Pulmonary Tuberculosis Subjects Research Articles

ESAT-6-Ag85C-polyHistag Antigen Fusion is Potential as Vaccine Candidate for Tuberculosis

BACKGROUND: BCG vaccine has been proven to be effective protection against tuberculosis (TB) meningitis and miliary TB. However, for protection against pulmonary TB, the results remains vary widely. Recombinant vaccine consisting of two immunodominant Mtb antigens ESAT-6-Ag85C-polyHistag (EAH) is currently being developed as a new TB vaccine candidate for booster. An immugonecity test for vaccine candidates is required in the initial phase to evaluate cellular immune response. This study was conducted to evaluate the cellular immune response by measuring interferon-gamma (IFN-γ) cytokines produced by T cells after ex vivo stimulation by TB EAH antigen fusion.METHODS: Peripheral blood mononuclear cells supernatant samples were collected from 16 new pulmonary TB subjects, 17 pulmonary TB in treatment subjects, and 10 healthy subjects. Samples were tested for IFN-γ level with enzyme-linked immunosorbent assay (ELISA). Kruskal-Wallis test was used to test the differences between IFN-γ levels among three groups, and followed by post-hoc analysis using Mann Whitney.RESULTS: The median of IFN-γ levels for new pulmonary TB, pulmonary TB in treatment, and healthy subjects were 17.09 (2.65-140.14) pg/mL, 4.36 (2.43-21.41) pg/mL, and 2.91 (2.39-3.85) pg/mL, respectively. There were significant differences of IFN-γ levels between new pulmonary TB group and pulmonary TB in treatment group (p=0.012), between new pulmonary TB group and healthy group (p=0.001), and also between pulmonary TB in treatment group and healthy group (p=0.035).CONCLUSION: Results show that TB EAH could stimulate cell-mediated immune responses in the three groups, with the highest IFN-γ levels are found in new pulmonary TB group, suggesting a potential immunodominant antigen fusion for vaccine candidate development.KEYWORDS: Ag85C, ESAT-6, immunogenicity test, IFN-γ, TB vaccine candidate, tuberculosis

The Footprint of Diabetes Mellitus on the Characteristics and Response to Anti-Tuberculous Therapy in Patients with Pulmonary Tuberculosis from Saudi Arabia.

BackgroundRight now, a tuberculosis (TB) and diabetes mellitus (DM) syndemic is re-emerging worldwide. Given the contradictory results of the impact of DM on the natural history of pulmonary TB (PTB), this study was undertaken to shed light on the precision of this hypothesis from a community with a substantial caseload of both diseases.MethodsThe present 5-year, retrospective, cohort study involved 487 (60.8% males, and 39.2% females) adult PTB patients (mean age 53.71 ± 15.78 years) selected from Dr. Soliman Fakeeh Hospital (DSFH), Jeddah, Kingdom of Saudi Arabia (KSA). The relevant patients’ clinical, radiological and microbiological data were extracted from the hospital medical and laboratory database.ResultsIn our study, the cumulative prevalence of DM among PTB subjects was 27.1%. Both diabetic and non-diabetic groups were matched with regard to gender (p = 0.46); however, diabetic patients were significantly older (p = 0.0001). Patients with concomitant DM displayed higher frequency of the classic clinical presentations of PTB and were 1.8 times more likely to have cavitary lesions on imaging studies (p = 0.012). Furthermore, diabetic patients showed higher initial sputum acid-fast bacillus (AFB) smear grade (p = 0.0001) and were more prone to have delayed culture conversion as compared to their non-diabetic counterparts (77.55 ± 37.74 versus 54.95 ± 27.67 days, respectively; p = 0.0001) which points out to less favorable treatment outcome.ConclusionDM showed an impact on different aspects of PTB. Accordingly, integrated bi-directional screening programs for both diseases in the KSA need to be implemented to upgrade health-care services of patients with dual diagnosis.

Phenotype of Peripheral NK Cells in Latent, Active, and Meningeal Tuberculosis.

The mechanisms underlying the immunopathology of tuberculous meningitis (TBM), the most severe clinical form of extrapulmonary tuberculosis (TB), are not understood. It is currently believed that the spread of Mycobacterium tuberculosis (Mtb) from the lung is an early event that occurs before the establishment of adaptive immunity. Hence, several innate immune mechanisms may participate in the containment of Mtb infection and prevent extrapulmonary disease manifestations. Natural killer (NK) cells participate in defensive processes that distinguish latent TB infection (LTBI) from active pulmonary TB (PTB). However, their role in TBM is unknown. Here, we performed a cross-sectional analysis of circulating NK cellCID="C008" value="s" phenotype in a prospective cohort of TBM patients (n = 10) using flow cytometry. Also, we addressed the responses of memory-like NK cell subpopulations to the contact with Mtb antigens in vitro. Finally, we determined plasma levels of soluble NKG2D receptor ligands in our cohort of TBM patients by enzyme-linked immunosorbent assay (ELISA). Our comparative groups consisted of individuals with LTBI (n = 11) and PTB (n = 27) patients. We found that NK cells from TBM patients showed lower absolute frequencies, higher CD69 expression, and poor expansion of the CD45RO+ memory-like subpopulation upon Mtb exposure in vitro compared to LTBI individuals. In addition, a reduction in the frequency of CD56brightCD16− NK cells characterized TBM patients but not LTBI or PTB subjects. Our study expands on earlier reports about the role of NK cells in TBM showing a reduced frequency of cytokine-producing cells compared to LTBI and PTB.

Auxiliary Diagnosis for COVID-19 with Deep Transfer Learning.

To assist physicians identify COVID-19 and its manifestations through the automatic COVID-19 recognition and classification in chest CT images with deep transfer learning. In this retrospective study, the used chest CT image dataset covered 422 subjects, including 72 confirmed COVID-19 subjects (260 studies, 30,171 images), 252 other pneumonia subjects (252 studies, 26,534 images) that contained 158 viral pneumonia subjects and 94 pulmonary tuberculosis subjects, and 98 normal subjects (98 studies, 29,838 images). In the experiment, subjects were split into training (70%), validation (15%) and testing (15%) sets. We utilized the convolutional blocks of ResNets pretrained on the public social image collections and modified the top fully connected layer to suit our task (the COVID-19 recognition). In addition, we tested the proposed method on a finegrained classification task; that is, the images of COVID-19 were further split into 3 main manifestations (ground-glass opacity with 12,924 images, consolidation with 7418 images and fibrotic streaks with 7338 images). Similarly, the data partitioning strategy of 70%-15%-15% was adopted. The best performance obtained by the pretrained ResNet50 model is 94.87% sensitivity, 88.46% specificity, 91.21% accuracy for COVID-19 versus all other groups, and an overall accuracy of 89.01% for the three-category classification in the testing set. Consistent performance was observed from the COVID-19 manifestation classification task on images basis, where the best overall accuracy of 94.08% and AUC of 0.993 were obtained by the pretrained ResNet18 (P < 0.05). All the proposed models have achieved much satisfying performance and were thus very promising in both the practical application and statistics. Transfer learning is worth for exploring to be applied in recognition and classification of COVID-19 on CT images with limited training data. It not only achieved higher sensitivity (COVID-19 vs the rest) but also took far less time than radiologists, which is expected to give the auxiliary diagnosis and reduce the workload for the radiologists.

Hepatitis C Virus and Helicobacter pylori infections in Patients with Pulmonary Tuberculosis

Aims and objectives: The control of pulmonary tuberculosis (PTB) mainly depends upon prompt diagnosis and effective treatment which can be hindered by co-infections affecting organs like gastrointestinal system and liver involved in drug bioavailability and metabolism. Among those, Helicobacter pylori (H. pylori) causes chronic gastritis leading to peptic ulcer and related gastric malignancies and liver malfunctions induced by Hepatitis C virus (HCV) co-infections increase the risk of anti-tuberculosis drug-induced hepatotoxicity. The rates of Hepatitis C virus and Helicobacter pylori infections seem to increase day by day in pulmonary tuberculosis patients which need proper investigation followed by timely control and prevention form disease. Methods: The hospital-based study was performed in the area of Southern Punjab, Pakistan. The Tehsil Headquarter hospital in the area, where the study was conducted contained TB Clinic. Inclusion and exclusion criteria of suspected patients of pulmonary tuberculosis included in the study. A total of 132 subjects were screened for PTB, HCV and H. pylori infections for finding the role of co-infection. The positive PTB subjects were screened for HCV and H. pylori infections. Both infections (H. pylori and HCV) were also found among TB patients. Results: A total of 52.27% were positive for PTB in which 50.72% and 17.39% cases were found in H. pylori and HCV infections respectively. H. pylori had increased rate of infection among PTB cases when compared with that of non-TB cases. HCV was also found to be associated with PTB when compared with non-TB cases. Non-significant gender and age-based differences were present, among study population. Among all PTB patients, HCV and H. pylori coinfections were also found in 5.8% patients in current study. Conclusions: Our study showed a high prevalence of HCV and H. pylori infections among PTB patients, which suggest that PTB patients must be screened for the two infections which might be helpful in the control of further complications during the treatment of PTB.

Predictors of smear non-conversion among new-treatment pulmonary tuberculosis: a single center case-control study in Indonesia

BACKGROUND Previous studies concluded predictors of smear non-conversion pulmonary tuberculosis (TB) globally as well as in Indonesia. However, there is a limited data in hospital setting. This study aimed to explore predictors of smear non-conversion pulmonary TB in hospital setting.&#x0D; METHODS A case-control study was conducted to explore predictors of smear nonconversion among new-treatment pulmonary TB in Dr. Kariadi General Hospital from 2017 to 2019. Number of cases and controls have been determined consecutively. Data were collected from secondary data accessed in medical records and directly from subjects. Non-conversion status in the case group was defined as a persistent sputum smear-positive after 2 months of intensive phase of treatment. The subjects’ characteristics i.e., age, sex, BMI, education level, occupational status, and predictors of smear non-conversion, i.e., patient’s compliance, smoking status, alcohol consumption, presence of drugs side effects, health care access, first acid-fast bacilli (AFB) smear grading, diabetes mellitus (DM), housing condition, housing density, and household income were observed. Chi-square test and binary logistic regression were used.&#x0D; RESULTS 35 subjects were determined in the case group while 76 subjects were the control group and involved in the final analysis. Age, sex, first AFB smear grading, smoking status, housing condition, housing density, and DM were involved in the model of logistic regression. DM (OR = 3.4; 95% CI = 1.19–10.00) and first AFB smear grading (OR = 11.2; 95% CI = 3.86–33.00) were concluded as the predictors of smear nonconversion.&#x0D; CONCLUSIONS DM and first AFB smear grading were the predictors of smear nonconversion among new-treatment pulmonary TB subjects.

Determination of Malondialdehyde and Superoxide Dismutase in Pulmonary Tuberculosis Subjects

Pulmonary tuberculosis (PTB) is a dangerous bacterial infection that attacks the lungs. It has long been documented that there is an increase circulating levels of free radicals and oxidative stress markers in TB subjects. Malnutrition and deficient antioxidant capabilities further complicate the patient’s situation. The aim of this study is to determine the serum levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in pulmonary tuberculosis patients and normal volunteers at Rasheed Shekoni Teaching Hospital Dutse, Jigawa State, Nigeria. The present study consists of one hundred and thirty-four (134) subjects, Ninety (90) among which are diagnosed TB patients and forty-four (44) apparently healthy controls attending Rasheed Shekoni Teaching Hospital Dutse. Venous samples were collected from ninety consecutive, consenting PTB on drugs and those that have not started medications. MDA levels were analysed using the method of Nadigar et al (1986). The mean values of MDA in the 24 tuberculosis infected males who are yet to commence drug was 4.0±0.32, 2.8±0.53 in those that are on drugs and 2.0±0.23 in the male control subjects. It was 4.1±0.35, 2.9±0.29 and 1.9±0.32 in female that are TB infected and yet to commence drugs, those on drugs and the control subjects respectively. The total mean MDA value for those on tuberculosis drugs was 4.0±0.33, 2.8±0.46 for those that are yet to commence the treatment and 2.0±0.28 for the control subjects, the serum levels of SOD was found significantly lower (p&lt;0.005) in PTB subjects on treatment compared to those without treatment and control subjects. Conclusively, the findings of the current study showed that pulmonary tuberculosis patients are predisposed to oxidative stress leading to an increased MDA and consequent decreased SOD levels as compared to the control subjects.

Prognostic value of some serum protein fractions as Early Index of Clinical Recovery in Pulmonary Tuberculosis subjects

BackgroundMalnutrition is an important risk factor for pulmonary tuberculosis and can result to adverse treatment outcomes. AimThis was a cross-sectional study designed to assess prognostic value of some serum protein fractions in pulmonary tuberculosis (PTB) subjects at Oron, Akwa Ibom State, Nigeria. Thirty (30) TB subjects on Anti-tuberculosis therapy, thirty (30) drug naive TB subjects and thirty (30) apparently healthy control subjects aged 21–52 (35 ± 16) years were conveniently recruited. MethodsTotal protein and albumin were measured colourimetrically, Albumin-globulin ratio was calculated while demographic data was obtained using questionnaire. ResultsBMI (kg/m2), Albumin (g/dl) and AGR were significantly lower in TB subjects with or without ATT when compared with control subjects (p < 0.000 respectively), but higher in PTB subjects on ATT when compared with drug naive PTB subjects (p = 0.000 respectively). Serum Total protein (g/dl) level in PTB subjects with or without ATT was significantly higher when compared with controls (p = 0.004) while globulin (g/dl) level was lower in PTB subjects on ATT when compared with drug naive PTB subjects (p = 0.000). ConclusionDecreased BMI in TB subjects signifies reduction in muscle mass and wasting precipitated by PTB infection, while depleted albumin and AGR suggests high degree of malnutrition. Increased albumin and AGR in PTB subjects on ATT suggests improvement with ATT. Assessment of serum albumin and AGR may serve as affordable and early index of clinical recovery in PTB subjects especially in resource limited settings, and may be more reliable than the traditionally used BMI.

Tuberculosis-Candida Co-Infection in Patients having Pulmonary Tuberculosis Attending DOTs Clinic in Rumuigbo Model Primary Health Centre in Port Harcourt, Nigeria

Introduction: Some pulmonary tuberculosis subjects were some co-infected with Candida such as C. albicans, C. tropicalis, C. kruezi and C. paraspsilosis which were initially thought to be normal floras of the oral cavity. The percentage of tuberculosis patients co-infected with Candida is becoming a concern and might complicate the treatment of tuberculosis.&#x0D; Materials and Methods: A total of 400 sputum samples were collected and subjected to Ziehl-Neelsen staining technique and Genexpert system, Gram’s stain, Germ tube test and examination in KOH preparation were conducted. Culture on Sabouraud Dextrose Agar with gentamicin, and cultured on CHROMagar Candida and sugar fermentation were carried out for Candida.&#x0D; Results: Out of the 400 sputum samples examined 93(23.3%) had TB and 32(8.0%) were positive for Candida. By gender the prevalence of tuberculosis were females 51(22.4%), males 42(24.4%) while the prevalence of Candida were females 18(35.3%) and males 14(33.3%). The percentage occurrences of Candida sp. isolated were C. albicans which was the predominant species 10(21.5%), C. tropicals 5(5.4%), C. krusei 4(4.3%) and C. Parapsilosis 3(3.2%) respectively.&#x0D; Conclusion: Candida albicans remains the most predominant species of Candida in patients suffering from pulmonary tuberculosis and colonization by Candida sp should not be ignored. The presence of Candida sp. might contribute to in one way to the progression of the disease.

CORRELATION BETWEEN LESION EXTENT ON CHEST X-RAY AND POSITIVITY OF SPUTUM SMEAR WITH PLATELET PROFILE IN NEW CASE PULMONARY TUBERCULOSIS PATIENTS

Background: Pulmonary Tuberculosis (PTB) is an infection disease caused by bacilli bacteria called Mycobacterium Tuberculosis (MTB).1 Mycobacterium Tuberculosis invades the human body via droplet and induces pulmonary inflammation.2 Platelets play a role as inflammatory cells that contributed in chemotaxis, phagocytosis, complement activation and inflammatory mediators release. Platelet count and indices can be used to assess the PTB disease severity.3 Objective: To assess the correlation between lesion extent of chest x-ray and positivity of sputum smear with platelet profile in positive sputum smear new case PTB patients. Methods: This study was analytical study with cross-sectional design. Research subjects were 50 patients with positive sputum smear new case PTB. Lesion extent on chest x-ray was assessed and the platelet profile including platelet count, plateletcrit (PCT), Mean Platelet Volume (MPV) and Platelet Distribution Width were estimated. Results: Platelet count and PCT were significantly higher in PTB subjects with advanced lesion than minimal lesion (p0,05 and p>0,05). According to the positivity of AFB smear sputum, platelet count was significantly higher in PTB subjects with sputum smear +2 than sputum smear +1 (p

Pulmonary and Rifampicin-Resistant Tuberculosis Associated with Human Immunodeficiency Virus Infection Prevalence in Bayelsa State, Nigeria: A Case of Patients Attending Federal Medical Centre Yenagoa

This study investigated the prevalence of pulmonary tuberculosis (PTB) associated human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDs) infection among patients attending Federal Medical Centre Yenagoa, Bayelsa state, Nigeria. Out of the 456 subjects recruited for the study, 88 patients (comprising of male and females) with known cases of PTB was studied for the association of HIV with PTB. Blood and sputum samples were collected following standard procedure. HIV/AIDS was determined following serial all logarithm test viz: Determine, Unigold, Stat pack, while the PTB and rifampicin resistant tuberculosis (RMPR – TB) was analyzed using GeneXpert System. Results showed that 41(9.0%) and 47 (10.3%) was seropositive and seronegative to HIV/AIDS. There was no significant difference (P>0.01) among the serotypes/groups. Also 0.7% of the PTB subjects with HIV were resistant to rifampicin. Therefore, there is the need for surveillance of drug resistance in tuberculosis which could lead strengthening of laboratory networks and enhance its prevention and control.

A genome-wide association study of pulmonary tuberculosis in Morocco.

Although epidemiological evidence suggests a human genetic basis of pulmonary tuberculosis (PTB) susceptibility, the identification of specific genes and alleles influencing PTB risk has proven to be difficult. Previous genome-wide association (GWA) studies have identified only three novel loci with modest effect sizes in sub-Saharan African and Russian populations. We performed a GWA study of 550,352 autosomal SNPs in a family-based discovery Moroccan sample (on the full population and on the subset with PTB diagnosis at <25 years), which identified 143 SNPs with p < 1 × 10(-4). The replication study in an independent case/control sample identified four SNPs displaying a p < 0.01 implicating the same risk allele. In the combined sample including 556 PTB subjects and 650 controls these four SNPs showed suggestive association (2 × 10(-6) < p < 4 × 10(-5)): rs358793 and rs17590261 were intergenic, while rs6786408 and rs916943 were located in introns of FOXP1 and AGMO, respectively. Both genes are involved in the function of macrophages, which are the site of latency and reactivation of Mycobacterium tuberculosis. The most significant finding (p = 2 × 10(-6)) was obtained for the AGMO SNP in an early (<25 years) age-at-onset subset, confirming the importance of considering age-at-onset to decipher the genetic basis of PTB. Although only suggestive, these findings highlight several avenues for future research in the human genetics of PTB.

Transcriptional profiles discriminate patients with pulmonary tuberculosis from non-tuberculous individuals depending on the presence of non-insulin diabetes mellitus

Our objective was to identify transcriptional biomarkers in peripheral blood mononuclear cells (PBMC) that discriminate individuals with latent tuberculosis infection (LTBI) from those with pulmonary tuberculosis (PTB) in subjects with non-insulin-dependent diabetes mellitus (NIDDM) and in individuals without NIDDM. Using gene expression microarrays we identified differentially expressed genes from lungs of mice infected with Mycobacterium tuberculosis (Mtb) or a mutant (ΔsigH) representing a non-inflammatory model. Genes expressed in blood, with inflammatory related functions were evaluated in humans by RT-qPCR. NCF1 and ORM transcripts have the better discriminatory capacity to identify PTB subjects from LTBI and non-infected controls (NICs) independently of the presence of NIDDM. The sequential evaluation of the mRNA levels of NCF1 and ORM as multiple diagnostic tests showed 95% Sensitivity (Se) and 80% Specificity (Sp). In addition, FPR2 promises to be a good biomarker for the PTB detection in subjects with NIDDM (Se=100%; Sp=90%).

PON1 activity and total oxidant status in patients with active pulmonary tuberculosis

Objectives: The aim of this study was to the investigate effect of tuberculosis infection on paraoxonase-1 (PON1) activity and oxidative status in patients with pulmonary tuberculosis (PTB). Design and methods: Twenty-five active PTB subjects and 33 healthy controls were included in the study. Serum PON1 activity, total oxidant status (TOS), lipid hydroperoxide (LOOH) and total free sulfydryl (-SH) groups were determined. Results: Serum basal/salt-stimulated paraoxonase activities, arylesterase activity and total -SH group levels were significantly lower in patients with PTB than controls ( p < 0.05, p < 0.05, p < 0.001 and p < 0.01 respectively), while TOS and LOOH levels were significantly higher ( p < 0.01 and p < 0.05, respectively). In PTB patients, TOS, LOOH and total -SH group levels were significantly correlated with paraoxonase ( r = − 0.371, p < 0.05; r = − 0.286, p < 0.05; r = 0.625 p < 0.01; respectively) and arylesterase ( r = − 0.437, p < 0.01; r = − 0.352, p < 0.05; r = 0.653, p < 0.01; respectively). Conclusions: Patients with active PTB are exposed to potent oxidative stress and they have decreased PON1 activity. These predisposal factors may, in part, play a role in the pathogenesis of atherosclerosis in PTB.

Chest Radiographic Findings in Newly Diagnosed Pulmonary Tuberculosis Cases in Iwo, Nigeria

A clinical study was carried out on newly diagnosed pulmonary tuberculosis cases seen at Iwo Tuberculosis Control Clinic in Nigeria between January 1996 and December 1997. Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%), pleural effusion 10(1%), emphysema 30(30%), lymphadenopathy 10(10%), cavitation 10(10%), consolidation 10(10%) and destroyed lung syndrome 5(5%). The cases of pulmonary tuberculosis with Human immunodeficiency virus seropositivity (30) showed a less significantly higher percentages of fluffy exudative changes 30(37.5%), fibrosis 30(32.8%) pleural effusion 6(60%) emphysema 10(33.3%), lymphadenopathy 80(80%), consolidation 8(80%), and destroyed lung syndrome 4(80%), as compared with 70 in the seronegative group (62.5%, 57.1%, 40%, 66.6%, 20%, 20% and 20% respectively). Cavitation 1(10%) was significantly less common in the HIV sero-positive group than in the HIV sero-negative group 9(90%), Upper lobe infiltrates and cavitations are the most frequent radiographic presentations in both the HIV-infected and non-HIV infected pulmonary tuberculosis cases. Left upper lung lobe 48(48%) is more frequently affected than the right upper lung lobe 24(24%). Tuberculosis frequently affects the upper lung lobes more than the other lung lobes. The left upper lung lobe was more frequently involved than the right HIV-seropositive pulmonary tuberculosis subjects showed more significant (P

Immunodiagnosis of pulmonary tuberculosis by concomitant detection of antigen and antibodies of excretory-secretory protein ofMycobacterium tuberculosis H37Ra

With a view to diagnosing tuberculosis in populations in endemic areas, excretory-secretory antigen fraction(Mtb EST-6) of purifiedMycobacterium tuberculosis H37Ra and affinity purified polyclonal antibodies againstMtb EST were used to detect both antibodies and circulating antigen in the sera of patients and disease-free individuals. Indirect stick penicillinase ELISA system usingMtb EST-6 detected antigen-specific IgG antibody in 84% of sputum positive, 77% of sputum negative pulmonary tuberculosis patients and 7% of healthy and 11% of subjects with nontub~rculosis diseases. Similarly, a sandwich penicillinase ELISA system using affinity purified antiMtb EST antibodies detected circulating antigen in 83% and 61% of sputum positive and negative pulmonary tuberculosis subjects. In contrast only 24% of healthy and 18% of disease controls showed seropositivity. Antibody assay showed higher sensitivity and specificity (83% and 91% respectively) compared to antigen detection (sensitivity of 79% and specificity of 79%). However, by concomitant use of both assays it was possible to enhance the specificity of detection to 98%, though sensitivity was reduced marginally to 70%. The present study confirms the presence of both antigen and specific antibodies in the circulation during clinical disease and draws attention to the utility ofMtb EST-6 as a diagnostic marker of pulmonary tuberculosis.

Lipoarabinomannan antigen and anti-lipoarabinomannan antibody profile in the serum of patients with mycobacterial infections and their significance in disease process

A sandwich antigen capture assay using a double monoclonal antibody system revealed the presence of lipoarabinomannan (LAM) antigen in about 25% of the serum samples in subjects with pulmonary tuberculosis and tuberculoid leprosy. Lepromatous leprosy sera showed about 40% antigen positivity. Anti-LAM antibodies could be detected in about 90% of subjects with pulmonary tuberculosis and lepromatous leprosy. However in tuberculoid leprosy sera anti-LAM antibodies were positive in only 22% of the patients. Antigen and antibody levels in pulmonary tuberculosis and lepromatous leprosy declined steadily during anti-mycobacterial therapy, whereas in the tuberculoid type leprosy a distinct increase in antibody positivity was noticed. The high percentage of anti-LAM antibodies in pulmonary tuberculosis subjects may be of diagnostic significance.

Side-effects of drugs used in directly observed treatment short-course in newly diagnosed pulmonary tuberculosis subjects in Nigerians: A controlled clinical study

A clinical study was carried out between January 1996 and December 1997 in Iwo Nigeria to determine among others the types and frequency of occurrence of side-effects of anti-tuberculous drugs in the 8-month regimen recommended by the Nigerian National Tuberculosis Control Programme Committee (NTCP) for newly diagnosed (ND) Pulmonary Tuberculosis (PTB) cases. This was compared with a 6-month regimen used within the same population of ND PTB subjects at Iwo Nigeria. 65 (13%) of the 500 patients in group one on the 8-month regimen had various side-effects while 7 (14%) of the 50 patients in group two on the 6-month regimen manifested various side-effects. The side-effects rate and frequencies were similar and in both, they were mild and did not materially lead to major change of the anti-tuberculous medications. The regimen used in this study in group one (NTCP recommended) and group two recorded low incidence of side-effects. It confirmed that Directly Observed Treatment Short-course (DOTS) when applied with the recommended regimen by the Nigerian NTCP is effective and is characterised by low and minor side-effects.