Received Antituberculosis Drugs Research Articles

Impact of Health Education in Combination with Nutrition Support Nursing on the Nutritional Status and Quality of Life in Patients with Pulmonary Tuberculosis

ABSTRACT This study aimed to ascertain the effects of health education combined with nutrition support nursing on the nutritional status and quality of life of patients with pulmonary tuberculosis. A clinical study was conducted. Sixty-four patients with tuberculosis were selected as the study participants and divided into control and observation groups (n = 32). Both groups received antituberculosis drugs. The control group received standard nursing care, while the observation group received health education in conjunction with nutrition support nursing. After 3 months of intervention, the total effective treatment rate and adherence were compared. Before and after the intervention, the albumin (ALB), prealbumin (PA), transferrin (TF), and hemoglobin (Hb) level, body mass index (BMI), and Short Form-36 (SF-36) scores were compared. The occurrence of adverse reactions during intervention was recorded. Following the intervention, the observation group exhibited a higher treatment total effective rate and increased levels of ALB, PA, TF, Hb, and BMI compared with the control group (p < 0.05). The observation group demonstrated a higher total adherence rate and a lower incidence of adverse reactions compared with the control group (p < 0.05); the SF-36 score of the observation group was higher than that of the control group (p < 0.05). The integration of health education and nutrition support nursing can effectively enhance the therapeutic outcomes of patients with pulmonary tuberculosis. This approach not only improves their nutritional status, treatment adherence, and quality of life, but also reduces the incidence of adverse reactions. The findings of this study lay a solid foundation for further exploration of the combined effects of health education and nutrition support nursing on pulmonary tuberculosis.

NON-ADHERENCE FACTORS TO TUBERCULOSIS TREATMENT IN PULMONARY TUBERCULOSIS PATIENTS IN SURAKARTA CENTRAL GENERAL HOSPITAL, INDONESIA

Tuberculosis is an infectious disease that must be treated in the long term. One of the therapeutic efficacy factors in tuberculosis treatment is medication adherence by patients. Non-compliance to treatment leads to no achievement of treatment goals, increasing the risk of resistance, mortality, and morbidity. This study analyzed association factors that predicted the influence of the pulmonary tuberculosis patient’s non-adherence to anti-tuberculosis medicines in Surakarta Public Hospital, Indonesia. The research was analytical research with a cross-sectional approach. The study samples were 80 respondents. The inclusion criteria were patients diagnosed with pulmonary tuberculosis in Surakarta Public Hospital, aged &gt;17 years old, and patients who received Anti-Tuberculosis Drugs for at least two months. This study used a questionnaire that has been validated. Data were analyzed by bivariate analysis (chi-square or Fisher) and continued by multivariate logistic analysis. Of 80 respondents, there were 30 respondents (37.5%) were non-adherence to taking Tuberculosis (TB) drugs. The predicted factors that influenced non-adherence in taking anti-tuberculosis drugs were beliefs about the medicine of the harm subscale (p = 0.001; OR = 8.167), suffering from drug side effects (p = 0.022; OR = 4.222), and beliefs about the medicine of overuse subscale (p = 0.038; OR = 3.504). The wrong beliefs of patients and side effects may influence patients’ adherence to TB medicines. Counseling and education are needed to improve patients’ beliefs and manage medicines’ side effects.

Population study on diagnosis, treatment and outcomes of critically ill patients with tuberculosis (2008–2018)

BackgroundTuberculosis (TB) is a preventable and curable disease, but mortality remains high among those who develop sepsis and critical illness from TB.MethodsThis was a population-based, multicentre retrospective cohort study of...

Tuberculome cérébral un challenge diagnostic: à propos d’un cas et mise au point

La tuberculose du système nerveux central est le deuxième site le plus fréquent après la méningite tuberculeuse. Elle est une cause majeure de morbidité et de mortalité dans les pays en développement et représente 10 à 30% des lésions expansives intracrâniennes dans ces pays contre 0,2% dans certains pays occidentaux. Le but de cet article est de présenter un cas atypique de tuberculome cérébral dans sa présentation clinique et radiologique (l'IRM cérébrale et de la spectroscopie), de faire une mise au point à partir de cette observation sur cette pathologie infectieuse. Il s'agit d'une patiente de 44 ans, sans antécédent médico-chirurgical, qui a présenté depuis un an des céphalées, compliquées 08 mois après de crises d'épilepsies partielles à généralisation secondaire et de lourdeur de l'hémicorps gauche avec des épisodes de vomissements sans trouble visuel ni fièvre ni altération de l'état général. L'examen clinique trouvait une patiente consciente GCS= 15, pupilles égales et réactives, station debout et marche possible sans anomalie, avec hémiparésie gauche 4/5 sans autres signes neurologiques. L'IRM cérébrale objectivait en séquence T1 non injectée une lésion pariétale droite sus tentoriel plurilobées iso intense mal limitée, en séquence T2 elle est hétérogène avec un liseré hyper intense et un fond hypo intense traduisant un processus charnu avec des zones de nécroses centrales et un œdème péri-lésionnel en doigt de gans en séquence FLAIR, avec une prise de contraste annulaire intense après injection de gadolinium. L'analyse de la spectroscopie était en faveur d'une tumeur gliale. La patiente fut mise sous anticonvulsivant et a bénéficié d'un abord direct avec exérèse macroscopiquement complète. L'analyse anatomopathologique était en faveur d'un tuberculome cérébral. Elle a été mise sous traitement antituberculeux avec arrêt des crises et récupération du déficit après 04 semaines. A travers ce cas nous entrevoyons le polymorphisme clinique et radiologique qu'est le tuberculome cérébral. Il est évoqué devant un faisceau d'argument clinique, biologique et radiologique mais le diagnostic de certitude reste essentiellement anatomopathologique. La prise en charge ne saurait tarder car les complications sont néfastes et de mauvais pronostic lorsqu'il est détecté tardivement.

Impact of nursing interventions on adherence to treatment with antituberculosis drugs in children and young people: A nonrandomized controlled trial.

To evaluate the association of a new nursing intervention on the adherence to antituberculosis treatment in a paediatric cohort (<18years). Tuberculosis remains a public health problem worldwide. The risk of developing tuberculosis after primary infection and its severity are higher in children. Proper adherence to antituberculosis treatment is critical for disease control. Nonrandomized controlled trial; Phase 1, retrospective (2011-2013), compared with Phase 2, prospective with intervention (2015-2016), in a referral centre for paediatric tuberculosis in Spain (NCT03230409). A total of 359 patients who received antituberculosis drugs after close contact with a smear-positive patient (primary chemoprophylaxis) or were treated for latent tuberculosis infection or tuberculosis disease were included, 261 in Phase 1 and 98 in Phase 2. In Phase 2, a new nurse-led intervention was implemented in all patients and included two educational steps (written information in the child's native language and follow-up telephone calls) and two monitoring steps (Eidus-Hamilton test and follow-up questionnaire) that were exclusively carried out by nurses. Adherence to antituberculosis treatment increased from 74.7% in Phase 1% to 87.8% in Phase 2 (p=0.014; Chi-square test), after the implementation of the nurse-led intervention. In Phase 2, nonadherence was only associated with being born abroad (28.6% vs. 7.8%; p=0.019; Chi-square test) and with foreign origin families (27.3% vs. 0%; p<0.0001; Chi-square test). The nurse-led intervention was associated to an increase in adherence to antituberculosis treatment. Immigrant-related variables remained major risk factors for sub-optimal adherence in a low-endemic setting.

Damage of testicular cell macromolecules and reproductive capacity of male rats following co-administration of ethambutol, rifampicin, isoniazid and pyrazinamide.

The necessity to minimize adverse effects of tuberculosis chemotherapy requires a comprehensive evaluation of the effects of antituberculosis drugs on the reproductive system and testicular cell macromolecules. The epidemiological situation of tuberculosis in Central and Eastern Europe is getting worse. Data on adverse effects of antituberculosis drugs are scare concerning particularly their effects on the reproductive system. The aim of the present study was to investigate the potential effect of ethambutol, rifampicin, isoniazid and pyrazinamide co-administration on lipid peroxidation, glutathione content and protein SH-groups, DNA fragmentation levels, the reproductive capacity of Wistar male rats and the antenatal development of their posterity. The rats (150–170 g) were divided into two groups: group I – received antituberculosis drugs suspended in 1% starch gel per os: ethambutol – 155 mg/kg b.w./day, rifampicin – 74.4 mg/kg b.w./day, isoniazid – 62 mg/kg b.w./day, pyrazinamide – 217 mg/kg b.w./day, group II (control) – received only starch gel in corresponding volumes. The contents of TBA-active compounds, glutathione and protein SH-groups in testis and sperm were determined spectrophotometrically, the DNA-fragmentation was determined using an UV transilluminator (BIORAD, USA), reproductive system indices were measured by standard methods. The co-administration of therapeutic doses of ethambutol, isoniazid, rifampicin and pyrazinamide to male rats during the period of spermatogenesis caused an increase in the rate of thiobarbituric acid reactive substances formation in testis and sperm, decrease of testis glutathione and protein SH-group contents, significant changes in DNA fragmentation, fatal decrease of male fertilizing capacity and fertility, and increase of pre- and post-implantation embryo lethality. The changes in reproductive indices could be the result of direct or indirect effects of one or more drugs investigated.

Bacillus Calmette-Guérin-related cold thigh abscess as an unusual cause of thigh swelling in infants following BCG vaccine administration: a case series

IntroductionThigh swelling in an infant can be a symptom of a simple benign condition or a life-threatening condition. We observed a cluster of thigh swelling episodes in infants in which the cause was Bacillus Calmette-Guérin-related cold thigh abscess. We report this unusual case series to raise awareness about this diagnosis.Case presentationsWe performed a retrospective review of five infants (four boys and one girl) who presented with Bacillus Calmette-Guérin-related left thigh abscess. The swelling was noticed by the parents at a mean period of three months prior to presentation. The ages at presentation were five, five, eight and nine months for the boys, and six months for the girl. All of the patients were healthy Saudi infants, and received the Bacillus Calmette-Guérin vaccine at birth. Clinically, all of the patients were well and did not demonstrate signs of systemic infection. All patients underwent needle aspiration, with subsequent incision and drainage in four of the five cases. The cultures obtained from the abscess fluids were the key to establishing the diagnosis. Only three patients (60%) received antituberculosis drugs. Wound healing lasted for a mean period of approximately seven months. Two-year follow-up was unremarkable for all of our patients.ConclusionsTechnical errors continue to be significant in the development of vaccine-related complications. Bacillus Calmette-Guérin-related cold thigh abscess is an extremely rare entity.

Endomyocardial Fibrosis: An Under-diagnosed Cause of Cardiomyopathy in Sudanese Children

Endomyocardial fibrosis (EMF) is a tropical cardiomyopathy reported in many tropical countries. Patients were seen at the Children's Hospital-Khartoum, Sudan during September 2007-08 where cardiac evaluation was done. Six patients were identified (18% of all children with cardiomyopathy); all were males aged 8-17 years. All patients presented with abdominal distention, stunted growth, raised jugular venous pressure, ascites and hepatosplenomegaly. Electrocardiogram abnormalities included atrial fibrillation, first and third degree AV block and tall P wave. Echocardiography revealed huge right atrium dilatation and right ventricle apex obliteration by fibrous tissue. One patient had left-side affection with moderate mitral regurgitation. Eosinophilia was present in three patients. Two patients received antituberculosis drugs with no improvement, two had history of treated bilharziasis and two had been labeled as having Ebstein disease. EMF is an important cause of cardiomyopathy in Sudan that is often misdiagnosed. Clinical and echocardiographic examinations can lead to the correct diagnosis.

Secondary tuberculosis of tongue in an HIV-infected patient

Background. Mycobacterium tuberculosis infection is a chronic granulomatous disease, which may present with a broad spectrum of pulmonary and/or extrapulmonary manifestations. The latter are rare, accounting for 10%-15% (oral cavity, 0.05%-5%) of all cases, most often being secondary to pulmonary involvement. Recently, HIV infection has been deemed as a potent factor in promoting the development of tuberculosis.Case report. A 40-year-old male complained of painful ulcers and burning sensation on his tongue. His medical history revealed HIV infection, Kaposi's sarcoma of the extremities, thrombocytopenia, and hypertension. He denied symptoms of fever, coughing, and weight loss. His social history included smoking cigarettes. Oral examination revealed 2 ulcerative lesions on the tip and right lateral border of the tongue respectively, which were shallow with elevated, irregular, nonindurated borders. In addition, white wipeable plaques were present diffusely on his tongue mucosa. Owing to his thrombocytopenia, a biopsy was contraindicated. An initial diagnosis of ulceration not otherwise specified and pseudomembranous candidiasis associated with HIV infection was rendered, and the patient was treated with topical corticosteroids and antifungal medication. However, the ulcerative lesions dramatically enlarged and became more symptomatic, despite additional empirical treatment with acyclovir, thalidomide, and erythromycin mouthwash. After platelet transfusion, a biopsy was performed which revealed granulomatous inflammation with numerous multinucleated Langhans-type giant cells. Tissue section stained with Zeihl-Neelson showed acid-fast bacilli, supporting the diagnosis of tuberculosis. A complete medical examination and chest radiograph confirmed the presence of pulmonary tuberculosis. The patient received antituberculosis drugs (pyrazinamide and isoniazid), which induced complete healing of his tongue ulcers.Conclusions. Oral lesions in HIV-infected patients may represent manifestations of uncommon systemic diseases. Tuberculosis should be included in the differential diagnosis of nonhealing oral ulcers in an HIV-infected patient. Extrapulmonary lesions in patients infected with HIV may be the first detected sign of undiagnosed pulmonary tuberculosis. Background. Mycobacterium tuberculosis infection is a chronic granulomatous disease, which may present with a broad spectrum of pulmonary and/or extrapulmonary manifestations. The latter are rare, accounting for 10%-15% (oral cavity, 0.05%-5%) of all cases, most often being secondary to pulmonary involvement. Recently, HIV infection has been deemed as a potent factor in promoting the development of tuberculosis. Case report. A 40-year-old male complained of painful ulcers and burning sensation on his tongue. His medical history revealed HIV infection, Kaposi's sarcoma of the extremities, thrombocytopenia, and hypertension. He denied symptoms of fever, coughing, and weight loss. His social history included smoking cigarettes. Oral examination revealed 2 ulcerative lesions on the tip and right lateral border of the tongue respectively, which were shallow with elevated, irregular, nonindurated borders. In addition, white wipeable plaques were present diffusely on his tongue mucosa. Owing to his thrombocytopenia, a biopsy was contraindicated. An initial diagnosis of ulceration not otherwise specified and pseudomembranous candidiasis associated with HIV infection was rendered, and the patient was treated with topical corticosteroids and antifungal medication. However, the ulcerative lesions dramatically enlarged and became more symptomatic, despite additional empirical treatment with acyclovir, thalidomide, and erythromycin mouthwash. After platelet transfusion, a biopsy was performed which revealed granulomatous inflammation with numerous multinucleated Langhans-type giant cells. Tissue section stained with Zeihl-Neelson showed acid-fast bacilli, supporting the diagnosis of tuberculosis. A complete medical examination and chest radiograph confirmed the presence of pulmonary tuberculosis. The patient received antituberculosis drugs (pyrazinamide and isoniazid), which induced complete healing of his tongue ulcers. Conclusions. Oral lesions in HIV-infected patients may represent manifestations of uncommon systemic diseases. Tuberculosis should be included in the differential diagnosis of nonhealing oral ulcers in an HIV-infected patient. Extrapulmonary lesions in patients infected with HIV may be the first detected sign of undiagnosed pulmonary tuberculosis.

Evaluation of young children in household contact with adult multidrug-resistant pulmonary tuberculosis cases.

The prevention and management of multidrug-resistant (MDR) tuberculosis has received much attention, but little attention has been given to children with MDR tuberculosis or children in contact with adults with MDR tuberculosis. The aim of this study was to determine the prevalence of tuberculous infection and disease in childhood contacts of adults with MDR pulmonary tuberculosis. All children <5 years of age in household contact with 75 recently diagnosed adults with MDR pulmonary tuberculosis were evaluated. Evaluation included clinical examination, tuberculin skin test, chest radiography and culture for Mycobacterium tuberculosis from gastric aspirates. One hundred twenty-eight children, median age 27 months, were evaluated. Fifty children had recent contact with other adult tuberculosis cases. Sixty-six children previously had chemoprophylaxis or treatment of whom 36 defaulted treatment or received insufficient chemoprophylaxis. One child had HIV infection. Forty-seven children were classified as noninfected, 66 were considered infected only (Mantoux test, > or = 15 mm) and 15 had disease. Three children, who had not previously received antituberculosis drugs, had positive cultures for M. tuberculosis; all were multidrug-resistant. This study documents the transmission of multidrug-resistant M. tuberculosis to childhood contacts, the development of disease in these contacts and the importance of knowing the index case's M. tuberculosis susceptibility pattern in choosing a proper treatment regimen for the childhood contact.

High rate of rifampicin resistance of Mycobacterium tuberculosis in the Taif region of Saudi Arabia

This retrospective study was undertaken to determine the prevalence and pattern of resistance to antituberculosis drugs among patients with sputum-proven pulmonary tuberculosis who were seen in Taif Chest Hospital over 24 months (between June 1986 and May 1988). The overall prevalence was 22.6% and the majority (53%) were resistant to two drugs. Resistance to streptomycin was most frequent (16%) followed by rifampicin (15%). Resistance to isoniazid was surprisingly low (6.5%). 23.3% of the resistant group had previously received antituberculosis drugs as against 15.4% in the sensitive group. There was a significant association between previous therapy and resistance to antituberculosis drugs. Recommendations to reduce the problem of resistance and to improve compliance are discussed.

Effect of Direct Irradiation on the Course of Pulmonary Tuberculosis (Using Cancerocidal Doses)

1. In this study, cases of inoperable lung cancer coexistent with pulmonary tuberculosis were irradiated with cancerocidal doses. 2. Seven patients in whom neoplasm developed in an area of tuberculosis were treated. The dose of irradiation at the central lung varied from 4000 r to 6800 r given in 37 to 104 days. 3. All patients received antituberculosis drugs. 4. The total period of observation after irradiation varied from seven weeks to thirty-two and one-half months. 5. In only one of the seven patients was there x-ray film evidence of change that could possibly be due to relapse of tuberculosis. In this patient (Case 7) the changes might be due to radiation necrosis (8800 r). This patient, moreover, had discontinued antituberculosis drug treatment after irradiation. 6. The experience in this small series of patients would indicate that irradiation of pulmonary neoplasms coexistent with pulmonary tuberculosis with cancerocidal doses can be accomplished without danger of deterioration of the tuberculosis if proper antituberculosis drug coverage is provided. In the presence of considerable drug resistance it would be desirable to add another antituberculosis drug to which the microorganism is sensitive to avoid any possible hazard of irradiation.