosing Pulmonary Tuberculosis in Pediatric Patients

Background: Pulmonary TB in children remains to be a burden in the Philippines. Diagnosis remains to be a challenge for pediatricians due to its paucibacillary nature, difficulty in obtaining specimens, cost of test as well as the varied sensitivity of the different tests available. Gastric aspirate (GA), commonly used for bacteriological diagnosis of pulmonary tuberculosis (PTB) in children, involves an invasive procedure that may cause discomfort and sometimes require admission. Nasopharyngeal aspirate (NPA), on the other hand, can be easily and non-invasively obtained but is currently not a recommended specimen for testing for PTB. Objectives: This study aims to determine the accuracy of NPA GeneXpert in diagnosing PTB among pediatric patients 0-18 years old with presumptive TB using GA GeneXpert as the initial screening test and GA TB culture as gold standard. Methodology: This prospective, cross-sectional diagnostic study involved collection of single NPA and GA specimens for GeneXpert and TB culture in 100 patients with presumptive PTB seen at a tertiary government hospital in the Philippines. Results: Of the one hundred pediatric patients (mean age 6 ± 5.63 years) enrolled, 50 were clinically diagnosed PTB, 16 bacteriologically-confirmed and 34 were not PTB disease. Sensitivity, specificity and predictive values with 95% confidence intervals of the NPA GeneXpert were determined compared to GA GeneXpert and GA culture. Sensitivity, specificity, positive and negative predictive values of the NPA GeneXpert compared to GA GeneXpert were 70%, 96.67%, 70% and 96.67%, respectively. While NPA GeneXpert compared to GA TB culture were 40%,91.58%, 20% and 96.67%, respectively. Conclusion: GeneXpert testing on a single NPA specimen is a highly specific and rapid test that can be used to diagnose PTB in pediatric patients, particularly where gastric aspiration or mycobacterial culture is not feasible.

Hubungan Lingkungan Fisik Rumah Dengan Penyakit Tuberkulosis Paru Di Puskesmas Kuala Tungkal II, Jambi

The purpose of this study was to determine the relationship between occupancy, ventilation area, humidity, temperature, lighting, and floor conditions on pulmonary tuberculosis. This was a case-control study with the number of samples as many 60 cases of positive pulmonary tuberculosis patients and 60 control, not pulmonary tuberculosis patients and applied logistic regression analysis. The result of the bivariate analysis was showing that there was a correlation between pulmonary tuberculosis disease with the physical house condition crowded household, ventilation, room temperature, humidity of the house, lighting, and floor condition p-value indicates a row of ((0.002, 0.028, 0.010, 0.006, 0.003, 0.009). Results of regression analysis showed that ventilation is the most dominant factor affecting pulmonary tuberculosis disease OR (2,207). The conclusion of this study, there is relationship between crowded household, ventilation, room temperature, humidity, light intensity and floor condition with Pulmonary Tuberculosis. Recommended to pay attention to healthly house sanitary aspects in terms of crowded household, ventilation, room temperature, light intensity, floor condition, habit of opening the windows in the morning and increase hygiene and healthy behaviors to prevent transmission of pulmonary tuberculosis and doing health promotion for the community.

The Analysis of Complications of Tuberculosis Sufferers Due to History of Drug Breakup in The Area of Puskesmas Puri Mojokerto Regency

Pulmonary TB disease is one of the priorities of eradication of infectious diseases. Early-stage drug breakup occurs if the patient does not take medication 2 months in a row or more before the treatment period is complete. Drug breakups result in patients being resistant to OAT (Anti-Tuberculosis Drugs) and can lead to complications. This study aimed to analyze the occurrence of complications of tuberculosis sufferers due to a history of drug breakup. The design in this study was Correlation Analytics with Retrospective approach methods. The population in this study was all TB sufferers who had a history of drug breakups and complications. The sampling technique in this study was Non-Probability Sampling with purposive sampling type. The sample was 30 respondents. The instruments were interview for the history of drug breakup and patient treatment cards and observation and status of patient as the instruments of complications. Spearman Rho test results showed that value = 0.055 or more than α (0.05) which meant there was no correlation between the history of drug breakup with complications of tuberculosis. Based on this study, it could be concluded that the complications of tuberculosis that occur not only because of drug breakup factors but can be due to the spread of increasingly widespread germ infections, the immune system of the sufferers who are lacking, tuberculosis concomitant diseases, nutritional status of tuberculosis sufferers, and also knowledge from TB sufferers who lack the awareness to maintain health.

Seeking New Parameters In Differentiating Child Tuberculosis From Community Acquired Pneumonia- Is It Possible?”

Abstract Background: The neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio(MLR) are useful biomarkers of inflammation used in many diseases to evaluate bacteremia, disease activity, recurrence rate, surveillance and prognosis. Objective: Aim of this study was to evaluate NLR and MLR in the differential diagnosis of children with pulmonary tuberculosis disease from CAP. Materials and Methods: I reviewed hospital-records of 50 children with pulmonary tuberculosis disease in the Pediatric Infectious Disease Ward between June 2016 and December 2018, and compared; NLR and MLR with 50 CAP and 50 healthy children. Also; erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were compared between the tuberculosis and CAP group. Results: When 3 groups were compared there was significant difference among NLR and MLR values between 3 groups. In pairwise-comparisons, there was significant difference among NLR and MLR values between tuberculosis versus healthy controls, and CAP versus healthy controls. However, there was no significant difference among NLR, MLR values between tuberculosis versus CAP groups. Conclusion: This study is unique that evluates NLR and MLR in tuberculosis differentiation. Although NLR and MLR values are useful biomarkers of inflammation in both pulmonary tuberculosis and CAP seperately, they’re not as useful as expected in differentiating tuberculosis from CAP in children.

PEMETAAN PENYAKIT TUBERKULOSIS PARU DI WILAYAH KERJA PUSKESMAS KARANGAYU TAHUN 2016-2018

Based on a preliminary survey at the Karangayu Primary Health Center, the number of pulmonary tuberculosis cases is increasing every year. This study aims to map and describe pulmonary tuberculosis by kelurahan, gender, and age group This study is a descriptive research, data collection by reviewing documents and records the data needed. The research object is all data of pulmonary tuberculosis patients in Karangayu Primary Health Center in 2016-2018. Based on research, the majority of patients with pulmonary tuberculosis located in Karangayu village, men and women have the same potential to get pulmonary TB, most patients included in the adolescent and adult age groups. Whereas based on the region, Based on the kelurahan, The number of TB sufferers in Kelurahan Bojong Salaman was more evenly distributed, in Kelurahan Salaman Mloyo TB cases incidence were found in 2017 and the number of TB sufferers in Kelurahan Cabean was lower than the other kelurahan. Areas with high population density are at risk of transmission. All age groups have the possibility of exposure to diseases, especially the adult age groups who have high mobility. Pulmonary tuberculosis disease control and prevention programs should continue

On organizational forms of bone tuberculosis control in Tatarstan

We can note with great satisfaction the major achievements that our health organs have by this moment. Hundreds of new hospitals, many thousands of health centers, tens of thousands of nurseries and many different research institutions - these are the assets of Soviet health care. The question of the fight against tuberculosis also gained a lot of momentum. But we have one area which is not yet given full attention by the medical workers. This sphere is bone tuberculosis. A related and related to pulmonary tuberculosis disease, unfortunately, does not get the attention it deserves.

Chronic Pulmonary Aspergillosis - Case Series and Review of Indian Literature

Aspergillus species, especially Aspergillus fumigatus, can cause varied pulmonary manifestations depending on the host immune status and duration of infection. Chronic pulmonary aspergillosis (CPA) is an under-reported entity, and its diagnosis remains a diagnostic challenge for clinicians. CPA can have varied presentations including chronic cavitary pulmonary aspergillosis (CCPA), subacute invasive pulmonary aspergillosis, and chronic fibrosing pulmonary aspergillosis. Underlying lung diseases such as chronic obstructive pulmonary disease and sequelae of pulmonary tuberculosis predisposes these individuals to CPA. These cases can present as chronic cough with hemoptysis even requiring emergency bronchial artery embolization. Here, we present a series of four CCPA cases who were diagnosed on the basis of clinico-radiological features and the Aspergillus-specific IgG antibody levels. A review of case series published in India is also presented.

Impact of vitamin D status and cathelicidin antimicrobial peptide on adults with active pulmonary TB globally: A systematic review and meta-analysis.

Tuberculosis remains a global threat and a public health problem that has eluded attempts to eradicate it. Low vitamin D levels have been identified as a risk factor for tuberculosis infection and disease. The human cathelicidin LL-37 has both antimicrobial and immunomodulatory properties and is dependent on vitamin D status. This systematic review attempts to compare vitamin D andLL-37 levels among adult pulmonary tuberculosis patients to non-pulmonary TB individuals between 16-75 years globally and to determine the association between vitamin D and cathelicidin and any contributing factor among the two study groups. We performed a search, through PubMed, HINARI, Google Scholar, EBSCOhost, and databases. A narrative synthesis through evaluation of vitamin D and LL-37 levels, the association of vitamin D and LL-37, and other variables in individual primary studies were performed. A random-effect model was performed and weighted means were pooled at a 95% confidence interval. This protocol is registered under the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42019127232. Of the 2507 articles selected12 studies were eligible for the systematic review and of these only nine were included in the meta-analysis for vitamin D levels and six for LL-37 levels. Eight studies were performed in Asia, three in Europe, and only one study in Africa. The mean age of the participants was 37.3±9.9 yrs. We found low vitamin D and high cathelicidin levels among the tuberculosis patients compared to non-tuberculosis individuals to non-tuberculosis. A significant difference was observed in both vitamin D and LL-37 levels among tuberculosis patients and non-tuberculosis individuals (p = < 0.001). This study demonstrated that active pulmonary tuberculosis disease is associated with hypovitaminosis D and elevated circulatory cathelicidin levels with low local LL-37 expression. This confirms that vitamin D status has a protective role against tuberculosis disease.

Clinical aspects of using artificial intelligence for the interpretation of chest X-rays

The review considers the possible use of artificial intelligence for the interpretation of chest X-rays by analyzing 45 publications. Experimental and commercial diagnostic systems for pulmonary tuberculosis, pneumonia, neoplasms and other diseases have been analyzed.

Morbidity patterns among medical admissions at Niger Delta University Teaching Hospital, Bayelsa State, Nigeria

Hospital statistics on morbidity and mortality are essential in assessing disease burden, evaluation of health policies and health planning. The study aimed to determine the morbidity pattern and short-term outcome among medical admissions in the Niger Delta University Teaching Hospital (NDUTH), Bayelsa State, Nigeria. This retrospective 7-years disease audit was carried out in the medical wards of NDUTH, Bayelsa State, Nigeria. Information extracted included name and gender of patients, diagnoses and disease outcomes. One thousand, one hundred and twenty five (60.5%) females and seven hundred and thirty three (39.5%) males had complete records and were therefore used for the analysis. The mean age of the patients was 50.14±16.66 years with males being older (p&lt;0.001). Non-Communicable Diseases (NCDs) accounted for a majority of cases (1270; 68.4%) while 588 (31.6%) were Communicable Diseases (CDs) NCDs were more prevalent among males and older individuals (p&lt;0.03; p&lt;0.001) and showed a rising trend over the years. CDs were however the leading cause of morbidities among females. The commonest diagnoses among males were retroviral disease, stroke, heart failure, pulmonary tuberculosis, diabetes and renal disease with women showing a similar trend except that heart failure replaced stroke as the second commonest morbidity while stroke came third, followed by diabetes, renal disease and hypertension. The all-cause mortality rates were 10.6% and 15.9% for females and males respectively. The major causes of mortality were infectious diseases and circulatory disorders for both genders. About 6.4% males and 3.8% females Left Against Medical Advice (LAMA). The pattern shows a rising prevalence of NCDs. Although CDs witnessed some decline, it however remained prevalent. The mortality rate was high while a good proportion LAMA. There is a need for strategic health programs to address this increasing tide of NCDs in our society, control CDs, and improve patient care while reducing mortality.

Influence of NOD-like receptor 2 gene polymorphisms on muramyl dipeptide induced pro-inflammatory response in patients with active pulmonary tuberculosis and household contacts

PurposeThe immune response induced by nucleotide-binding oligomerization domain-2(NOD2) is associated with the production of cytokines affected by the host's genetic background. The present study aimed to examine the effects of NOD2; 802C > T, 2105G > A polymorphisms associated with altered cytokine levels in patients with active pulmonary tuberculosis disease, Latent TB subjects (household contacts(HHC) and healthy controls(HC). MethodsGenetic polymorphisms were analyzed by Restriction Fragment Length Polymorphism(RFLP) in 102-PTB patients, 102-HHC, and 132-HC. QuantiFERON-TB Gold In-Tube test was performed to identify latent TB infection in 60-HHC. Estimated their cytokine levels by ELISA in MDP (muramyl dipeptide) stimulated culture supernatants of all the groups. Further, we studied pre-mRNA structures by insilico analysis and relative gene expression by RT-PCR. ResultsRecessive genetic models of NOD2 802C > T SNP with TT genotype and AA genotype of NOD2 2105G > A SNP were significantly associated with increased TB risk in PTB patients and HHC compared with HC. In vitro stimulations were performed with NOD2 ligand MDP in PTB patients and latent TB subjects: QuantiFERON positive household contacts (QFT + ve HHC)and QuantiFERON negative household contacts(QFT-ve HHC). The results showed that reduced TNF-α and enhanced IL-12, IL-1β indicate that these cytokines may play an essential role in the initial maintenance of cell-mediated immunity. Our study demonstrated the correlation between NOD2 polymorphism with IL-1β, TNF-α, IL-12 levels. Insilico analysis represents the pre-mRNA secondary structures affected by NOD2 SNPs. We also observed the difference in m RNA levels in variant and wild genotypes. ConclusionThis finding may lead to the forthcoming development of immunotherapy and may be used as predictive markers to identify high-risk individuals for TB disease.

Influence of Health Belief Model and Motivation with Prevention of Pulmonary Tuberculosis Transmission in Public Health Center Gurah Kediri Regency

Tuberculosis is a health problem, both in terms of mortality or mortality, and the incidence rate of disease or morbidity. This infectious disease is mostly caused by the germ mycobacterium tuberculosis. The purpose of this study is to find out the influence of health belief models and motivation with the prevention of pulmonary tuberculosis transmission.&#x0D; The design used in the study is correlational analytics with a cross sectional method approach. While the sample in this study which is Some people with pulmonary tuberculosis (TB) in Gurah Health Center with BTA (+) as many as 22 respondents. The research instrument used is a questionnaire. Spearman Rhodengan test analysis of the level of significanceα=0.05, so as to be able to answer the purpose of the study.&#x0D; Based on Spearman Rho correlation statistical test, obtained p 0.001 result for health belief model and p 0.021, which means that the values p 0.001 and 0.021 &lt; 0.05. From the results obtained that H1 received which means there is an influence of health belief model and motivation with the prevention of pulmonary tuberculosis transmission in Gurah Health Center Kediri Year 2020.&#x0D; It was concluded that the prevention of transmission of Pulmonary TB disease can be improved reciprocal relationship between health workers, families and sufferers with self-awareness of the adverse effects of Pulmonary TB disease.

Improvement of Knowledge and Attitudes on Tuberculosis Patients with Poster Calendar and Leaflet

Background: Leaflet and poster calendars are one medium to provide health education to patients with pulmonary tuberculosis on the treatment of pulmonary Tuberculosis. The purpose of this research for media want to effectivity leaflet and poster calendars on health promotion to improve the knowledge and attitudes of pulmonary tuberculosis treatment at the Martubung Public Health Center. &#x0D; Methods: Research is a quasi-experimental design with pre-test and post-test group. The population in this study were all patients with pulmonary tuberculosis treatment in Martubung Public Health Center and analyzed with the wilcoxon test.&#x0D; Results: The results of the study using the wilcoxon test showed that the leaflet could increase the pretest value of 10 knowledge to 11.03 (p &lt;0.001) and the attitude of having a pretest value of 41.77 to 45.7 (p &lt;0.001). The wilcoxon test results show that the poster calendar can increase the pretest knowledge value from 8.7 to 11.97 (p &lt;0.001) and the pretest attitude value from 43.7 to 50.27 (p &lt;0.001).&#x0D; Conclusions: The media are most effective in improving knowledge and attitudes about the treatment of patients with pulmonary tuberculosis disease in Martubung Public Health Center is media poster calendar from the average value based on the pre-test and post-test conducted.

Collect Once, Use Many Times: Attaining Unified Metrics for Tuberculosis Preventive Treatment for People Living With HIV

The World Health Organization (WHO) recommends providing tuberculosis preventive treatment (TPT) to all persons living with HIV and to all household contacts of persons with bacteriologically confirmed pulmonary tuberculosis disease. Regrettably, the absence of a harmonized data collection and management approach to TPT indicators has contributed to programmatic challenges at local, national, and global levels. However, in April 2020, the WHO launched the Consolidated HIV Strategic Information Guidelines, with an updated set of priority indicators. These guidelines recommend that Ministries of Health collect, report, and use data on TPT completion in addition to TPT initiation. Both indicators are reflected in the WHO’s list of 15 core indicators for program management and are also required by the US President’s Emergency Plan for AIDS Relief’s Monitoring, Evaluation, and Reporting (MER) guidance. Although not perfectly harmonized, both frameworks now share essential indicator characteristics. Aligned indicators are necessary for robust strategic and operational planning, resource allocation, and data communication. “Collect once, use many times” is a best practice for strategic information management. Building harmonized and sustainable health systems will enable countries to successfully maintain essential HIV, tuberculosis, and other health services while combatting new health threats.

Analisis Indeks Keluarga Sehat untuk Mendukung Program Promosi Kesehatan

Health development starts from the smallest unit of society, namely the family. The Ministry of Health establishes an operational strategy for health development through the Healthy Indonesia Program with a Family Approach (PIS-PK). Data collection activities carried out in the PIS-PK aim to obtain health data for each family member by the Puskesmas. This study aims to determine the description of the index of healthy families in the working area of Puskesmas Batang I by using 12 indicators of healthy families related to the Health Promotion Program. This research is a quantitative study carried out in a descriptive observative manner, namely by analyzing the data narrative. Desa Kecapak has an index value of 0.08 (Unhealthy Family), Kelurahan Sambong has an index of 0.2 (Unhealthy Family), Kelurahan Proyonanggan Utara has an index 0.13 (Unhealthy Family), and Kelurahan Proyonanggan Tengah has an index 0 , 21 (Unhealthy Family). Puskesmas Batang I work area has an index of 0.18 and is in the Unhealthy Family category. The families that were recorded had not had total coverage, which was still 54.2%. The health promotion program of the Batang I Puskesmas includes data collection on Clean dan Healthy Behavior/Perilaku Hidup Bersih dan Sehat (PHBS), training for posyandu cadres, self-awareness surveys/Survey Mawas Diri (SMD), and guidance for Alert Village/Desa Siaga.. The Health Promotion Program can refer to data on the healthy family index and PHBS by looking at the low indicator coverage of healthy families. Puskesmas can cooperate with educational institutions so that the number of families being recorded is maximized. Based on the healthy family index coverage figures, the health promotion program must synergize with the Disease Eradication Program, especially pulmonary TB disease, hypertension, and mental disorders. It is hoped that the development of posyandu and posbindu cadres can increase the coverage of the healthy family index, especially in increasing family knowledge about infectious and non-communicable diseases

Effect of Self Management Education on Knowledge and Self Efficacy of pulmonary TB Clients in Timor Tribal Community

Background: Pulmonary Tuberculosis (TB) disease is still the main cause of death among the poor with low knowledge. Knowledge and self efficacy are the keys to the successful management of pulmonary TB. Objective: The purpose of this study was to investigate the effect of self management education (SME) by emphasizing the five pillars of TB management on knowledge and self efficacy of pulmonary TB clients in the Timor tribal community in Kupang, Indonesia. Methods: This quasi experimental study was conducted on 30 primary pulmonary tuberculosis patients who undergoing treatment for 6 months. The research was conducted from January to October 2020 in the working area of the Naibonat Community Health Center, Kupang Regency. Data were collected using a questionnaire on demographic data, knowledge and self efficacy which had been tested for validity and reliability.. Data were analyzed by the Paired T-test with SPSS 21. Results: The mean score of pre test knowledge and self efficacy of clients with pulmonary TB, respectively, 5.23 ± 1.04 and 4.77 ± 1.07 increased significantly to 6, 33 ± 1.18, and 7.13 ± 0.94 on the post test (P &lt;0.001). Conclusion and recommendation: giving SME by emphasizing the five pillars of pulmonary TB management increases the knowledge and self-efficacy of pulmonary TB clients in the Timor tribal community. The recommendation of this study is that SME interventions can be used as one of the nursing interventions in the public health center in community empowerment based pulmonary TB management

DETERMINANTS RELATED TO LUNG TUBERCULOSIS IN THE WAY OFPUBLIC HOSPITAL ANUTAPURA

Pulmonary Tuberculosis (pulmonary TB) is an infectious airborne disease caused by the bacterium Mycobacterium tuberculosis, which affect the lower respiratory tract. Education level, smoking, income, and family history were known as risk factors for pulmonary TB. The purpose of this study was to determine the determinants associated with pulmonary TB in the outpatient department of Anutapura General Hospital, Palu.&#x0D; This research was an analytical study with a cross-sectional design. The independent variables in this study were the level of education, smoking status, income, and family contact history, while the dependent variable was pulmonary TB. We enrolled 43 respondents with accidental sampling method. Data analysis using univariate and bivariate analysis.&#x0D; The results showed that there was a relationship between education level and pulmonary TB (p = 0.024), smoking status and pulmonary TB (p = 0.004), income and pulmonary TB (p = 0.001), and family contact history with pulmonary TB (p = 0.001).There is a relationship between education level, smoking status, income, and family contact history with pulmonary TB. It is suggested to the health workers of RSU Anutapura Palu to increase understanding and knowledge of patients regarding the prevention and transmission of pulmonary TB disease.

Effect of Inflammatory Cytokines/Chemokines on Pulmonary Tuberculosis Culture Conversion and Disease Severity in HIV-Infected and -Uninfected Individuals From South Africa.

Novel tuberculosis (TB) prevention and control strategies are urgently required. Utilising specimens from the Improving Retreatment Success (NCT02114684) trial we assessed the associations between inflammatory markers, measured during active TB, with treatment response and disease severity in HIV-infected and uninfected individuals. Multiplex immunoassays and ELISA were used to measure plasma expression of 24 cytokines/chemokines. Cytokines were log transformed to adjust for skewness. We conducted a nested, un-matched, case (n= 31) - control (n=101) study with cases defined as those participants who failed to sputum culture convert within 8-weeks of TB treatment initiation. Additionally, we examined the association between the measured cytokines and time to culture conversion and presence of lung cavitation using cox proportional hazards and logistic regression models, respectively. Multivariable analyses adjusted for a wide range of baseline clinical and demographic variables. IP-10 expression during active TB was associated with increased odds of sputum culture conversion by 8-weeks overall (aOR 4.255, 95% CI 1.025 – 17.544, p=0.046)) and among HIV-infected individuals (OR 10.204, 95% CI 1.247 – 83.333, p=0.030). Increased MCP-3 (aHR 1.723, 95% CI 1.040 – 2.855, p=0.035) and IL-6 (aHR 1.409, 95% CI 1.045 – 1.899, p=0.024) expression was associated with a shorter time to culture conversion in the total cohort. Higher plasma expression of IL-6 (aHR 1.783, 95% CI 1.128 – 2.820, p=0.013), IL-1RA (aHR 2.595, 95% CI 1.136 – 5.926, p=0.024), IP-10 (aHR 2.068, 95% CI 1.034 – 4.137, p=0.040) and IL-1α (aHR 2.008, 95% CI 1.053 – 3.831, p=0.035) were significantly associated with shorter time to culture conversion among HIV-infected individuals. Increased IL-6 and IL-1RA expression was significantly associated with the presence of lung cavitation during active TB in the total cohort (OR 2.543, 95% CI 1.254 – 5.160, p=0.010), (OR 4.639, 95% CI 1.203 – 21.031, p=0.047) and in HIV-infected individuals (OR 2.644, 95% CI 1.062 – 6.585, p=0.037), (OR 7.795, 95% CI 1.177 – 51.611, p=0.033) respectively. Our results indicate that inflammatory cytokines/chemokines play an important role in TB disease outcome. Importantly, the observed associations were stronger in multivariable models highlighting the impact of behavioural and clinical variables on the expression of immune markers as well as their potential effects on TB outcome.

Pendidikan Kesehatan Terhadap kesiapan pemulangan Pasien TB

Background: A large number of reccurence in pulmonary TB patients is due to a lack of knowledge to perform self-care at home, which is assumend as a lack of readiness of pulmonary TB patients when facing discharge. Health education can increase knowledge, willingness, and community role in preventing pulmonary TB disease. Objective: The research aimed at determining the effect of health education towards discharge readiness of pulmonary TB patients at Interna Ward II of RSUD Toto Kabila, Bone Bolango District. Methods:This research applied Pre-Experimental design with One Group Pretest-Posttest design. The research samples were 23 respondents with the purposive sampling method. Results: Research finding based on the Wilcoxon statistical test revealed that there was a significant change in the knowledge before and after was given health education with the p-value = 0,000. Conclusion: It can be concluded that there was an effect of healt education towards discharge readiness of pulmonary TB patients at Interna Ward II of RSUD Toto Kabila,Bone Bolango District.

CHEMICAL COMPOSITION AND BIOLOGICAL ACTIVITY OF METABOLITES OF THE GENUS EQUISETUM

The review summarizes the scientific literature on the degree of knowledge of the chemical composition and biological activity of metabolites and plant extracts of the genus Equisetum L. of the world flora. Many types of horsetail are widely used in folk medicine as a diuretic, hemostatic, as well as for pulmonary tuberculosis and skin diseases, ulcers, dropsy, jaundice, as a heart remedy, for diseases of the kidneys, bladder, etc. Based on extracts of the horsetail canes (Equisetum arvense L.) a number of drugs and biologically active additives with a wide spectrum of pharmacological action have been created. The review presents data on the structural diversity and biological activity of metabolites of plants of the genus Equisetum L. Information is provided on the composition of the metabolites of 16 species of the genus Equisetum L., the structure and sources of more than 200 natural substances related to terpenoids, phytosterols, brassinosteroids, vitamins, alkaloids and other nitrogen-containing compounds , lignans, styryl pyrones, indanones, phenylpropanoids, organic acids, hydrocarbons, aldehydes and phenolic compounds. The main biologically active substances of plants of the genus Equisetum are flavonoids and other plant phenolic compounds. Extracts and individual compounds possess antioxidant, diuretic, antibacterial, antifungal, hepatoprotective, hypoglycemic, antimutagenic, sedative, anxiolytic, anti-tumor, anti-inflammatory properties. An analysis of literature data shows that plants of the genus Equisetum are promising for the creation of new effective drugs. The information presented in the review can be used as reference literature by phytochemists, biologists, and pharmacologists, as well as to solve the problems of chemosystematics of plants of the genus Equisetum L.