scholarly journals A Perspective on the Success and Failure of BCG

2021 ◽  
Vol 12 ◽  
Author(s):  
Pawan Kumar
Keyword(s):  
Public Health ◽  
Immune Response ◽  
Protective Efficacy ◽  
Repeated Administration ◽  
Additional Benefit ◽  
Significant Protection ◽  
Pulmonary Tb ◽  
Childhood Disease ◽  
Environmental Mycobacteria ◽  
Childhood Tb

TB continues to be one of the major public health threats. BCG is the only available vaccine against TB and confers significant protection against the childhood disease. However, the protective efficacy of BCG against adult pulmonary TB, which represents a larger burden of disease, is highly variable. It has been suggested that prior exposure to environmental mycobacteria (EMb) mitigates the anti-TB efficacy of BCG by blocking its duplication or masking its immunogenicity. However, its effectiveness against childhood TB and failure of repeated administration to provide additional benefit against pulmonary TB, suggest of some other mechanisms for the variable efficacy of BCG against the pulmonary disease. Importantly, TB is a heterogeneous disease occurring in different forms and having distinct mechanisms of pathogenesis. While inability of the immune system to contain the bacilli is responsible for TB pathogenesis in infants, an aggravated immune response to Mtb has been blamed for the development of adult pulmonary TB. Available data suggest that EMb play a key role in heightening the immune response against Mtb. In this article, differential efficacy of BCG against childhood and adult TB is explained by taking into account the heterogeneity of TB, mechanisms of TB pathogenesis, and the effect of EMb on anti-Mtb immunity. It is believed that a refined understanding of the success and failure of BCG will help in the development of effective anti-TB vaccines.

Faktor-Faktor yang Berhubungan dengan Pemberian Dukungan Keluarga Penderita TB Paru

2019 ◽  
Vol 4 (2) ◽  
pp. 235
Author(s):  
Dian Sari
Keyword(s):  
Public Health ◽  
Random Sampling ◽  
Health Centre ◽  
Negative Attitude ◽  
Simple Random Sampling ◽  
Chi Square ◽  
Cross Sectional ◽  
Public Health Centre ◽  
Pulmonary Tb ◽  
Knowledge And Attitude

<p><em>Pulmonary Tuberculosis is one of the infectious diseases that become the main problem of Indonesian society. Based on a survey conducted at Andalas Public Health Centre obtained PMO (supervisor taking medicine) TB Lungless provide support to the patient of Pulmonary TB.. This study aims to determine the relationship of knowledge and attitude with the support of family as the PMO of Pulmonary TB patients. The study was conducted at the Andalas Public Health Centre Padang in 2017. The type of descriptive analytic research using a cross-sectional approach with a sample of 59 people taken from a population of 145 people PMO using simple random sampling systematic techniques. The results showed that 27.1% of PMO was not good at providing support, 32.2% knowledge was low, and 37.3% had a negative attitude. Chi-square test concluded that there is a significant correlation between knowledge (p = 0,036), and attitude (p = 0,000), with family support as PMO in Public health centre working area Andalas Padang of the year 2017. The result of this research can be used as a reference in improving TB program Lung so it can reduce the incidence of Pulmonary TB in Public health centre working area Andalas Padang.</em><em></em></p><p> </p><p><em>Tuberkulosis Paru merupakan salah satu penyakit menular yang menjadi masalah utama masyarakat Indonesia. Berdasarkan survei yang dilakukan di Puskesmas Andalas Kota Padang didapatkan sebahagian PMO (pengawas minum obat) TB Paru kurang memberikan dukungan kepada penderita TB Paru. Penelitian ini bertujuan untuk mengetahui hubungan pengetahuan dan sikap dengan dukungan keluarga sebagai PMO penderita TB Paru.Penelitian dilakukan di Wilayah Kerja Puskesmas Andalas Padang Tahun 2017. Jenis penelitian deskriptif analitik dengan menggunakan pendekatan cross sectionaldengan sampel sebanyak 59 orang yang diambil dari populasi 145 orang PMO menggunakan teknik sistematik simple random sampling. Hasil penelitian menunjukkan 27,1% PMO kurang baik dalam memberikan dukungan, 32,2% pengetahuan rendah, dan 37,3% mempunyai sikap negatif. Uji chi-square disimpulkan bahwa terdapat hubungan yang signifikan antara pengetahuan (p= 0,036), dan sikap (p=0,000), dengan dukungan keluarga sebagai PMO di Wilayah kerja Puskesmas Andalas Padang Tahun 2017. Hasil penelitian ini dapat dijadikan referensi dalam meningkatkan program TB Paru sehingga dapat menurunkan angka kejadian TB Paru di Wilayah Kerja Puskesmas Andalas Padang</em></p>

scholarly journals Randomized, Blinded, Dose-Ranging Trial of an Ebola Virus Glycoprotein Nanoparticle Vaccine With Matrix-M Adjuvant in Healthy Adults

2019 ◽  
Vol 222 (4) ◽  
pp. 572-582 ◽  
Author(s):  
Louis Fries ◽  
Iksung Cho ◽  
Verena Krähling ◽  
Sarah K Fehling ◽  
Thomas Strecker ◽  
...  
Keyword(s):  
Public Health ◽  
Immune Response ◽  
Ebola Virus ◽  
Vaccine Development ◽  
Phase 1 ◽  
Healthy Adults ◽  
Wild Type ◽  
Dose Ranging ◽  
Further Development ◽  
Human Vaccine

Abstract Background Ebola virus (EBOV) epidemics pose a major public health risk. There currently is no licensed human vaccine against EBOV. The safety and immunogenicity of a recombinant EBOV glycoprotein (GP) nanoparticle vaccine formulated with or without Matrix-M adjuvant were evaluated to support vaccine development. Methods A phase 1, placebo-controlled, dose-escalation trial was conducted in 230 healthy adults to evaluate 4 EBOV GP antigen doses as single- or 2-dose regimens with or without adjuvant. Safety and immunogenicity were assessed through 1-year postdosing. Results All EBOV GP vaccine formulations were well tolerated. Receipt of 2 doses of EBOV GP with adjuvant showed a rapid increase in anti-EBOV GP immunoglobulin G titers with peak titers observed on Day 35 representing 498- to 754-fold increases from baseline; no evidence of an antigen dose response was observed. Serum EBOV-neutralizing and binding antibodies using wild-type Zaire EBOV (ZEBOV) or pseudovirion assays were 3- to 9-fold higher among recipients of 2-dose EBOV GP with adjuvant, compared with placebo on Day 35, which persisted through 1 year. Conclusions Ebola virus GP vaccine with Matrix-M adjuvant is well tolerated and elicits a robust and persistent immune response. These data suggest that further development of this candidate vaccine for prevention of EBOV disease is warranted.

scholarly journals Diabetes mellitus: an important risk factor for reactivation of tuberculosis

2016 ◽  
Vol 2016 ◽  
Author(s):  
Ernesto Solá ◽  
Carmen Rivera ◽  
Michelle Mangual ◽  
José Martinez ◽  
Kelvin Rivera ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Risk Factor ◽  
Pulmonary Tuberculosis ◽  
Important Risk Factor ◽  
World Population ◽  
Lung Field ◽  
List Type ◽  
Global Public Health ◽  
Pulmonary Tb

Summary Diabetes mellitus was identified as a risk factor for developing tuberculosis (TB) infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3× times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR), with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace. Learning points Diabetes mellitus should be considered an important risk factor for the reactivation of pulmonary tuberculosis. High clinical suspicious should be taken into consideration as radiological findings for pulmonary tuberculosis in patients with diabetes mellitus may be atypical, involving middle and lower lobes. Inability to recognize pulmonary tuberculosis will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.

The Relationship between Smoking Behavior and the Incidence of Tuberculosis at the Medan Sunggal Public Health Center

2021 ◽  
Vol 2 (1) ◽  
pp. 97-104
Author(s):  
Andre Christian Ginting ◽  
Andrico Napolin Lumbantobing
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Pulmonary Tuberculosis ◽  
Health Center ◽  
Smoking Behavior ◽  
Sources Of Information ◽  
Limit Values ◽  
Pulmonary Tb ◽  
Public Health Center ◽  
The Relationship

A B S T R A C TIntroduction Tuberculosis is an infectious disease caused by bacteria in the form ofrods (bacilli) known as Mycobacterium tuberculosis. This disease is included as achronic infectious disease. The causes of the increase in TB cases each year are stillvarious. One of them is smoking behavior. A person who smokes will have twice therisk of contracting TB. This study aims to determine the relationship between smokingbehavior and the incidence of pulmonary tuberculosis in the work area of the MedanSunggal Puskesmas in 2019. Methods This study is an analytical study with a crosssectional design. The population of this study were patients with pulmonary TB in thework area of the Medan Sunggal Public Health Center in 2019. The sample size usedwas 104 people who had met the inclusion and exclusion criteria. In the second study,the data collection tool was through the Puskesmas medical records. Data analysis wasperformed using the statistical test is chi square. Results the result showed that therewas a relationship between smoking behavior and the incidence of pulmonarytuberculosis in Medan Sunggal Public Health Center with an OR (95% CI) value of105,125 (13,280-832,161), which means that respondents who smoke will have105,125 times the risk of suffering from pulmonary tuberculosis compared to non-smoking respondents. From the results of 95% CI, it can be seen that the lower limitand upper limit values (CI values) not include 1.00, so the results of the study arestatistically significant at the value of α = 0.001. Conclusion. Smoking behavior hasan insignificant relationship with the incidence of pulmonary tuberculosis at MedanSunggal Puskesmas in 2019. It is recommended that the primary care should providesupport and sources of information about smoking habits, especially for patients whohave been diagnosed with pulmonary TB.

scholarly journals Systematic evaluation of Mycobacterium tuberculosis proteins for antigenic properties identifies Rv1485 and Rv1705c as potential protective subunit vaccine candidates

2020 ◽  
pp. IAI.00585-20
Author(s):  
Yaguo Wang ◽  
Zihui Li ◽  
Shucai Wu ◽  
Joy Fleming ◽  
Chuanyou Li ◽  
...  
Keyword(s):  
Immune Response ◽  
Mycobacterium Tuberculosis ◽  
Mononuclear Cells ◽  
Protective Efficacy ◽  
Age Groups ◽  
Infectious Agent ◽  
Systematic Evaluation ◽  
Limiting Factor ◽  
Peripheral Blood Mononuclear ◽  
Antigenic Properties

Lack of efficacious vaccines against Mycobacterium tuberculosis (MTB) infection is a limiting factor in the prevention and control of tuberculosis (TB), the leading cause of death from an infectious agent. Improvement or replacement of the BCG vaccine with one that reliably protects all age-groups is urgent. Concerns exist that antigens currently being evaluated are too homogeneous. To identify new protective antigens, we screened 1781 proteins from a high-throughput proteome-wide protein purification study for antigenic activity. Forty-nine antigens (34 previously unreported) induced antigen-specific IFN-γ release from peripheral blood mononuclear cells (PBMCs) derived from 4452 TB and suspected TB patients and 167 healthy donors. Three (Rv1485, Rv1705c and Rv1802) of the 20 antigens evaluated in a BALB/c mouse challenge model showed protective efficacy, reducing lung CFU counts by 66.2%, 75.8%, and 60%, respectively. Evaluation of IgG2a:IgG1 ratios and cytokine release indicated that Rv1485 and Rv1705c induce a protective Th1 immune response. Epitope analysis of PE/PPE protein Rv1705c, the strongest candidate, identified a dominant epitope in its extreme N-terminal domain accounting for 90% of its immune response. Systematic pre-clinical assessment of antigens Rv1485 and Rv1705c is warranted.

scholarly journals Declining Trends in Childhood TB Notifications and Profile of Notified Patients in the City of Harare, Zimbabwe, from 2009 to 2018

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Phoebe Nzombe ◽  
Srinath Satyanarayana ◽  
Hannock Tweya ◽  
Collins Timire ◽  
Kelvin Charambira ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Scale Up ◽  
Preventive Therapy ◽  
Hiv Positive ◽  
Drug Resistant ◽  
Pulmonary Tb ◽  
Childhood Tb ◽  
Clinical Profiles ◽  
The City

Globally, childhood tuberculosis (TB among those aged <15 years) is a neglected component of national TB programmes in high TB burden countries. Zimbabwe, a country in southern Africa, is a high burden country for TB, TB-HIV, and drug-resistant TB. In this study, we assessed trends in annual childhood TB notifications in Harare (the capital of Zimbabwe) from 2009 to 2018 and the demographic, clinical profiles, and treatment outcomes of childhood TB patients notified from 2015–2017 by reviewing the national TB programme records and reports. Overall, there was a decline in the total number of TB patients (all ages) from 5,943 in 2009 to 2,831 in 2018. However, the number of childhood TB patients had declined exponentially 6-fold from 583 patients (117 per 100,000 children) in 2009 to 107 patients (18 per 100,000 children) in 2018. Of the 615 childhood TB patients notified between 2015 and 2017, 556 (89%) patient records were available. There were 53% males, 61% were aged <5 years, 92% were new TB patients, 85% had pulmonary TB, and 89% were treated for-drug sensitive TB, 3% for drug-resistant TB, and 40% were HIV positive (of whom 59% were on ART). Although 58% had successful treatment outcomes, the treatment outcomes of 40% were unknown (not recorded or not evaluated), indicating severe gaps in TB care. The disproportionate decline in childhood TB notifications could be due to the reduction in the TB burden among HIV positive individuals from the scale up of antiretroviral therapy and isoniazid preventive therapy. However, the country is experiencing economic challenges which could also contribute to the disproportionate decline in childhood TB notification and gaps in quality of care. There is an urgent need to understand the reasons for the declining trends and the gaps in care.

scholarly journals Comparative Evaluation of T-Cell Immune Response to BTV Infection in Sheep Vaccinated with Pentavalent BTV Vaccine When Compared to Un-Vaccinated Animals

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Molalegne Bitew ◽  
Chintu Ravishankar ◽  
Soumendu Chakravarti ◽  
Gaurav Kumar Sharma ◽  
Sukdeb Nandi
Keyword(s):  
Immune Response ◽  
T Cells ◽  
T Cell ◽  
Protective Efficacy ◽  
Cell Immune Response ◽  
Respective Group ◽  
Cytokine Induction ◽  
Cell Mediated Immune Response ◽  
Significant Difference ◽  
The Mean

Recent invasion of multiple bluetongue virus serotypes (BTV) in different regions of the world necessitates urgent development of efficient vaccine that is directed against multiple BTV serotypes. In this experimental study, cell mediated immune response and protective efficacy of binary ethylenimine (BEI) inactivated Montanide™ ISA 206 adjuvanted pentavalent (BTV-1, 2, 10, 16 and 23) vaccine was evaluated in sheep and direct challenge with homologous BTV serotypes in their respective group. Significant (P<0.05) up-regulation of mRNA transcripts of IFN-α, IL-2, IL-6, IL-12, IFN-γ and TNF-α in PBMCs of vaccinated animals as compared to control (un-vaccinated) animals at certain time points was observed. On the other hand, there was a significant increase in mean ± SD percentage of CD8+ T cells after 7 days post challenge (DPC) but, the mean ± SD percentage of CD4+ T-cell population slightly declined at 7 DPC and enhanced after 14 DPC. Significant differences (P<0.05) of CD8+ and CD4+ T cells population was also observed between vaccinated and unvaccinated sheep. The vaccine also significantly (P<0.05) reduced BTV RNA load in PBMCs of vaccinated animals than unvaccinated animals following challenge. There were no significant difference (P>0.05) in cytokine induction, BTV RNA load and CD8+ and CD4+ cell count among BTV-1, 2, 10, 16 and 23 serotype challenges except significant increase in mean ± SD percentage of CD8+ in BTV-2 group. These findings put forwarded that binary ethylenimine inactivated montanide adjuvanted pentavalent bluetongue vaccine has stimulated cell mediated immune response and most importantly reduced the severity of BTV-1, 2, 10, 16 and 23 infections following challenge in respective group.

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