Pulmonary Tuberculosis among Male Inmates in the Largest Prison of Eastern Nepal

Introduction. The prevalence of Pulmonary Tuberculosis (PTB) is much higher in the prison population than in the general population. This study aims to find out the prevalence of PTB and its associated factors among inmates in eastern Nepal. Methods. This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison of Eastern Nepal from September 2014 to August 2015. Semi-structured questionnaires were used to identify individuals with a cough more than one-week duration among 434 randomly selected inmates. Screening of PTB was done by sputum smear test and/or GeneXpert test. Prevalence of TB was defined as the number of cases detected during the study period divided by the total number of inmates screened during that period. Fisher’s exact test was used to find out the association of PTB with related variables. Results. A total of 434 inmates were screened for PTB with mean age 35.7 years and body mass index 22.7 kg/m2. A total of 68 inmates had a productive cough of more than a week and two patients were already on anti-tuberculosis therapy at the time of screening. Sixty sputum samples were considered for sputum smear/GeneXpert test and 6 of them (10%) had positive results. The prevalence of TB in the Prison was 1843/100,000 population. Chest pain and abnormal chest auscultation findings were found to be significantly associated with PTB. Conclusions. This study showed that there was a high rate of PTB among inmates in Nepal. The results suggest a need for effective screening of PTB and strategies to improve management including reduction of PTB transmission in the prison.

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Tuberculosis Status and Coinfection of Pulmonary Fungal Infections in Patients Referred to Reference Laboratory of Health Centers Ghaemshahr City during 2007-2017

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v28i6.2 ◽

1970 ◽

Vol 28 (6) ◽

Author(s):

Mohammad Reza Jabbari Amiri ◽

Rora Siami ◽

Azad Khaledi

Keyword(s):

Pulmonary Tuberculosis ◽

Fungal Infections ◽

Cross Sectional Study ◽

Health Centers ◽

Sputum Smear ◽

P Value ◽

Reference Laboratory ◽

Cross Sectional ◽

Pulmonary Fungal Infections ◽

Student’S T

BACKGROUND: Pulmonary tuberculosis is one of the most important health concerns. Pulmonary fungal infections have clinical and radiological characteristics similar to tuberculosis which may be easily misdiagnosed as tuberculosis. This study aimed to evaluate tuberculosis (TB) status and coinfection of TB with pulmonary fungal infections in patients referred to reference laboratory of health centers Ghaemshahr city during 2007-2017.METHODS: This cross-sectional study was conducted during eleven years, between 2007 2017, on 3577 patients with suspected TB referred to health centers of Ghaemshahr City. For isolation, sputum smear preparation and Ziehl-Neelson staining in companying with microscopy direct observation and KOH 10% + white Calcofluor staining was used. The culture of fungi was performed on Sabouraud Dextrose agar, Czapek and chrome agar media. Then, data were analyzed using SPSS software (version 16) through Student's t-test, Fisher test, and Odds Ratio. P values <0.05 were considered statistically significant.RESULTS: Of 3577 patients, 10731 smears were prepared, 3.6% (n=130) of patients were identified as smear-positive pulmonary tuberculosis, 86.4% (n=3090) were smear negative and 10% (n=357) drug-resistant TB. The mean age of patients was 48±1.8 years. With increasing age, the prevalence of TB has increased which was statistically significant (P value <0.05). Prevalence of tuberculosis in the age group over than 57 years in males and females had an ascending trend. Amongst the positive tuberculosis patients, 16/130 cases (12.3%) had the coinfection of TB with fungi microorganisms.CONCLUSION: Our findings showed the coinfection of fungi agents in patients with tuberculosis that should be considered.

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Use of GeneXpert and the Role of an Expert Panel in Improving Clinical Diagnosis of Smear-Negative Tuberculosis Cases

10.20944/preprints201905.0225.v1 ◽

2019 ◽

Author(s):

Jovilia Abong ◽

Victoria Dalay ◽

Ivor Langley ◽

Ewan Tomeny ◽

Danaida Marcelo ◽

...

Keyword(s):

Expert Panel ◽

Cross Sectional Study ◽

The Philippines ◽

Sputum Smear ◽

Smear Microscopy ◽

Cross Sectional ◽

X Ray ◽

Abnormal Chest ◽

Smear Negative ◽

The Impact

Setting A high proportion of notified tuberculosis cases in the Philippines are clinically diagnosed (63%) as opposed to bacteriologically confirmed. Better understanding of this phenomenon is required to improve tuberculosis control. Objectives To determine the percentage of Smear Negative Presumptive Tuberculosis patients that would be diagnosed by GeneXpert; compare clinical characteristics of patients diagnosed as tuberculosis cases; and review the impact that the current single government physician and a reconstituted Tuberculosis Diagnostic committee (Expert Panel) may have on tuberculosis over-diagnosis. Design This is a cross-sectional study of 152 patients 15-85 years old with two negative Direct Sputum Smear Microscopy results, with abnormal chest X-ray who underwent GeneXpert testing and review by an Expert Panel. Results 31% (48/152) of the sample were Xpert positive. 93% (97/104) of GeneXpert negatives were clinically diagnosed by a Single Physician. Typical symptoms and X-ray findings were higher in bacteriologically confirmed tuberculosis. When compared to GeneXpert results, the Expert panel’s sensitivity for active tuberculosis was high (97.5%, 39/40) but specificity was low (40.2%, 35/87). Conclusion Using the GeneXpert would increase the level of bacteriologically confirmed tuberculosis substantially among presumptive Tuberculosis. An Expert panel will greatly reduce over-diagnosis usually seen when a decision is made by a Single Physician.

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Compliance to Directly Observed Treatment Short Course (DOTS) Chemotherapy among the Patient of Pulmonary Tuberculosis in Banke District of Nepal

Journal of Health and Allied Sciences ◽

10.37107/jhas.45 ◽

2019 ◽

Vol 3 (1) ◽

pp. 17-20

Author(s):

Ram Bahadur Nepali ◽

Damaru Prasad Paneru

Keyword(s):

Alcohol Consumption ◽

Pulmonary Tuberculosis ◽

Public Health Problem ◽

Treatment Compliance ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

Regular Treatment ◽

Drinking Habits ◽

Smear Positive Pulmonary Tuberculosis

Tubercular infection is still a pervasive public health problem in Nepal despite the massive efforts of National Health Service stakeholders. High bacterial infectivity, transmissibility, increasing drug resistance and non compliance to the therapy have been adding up challenges to prevention and control of tuberculosis. This study was conducted to observe the treatment compliance pattern among new pulmonary sputum smear positive cases of tuberculosis. A cross sectional study was carried out in the year 2009. The 114 new smear positive pulmonary tuberculosis patients registered in the six selected DOTS centres of the Banke Disrtict were randomly selected. Participants were selected from each DOTS centre by probability proportionate sampling methods. Data were analyzed by SPSS (11.0 Version) and P< 0.05 was considered as significant. Overall compliance to DOTS was 86.80 percent; of these, 57.00 percent showed excellent and regular compliance followed by nearly 30 percent good compliance. And 13.20 percent participants were non complaint to DOTS therapy. Positive Family behaviors were positively associated with compliance while alcohol consumption was found to be negatively associated with compliance however; age, sex and income were found to be non significant factors for compliance. Feeling of getting cure even before the course of DOTS therapy (feeling better after 2-3 months regular treatment) and drinking habits were found to be the major causes of non compliance. Supportive family behaviors and avoidance of alcohol consumption may promote the compliance. Excellent treatment compliance in the face of many odds is highly encouraging and the pattern can be useful in treatment despite little non compliances; furthermore compliance can be enhanced by acting on these causes of non compliances. Key words: Pulmonary, Tuberculosis, DOTS, Banke, Nepal

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Thin-layer agar (TL7H11) for rapid isolation of Mycobacterium tuberculosis in sputum specimens

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v7i1.29144 ◽

2016 ◽

Vol 7 (1) ◽

pp. 39

Author(s):

Habiba Binte Alam ◽

Md. Ruhul Amin Miah ◽

Mostofa Kamal ◽

Chandan Kumar Roy ◽

Ahmed Abu Saleh

Keyword(s):

Pulmonary Tuberculosis ◽

Thin Layer ◽

Infectious Agent ◽

Control Program ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

National Tuberculosis ◽

Lowenstein Jensen ◽

Mean Time

Background: Tuberculosis (TB) remains one of the major causes of death from a single infectious agent worldwide. The early detection of new cases of pulmonary tuberculosis is an important goal in tuberculosis control program.Objective: 1n this study, thin layer agar (TLA) culture was compared with Lowenstein-Jensen (LJ) culture for rapid detection of pulmonary tuberculosis. Methods: It was a cross sectional study conducted in National Tuberculosis Reference Laboratory (NTRL) of National Institute of Disease of Chest and Hospital (NIDCH), Dhaka, from July 2010 to June 2011. A total of 100 sputum smear positive for acid fast bacilli (AFB) by Z-N staining, pulmonary tuberculosis patients were included in this study. Samples were processed by modified Petroff method and then cultured on thin layer 7H11(TL7H11) plates and L-J tubes. TL7H11 plates were observed microscopically for rnicrocolony growth once a week for 6 weeks, and L-J tubes were observed once a week for 8 weeks. Results: The recovery rates of mycobacteria on only TLA, only LJ and on both media were 90%, 97% and 88% respectively. Overall positivity was 99% in both L-J and TLA media. Mean time for detection of mycobacteria on TLA was 9.04±1.66 days compared to 21.78±6.19 days on L-J media. The rate of contamination was higher (6%) in L-J media than in TLA media (4%). Conclusion: The TL7H11 media can be used as an alternative to the Lowenstein-Jensen medium for early isolation of mycobacteria in resource constrained settings.

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Comparison of Xpert MTB/RIF Assay and the Conventional Sputum Microscopy in DetectingMycobacterium tuberculosisin Northern Thailand

Tuberculosis Research and Treatment ◽

10.1155/2015/571782 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Kanokwan Pinyopornpanish ◽

Romanee Chaiwarith ◽

Chansom Pantip ◽

Rassamee Keawvichit ◽

Kanlaya Wongworapat ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Cross Sectional Study ◽

University Hospital ◽

Sputum Smear ◽

Cross Sectional ◽

Sputum Microscopy ◽

Lower Specificity ◽

Negative Sputum ◽

Low Sensitivity ◽

Higher Sensitivity

Background.Despite low sensitivity in detection ofMycobacterium tuberculosis, sputum acid-fast smear remains the main diagnostic method. This study aimed to compare the diagnostic performance of Xpert MTB/RIF assay versus conventional sputum acid-fast smear.Materials and Methods.A cross-sectional study was conducted at Chiang Mai University Hospital, Thailand. Patients who were ≥15 years old and had clinically suspected pulmonary tuberculosis were included.Results.109 specimens from 57 patients were included. Using MGIT sputum culture as a reference standard, the sensitivity (SEN) and specificity (SPEC) for Xpert were 95.3% (95% CI, 84.2%, 99.4%) and 86.4% (95% CI, 75.7%, 93.6%). The SEN and SPEC for sputum acid-fast smear were 60.5% (95% CI, 44.4%, 75.0%) and 98.5% (95% CI, 91.8%, 100%). Xpert had significantly higher sensitivity (pvalue < 0.001) and lower specificity (pvalue = 0.022) than sputum acid-fast smear. Among 43 culture-provenM. tuberculosisspecimens, sensitivity of Xpert was 100% (95% CI, 86.7%, 100%) in acid-fast positive smears (n=26) and 88.2% (95% CI, 63.5%, 98.5%) in acid-fast negative smears (n=17).Conclusions.The good sensitivity and specificity of Xpert assay in detectingM. tuberculosisfrom sputum specimens may help in early diagnosis and treatment of pulmonary tuberculosis, particularly among patients who had acid-fast negative sputum smear.

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SEROPREVALENCE OF HIV INFECTION IN PULMONARY TUBERCULOSIS PATIENTS.

10.36106/gjra/7900635 ◽

2020 ◽

pp. 1-3

Author(s):

K.G.R. Mallan ◽

A. Fathahudeen ◽

Manjula V.D.

Keyword(s):

Pulmonary Tuberculosis ◽

Tertiary Care ◽

Cross Sectional Study ◽

Sputum Smear ◽

Cross Sectional ◽

Tuberculosis Patients ◽

Pulmonary Tb ◽

Medical College ◽

Elimination Programme ◽

Kerala State

Aim : To Determine the seroprevalence of Human immunodeficiency virus infection among Pulmonary Tuberculosis patients in a tertiary care teaching institution, in Ernakulam district of Kerala state in India. Methods : Study was conducted in Respiratory medicine department and integrated counselling and testing centre (ICTC) of Government Medical College, Ernakulam With approval of IEC after getting written informed consent , a cross sectional study was conducted among 384 pulmonary TB patients who were registered under the National TB elimination Programme (RNTCP). Result :The prevalence of HIV among study population was 1.3 %. There was no gender difference while the highest age group less than 30 followed by 30-60. The major respiratory pathology among study subjects was consolidation (42.7%) followed by fibrosis(25.3%).Consolidation was a predominant presenting pathology seen in female pulmonary TB patients.The sensitivity of sputum smear against CBNAAT was 60.4% and specificity was 83%. Conclusion : The prevalence is low compared with the national average of 3 to 3.4 % HIV co infection among Tuberculosis patients during the study period.

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Utility of Bronchoalveolar Lavage in the Diagnosis of Sputum Negative Pulmonary Tuberculosis

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v8i1.29828 ◽

2020 ◽

Vol 8 (1) ◽

pp. 19-22

Author(s):

Subodh Sagar Dhakal ◽

Ashmita Neupane ◽

Shatdal Chaudhary ◽

Navin Mishra ◽

Damber Bdr Karki

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Bronchoalveolar Lavage ◽

Diagnostic Yield ◽

Cross Sectional Study ◽

Fibreoptic Bronchoscopy ◽

Sputum Smear ◽

Cross Sectional ◽

Acid Fast Bacilli ◽

Smear Negative

INTRODUCTION: Sputum smear examination for acid fast bacilli (AFB) by Ziehl-Neelsen stain (ZN stain) is the initial approach to the diagnosis of pulmonary tuberculosis (PTB). But 50% of the cases are reported to be sputum smear negative. This study was aimed to investigate the diagnostic yield of fibreoptic bronchoscopy (FOB) guided bronchoalveolar lavage (BAL) in patients suspected to have tuberculosis. The sample was tested for Mycobacterium tuberculosis using the XpertMTB/RIF assay, which is a new test that detects Mycobacterium tuberculosis complex and resistance to rifampin in less than two hours. MATERIAL AND METHODS: This is a prospective cross sectional study carried out on 58 sputum smear negative patients who were clinically suspected to have pulmonary tuberculosis from April 2017 to January 2019. All patients are subjected to FOB, BAL and BAL specimens were stained for AFB and also sent for Xpert (MTB)/RIF. RESULTS: Among 58 patients enrolled for the study 26 patients were positive for acid fast bacilli (AFB) through BAL stain and Xpert (MTB)/RIF combined. CONCLUSION: FOB guided BAL is a reliable, alternative and rapid method for diagnosing smear negative pulmonary tuberculosis with minimal complications.

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RELATIONSHIP BETWEEN SUCCESSFUL TREATMENT OF PULMONARY TUBERCULOSIS PATIENTS WITH THE AVAILABILITY OF TREATMENT SUPPORTER IN ATMA JAYA HOSPITAL

Damianus: Journal of Medicine ◽

10.25170/djm.v18i2.2221 ◽

2019 ◽

Vol 18 (2) ◽

pp. 67-73

Author(s):

Fariz Abdul Mujib Dailami ◽

Regina Satya Wiraharja ◽

Febie Chriestya

Keyword(s):

Pulmonary Tuberculosis ◽

Successful Treatment ◽

World Health ◽

Sputum Smear ◽

Smear Microscopy ◽

Fisher Exact Test ◽

Sputum Smear Microscopy ◽

Cross Sectional ◽

Exact Test ◽

Tb Treatment

Introduction: One of the biggest health problems faced by community is pulmonary tuberculosis (TB).TB is an respiratory tract infectious disease caused by Mycobacterium Tuberculosis. World Health Organization (WHO) recommends TB treatment with Directly Observed Treatment Short-course (DOTS) strategy, one of which is through the help of treatment supporter (PMO or Pengawas Minum Obat) who supervises the patient during the treatment period. Methods: This was an analytic descriptive study with cross sectional approach.. Respondents were taken by consecutive sampling, based on medical records at Atma Jaya Hospital. We applied inclusion criteria such as newly diagnosed TB patient with positive sputum smear microscopy results, adult TB patient who has finished 6 month of treatment and patients who have done sputum smear microscopy test after finishing their TB treatment. The exclusion criteria were TB-HIV patients and Milliary TB patients. After fulfilment of those criteria, a total of 81 respondents were selected. Data was analysed by Chi Square test (Fisher Exact test). Results: Most of patients were 15-50 years old (70,4%) with mean age at 38.49±17.83 years old),male (53.1%), had family as treatment supporter (91.4%) and had successful TB treatment (74.1%). TB patients with treatment supporter had more successful treatment (66.7%) than TB patients with no treatment supporter (7.4%), however there was no significant among the avalibility of treatment supporter and the success of TB treatment (p=0.670). Conclusion: Despite the insignificant result, this study gives good insight to implementation of TB DOTS strategy in Atma Jaya Hospital. The implementation of this strategy contributes to imbalance number of samples between patient with and without treatment supporter, leading to overestimate results on with TB treatment supporter group.

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Cavities Herald Persistent Sputum Positivity

10.21203/rs.3.rs-324393/v1 ◽

2021 ◽

Author(s):

Nadia Jawad ◽

Nausheen Saifullah ◽

Naseem Ahmed ◽

Saira Jafri

Keyword(s):

Pulmonary Tuberculosis ◽

Medical Center ◽

Tertiary Care ◽

National Policy ◽

Cross Sectional Study ◽

Tuberculosis Patient ◽

Sputum Smear ◽

Care Hospital ◽

Cross Sectional ◽

Directly Observed Treatment

Abstract Aim: To determine the factors associated with persistent sputum positivity at the end of two months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi.Setting: A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi over six months.Methods:A sample of 73 consenting, newly diagnosed, smear positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, body mass index (BMI), socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at two months of treatment with a sputum smear. Data analysis was done on SPSS-20.0.Results:Rate of sputum positivity after two months of treatment was 17.8%. None of the factors was associated with persistence of sputum positivity except for the presence of chest radiograph (CXR) cavities; which made it 5.5 times more likely that the patient would remain smear-positive at two months (p=0.035).Conclusion:The finding of CXR cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavourable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and pay particular attention in terms of stringent monitoring and Directly Observed Treatment Short-course (DOTS) provision.

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Microbiological Study of Etiological Pathogen in Early Infection of Open Fracture in Orthopedics

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v17i1.867 ◽

2018 ◽

Vol 17 (1) ◽

Author(s):

Tai Ken Meng ◽

Ahmad Fadzli Bin Sulong ◽

Nazri Bin Mohd. Yusof

Keyword(s):

Injury Severity Score ◽

Severity Score ◽

Open Fracture ◽

Injury Severity ◽

Cross Sectional Study ◽

Early Infection ◽

High Rate ◽

Cross Sectional ◽

Gram Negative ◽

Exact Test

Introduction: Infection is a dreaded complication of open fracture in the field of orthopaedics. This study was conducted to evaluate the susceptibility of microorganism involved in early infection of open fractures to current prophylactic antibiotics practice and determine the association of various characteristics to the resistance of such microorganisms. Materials and Methods: This cross sectional study was conducted from January 2015 to December 2017 in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. A total of 179 cases were collected from the operating record with 110 cases fulfilling the inclusion and exclusion criteria. The patients underwent routine debridement where culture and sensitivity were followed up. Previous notes were traced to identify the various risk factors involved and evaluated against resistance of microorganism. Statistical analysis was done with SPSS version 23 applying Pearson chi-square tests and Fisher's exact test. Results: Admission to intensive care unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of admission were all significantly associated with resistance of microorganism (p < 0.0001). This study also demonstrated 65.9% predominance of Gram-negative microorganisms. These gram-negative microorganisms were seen more in higher fracture grades, injury severity score, and longer duration of admission or antibiotics prescribed. The overall resistance to cefuroxime and gentamicin were 68.6% and 36.9% respectively. Conclusion: The shift of microorganism species to gram-negative and the high rate of resistance suggested that current antibiotic guidelines and regime needed to be fine-tuned to achieve optimal results in managing open fracture.

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