scholarly journals Tracing the Children in Contact of Sputum Smear Negative Adults is the Need of the Hour to Achieve WHO “Stop TB Strategy”

2021 ◽  
Vol 18 (2) ◽  
pp. 367-372
Author(s):  
Diwan Israr Khan ◽  
Samreen Khan ◽  
M Anas ◽  
Abiha A Khan

Tuberculosis has been a public health issue affecting a large number of population world wide. 1According to 2019 report, approximately 10 million of people fell ill by the disease around the globe. A considerable proportion of TB affected cases is constituted by paediatric patients solely. The WHO estimates that about 1 million children endure the disease each year of which a significant figure harbours the latent form of infection. Since, the accurate diagnostic test to confirm the tuberculosis in children has not been unrolled, a positive history of contact is regarded as the foremost feature for authenticating the diagnosis in children. A large proportion of children with tuberculosis lives under the same roof with sputum smear positive adults, tracing out the childhood TB cases in sputum smear negative contacts is equally important and needs to be diagnosed timely. This category of children left undiagnosed acts as a pool for further transmission of the disease from where new TB cases arise. Therefore, the early diagnosis of children of this group is the need of the hour and a challenge to “STOP TB Strategy”.

2019 ◽  
Vol 33 ◽  
pp. 205873841982717 ◽  
Author(s):  
Ghulam Rasool ◽  
Arif Muhammad Khan ◽  
Raza Mohy-Ud-Din ◽  
Muhammad Riaz

Tuberculosis (TB) is an important public health issue around the globe which is a chronic infectious disease and is still one of the major challenges for developing countries. The emergence of drug-resistant TB makes the condition worse and there is an urgent need of fast, highly sensitive diagnostic methods. This study was undertaken to evaluate the performance of GeneXpert® MTB/RIF assay and MTB culture for the detection of Mycobacterium tuberculosis (MTB) in sputum smear-negative pulmonary TB/drug-resistant tuberculosis (DR-TB) suspects. A total of 168 sputum smear-negative TB suspects were recruited for the study. Among the suspected TB cases, 52.98% were male and 47.02% were females with the mean age of 42 ± 17.6 years. All the sputum specimens collected from the study population were subjected to Ziehl–Neelsen (ZN) smear microscopy, GeneXpert MTB/RIF assay, and MTB culture. The results revealed that, out of 168 acid-fast bacilli (AFB)/ZN smear microscopy–negative sputum specimens, 48 (28.57%) and 58 (34.52%) were detected MTB positive by GeneXpert MTB/RIF assay and MTB culture, respectively, while 120 (71.43%) and 110 (65.48%) suspected TB cases were confirmed negative by GeneXpert MTB/RIF assay and MTB culture, respectively. The study concluded that GeneXpert assay was found to be a rapid and accurate tool for MTB detection in smear-negative sputum specimens. GeneXpert has advantage over ZN smear microscopy and MTB culture as it detects MTB and rifampicin resistance simultaneously within 2 h with minimal biohazards.


2013 ◽  
Vol 5 (1) ◽  
pp. e2013064 ◽  
Author(s):  
Susanna Esposito

Tuberculosis (TB) in children is a neglected aspect of the TB epidemic despite it constituting 20% or more of all TB cases in many countries with high TB incidence. Childhood TB is a direct consequence of adult TB but remains overshadowed by adult TB because it is usually smear-negative. Infants and young children are more likely to develop life-threatening forms of TB than older children and adults due to their immature immune systems. Therefore, prompt diagnoses are extremely important although difficult since clinical and radiological signs of TB can be non-specific and variable in children. Despite undeniable advances in identifying definite, probable, or possible TB markers, pediatricians still face many problems when diagnosing TB diagnosis. Moreover, curing TB can be difficult when treatment is delayed and when multi-drug resistant (MDR) pathogens are the cause of the disease. In these cases, the prognosis in children is particularly poor because MDR-TB treatment and treatment duration remain unclear. New studies of diagnostic tests and optimal treatment in children are urgently needed with the final goal of developing an effective anti-TB vaccine.


2020 ◽  
Vol 24 (1) ◽  
pp. 113-117
Author(s):  
S. Deshmukh ◽  
S. Atre ◽  
A. Chavan ◽  
S. Raskar ◽  
T. Sawant ◽  
...  

SETTING: Pune and Pimpri-Chinchwad Municipal Corporation area, Maharashtra State, India.OBJECTIVE: To assess the sensitivity and specificity of the Xpert® MTB/RIF assay among adults with suspected pulmonary tuberculosis (PTB) and with or without diabetes (DM).DESIGN: As part of a prospective cohort study, we screened 2359 adults presumed to have PTB with no history of TB. All individuals underwent testing for two sputum smears, culture, Xpert, glycated haemoglobin and fasting blood sugar. We calculated sensitivity and specificity of Xpert by comparing it with TB sputum culture result as a gold standard.RESULTS: Among screened individuals, 483 (20%) were diagnosed with DM and 1153 (49%) with pre-DM; 723 (31%) had no DM. Overall sensitivity of Xpert was 96% (95%CI 95–97) and specificity was 91% (95%CI 89–93). Xpert sensitivity was significantly higher among DM group (98%) than in the ‘No DM' (95%; P < 0.01) and pre-DM (96%; P < 0.05) groups. Among sputum smear-negative individuals, Xpert sensitivity was higher in the DM group than in the No DM (92% vs. 82%; P = 0.054) and pre-DM group (92% vs. 82%; P = 0.037).CONCLUSION: High sensitivity and specificity of Xpert underscores the need for its rapid scale up for the early detection of TB in settings with a high dual burden of TB and DM.


2019 ◽  
Author(s):  
Martin Greta

BACKGROUND Tuberculosis is a widespread and in many cases a fatal, infectious disease caused by many strains of mycobacterium complex usually mycobacterium tuberculosis. It can affect any part of the body but mainly the lungs hence called pulmonary tuberculosis. Tuberculosis in children has been less of a public health priority in the recent years despite the fact that TB has been a major cause of childhood morbidity and mortality worldwide with difficulties in diagnosis. Data on trends of childhood TB is rarely in published literature hence need for this research which will help in publishing OBJECTIVE To establish the trends in TB among children aged 1-12 years and its management over a period of five years from 2011- 2015 at Arthur Davison children’s hospital in Ndola and also to determine the proportion of TB in these children and to establish the age group most affected by TB over the period of five years and lastly to assess the proportion of TB and HIV as a co-morbidity METHODS The study reviewed all records that were registered in the MOH TB register at ADH from 2011 to 2015 coming up with a total number of 483 TB records and these records had satisfied the inclusion and exclusion criteria. The data capturing tool was used to collect the data. RESULTS : This study determined the trends of TB in children aged 1 to 12 over the five years period from a total of 483 reviewed paediatric TB cases , its proportion in these children, the age range most affected by TB and lastly assessed TB and HIV as a co-morbidity at Arthur Davison Children’s hospital. It revealed that the trends were decreasing and that out of 483 TB patient, the majority 157(32.5%) of the TB patients were seen in the year 2011, followed by 129(26.7%), 84(17.4%), 57(11.8%) and 56(11.6%) representing the year 2012, 2013, 2014 and 2015 respectively. Findings on the age range most affected are that the majority 282(58.4%) of the TB patients were aged (5-12) years old while 201(41.6%) were aged between (1-5) years old. Therefore, the age range most affected by TB was between (5-12) years. The TB proportion results showed that Out of 483, the majority 467(96.7%) of the TB patient type were newly diagnosed, followed by 13(2.7%), 2(.4%) and the rest 1(.2%) that were Relapse, Trans-in and Treatment resumed respectively. And that many 467(96.7%) of TB condition types were PTB while 16(3.3%) were EPTB. Furthermore, the majority of 463(95.9%) were diagnosed by X-ray while 20(4.1%) were diagnosed by smear microscopy. And lastly In terms of HIV as a co-morbidity, the majority 175(36.2%) of the TB patients were HIV positive, followed by 173(35.8%) that were HIV negative while the rest 135(28%) of the TB patients were not tested for HIV CONCLUSIONS This study reports that the trends of TB in children aged 1-12 years have been decreasing from 2015 to 2011 .And the age range most affected was found to have been 5-12 years and the proportion of TB cases were mostly newly diagnosed and the diagnosis was made by use x-ray and lastly the large proportion of TB patients had tested positive for HIV as a co-morbidity. Therefore efforts should be made to sustain this decreasing trend of childhood TB.


2019 ◽  
Vol 70 (11) ◽  
pp. 2396-2402
Author(s):  
Kristin N Nelson ◽  
Samuel M Jenness ◽  
Barun Mathema ◽  
Benjamin A Lopman ◽  
Sara C Auld ◽  
...  

Abstract Background Tuberculosis (TB) is the leading infectious cause of death globally, and drug-resistant TB strains pose a serious threat to controlling the global TB epidemic. The clinical features, locations, and social factors driving transmission in settings with high incidences of drug-resistant TB are poorly understood. Methods We measured a network of genomic links using Mycobacterium tuberculosis whole-genome sequences. Results Patients with 2–3 months of cough or who spent time in urban locations were more likely to be linked in the network, while patients with sputum smear–positive disease were less likely to be linked than those with smear-negative disease. Associations persisted using different thresholds to define genomic links and irrespective of assumptions about the direction of transmission. Conclusions Identifying factors that lead to many transmissions, including contact with urban areas, can suggest settings instrumental in transmission and indicate optimal locations and groups to target with interventions.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anita G. Amin ◽  
Prithwiraj De ◽  
Barbara Graham ◽  
Roger I. Calderon ◽  
Molly F. Franke ◽  
...  

AbstractOur study sought to determine whether urine lipoarabinomannan (LAM) could be validated in a sample cohort that consisted mainly of HIV uninfected individuals that presented with tuberculosis symptoms. We evaluated two tests developed in our laboratory, and used them on clinical samples from Lima, Peru where incidence of HIV is low. ELISA analysis was performed on 160 samples (from 140 adult culture-confirmed TB cases and 20 symptomatic TB-negative child controls) using 100 μL of urine after pretreatment with Proteinase K. Two different mouse monoclonal antibodies-CS35 and CHCS9-08 were used individually for capture of urine LAM. Among cases, optical density (OD450) values had a positive association with higher bacillary loads. The 20 controls had negative values (below the limit of detection). The assay correctly identified all samples (97–100% accuracy confidence interval). For an alternate validation of the ELISA results, we analyzed all 160 urine samples using an antibody independent chemoanalytical approach. Samples were called positive only when LAM surrogates—tuberculostearic acid (TBSA) and d-arabinose (d-ara)—were found to be present in similar amounts. All TB cases, including the 40 with a negative sputum smear had LAM in detectable quantities in urine. None of the controls had detectable amounts of LAM. Our study shows that urinary LAM detection is feasible in HIV uninfected, smear negative TB patients.


1994 ◽  
Vol 75 ◽  
pp. 29
Author(s):  
A. McDaniel ◽  
N. Schoenfeld ◽  
W. Frank ◽  
A. Grassot ◽  
H. Mauch ◽  
...  

Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.


Tubercle ◽  
1991 ◽  
Vol 72 (3) ◽  
pp. 210-213 ◽  
Author(s):  
I. Gomes ◽  
E. Trindade ◽  
O. Vidal ◽  
O. Yeep ◽  
I. Amendoeirai ◽  
...  

PLoS ONE ◽  
2012 ◽  
Vol 7 (11) ◽  
pp. e49238 ◽  
Author(s):  
Sumit Malhotra ◽  
Sanjay P. Zodpey ◽  
Shivani Chandra ◽  
Ram Pal Vashist ◽  
Srinath Satyanaryana ◽  
...  

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