scholarly journals A prospective study of spectrum of pulmonary tuberculosis in HIV sero positive patients

2021 ◽  
Vol 8 (12) ◽  
pp. 1856
Author(s):  
Ganedi Seshu Kumari
Keyword(s):  
Miliary Tuberculosis ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Hiv Positive ◽  
Cd4 Cells ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Male Predominance ◽  
Chest X Ray ◽  
A Prospective Study

Background: Tuberculosis is the leading cause of death in India contributing to 30% of total global burden. Approximately 0.5 million people dies of TB annually and 5% of the incident TB cases in India have HIV. So it is important to understand the effect of tuberculosis and HIV on each other. HIV epidemics have leads to increased number of tuberculosis cases with various presentations.Methods: It is an observational cross-sectional study of patients with HIV positive and pulmonary TB. Patients were investigated for HIV positivity by HIV coomb's test, if positive confirmed by capillaries and tridot method. Some patients, who are diagnosed as having pulmonary Koch, are sent for HIV testing. CD4 cells count as tested in all patients with HIV positive and severity of pulmonary TB and relation with CD count is studied in all patients.Results: In chest x-ray of patients we have observed that upper zone infiltration was found in 10 (16.67%) patients, mid and lower zone infiltration was found in 19 (31.67%) patients, bilateral infiltration and miliary tuberculosis was found in 22 (36.67%). We have found that 9 (15%) patients were presented with fibro cavitary lesion.Conclusions: From present study we can conclude that tuberculosis and HIV is common between 3rd and 5th decade of life with male predominance. It was more common in daily labourer and BMI was 18.22±3.21 kg/m2. Fever, weight loss and cough was most common presentation and present in more than 90% patients pallor and lymphadenopathy was common finding and present in more than 50% patients.

scholarly journals Diagnostic accuracy of a novel point-of-care urine lipoarabinomannan assay for the detection of tuberculosis among adult outpatients in Zambia: a prospective cross-sectional study

2021 ◽  
pp. 2003999
Author(s):  
Monde Muyoyeta ◽  
Andrew D. Kerkhoff ◽  
Lophina Chilukutu ◽  
Emmanuel Moreau ◽  
Samuel G. Schumacher ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Point Of Care ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Smear Microscopy ◽  
Reference Standard ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Hiv Negative

BackgroundA novel, rapid, point-of-care urine-based lipoarabinomannan assay (Fujifilm SILVAMP TB-LAM, “FujiLAM”) has previously demonstrated substantially higher sensitivity for tuberculosis (TB) compared to the commercially-available Determine TB-LAM assay using bio-banked specimens. However, FujiLAM has not been prospectively evaluated using fresh urine specimens. Therefore, we determined the diagnostic accuracy of FujiLAM among HIV-positive and HIV-negative outpatients with presumptive TB in Zambia.MethodsAdult (≥18 years) presumptive TB patients presenting to two outpatient public health facilities in Lusaka, were included. All patients submitted sputa samples for smear-microscopy, Xpert Ultra and Mycobacterial culture and urine samples for the FujiLAM assay. Microbiologically-confirmed TB was defined by the detection of Mycobacterium tuberculosis in sputum using culture; this served as the reference standard to assess the diagnostic accuracy of FujiLAM.Results151 adults with paired sputum microbiologic tests and urine FujiLAM results were included; 45% were HIV-positive. Overall, 34/151 (23%) patients had culture-confirmed pulmonary TB. The overall sensitivity and specificity of FujiLAM was 77% (95% CI: 59–89) and 92% (95% CI: 86–96), respectively. FujiLAM's sensitivity among HIV-positive patients was 75% (95% CI: 43–95) compared to 75% (95% CI: 51–91) among HIV-negative patients. The sensitivity of FujiLAM in patients with smear-positive, confirmed pulmonary TB was 87% (95% CI: 60–98) compared to 68% (95%: 43–87) among patients with smear-negative, confirmed pulmonary TB.ConclusionsFujiLAM demonstrated high sensitivity for the detection of TB among both HIV-positive and HIV-negative adults and also demonstrated good specificity despite the lack of systematic extra-pulmonary sampling to inform a comprehensive microbiological reference standard.

scholarly journals Prevalence of latent tuberculosis infection and feasibility of TB preventive therapy among Thai prisoners: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sivaporn Gatechompol ◽  
Weerakit Harnpariphan ◽  
Ruamthip Supanan ◽  
Gompol Suwanpimolkul ◽  
Jiratchaya Sophonphan ◽  
...  
Keyword(s):  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
History Of ◽  
Chest X Ray ◽  
Latent Tb ◽  
Latent Tb Infection

Abstract Background Prisons are considered as major reservoirs for tuberculosis. Preventive therapy for latent TB infection (LTBI) is an adjunctive strategy to control TB. However, LTBI data in Thai prisoners is limited. This study assessed the prevalence of LTBI and feasibility of isoniazid preventive therapy (IPT). Methods A cross-sectional study was conducted among prisoners in Klong Prem Central Prison, Bangkok. Participants were screened for active TB by questionnaire and chest X-ray. LTBI was evaluated by Tuberculin skin test (TST) and QuantiFERON-TB Gold Plus (QFTP) among subgroup. Participants with positive TST or QFTP were considered to have LTBI. Participants with LTBI were offered IPT. Results From August 2018–November 2019, 1002 participants were analyzed. All participants were male with a median age of 38 (IQR 32–50) years. LTBI identified by either TST/QFTP was present in 466 (46.5%) participants. TST was positive in 359 (36%) participants. In the subgroup of 294 participants who had both TST and QFTP results, 181/294 (61.6%) tested positive by QFTP. Agreement between TST and QFTP was 55.1% (Kappa = 0.17). The risk factors associated with LTBI were previous incarceration (aOR 1.53, 95%CI, 1.16–2.01, p = 0.002), history of prior active TB (aOR 3.02, 95%CI, 1.74–5.24, p < 0.001) and duration of incarceration ≥10 years (aOR 1.86, 95%CI, 1.24–2.79, p = 0.003). Majority of LTBI participants (82%) agreed to take IPT. Three hundred and 56 (93%) participants completed treatment whereas 27 (7%) participants discontinued IPT due to the side effects of INH. Conclusion This is the first study to evaluate the prevalence of LTBI and feasibility of IPT among Thai prisoners. LTBI prevalence in male prisoners in Thailand is high. LTBI screening and treatment should be implemented together with other preventive components.

Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study

2021 ◽  
pp. 089198872110026
Author(s):  
Sivan Klil-Drori ◽  
Natalie Phillips ◽  
Alita Fernandez ◽  
Shelley Solomon ◽  
Adi J. Klil-Drori ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Cross Sectional Study ◽  
Montreal Cognitive Assessment ◽  
Cutoff Score ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
A Prospective Study ◽  
Sectional Analysis ◽  
State Examination ◽  
Normal Cognition

Objective: Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. Results: Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). Conclusions: Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.

scholarly journals Prevalence of suicidal ideation and associated factors among HIV positive perinatal women on follow-up at Gondar town health institutions, Northwest Ethiopia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leul Belachew Zewdu ◽  
Mebratu Mitiku Reta ◽  
Niguse Yigzaw ◽  
Koku Sisay Tamirat
Keyword(s):  
Suicidal Ideation ◽  
Unplanned Pregnancy ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional ◽  
Factors Associated ◽  
Gondar Town ◽  
Perinatal Women ◽  
Significant Factors

Abstract Background Suicidal behaviors cover a range or continuum of acts from suicidal ideations to a series of actions, commonly known as suicidal attempts or deliberate self-harms. Though different mental disorders related studies were conducted among HIV/AIDS patients, there is a scarcity of information about the magnitude and determinants of suicidal thoughts among perinatal women. Therefore, this study aimed to determine the prevalence of suicidal ideation and associated factors among HIV positive perinatal women in the study setting. Methods An institution-based cross-sectional study was conducted among perinatal women on treatment to the prevention of mother to child transmission of HIV/AIDS at Gondar town health facilities. A total of 422 HIV-positive perinatal women were selected systematically and the data collected through medical record review and interview using a Composite International Diagnostic Interview (CIDI) toolkit. A binary and multivariable logistic regression model was employed to identify factors associated with suicidal ideation. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed to see the strength of association between outcome and independent variables. Characteristics having less than 0.05 p-value had been taken as significant factors associated with the outcome of interest. Result The prevalence of suicidal ideation was found to be 8.2% (95% CI; 5.7 to 11.3) and with a standard error of 0.013. Perinatal depression (AOR=4.40, 95%CI: 1.63 11.85), not disclosed HIV status (AOR=3.73, 95%CI: 1.44 9.65), and unplanned pregnancy (AOR=2.75, 95%CI: 1.21 6.21) were significant factors associated with suicidal ideation. Conclusion The magnitude of suicidal ideation among HIV positive perinatal women was found to be low. Perinatal depression, non-disclosed HIV status, and unplanned pregnancy were factors significantly associated with suicidal ideation. This finding suggests the integration of mental health services with maternal and HIV support programs.

scholarly journals Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abiyu Ayalew Assefa ◽  
Feleke Hailemichael Astawesegn ◽  
Bethlehem Eshetu
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cross Sectional Study ◽  
Partner Support ◽  
Hiv Positive ◽  
Screening Service ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Hiv Positive Women

Abstract Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.

High Prevalence of Sexually Transmitted Infections and Risk Factors Among HIV-Positive Individuals in Yunnan, China

2021 ◽  
Author(s):  
Wei Tu ◽  
Yu-Ye Li ◽  
Yi-Qun Kuang ◽  
Rong-Hui Xie ◽  
Xing-Qi Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexually Transmitted Infections ◽  
Genital Tract ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Multiple Infections ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
High Prevalence

Abstract Background Yunnan has the highest rates of HIV in the country. Other treatable sexually transmitted infections (STIs) are associated with accelerated HIV transmission and poor ART outcomes, but are only diagnosed by syndromic algorithms. Methods We recruited 406 HIV-positive participants for a cross-sectional study (204 ART-naive and 202 ART). Blood samples and first-voided urine samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma genitalium (MG). Syphilis and HSV-2 tests were also performed. Results Among 406 participants, the overall prevalence of STI was 47.0% and 45.1% in ART-naive individuals and 49.0% in ART individuals, respectively. Testing frequency was 11.6% (11.8% vs 11.4%), 33.2% (29.4% vs 37.1%), 3.2% (3.4% vs 3.0%), 2.0% (3.4% vs 0.5%) and 4.7% (6.4% vs 3.0%) for active syphilis, HSV-2, chlamydia, gonorrhoeae and genitalium. Percentage of multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in ART participants. Females, age between 18 to 35 years, ever injected drugs, homosexual or bisexual, HIV/HBV coinfection, and not receiving ART were identified as risk factors. Self-reported asymptom was not eliminating of having a laboratory-diagnosed STI. Conclusions STI prevalence was 47.0% (45.1% vs 49.0%), HSV-2, syphilis and MG were the most common STIs in HIV-infected individuals. We found high prevalence (6.4%) of Mycoplasma genitalium in ART-naive individuals. ART can reduce the diversity of STI-HIV coinfection but not the prevalence. HIV-positive individuals tend to neglect or maybe hide their genital tract discomfort, thus we suggest strengthening STI joint screening and treatment services among HIV-infected individuals whether they describe genital tract discomfort or not.

Cardiac Manifestation among Patients with Hypothyroidism - A Cross-Sectional Study in North Karnataka

2021 ◽  
Vol 8 (26) ◽  
pp. 2283-2287
Author(s):  
Swetha Rajshekar Lakshetty ◽  
Nandini Devru
Keyword(s):  
Pericardial Effusion ◽  
Diastolic Dysfunction ◽  
Cardiac Dysfunction ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Low Density ◽  
Sectional Study ◽  
Cross Sectional

BACKGROUND Hypothyroidism is the second most common endocrinopathy next to diabetes mellitus (DM). Hypothyroidism is associated with increased cardiovascular mortality and morbidity. Cardiovascular complications are some of the most profound, reproducible and reversible clinical findings associated with thyroid disease1 . Hence this study was undertaken to assess the cardiac dysfunction among patients with hypothyroidism by electrocardiogram (ECG) and echocardiogram (ECHO) so as to provide a proper treatment guideline even among milder cases. METHODS This was a cross sectional study carried among 50 new patients of hypothyroidism who presented to Navodaya Hospital, Raichur during 2015 to 2017. They were clinically evaluated and underwent relevant investigations, including thyroid profile estimation, cardiac evaluation using ECG and 2D ECHO. RESULTS Most cases fell in the age group of 31 - 40 years. There was an overall female preponderance (76 %) over all age groups with mean age of 42.02 years. Goiter was found in 8 % of patients, bradycardia and hypertension was seen in 30 % and 22 % respectively. Central nervous system (CNS) examination revealed delayed ankle jerk in 40 % followed by hoarseness of voice in 38 % of patients. Lipid analysis showed increase of total cholesterol (TC), low density lipoprotein (LDL), very low-density lipoprotein (VLDL), triglycerides (TGL) and decrease of highdensity lipoprotein (HDL). Normal ECG was found in 26 % of patients. Bradycardia was most common finding seen in 30 % (15) of patients. 24 % (12) of patients exhibited low voltage complexes. While, 46 % cases showed normal ECHO findings. 24 % of cases presented with pericardial effusion. 18 % cases presented with diastolic dysfunction among which majority were mild. None of the cases had severe diastolic dysfunction. Only a meagre 10 % cases showed intraventricular septum (IVS) thickness. CONCLUSIONS Pericardial effusion was seen among 24 % of patients while diastolic dysfunction was seen in 18 % patients. Thus, any unexplained pericardial effusion should be screened for hypothyroidism. KEYWORDS Hypothyroidism, Cardiac Dysfunction, 2D ECHO, ECG, Thyroid Stimulating Hormone (TSH)

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