Terms Of Tuberculosis Research Articles

Investigation of the Frequency of Positive PPD Test in Candidate Patients Receiving Immunosuppressive Drugs Hospitalized in Shahid Sadoughi Hospital in Years 2019-2020

Introduction: Tuberculosis is one of the most common infections that lead to death,; incidence of tuberculosis is higher in individuals with immune system deficiency. Candidates for receiving immunosuppressive drugs should be examined for the presence of latent tuberculosis, so that if this test is positive, appropriate treatment and prophylaxis measures for tuberculosis can be carried out for them. The purpose of this study was to screen patients who are candidates for receiving immunosuppressive drugs in terms of tuberculosis.
 Methods: This cross-sectional study was conducted on the patients who were candidates for injectable immunosuppressive drugs hospitalized in Shahid Sadoughi Hospital between 2019 to 2020. Tuberculin skin test (TST) was taken from all eligible patients by the infection control unit of the hospital. Statistical analysis was done by SPSS V16. The P value less than 0.05 was considered statistically significant.
 Results: Participants were divided into three groups: healthy (TST=0-4), suspected (TST=5-9) and infected with tuberculosis (TST≥10); the frequency in the three groups was 83 (23.9%), 164 respectively. (47.3%) and 100 (28.8%). There was a significant relationship between the reason for referral to receive immunosuppressive drugs and the results of the TST test (P=0.003).
 Conclusion: If the patients with rheumatology, dermatology disorders and kidney transplant candidates receive immunosuppressive drugs, they are at high risk of primary tuberculosis infection and activation of latent tuberculosis, and it is necessary for health workers to pay more attention to this issue

Diagnostic value of serum IgG by Eliza to detecting Mycobacterium tuberculosis, Original Article

Introduction: In developing countries, which is an endemic region in terms of tuberculosis, there is an urgent need for fast, accurate, and inexpensive serological testing. The aim of this study was to determine the diagnostic value of patient serum IgG antibodies by ELISA in the diagnosis of Mycobacterium tuberculosis. Method: This case-control study was performed on patients with pulmonary tuberculosis in 2017-2020. After selecting the case (n = 30) and control (n = 30) subjects according to inclusion criteria, their blood samples were obtained and analyzed in the reference laboratory by standard kits for immunoglobulin G against 16, 36, and 40 kDa antigens of mycobacterium tuberculosis. Results: The mean age of the subjects was 47.07 (15.57%). The majority of participants were 46 (51.1%) women. There was no significant difference between the two groups regarding sex and age. serological examination of patients with pulmonary tuberculosis showed 25 positive results and only 4 of the control group had a positive result. Sensitivity, specificity, positive and negative predictive values of serology test were 83.3%, 86.67%, 86.20% and 87.88% respectively. Conclusion: Despite the acceptable sensitivity of the serologic immunoglobulin G test, according to the statement of World health organization (WHO), it did not possess an acceptable specificity. It is recommended that a a wider range of different antigens to be studied also it is essential to evaluate the diagnostic value of the other immunoglobulins inpatient in different stages of the disease.

Mainstreaming tuberculosis case detection and reporting in medical colleges in India: early lesson learnt.

In India, the contribution of medical colleges to the Revised National Tuberculosis Control Programme (RNTCP) in terms of tuberculosis (TB) case detection is exemplary.1 In 2013, about 15.2% of TB cases were detected in the 330 medical colleges across the country.2 The RNTCP extends support to medical colleges by providing human resources (a medical officer, TB health visitor and laboratory technician), the requisite logistics for microscopy activities and drugs for TB treatment.3 The infrastructure to establish this programme unit is provided by each medical college, and is often known as the ‘RNTCP cell’. The programme guidelines suggest that all TB cases detected in medical college clinical departments should be routed through the RNTCP cell, where patients are registered and initiated on anti-tuberculosis treatment. For programme monitoring and reporting, the medical college is considered as the peripheral health institute (PHI), and they submit monthly PHI report and quarterly case finding reports to the district TB control officer. We discuss an innovative approach to mainstreaming TB case detection and reporting by the academic sector. Missed TB cases are one of the main challenges to TB control today.4 The contribution to reducing ‘missed TB cases’—those who are either never diagnosed or are diagnosed in the laboratory but do not appear on the TB treatment register—is of paramount importance. As medical colleges are well resourced with diagnostic equipment and many more severe cases might end up there, there may be an impact on TB transmission and mortality which is of likely benefit to the new ‘End TB’ strategy. The issues prevailing in the current reporting mechanisms and ways of strengthening the recording and reporting at medical colleges are enumerated below. The medical college is a huge institution, with 18 departments, the majority of which (except anatomy and physiology) are involved directly or indirectly in screening, diagnosing, investigating, treating or managing a case of TB. The burden of TB cases detected for the first time at autopsy by the department of forensic medicine is also well recognised.5 In the current system, all presumptive TB cases screened for TB who are either smear-negative or extra-pulmonary are not captured. We believe it is crucial to record these data from all the departments, as there remains a high probability that some of these missed cases may later turn out positive.6 As tertiary health facilities, medical colleges are equipped with all types of equipment for investigating a case. The decreasing trend of nationwide smear-negative TB case detection augments the importance of capturing the data at subunit levels of a medical college. The majority of TB cases diagnosed at medical colleges are referred to the primary health centre nearest to the patient's residence for initiation of treatment. The programme depends entirely on referral forms, the postal service, short messaging service (SMS) using mobile phones and telephone to inform the primary health centre and district TB officer about the referral. However, this communication mechanism is tedious, often delayed and lacks promptness in providing feedback. This inefficient system also leads to interdistrict and interstate referral meetings that are usually less fruitful. It is thus imperative for the programme to develop a real-time web-based referral mechanism that is effective and prevents unnecessary loss of time for the programme staff. There is an urgent need to develop better recording and reporting systems in medical colleges. Mechanisms to capture all presumptive and diagnosed TB cases should be made operational through full involvement of the medical records department of the medical colleges. Strengthening the medical colleges will be a very helpful investment for the RNTCP in years to come.

Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003-2012.

What kills people around the world and how it varies from place to place and over time is critical in mapping the global burden of disease and therefore, a relevant public health question, especially in developing countries. While more than two thirds of deaths worldwide are in developing countries, little is known about the causes of death in these nations. In many instances, vital registration systems are nonexistent or at best rudimentary, and even when deaths are registered, data on the cause of death in particular local contexts, which is an important step toward improving context-specific public health, are lacking. In this paper, we examine the trends in the causes of death among the urban poor in two informal settlements in Nairobi by applying the InterVA-4 software to verbal autopsy data. We examine cause of death data from 2646 verbal autopsies of deaths that occurred in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) between 1 January 2003 and 31 December 2012 among residents aged 15 years and above. The data is entered into the InterVA-4 computer program, which assigns cause of death using probabilistic modeling. The results are presented as annualized trends from 2003 to 2012 and disaggregated by gender and age. Over the 10-year period, the three major causes of death are tuberculosis (TB), injuries, and HIV/AIDS, accounting for 26.9, 20.9, and 17.3% of all deaths, respectively. In 2003, HIV/AIDS was the highest cause of death followed by TB and then injuries. However, by 2012, TB and injuries had overtaken HIV/AIDS as the major causes of death. When this is examined by gender, HIV/AIDS was consistently higher for women than men across all the years generally by a ratio of 2 to 1. In terms of TB, it was more evenly distributed across the years for both males and females. We find that there is significant gender variation in deaths linked to injuries, with male deaths being higher than female deaths by a ratio of about 4 to 1. We also find a fifteen percentage point increase in the incidences of male deaths due to injuries between 2003 and 2012. For women, the corresponding deaths due to injuries remain fairly stable throughout the period. We find cardiovascular diseases as a significant cause of death over the period, with overall mortality increasing steadily from 1.6% in 2003 to 8.1% in 2012, and peaking at 13.7% in 2005 and at 12.0% in 2009. These deaths were consistently higher among women. We identified substantial variations in causes of death by age, with TB, HIV/AIDS, and CVD deaths lowest among younger residents and increasing with age, while injury-related deaths are highest among the youngest adults 15-19 and steadily declined with age. Also, deaths related to neoplasms and respiratory tract infections (RTIs) were prominent among older adults 50 years and above, especially since 2005. Emerging at this stage is evidence that HIV/AIDS, TB, injuries, and cardiovascular disease are linked to approximately 73% of all adult deaths among the urban poor in Nairobi slums of Korogocho and Viwandani in the last 10 years. While mortality related to HIV/AIDS is generally declining, we see an increasing proportion of deaths due to TB, injuries, and cardiovascular diseases. In sum, substantial epidemiological transition is ongoing in this local context, with deaths linked to communicable diseases declining from 66% in 2003 to 53% in 2012, while deaths due to noncommunicable causes experienced a four-fold increase from 5% in 2003 to 21.3% in 2012, together with another two-fold increase in deaths due to external causes (injuries) from 11% in 2003 to 22% in 2012. It is important to also underscore the gender dimensions of the epidemiological transition clearly visible in the mix. Finally, the elevated levels of disadvantage of slum dwellers in our analysis relative to other population subgroups in Kenya continue to demonstrate appreciable deterioration of key urban health and social indicators, highlighting the need for a deliberate strategic focus on the health needs of the urban poor in policy and program efforts toward achieving international goals and national health and development targets.

Tuberculosis in BRICS: challenges and opportunities for leadership within the post-2015 agenda.

Tuberculosis in BRICS: challenges and opportunities for leadership within the post-2015 agenda.

FRI0268 Multifunctional Flow Cytometry Analysis of CD4+ T Cells as an Immune Biomarker for Latent Tuberculosis Status in Patients Treated with TNF Antagonists

BackgroundNo strategy has yet proved successful in monitoring tuberculosis (TB) infection during treatment with TNF antagonists. Even the new interferon-gamma (IFN-γ) release assays (IGRAs) produce dynamic changes in IFN-γ plasma...

Association between tuberculosis and smoking.

BackgroundThe association between smoking and tuberculosis (TB), which has been proven in multiple studies with different study population ethnicity, has not yet received sufficient attention in terms of TB control.ObjectivesThe aim of the present study was to determine the association between TB and cigarette smoking in southeastern Iran, an endemic area for tuberculosis.Patients and MethodsThis prospective case-control study conducted at a University-Affiliated Hospital (Boo-Ali Hospital, Zahedan, and Southeastern Iran) from March 2007 to March 2012 enrolled 253 TB patients and 312 healthy controls. Factors including history of cigarette smoking, duration of smoking, number of cigarettes smoked per day, consumption of other drugs (parenteral and non-parenteral), and family history of tuberculosis and smoking, were evaluated in both cases and controls. Univarate and multivariate logistic regressions were performed to compare TB cases and controls. The odds ratio (OR) and 95% confidence intervals (CI) were also estimated.ResultsThe results of the study revealed a significant difference between TB and control groups in relation to smoking (P < 0.0001). In multivariate logistic regression, cigarette smokers were 3.1 (95% CI: 1.4-10.3) times more frequent in TB patients compared with controls. Other factors that showed significant differences between TB patients and controls were the use of non-parenteral drugs (OR = 3.6, 95% CI: 2.2-21.4), family history of TB (OR = 6.6, 95% CI: 2.3-18.2), family history of smoking (OR = 2.8, 95% CI: 1.1-8.4), and smoking history of more than 10 years (OR = 1.6, 95% CI: 1.2-9.8).ConclusionsThe present study evidenced the association between TB and smoking. It is therefore recommended to include interventions for smoking cessation in the current TB control practice.

A female presenting with prolonged fever, weakness, and pain in the bilateral pelvic region: a case report

IntroductionPsoas abscess, a collection of pus in the iliopsoas compartment that has traditionally been classified as primary and secondary according to its origin.Case presentation48-year-old Turkish female presented to the department with fever, weakness and pain in the bilateral pelvic region. In contrast abdominal magnetic resonance, a collection compatible with the hyperintense abscess was observed in the right and left ilipsoas muscles. It was decided to simultaneously drain both abscesses of the case who had been using oral and intravenous broad-spectrum antibiotics for two months. No factors were detected in the microbiological reviews made on the abscess fluid of the operated case. The case was also examined in terms of tuberculosis and Crohn's disease and no findings were encountered to rise suspicions of such diseases.ConclusionAn abscess of the psoas muscle was a rare entity. However, with the increased use of computed tomography scans to evaluate patients with unknown foci of sepsis, psoas abscesses now are diagnosed and reported more frequently. What should be done after diagnosis are, if possible, defining the infection factor, selecting the appropriate antibiotics and draining the abscess openly or percutaneously.

Modelling a traditional game as an agent in HIV/AIDS behaviour-change education and communication

The level of HIV/AIDS awareness among the Luo of western Kenya is at its highest yet the epidemic continues unabated. While HIV/AIDS is locally recognised as an emergent deadly condition, people seem unconcerned. Deaths related to HIV/AIDS are often euphemistically explained in terms of tuberculosis, respiratory diseases, and 'thinning disease' or chira. The situation is aggravated by gender-based cultural attitudes that are unfortunately predisposing to risk of HIV infection. This ethnographic study explores the potential to model cultural constructs such as traditional games as a means of health communication and agent of behaviour change. The gender undertones and implications for HIV/AIDS in the language of the game ajua are significant in understanding community-specific HIV infection risk. Modelling this traditional game as an agent in HIV/AIDS behaviour-change education and communication allows for forging a socially and culturally compatible and enabling intervention mechanism. The study leads to the conclusion that behaviour-change education and communication in a complex cultural setting should be culture specific and internally derived. Significantly, cultural constructs like traditional games can provide 'rootedness' in terms of HIV/AIDS communication and intervention.

Air pollution and tuberculosis disease mortality ‐ a quantitative analysis (A viewpoint)†

This paper establishes a quantitative relationship between tuberculosis mortality rates and the levels of air pollution and other socio‐economic variables by using a macro‐model. With the help of regression analysis, it is observed that a hundred percent increase in the air pollution would imply an increase in the mortality rate by about 45–79 percent. An average improvement of 50 percent in the quality of air would reduce the tuberculosis mortality rate by 22.5–39.5 percent. This would imply a social saving of about $139 to $234 million per year in terms of tuberculosis only.