scholarly journals Clinical Profile and Outcome of Childhood Tuberculosis at Dhulikhel Hospital

1970 ◽  
Vol 31 (1) ◽  
pp. 11-16 ◽  
Author(s):  
S Shrestha ◽  
SB Marahatta ◽  
P Poudyal ◽  
SM Shrestha
Keyword(s):  
Pulmonary Tuberculosis ◽  
Clinical Laboratory ◽  
Significant Proportion ◽  
Abdominal Distension ◽  
Childhood Tuberculosis ◽  
Mantoux Test ◽  
Pulmonary Tb ◽  
Pediatric Tb ◽  
Extra Pulmonary

The corrected PDF for this article was loaded on 07/02/2011.Background: Children contribute a significant proportion of the tuberculosis (TB) burden in Nepal and suffer severe TB related morbidity and mortality, particularly in endemic areas. Diagnosis and management of pediatric TB especially Extra pulmonary TB (EPTB) is challenging.Objectives: The present study was designed to study clinical, laboratory characteristics and outcome of childhood tuberculosis. Methods: A prospective analysis of 60 cases of TB children within three years period was conducted at Pediatric Department, Dhulikhel Hospital and followed up till child completely recovered.Results: In the present study 60 children had clinical and lab evidence of tuberculosis and received anti tubercular therapy. Extra pulmonary tuberculosis was common (78.3%) than pulmonary tuberculosis (21.6%). BCG scar was absent in eight (13.33%) and absent BCG vaccination was significantly associated with disseminated TB (p<0.05). The most frequently seen symptoms were fever (65 %), cough (46.67 %) and abdominal distension (36.67%). Hepatomegaly (45%), ascites (33.33%), lymphadenopathy (23.33 %) and splenomegaly (11.67 %), and are common signs. Malnutrition seen in (33.3%) with more malnourished children with disseminated TB than in other diagnosis (p<0.001). Mantoux test was positive in (48.3%). Isolation of AFB was possible only in (8.33%). Among 60 cases (60%) were recovered completely with the primary regimen, (5%) recovered with extending the duration of primary regimen to three more months. (25%) failed to follow up, while (6.67%) died.Conclusion: EPTB is common than pulmonary TB. Among 60 cases 36 (60%) recovered completely with the primary regimen, three cases (5%) recovered with extending the duration with primary regimen. Fifteen cases (25%) failed to follow up, while four cases (6.67%) died.Key words: Children; Tuberculosis; Diagnosis; Outcome DOI: 10.3126/jnps.v31i1.4160J Nep Paedtr Soc 2010;31(1):11-16

A retrospective analysis of congenital anomalies in congenital hypothyroidism

2020 ◽  
Vol 33 (9) ◽  
pp. 1147-1153
Author(s):  
Fatima Ali Mazahir ◽  
Manal Mustafa Khadora
Keyword(s):  
United Arab Emirates ◽  
Congenital Hypothyroidism ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
High Rate ◽  
Lingual Thyroid ◽  
Cross Sectional

AbstractObjectivesWe evaluated the spectrum of diseases accompanying congenital hypothyroidism (CH) in the United Arab Emirates and compared them with internationally studied patterns.MethodsThe presented retrospective cross-sectional study took place in two government tertiary care centres. In total, 204 patients with a confirmed diagnosis of CH and a minimum period of follow-up of 1 year were included. Patients with Down syndrome, infants born at <35 weeks of gestation, and babies with TORCH (Toxoplasma gondii, Other viruses [HIV, measles, etc.], Rubella, Cytomegalovirus, and Herpes simplex) infections were subsequently excluded from the study.ResultsOf the subjects with CH, 39% had associated extrathyroidal anomalies (ETAs); among these, 25% had a single anomaly. A significant proportion of Arab males were affected by CH as compared to other ethnic groups. Dyshormonogenesis was the commonest aetiological cause (55%) of CH. Males with an ectopic lingual thyroid gland had significant ETAs as compared to females of the same cohort. The most common ETAs were congenital heart disease (16%), followed by urogenital tract anomalies (14%).ConclusionsDetection of a high rate and variability of ETAs associated with CH necessitates the formulation of a structured screening programme including appropriate clinical, laboratory, and imaging tools to detect ETAs at an earlier stage.

scholarly journals Mantoux test results and BCG vaccination status in TB-exposed children

2015 ◽  
Vol 55 (1) ◽  
pp. 7
Author(s):  
Fadilah Harahap ◽  
Ridwan M. Daulay ◽  
Muhammad Ali ◽  
Wisman Dalimunthe ◽  
Rini Savitri Daulay
Keyword(s):  
Pulmonary Tuberculosis ◽  
Nutritional Status ◽  
Household Contact ◽  
Mantoux Test ◽  
Skin Tests ◽  
Sputum Smear ◽  
Test Results ◽  
Time Duration ◽  
Pulmonary Tb ◽  
Bcg Vaccination

Background Tuberculosis (TB) infection is highly prevalent in Indonesia. The source of transmission of TB to a child is usually via an adult with sputum smear-positive pulmonary tuberculosis. The Mantoux test is a diagnostic tool for tuberculosis infection. The BCG vaccine has been used for the prevention of TB, but its efficacy is still debated. Objective To assess for an association between Mantoux test results and BCG vaccination in children who had contact with adult pulmonary tuberculosis and to assess for differences in Mantoux test induration with regards to nutritional status, age, type of TB contact, and time duration since BCG vaccination in BCG-vaccinated and BCG-unvaccinated children. Methods A cross-sectional study was conducted in FebruaryMarch 2011 on infants and children (aged 3 months to five years), who had household contact with adult pulmonary TB. We performed tuberculin (Mantoux) skin tests to detect TB infection in the children. Subjects were consisted of two groups: BCG-vaccinated and BCG-unvaccinated. Results Subjects were 100 children (50 BCG-vaccinated and 50 BCG-unvaccinated subjects). Positive Mantoux test results were observed in 9 vaccinated subjects and 33 unvaccinated subjects. The mean diameters of induration in the vaccinated and unvaccinated groups were 7.6 mm and 9.6 mm, respectively (95%CI of difference -4.25 to 0.20; P=0.074). In children who had household contact with sputum smear-positive adult pulmonary TB, BCG vaccination was a protective factor against TB infection, with an odds ratio (OR) of 0.113 (95%CI 0.045 to 0.286; P=0.0001). There were no significant differences in Mantoux test induration associated with nutritional status, age, type of TB contact, and duration since BCG vaccination, between the two groups. Conclusion BCG vaccination has a protective effect on TBexposed children, based on Mantoux test results. However, there are no differences in Mantoux test induration associated with nutritional status, age, type of TB contact, or duration since BCG vaccination, between the BCG-vaccinated and BCGunvaccinated groups.

scholarly journals Family Health Exercise: Follow-up of an Extra-pulmonary Tuberculosis Patient

2017 ◽  
Vol 9 (2) ◽  
pp. 70-75
Author(s):  
Kavindra Thapa ◽  
D Sharma ◽  
D Karki ◽  
D Sharma ◽  
FK Gurung ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Family Environment ◽  
Family Health ◽  
Tuberculosis Patient ◽  
Extra Pulmonary Tuberculosis ◽  
The Family ◽  
Service Role ◽  
Psychological Gender ◽  
Extra Pulmonary

During the third year of MBBS program, we had a course of family health exercise in community medicine. This course was designed to produce competent family physicians; to enable us to understand the social, cultural, psychological, gender and economical aspects of illness, the interactions of ill persons with different members of the family and community health service, role of family members and family environment in patient care. It helped us to understand the natural history of the disease and importance of patient follow up. We were able to differentiate the nature of the problems while seeing the patients in the family from the nature of the same problems when the patient is seen in clinic or hospital. Here we present a follow-up of extra-pulmonary tuberculosis patient in our family health exercise during third year MBBS program.Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December  2016, Page: 70-75

scholarly journals Evaluation of Anti-TBGL Antibody in the Diagnosis of Tuberculosis Patients in China

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Jingge Zhao ◽  
Zhaoqin Zhu ◽  
Xiaoyan Zhang ◽  
Yasuhiko Suzuki ◽  
Haorile Chagan-Yasutan ◽  
...  
Keyword(s):  
Cell Wall ◽  
Health Care Workers ◽  
Healthy Controls ◽  
Exposure Risk ◽  
Tuberculosis Patients ◽  
Pulmonary Tb ◽  
Care Workers ◽  
Antibody Titers ◽  
Extra Pulmonary

Tuberculous glycolipid (TBGL) is a component of the Mycobacterium tuberculosis cell wall, and anti-TBGL antibodies are used for serodiagnosis of tuberculosis. Anti-TBGL IgG and IgA levels were measured in 45 pulmonary TB patients (PTB), 26 extra-pulmonary TB patients (ETB), 16 AIDS-TB patients, and 58 healthy controls (HC) including 39 health care workers (HW) and 19 newly enrolled students (ST). Anti-TBGL IgG measurements yielded 68.9% and 46.2% sensitivity in PTB and ETB, respectively, and 81.0% specificity. However, anti-TBGL IgA measurements were significantly less sensitive in detecting ETB than PTB (15.4% versus 46.7% sensitivity) but showed up to 89.7% specificity. Samples from AIDS-TB patients exhibited low reaction of anti-TBGL IgG and IgA with 6.3% and 12.5% sensitivity, respectively. Unlike anti-lipoarabinomannan (LAM) IgG that was found to elevate in sputum smearpositive subjects, anti-TBGL IgG and IgA elevated in those with cavitation and bronchiectasis, respectively. Anti-TBGL IgG in cavitary TB yielded 78.2% sensitivity compared to 57.1% in those otherwise. Meanwhile, higher anti-TBGL IgA titers were observed in HW than in ST, and increasing anti-TBGL IgG titers were observed in HW on follow-up. Therefore, higher anti-TBGL antibody titers are present in patients presenting cavities and bronchiectasis and subjects under TB exposure risk.

scholarly journals Clinical profile of children with tuberculosis from a semi urban referral centre in South India: a prospective observational study

2019 ◽  
Vol 6 (4) ◽  
pp. 1450
Author(s):  
Anuradha G. ◽  
Muraleetharan G.
Keyword(s):  
Clinical Examination ◽  
Complete Blood Count ◽  
Childhood Tuberculosis ◽  
Diagnostic Methods ◽  
Clinical Profile ◽  
Mantoux Test ◽  
Presenting Symptoms ◽  
Bacteriological Diagnosis ◽  
Laboratory Investigations ◽  
Extra Pulmonary

Background: Global TB report 2018 reports that in India, an estimated 2.2 lakh children become ill with tuberculosis (TB) each year. In spite of new rapid diagnostic methods, lack of gold standard test for confirming childhood tuberculosis remains an obstacle for the effective reporting of childhood TB and hence these cases often remain under diagnosed. The main objective was to study the clinical profile of childhood tuberculosis with relevant laboratory investigations aiding in early diagnosis.Methods: A prospective observational hospital-based study was conducted in IRT-Perundurai medical college hospital from April 2016 to March 2018. Children less than 18 years of age with tuberculosis were included in the study. Demographic details, presenting symptoms, family history of TB contact, nutritional status and clinical examination findings were documented. Complete blood count, ESR, Mantoux test, chest X-ray and sputum analyses for AFB were done for all patients.Results: Out of the total 124 children studied, the most common age of presentation of tuberculosis was >10 years of age (n=58, (46.8%)). There was a female preponderance (n=71 (57.25%)). Pulmonary tuberculosis (n= 87, (70.16%)) was the most common form followed by extra pulmonary (n=32, (25.80%)) and disseminated type (n=5, (4%)).  Lymph node TB was the most common manifestation (n=20, 62.50%) among extra pulmonary form. Cough (n=75, 60.5%) with sputum (n=55,44.4%) were the predominant symptoms noted followed by fever (n=53, 42.7%). Bacteriological diagnosis was possible in 19.5% (n=17) patients only.Conclusions: This study reinforces that the diagnosis of childhood tuberculosis is based on the constellation of symptom evaluation, contact history, clinical examination, with relevant laboratory investigations.

scholarly journals Trends in sputum smear conversion among smear-positive pulmo-nary tuberculosis patients

2015 ◽  
Vol 4 (1) ◽  
pp. 24-33
Author(s):  
SEK Acquah ◽  
L Quaye ◽  
W Walana ◽  
EK Vicar ◽  
YN Osei ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Significant Proportion ◽  
Response To Therapy ◽  
Sputum Smear ◽  
Patient Response ◽  
Important Indicator ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Conversion Rates

Sputum smear conversion during pulmonary tuberculosis treatment is an important indicator of patient response to therapy and as such determines the direction of TB patient care. This retro-spective review assessed the trends in sputum smear evaluation and conversion rates among follow up pulmonary tuberculosis patients presenting to the Tamale Teaching Hospital from January 2004 to December 2012. A total of 8,238 sputum smear cases comprising of 6,892 (83.7%) diagnoses and 1,346 (16.3%) follow-up cases were recorded. The 1,346 follow-up cases comprised of 57.8% (778/1346) males and 42.2% (568/1346) females. The percentage proportion of follow up cases that had their month of follow up, residential addresses, ages and smear results reported are 93.8% (1262/1346), 95.2% (1281/1346), 98.2% (1322/1346) and 97.8% (1309/1346) respectively. The cumula-tive median age was 43years (IQR: 30 to 55years) with the minimum and maximum ages being 14 and 80 years recorded in 2008 and 2012 respectively. Thirty eight percent (511/1,346) of follow-up cases were from the intensive phase (month 2) evaluation period. One hundred and eleven (111) of the follow up cases were smear positive representing a cumulative positivity rate of 8.5% (111/1309). This comprised of 75(67.6 %) males and 36(32.4%) females. Generally males were observed to be significantly more likely to delay smear conversion during treatment (OR = 1.560; p = 0.035, 95% CI=1.032- 2.359) compared to females. The ages of the positive cases ranged from 14 to 75 years with a median age of 45.5 years. The intensive phase (month 2) positivity rate was 8.1% (63/776) representing a conversion rate of 91.9%. Significant proportion (15.4%) of males were smear posi-tive and were more likely to remain positive after two months of therapy compared to their female counterparts (OR = 2, p = 0.02, CI = 0.098 – 1.299). Periodic surveillance of regional sputum smear late/non conversion among PTB patients on treatment would be useful in supporting Tb manage-ment in Ghana.Keywords: Mycobacterium tuberculosis, follow up, microscopy, acid fast bacilli, Ghana

scholarly journals LATENT PULMONARY TUBERCULOSIS

2007 ◽  
Vol 14 (01) ◽  
pp. 49-55
Author(s):  
MOHAMMAD ATIF SHIRAZ ◽  
ABDULLAH KHAN
Keyword(s):  
Pulmonary Tuberculosis ◽  
Adult Population ◽  
Chest Radiographs ◽  
Mantoux Test ◽  
Military Hospital ◽  
Pulmonary Tb ◽  
Screening Design ◽  
Cheap Method ◽  
Cardiac Lesions ◽  
Asymptomatic Adult

Objective: To assess the prevalence of latent pulmonary tuberculosis (TB) in young adults males on MMR screening. Design: Descriptive study Place and duration of study: The study was carried out at Combined Military Hospital Kohat from January 2004 to August 2005. Material and Methods: A total of 4000 freshly inducted recruits aged between 18-23 years were subjected to MMR using an Odalka camera. Individuals with suspicious findings had a standard chest radiograph taken and on confirmation of findings they were inoculated with tuberculin and readings of Mantoux test were recorded. Results: Out of 4000 MMR films, 2.15% were judged suspicious and standard chest radiographs were taken. 1.2% showedfeatures suggestive of pulmonary TB. 0.175% showed non-tuberculous pulmonary findings and 0.05% showed cardiac lesions. 0.725 % chest radiographs were normal. 1.2 % suspected cases of pulmonary TB were investigated further with Mantoux test. 0.745% had strongly positive Mantoux test and were labeled as latent pulmonary TB. Conclusions: Pulmonary TB is a major health issue in our country. There is a highprevalence of latent pulmonary TB in our asymptomatic adult population. MMR is an effective and cheap method of early detection and should be considered for mass screening of our younger population on a larger scale.

scholarly journals TO ASSESS THE RESPONSE AND OUTCOME OF THE TB PATIENTS REGISTERED AT DTC REWA OF CENTRAL INDIA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Anjana Niranjan ◽  
Sanjeev Sharma ◽  
Rohit Trivedi ◽  
Pahram Adhikari ◽  
Achala Jain ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Conversion Rate ◽  
The Body ◽  
Treatment Result ◽  
Sputum Smear ◽  
Prospective Longitudinal Study ◽  
Pulmonary Tb ◽  
Sputum Conversion ◽  
Extra Pulmonary ◽  
Prospective Longitudinal

Background-Tuberculosis is a highly infectious disease caused by Mycobacterium tuberculosis. The disease primarily affects lungs so it known as Pulmonary TB and other tissues of the body which is known as Extra-pulmonary TB. The vast majority of TB deaths are in the developing world left untreated, Tuberculosis is treatable with a course of antibiotics. The most successful strategy to treat TB patients is DOTS. Material and Method: This is a Prospective Longitudinal  study conducted  among the patients attending DOTS center of DTC located at S.G.M.H. campus  Rewa for the Treatment  provided under of a definitive time period ( as per RNTCP, last quarter of 2014) from 1st Oct to 31st Dec 2014. Aim & Objective:  1. To observe the sputum conversion rate of study population. 2. To find out the outcome of treatment. Result: 69.92%were pulmonary tuberculosis and 30.07% was Extra-pulmonary tuberculosis and sputum conversion rate of Pulmonary TB cases at the end of IP in new sputum smear positive cases was 96.66% but at the end of 5 month it was 100%. In retreatment cases Sputum Conversion rate at the end of IP was 89.28% and at the end of 5 month 92.85%.and overall treatment success rate were 90.97%.  Conclusion: At the end of treatment as per DOTS schedules sputum smear examination is mandatory to know the exact treatment cure rate.  Key words: Pulmonary, Extra-Pulmonary, Sputum Conversion, cured, Treatment completed, Defaulter etc.

scholarly journals A systematic review of endpoint definitions in late phase pulmonary tuberculosis therapeutic trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. K. Hills ◽  
J. Lyimo ◽  
P. Nahid ◽  
R. M. Savic ◽  
C. Lienhardt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Tuberculosis ◽  
Late Phase ◽  
Outcome Data ◽  
Binary Outcomes ◽  
Clinical Trial Registry ◽  
Pulmonary Tb ◽  
Therapeutic Trials ◽  
Broad Consensus

Abstract Background Safe, more efficacious treatments are needed to address the considerable morbidity and mortality associated with pulmonary tuberculosis (TB). However, the current practice in TB therapeutics trials is to use composite binary outcomes, which in the absence of standardization may inflate false positive and negative errors in evaluating regimens. The lack of standardization of outcomes is a barrier to the identification of highly efficacious regimens and the introduction of innovative methodologies Methods We conducted a systematic review of trials designed to advance new pulmonary TB drugs or regimens for regulatory approval and inform practice guidelines. Trials were primarily identified from the WHO International Clinical Trial Registry Platform (ICTRP). Only trials that collected post-treatment follow-up data and enrolled at least 100 patients were included. Protocols and Statistical Analysis Plans (SAP) for eligible trials from 1995 to the present were obtained from trial investigators. Details of outcome data, both explicit and implied, were abstracted and organized into three broad categories: favorable, unfavorable, and not assessable. Within these categories, individual trial definitions were recorded and collated, and areas of broad consensus and disagreement were identified and described. Results From 2205 trials in any way related to TB, 51 were selected for protocol and SAP review, from which 31 were both eligible and had accessible documentation. Within the three designated categories, we found broad consensus in the definitions of favorable and unfavorable outcomes, although specific details were not always provided, and when explicitly addressed, were heterogeneous. Favorable outcomes were handled the most consistently but were widely variable with respect to specification. In some cases, the same events were defined differently by different protocols, particularly in distinguishing unfavorable from not assessable events. Death was often interpreted as conditional on cause. Patients who did not complete the study because of withdrawal or loss to follow-up presented a particular challenge to consistent interpretation and analytic treatment of outcomes. Conclusions In a review of 31 clinical trials, we found that outcome definitions were heterogeneous, highlighting the need to establish clearer specification and a move towards universal standardization of outcomes across pulmonary TB trials. The ICH E9 (R1) addendum provides guidelines for undertaking and achieving this goal. PROSPERO registration PROSPERO CRD42020197993. Registration 11 August 2020.

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