RESUMO
SETTING: Several projects involving accelerated or active case finding (ACF) of tuberculosis (TB) cases are being implemented in Myanmar. However, there is a concern that patients detected using ACF have poorer TB treatment outcomes than those detected using passive case finding (PCF). OBJECTIVE: To assess differences in the demographics, clinical profile and treatment outcomes of patients detected using ACF and PCF. DESIGN: Retrospective cohort study of TB patients diagnosed and enrolled for treatment during 2014-2016. RESULTS: Of 16 048 patients enrolled, 2226 (16%) were detected using ACF; the treatment success rate (cured and completed) was 88%. A higher proportion of cases detected using ACF were aged î¶55 years, human immunodeficiency virus (HIV) negative and sputum smear-positive pulmonary TB. After adjusting for differences in demographic and clinical characteristics, we found that treatment outcomes in patients detected using ACF and PCF were not significantly different (adjusted relative risk [aRR] 0.89, 95%CI 0.78-1.00). Male sex, age î¶ 55 years, patients with a previous history of TB and HIV positivity were independently associated with unsuccessful outcomes. CONCLUSION: ACF detected a significant proportion of TB cases in study townships; treatment outcomes in cases detected using ACF and those detected using PCF were similar. More tailored interventions are needed to improve treatment outcomes in patients at a higher risk of unsuccessful treatment outcomes.
Assuntos
Administração de Caso/organização & administração , Programas de Rastreamento/métodos , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Mianmar/epidemiologia , Estudos Retrospectivos , Escarro/microbiologia , Resultado do Tratamento , Tuberculose/terapia , Adulto JovemRESUMO
Thirty cases of chyluria seen in Rangoon during the years 1968-1973 have been investigated. Blood micro-filaria was positive in only a small number of cases. Renal function was not disturbed and blood eosinophil count was normal. The duration of symptoms varied from 3 months to 10 years. Males and females were equally affected and the disease was much more commonly seen in the 20 and 40 age group. Retrograde pyelography demonstrated pyelolymphatic reflux. Lymphangiograms showed numerous lymphatics in the region of the calves and contrast was often seen in the calyceal system. The thoracic duct was patent in all the cases. Renal lymphatics were opacified in three patients who were investigated by intravenous urography. Para-renal cysts, pressure on the renal pelvis by an enlarged lymph node and dilated lymphatic vessels were associated features.