Relapse Of Pulmonary Tuberculosis Research Articles

Studying The Factors Associated With Relapse Of Pulmonary Tuberculosis in Baghdad

Background: Relapse is defined as recurrent tuberculosis at any time after completion of treatment and apparent cure Recurrence of tuberculosis may occur as a result of relapsed infection due to the same Mycobacterium tuberculosis strain, or due to exogenous reinfection with a new strain.
 Objective: To study the factors associated with relapse of pulmonary tuberculosis.
 Methods:. Across sectional study had been done in the chest and respiratory diseases teaching specialized center in Baghdad during the period from the 1st of January 2010 to the 30th of July 2011. A total of 58 patients with relapsed pulmonary tuberculosis were included in this study. For each patient.the fallowing variables were collected age, gender, marital status, regularity of treatment, diabetes mellitus, smoking, alcohol intake and prisonment have been studied.
 Results: Mean age for all relapsed cases was 47.4years.A 53patients(91.4%) of relapse cases were married. There was only 30 patients(51.7%)of relapse cases regular on treatment. It was 15 patients (25.9%) contribute to about one forth (25.9%) of relapsed cases was diabetic. There was 28 patients (48.3%)of relapsed cases was smokers. A17 patients (29.3)% of them was prisons.Finaly 13 patients(22.4%) of relapsed cases had history of alcoholic intake.
 Conclusions: Recurrence of tuberculosis was more common in male, married, diabetic, prisoners, and history of alcohol patients and patients presenting at least one of the risk factor can benefit from the implementation of a post-treatment surveillance system for early detection of recurrence.

Health-Related Quality of Life (HRQoL) in Co-Morbid Tuberculosis Relapse Patient: A Case Report from Malaysia

Purpose: To describe changes in HRQoL of pulmonary tuberculosis (PTB) patient and illustrate impact of malnutrition and Type II diabetes on relapse of PTB. Case: A Chinese male patient with complaints of productive cough, and loss of weight and appetite was registered; sputum smear confirmed that patient had PTB. Diagnosis was also supported by routine investigations. Patient had past history of PTB and Type II diabetes mellitus. For management of secondary tuberculosis, he was prescribed WHO recommended therapy. Elevated HbA1c levels and history of drop-off serum albumin concentration at the start of treatment demonstrated inappropriate glycaemic control and malnutrition over the past months. SF-36v2 was used to estimate HRQoL scores at start, after two months and at the end of TB therapy. Although patient’s perception of mental and physical health improved with progress of treatment, vitality (VT), social functioning (SF) and role emotion (RE) scores were still lower than Malaysian norms. Patient was declared ‘cured’ but state of ‘health’ as defined by WHO was not achieved. Conclusion: Relapse of PTB might be a consequence of inappropriate glycaemic control and malnutrition. This case report demonstrates the need for more comprehensive efforts at TB programs to improve HRQoL of TB patients.Keywords: Health-Related Quality of Life, Pulmonary tuberculosis, Malnutrition, Type II diabetes, SF 36v2

Investigation of self-discharged patients of pulmonary tuberculosis

This study investigates 27 cases in which the patients left hospital care without permission for personal reasons. These patients were classified as "self-discharged patients". Each of the patients had been diagnosed as having pulmonary tuberculosis, and were receiving treatment at the National Chiba Higashi Hospital during the period from January 1988 to July 1991. Disease was in an advanced stage in each of the patients when admitted: all sputum examinations were positive and chest roentgenograms revealed cavities in 26 patients. In addition to pulmonary tuberculosis, the patients were also diagnosed has having a variety of other medical complications such as diabetes mellitus, gastric ulcers and liver disease. Many of them were unemployed or were day labors. Reasons attributed to patients self-discharge from the hospital included repetition of alcohol drinking and unauthorized outings. At the time patients chose to leave hospitalization 11 cases checked positive for sputum examinations, and 16 cases never returned to complete therapy. Many of them were rated as high risk patients for pulmonary tuberculosis because they had no immediate family, did not own a residence or have regular employment thus economic and psychological conditions were very low. There is a high possibility that these individuals will suffer pulmonary tuberculosis relapse and become infectious bacteria carriers. It is important that such patients be hospitalized long enough to receive adequate treatment to prevent then from becoming infectious carriers and spreading disease.

Effect of Improving the Quality of Radiographic Interpretation on the Ability to Predict Pulmonary Tuberculosis Relapse

Chest radiographic findings are important for diagnosis and management of tuberculosis. The reliability of these findings is therefore of interest. We sought to describe interobserver reliability of chest radiographic findings in pulmonary tuberculosis, and to understand how the reliability of these findings might affect the utility of radiographic findings in predicting tuberculosis relapse. Three blinded readers independently reviewed chest radiographs from a randomly selected group of 10% of HIV-seronegative subjects participating in a tuberculosis treatment trial. The three readers then arrived at a fourth, consensus radiographic interpretation. A total of 241 films obtained from 99 patients were reviewed. Agreement among the independent readers was very good for the findings of bilateral disease (kappa = 0.71-0.86 among readers) and cavitation (kappa = 0.66-0.73). The original interpretation was reasonably sensitive and specific (compared to the consensus interpretation) for bilateral disease, but the sensitivity for cavity decreased from 81% for the 2-month film to 47% at end of treatment (P = 0.013). Substituting the consensus interpretation for the original interpretation increased the odds ratio for the association between cavitation on early chest radiograph and subsequent tuberculosis relapse from 4.97 to 8.97. Radiographic findings were reasonably reliable between independent reviewers and the original interpretations. The original investigators, who knew the patient's clinical course, were less likely to identify cavitation on the end of treatment chest radiograph. Improving the reliability of these findings could improve the utility of chest radiographs for predicting tuberculosis relapse.

Clinical profile of patients having pulmonary tuberculosis and renal amyloidosis

Objectives:This study was planned to define the clinical profile of pulmonary tuberculosis (PTB) patients having renal amyloidosis, to identify the factors responsible for development of amyloidosis, to detect the time period between onset of amyloidosis and PTB, and analyze clinical features of amyloidosis in PTB patients for early diagnosis and timely assessment.Materials and Methods:Patients of PTB having pedal edema, proteinuria, and grossly diseased kidneys on ultrasound abdomen were subjected to renal biopsy and appropriate biochemical investigations. Clinical profile of biopsy proven amyloidosis cases was analyzed.Results:There were 43 patients (32 males, 11 females, age range 20–65 years) having PTB with pedal edema, proteinuria, and renal medical disease on abdominal ultrasound where amyloidosis was confirmed by renal biopsy. The total duration of illness ranged from two months to seven years (mean 2.25 years) and was less than five years in 93% patients. All patients had significant proteinuria. Nephrotic syndrome was seen in 23, hypertension in 19, hypoalbuminemia in 33, hypercholesterolemia in 29, and deranged renal functions in 32 patients. Ninety percent patients had moderate to far advanced pulmonary lesions on chest radiography with smear positivity in 21 patients.Conclusions:Renal amyloidosis is an important complication of PTB and should be suspected clinically in patients presenting with a triad of pedal edema, proteinuria, and medical renal disease on ultrasound. Contrary to general belief, renal amyloidosis may occur in PTB patients having disease for relatively shorter duration, and even if adequately treated.

Exogenous reinfection as a cause of recurrent tuberculosis after curative treatment.

For decades it has been assumed that postprimary tuberculosis is usually caused by reactivation of endogenous infection rather than by a new, exogenous infection. We performed DNA fingerprinting with restriction-fragment-length polymorphism analysis on pairs of isolates of Mycobacterium tuberculosis from 16 compliant patients who had a relapse of pulmonary tuberculosis after curative treatment of postprimary tuberculosis. The patients lived in areas of South Africa where tuberculosis is endemic. Medical records were reviewed for clinical data. For 12 of the 16 patients, the restriction-fragment-length polymorphism banding patterns for the isolates obtained after the relapse were different from those for the isolates from the initial tuberculous disease. This finding indicates that reinfection was the cause of the recurrence of tuberculosis after curative treatment. Two patients had reinfections with a multidrug-resistant strain. All 15 patients who were tested for the human immunodeficiency virus were seronegative. Exogenous reinfection appears to be a major cause of postprimary tuberculosis after a previous cure in an area with a high incidence of this disease. This finding emphasizes the importance of achieving cures and of preventing anyone with infectious tuberculosis from exposing others to the disease.

Tuberculosis and Pregnancy: Five- to Ten-Year Review of 215 Patients in their Fertile Age

This study evaluated the influence of pregnancy as a relapse factor in pulmonary tuberculosis in 215 patients who recieved adequate chemotherapy. A comparison was made between the evolution of patients who had pregnancies and those who did not. On ending the period of observation (details are lacking with respect to only of observation (details are lacking with respect to only seven patients), 203 patients continued to be well without active pulmonary lesions, and no relapses had been seen. Of these patients, 100 had 149 pregnancies, giving birth to 135 children; 108 had no pregnancies. Fifteen pregnancies took place while patients were in the active phase of their tuberculosis, and 134 occurred once chemotherapy had ended; seven patients gave birth to nine children while their postchemotherapy cavity remained inactive. From the extended period of observation, it can be concluded that pregnancy, birth, puerperium, and lactation do not presuppose any risk of relapse of pulmonary tuberculosis when it is adequately treated even in patients in whom an inactive postchemotherapy cavity persisted.

Problematik der Ethambutol-Dosierung

Single daily doses of 15 or 20 mg/kg Ethambutol (EMB) are not sufficient to prevent exacerbation or relapse of pulmonary tuberculosis or development of bacterial resistance to INH or SM. At this level, development of EMB resistance was seldom or never observed.

Public health aspects of relapsing tuberculosis.

It was possible to assess the problem of relapse of pulmonary tuberculosis in Denmark from a public health point of view since, in 1950, it became obligatory to report to a national register all arrest of disease among patients with active pulmonary tuberculosis. A uniform criterion for arrest was used. Relapse rates were studied among 6,242 persons whose disease was arrested during 1951–1953. A total of 522 relapses were reported during a seven-year follow-up period. Rate of relapse was 13 per 1,000 person-years, 50 times higher than the incidence of new cases in the general population. The rate was higher in males than in females and increased considerably with age. Frequency of relapse was higher among infectious than among noninfectious patients. Rate of relapse decreased during the first part of the observation period but then levelled off. The relapse rate in the study population was twice as high as among patients from the isoniazid era. The excess mortality, which is based on deaths from all cause...

On the Relapse of Pulmonary Tuberculosis Occurred in the Course of Chemotherapy

On the Relapse of Pulmonary Tuberculosis Occurred in the Course of Chemotherapy

Relapse of pulmonary tuberculosis after five years or more of arrest.

IT has long been recognized that many years of observation are needed for proper evaluation of a therapy for pulmonary tuberculosis. Information on the pattern of primary relapse over many years after the attainment of arrest has recently been accumulating.1 2 3 4 It appears that the vast majority (80 to 90 per cent) of primary relapses occur within five years of attainment of arrest. Under what circumstances does later relapse occur? Just how common is it? Is it usually a manifestation of endogenous reinfection, as is generally believed, or is exogenous reinfection an important consideration?This study was undertaken in an effort . . .

Pulmonary tuberculosis relapse and mortality.

Pulmonary tuberculosis relapse and mortality.