Effectiveness and trend forecasting of tuberculosis diagnosis after the introduction of rapid molecular testing in a city in south-eastern Brazil

2020 ◽  
Author(s):  
Thaís Zamboni Berra ◽  
Dulce Gomes ◽  
Antônio Carlos Vieira Ramos ◽  
Yan Mathias Alves ◽  
Alexandre Tadashi Inomata Bruce ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Ecological Study ◽  
Extrapulmonary Tuberculosis ◽  
Incidence Rates ◽  
Molecular Testing ◽  
Lung Tuberculosis ◽  
Eastern Brazil ◽  
Immunodeficiency Virus ◽  
Trend Forecasting ◽  
Tuberculosis Diagnosis

Abstract Background To evaluate the effectiveness of a rapid molecular test for the detection of tuberculosis and to predict the behaviour of the disease in a municipality of Brazil where tuberculosis is endemic. Methods An ecological study was carried out in Ribeirão Preto-SP on a population of tuberculosis cases notified between 2006 and 2017. Monthly tuberculosis incidence rates and the Average Monthly Percentage Change (AMPC) were calculated. In order to identify changes in the series, the breakpoint technique was performed; the rates were modelled and predictions of the incidence of tuberculosis until 2025 were made. Results AMPC showed a fall of 0.69% per month in tuberculosis and human immunodeficiency virus (TB-HIV) co-infection, a fall of 0.01% per month in general and lung tuberculosis and a fall of 0.33% per month in extrapulmonary tuberculosis. With the breakpoint technique, general and pulmonary tuberculosis changed in structure in late 2007, and extrapulmonary tuberculosis and TB-HIV co-infection changed in structure after 2014, which is considered as the cut-off point. The IMA(3) models were adjusted for general and pulmonary tuberculosis and TB-HIV co-infection, and the AR(5) models for extrapulmonary TB, and predictions were performed. Conclusions It is necessary that the algorithms for the care of a person with tuberculosis are followed and the diagnostic means used correctly in order to break the chain of transmission of tuberculosis and reduce its indexes.

scholarly journals Effectiveness and trend forecasting of tuberculosis diagnosis after the introduction of GeneXpert in a city in south-eastern Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252375
Author(s):  
Thaís Zamboni Berra ◽  
Dulce Gomes ◽  
Antônio Carlos Vieira Ramos ◽  
Yan Mathias Alves ◽  
Alexandre Tadashi Inomata Bruce ◽  
...  
Keyword(s):  
Ecological Study ◽  
Incidence Rates ◽  
Molecular Test ◽  
Pulmonary Tb ◽  
Case Identification ◽  
Eastern Brazil ◽  
Immunodeficiency Virus ◽  
Trend Forecasting ◽  
Early Case ◽  
Tuberculosis Diagnosis

Background To evaluate the effectiveness of a rapid molecular test for the detection of tuberculosis (TB) and to predict the rates of disease in a municipality of Brazil where TB is endemic. Methods An ecological study was carried out in Ribeirão Preto-SP on a population of TB cases notified between 2006 and 2017. Monthly TB incidence rates and the average monthly percentage change (AMPC) were calculated. In order to identify changes in the series, the breakpoint technique was performed; the rates were modelled and predictions of the incidence of TB until 2025 were made. Results AMPC showed a fall of 0.69% per month in TB and human immunodeficiency virus (TB-HIV) co-infection, a fall of 0.01% per month in general and lung TB and a fall of 0.33% per month in extrapulmonary TB. With the breakpoint technique, general and pulmonary TB changed in structure in late 2007, and extrapulmonary TB and TB-HIV co-infection changed in structure after 2014, which is considered the cut-off point. The IMA(3) models were adjusted for general and pulmonary TB and TB-HIV co-infection, and the AR(5) models for extrapulmonary TB, and predictions were performed. Conclusions The rapid molecular test for TB is the method currently recommended by the WHO for the diagnosis of the disease and its main advantage is to provide faster, more accurate results and to already check for drug resistance. It is necessary that professionals encourage the use of this technology in order to optimize the diagnosis so that the treatment begins as quickly as possible and in an effective way. Only by uniting professionals from all areas with health policies aimed at early case identification and rapid treatment initiation it is possible to break the chain of TB transmission so that its rates decrease and the goals proposed by the WHO are achieved.

scholarly journals IgM and IgG Antibodies in Tuberculosis

1970 ◽  
Vol 31 (3) ◽  
pp. 34-40
Author(s):  
N. Bam ◽  
R. Karn
Keyword(s):  
Pulmonary Tuberculosis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Extrapulmonary Tuberculosis ◽  
University Teaching ◽  
Institute Of Medicine ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Tuberculosis Diagnosis ◽  
Sensitivity Specificity

Introduction: The diagnosis of tuberculosis relies on the identification of acid-fast bacilli on unprocessed sputum smears using conventional light microscopy. Microscopy has high specificity in tuberculosis-endemic countries, but modest sensitivity which varies among laboratories (range 20% to 80%). Moreover, the sensitivity is poor for paucibacillary disease (e.g., pediatric and HIVassociated tuberculosis). Many supportive investigations including serolological tests being utilized for tuberculosis diagnosis have wide variations in sensitivity, specificity in different studies. The aim of study was to evaluate the recombinant 38 KDa antigen from M. tuberculosis - based Enzyme Immunoassays (EIA) test for its sensitivity, specificity and other statistical parameters. Methods: This hospital based prospective cross-sectional study was conducted at Tribhuvan University Teaching Hospital, Kathmandu, from April 28, 2009 to November 30,2009. Sera from total 90 patients, pulmonary tuberculosis, extrapulmonary tuberculosis and non-tubercular chest infection patients who did not have past TB or exposure history , 30 in each group were used for Pathozyme Myco kit evalution to determine the IgM and IgG antibodies activity against the recombinant 38 KDa antigen of Mycobacteria Results: In overall tuberculosis, IgM TB had sensitivity 48.3%,specificity 76.7%, positive predictive value 80.6% which was statistically significant(p=0.025) . The IgG TB had sensitivity 66.7%,specificity 83.3%,positive predictive value 88.9% which is statistically highly significant(p<0.001) to diagnose tuberculosis. Utilizing IgM and IgG both together, sensitivity decreased to 44.3%, but specificity increased to 90.0% and positive predictive value 88.5%, which was statistically significant (p=0.006) for the diagnosis of tuberculosis. Conclusions: IgG TB antibody has high sensitivity and specificity for tuberculosis diagnosis, but IgM antibody should also be evaluated along with IgG antibody to increase specificity. Keywords: Extrapulmonary tuberculosis (EPTB), 38 kDa antigen, IgM, IgG TB antibody, Pathozyme-Myco, Pulmonary tuberculosis (PTB). DOI: 10.3126/joim.v31i3.2995 Journal of Institute of Medicine, December, 2009; 31(3) 34-40

scholarly journals Incidence Rates of Tuberculosis among Children and Adolescents Living in Areas Most Affected by the Chernobyl Disaster

2016 ◽  
Vol 6 (10) ◽  
pp. 28-41 ◽  
Author(s):  
Larissa Gorbach
Keyword(s):  
Pulmonary Tuberculosis ◽  
Children And Adolescents ◽  
Extrapulmonary Tuberculosis ◽  
Age Groups ◽  
Incidence Rates ◽  
Tuberculosis Incidence ◽  
Chernobyl Disaster ◽  
Gender And Age ◽  
Negative Factors ◽  
Direct Standardization

Background. The Chernobyl accident has attracted the attention of healthcare experts all over the world due to the unprecedented scale of damage the disaster inflicted upon human health. Objectives. To examine incidence rates of tuberculosis and patterns among children and adolescents living in areas most affected by the Chernobyl disaster between 2004 and 2014. Methods. The tuberculosis incidence rate was calculated per 100,000 people. Incidence dynamics were traced for the period 2004 to 2014 and average rates were measured. Average incidence rates were calculated for different age groups, including 0–4 years, 5–9 years, 10–14 years, and 15–19 years, as well as the total value for all those between 0–19 years of age. Average incidence rates were estimated for tuberculosis, pulmonary tuberculosis and extrapulmonary tuberculosis. A comparative analysis of incidence rates of tuberculosis in areas more and less affected by the Chernobyl disaster was conducted. To avoid gender and age disparities among the population in the two different study areas, a method of direct standardization was applied. Results. Tuberculosis incidence rates showed identical patterns among the population across all areas in this region. At the same time, the incidence rates of tuberculosis, pulmonary tuberculosis, and extrapulmonary tuberculosis were higher among children and adolescents living in the most affected areas in comparison to those living in less affected areas. Conclusion. The results do not allow us to conclude whether radioactive pollution has a direct impact on incidence of tuberculosis among children and adolescents in the most radioactively contaminated areas. The author believes that the higher incidence rates of tuberculosis in the most affected areas are conditioned by a set of negative factors that have a pernicious influence on the general health of the population, and on the health of children and adolescents in the areas most affected by the Chernobyl disaster.

scholarly journals Concurrent pulmonary tuberculosis and lepromatous leprosy in a newly diagnosed HIV positive patient: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Josiah T. Masuka ◽  
Zamambo Mkhize ◽  
Somasundram Pillay ◽  
Anisa Mosam
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lepromatous Leprosy ◽  
Positive Patient ◽  
Hiv Positive ◽  
Interdisciplinary Management ◽  
Immunodeficiency Virus ◽  
The Face ◽  
History Of ◽  
Tuberculosis Diagnosis ◽  
High Index Of Suspicion

Abstract Background The leprosy-tuberculosis (TB) co-infection is rarely reported in recent times. However, this dual comorbidity is associated with high mortality and major morbidity. Unrecognised leprosy-TB co-infection may predispose affected patients to rifampicin monotherapy and subsequent drug resistance. Case presentation A 35 year old migrant, human immunodeficiency virus (HIV) positive male worker presented with 6 month history of symmetric infiltrative nodular plaques of the face and distal, upper extremities. A few days after initial dermatology presentation, a sputum positive pulmonary tuberculosis diagnosis was made at his base hospital. Subsequent dermatology investigations revealed histology confirmed lepromatous leprosy and a weakly reactive rapid plasma reagin test. The presenting clinical features and laboratory results were suggestive of lepromatous leprosy coexisting with pulmonary tuberculosis in an HIV positive patient. Conclusions This case illustrates the occurrence of leprosy with pulmonary tuberculosis in an HIV infected patient and the difficulties in interpreting non-treponemal syphilis tests in these patients. This case also highlights the need for a high index of suspicion for co-infection and the need to exclude PTB prior to initiation of rifampicin containing multi-drug therapy (MDT). Interdisciplinary management and social support are crucial in these patients.

scholarly journals Bronchial lavage role in human immunodeficiency virus-positive acid-fast negative patients in pulmonary tuberculosis diagnosis

2020 ◽  
Vol 83 (3) ◽  
Author(s):  
Raúl Cicero-Sabido ◽  
Carlos Núñez-Pérez-Redondo ◽  
Claudia A. Bäcker ◽  
Elizabeth Luis-Martínez ◽  
Heleodora Gonzalez-Gonzalez ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Pulmonary Tuberculosis ◽  
Bronchial Lavage ◽  
Immunodeficiency Virus ◽  
Tuberculosis Diagnosis

Sociodemographic, Clinical Profile and Outcome of Tuberculosis in Baramulla District of North Kashmir of India

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 11-16
Author(s):  
Abdul Ahad Wani ◽  
Javeed Iqbal Bhat ◽  
Muzafar Naik ◽  
Nisar Ahmed Dar ◽  
Syed Masood Ahmed
Keyword(s):  
Elementary Education ◽  
Pulmonary Tuberculosis ◽  
Rural Areas ◽  
Extrapulmonary Tuberculosis ◽  
Steady Increase ◽  
Female Ratio ◽  
Directly Observed Treatment ◽  
Night Sweats ◽  
Immunodeficiency Syndrome ◽  
A Prospective Study

Background: India accounts for one-fourth of the global tuberculosis (TB) burden. Since the countrywide implementation of RNTCP, tuberculosis care has received renewed focus. Directly observed treatment short-term (DOTS) is a cornerstone of RNTCP program. Objective: To evaluate demographic profile, clinical presentation and outcome of TB in district Baramulla of North Kashmir. Methods:  A prospective study over a period of seven years in patients diagnosed with TB in district Baramulla of North Kashmir. Results: This study was conducted prospectively over seven years from March 2011 to February 2017. A total of 802 patients were enrolled in the study. Among them, there were a total of 638 adult patients and 164 paediatric patients with a male: female ratio of 1:0.99. Majority of patients belonged to rural areas of north Kashmir and had received no or elementary education. Pulmonary tuberculosis was diagnosed in 530 (66 %) patients and 272 (34%) patients were diagnosed as extrapulmonary tuberculosis. Sputum for AFB was important mode of diagnosis in our series and was positive in 525 (65%) our patients. Majority of patients presented with fever, weight loss, and night sweats. None of the patients had Acquired Immunodeficiency syndrome (AIDS). There was a consistent improvement in AFB isolation among TB patients over the study period. Majority of our patients were cured completely of disease Conclusion: Sputum positive pulmonary tuberculosis remains the most common presentation of tuberculosis in North Kashmir. There is a steady increase in the proportion of bacteriologically confirmed TB cases over the study period. Furthermore, DOTS treatment is successful in all forms of tuberculosis. JMS 2018;21(1):11-16

scholarly journals Limited Sustained Local Transmission of HIV-1 CRF01_AE in New South Wales, Australia

Viruses ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 482 ◽  
Author(s):  
Francesca Di Giallonardo ◽  
Angie N. Pinto ◽  
Phillip Keen ◽  
Ansari Shaik ◽  
Alex Carrera ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
New South ◽  
New South Wales ◽  
Incidence Rates ◽  
Effective Control ◽  
South Wales ◽  
Immunodeficiency Virus ◽  
Hiv 1 ◽  
Local Transmission

Australia’s response to the human immunodeficiency virus type 1 (HIV-1) pandemic led to effective control of HIV transmission and one of the world’s lowest HIV incidence rates—0.14%. Although there has been a recent decline in new HIV diagnoses in New South Wales (NSW), the most populous state in Australia, there has been a concomitant increase with non-B subtype infections, particularly for the HIV-1 circulating recombinant form CRF01_AE. This aforementioned CRF01_AE sampled in NSW, were combined with those sampled globally to identify NSW-specific viral clades. The population growth of these clades was assessed in two-year period intervals from 2009 to 2017. Overall, 109 NSW-specific clades were identified, most comprising pairs of sequences; however, five large clades comprising ≥10 sequences were also found. Forty-four clades grew over time with one or two sequences added to each in different two-year periods. Importantly, while 10 of these clades have seemingly discontinued, the remaining 34 were still active in 2016/2017. Seven such clades each comprised ≥10 sequences, and are representative of individual sub-epidemics in NSW. Thus, although the majority of new CRF01_AE infections were associated with small clades that rarely establish ongoing chains of local transmission, individual sub-epidemics are present and should be closely monitored.

scholarly journals FRI0435 THE CLINICAL SIGNIFICANCE OF SERUM AUTOANTIBODIES AND HLA-B27 MOLECULE TESTING IN UYGUR PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 815.3-815
Author(s):  
X. Chen ◽  
L. Wu ◽  
X. Wu ◽  
C. N. Luo ◽  
Y. M. Shi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Molecular Mimicry ◽  
Molecular Testing ◽  
Hla B27 ◽  
Clinical Value ◽  
Rheumatic Manifestations ◽  
Immunodeficiency Virus ◽  
Positive Rate

Background:AIDS is a deadly infectious disease caused by the HIV. When HIV infects a host, it may induce production of autoantibodies due to the structural antigen similarity between viral proteins and selfantigens.The molecular mimicry between HIV protein and self-antigens could cause antibody cross-reactions and lead to development of autoimmune disease.Objectives:To explore the clinical value of serum autoantibodies and human leukocyte antigen (HLA-B27) molecular testing in Uygur patients with human immunodeficiency virus (HIV) infection.Methods:A total of 727 HIV-infected Uygur patients who visited Kuche Infectious Diseases Hospital during May 2016 to March 2017 were include in this study. The other 390 healthy people were enrolled as controls. Serum antinuclear antibodies (ANA) and ANA Profile, anti-cyclic citrullinated peptide (CCP) antibody, and HLA-B27 molecule were tested.Results:Among 727 HIV-infected Uygur patients, 317 were males and 410 were females with mean age (35.52±13.44) years old. The mean duration of disease was (6.34±3.05)years. There were 697(95.87%) patients receiving Highly active antiretroviral therapy (HAART) with mean duration of treatment (6.34±3.05)years. Rheumatic manifestations were recorded in 238 (32.74%) HIV-infected Uygur patients, mainly with dry mouth and dry eye (15.41%), alopecia (9.90%), arthralgia (8.94%), ect. Compared with the health controls, positive ANA was more common in HIV infected Uygur patients (33.42%vs.17.43%,P< 0.001) with low titers (ANA titer:1:100). HIV-infected Uygur patients had higher positive anti-u1-RNP antibodies positive rate (1.10%), but lower anti-SSA antibodies positive rate (0.14%) and anti-CCP antibodies positive rate (0.28%). Patients with positive ANA in HAART group were significantly less than that in non-treatment group (38.72%vs.50.00%,P=0.049).Only one female patient was HLA-B27 positive (0.14%), which was significantly lower than that in healthy controls (3.08%) (P<0.001). Also, only one patient was diagnosed with rheumatoid arthritis (RA).Conclusion:Rheumatic manifestations are common in HIV-infected Uygur patients. Several autoantibodies are positive, but the coincidence of rheumatic diseases is rare. It’s noted that patients with Rheumatic manifestations and low titre positive ANA should be considered as a differential diagnosis of HIV infection.Disclosure of Interests:None declared

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