scholarly journals The Effect of KatG S315t M. Tuberculosis Gene Mutation on Conversion Rate of MDR-TB Patients with Shorter-Course Treatment

2020 ◽  
Vol 4 (4) ◽  
pp. 1-7
Author(s):  
Raden Ayu Linda Andriani ◽  
Zen Ahmad
Keyword(s):  
General Hospital ◽  
Gene Mutation ◽  
Conversion Rate ◽  
Sputum Smear ◽  
High Dose ◽  
Katg Gene ◽  
Short Term ◽  
Tb Treatment ◽  
Significant Difference ◽  
Mdr Tb

Background. Resistance to the INH drug is most often caused by a mutation of the KatG S315T M.Tb gene. MDR TB treatment with short-term WHO mixes using high-dose INH drugs is considered less effective in this mutation condition because it causes high resistance to INH. The effectiveness of MDR TB treatment can be seen from the sputum smear conversion rate. This study was aimed to determine the effect of the S315T katG gene mutation on the treatment response of patients with MDR TB who received WHO short-term alloys at Dr Moh Hoesin general hospital, Palembang, Indonesia. Method. This study uses observational analytic with a prospective cohort approach. The study subjects were MDR TB patients at Dr Moh Hoesin general hospital, Palembang, Indonesia, and a PCR-RFLP examination was performed to see the katG gene, followed by sputum smear evaluation at the end of the first and second months of treatment to assess the speed of conversion. Data analysis using SPSS 25 with the chi-square statistical test. Results. The frequency of katG S315T M.Tb gene mutations was 51.85%. The majority of MDR TB sufferers experience rapid conversion (92.59%). 64.29% of the katG S315T gene mutation group experienced sputum smear conversion after one month, 28.57% after two months, and 7.14% after three months of treatment. There was no significant difference in conversion speed in the two groups (p = 0.741). Conclusion. There was no effect of the S315T M.Tb katG gene mutation on the speed of sputum smear conversion of MDR TB patients who received short-term alloy treatment.

scholarly journals The implementation of health istithaah to the pilgrims with tuberculosis: a cross-sectional study in Jakarta, Indonesia

2020 ◽  
Vol 29 (2) ◽  
pp. 198-203
Author(s):  
Ibnu Mas'ud ◽  
Ujainah Zaini Nasir ◽  
Ceva Wicaksono Pitoyo ◽  
Ikhwan Rinaldi
Keyword(s):  
Secondary Data ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Sectional Study ◽  
District Health ◽  
Cross Sectional ◽  
Intensive Phase ◽  
Health Team ◽  
Tb Treatment ◽  
Mdr Tb

BACKGROUND Based on the regulation of the Indonesian Ministry of Health No. 15 of 2016 about health istithaah for the Hajj, patients with tuberculosis (TB) can be categorized into ineligible or temporarily ineligible pilgrims. This study aimed to know the characteristics of pilgrims with TB and determined their level of fitness for fulfilling the health istithaah. METHODS A cross-sectional study of pilgrims from Jakarta who were receiving TB treatment during the Hajj in 2018 was conducted with consecutive sampling. The secondary data was collected from the Hajj Integrated Computer Health System 2018, TB registered form, and six-minute walk test (the fitness level data) conducted by the District Hajj Health Team at district health centers in DKI Jakarta and Pondok Gede before the Hajj embarkation in June–July 2018. The questionnaire to the Indonesian Hajj Health Team during pilgrimage was also included as additional data. RESULTS Thirty-one pilgrims received TB treatment and completed the intensive phase of TB treatment, but 29 pilgrims had no symptoms. Among them, 2 patients had MDR-TB. Most of them were male aged ≥40 years old. Twelve pilgrims with TB have a sufficient fitness. All pilgrims were able to run the pillars of the Hajj. CONCLUSIONS Pilgrims with TB, including MDR-TB, who had completed the intensive phase with a negative sputum smear test were declared eligible for the Hajj with assistance.

scholarly journals The Prevalence of Absolute and Functional Iron Deficiency Anemia in New Cases of Smear-positive Pulmonary Tuberculosis and Their Sputum Conversion Rate at the End of Intensive Tuberculosis Treatment Phase

2020 ◽  
Vol 121 (1) ◽  
pp. 35-41
Author(s):  
Maliheh Metanat ◽  
Mohammad Ali Mashhadi ◽  
Roya Alavi-Naini ◽  
Leli Rezaie-Kahkhaie ◽  
Nahid Sepehri-Rad ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Treatment Phase ◽  
Deficiency Anemia ◽  
Sputum Smear ◽  
Tb Treatment ◽  
Significant Difference ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Sputum Conversion ◽  
Positive Sputum Smear

About one third of the population is infected with tuberculosis (TB). On the other hand, iron deficiency is the most common micronutrient deficiency in the world. A number of studies have documented anemia in patients with TB, however, this study aimed to assess the prevalence of iron deficiency anemia (IDA) in patients with acid-fast bacilli (AFB) sputum smear-positive, and sputum conversion in these two groups of patients with absolute and functional IDA at the end of the second month of anti-TB therapy in Zahedan, Iran. The results of this study revealed that 91 out of 198 (45.9%) sputum positive pulmonary TB patients were anemic, and among those 72 (79.1%) had iron deficiency anemia. The overall prevalence of IDA in this study was 36.3%. In 72 patients with IDA, 54 (75%) had functional while the remainder had absolute IDA 18 (25%). Twenty-one out of 72 (29.2%) of patients with IDA remained sputum positive and among 126 non IDA patients 47 (37.3%) had positive sputum smear at the end of intensive TB treatment phase (p=0.278). Approximately, less than half of patients with tuberculosis had anemia among them 79% had iron deficiency anemia. The frequency of functional IDA was three times more than absolute IDA. There was no statistically significant difference in sputum conversion between two groups of IDA and non-IDA patients after intensive phase of anti-TB therapy.

scholarly journals Monocyte Lymphocyte Ratio, Platelet Lymphocyte Ratio, Neutrophil Lymphocyte Ratio as Prognostic Markers in Patients with Multidrugs Resistant Tuberculosis Treated at Ulin General Hospital Banjarmasin

2018 ◽  
Vol 14 (2) ◽  
pp. 165
Author(s):  
Bagus Wicaksono
Keyword(s):  
General Hospital ◽  
Prognostic Biomarker ◽  
Laboratory Evaluation ◽  
Treatment Progress ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb

Abstract: Multi Drugs Resistant Tuberculosis (MDR TB) is tubercolusis with the least resistance to rifampicin and isoniazid. The progresivity and side effects of MDR TB treatment can be monitored through clinical, imaging, and laboratory evaluation. Monocyte Lymphocyte Ratio (MLR), Neutrophil Lymphocyte Ratio (NLR), and Platelet Lymphocyte Ratio (PLR) are the inflammatory markers used as biomarkers of treatment progress in MDR TB. The purpose of this research was to determine the difference of MLR, NLR, and PLR value pre and post MDR TB therapy and to determine the best prognostic biomarker in the evaluation of MDR TB treatment progress at Ulin General Hospital in January-December 2017. This research was an analytic observational study with a cross-sectional design. The sample was 17 patients selected based on the inclusion and exclusion criteria. Results obtained from paired T-tests showed the decreasing of MLR, NLR, PLR value in MDR TB patients receiving TB therapy. PLR had a more role as inflammatory biomarker of MDR TB treatment with p = 0.000, compared to MLR (ρ = 0.01), and NLR ( ρ = 0.006). The conclusion is PLR was significantly the best prognostic biomarker for MDR TB treatment.  Keywords: MDR TB, Monocyte Lymphocyte Ratio, Neutrophil Lymphocyte Ratio, Platelet Lymphocyte Ratio

scholarly journals Assessment of Neopterin Serum Level for Monitoring Therapy of Patients with Mycobacterium Tuberculosis

2021 ◽  
Vol 13 (3) ◽  
Author(s):  
Shokrollah Salmanzadeh ◽  
Razieh Mombeini ◽  
Seyed Mohammad Alavi ◽  
Morteza Abdullatif Khafaie
Keyword(s):  
Serum Levels ◽  
Response To Treatment ◽  
Sputum Smear ◽  
Major Health Problem ◽  
Tb Treatment ◽  
Monitoring Therapy ◽  
Significant Difference ◽  
The Mean ◽  
First Time

Background: Tuberculosis (TB) is a major health problem worldwide. To date, the standard diagnostic method for TB is still the direct observation of Mycobacterium TB in a sputum smear or culture. Objectives: There is an urgent need for a method to detect the disease in a shorter time with acceptable sensitivity and specificity and help monitor the treatment. Methods: A panel of 34 adults newly diagnosed with smear-positive pulmonary TB was followed during their treatment period of five months. Neopterin (NPT) serum levels were measured three times (before treatment and two and five months after treatment) using the Brahms ELItest Neopterin kit, and the results were analyzed using descriptive and graphical methods. Results: The mean NPT for the first time before treatment was 27.47 ± 20.7 nmol/L. NPT was measured two months after the anti-TB treatment, and the associated mean was 16.97 ± 14.14 nmol/L. At the end of the fifth month, the mean NPT concentration reached 11.3 ± 10.5 nmol/L. The mean serum NPT before treatment had a statistically significant difference with the mean NPT at the end of the second and fifth months of the treatment (P = 0.001). Conclusions: According to the national protocol for treating TB, a sputum smear is still necessary for patients’ follow-up. It seems that the serum NPT level should be measured to monitor response to treatment in patients that, for any reason are not able to give sputum in TB treatment follow-up.

Abstract 12540: High-Dose Statins Reduce the Risk of Contrast-Induced Nephropathy in Patients Undergoing Angiography: Meta-Analysis of 27 Randomized Controlled Trials

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Firas Rabbat ◽  
Shadi Al Halabi ◽  
Mehdi H Shishehbor
Keyword(s):  
Randomized Controlled Trials ◽  
Low Dose ◽  
Random Effect Model ◽  
Controlled Trials ◽  
High Dose ◽  
Short Term ◽  
Contrast Induced Nephropathy ◽  
Coronary Syndrome ◽  
Randomized Controlled ◽  
Significant Difference

Introduction: Contrast-induced nephropathy (CIN) is a common complication of contrast administration during angiography. Short-term high-dose statins have been suggested for the prevention of CIN in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Hypothesis: Multiple randomized controlled trials (RCT) have examined the role of statin in preventing CIN with conflicting results. We expanded on previous meta-analyses by including additional RCTs to provide a better outlook on the efficacy of statins in the prevention of CIN. Methods: We searched Pubmed, Medline, Embase, Cochrane, and conference abstracts for prospective RCTs that compared short-term high-dose statins to low-dose statins or placebo in patients undergoing CAG, PCI, computed tomography angiography, or peripheral angiography. High-dose statin was defined as Atorvastatin 40-80 mg, Simvastatin 40 mg, and Rosuvastatin 10-40 mg. Study quality was assessed using the Jadad score. Heterogeneity of the studies was analyzed by Cochran’s Q statistics. Mantel Haenszel relative risk was calculated using the random effect model. Results: Twenty seven trials (N=9559) were included in the analysis. Eight of the included trials enrolled patients with acute coronary syndrome (ACS) exclusively. High-dose statin was associated with statistically significant reduction in the incidence of CIN (RR=0.56; 95% CI 0.46, 0.69; P<001) compared to low-dose statin or placebo. This protective effect remained significant upon looking on trials that enrolled patients with ACS only (RR=0.40; 95% CI 0.29, 0.56; P<001). Subgroup analysis based on the type of statin showed no significant difference between simvastatin, atorvastatin, or rosuvastatin. No heterogeneity was detected among the studied outcomes (I2=0%). Conclusions: Peri-procedural Short-term high-dose statin administration significantly reduces the incidence of CIN in patients undergoing angiography.

scholarly journals Pharmacokinetics and Drug-Drug Interactions of Lopinavir-Ritonavir Administered with First- and Second-Line Antituberculosis Drugs in HIV-Infected Children Treated for Multidrug-Resistant Tuberculosis

2017 ◽  
Vol 62 (2) ◽  
Author(s):  
Louvina E. van der Laan ◽  
Anthony J. Garcia-Prats ◽  
H. Simon Schaaf ◽  
Tjokosela Tikiso ◽  
Lubbe Wiesner ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Multidrug Resistant ◽  
Inhibitory Effect ◽  
Pharmacokinetic Parameters ◽  
Population Pharmacokinetic ◽  
High Dose ◽  
Large Variability ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb

ABSTRACT Lopinavir-ritonavir forms the backbone of current first-line antiretroviral regimens in young HIV-infected children. As multidrug-resistant (MDR) tuberculosis (TB) frequently occurs in young children in high-burden TB settings, it is important to identify potential interactions between MDR-TB treatment and lopinavir-ritonavir. We describe the pharmacokinetics of and potential drug-drug interactions between lopinavir-ritonavir and drugs routinely used for MDR-TB treatment in HIV-infected children. A combined population pharmacokinetic model was developed to jointly describe the pharmacokinetics of lopinavir and ritonavir in 32 HIV-infected children (16 with MDR-TB receiving treatment with combinations of high-dose isoniazid, pyrazinamide, ethambutol, ethionamide, terizidone, a fluoroquinolone, and amikacin and 16 without TB) who were established on a lopinavir-ritonavir-containing antiretroviral regimen. One-compartment models with first-order absorption and elimination for both lopinavir and ritonavir were combined into an integrated model. The dynamic inhibitory effect of the ritonavir concentration on lopinavir clearance was described using a maximum inhibition model. Even after adjustment for the effect of body weight with allometric scaling, a large variability in lopinavir and ritonavir exposure, together with strong correlations between the pharmacokinetic parameters of lopinavir and ritonavir, was detected. MDR-TB treatment did not have a significant effect on the bioavailability, clearance, or absorption rate constants of lopinavir or ritonavir. Most children (81% of children with MDR-TB, 88% of controls) achieved therapeutic lopinavir trough concentrations (>1 mg/liter). The coadministration of lopinavir-ritonavir with drugs routinely used for the treatment of MDR-TB was found to have no significant effect on the key pharmacokinetic parameters of lopinavir or ritonavir. These findings should be considered in the context of the large interpatient variability found in the present study and the study's modest sample size.

scholarly journals Epidemiology of Drug Resistant Tuberculosis in Samtse General Hospital, Bhutan: A Retrospective Study

2019 ◽  
Vol 17 (1) ◽  
pp. 41-46
Author(s):  
Thinley Dorji
Keyword(s):  
General Hospital ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
High Prevalence ◽  
Mdr Tb

Introduction: Multidrug resistant tuberculosis (MDR-TB) is defined as a case of tuberculosis resistant to rifampicin and isoniazid which are the first line anti tuberculosis drugs. Globally emergences of MDR-TB possess a challenge to TB control. In Bhutan, the proportion of MDR-TB is high at par with the global level. This study will explore the predictors of MDR-TB and the trend at Samtse General Hospital which has high burden of tuberculosis. Methods: This was a retrospective cross sectional study. The data was extracted from TB treatment cards maintained at TB unit of Samtse General Hospital TB from January 2012 to June 2018. Results: The study showed the prevalence of drug resistant to at least one drug at 21% and MDR-TB prevalence at 16%. The patients with previous treatments (AOR: 4.59; 95% CI .03-.18) and patients under the age of 30 years (AOR: 2.7; 95% CI 1.01- 7.42) were significantly associated with MDR-TB. Conclusion: This study shows high prevalence of MDR-TB in Samtse. Better strategies and concrete actions need to be developed to combat the increase of MDR-TB.

scholarly journals Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study

2020 ◽  
Vol 7 (1) ◽  
pp. e000606 ◽  
Author(s):  
Samiksha Ghimire ◽  
Samriddhi Karki ◽  
Bhagwan Maharjan ◽  
Jos G W Kosterink ◽  
Daan J Touw ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Retrospective Chart Review ◽  
Therapeutic Drug ◽  
Sputum Smear ◽  
Success Rates ◽  
Tb Treatment ◽  
Treatment Implementation ◽  
Good Treatment Outcome ◽  
Mdr Tb

ObjectivesThe objectives of this study were to evaluate treatment in patients on current programmatic multidrug-resistant tuberculosis (MDR-TB) regimen and verify eligibility for the 9-month regimen and therapeutic drug monitoring (TDM).MethodsWe performed a retrospective chart review of patients with MDR-TB receiving standardised regimen at the German Nepal TB Project Clinic, Nepal, between 2014 and 2016. Eligibility for the 9-month regimen and indications for TDM were evaluated.ResultsOut of 107 available patients’ medical records, 98 were included. In this centre, the MDR-TB treatment success rates were 69.0% in 2015, 86.6% in 2016 and 86.5% in 2017. The median time to sputum smear conversion was 60 days (60–90 IQR) and culture conversion was 60 days (60–90 IQR). Observed side effects did not impact treatment outcomes. No difference in treatment success rates was observed between patients with predisposing risk factors and those without. Only 49% (36/74) of patients were eligible for the 9-month regimen and 23 patients for TDM according to American Thoracic Society guideline criteria.ConclusionsNepalese patients with MDR-TB on ambulatory care had good treatment outcome after programmatic treatment. Implementation of the new WHO oral MDR-TB treatment regimen may further improve treatment results. The 9-month regimen and TDM should be considered as part of programmatic care.

scholarly journals Pattern of Multi-Drug Resistant Tuberculosis in HIV Sero Positive Patients in Rivers State Nigeria

2020 ◽  
pp. 75-83
Author(s):  
Mary A. Alex- Wele ◽  
Nneka Onyejepu ◽  
Orikomaba K. Obunge
Keyword(s):  
Health Concern ◽  
Drug Resistant ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Hiv Coinfection ◽  
Multi Drug Resistant Tuberculosis ◽  
Significant Difference ◽  
Mdr Tb ◽  
Probe Assay ◽  
Rivers State

Background: Tuberculosis (TB) presents a major worldwide health concern, especially in immune-suppressed persons, with a high mortality rate. The emergence of drug-resistant variants of TB further weighted down by the high HIV prevalence continues to make it difficult to treat this disease. Nigeria is currently listed among the 30 high burden countries for TB, TB/HIV and drug resistant TB (DR-TB). The current study assessed the resistant patterns of Mycobacterium tuberculosis to first-line anti-TB drugs among individuals with tuberculosis and HIV coinfection in Rivers State. Methods: A sample size of 260 HIV sero-positive patients were separated into two groups consisting of 130 patients on anti-TB treatment and 130 individuals yet to commence anti-TB treatment. Sputum samples were collected and processed by line probe assay (GenoType®MTBDRplus by HAIN Lifescience). Results: The study showed that about 61.5% of the subjects with TB/HIV coinfection were between the ages of 26 and 40 years, with a mean age of 37.2 ± 9.6 years, (102) 64.1% of the subjects had drug susceptible TB, 24 (15%) had INH mono-resistant TB, 17 (10.7%) had RIF mono-resistant TB and 16 (10.1%) had multi-drug resistant TB. There was no significant difference observed in the occurrence of drug resistance between the different sexes. The results also showed that 11.0% of the individuals receiving anti-TB treatment had MDR-TB; INH and RIF mono-resistance were observed in 15.7% and 11.8% of these subjects respectively. Amongst subjects that were yet to receive anti-TB treatment, 6.3% had MDR-TB, 12.5% had INH mono-resistant and 6.3% had RIF mono-resistant TB. Conclusion: The findings of the study indicate that drug-resistant TB appears to be prevalent among persons with TB/HIV coinfection in Rivers State, Nigeria.

Sign in / Sign up

Export Citation Format

Share Document