Tuberculosis among individuals with community-acquired pneumonia presenting to emergency in Gaborone, Botswana

Delays in diagnosing Tuberculosis (TB) are associated with increased transmission. TB may present as a clinical syndrome that mimics community-acquired pneumonia (CAP). The aim of this paper was to determine frequency of TB among patients with CAP at a referral hospital in Gaborone, Botswana. We performed a retrospective study of adults presenting with CAP from April 2010-October 2011 to the Emergency Department (ED); we matched this cohort to the National Botswana Tuberculosis Registry (NBTR) to identify individuals subsequently diagnosed with TB. We assessed demographics, time to TB diagnosis, clinical outcomes and performed logistic regressions to identify factors associated with TB diagnosis. We identified 1305 individuals presenting with CAP; TB was subsequently diagnosed in 68 (5.2%). The median time to TB diagnosis was 9.5 days. Forty percent were AFB sputum smear positive and 87% were identified as being HIV-positive. Subsequent diagnosis of TB is common among individuals with CAP at our ED, suggesting that TB may be present at the time of CAP presentation. Given the lack of distinguishing clinical factors between pulmonary TB and CAP, adults presenting with CAP should be evaluated for active TB in Botswana.

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Factors Associated with Unsuccessful Treatment of Tuberculosis in Arsi-Robe Hospital, Arsi Zone, Ethiopia: A Retrospective Study

10.21203/rs.3.rs-151177/v1 ◽

2021 ◽

Author(s):

Addisu Assefa ◽

Ararsa Girma ◽

Helmut Kloos

Keyword(s):

Treatment Outcome ◽

Retrospective Study ◽

Rural Areas ◽

Urban Areas ◽

Treatment Success ◽

Hiv Positive ◽

Multivariable Logistic Regression Analysis ◽

Eastern Ethiopia ◽

Factors Associated ◽

Unsuccessful Treatment

Abstract Background: Tuberculosis remains a major global health problem and ranks along with the human immunodeficiency virus (HIV) as a leading cause of mortality worldwide. The aim of this study was to investigate the treatment outcome of tuberculosis, and factors associated with treatment outcome of tuberculosis in TB patients enrolled in Arsi-Robe Hospital, Oromia regional state, South eastern Ethiopia between January 2013 to December 2017. Methods: An Institutional-based retrospective study was conducted in Arsi-Robe Hospital from 2013 to 2017 in study patients who had all forms of TB in DOTS clinic. The predictors of treatment outcomes were analyzed through bivariate and multivariable logistic regression analysis and a P-value < 0.05 were considered statistically significant. Results: Out of the 257 registered TB patients, most of them were males (57.9%), from rural areas (62.6%) and in age of 15-24 category (39.3%). PTB-, PTB+ and EPTB were recorded in 48.2%, 32% and 19.8% of the patients, respectively. Among all cases, 8.6% had TB-HIV co-infection. Among all TB cases, 84.0% had successful treatment outcome. TB patients from urban areas (AOR: 3.34, 95% CI: 1.338.38, P = 0.01), with failure treatment (AOR: 6.66, 95% CI = 1.12- 39.57; P = 0.037) and HIV positive (AOR: 4.92, 95% CI = 1.38-17.51; P = 0.014) had higher odd of unsuccessful treatment outcome of tuberculosis. However, TB patients with PTB+ (AOR: 0.1470, 95% CI = 0.031-0.687; P = 0.015) and EPTB (AOR: 0.194, 95% CI = 0.054-0.688; P = 0.011) had significantly lesser odd of unsuccessful treatment outcome. Conclusions: Being urban resident, treatment failure and HIV positive considerably challenge the treatment outcome of tuberculosis, but being PTB+ and EPTB were associated with higher treatment success rate of TB. Continuous follow-up of patients with unsuccessful treatment outcome of tuberculosis with strengthened implementation of the DOTs strategies are suggested. Trial Registered: retrospectively registered

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Clinical Factors Associated with a Shorter or Longer Course of Antibiotic Treatment in Patients with Exacerbations of Bronchiectasis: A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm8111950 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1950

Author(s):

Giulia Scioscia ◽

Rosanel Amaro ◽

Victoria Alcaraz-Serrano ◽

Albert Gabarrús ◽

Patricia Oscanoa ◽

...

Keyword(s):

Antibiotic Therapy ◽

Antibiotic Treatment ◽

Prospective Observational Study ◽

Antibiotic Use ◽

Community Acquired Pneumonia ◽

Clinical Factors ◽

Treatment Results ◽

Factors Associated ◽

Long Term Oxygen Therapy

Background: Bronchiectasis exacerbations are often treated with prolonged antibiotic use, even though there is limited evidence for this approach. We therefore aimed to investigate the baseline clinical and microbiological findings associated with long courses of antibiotic treatment in exacerbated bronchiectasis patients. Methods: This was a bi-centric prospective observational study of bronchiectasis exacerbated adults. We compared groups receiving short (≤14 days) and long (15–21 days) courses of antibiotic treatment. Results: We enrolled 191 patients (mean age 72 (63, 79) years; 108 (56.5%) females), of whom 132 (69%) and 59 (31%) received short and long courses of antibiotics, respectively. Multivariable logistic regression of the baseline variables showed that long-term oxygen therapy (LTOT), moderate–severe exacerbations, and microbiological isolation of Pseudomonas aeruginosa were associated with long courses of antibiotic therapy. When we excluded patients with a diagnosis of community-acquired pneumonia (n = 49), in the model we found that an etiology of P. aeruginosa remained as factor associated with longer antibiotic treatment, with a moderate and a severe FACED score and the presence of arrhythmia as comorbidity at baseline. Conclusions: Decisions about the duration of antibiotic therapy should be guided by clinical and microbiological assessments of patients with infective exacerbations.

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Clinical factors associated with syphilis concordance in men in sexual partnerships: a cross-sectional couples study

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053297 ◽

2017 ◽

Vol 94 (8) ◽

pp. 571-573 ◽

Cited By ~ 1

Author(s):

Janet M Towns ◽

Sarah Huffam ◽

Eric P F Chow ◽

Ian Denham ◽

Lei Zhang ◽

...

Keyword(s):

Health Centre ◽

Secondary Syphilis ◽

Sexual Partners ◽

Concordance Rate ◽

Hiv Positive ◽

Clinical Factors ◽

Syphilis Infection ◽

Factors Associated ◽

Early Syphilis ◽

Male Sexual Partners

BackgroundSyphilis infections continue to increase among men who have sex with men (MSM) in many countries, with rates often higher among HIV-positive MSM. There is limited understanding of the risk and determinants of syphilis transmission between men. We aimed to examine the concordance of early syphilis infection between male sexual partners and clinical factors associated with transmission.MethodsMen attending Melbourne Sexual Health Centre with their male partners, where at least one was diagnosed with early syphilis, were identified from linkage of partner records between March 2011 and April 2016. Early latent syphilis was defined as a new asymptomatic syphilis presentation of less than 2 years’ duration. Associations between concordance and potential risk factors were examined using Fisher’s exact test.ResultsAmong 43 couples (86 men) identified, there were 13 couples (26 men) where both were diagnosed with early syphilis, representing a concordance rate of 30.2% (95% CI 17.2% to 46.1%). Among the 13 concordant couples, 5 men had primary syphilis (4 penile, 1 anal), 11 secondary syphilis (8 generalised rash, 3 penile, 2 anal, 1 oral lesion) and 10 early latent infections. Concordance was higher among couples where at least one partner had secondary syphilis compared with couples where neither partner had secondary syphilis (53% (9/17) vs 15% (4/26), P=0.016). Furthermore, concordance was higher among couples where one was HIV positive compared with couples where both were HIV negative (62% (5/8) vs 23% (8/35), P=0.042).ConclusionsThere was an overall concordance rate of 30%. Higher concordance rates for early syphilis infection between male sexual partners were associated with HIV and secondary syphilis.

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Factors Associated with Unfavourable Treatment Outcomes in Patients with Tuberculosis: A 16-Year Cohort Study (2005–2020), Republic of Karakalpakstan, Uzbekistan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312827 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12827

Author(s):

Jamshid Gadoev ◽

Damin Asadov ◽

Anthony D. Harries ◽

Ajay M. V. Kumar ◽

Martin Johan Boeree ◽

...

Keyword(s):

Cohort Study ◽

Treatment Outcomes ◽

Rural Areas ◽

Hiv Positive ◽

Loss To Follow Up ◽

Pulmonary Tb ◽

Public Health Burden ◽

Factors Associated ◽

Disability Pensioner ◽

The Republic

Tuberculosis (TB) remains a public health burden in the Republic of Karakalpakstan, Uzbekistan. This region-wide retrospective cohort study reports the treatment outcomes of patients registered in the TB electronic register and treated with first-line drugs in the TB Programme of the Republic of Karakalpakstan from 2005–2020 and factors associated with unfavourable outcomes. Among 35,122 registered patients, 24,394 (69%) patients were adults, 2339 (7%) were children, 18,032 (51%) were male and 19,774 (68%) lived in rural areas. Of these patients, 29,130 (83%) had pulmonary TB and 7497 (>22%) had been previously treated. There were 7440 (21%) patients who had unfavourable treatment outcomes. Factors associated with unfavourable treatment outcomes included: increasing age, living in certain parts of the republic, disability, pensioner status, unemployment, being HIV-positive, having pulmonary TB, and receiving category II treatment. Factors associated with death included: being adult and elderly, living in certain parts of the republic, having a disability, pensioner status, being HIV-positive, and receiving category II treatment. Factors associated with failure included: being adolescent, female, having pulmonary TB. Factors associated with loss to follow-up included: being male, disability, pensioner status, unemployment, receiving category II treatment. In summary, there are sub-groups of patients who need special attention in order to decrease unfavourable treatment outcomes.

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Clinical Factors Associated With Trabecular Bone Score in Koreans: A Retrospective Study

Annals of Geriatric Medicine and Research ◽

10.4235/agmr.2016.20.4.190 ◽

2016 ◽

Vol 20 (4) ◽

pp. 190-194

Author(s):

Eui Heon Chung ◽

Soon Hang Lee ◽

Jin Hee Kim ◽

Hyung Jun Park ◽

Hye Yeon Min ◽

...

Keyword(s):

Retrospective Study ◽

Trabecular Bone ◽

Trabecular Bone Score ◽

Clinical Factors ◽

Factors Associated

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Factors Associated With the Presence of Tuberculous Empyema in Children With Pleural Tuberculosis

Frontiers in Pediatrics ◽

10.3389/fped.2021.751386 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yan-Hua Wu ◽

Jun-Li Wang ◽

Mao-Shui Wang

Keyword(s):

Multivariate Analysis ◽

Retrospective Study ◽

Surgical Treatment ◽

Low Temperature ◽

Medical Records ◽

Clinical Laboratory ◽

Factors Associated ◽

Pleural Tuberculosis ◽

Logistic Regressions ◽

Age And Sex

Background: Until now, the factor of tuberculous empyema (TE) in children with pleural tuberculosis (TB) remains unclear. Therefore, a retrospective study was conducted to assess the factors associated with the presence of TE in children.Methods: Between January 2006 and December 2019, consecutive children patients (≤ 15 years old) with suspected pleural TB were selected for further analysis. Empyema was defined as grossly purulent pleural fluid. The demographic, clinical, laboratory, and radiographic features were collected from the electrical medical records retrospectively. Univariate and multivariate logistic regressions were used to explore the factors associated with the presence of TE in children with pleural TB.Results: A total of 154 children with pleural TB (definite, 123 cases; possible, 31 cases) were included in our study and then were classified as TE (n = 27) and Non-TE (n = 127) groups. Multivariate analysis revealed that surgical treatment (age- and sex-adjusted OR = 92.0, 95% CI: 11.7, 721.3), cavity (age- and sex-adjusted OR = 39.2, 95% CI: 3.2, 476.3), pleural LDH (>941 U/L, age- and sex-adjusted OR = 14.8, 95% CI: 2.4, 90.4), and temperature (>37.2°C, age- and sex-adjusted OR = 0.08, 95% CI: 0.01, 0.53) were associated with the presence of TE in children with pleural TB.Conclusion: Early detection of the presence of TE in children remains a challenge and several characteristics, such as surgical treatment, lung cavitation, high pleural LDH level, and low temperature, were identified as factors of the presence of TE in children with pleural TB. These findings may improve the management of childhood TE.

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