scholarly journals An outbreak of pulmonary tuberculosis and a follow-up investigation of latent tuberculosis in a high school in an eastern city in China, 2016–2019

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247564
Author(s):  
Yirong Fang ◽  
Yan Ma ◽  
Qiaoling Lu ◽  
Jiamei Sun ◽  
Yingxin Pei
Keyword(s):  
High School ◽  
Pulmonary Tuberculosis ◽  
Chest Radiograph ◽  
Index Case ◽  
Variable Number Tandem Repeat ◽  
Sputum Smear ◽  
Post Exposure Prophylaxis ◽  
Probable Case ◽  
Post Exposure ◽  
Latent Tb

Background In October 2016, a senior high school student was diagnosed with sputum-smear positive [SS(+)] pulmonary tuberculosis (TB). We conducted an investigation of an outbreak in the school, including among students and teachers diagnosed with latent TB, who we followed until July 2019. Methods We defined latent TB infection (LTBI) as a tuberculin skin test (TST) induration of 15mm or larger; probable TB as a chest radiograph indicative of TB plus productive cough/hemoptysis for at least 2 weeks, or TST induration of 15mm or larger; and confirmed TB as two or more positive sputum smears or one positive sputum smear plus a chest radiograph indicative of TB or culture positive with M. tuberculosis. We conducted mycobacterial interspersed repetitive unit–variable number tandem repeat (MIRU-VNTR) typing based on 24 loci in the isolates. Results Between October 2016 and July 2019, we identified 52 cases, including nine probable, six confirmed, and 37 LTBI cases. The index case-student had attended school continuously despite having TB symptoms for almost three months before being diagnosed with TB. We obtained three isolates from classmates of the index case in 2016; all had identical MIRU-VNTR alleles with the index case. The LTBI rate was lower among students (7.41%, 30/405) than among teachers (26.92%, 7/26) (rate ratio [RR] = 0.28, 95% confidential interval [CI]: 0.13–0.57). Among the 17 students who had latent TB and refused prophylaxis in October 2016, 23.53% (4/17) became probable/confirmed cases by July 2019. None of the six teachers who also refused prophylaxis became probable or confirmed cases. Of the 176 students who were TST(-) in October 2016, 1.70% (3/176) became probable/confirmed cases, and among the 20 teachers who were TST(-), 1 became a probable case. Conclusions Delayed diagnosis of TB in the index patient may have contributed to the start of this outbreak; lack of post-exposure chemoprophylaxis facilitated spread of the outbreak. Post-exposure prophylaxis is strongly recommended for all TST-positive students; TST-negative students exposed to an SS(+) case should be followed up regularly so that prophylaxis can be started if LTBI is detected.

scholarly journals Radiological Findings of Pulmonary Tuberculosis in Patients with and Without HIV Infections

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Radhiana binti Hassan ◽  
Haziq Hussaini bin Fauzi ◽  
Kamil Irsyad bin Yusoff ◽  
Muhammad Faizol bin Mohd Satar ◽  
Hafizah bt Pasi
Keyword(s):  
Pulmonary Tuberculosis ◽  
Chest Radiograph ◽  
Chest Radiographs ◽  
Mediastinal Lymphadenopathy ◽  
Hiv Positive ◽  
Sputum Smear ◽  
P Value ◽  
Radiological Findings ◽  
Radiological Manifestation ◽  
Hiv Negative

Introduction: Radiological manifestation of pulmonary tuberculosis in HIV positive patients is different with HIV negative patients. We aim to determine the differences in chest radiological findings of Pulmonary Tuberculosis among HIV and non-HIV infected patients in HTAA. Materials and method: A retrospective study was conducted in Chest Clinic, Hospital Tunku Ampuan Afzan, Kuantan Pahang. There were 101 chest radiographs with sputum smear-positive retrieved and reviewed. Socio-demographic status and chest radiographs findings were documented and analyzed. Results: Of the 101 patients, 12 patients were HIV positive. Of the 89 HIV negative patients, 96% had consolidation change on chest radiograph, in contrast with HIV positive patients, only 4% among them had this appearance and this is statistically significant (p value less than 0.05). Mediastinal lymphadenopathy is significantly higher (17%) in HIV positive patients compared to HIV negative patients (1%). Normal chest radiographs were more common in HIV positive patients (33%) as compared to HIV negative patients (2%). Conclusion: HIV positive patients with pulmonary tuberculosis exhibit different radiological manifestation on chest radiograph when compared to HIV negative patients.

scholarly journals Pulmonary Tuberculosis in HIV-infected Patients Presenting with Normal Chest Radiograph and Negative Sputum Smear

2016 ◽  
Vol 4 (3) ◽  
Author(s):  
Mounika Arrabelli ◽  
Raghuram Reddy Adidala ◽  
Chakrapani Chatla ◽  
Shireesha T ◽  
Suryaprakash Chakramahanty ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Chest Radiograph ◽  
Sputum Smear ◽  
Normal Chest Radiograph ◽  
Normal Chest ◽  
Negative Sputum

scholarly journals Tuberculosis Outbreak in an Educational Institution in Norway

2017 ◽  
Vol 55 (5) ◽  
pp. 1327-1333 ◽  
Author(s):  
Gunnstein Norheim ◽  
Siri Seterelv ◽  
Trude M. Arnesen ◽  
Anne Torunn Mengshoel ◽  
Tone Tønjum ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Index Case ◽  
Educational Institution ◽  
Variable Number Tandem Repeat ◽  
Variable Number ◽  
Contact Tracing ◽  
Whole Genome ◽  
Content Type ◽  
Transmission Chain

ABSTRACTWithin 1 week in April 2013, three cases of pulmonary tuberculosis (TB) were reported among students attending training sessions at an educational institution in Oslo, Norway. By the end of October 2013, a total of nine epidemiologically linked cases had been reported. The outbreak encompassed a total of 24 cases from 2009 to 2014, among which all of the 22Mycobacterium tuberculosisisolates available had identical mycobacterial interspersed repetitive-unit–variable-number tandem-repeat (MIRU-VNTR) profiles (MtbC15-9 code 10287-189) belonging to the Beijing lineage. Whole-genome sequencing (WGS) of theM. tuberculosisisolates revealed 20 variable nucleotide positions within the cluster, indicating a clonal outbreak. The most likely index case was identified and diagnosed in Norway in 2009 but was born in Asia. WGS analyses verified that all of the cases were indeed part of a single transmission chain. However, even when combining WGS and intensified contact tracing, we were unable to fully reconstruct the TB transmission events.

scholarly journals A tuberculosis school outbreak in China, 2018: reaching an often overlooked adolescent population

2019 ◽  
Vol 147 ◽  
Author(s):  
N. N. You ◽  
L. M. Zhu ◽  
G. L. Li ◽  
L. Martinez ◽  
W. Lu ◽  
...  
Keyword(s):  
High School ◽  
Skin Testing ◽  
Variable Number Tandem Repeat ◽  
Variable Number ◽  
Sputum Smear ◽  
Tuberculin Skin Testing ◽  
Age Group ◽  
School Based ◽  
Symptom Screening ◽  
Index Cases

Abstract Adolescents have been largely neglected from tuberculosis control efforts. In low- to medium burden settings much of the tuberculosis burden in this age group occurs from school outbreaks. We report on a large tuberculosis outbreak in adolescents from a boarding high school in Jiangsu Province, China. From March to June 2018, a tuberculosis outbreak occurred in a boarding high school. We conducted an outbreak investigation involving clinical diagnostic tests and molecular analysis to determine the outbreak origin. Cases were detected through symptom screening, tuberculin skin testing (TST), chest radiography, sputum smear, solid sputum culture and GeneXpert MTB/RIF. Mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping and spoligotyping methods were performed on Mycobacterium tuberculosis (M. tuberculosis) isolates to identify the outbreak origin. A total of 845 students and 131 teachers/staff attended a TST screening for tuberculosis infection. The prevalence of elevated tuberculin reactions at ≥5, ≥10 and ≥15 mm was 12.19% (119/976), 6.35% (62/976) and 3.28% (32/976), respectively. Radiographic abnormalities were present in 5.73% (56 of 976) individuals, 40 students and 16 teachers/staff. Of these, 12 students were diagnosed with confirmed tuberculosis. In total, 14 students (two index cases and 12 confirmed cases) were diagnosed and reported in the tuberculosis outbreak, an attack rate of 1.7% (14/847) among students (two index cases and 845 screened students). Results from MIRU-VNTR typing and spoligotyping analyses demonstrated that three M. tuberculosis strains belong to the Beijing family with corresponding MIRU-VNTR alleles. This school-based tuberculosis outbreak among adolescents demonstrates that transmission among individuals in this age group is common and must be prioritised. It suggests that identifying and timely diagnosis of smear-positive cases, especially in the early phase of outbreaks, is the key to preventing further spread among close contacts.

Pulmonary Tuberculosis in HIV-Infected Patients Presenting with Normal Chest Radiograph and Negative Sputum Smear

Infection ◽  
2002 ◽  
Vol 30 (2) ◽  
pp. 68-74 ◽  
Author(s):  
F. Palmieri ◽  
E. Girardi ◽  
A. M. Pellicelli ◽  
A. Rianda ◽  
E. Bordi ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Chest Radiograph ◽  
Sputum Smear ◽  
Normal Chest Radiograph ◽  
Normal Chest ◽  
Negative Sputum

Low awareness and use of post-exposure prophylaxis among adolescents and young adults in South Africa: implications for the prevention of new HIV infections

2020 ◽  
Vol 19 (3) ◽  
pp. 242-248
Author(s):  
Anthony Idowu Ajayi ◽  
Mohammed Sanusi Yusuf ◽  
Elmon Mudefi ◽  
Oladele Vincent Adeniyi ◽  
Ntombana Rala ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Hiv Infections ◽  
Adolescents And Young Adults ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Study of sharp injuries and blood splash exposures among healthcare workers in a tertiary hospital in Bangalore

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Shalini Sivananjiah Pradeep ◽  
Suman Gadicherla Raghu ◽  
Prathab A G ◽  
Banashankari G Rudresh ◽  
Radhika Kunnavil
Keyword(s):  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Post Exposure Prophylaxis ◽  
Care Hospital ◽  
Post Exposure ◽  
Increased Risk ◽  
Management Procedures ◽  
Exposure Prophylaxis ◽  
Sharps Injury ◽  
Sharps Injuries

The working environment of healthcare workers (HCW) exposes them to sharp injuries. This communication attempts to examine the injury registers, incidence of sharps injuries and blood splash exposures, and the post-exposure prophylaxis status of employees in a tertiary care hospital. Analysis included records form 54 locations of two units of a tertiary hospital attached to a Medical College. Maintenance of the injury register overall was highly satisfactory in both units. Two hundred and nine injuries were recorded from both units of the hospital. The majority of injuries (60.5%) occurred in the age group of 20-30 years with 70% among females. Waste handlers were at increased risk during waste management procedures. Thirty two percent of sharps injury injuries occurred in wards. Of the ward nursing staff, 25.3% received sharps injuries. Post-exposure prophylaxis for Hepatitis B (primary dose) was given to 25 HCWs; 11 received booster doses. The basic regimen for HIV post-exposure prophylaxis was given to 4 HCWs. Awareness about records maintenance, regular documentation, awareness and training, and implementation of appropriate preventive measures can reduce the incidence of injuries. Key words: Sharps, injury register, Health care workers (HCW),Post exposure prophylaxis (PEP)

scholarly journals 986. Improvement in Administration of HIV Post-Exposure Prophylaxis in the Emergency Department Following Sexual Assault

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Hiv Transmission ◽  
Post Exposure Prophylaxis ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Exposure ◽  
Assault Victims ◽  
Exposure Prophylaxis

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P< 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P< 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P< 0.001), pregnancy (39.0% vs 79.6%; P< 0.001), syphilis (3.4% vs 89.8%; P< 0.001), hepatitis B (15.3% vs 95.5%; P< 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)

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