Transmission Of Pulmonary Tuberculosis Research Articles

Bronchial Washing to Diagnose Smear-Negative Pulmonary Tuberculosis

Introduction: Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative. However, its indication has not been standardized. Therefore, we conducted a retrospective study to assess the diagnostic value of bronchial washing in patients suspected with pulmonary TB. Methodology: A retrospective analysis was performed on patients diagnosed with pulmonary TB in Kosin university gospel hospital, a tertiary hospital with 969 beds in South Korea, from March 2017 to December 2018. We obtained three serial sputum samples for acid-fast bacilli (AFB) smear and culture, and all patients underwent bronchoscopy with bronchial washing for AFB smear and culture. Results: Fifty-six patients were enrolled in the study. Smear-negative pulmonary TB (SNPT) was diagnosed in 42/56 (75%) patients. Among the patients with smear-positive sputum, 14/14 (100%) showed culture-positive sputum, while smear- and culture-positive bronchial washing were seen in 7/14 (50%) and 12/14 (85.7%) patients, respectively. Among the patients with SNPT, 17/42 (40.47%) had culture-negative sputum and were diagnosed using the bronchoscopic washing. Conclusions: For patients with smear-negative sputum, it is necessary to perform bronchoscopic washing to increase the diagnostic rate of pulmonary TB. To control the transmission of pulmonary TB, it is necessary to use a fast and accurate examination method.

Determinants of pulmonary tuberculosis in public health facilities of Dire Dawa City, Eastern Ethiopia: Unmatched Case-control study.

The Federal Ministry of Health of Ethiopia Annual performance report in 2014-2015 showed that the highest prevalence of tuberculosis (TB) case in Ethiopia was reported from Dire Dawa city which was 400/100,000 population. The aim of this study was to identify the determinants of pulmonary TB (PTB) in public health facilities of Dire Dawa city, Eastern Ethiopia. A case-control study was conducted from October to December 2017 among 95 cases and 190 controls in Dire Dawa city. Dire Dawa is one of the two chartered cities in Ethiopia like the capital city Addis Ababa. Cases and controls were identified and selected randomly from the health facilities. Data were collected using a pretested and structured questionnaire by trained data collectors. We used logistic regression to model the associations of independent variables with PTB infection. PTB was associated with patients' education (no formal education vs. formal education) (adjusted odds ratio [AQR] [95% confidence interval [CI]: 3.0, [1.3, 7.1]), human immunodeficiency virus (HIV) positive status (AOR [95% CI]: 3.1: [1.1,9.1]), previous contact history with TB patient (AOR [95% CI]: 9.9 [4.3,23.0]), body mass index (BMI) of ≤18 (AOR [95% CI]: 14.9 [6.4,35.1]), and cigarette smoking history (ever vs. never) (AOR [95% CI]: 6.7 [2.3,19.5]). This study showed that patients' educational status, HIV status, cigarette smoking, contact history with PTB patient, and BMI were independently associated with being infected with PTB. To reduce PTB transmission, peoples should be educated on TB prevention and consequences of risky behaviors.

High risk disease mapping and spatial effect of pulmonary tuberculosis in Kerbala, Iraq

Introduction: Pulmonary tuberculosis (PTB) remains one of the top ten causes of death globally. A crucial component of controlling this infection is by limiting the spread of the disease. This study aimed to identify hot spot geographical areas with PTB incidence and to evaluate spatial global autocorrelation using geographical information science (GIS) technology. Methods: Using tuberculosis register software, cases of PTB were recorded by Chest and Respiratory illnesses center in Kerbala governorate. Seven years' data records were used to investigate hot spots and spatial distribution of PTB cases in Kerbala. Patients whom reside outside Kerbala were excluded from the current analysis. Loess smoothing Seasonal decomposition trend was applied to analyze temporal patterns and clusters mapping of tuberculosis, using R statistical software version 3.5.1. Correlation analysis (pairwise Spearman) was used to observe the association among the factors contributing to PTB prevalence. Standard morbidity ratio (SMRs) was used to find the morbidity rate Bayesian conditional auto-regressive model was used in the analysis and estimation of the parameters was done through Markov Chain Monte Carlo methods to estimate the space mapping variability cluster of disease risk and covariates effect. Results: A significant correlation was found between PTB prevalence and the age (r = 0.731) and was also found in gender (r = 0.822). Most of the cases were distributed within the age of 17–50 years (68.4%). Tuberculosis cases were not randomly distributed in which the variables occur with asymptotic probabilities with unpredictable spacing and that there was the presence of high global autocorrelation among PTB cases in the City of Kerbala. Approximately, 59% of all PTB cases were seen in six quarters. Conclusion: Spatial analysis using GIS reveals useful information about epidemiological situation of PTB cases in Kerbala Province, Iraq. Additionally, this study predicted possible places for PTB transmission based on hot spot analysis and the continuous presence of infection during the studied period.

Tuberculosis Patient Adherence to Treatment and Transmission to Home Contact Family Members

Tuberculosis is a contagious disease that is still a problem in the health world until today. Treatment of tuberculosis is one of the main strategies in controlling tuberculosis because it can break the transmission chain, especially in families of household contacts where transmission is twice as risky as casual or unfamiliar contact. This study analyzed the secondary data on patient adherence to pulmonary tuberculosis treatment sessions and transmission to household contact families in 2016-2017 at a private hospital in Indonesia. This research used a correlative descriptive design with Secondary Data Analysis (ADS) approach using existing data namely, TB 06 and TB 09. Sixty TB patients were utilized based on the report of patient data of TD DOTS year 2016-2017. The statistical analysis used was Pearson’s r. Result showed patient compliance of pulmonary tuberculosis to treatment sessions. The value of adherence was seen from all respondents who come to the referral clinic according to the TB 06, and TB 09. Investigation based on sputum is 23.3%. It means that from 60 respondents, there are only 14 people (23.3%) diagnosed of tuberculosis based on result of sputum and the remaining 46 people (76.7%) based on the result of the radiology. Identification of household contact family members found positive sputum smear examination of five people (8.3%) while four people (6.7%) were found to be undergoing tuberculosis treatment. There is a significant relationship between tuberculosis patient adherence to treatment sessions and transmission to household contact family with p value 0.001 (<0.05) with a moderate correlation (r) = 0.378%. In Discharge Planning Patient, the nurse includes TB 06 and TB 09 sheets for follow up treatment at the public health service center. The nurse needs to run educational programs on transmission behavior to hospitalized tuberculosis patient.

Recent transmission of pulmonary tuberculosis and its influencing factors in Jing'an district, Shanghai, 2010-2015

Objective: To understand the recent transmission of Mycobacterium tuberculosis (MTB), and to identify the influencing factors of recent transmission among pulmonary tuberculosis (TB) patients in Jing'an district, Shanghai. Methods: The genotypes and drug resistances of MTB isolated from TB patients registered in the TB designated hospitals in Jing'an district during 2010-2015 were analyzed through 12-loci Mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR)(QUB11b, QUB18, Mtub21, Miru26, QUB26, Mtub04, Miru31, Miru40, VNTR2372, VNTR3820, 3232, 4120), and tested for drug susceptibility as well. With the results of field epidemiological investigation, univariate and multivariate analyses were performed to analyze the distribution of the clusters and influencing factors on recent transmission. Results: This study enrolled 80 TB patients, 23 (28.75%) had a resistance to at least one anti-TB drug, and the prevalence of multidrug-resistant tuberculosis (MDR-TB) was 16.25%. A total of 65 genotypes were identified with 58 (72.50%, 58/80) being unique and 7 clusters with 2-10 isolated in each cluster. The proportion of clustering was 27.50% (22/80). Results from the multivariate analysis revealed that multidrug- resistance (OR=35.799, 95%CI: 4.239-302.346) and having comorbidity with TB (OR=7.695, 95%CI: 1.421-41.658) were independently associated with the clustering, which suggesting a recent transmission. The field investigation to the clustered cases proved that the patients in two clusters had epidemiological links, one was between family members, and the other contained 10 MDR-TB patients with 9 knowing each other which have a definite connection and 1 having the possible connection with them. Conclusion: Recent transmission of tuberculosis happened among TB patients in Jing'an district, with high risks among the MDR-TB patients.

Molecular epidemiology and drug resistance patterns of Mycobacterium tuberculosis complex isolates from university students and the local community in Eastern Ethiopia.

BackgroundPrevious studies suggest the burden of pulmonary tuberculosis (PTB) in Ethiopia may be greater in university students relative to the overall population. However, little is known about the transmission dynamics of PTB among students and members of the communities surrounding university campuses in Eastern Ethiopia.MethodsA cross sectional study was conducted in Eastern Ethiopia among prevalent culture-confirmed PTB cases from university students (n = 36) and community members diagnosed at one of four hospitals (n = 152) serving the surrounding area. Drug susceptibility testing (DST) was performed on Mycobacterium tuberculosis complex (MTBC) isolates using BD Bactec MGIT 960 and molecular genotyping was performed using spoligotyping and 24-loci MIRU-VNTR. MTBC strains with Identical genotyping patterns were assigned to molecular clusters as surrogate marker for recent transmission and further contact tracing was initiated among clustered patients.ResultsAmong all study participants, four MTBC lineages and 11 sub-lineages were identified, with Ethiopia_3 (Euro-American lineage) being most common sub-lineage (29.4%) in both cohorts and associated with strain clustering (P = 0.016). We further identified 13 (8.1%) strains phylogenetically closely related to Ethiopia_3 but with a distinct Spoligotyping pattern and designated as Ethiopia_4. The clustering rate of MTBC strains was 52.9% for university students and 66.7% for community members with a Recent Transmission Index (RTI) of 17.6% and 48.4%, respectively. Female gender, urban residence, and new TB cases were significantly associated with strain clustering (P<0.05). Forty-eight (30%) of the study participants were resistant to one or more first line anti TB drugs, three patients were classified as multidrug resistant (MDR).ConclusionWe found evidence for recent transmission of PTB among Ethiopian university students and the local community in Eastern Ethiopia, mainly linked to strains classified as Ethiopia_3 sub lineage. Drug resistance didn’t have a major impact on recent transmission but comprehensive molecular surveillance in combination with drug resistance profiling of MTBC strains is desirable to better characterize TB transmission dynamics in high risk congregate living environments such as university campuses and guide regional TB control programs.

PENGARUH KONDISI FISIK RUMAH TERHADAP PENULARAN TB PARU PADA ANGGOTA KELUARGA (Studi Kasus di Wilayah Kerja Puskesmas Perak Timur Surabaya Tahun 2018)

Tuberculosis is an infectious disease that caused by the bacterium Mycobacterium tuberculosis and more often infects lung organs than the other body organs . Healthy people at home with pulmonary TB sufferers are a group that is very susceptible to contracting the disease. One of possible factors that is at risk for pulmonary TB is the physical condition of the house which includes ventilation, occupancy, density, lighting, floor conditions, humidity, and temperature. The purpose of this study was to analyze the effect of the physical condition of the house on pulmonary TB transmission in the family members in the working area of Health Center East Perak Surabaya.This research is an observational analytic research with cross-sectional study design. The data collection is done by interviewing, observing, and measuring the physical condition of the house. The population in this study were 51 houses with pulmonary tuberculosis patients and a large sample of 45 houses with pulmonary TB patients. The data obtained were then analyzed analytically using Exact Fisher test. The results of univariate analysis showed pulmonary tuberculosis transmission in family members (17.8%), the ventilation was unfullfilled the requirements (68.9%), lighting was unfullfilled the requirements (75.6%), the temperature was unfullfilled the requirements (68.9%) , humidity was unfullfilled the requirements (35.6%), floor conditions was unfullfilled the requirements (2.2%), and occupancy of density was unfullfilled the requirements (68.9%). The results of bivariate analysis showed that there was an influence on pulmonary TB transmission in family members, by the temperature (Pvalue = 0.007) and humidity (Pvalue = 0.017).The conclusion, the temperature and humidity affect the transmission of pulmonary TB in family members; ventilation, lighting, floor conditions, and occupancy of density do not affect the transmission of pulmonary TB in family members. It is recommended to do data collection and counseling about healthy homes and TB disease, treatment for all TB patients completely, and check family members immediately if they have symptoms of coughing for more than 2 weeks. Keywords : Tuberculosis, family members, physical condition of the house.

KARAKTERISTIK FISIK RUMAH DENGAN KEJADIAN TB PARU DI WILAYAH KERJA PUSKESMAS SEI JANG KOTA TANJUNGPINANG

Tuberculosis remains a public health problem in Indonesia. While the percentage of unhealthy homes in Indonesia is still high at 75.1% and in the Riau Islands 76,3%. Construction of houses and the neighborhood does not meet health requirements would be a risk factor for pulmonary tuberculosis transmission source. This study aims to determine the relationship between the physical characteristics of the home (residential density, types of flooring, ventilation, lighting, temperature and humidity) and the incidence of pulmonary tuberculosis in Puskesmas Sei Jang Tanjungpinang. This study uses a case control design were analyzed by chi-square test and Fisher exact. The number of samples in this study were 36 cases and 36 controls. Cases were all TB patients with sputum examination results at the health center laboratory stated smear positive (suffering from pulmonary TB) 2016 to June 2017. Control is a neighboring group of cases have a history of not suffering from pulmonary TB. Results showed that the floor of the house (OR = 2.12; 95% CI: 0.364 to 12.049), ventilation (OR = 3.4; 95% CI 0.638 to 18.132), lighting (OR = 2.08; 95% CI: 0.779 to 5.552), population density (OR = 2.5; 95% CI: 0.962 to 6.498), and humidity (OR = 2.742; 95% CI: 0.496 to 15.168) who do not qualify is a risk factor to the incidence of pulmonary tuberculosis. However, this study found no statistically significant relationship. Suggested to the respondents whose homes are not eligible to be regularly open the window every morning before going on air circulation and sunlight can kill the TB germs.

Hubungan Faktor Lingkungan Fisik Rumah terhadap Kejadian TB Paru di Wilayah Kerja Puskesmas Panjang, Lampung

WHO in 2015 revealed that six of the countries contribute for 60% of new cases of Pulmonary TB, one of which is Indonesia. Houses that do not meet health requirements was one of the influential factors in the spread of bacteria tuberculosis. Pulmonary TB cases in Lampung Province in 2014 were 108 cases, of which 83 cases occurred at Panjang Community Health Centre. The condition of houses in the District of Panjang was only 26.28% that qualify healthy homes. This study was to identify the relationship physical environment of the house and pulmonary TB in Panjang Community Health Centre. This was a case-control study with the number of samples as many 50 cases of positive pulmonary tuberculosis patients and 50 control, not pulmonary tuberculosis patients and applied logistic regression analysis. The result showed that pulmonary TB was closely related to crowded household, ventilation, lighting, humidity of the house and lighting was the most important indicators in Panjang Community Health Centre. A healthy home and healthy life behavior were keys to reducing the risk of transmission of pulmonary tuberculosis.

AN ANALYSIS OF PREDISPOSING, ENABLING, AND REINFORCING FACTORS IN PREVENTING THE TRANSMISSION OF PULMONARY TUBERCULOSIS DISEASE ON PATIENTS’ RELATIVES IN TULUNGAGUNG REGENCY

Tuberculosis (TB) is one of the major causes of death. In the report of Tuberculosis Global 2014 which was realeased by World Health Organization (WHO) stated that the incidence happened in Indonesia was 1 million new cases every year. The percentage of the cases in Indonesia is 10 percent from entire cases in the world, so as to be the most second cases country along with Tiongkok. The objective of this study is to know the effect of predisposing, enabling, and reinforcing factors towards the efforts in preventing the transmission of pulmonary TB diseases on patients’ relatives in Tulungagung regency.This study was non experimental quantitative research by using research design with Cross Sectional observation method. The samples this study were the relatives who have the most emotional closeness with the patient of pulmonary TB as much as 285 respondents. The data obtained through questionnaire then it was analyzed by using ordinal regression test. Based on the ordinal regression test which was conducted where ρ &lt; 0,05, hence that there was the effect of gender on the prevention of pulmonary TB transmission in Tulungagung regency, the effect of educational level on the prevention of pulmonary TB transmission in Tulungagung regency, the effect of knowledge on the prevention of Pulmonary TB transmission in Tulungagung regency, the effect of dwelling density on the prevention of pulmonary TB transmission in Tulungagung regency and the effect of coaching officer on the prevention of Pulmonary TB transmission in Tulungagung regency. Improvement of guidance and quality of service in Pulmonary TB prevention program by involving the family is expected so the patient will do prevention effort to pulmonary tuberculosis disease to support local goverment effort in decreasing incidence of pulmonary TB generally and particularly maintain personal health to achieve health society which play an active role in national development.

Infection Control Prevention Practices on Pulmonary TB Transmission among Health Care Personnel of Selected Hospital in India

Introduction: Fundamental infection control practices in India revolve around biomedical waste management and disposal of sharps; while Airborne Infection Control (AIC) measures are mostly absent from the protocol of health care facilities. Aim: To assess infection control practices that a health care personnel follows to prevent transmission of Tuberculosis (TB) and to evaluate the resources and facilities available in the area and also to identify the factors which helps to improve the practices. Materials and Methods: A mixed methodological study was carried out to assess the infection control practices for prevention of pulmonary TB. This study was conducted among 82 health care personnel between 2nd January 2017 and 4th February 2017. Health care personnel (20-35 years) and people who worked in TB units were recruited from a multi-specialty tertiary care hospital. An observation checklist on infection control practices was developed to assess the preventive practices followed by acknowledge questionnaire. Complete enumerated sampling was used for observing the practices. A focus group discussion was conducted after analysing the Survey findings among health care personnel by purposive sampling. Thematic analysis was used to analyse and identify the emerging themes. Results: The mean age of the participants was 25.76±5.968 years. Non-compliance was found in infection control practices among health care personnel in preventing TB transmission. A total of 58.5% of the participants have good knowledge, 74.1% had answered correctly in the area of personal protective equipment. Intermittent interruption of supply (e.g., N95 masks), lack of knowledge, lack of adherence to infection control practices and lack of awareness by the patients were found to be the factors for non-compliance. Conclusion: This study emphasizes the challenges faced in infection control preventive practices in a resource limited countries and how collective efforts may change and strengthen the practices using available resources.

The Correlation between knowledge and self-efficacy in preventing the spread of Pulmonary Tuberculosis

The World Health Organization (WHO) has stated that the current situation of Tuberculosis (TB) worldwide is getting worse. Based on the survey conducted by the Ministry of Health of the Republic of Indonesia (2011) on the prevalence of TB in 2009, knowledge shows that 76% of families have heard about TB and 85% know that TB can be cured, but only 26% can mention two signs and symptoms main TB. The mode of transmission of TB is understood by 51% of families and only 19% know that TB drugs are available for free. The purpose of this research is to know the relationship between knowledge and self-efficacy about prevention of transmission in lung tuberculosis patients. Methods: The research design used was correlational with the cross-sectional approach. The population is lung TB patients in the working area of Ponggok Puskesmas. Sampling technique using purposive sampling with a sample of 20 respondents. The data collected was then processed and analyzed using spearman-rho statistic test with a significance value of 0.05. Results: The results showed significance value p = 0,001 (p &lt;0,05). Thus there is a relationship between knowledge and self-efficacy about prevention of transmission of pulmonary tuberculosis. Discussion: Knowledge is one factor that plays a role in the formation of self-efficacy in patients with pulmonary tuberculosis.

Comprehensive understanding of health-seeking behaviour among pulmonary tuberculosis patients in China.

In China, there were 918 000 tuberculosis (TB) cases in 2015 alone. The primary challenge facing TB control is the allocation of limited health care resources. To gain a comprehensive understanding of the first choice of health care facility among Chinese patients with suspected pulmonary TB (PTB) and the number of visits required to make the diagnosis. Relevant full-text articles in three Chinese and one English literature databases up to November 2016 were reviewed. Meta-analyses were performed using Stata v12.0. Among 1257 potentially relevant selected articles, 27 cross-sectional studies involving 9891 patients were included in the final analyses. Most PTB patients chose county-level hospitals (40%, 95%CI 33-46) and village clinics (34%, 95%CI 27-42); only 13% (95%CI 10-16) of patients chose to visit PTB dispensaries first. Before obtaining the correct diagnosis, 28% (95%CI 11-44) of patients had to visit health facilities more than three times. Patients with suspicion of PTB were more likely to visit low-level facilities than dispensaries. Repeated visits resulted in both overall delay and high risk of PTB transmission. These findings suggest that a shift in government policy for PTB is required.

Estimating the effect of lay knowledge and prior contact with pulmonary TB patients, on health-belief model in a high-risk pulmonary TB transmission population.

ObjectiveThe research aimed to investigate the effect of lay knowledge of pulmonary tuberculosis (TB) and prior contact with pulmonary TB patients on a health-belief model (HBM) as well as to identify the social determinants that affect lay knowledge.MethodsSurvey research design was conducted, where participants were required to fill in a questionnaire, which measured HBM and lay knowledge of pulmonary TB. Research participants were 500 residents of Semampir, Asemrowo, Bubutan, Pabean Cantian, and Simokerto districts, where the risk of pulmonary TB transmission is higher than other districts in Surabaya.ResultsBeing a female, older in age, and having prior contact with pulmonary TB patients significantly increase the likelihood of having a higher level of lay knowledge. Lay knowledge is a substantial determinant to estimate belief in the effectiveness of health behavior and personal health threat. Prior contact with pulmonary TB patients is able to explain the belief in the effectiveness of a health behavior, yet fails to estimate participants’ belief in the personal health threat.ConclusionHealth authorities should prioritize males and young people as their main target groups in a pulmonary TB awareness campaign. The campaign should be able to reconstruct people’s misconception about pulmonary TB, thereby bringing around the health-risk perception so that it is not solely focused on improving lay knowledge.

Knowledge and Preventive Action of Pulmonary Tuberculosis Transmission in Household Contacts

Tuberculosis is an infectious disease directly caused by Mycobacterium tuberculosis. Family involvement for its prevention need to be taken into account includes knowledge, attitudes and practice. The purpose of this study was to analyze the differences of the prevention behavior of the disease in household contact families in the working area of Puskesmas Rangkah, Pacar Keling and Gading at Surabaya 2015. This research was case control study uses a sample of 25 cases and 25 control samples. Collecting data using questionnaires to obtain information about the variables: the prevention of the disease transmission, socio-economic status, gender, knowledge and attitudes. The results showed that the majority of respondents have a socio-economic status in the low category (72 %), female (58 %), have a good knowledge (78 %), a good attitude (72 %), and good transmission prevention of pulmonary TB (56 %). Chi square test showed that there is a gender difference (p = 0.010). Wilxocon Mann Whitney test shows that no differences in socioeconomic status (p = 0.533), attitude ( p = 0.212 ) and there are differences in knowledge (p = 0.018) and action (p = 0.000) prevention of transmission of the disease in the household contacts. It can be concluded that there is a difference in behavior includes knowledge and preventive measures of pulmonary TB transmission in the household contacts. Suggest the need for cooperation and intervention from a health personnel to family and patient as well as the strong motivation of the people against infection-prevention measures of pulmonary TB. Keywords: family, knowledge, attitude, precaution of Pulmonary Tuberculosis infection

Knowledge and Preventive Action of Pulmonary Tuberculosis Transmission in Household Contacts

Tuberculosis is an infectious disease directly caused by Mycobacterium tuberculosis. Family involvement for its prevention need to be taken into account includes knowledge, attitudes and practice. The purpose of this study was to analyze the differences of the prevention behavior of the disease in household contact families in the working area of Puskesmas Rangkah, Pacar Keling and Gading at Surabaya 2015. This research was case control study uses a sample of 25 cases and 25 control samples. Collecting data using questionnaires to obtain information about the variables: the prevention of the disease transmission, socio-economic status, gender, knowledge and attitudes. The results showed that the majority of respondents have a socio-economic status in the low category (72 %), female (58 %), have a good knowledge (78 %), a good attitude (72 %), and good transmission prevention of pulmonary TB (56 %). Chi square test showed that there is a gender difference (p = 0.010). Wilxocon Mann Whitney test shows that no differences in socioeconomic status (p = 0.533), attitude ( p = 0.212 ) and there are differences in knowledge (p = 0.018) and action (p = 0.000) prevention of transmission of the disease in the household contacts. It can be concluded that there is a difference in behavior includes knowledge and preventive measures of pulmonary TB transmission in the household contacts. Suggest the need for cooperation and intervention from a health personnel to family and patient as well as the strong motivation of the people against infection-prevention measures of pulmonary TB. Keywords: family, knowledge, attitude, precaution of Pulmonary Tuberculosis infection

Delays in diagnosis and treatment of pulmonary tuberculosis in AFB smear-negative patients with pneumonia.

Diagnostic and treatment delays increase the severity and transmission of pulmonary tuberculosis (PTB). This study aimed to evaluate TB diagnostic and treatment delays in acid-fast bacilli (AFB) smear-negative patients. This was a retrospective observational study. Patients with positive AFB culture of Mycobacterium tuberculosis complex (MTC) were selected from among hospitalised patients with a diagnosis of pneumonia. Admission ward, anti-tuberculosis treatment and the duration of AFB culture were compared between smear-positive and smear-negative patients. Of the 70 patients with positive isolation of MTC in AFB culture, 27 (38.5%) were smear-negative; of these, 18 (66.7%) were not isolated while in hospital, and 17 (63%) were neither diagnosed nor treated for TB. In contrast, 41 of the 43 smear-positive patients (95.3%) were directly admitted or quickly transferred to the isolation room and started on anti-tuberculosis treatment (P < 0.001). Samples from smear-negative patients required more time to grow MTC in AFB culture than those of smear-positive patients (23 days vs. 14 days, P < 0.001). Diabetes was significantly associated with AFB smear positivity, with an odds ratio of 12.2. Negative AFB smears caused significant diagnostic and treatment delay. Patients staying in the general ward were exposed to TB patients who were not diagnosed in time.

IDENTIFIKASI FAKTOR PENCEGAH PENULARAN TB PARU DALAM RUMAH DI WILAYAH KERJA PUSKESMAS WONOKUSUMO SURABAYA TAHUN 2016

Surabaya ranked the first position for the incident of Pulmonary TB in East Java. In Wonokusumo health center, the number of patients with pulmonary TB increased from 2014 to 2015 by 57% and treatment success rate in 2015 reached 96%. This study aims to determine the relationship of behavior with home sanitation to prevent pulmonary tb infection in the house. This is a Case Control study with study population was family member of patients with pulmonary TB. The sample size was 49 cases and 49 controls. The sampling technique used multistage sampling method. Technique of collecting data used questionnaires and home observation sheets. Data was analyzed by SPSS Chis-Square test. This study shows that ρ (0,000) &lt;α (0.05), which means there was relationship between behavior with home sanitation condition to prevent pulmonary TB transmission at home. The conclusion of this study is that family members had poor level of knowledge, attitudes, and sanitation condition. 61.2% did not meet the standard and there was relationship of behavior and home sanitation. the society should add information about pulmonary TB condition and home sanitary as well as conducting routine mass cleaning program. Wonokusumo health center needs to provide counseling and formation of cadres that serves to provide information and motivation to pulmonary TB patients. Keywords : Behavior, home sanitation condition, pulmonary tuberculosis

White Plague, Mexican Menace

This article examines a debate that emerged in El Paso, Texas at the turn of the twentieth century surrounding the transmission of pulmonary tuberculosis from predominantly Anglo American migrants to the city’s ethnic Mexican population. Reports of Anglo-to-Mexican infections came from cities and towns throughout the U.S. Southwest, but by 1915 El Paso had emerged as the epicenter of the debate. Using popular and professional sources, the article tracks a shift in dominant perceptions of tubercular contagion from an association with white bodies to Mexican ones. An early narrative casts the Mexican female domestic servant as a victim of the infectious indigent white consumptive male health seeker. In 1915, as the Mexican Revolution raged and tensions between whites and ethnic Mexicans in the city sharpened, federal public health authorities published a report dismissing health seekers as a source of contagion to ethnic Mexicans. This article highlights the power of notions of race, gender, and class in shaping perceptions of and responses to epidemics, often with tragic results.

Spatial-temporal analysis of pulmonary tuberculosis in Shandong province, 2015

Objective: To analyze the spatial-temporal epidemiological characteristics of active pulmonary tuberculosis (PTB) and sputum smear positive (SS+) PTB in Shandong province, China, 2015. Methods: The surveillance data of active PTB and SS+PTB in Shandong in 2015 were collected and analyzed by using the global and local indicators of spatial association (Moran's I) for the spatial autocorrelation of PTB, and by using SaTScan forspatial-temporal clustering characteristics of PTB based on geographic information system. Results: Totally, 31 776 active PTB cases and 8 631 SS+PTB cases were reported in Shandong in 2015, and the reported incidence rates of active PTB and SS+PTB were 33.09/100 000 and 8.99/100 000, respectively. Active PTB had positive spatial autocorrelation at county level, and the value of Moran's I value was 0.219 (P<0.001), indicating that the high-high (HH) aggregation areas with high incidence were in the northwestern, southeastern and central southern Shandong; SS+PTB also had positive spatial autocorrelation at county level, and the value of the Moran's I was 1.178 (P<0.001), indicating that the HH aggregation areas with high incidence were in the southeastern and northwestern Shandong. The results of spatial-temporal scanning indicated that there was incidence clustering of active PTB in the second quarter and the third quarter in 2015, and the clustering areas were in the central southern, southeastern and northwestern Shandong; there also was incidence clustering of SS+PTB in the second quarter and the third quarter in 2015, and the clustering areas were in the southeastern and northwestern Shandong. Conclusions: The incidence of active PTB and SS+PTB showed spatial and temporal clustering in Shandong in 2015. The areas with high PTB burden and high PTB transmission risks were in the northwestern and southeastern Shandong. The areas with high PTB burden but without high PTB transmission risks were in the central southern Shandong.