Telomere length and outcome of treatment for pulmonary tuberculosis in a gold mining community

AbstractTelomere length (TL) is a marker of ageing and mitochondrial DNA (mtDNA) is an early marker of inflammation caused by oxidative stress. We determined TL and mtDNA content among active pulmonary tuberculosis (PTB) patients to assess if these cellular biomarkers differed between artisanal miners and non-miners, and to assess if they were predictive of treatment outcome. We conducted a prospective cohort study from August 2018 to May 2019 involving newly diagnosed PTB patients at three outpatient TB clinics in a rural Democratic Republic of Congo. We measured relative TL and mtDNA content in peripheral blood leukocytes (at inclusion) via qPCR and assessed their association with PTB treatment outcome. We included 129 patients (85 miners and 44 non-miners) with PTB (median age 40 years; range 5–71 years, 22% HIV-coinfected). For each increase in year and HIV-coinfection, TL shortened by − 0.85% (− 0.19 to − 0.52) (p ≤ 0.0001) and − 14% (− 28.22 to − 1.79) (p = 0.02) respectively. Independent of these covariates, patients with longer TL were more likely to have successful TB treatment [adjusted hazard ratio; 95% CI 1.27 for a doubling of leucocyte telomere length at baseline; 1.05–1.44] than patients with a shorter TL. Blood mtDNA content was not predictive for PTB outcome. For a given chronological age, PTB patients with longer telomeres at time of diagnosis were more likely to have successful PTB treatment outcome.

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Respiratory symptoms and lung function in patients treated for pulmonary tuberculosis in Malawi: a prospective cohort study

Thorax ◽

10.1136/thoraxjnl-2021-217190 ◽

2021 ◽

pp. thoraxjnl-2021-217190

Author(s):

Rebecca Nightingale ◽

Beatrice Chinoko ◽

Maia Lesosky ◽

Sarah J Rylance ◽

Bright Mnesa ◽

...

Keyword(s):

Lung Function ◽

Pulmonary Tuberculosis ◽

Respiratory Symptoms ◽

Treatment Completion ◽

First Year ◽

Tb Treatment ◽

Effective Interventions ◽

Hiv Coinfection ◽

History Of ◽

Chest X Ray

RationalePulmonary tuberculosis (PTB) can cause post-TB lung disease (PTLD) associated with respiratory symptoms, spirometric and radiological abnormalities. Understanding of the predictors and natural history of PTLD is limited.ObjectivesTo describe the symptoms and lung function of Malawian adults up to 3 years following PTB-treatment completion, and to determine the evolution of PTLD over this period.MethodsAdults successfully completing PTB treatment in Blantyre, Malawi were followed up for 3 years and assessed using questionnaires, post-bronchodilator spirometry, 6 min walk tests, chest X-ray and high-resolution CT. Predictors of lung function at 3 years were identified by mixed effects regression modelling.Measurement and main resultsWe recruited 405 participants of whom 301 completed 3 years follow-up (mean (SD) age 35 years (10.2); 66.6% males; 60.4% HIV-positive). At 3 years, 59/301 (19.6%) reported respiratory symptoms and 76/272 (27.9%) had abnormal spirometry. The proportions with low FVC fell from 57/285 (20.0%) at TB treatment completion to 33/272 (12.1%), while obstruction increased from and 41/285 (14.4%) to 43/272 (15.8%) at 3 years. Absolute FEV1 and FVC increased by mean 0.03 L and 0.1 L over this period, but FEV1 decline of more than 0.1 L was seen in 73/246 (29.7%). Higher spirometry values at 3 years were associated with higher body mass index and HIV coinfection at TB-treatment completion.ConclusionSpirometric measures improved over the 3 years following treatment, mostly in the first year. However, a third of PTB survivors experienced ongoing respiratory symptoms and abnormal spirometry (with accelerated FEV1 decline). Effective interventions are needed to improve the care of this group of patients.

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Tuberculosis Treatment Outcome in Patients with TB-HIV Coinfection in Kuala Lumpur, Malaysia

Journal of Tropical Medicine ◽

10.1155/2021/9923378 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Diana Safraa Selimin ◽

Aniza Ismail ◽

Norfazilah Ahmad ◽

Rohani Ismail ◽

Nurul Farhana Mohd Azman ◽

...

Keyword(s):

Treatment Outcome ◽

Healthcare Providers ◽

Risk Groups ◽

National Database ◽

Kuala Lumpur ◽

Treatment Rate ◽

Cross Sectional ◽

Tb Treatment ◽

Hiv Coinfection

Background. Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). This study aimed to identify the characteristics, unsuccessful TB treatment rate, and determinants of unsuccessful TB treatment outcome among patients with TB-HIV coinfection in Kuala Lumpur. Methods. This was a cross-sectional study. The data of all patients with TB-HIV in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018. Results. Out of 235 randomly selected patients with TB-HIV, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed, or lost to follow-up). Patients who did not receive DOTS (directly observed treatment, short course) (adjusted odds ratio: 21.71; 95% confidence interval: 5.36–87.94) and those who received shorter treatment duration of <6 months (aOR: 34.54; 95% CI: 5.97–199.93) had higher odds for unsuccessful TB treatment outcome. Conclusions. Nearly half of the patients with TB-HIV had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV to gain treatment adherence and for better rates of successful TB treatment.

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Change in body weight and treatment outcome in sputum positive pulmonary tuberculosis patients treated under directly observed treatment short-course

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20182172 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2431

Author(s):

Malangori A. Parande ◽

Pradip S. Borle ◽

Vinay S. Tapare ◽

Sudhakar W. More ◽

Susmita S. Bhattacharya

Keyword(s):

Body Weight ◽

Treatment Outcome ◽

Weight Gain ◽

Pulmonary Tuberculosis ◽

Prognostic Significance ◽

Intensive Phase ◽

Tuberculosis Patients ◽

Tb Treatment ◽

End Of Treatment ◽

Significant Difference

Background: Patients with tuberculosis often suffer from severe weight loss and is used as useful marker to predict TB treatment outcome. Hence a study was planned with an objective to determine the change of patient’s body weight over time throughout treatment and to determine whether there was any association with treatment outcome.Methods: This was a retrospective cohort study, planned to be conducted among all smear positive pulmonary tuberculosis patients registered in a Tuberculosis Unit of Pune corporation, during the period of January to December 2015. Body weights of patients were recorded from TB treatment cards at the time of diagnosis, after 2 months of intensive phase of treatment and at the end of treatment. Total 344 cases were enrolled. Chi-Square test and Fisher’s exact test and repeated measure ANOVA test was used for analysis.Results: A bad outcome was more likely among the category II cases as compared to category I, among non-adherent to treatment cases in continuation phase and higher sputum grading at the time of diagnosis i. e. in 3+ sputum smear grading. The weights of the patients at the time of diagnosis, at end of intensive phase and at end of treatment showed statistical significant difference (p<0.0001). The weight gain, more so at end of treatment was significantly associated with good outcome.Conclusions: Weight gain has prognostic significance in patients with tuberculosis and should be considered as a surrogate marker to monitor response to TB treatment especially in developing countries where extensive laboratory tests are not feasible.

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Abstract #542 An Unusual Initial Presentation of Active Pulmonary Tuberculosis: Severe Hypercalcemia with Altered Mental Status and Renal Failure

Endocrine Practice ◽

10.1016/s1530-891x(20)47219-2 ◽

2018 ◽

Vol 24 ◽

pp. 130

Author(s):

Matthew Mandell ◽

Jennifer Velasco ◽

Armand Krikorian ◽

Anupama Ananth ◽

Joumana Chaiban ◽

...

Keyword(s):

Renal Failure ◽

Pulmonary Tuberculosis ◽

Mental Status ◽

Altered Mental Status ◽

Initial Presentation ◽

Active Pulmonary Tuberculosis ◽

Severe Hypercalcemia

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Electroconvulsive and insulin coma therapy in the presence of active pulmonary tuberculosis

PsycEXTRA Dataset ◽

10.1037/e534382008-003 ◽

1955 ◽

Author(s):

Louis Weinstein

Keyword(s):

Pulmonary Tuberculosis ◽

Active Pulmonary Tuberculosis ◽

Insulin Coma ◽

Insulin Coma Therapy

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Faculty Opinions recommendation of Association of telomere length of peripheral blood leukocytes with hematopoietic relapse, malignant transformation, and survival in severe aplastic anemia.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.5972958.5974056 ◽

2010 ◽

Author(s):

Albert N Békássy

Keyword(s):

Aplastic Anemia ◽

Telomere Length ◽

Malignant Transformation ◽

Peripheral Blood ◽

Severe Aplastic Anemia ◽

Peripheral Blood Leukocytes ◽

Blood Leukocytes

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Deep-Learning Based Automated Detection Algorithm for Active Pulmonary Tuberculosis on Chest Radiographs: Diagnostic Performance in Systematic Screening of Asymptomatic Individuals

SSRN Electronic Journal ◽

10.2139/ssrn.3369785 ◽

2019 ◽

Author(s):

Jong Hyuk Lee ◽

Sunggyun Park ◽

Eui Jin Hwang ◽

Jin Mo Goo ◽

Woo Young Lee ◽

...

Keyword(s):

Deep Learning ◽

Pulmonary Tuberculosis ◽

Diagnostic Performance ◽

Detection Algorithm ◽

Automated Detection ◽

Chest Radiographs ◽

Systematic Screening ◽

Active Pulmonary Tuberculosis ◽

Asymptomatic Individuals

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Metabolism of Heterogenic Hemoglobins

Blood ◽

10.1182/blood.v22.3.334.334 ◽

1963 ◽

Vol 22 (3) ◽

pp. 334-341 ◽

Cited By ~ 10

Author(s):

RICHARD D. LEVERE ◽

HERBERT C. LICHTMAN ◽

Joan Levine

Keyword(s):

Pulmonary Tuberculosis ◽

Sickle Cell ◽

Sickle Cell Trait ◽

Hemoglobin S ◽

Active Pulmonary Tuberculosis ◽

Hemoglobin A ◽

Abnormal Hemoglobin

Abstract The relative rates of incorporation of Fe59 into heterogenic hemoglobins was studied in four patients with sickle cell trait. Three of the patients were free of superimposed disease, while one had active pulmonary tuberculosis. In all subjects there was a significantly greater incorporation of radioiron, per milligram of hemoglobin, into hemoglobin S than into hemoglobin A. The data indicate that in sickle cell trait the rates of synthesis of the heterogenic hemoglobins are not proportional to their circulating concentrations. Two interpretations appear possible. Since the size of the intra-marrow pool of hemoglobin S was not known, it is possible that there exists a smaller preformed pool of the abnormal hemoglobin, with the isotope making its appearance first in hemoglobin S. However, it is also possible that hemoglobin S is synthesized at a rate which is greater than that reflected by its circulating concentration. This implies that the relative concentrations of hemoglobin S and hemoglobin A vary from erythrocyte to erythrocyte, and that those cells with the greatest proportion of hemoglobin S are selectively destroyed.

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