History Of Tuberculosis Contact Research Articles

Accessibility of Finding Tuberculosis Case Actively, Separate Safely and Treat Effectively (FAST) Strategy for Early Detection of Suspected and Symptomatic Tuberculosis Patients: A Hospital Based Quantitative Study

Introduction: Tuberculosis is a contagious disease which has always been a challenge over the course of human history. It is known to spread mostly from persons with undiagnosed and suspected tuberculosis cases. Diagnosing tuberculosis in an early stage with effective treatment is one of the best ways to reduce the burden of tuberculosis. Finding cases Actively, Separate safely and Treat effectively (FAST) Strategy in Nepal, is a rapid diagnostic tool for rapid tuberculosis case detection. Aims: To access tuberculosis case Actively, Separate safely and Treat effectively (FAST) strategy for suspected and symptomatic tuberculosis patients coming to the hospital for early case detection and also to identify patient’s health care behaviour, technical barrier during surveillance. Methods: An observational quantitative study of active cough surveillance was carried at an entry point of FAST corner of Nepalgunj Medical College Teaching Hospital, Banke from April 2023 to December 2023. Scrutinized data was obtained by purposive sampling method with sample size 128 from FAST corner. Results: Maximum cases belonged to the aged group 65 and above having lower middle to lower socioeconomic status. Most of them were from joint family with contact history of tuberculosis in 35 (27.3) % of total cases. Out of total cases, 72 (56.25) % were confirmed with tuberculosis. Among those confirmed tuberculosis cases, multi drug resistance TB was found in 6 (4.7) %. Uses of mask was found significant (P< 0.05) in our study although number of these health care behaviour were less appropriate. Pneumonia was a significant association 17 (P = 0.004) with tuberculosis patient. Insufficient volunteers, and limited Gene xpert machine were major barriers to implement FAST strategy screening in Hospital. Conclusion: FAST strategy is feasible tool in high tuberculosis burden healthcare settings in Nepal. However, the technical and behavioral factors should be managed to ensure an effective approach.

Village as Contextual Factors and Other Risk Factors Related with the Incidence of Clinical Tuberculosis in Children in Wonogiri, Central Java: A Multilevel Analysis

Background: Indonesia is in the second rank with the highest burden of tuberculosis (TB) in the world. Childhood is a period of rapid growth, the body still has a low immune system so it is susceptible to disease including tuberculosis in children which requires control efforts. This study aims to analyze the influence of risk factors and village contextual factors on the incidence of TB in children.Subjects and Method: Case-control study research was conducted in 82 villages in Wonogiri Regency, from November to December 2023. A sample of 200 children aged 0 to 4 years old was selected through fixed disease sampling. The dependent variable of this study was the incidence of TB in children. The independent variables in this study were stunting, contact history, exposure to cigarette smoke, home sanitation, gender, parental education, child age, parental income, BCG immunization status, and village contextual influences. Data on TB disease was obtained from the Tuberculosis Information System Application (SITB) at the Wonogiri District Health Service in 2023. Other data was collected through questionnaires. The data analysis was done through multilevel multiplelogistic regression.Results: The factors that increased the incidence of TB in children were stunting (OR= 10.94; CI 95%= 2.50 to 47.90; p= 0.001), contact history to TB (OR= 8.37; CI 95%= 1.60 to 43.83; p= 0.012), and exposure to cigarette smoke (OR= 7.36; CI 95%= 1.99 to 27.14; p= 0.003). The reducing factors were healthy sanitation (OR= 0.24; CI 95%= 0.08 to 0.78; p= 0.017), female children (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062), and parents with ≥high school education (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062). There was no relationship between age (OR= 0.93; CI 95%= 0.13 to 6.23; p= 0.940), parental income (OR= 1.14; CI 95%= 0.40 to 3.25; p= 0.807), and BCG immunization status (OR= 0.12; CI 95%= 0.00 to 105.98; p= 0.550). Village has a contextual influence on the incidence of clinical TB in children (ICC= 52.95%).Conclusion: The risk of clinical TB in children increased with stunting, a history of TB contact and exposure to cigarette smoke, it decreased with healthy home sanitation, female gender, parents with ≥high school education. There was no relationship between age, parental income, and BCG immunization status. The village has a contextual effect on the incidence of clinical TB in children.

Development of tuberculosis treatment decision algorithms in children below 5 years hospitalised with severe acute malnutrition in Zambia and Uganda: a prospective diagnostic cohort study

In children with severe acute malnutrition (SAM) tuberculosis is common, challenging to diagnose, and often fatal. We developed tuberculosis treatment decision algorithms (TDAs) for children under the age of 5 years with SAM. In this prospective diagnostic study, we enrolled and followed up children aged <60 months hospitalised with SAM at three tertiary hospitals in Zambia and Uganda from 4 November 2019 to 20 June 2022. We included children aged 2-59 months with SAM as defined by WHO and hospitalised following the WHO clinical criteria. We excluded children with current or history of antituberculosis treatment within the preceding 3 months. They underwent tuberculosis symptom screening, clinical assessment, chest X-ray, abdominal ultrasound, Xpert MTB/RIF Ultra (Ultra) and culture on respiratory and stool samples with 6 months follow-up. Tuberculosis was retrospectively defined using the 2015 standard case definition for childhood tuberculosis. We used logistic regression to develop diagnostic prediction models for a one-step diagnosis and a two-step screening and diagnostic approaches. We derived scores from models using WHO-recommended thresholds for sensitivity and proposed TDAs. This study is registered with ClinicalTrials.gov, NCT04240990. Of 1906 children hospitalised with SAM during the study period, 1230 were screened, 1152 were eligible and 603 were enrolled. Of the 603 children enrolled-median age 15 (inter-quartile range (IQR): 11-20) months and 65 (11.0%) living with HIV-114 (18.9%) were diagnosed with tuberculosis, including 51 (8.5%) with microbiological confirmation and 104 (17.2%) initiated treatment at a median of 6(IQR: 2-10) days after inclusion. 108 children were retrospectively classified as having tuberculosis resulting in a prevalence of 17.9% (95% confidence intervals (CI): 15.1; 21.2). 75 (69.4%) children with tuberculosis reported cough of any duration, 32 (29.6%) cough ≥2 weeks and 11 (10.2%) tuberculosis contact history. 535 children had complete data and were included in the diagnostic prediction model. The one-step diagnostic model had 15 predictors, including Ultra, clinical, radiographic, and abdominal features, an area under the receiving operating curve (AUROC) of 0.910, and derived TDA sensitivity of 86.14% (95% CI: 78.07-91.56) and specificity of 80.88% (95% CI: 76.91-84.30). The two-step model had AUROCs of 0.750 and 0.912 for screening and diagnosis, respectively, and derived combined TDA sensitivity of 79.21% (95% CI: 70.30-85.98) and a specificity of 83.64% (95% CI: 79.87-86.82). Tuberculosis prevalence was high among hospitalised children with SAM, with atypical clinical features. TDAs achieved satisfactory diagnostic accuracy and could be used to improve diagnosis in this vulnerable group. Unitaid.

Risk factors for Tuberculosis in children at labuang baji hospital and center for community pulmonary health Makassar in 2023

Efforts to achieve the Sustainable Development Goals (SDGs) include eradicating the global tuberculosis (TB) epidemic by 2030. In 2020, the global TB incidence rate stood at 121 per 100,000 people, with 1.1 million children succumbing to the disease worldwide. Indonesia alone recorded 42,187 pediatric TB cases in 2021, emphasizing the urgency of addressing this public health concern.A recent observational study in Makassar City focused on children aged 0-14, revealing 380 cases in 2022, notably concentrated in Labuang Baji Regional Hospital, Tajuddin Chalid Hospital, and Community Center for Lung Health Makassar. Developing countries, where children under 15 constitute 40-50% of the population, witness around 500,000 pediatric TB cases annually, leading to severe morbidity and mortality, especially in those under 14. May to July 2023, researchers conducted a case-control study involving 114 children. The study revealed that malnutrition (with an odds ratio of 2.614 and a 95% confidence interval of 1.133-6.085) and a history of TB contact (with an odds ratio of 7.84 and a 95% confidence interval of 2.932-22.319) emerged as noteworthy risk factors for pediatric TB. Notably, economic status, residential density, BCG vaccination status, and exposure to smokers showed no significant impact on the prevalence of the disease.The study advocates consistent screening of adult TB patients' family contacts to trace potential cases in children. Future research should explore the feasibility of TB transmission among children. Tackling malnutrition and strengthening contact tracing initiatives are imperative to curbing pediatric TB, aligning with global goals for a TB-free world by 2030.

Active case finding of tuberculosis among nomads and semi-nomads in Puducherry.

Tuberculosis (TB), is a global epidemic and communicable disease that accounts for increased global mortality and morbidity. India is also marching towards the elimination of tuberculosis by 2025 with this background we conducted this study. To identify the undiagnosed TB cases in nomadic and semi-nomadic populations of Puducherry. A community-based cross-sectional study was done among nomads and semi-nomads in Puducherry for four months between May 2022 to September 2022 after getting the Institute's ethical committee approval. After obtaining written consent/assent, a pretested semi structured questionnaire was used to record the data. The questionnaire consists of three parts that include, sociodemographic details and history specific to tuberculosis based on operational definitions such as presumptive TB and physical examination. Those participants fulfilling the criteria for presumptive TB was provided a Falcon tube for spot sample. The participants were explained the procedure to collect the sputum and its quality was verified by the principal investigator before sending it to the laboratory. Data was analysed with Statistical Package for Social Science (SPSS Inc, Chicago, Illinois, USA) software version 16.0 and Microsoft Excel 2016. Frequencies and percentages were estimated for categorical data. Our study showed 6.25% was the proportion of presumptive TB cases in our study population. In the presumptive TB cases 60% belonged to age >45yrs 80% belonged to the male gender and all of them belonged to lower socioeconomic status. The macro-environment findings of those presumptive TB cases were 80% belonged Kutcha houses, with poor ventilation and overcrowding present. Their co-morbidity status indicates 60% were diabetics and 20% were hypertensive. Their predominant findings were 80% reported Cough and 20% fever, significant weight loss. No contact history of TB was found. When these presumptive TB cases underwent microbiological examination, none were sputum positive. This study showed ACF helped to identify presumptive TB in an effective way and needs large-scale screening to identify sputum-positive cases.

Development and validation of a risk prediction model for pulmonary tuberculosis among presumptive tuberculosis cases in Ethiopia

BackgroundEarly diagnosis and treatment of tuberculosis (TB) is one of the key strategies to achieve the WHO End TB targets. This study aimed to develop and validate a simple, convenient...

Characteristics of Pediatric Tuberculosis Patients at Simpang Lima Gumul Hospital, Kediri, East Java

Introduction: Pediatric tuberculosis can cause a variety of problems, including growth failure, disability, and death. In 2021, WHO recorded 10.6 million individuals had tuberculosis globally, with pediatric tuberculosis accounting for 11% of these cases. Indonesia is the second highest high-burden country for tuberculosis, according to the WHO. Children with tuberculosis often present non-specific and uncommon symptoms, making diagnosis challenging and frequently delayed. This study aims to present an overview of the characteristics of pediatric tuberculosis patients at Simpang Lima Gumul Hospital in Kediri, East Java. Material and Methods: This was a descriptive retrospective study with a cross-sectional method. Pediatric tuberculosis patients who received treatment at the Simpang Lima Gumul Hospital in Kediri, East Java, were the subject of research. We compiled pediatric tuberculosis patients' demographic data and clinical characteristics using medical records. Results: Sixty-one children included in the study. Most of them were male (56%) between 1 to 5 years old (52%). Seventy-two percent had a positive tuberculin skin test; chronic cough was noted in 69% of cases. An adult contact history of tuberculosis was reported in 64% of cases, while 61% had radiographic findings from TB. 52% also had fever, 51% had lymphadenopathy, and 72% had good nutritional status. Conclusion: Tuberculosis occurs most commonly in male children 1 to 5 years of age. The most common symptoms of pediatric tuberculosis include a positive tuberculin skin test, chronic cough, contact with adults with tuberculosis, positive radiographic findings, fever, and lymphadenopathy.

A RARE CASE OF PAPILLARY CARCINOMA OF THYROID IN A YOUNG FEMALE: A CASE REPORT

Background: The papillary carcinoma thyroid is a rare disease in adolescents and children. A high level of suspicion should arouse as soon as the physician comes across swelling in neck. Appropriate management yields a good survival rate.&#x0D; Case history: We present a case of the papillary carcinoma thyroid in a 13-year old girl presented to outdoor of Jinnah Hospital, Lahore with painless swelling in right side of neck for three months. There were associated smaller swelling matted on palpation. No history of palpitations, fever, weight loss and family history of tuberculosis contact or cancer in family. Initial radiology and blood investigations showed an euthyroid goitre. The fine needle aspiration of lymph node only showed reactive hyperplasia. The matted lymph node was partially excised for histopathology as suspicion of tuberculosis existed due to its endemic feature. Later, it was found to be papillary carcinoma of thyroid. Total thyroidectomy was done with neck dissection followed by treatment at nuclear medicine department.&#x0D; Conclusion: Thyroid cancer is quite uncommon in adolescents but strong suspicion should arise when dealing with neck swelling even in this age group. Thorough history, watchful physical examination and timely investigations can save clinician from missing the diagnosis.

A meta-analysis of risk factors for multidrug-resistant tuberculosis in China

Objective: To explore the main risk factors of multidrug-resistant tuberculosis (MDR-TB) in China and to provide evidence-based evidence for MDR-TB preventon and control. Methods: All relevant literatures were searched in thedatabases, such as Pubmed, Web of Science and CNKI, Wanfang, VIP and SinoMed from 2000 to 2021. Quality evaluation and data extraction were carried out, and then a meta-analysis was performed using Stata 16.0 software. Results: A total of 59 literatures (36 cross-sectional and 23 case-control) including 75 793 participants were included in this study, and meta-analysis results showed age (OR=1.27, 95%CI: 1.05-1.54), education level (OR=1.29, 95%CI: 1.02-1.65), positive sputum smear (OR=2.56, 95%CI: 1.09-6.04), pulmonary cavity (OR=1.99, 95%CI: 1.57-2.52), course of disease (OR=4.25, 95%CI: 1.95-9.30), history of tuberculosis treatment (OR=6.42,95%CI:5.40-7.63), treatment interruption (OR=2.81, 95%CI: 1.50-5.29), irregular medication (OR=5.02, 95%CI: 2.95-8.54), adverse drug reactions (OR=4.27, 95%CI: 2.22-8.19), combined chronic obstructive pulmonary disease (COPD) (OR=2.21, 95%CI: 1.45-3.37), tuberculosis exposure history (OR=1.99, 95%CI: 1.36-2.91), smoking history (OR=1.35, 95%CI: 1.09-1.66) and floating population (OR=1.60, 95%CI: 1.04-2.44) were associated with the occurrence of MDR-TB. Conclusions: The high risk groups were farmer, low education level, pulmonary cavity, long course of disease, history of tuberculosis treatment, treatment interruption, irregular medication, adverse drug reaction, co-COPD, contact history of tuberculosis, smoking history, rural residence, and floating population. We should pay attention to high-risk groups, strengthen management and take effective measures such as early screening, knowledge education on tuberculosis, standardized and personalized treatment and whole-course supervision.

Brief Report: Performance of Tuberculosis Symptom Screening Among Hospitalized ART-Naive Children With HIV in Kenya.

The World Health Organization (WHO) recommends tuberculosis (TB) diagnostic evaluation for children with HIV (CHIV) who have history of TB contact, poor weight gain, cough, or fever. These screening criteria were developed based on studies of symptomatic CHIV with incomplete microbiologic confirmation. We performed routine TB microbiologic evaluation of hospitalized CHIV with and without symptoms to develop a data-driven TB symptom screen. Among hospitalized antiretroviral therapy-naive Kenyan CHIV enrolled in the Pediatric Urgent Start of Highly Active Antiretroviral Therapy (PUSH) trial, we performed Xpert MTB/RIF and mycobacterial culture of respiratory and stool specimens independent of TB symptoms. We evaluated performance of WHO and other published pediatric TB screening criteria and derived optimized criteria using a combination of symptoms. Of 168 CHIV who underwent TB microbiologic evaluation, 13 (8%) had confirmed TB. WHO TB symptom screening had 100% sensitivity and 4% specificity to detect confirmed TB. Published TB screening criteria that relied on prolonged symptoms missed cases of confirmed TB (sensitivity 85%-92%). An optimized symptom screen including weight loss, cough, anorexia, or TB contact had 100% sensitivity and improved specificity (31%) compared with the WHO pediatric TB symptom screen. The WHO TB symptom screen was highly sensitive but resulted in a high proportion of hospitalized CHIV who would require TB diagnostic evaluation. Other published TB screening criteria missed CHIV with confirmed TB. Our optimized screening tool increased specificity while preserving sensitivity. Future multicenter studies are needed to improve TB screening tools for CHIV in both inpatient and outpatient settings.

Development of a Clinical Prediction Score Including Monocyte-to-Lymphocyte Ratio to Inform Tuberculosis Treatment Among Children With HIV: A Multicountry Study.

Clinical pediatric tuberculosis (TB) diagnosis may lead to overdiagnosis particularly among children with human immunodeficiency virus (CHIV). We assessed the performance of monocyte-lymphocyte ratio (MLR) as a diagnostic biomarker and constructed a clinical prediction score to improve specificity of TB diagnosis in CHIV with limited access to microbiologic testing. We pooled data from cohorts of children aged ≤13 years from Vietnam, Cameroon, and South Africa to validate the use of MLR ≥0.378, previously found as a TB diagnostic marker among CHIV. Using multivariable logistic regression, we created an internally validated prediction score for diagnosis of TB disease in CHIV. The combined cohort had 601 children (median age, 1.9 [interquartile range, 0.9-5.3] years); 300 (50%) children were male, and 283 (47%) had HIV. Elevated MLR ≥0.378 had sensitivity of 36% (95% confidence interval [CI], 23%-51%) and specificity of 79% (95% CI, 71%-86%) among CHIV in the validation cohort. A model using MLR ≥0.28, age ≥4 years, tuberculin skin testing ≥5 mm, TB contact history, fever >2 weeks, and chest radiograph suggestive of TB predicted active TB disease in CHIV with an area under the receiver operating characteristic curve of 0.85. A prediction score of ≥5 points had a sensitivity of 94% and specificity of 48% to identify confirmed TB, and a sensitivity of 82% and specificity of 48% to identify confirmed and unconfirmed TB groups combined. Our score has comparable sensitivity and specificity to algorithms including microbiological testing and should enable clinicians to rapidly initiate TB treatment among CHIV when microbiological testing is unavailable.

Tuberculin test versus interferon gamma release assay in pregnant women with household contacts of tuberculosis patients.

Pregnant women who live in tuberculosis (TB)-affected households are more likely to develop latent TB infection (LTBI), which often escapes treatment. This study aims to determine if Interferon-gamma release (IGRA) is reliable in screening for LTBI in pregnant women, compare to the tuberculin skin test (TST). It was a cross-sectional study that involved 60 pregnant women with TB contact history as a proxy for LTBI and 30 pregnant women without contact history. Latent TB was detected using the TST 5 tuberculin units and IGRA using the QuantiFERON Gold Plus TB Test kit (QFT-Plus). The sensitivity and specificity of the two diagnostic methods and the agreement between them were estimated using SPSS version 20.0. The sensitivity 95% (95% confidence interval [CI]: 86.08%-98.96%) and specificity 26.7% (95% CI: 12.28%-45.89%) of TST were compared to that of the IGRA with 60% (95% CI: 46.54%-72.44%) and 73.3% (95% CI: 54.11%-87.72%) sensitivity and specificity, respectively in detecting LTBI in pregnancy. Although there was a significant difference (P < 0.05) between TST and IGRA, the agreement was fair (kappa 0.39; 95% CI: 0.24-0.45). TST assay is more sensitive than IGRA; however, the specificity of IGRA was superior to the TST method. In this study, a fair agreement of TST and IGRA was observed for detecting latent TB infection in pregnant women with household contact with TB patients.

Adolesan Bir Hastada Granülomatöz Üveit ile Seyreden Oküler Tüberküloz: Nadir Bir Olgu Sunumu

Tuberculosis continues to be a significant global public health issue. Tuberculosis most often affects the lungs. However, children are more likely to have extrapulmonary involvement compared to adults. Ocular involvement is a rare extrapulmonary manifestation of tuberculosis. Ocular tuberculosis may affect any part of the eye and can be remain unnoticed due to the lack of clinically evident symptoms or findings, if there is no history of tuberculosis contact or other systemic signs or if these are not questioned. Here, we present an adolescent case who was diagnosed with pulmonary and ocular tuberculosis when investigating the underlying cause of granulomatous uveitis and successfully controlled with four drug regimen anti-tuberculosis and methylprednisolone treatment. In conclusion, ocular tuberculosis is an important cause of ocular morbidity. Diagnosis and follow-up require a multidisciplinary approach.

P486 Disseminated Cryptococcosis diagnosed on fine needle aspiration cytology

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PMObjectives (Case)A 48-year-old male with no prior comorbidities presented to our infectious disease clinic with intermittent low-grade fever and gradual progressive swelling in his left axilla for 3 months. On further probing, the patient also gives a history of weight loss of around 7 kg. The patient belonged to a northern state of the Indian subcontinent and owned a grocery shop, where he worked. There was no recent or remote travel history, no history of exposure to animals or birds, no high-risk behavior, and no past or known contact history of tuberculosis. Still, in an endemic country like India and in this given clinical scenario, we kept tubercular lymphadenitis as the first differential and investigated the case further.Methods (Investigation)A contrast-enhanced computed tomography (CECT) of the chest and abdomen was done, showing multiple enlarged mediastinal and axillary lymph nodes with bilateral adrenal mass (Fig. 1). To further evaluate the etiology, a fine needle aspiration of the left axillary swelling was done. A hematoxylin and eosin (H and E) stain of the same showed the presence of numerous organisms of varying sizes present both intracellularly and extracellularly along with chronic inflammatory cells (Fig. 2a). Based on this picture, differentials of Histoplasma, Cryptococcus, or Toxoplasma were kept. But considering the empty spaces (halos) which probably represent the capsule and variability in the size, a strong possibility of Cryptococcus was kept. Serum cryptococcal antigen (latex agglutination) was negative but eventually, the fungal culture of the aspirated sample grew cream-colored, shiny dome-shaped, mucoid colonies on Sabouraud Dextrose Agar suggestive of Cryptococcus (Fig. 2b). The same was confirmed on Bird Seed Agar and Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS). Gene Xpert of the aspirated sample was negative and serum cortisol with serum adrenocorticotropic hormone (ACTH) were under normal limits.Results (Diagnosis)A diagnosis of disseminated cryptococcosis was made based on the involvement of more than two non-contiguous sites (mediastinal with axillary lymph nodes and adrenal gland). The patient was initially started on liposomal Amphotericin B (5 mg/kg intravenous daily) with which he improved clinically. Same was continued for 2 weeks and later he was shifted to fluconazole 400 mg daily. As of now, the patient is on his 3rd month of fluconazole and doing well on follow-up.ConclusionCryptococcus (Cryptococcus neoformans and Cryptococcus gattii) is an encapsulated yeast causing invasive fungal infection, with vast majority occurring in immunocompromised host1. It has a global distribution, predominantly involving the central nervous system (CNS) and lung. Management of non-CNS and non-pulmonary cryptococcosis is tricky as looking for dissemination is key (as the initial choice of agent varies)2. Adrenal involvement in Cryptococcosis is uncommon (as seen in our case). Examination of FNAC samples for Cryptococcus is also challenging as other microbes can also closely mimic the same. Finally, in a tuberculosis endemic country like India, clinical symptoms of Cryptococcal lymphadenitis can closely resemble tubercular lymphadenitis, so empirical therapy may be risky.Figure 1 Axial CT Chest images showing multiple enlarged mediastinal lymph nodes (red arrow).Figure 2a Fine needle aspiration cytology (FNAC) from the left axillary swelling stained with hematoxylin and eosin showing numerous organisms of varying size present both intracellularly (black arrow) and extracellularly with surrounding halos in a background chronic inflammatory cells.Figure 2b Fine needle aspirate sample incubated at 37 0C on Sabouraud Dextrose Agar with gentamicin showing cream-colored, dome-shaped, shiny, mucoid colonies with smooth edge (characteristic of Cryptococcus).Sources:Iyer KR, Revie NM, Fu C, Robbins N, Cowen LE. Treatment strategies for cryptococcal infection: challenges, advances and future outlook. Nat Rev Microbiol. 2021 Jul;19(7):454–66.Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America | Clinical Infectious Diseases | Oxford Academic [Internet]. [cited 2022 Jul 28]. Available from: https://academic.oup.com/cid/article/50/3/291/392360

Prevalence and risk factors of latent tuberculosis infection in adolescent in Islamic boarding schools

Latent tuberculosis infection (LTI) is an obstacle in eradicating pulmonary tuberculosis. 5-10% people with LTI will develop into active tuberculosis (TB) in the first 5 years after the first TB infection. Islamic boarding schools are a highly potential area in increasing LTI incidents in adolescents. Existing studies are mostly focused on reporting LTI in the general population. To determine the prevalence and risk factors of LTI in adolescents in islamic boarding schools in Bangkalan Madura. A cross sectional study was conducted at the Islamic Boarding School Bangkalan Madura in January 2022 using a random sampling technique. The IGRA examination using the QIAreach QuantiFERON TB tool. The risk factors analyzed include age, gender, nutritional status, TB contact history, duration of stay in Islamic boarding schools and level of knowledge. The data obtained were further analyzed using chi-square and logistic regression test. A total of 100 subjects were examined by IGRA resulting in 30 positive subjects consisting of 30.3% male and 29.9% female. TB contact history (OR 5.167; 95% CI = 1.831-14.567; p=0.002) and level of knowledge about TB (OR 0.019; 95% CI = 0.005-0.069; p&lt;0.05) are significantly related to the incidence of LTI in adolescents in islamic boarding schools.

Magnitude of Mycobacterium tuberculosis, drug resistance and associated factors among presumptive tuberculosis patients at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Mycobacterium tuberculosis (M. tuberculosis) remains one of the most significant causes of death and a major public health problem in the community. As a result, the aim of this study was to determine magnitude of Mycobacterium tuberculosis, its drug resistance, and associated factors among presumptive tuberculosis (TB) patients at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Cross-sectional study was conducted at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia from January to July 2019. Demographic and clinical data were collected by structured questionnaire through face to face interview. Using microscopic examination and GeneXpert MTB/RIF assay and culturing in the Lowenstein-Jensen (LJ) culture media, we collected and analyzed both pulmonary and extra-pulmonary clinical samples. Data were analyzed by SPSS version 23. Binary logistic regression was done to identify the associated risk factors and p-value less than 0.05 was taken as significant association. Of the total 436 respondents, 223(51%) were male. The mean ±SD age of the participants was 38±17years. Overall, 27/436(6.2%) of the participants had confirmed Mycobacterium tuberculosis using the GeneXpert MTB/RIF assay and LJ culture media, and two isolates were resistant to RIF and one to INH medication, with two (0.5%) being MDR-TB. MTB infection was associated with previous TB contact history, patient weight loss, and CD4+ T-cell counts of 200-350/mm3 of blood. The magnitude of M. tuberculosis and MDR-TB in this study underscores the need for improved early case detection and management of MDR-TB in order to reduce transmission and patient suffering.

Characteristics Of Pediatric Tuberculosis Patients Hospitalized At dr. Soebandi Public Hospital Jember

Background: Tuberculosis (TB) remains a major public health problem globally. TB in children is an important component in TB control. The diagnosis of TB in children until now is still challenging, underdiagnosis often occurs in primary health facilities in Indonesia. This study aims to describe the demographic and clinical features of pediatric tuberculosis patients hospitalized in a tertiary care center.Methods: This study reviewed medical records of children with TB who were hospitalized in a referral hospital in Jember, East Java, Indonesia from January 2018 through December 2019.Results: Among 96 patients, 33,3% happened in the age group of 15-18 years, 53.1% were females, 35,4% had severely underweight nutritional status, majority (84,4%) live in rural area, 79,2% without known TB contact history and 81.1% were new cases. Pulmonary TB was the most common diagnosis (80,2%). Only 4.1% had co-infection with Human Immunodeficiency Virus (HIV) and 4.2% were reported to be resistant to anti-TB drugs. The most common symptoms were fever (84.3%), cough (65.6%), and dyspnea (65.6%). The miliary lesion was the most common lesions on chest X-ray examination results. The successful therapy reached a percentage of 61.4% of all cases.Conclusions: The majority of pediatric TB patients were diagnosed clinically and chest X ray. Examination of HIV status and drug-sensitivity testing is low. The rate of successful therapy was still under WHO target.. Keywords: tuberculosis, children, characteristics

Evaluation of endometrial tuberculosis among subjects undergoing endometrial biopsy at our teritiary care centre

Background: Female genital tuberculosis (FGTB) is known to cause severe tubal disease leading to infertility and its incidence closely parallels with the overall prevalence of tuberculosis (TB) in a community. Objectives of the study: To study the prevalence of endometrial tuberculosis among the infertility subjects undergoing endometrial biopsy. Materials and Methods: Demographic data regarding age, Socioeconomic status based on the Modified Kuppuswamy scale, menstrual pattern, type of infertility, past-history of TB in any part of the body or history of TB contact (living in the same household or in frequent contact with a sputum smear positive TB patient in last 2 years). Body Mass Index/ BMI was calculated. All the subjects were evaluated for GTB by CXR, CBNAAT, USG, Culture AFB, Biopsy, and histopathological examination. Results and Discussion: We performed various investigations which include CXR, USG, CBNAAT and CS for AFB, we found that all the subjects had normal CXR, 132 had tubo-ovarian mass on USG, 36 had CBNAAT positive and culture for AFB was positive in 23 subjects.

Magnitude of tuberculosis and its associated factors among under-five children admitted with severe acute malnutrition to public hospitals in the city of Dire Dawa, Eastern Ethiopia, 2021: multi-center cross-sectional study

ObjectiveThe aim of this study was to assess the prevalence of tuberculosis (TB) and its associated factors among children under 5 years of age with severe acute malnutrition. MethodsA multi-center, institution-based, retrospective cross-sectional study was conducted at public hospitals in Dire Dawa City Administration, Eastern Ethiopia from January 1, 2018 to December 30, 2020. A binary logistic regression model was fitted to identify factors associated with the prevalence of TB. ResultsThe overall prevalence of TB among children under 5 years of age admitted with severe acute malnutrition to public hospitals in the city of Dire Dawa, Eastern Ethiopia was 10.39% (95% confidence interval (CI) 7.61–13.73%). Repeated admission (adjusted odds ratio (AOR) 2.5, 95% CI 1.08–6.07), a TB contact history (AOR 3.58, 95% CI 1.21–10.6), pneumonia (AOR 2.8, 95% CI 1.29–6.23), stage IV HIV/AIDS (AOR 4.41, 95% CI 1.29–15.13), and being immunized (AOR 0.19, 95% CI 0.08–0.43) were variables significantly associated with the prevalence of TB. ConclusionsThe results of this study showed that the prevalence of TB among under-five children with severe acute malnutrition was high. The prevalence of TB was associated with having HIV/AIDS, having pneumonia, having a TB contact history, admission status, and immunization status. Integrated TB prevention and screening strategies with nutritional rehabilitation care should be implemented.

TUBERCULOSIS VERTEBRAL, UN DESAFIO DIAGNÓSTICO. REPORTE DE CASO Y REVISIÓN DE LA LITERATURA

Introduction: Spinal tuberculosis TB represents 1% of all TB cases and 50 - 60 of osteoarticular TB cases.1 Certain atypical clinical and radiological presentations of spinal tuberculosis are described infrequently. 2 The lack of recognition of these presentations can lead to a delay in diagnosis and the initiation of treatment. 3 We present the case of a patient with atypical vertebral tuberculosis operated on in our hospital. Clinical case: A 56-year-old male with a history of diabetes mellitus and no history of tuberculosis contact with a 3-year history of moderate low back pain without sciatic pain that did not improve with physical therapy. The general and systemic physical examination was normal. The tests showed PCR 9.8 ESR 24 BK in the sputum brucellosis test, and ELISA and chest X-ray were normal. A tomography and magnetic resonance imaging of the lumbosacral spine showed an osteolytic lesion involving L2 L3, isointense on T1, with regular punched-out borders sparing the L2 L3 intervertebral disc suggestive of vertebral tuberculosis. He received standard tuberculosis treatment for 24 months with no improvement. A new open biopsy revealed Mycobacterium tuberculosis GenXpert. Conclusion: Spinal tuberculosis continues to be a global health problem. Diagnosing atypical spinal tuberculosis remains difficult, which could lead to inappropriate treatment, especially regarding the choice of treatment regimens and surgical options. Histopathological confirmation is essential for time management. Keywords: Tuberculosis, Spinal, Mycobacterium tuberculosis, Lumbar Vertebrae, Biopsy (Source: MeSH NLM)