Smear-positive Pulmonary Tuberculosis Research Articles

The Cavity as a Lasting Abode for Tuberculous Bacilli: An Observational Study.

The aim of this study was to determine the factors associated with persistent sputum positivity at the end of 2 months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi. A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi, over 6 months. A sample of 73 consenting, newly diagnosed, smear-positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, BMI, socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at 2 months of treatment with a sputum smear. Data analysis was done on SPSS (Statistical Package for Social Sciences-version 20.0). Rate of sputum positivity after 2 months of anti-tubercular drug treatment was 17.8%. None of the above-mentioned demographic and clinical factors was associated with persistence of sputum positivity except for the presence of CXR cavities, which made it 5.5 times more likely that the patient would remain smear-positive at 2 months (p = 0.035). The finding of chest radiograph cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavorable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and therefore pay particular attention to such patients in terms of stringent monitoring and directly observed treatment short-course (DOTS) provision.Supplementary InformationThe online version contains supplementary material available at 10.1007/s42399-021-01098-6.

Changes of lymphocyte subsets in smear-negative pulmonary tuberculosis.

The host immune system plays an important role in the pathogenesis and defense mechanism of Mycobacterium tuberculosis (Mtb). This study aimed to explore the different changes in the immune system between smear-negative pulmonary tuberculosis (PTB) and smear-positive PTB patients. A total of 85 active PTB patients and 50 healthy adults were enrolled. The participants were divided into smear-negative PTB, smear-positive PTB, and control groups. Chest computed tomography (CT) and lymphocyte subgroup counts in peripheral blood were measured in all participants. There were higher numbers of CD4 + T-cells, NK cells, and pulmonary cavities in the smear-positive PTB group, whereas the numbers of B-ells were significantly increased in the smear-negative PTB group. Smear-negative PTB showed fewer pulmonary cavities, mild inflammatory response, lower numbers of immune cells, and higher numbers of B- cells.

Analysis of a tuberculosis outbreak in an office: Hokkaido, Japan, 2019-2020.

In August 2018, a male worker (Pt1) in an office was diagnosed with smear-positive pulmonary tuberculosis (TB). This study aims to characterize the cases found in the TB outbreak in the office. The risks of TB disease or infection were compared among the staff members by seating locations. A total of 116 current and ex-staff members were investigated, among whom 13 patients with active TB, including Pt1, and 20 with latent TB infection were found by the end of 2020. One-third of the seating groups located at one end of the office that Pt1 belonged to had the highest risk of TB disease (30.8%, 95% confidence interval [CI]: 14.3%-51.8%) and infection (61.5%, 95% CI: 40.6%-79.8%) with a high relative risk of TB infection (6.2, 95% CI: 2.0-18.8) compared to another one-third of the seating groups at the other end of the office that had the lowest risk of active TB (0%, 95% CI: 0%-11.6%) and TB infection (10.0%, 95% CI: 2.1%-26.5%). The seating groups that Pt1 belonged to had the highest risk of TB disease and infection because the staff members in the groups were exposed to the air containing TB bacilli from Pt1. Local health offices should initiate active case finding using chest X-rays as soon as they are notified of a sputum smear-positive TB case if the delay of the diagnosis is longer than three months.

Weight Changes and its Determinants among Sputum Positive Pulmonary TB Patients in Bengaluru – A Prospective Study

Background and Objectives Underweight indicating undernutrition has a bidirectional relationship with Tuberculosis TB and is an established prognostic risk factor. It contributes to an estimated 55 of annual TB incidence in India. Positive weight changes among Indian patients without additional nutritional support are in the range of 3ndash4 kg. Undernourished patients with TB get into a vicious cycle of worsening disease and undernutrition which is detrimental. With this background we intend to assess the weight changes and its determinants among newly diagnosed drug sensitive smear positive pulmonary TB patients and estimate the prevalence of undernutrition.Methodology A prospective study was conducted among 121 newly diagnosed drug sensitive smear positive pulmonary TB patients ge 18 years registered in selected tuberculosis units in Bangalore. A pretested questionnaire was administered weight and height were measured at recruitment. Patients were followed up for weight assessment at the end of two and six months. Repeated ANOVA measures were applied to see statistical differences in the weight changes between the start of treatment end of two months and six months.Results Mean weight at the start of the treatment end of two months and six months was 55.72plusmn8.9 56.7plusmn8.5 and 58.2plusmn8.2 kg respectively. The weight changes between the groups was found to be statistically significant p value lt0.001. Mean weight gain in the study subjects was 2.3plusmn1.4 kg. An average of 4 positive weight change was seen at the end of the treatment. Positive weight change was significantly associated with higher socio economic status absence of alcohol consumption absence of tobacco use absence of clubbing and pallor in TB patients while only absence of pallor OR-16.169.3-3.7 and tobacco use OR-12.6 43.9-3.5 in multivariate analysis showed a p value lt 0.05.Conclusion Monitoring the weight regularly in TB patients during the course of treatment with proper nutritional counselling is essential for treatment support and success of National TB Elimination Program NTEP as the nutritional status has a bidirectional relationship with TB acting as an important determinant factor for treatment success

Genetic polymorphism of toll-like receptors in HIV-I infected patients with and without tuberculosis co-infection.

Toll-like receptors (TLRs) are identified as one of the key components of innate immune system due to their ability to sense conserved molecular motifs associated with several pathogens. It has been implicated from several evidence that mutations in genes encoding TLRs are associated with increased or decreased susceptibility to various infectious diseases. The study was prospective, cross-sectional, as well as longitudinal in nature, which includes 223 HIV-positive patients, 150 HIV-positive patients with latent tuberculosis (TB) infection, 150 HIV-positive patients with active TB, 200 HIV-negative newly diagnosed sputum smear positive pulmonary TB patients, and 205 healthy subjects. A statistically significant difference was observed in allelic frequencies of TLR4 between healthy subjects and HIV + TB patients (P < 0.001), healthy subjects, and pulmonary TB (PTB) Category-I patients (P < 0.01) and between healthy subjects and HIV + TB patients (P < 0.001). TLR4 genotype frequencies were also significantly different between healthy subjects and PTB Cat I patients (P < 0.001) and HIV + and HIV + TB patients (P < 0.01). A statistically significant difference was also observed between HIV + and PTB Cat I patients (P = 0.04), HIV + LTBI and HIV + TB patients (P = 0.01), and between HIV + TB and PTB Cat I patients (P < 0.01). This study implicates that Asp299Gly polymorphism in TLR4 gene is associated with increased susceptibility to active TB in HIV-seropositive patients. Increased frequency of 'A' allele in TLR9 gene was also discovered at the time of active TB development in ART naïve HIV + patients, who developed active TB on follow-up.

Determinants of treatment interruption and outcome among smear-positive pulmonary tuberculosis patients in a tuberculosis unit of Purba Bardhaman district of West Bengal.

Context:The adoption of directly observed treatment short course (DOTS) in Revised National Tuberculosis Control Programme has given impressive results with higher treatment success. But interruption of treatment has been one of the major obstacles to treatment of tuberculosis.Aims:The aim of the study was to evaluate the determinants of treatment interruption and outcome. It also evaluated the impact of treatment interruption on treatment outcomes.Settings and Design:The study was carried out in the area covered under Bhatar tuberculosis unit (TU) of Burdwan district of West Bengal. The study was a descriptive cross-sectional study.Methods and Material:Smear-positive pulmonary tuberculosis patients were taken as study subjects in both the components of study. Complete enumeration technique, rather than sampling, was followed in this study. Data were collected in a predesigned and pretested schedule.Statistical Analysis Used:Data were analyzed by percentages and proportion. Chi-square test was used to find the association between variables.Results:Gender, religion, and substance abuse were found to be statistically significant factors with interruption. It was also observed that treatment outcome was not statistically significant with age, gender, religion, and category of treatment. In the study, 84.6% of the study subjects with interruption less than 1 week had favorable outcome. But in study subjects with longer duration of interruption (≥2 weeks), only 12.5% had favorable outcome. Not only interruption, duration of interruption was found to be adversely affecting the treatment outcome.Conclusions:Interruption had an impact on the treatment outcome in the present study. Unfavorable outcomes were significantly more frequent among patients with interruption as compared to those without any interruption.

Frequency of Smear Positive Pulmonary Tuberculosis in Rheumatoid Arthritis Patients Taking DMARDS at Khairpur Medical College/Hospital Khairpur

Background and Aim: The clinical tuberculosis infection risk increases with rheumatoid arthritis and its medication. Chronic systemic inflammation caused by rheumatoid arthritis is an autoimmune disease may affect various organs and tissues. The present study was aimed to assess the frequency of smear positive pulmonary tuberculosis in rheumatoid arthritis patients taking DMARDS at Khairpur Medical College/ Hospital Khairpur. Methodology: This cross-sectional study was conducted on 249 smear positive pulmonary tuberculosis in rheumatoid arthritis patients at the Department of Internal Medicine of Khairpur Medical College/Hospital Khairpur from March 2019 to July 2021. All the patients with cough for &gt;3 weeks were enrolled by taking three sputum sample and risk assessment questionnaire. The Mycobacterium tuberculosis bacilli presence was identified based on acid fast staining technique. Tuberculosis incidence, medical records, and clinical manifestation were explored. SPSS version 24 was used for data analysis. Results: Of the total 249 patients, 226 (90.8%) were male and 23 (9.2%) were females. The overall mean age was 65.73±7.53 years. The incidence of tuberculosis with rheumatoid arthritis was 4-fold. The prevalence of pulmonary tuberculosis and disseminated tuberculosis was 59 (72.8%) and 22 (27.2%) respectively in rheumatoid disease patients. The incidence of tuberculosis with rheumatoid arthritis reduced from 47.6 to 28 per 100 000 with p&lt;0.001. Conclusion: Our study found that pulmonary tuberculosis was more prevalent (72.7%) among adult tuberculosis patients with rheumatoid arthritis. Compared to general population, the tuberculosis incidence among rheumatoid arthritis patients was 4-fold. Keywords: Smear positive pulmonary tuberculosis, Rheumatoid arthritis, DMARDS

Epidemiology and factors of tuberculosis treatment outcome, Bangladesh, 2012-13

Tuberculosis (TB) treatment outcome is an important indicator to improve TB control efforts. We assessed factors associated with unfavorable treatment outcomes among smear-positive pulmonary TB patients reported to the national TB program from January 2012 to December 2013 in Bangladesh. Favorable outcomes were cured and treatment completed with unfavorable outcomes as failed, defaulted, died and lost to follow-up. We retrieved 98,932 patients with outcome data; 65,458 (66%) were male and 7,956 (8%) had unfavorable outcomes (3,737 (47%) died, 1,641 (21%) defaulted, and 1,599 (20%) lost to follow-up). In multivariable analysis, male gender (adjusted odds ratio [aOR] 1.41; 95% confidence interval [CI] 1.34-1.49) and treatment at a chest disease hospital (CDH) (aOR 1.44; 95% CI 1.25-1.66) were risk factors. The association between male gender and unfavorable outcomes may result from the high smoking rates among males in Bangladesh. The association of treatment at a CDH with unfavorable outcomes may occur because complicated cases (e.g., TB with co-infections) are usually treated in a chest hospital in Bangladesh. A case-control study could further confirm and explain these findings.

Reasonable Application of Moxifloxacin in the Clinical Treatment of Severe Smear-positive Pulmonary Tuberculosis

Reasonable Application of Moxifloxacin in the Clinical Treatment of Severe Smear-positive Pulmonary Tuberculosis

Capture - recapture based study on the completeness of smear positive pulmonary tuberculosis reporting in southwest Iran during 2016

BackgroundTuberculosis (TB) is one of the ten leading causes of death in infectious diseases and one of the ten leading causes of death in the world. For any TB control program, a valid surveillance is essential. In order to assess the status of the assessment, the quality of the record and the completeness of reporting should be assessed. The purpose of this study was to investigate the completeness of smear positive pulmonary tuberculosis reporting in Ahvaz, south west of Iran.MethodsThis cross-sectional study was conducted in 2016 in Ahvaz, southwest Iran. The study was conducted through a three-source Capture recapture method by collecting laboratory, hospital, physician prescription data; including patient referral to the health care center, prescriptions of patients receiving anti-tuberculosis drugs and prescriptions of medical TB diagnostic laboratories, and laboratory prescriptions. Percentage, mean and standard deviation were used to describe the variables. Data analysis was performed using log-linear model in Rcapture package R software.ResultsGenerally, 134 new cases of smear-positive pulmonary tuberculosis patients were reported through three sources from urban and rural regions during 2016. Pulmonary tuberculosis was reported through three sources from urban and rural regions during 2016. The most common age group was 25 to 44 years and 79.1% of the patient were man. The overall prevalence of new cases of smear-positive pulmonary tuberculosis was in persons that lived urban areas (97.8%). The completeness of reporting the disease estimated by log-linear model was 87.5% and the incidence rate was estimated to be 11.8 disease per 100,000 persons. Completeness of reporting of laboratory, hospital and physician resources were 79%, 30% and 16.3%, respectively.ConclusionsThe present study shows the necessity of evaluating the quality, completeness and linkage between data. Linking between data sources can improve the accuracy and completeness of TB surveillance.

Effectiveness of a case management model in newly treated smear-positive pulmonary tuberculosis patients.

To investigate the effectiveness of the case management mode on the application of smear-positive pulmonary tuberculosis patients. This was a randomized control trial. A total of 70 newly diagnosed smear-positive pulmonary tuberculosis patients were recruited and been randomly divided into experimental group and control group, with 35 participants in each group. In the experimental group, patients received the tuberculosis case management mode based on the conventional management mode. In the control group, patients received the routine management mode. We compared the knowledge, attitude, and practice score; sputum-negative conversion rate, effective imaging rate of the two groups at the time of initial admission, discharge, and one month after discharge. The results showed that there was no significant difference in baseline data between the two groups (p > 0.05); at the time of discharge and one month after discharge, the knowledge, belief, behavior, sputum-negative conversion rate, and imaging examination effective rate of the experimental group were higher than those of the control group (p < 0.05). The case management mode can improve the knowledge, attitude, and practice level; sputum-negative conversion rate; and imaging efficiency of newly treated smear-positive pulmonary tuberculosis patients.

Coinfection of Mycobacterial diseases

Although both mycobacterial infections are endemic in developing countries, the coinfection has hardly been reported in the last decade. The combined National TB &amp; Leprosy Control Programme of Bangladesh came into effect in 1994. Though the Elimination of Leprosy (&lt;1 case / 10,000 population) was achieved nationally in 1998, Bangladesh is still endemic for Tuberculosis. A 10 years cohort study was conducted in six districts of the Northern part of Bangladesh, covered by the Damien Foundation. This cohort consisted of a total of 4,788 leprosy cases registered from 2007 to 2016. Reviewing the records of all these cases, 25 (0.52%) patients were identified as having coinfection with Tuberculosis &amp; Leprosy. All cases were coinfected with smear positive pulmonary TB. This study concludes that duel infection with mycobacteria is uncommon. Early diagnosis is very important for better outcomes of both diseases.&#x0D; CBMJ 2020 July: Vol. 09 No. 02 P: 39-41

P6‐67: Study on sputum non‐conversion at the end of intensive phase in smear positive pulmonary tuberculosis patients

P6‐67: Study on sputum non‐conversion at the end of intensive phase in smear positive pulmonary tuberculosis patients

Examination of close contacts of smear positive tuberculosis patients in Shaanxi, 2012–2020

Objective To analyze the examination of close contacts of smear positive pulmonary tuberculosis (TB) patients and the detection of pulmonary TB patients in Shaanxi province. Methods The performance of screening of 190 542 close contacts of newly registered smear positive pulmonary TB patients in Shaanxi from 2012 to 2020 was analyzed. The relevant information of the close contacts were collected and input into Excel database. SPSS 21.0 was used for data analysis. Results The screening rate and examination rate of the close contacts of smear positive pulmonary TB patients in Shaanxi were 99.89% and 84.92%. The detection rate of TB patients and smear positive TB patients were 1.56% and 0.03%. The examination rate of close contacts, the annual detection rate of TB patients and the detection rate of smear positive TB patients showed an overall upward trend. The detection rate in family members, symptomatic patients were higher than that in non-family members and asymptomatic patients. The differences in the examination rate, detection rate of TB patients and detection rate of smear positive TB patients among all groups were significant. Conclusion It is important to conduct early detection of TB in close contacts of newly registered smear positive TB patients.

Prevalence and risk factors associated with latent tuberculosis infection among household contacts of smear positive pulmonary tuberculosis patients in South India.

We aimed to determine the prevalence and find the risk factors associated with latent tuberculosis infection (LTBI) among the household contacts (HHC) of pulmonary TB patients. This cohort study was conducted from 2014 to 2019. Pretested standardised questionnaires and tools were used for data collection. The prevalence of LTBI among HHCs of TB patients was summarised as proportion with 95% confidence interval (CI). Mixed-effects generalised linear modelling function (meglm) in STATA with family Poisson and log link was performed to find the factors associated with LTBI. In total, 1523 HHC of pulmonary TB patients were included in the study. Almost all HHC shared their residence with the index case (IC) for more than a year; 25% shared the same bed with the IC. The prevalence of LTBI among the HHC of TB patients was 52.6% (95% CI: 50.1-55.1%). In an adjusted model, we found that among HHC belonging to the age group of 19-64years (aIRR=1.2; 95% CI: 1.1-1.3; p-value: 0.02), to the age group >65years (aIRR=1.4, 95% CI: 1.1-1.9, p-value: 0.02) and sharing the same bed with the IC (aIRR=1.2, 95% CI: 1.1-1.3, p value: 0.04) were independent determinants of LTBI among the HHC. One in two household contacts of TB patients have latent tuberculosis infection. This underscores the need of targeted contact screening strategies, effective contact tracing and testing using standardised methods in high TB burden settings.

English

BACKGROUND Sputum smear conversion is the negative conversion of the sputum smear at the end of the second month of treatment regimen under the National Tuberculosis Elimination Program (NTEP). When the acid-fast bacillus (AFB) smear comes negative at the end of an intensive phase, the treatment regimen can shift to the continuation phase that indicates bacillary load is a minimum. Although some authors consider the conversion of cultures when the AFB smear is negative, two potent drugs in the continuation phase are sufficient to kill the remaining bacilli. The drug that can kill bacteria in the first 2 days of treatment is called early bactericidal activity (EBA). This can be assessed by the percentage of negative conversion of cultures at the end of the intensive phase of the treatment regimen. EBA is very essential because it reduces the transmission in the community and chances of patient death. When the purpose is to kill as many bacilli as possible in the first few days and weeks of treatment, it is very important to include bactericidal drugs in the treatment regimen so that it reduces the chances of patient death and infectiousness and the negative conversion of the cultures after 2-month treatment regimen is an indication of the bactericidal capacity of the drug. The purpose of this study was to compare sputum smear conversion in daily versus intermittent treatment regimens in diagnosed cases of new sputum smear-positive pulmonary tuberculosis patients. METHODS This retrospective observational study was carried out in the Department of Respiratory medicine and nodal drug resistance tuberculosis centre (DR-TB) at the Government medical college and hospital, Akola. In this study, a total of 120 new patients were taken. 60 patients were given daily and intermittent regimens respectively under NTEP. RESULTS Out of 120 patients, 56 (93.33 %) patients in intermittent and 53 (88.33 %) patients in daily regimen were sputum smear-negative at the end of 2nd month (intensive phase) and at the end of 6th month (continuation phase). 1 patient (1.6 %) remained sputum smear-positive after the intensive phase. That patient was given 1 month of extension of anti-tuberculosis treatment (AKT) in the intensive phase and the patient became sputum negative after 1 month of extension. CONCLUSIONS It was concluded in this study, daily regimens and intermittent regimens were equally effective in negative conversion of the sputum smear at the end of the intensive phase and the end of the continuation phase. Negative conversion of the sputum smear is quite important because the bacillary load will be so low at the end of 2nd month that reduces the chances of patient death and transmission in the community. KEY WORDS Pulmonary Tuberculosis (PTB), Drug-Resistant TB (DR-TB), National Tuberculosis Programme (NTP), Revised National TB Control Program (RNTCP), Intensive Phase (IP), continuation Phase (CP), National Tuberculosis Elimination Program (NTEP).

Tuberculosis in Poland in 2019.

To evaluate the main features of epidemiology of tuberculosis (TB) in 2019 in Poland and to compare with the situation in the European Union and European Economic Area (EU/EEA) countries. Analysis of case-based data on TB patients from National TB Register, data on anti-TB drug susceptibility in cases notified in 2019, data from Central Statistical Office on deaths from tuberculosis in 2018, data from National Institute of Public Health - National Institute of Hygiene on HIV-positive subjects for whom TB was an AIDS-defining disease, data from the report "European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2021 - 2019 data". In 2019, 5321 TB cases were reported in Poland. The incidence rate was 13.9 cases per 100,000 with large variability between voivodeships from 8.0 to 20.0 per 100,000. The number of all pulmonary tuberculosis cases was 5075 i.e. 13.2 per 100,000. Pulmonary cases represented 95.4% of all TB cases. In 2019, 246 extrapulmonary TB cases were notified (4.6% of all TB cases). Pulmonary tuberculosis was bacteriologically confirmed in 3926 cases (77.4% of all pulmonary TB cases, the incidence rate 10.2 per 100,000). The number of smear-positive pulmonary TB cases was 2565 i.e. 6.7 per 100,000 ( 48.2% of all pulmonary TB cases). In 2019, there were 41 cases (18 of foreign origin) with multidrug resistant TB (MDR-TB) representing 1.1% of cases with known drug sensitivity. The incidence rates of tuberculosis were growing along with the age group from 1.4 per 100,000 among children (0-14 years) to 23.9 per 100,000 among subjects in the age group 45-64 years, the incidence rate in the age group ≥65 years was 19.8 per 100,000. There were 81 cases in children up to 14 years of age (1.5% of the total) and 48 cases in adolescents between 15 and 19 years of age - rates 1.4 and 2.6 per 100,000 respectively. In 2019, there were 3897 cases of tuberculosis in men and 1424 in women. The TB incidence in men - 21.0 per 100,000 was 2.9 times higher than among women - 7.2. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 50-54 years - 40.2 vs. 8.1 and in age group 55 to 59 years - 45.1 vs. 9.0. In 2019, there were 121 patients of foreign origin among all cases of tuberculosis in Poland (2.3%). In 2018, TB was the cause of death for 519 people (mortality rate - 1.4 per 100,000). TB incidence in Poland in 2019 was lower than in the previous year. Differences in incidence between voivodships persist. The percentage of TB cases with bacteriological confirmation exceeded 75%, more than in EU/EEA countries (67.1%). In Poland, MDR-TB is less common than the average in the EU/EEA countries. In Poland, the highest incidence rates are found in older age groups. The percentage of children up to 14 years of age among all TB patients was 1.5%, lower than the average in EU/EEA countries (3.9%). The incidence of tuberculosis in men is nearly three times as high as in women. The impact of migration on the characteristics of tuberculosis in Poland is not substantial. The percentage of foreign-born persons among TB patients is low.

Combined assessment of tuberculosis case notification rate and infection control at health facilities of Dale districts, Sidama Zone, Southern Ethiopia.

BackgroundMycobacterium tuberculosis (TB) is the deadliest disease that claims millions of deaths globally. Ethiopia is among the countries heavily hit by the disaster. Despite the effective directly observed treatment and TB infection control (TBIC) measures provided by the world health organization (WHO), the rate of new cases increased daily throughout the country. Healthcare workers (HCWs) are at highest risk serving without having the necessary facility in place while overcrowding of patients exacerbated TB transmission. The study aimed to assess TBIC implementation and analyze case notification rate (CNR) of smear-positive pulmonary TB in the selected health facilities at Dale district, Sidama Zone, Southern Ethiopia.MethodsSeven health care facilities have been visited in the study area and smear-positive pulmonary TB notification rate was determined retrospectively during the years 2012 to 2014. Data on smear positive test results and demographic characteristics were collected from the TB unit registries. A structured questionnaire, facility survey, and observation checklists were used to assess the presence of TBIC plans at the health care facilities.ResultsThe overall case notification rate of smear-positive pulmonary tuberculosis was 5.3% among all 7696 TB suspected patients. The odds of being diagnosed with smear-positive TB were 24% more in males than in females (adj OR = 1.24, 95% CI: (1.22, 1.55). Moreover, in the study area, only 28% of the facilities have been practiced TB infection control and 71% of the facilities assigned a focal person for the TBIC plan. The implementation of environmental control measures in the facilities was ranged between 16–83%. N95 particulate respirators were found only in 14% of the facilities.ConclusionTB CNR in Dale district was low. Moreover, implementations of TBIC in Dale district health facilities were poor when the survey was done. Hence, urgent measures should be taken to reverse the burden of TB.

Study on serum zinc and copper levels in pulmonary tuberculosis patients before starting Directly Observed Treatment, Short-course

Background: Tuberculosis is a major public health concern throughout the world including Bangladesh. The prevalence of tuberculosis (TB) is increasing day by day. Around one-third of world population is infected with M. tuberculosis. Still pulmonary tuberculosis (PTB) remains one of the important causes of mortality throughout the world with economic burden. Objective: To evaluate levels of the serum zinc and serum copper in smear positive PTB patients before starting Directly Observed Treatment, Short-course (DOTs) therapy. Methods: This was a cross-sectional type of observational study. A total of 100 subjects were included in this study. Among them 50 were smear positive PTB patients denoted as case group and 50 were apparently healthy individuals denoted as control group. Biochemical tests were carried out in the department of biochemistry of Mymensingh Medical College, Mymensingh. All the statistical analyses were performed by using SPSS version 21. Results were evaluated by using Student’s t-test. Results: After careful evaluation there was significant decrease in serum zinc level along with significant increase in serum copper level among the case group when compared with the control group. The mean values of serum zinc level were 93.96±10.04 μg/dl and 72.84±7.73 μg/dl in control and case group respectively. Serum zinc level decreased significantly (p &lt;0.001) in PTB patients. The mean values of serum copper were 111.81±21.26 μg/dl and 125.99±27.93 μg/dl in control and case group respectively. There was significant (p &lt;0.001) rise of serum copper level in PTB patients. Mediscope 2021;8(2): 122-127

Five-year trend analysis of tuberculosis in Bahir Dar, Northwest Ethiopia, 2015-2019.

Background:Tuberculosis (TB) remains a major cause of morbidity and mortality in Ethiopia despite the increased availability of effective treatments. Trend analysis of issues and priorities affecting TB programs across different regions of the country is critical to ensure equitable and sustainable TB outcomes. We aimed to analyze the trends of TB in Bahir Dar, Northwest Ethiopia, over 5 years from 2015 to 2019.Methods:An institution-based, retrospective cross-sectional study was conducted in Bahir Dar, the capital city of the Amhara Region in Ethiopia. Five-year data and records of individual TB cases were reviewed from all public and private health-care facilities and health bureaus in Bahir Dar. Using a standard checklist adapted from the World Health Organization, data were abstracted relevant to sociodemographic characteristics of the patients, year and type of TB infection, and HIV status. SPSS version 20 software was used for data analysis.Results:Data of 4275 patients with TB were identified, of which 929 (21.7%) were smear-positive pulmonary TB, 1195 (28%) were smear-negative pulmonary TB, and 2151 (50.3%) were extrapulmonary TB patients. TB was more prevalent in the age group 15–34 years (51.2%), and females (55.5%). In the years from 2015 to 2019, the prevalence of all forms of TB was 922 (21.6%), 812 (19.0%), 843 (19.7%), 876 (20.5%), and 822 (19.2%), respectively, demonstrating a decreasing trend though inconsistent. The variables sex (adjusted odds ratio [AOR]: 1.734, 95% confidence interval [CI] [1.390–2.187]), HIV co-infection (AOR: 1.875, 95% CI [1.553–2.265]), and age <15 years (AOR: 1.372, 95% CI [1.121–1.680]) showed a significant association with TB infection.Conclusions:The prevalence of TB in Bahir Dar, Northwest Ethiopia, demonstrated a decreasing trend over the years from 2015 to 2019 but with inconsistencies. HIV co-infection significantly increased the risk of developing TB, and productive age groups and females were at the greater prevalence of TB, highlighting the importance of strengthening sustainable TB care and prevention interventions toward these groups of people.