scholarly journals BCG vaccination status may predict sputum conversion in patients with pulmonary tuberculosis: a new consideration for an old vaccine?

Thorax ◽  
2010 ◽  
Vol 65 (12) ◽  
pp. 1072-1076 ◽  
Author(s):  
K. Jeremiah ◽  
G. PrayGod ◽  
D. Faurholt-Jepsen ◽  
N. Range ◽  
A. B. Andersen ◽  
...  
2015 ◽  
Vol 55 (1) ◽  
pp. 7
Author(s):  
Fadilah Harahap ◽  
Ridwan M. Daulay ◽  
Muhammad Ali ◽  
Wisman Dalimunthe ◽  
Rini Savitri Daulay

Background Tuberculosis (TB) infection is highly prevalent in Indonesia. The source of transmission of TB to a child is usually via an adult with sputum smear-positive pulmonary tuberculosis. The Mantoux test is a diagnostic tool for tuberculosis infection. The BCG vaccine has been used for the prevention of TB, but its efficacy is still debated. Objective To assess for an association between Mantoux test results and BCG vaccination in children who had contact with adult pulmonary tuberculosis and to assess for differences in Mantoux test induration with regards to nutritional status, age, type of TB contact, and time duration since BCG vaccination in BCG-vaccinated and BCG-unvaccinated children. Methods A cross-sectional study was conducted in FebruaryMarch 2011 on infants and children (aged 3 months to five years), who had household contact with adult pulmonary TB. We performed tuberculin (Mantoux) skin tests to detect TB infection in the children. Subjects were consisted of two groups: BCG-vaccinated and BCG-unvaccinated. Results Subjects were 100 children (50 BCG-vaccinated and 50 BCG-unvaccinated subjects). Positive Mantoux test results were observed in 9 vaccinated subjects and 33 unvaccinated subjects. The mean diameters of induration in the vaccinated and unvaccinated groups were 7.6 mm and 9.6 mm, respectively (95%CI of difference -4.25 to 0.20; P=0.074). In children who had household contact with sputum smear-positive adult pulmonary TB, BCG vaccination was a protective factor against TB infection, with an odds ratio (OR) of 0.113 (95%CI 0.045 to 0.286; P=0.0001). There were no significant differences in Mantoux test induration associated with nutritional status, age, type of TB contact, and duration since BCG vaccination, between the two groups. Conclusion BCG vaccination has a protective effect on TBexposed children, based on Mantoux test results. However, there are no differences in Mantoux test induration associated with nutritional status, age, type of TB contact, or duration since BCG vaccination, between the BCG-vaccinated and BCGunvaccinated groups.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Khalid Bouti ◽  
Mohammed Aharmim ◽  
Karima Marc ◽  
Mouna Soualhi ◽  
Rachida Zahraoui ◽  
...  

Background. Sputum smear-positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following the commencement of treatment. Objective. To determine the time to sputum smear conversion and study the factors influencing it. Design. A prospective study was undertaken at our hospital in Rabat over a six-month period on a cohort of 119 sputum smear positive patients. Patients were followed up fortnightly. At each followup, specimens were collected and processed for microscopy using standard protocol. Results. 96.6% of our patients completed the study (4 deaths). Sputum conversion rate was 42% after two weeks, 73% after one month, and 95% after two months. Univariate and stepwise regression analysis showed that patients who had high smear grading, miliary, and bilateral radiologic lesions were more likely to undergo delayed sputum conversion (P<0.05). Other factors were thought to influence sputum conversion but were not statistically proven in our study. Conclusion. Since viable bacilli continue to be expelled for up to two months, infection control measures should be maintained for such a time. Patients with high smear grading, miliary, and bilateral radiologic lesions need to be monitored more closely.


2018 ◽  
Vol 1 (01) ◽  
pp. 41-46
Author(s):  
Pushpa Man Shrestha ◽  
Minani Gurung ◽  
Nabin Kumar Chaudhary

Introduction: Pulmonary tuberculosis is a contagious bacterial infection that involves the lungs and it may spread to other organs. Sputum smear and culture conversion are important indicators for the effectiveness of treatment and the infectivity of the patient. The present study aims to find sputum smear and culture conversion time and the factors that influence the conversion time among tuberculosis patients at National Tuberculosis Centre in Nepal. Methods: A total of 54 patients, who were diagnosed with laboratory confirmed pulmonary tuberculosis and under antitubercular therapy were monitored for sputum smear and culture conversion time. The blood specimens from each patient were processed for hemoglobin, platelets, erythrocyte sedimentation rate and blood glucose levels. Patient’s clinical history, risk factors that prolong conversion time and sociodemographic information were also collected by direct interview. Results: The mean sputum smear and culture conversion were found to be 54.4 days and 45.5 days respectively. Old age, smoking habit, low body mass index value, Treatment category II, initial bacillary load and abnormal erythrocyte sedimentation rate values were found to be associated with long sputum conversion time. Radiographic involvement of only left lungs, presence of fewer symptoms, aged between 15-45 years, having normal weight, without smoking habit and being married, were found to be associated with short sputum conversion time. Conclusions: The sputum microscopy, old age, smoking habit, low body mass index value, treatment category II, initial bacillary load and abnormal erythrocyte sedimentation rate value had been found to be significantly associated with long sputum conversion time.


2020 ◽  
Vol 98 (1) ◽  
pp. 35-40
Author(s):  
O. Yu. Askalonova ◽  
E. A. Tseymakh ◽  
A. V. Levin ◽  
P. E. Zimonin

The objective of the study: to assess the efficacy of complex treatment with endobronchial valve implantation in the patients suffering from drug resistant fibrous cavernous pulmonary tuberculosis.Subjects and methods. Treatment outcomes in 97 patients with limited fibrous cavernous pulmonary tuberculosis were analyzed. Main Group included 42 patients who had bronchial valve block implanted. Comparison Group included 55 patients. Artificial pneumoperitoneum was used in both groups.Results. In Main Group, sputum conversion was achieved in 12 months in 40 (95.2%) patients, and in 32 patients (58.2%) in Comparison Group (p < 0.01). In 12 months after treatment start, positive X-ray changes were observed in 42 (100%) patients of Main Group and 40 (72.7%) patients of Comparison Group. Healing of cavities in 12 months was observed only in the patients from Main Group (26 (61.9%) patients). Upon completion of the study, surgery was still indicated to 4 (9.5%) of patients from Main Group and to 35 (63.6%) patients from Comparison Group.


2017 ◽  
Vol 8 (1) ◽  
pp. 585
Author(s):  
Radita Ikapratiwi ◽  
Indah Rahmawati ◽  
Joko Mulyanto

Tuberculosis (TB) is considered as the leading killer among infectious diseases because of bacteria resulted in a high number ofmorbidity and mortality world wide. One risk factor for tuberculosisis diabetes mellitus (DM). The prevalence of TB and DM jump together globally, especially in developing countries, including Indonesia. Early and accurate diagnosis of TB cases in the enforcement is sputum smear examination. Monitoring of TB seen through sputum conversion. The purpose of this studyis to determine the duration of sputum conversion difference new case smear positive pulmonary TB patients with and without DM in hospital Prof. Dr.Margono Soekarjo (RSMS) Purwokerto. Thestudy design is observational analytic with cohort retrospective study. Sample of this study was patients who checked their health in Lung Clinis of RSMS Purwokerto obtained total sample of 44 people, consisting of 22 patients clinically diagnosed new cases smear-positive pulmonary TB with DM and 22 patients without DM in 2009 until 2012.Results of this study were analyzed using Fisher Exact Test. pvalues obtainedof 0.000 (p <0.05) (95% CI = 0,288-0,718) with relative risk 0,455. The conclusion is there were significant differences in sputum conversion time between the group of patients suffering from pulmonary uberculosis with and without DM. The conversion of sputum in patients with pulmonary tuberculosis who suffered DM is longer than patients without DM. Relative risk value which is equal to 0.455 which means that patients with DM have pulmonary tuberculosis risk by 0.455 times more likely to experience delays in sputum conversion than TB patients without DM


2021 ◽  
Vol 99 (2) ◽  
pp. 52-57
Author(s):  
E. V. Korzh ◽  
N. A. Podchos ◽  
T. V. Ivanitskaya

The article describes a clinical case of treatment of multiple drug resistant tuberculosis in the patient with type 1 diabetes mellitus who had received a kidney transplant (from his mother) 3 years before tuberculosis was diagnosed due to diabetic nephroangiosclerosis and the development of end-stage chronic renal disease. Pulmonary tuberculosis developed while taking immunosuppressive drugs, it manifested by an infiltrate with destruction of lung tissue in the upper lobe of the left lung, infiltrative tuberculosis of the left upper lobe and segmental bronchi, bacterial excretion confirmed by microscopy and culture. The strain of tuberculosis was resistant to 5 drugs including isoniazid and rifampicin. The chemotherapy regimen included pyrazinamide, capreomycin, levofloxacin, ethionamide, cycloserine, and paraaminosalicylic acid. Glomerular filtration rate was monitored every month. The full course of anti-tuberculosis chemotherapy (556 doses) was effectively completed, glomerular filtration by that time was 77.0 ml/min. Stable sputum conversion was achieved (confirmed by sputum culture), the cavity was healed, and some areas of pneumosclerosis and single solid foci persisted.


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