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1.
Infect Dis Poverty ; 10(1): 131, 2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34742353

RESUMO

BACKGROUND: Tuberculosis (TB) caused Mycobacterium tuberculosis (M.tb) is one of infectious disease that lead a large number of morbidity and mortality all over the world. Although no reliable evidence has been found, it is considered that combining chemotherapeutic drugs with Chinese herbs can significantly improves the cure rate and the clinical therapeutic effect. METHODS: Multi-drug resistant pulmonary tuberculosis (MDR-PTB, n = 258) patients with Qi-yin deficiency syndrome will be randomly assigned into a treatment group (n = 172) or control/placebo group (n = 86). The treatment group will receive the chemotherapeutic drugs combined with Chinese herbs granules (1 + 3 granules), while the control group will receive the chemotherapeutic drugs combined with Chinese herbs placebo (1 + 3 placebo granules). In addition, MDR-PTB (n = 312) patients with Yin deficiency lung heat syndrome will be randomly assigned to a treatment (n = 208) or control/placebo (n = 104) group. The treatment group will receive the chemotherapeutic regimen combined with Chinese herbs granules (2 + 4 granules), while the control group will receive the chemotherapeutic drugs and Chinese herbs placebo (2 + 4 placebo granules). The primary outcome is cure rate, the secondary outcomes included time to sputum culture conversion, lesion absorption rate and cavity closure rate. BACTEC™ MGIT™ automated mycobacterial detection system will be used to evaluate the M.tb infection and drug resistance. Chi-square test and Cox regression will be conducted with SAS 9.4 Statistical software to analyze the data. DISCUSSION: The treatment cycle for MDR-PTB using standardized modern medicine could cause lengthy substantial side effects. Chinese herbs have been used for many years to treat MDR-PTB, but are without high-quality evidence. Hence, it is unknown whether Chinese herbs enhances the clinical therapeutic effect of synthetic drugs for treating MDR-PTB. Therefore, this study will be conducted to evaluate the clinical therapeutic effect of combining Chinese herbs and chemotherapeutic drugs to treat MDR-PTB cases. It will assist in screening new therapeutic drugs and establishing treatment plan that aims to improve the clinical therapeutic effect for MDR-PTB patients. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (ChiCTR1900027720) on 24 November 2019 (prospective registered).


Assuntos
Resistência a Múltiplos Medicamentos , Medicamentos de Ervas Chinesas , Tuberculose Pulmonar , China , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Tuberculose Pulmonar/tratamento farmacológico
2.
Front Immunol ; 12: 656419, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34745081

RESUMO

Tuberculosis (TB) is the global health problem with the second highest number of deaths from a communicable disease after COVID-19. Although TB is curable, poor health infrastructure, long and grueling TB treatments have led to the spread of TB pandemic with alarmingly increasing multidrug-resistant (MDR)-TB prevalence. Alternative host modulating therapies can be employed to improve TB drug efficacies or dampen the exaggerated inflammatory responses to improve lung function. Here, we investigated the adjunct therapy of natural immune-modulatory compound berberine in C57BL/6 mouse model of pulmonary TB. Berberine treatment did not affect Mtb growth in axenic cultures; however, it showed increased bacterial killing in primary murine bone marrow-derived macrophages and human monocyte-derived macrophages. Ad libitum berberine administration was beneficial to the host in combination with rifampicin and isoniazid. Berberine adjunctive treatment resulted in decreased lung pathology with no additive or synergistic effects on bacterial burdens in mice. Lung immune cell flow cytometry analysis showed that adjunctive berberine treatment decreased neutrophil, CD11b+ dendritic cell and recruited interstitial macrophage numbers. Late onset of adjunctive berberine treatment resulted in a similar phenotype with consistently reduced numbers of neutrophils both in lungs and the spleen. Together, our results suggest that berberine can be supplemented as an immunomodulatory agent depending on the disease stage and inflammatory status of the host.


Assuntos
Antituberculosos/uso terapêutico , Berberina/uso terapêutico , Fatores Imunológicos/uso terapêutico , Isoniazida/uso terapêutico , Rifampina/uso terapêutico , Tuberculose Pulmonar/tratamento farmacológico , Animais , Antituberculosos/farmacologia , Berberina/farmacologia , Citocinas/imunologia , Células Dendríticas/efeitos dos fármacos , Quimioterapia Combinada , Feminino , Humanos , Fatores Imunológicos/farmacologia , Isoniazida/farmacologia , Pulmão/efeitos dos fármacos , Pulmão/imunologia , Pulmão/microbiologia , Pulmão/patologia , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Masculino , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/crescimento & desenvolvimento , Neutrófilos/efeitos dos fármacos , Neutrófilos/imunologia , Rifampina/farmacologia , Baço/efeitos dos fármacos , Baço/imunologia , Baço/microbiologia , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia
3.
Zhonghua Jie He He Hu Xi Za Zhi ; 44(11): 939-946, 2021 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-34758519

RESUMO

Objective: To analyze the differences in the composition and abundance of gut microbiota between patients with active pulmonary tuberculosis and healthy controls, and to identify the specific bacteria as biomarkers to distinguish between the two groups. Methods: Patients with active pulmonary tuberculosis treated in three municipal designated tuberculosis medical institutions in Sichuan, Jiangsu and Shanghai from September 2017 to September 2019 were selected as the case group (n=88), and the healthy people without a history of tuberculosis from the same regions were recruited as the control group (n=62). The fecal samples of the two groups were detected by 16S rRNA gene sequencing, and the differences of gut microbiota diversity, community composition and relative abundance at phylum and genus level from the two groups were analyzed. The random forest method was used to construct a predictive model to assess whether the specific bacterial flora could be used as biomarkers to distinguish tuberculosis patients from healthy people. Results: The alpha diversity analysis showed that the species richness and evenness of gut microbiota in tuberculosis patients were significantly lower than those in healthy controls (P<0.001). There was a statistically significant difference in the composition of microbiota between the two groups (Bray-Curtis distance, P<0.001). In the gut microbiota of tuberculosis patients, opportunistic pathogens were relatively enriched, while some of the beneficial bacteria that can produce short-chain fatty acids were less abundant. The discrimination accuracy of the random forest model composed of Lachnospira, Lachnospiraceae ND3007 group and Roseburia was 76.67%, with area under the curve (AUC) being 75.29% (95%CI: 0.661-0.845). Conclusion: There were differences in gut microbiota between patients with active pulmonary tuberculosis and healthy people, and specific bacterial flora showed the potential to be used as biomarkers to distinguish between the two groups.


Assuntos
Microbioma Gastrointestinal , Tuberculose Pulmonar , Biomarcadores , China , Humanos , RNA Ribossômico 16S
4.
J Med Invest ; 68(3.4): 220-227, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34759134

RESUMO

The incidence rate of pulmonary nontuberculous mycobacterial disease (PNTMD) in Japan is the highest among major industrialized nations. Although the typical clinical course and radiological manifestations of PNTMD are different from those of pulmonary tuberculosis (TB), confusion about these mycobacterial diseases leads to a diagnostic pitfall. Diagnostic challenges include the coexistence of Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM), false positives for NTM in MTB nucleic acid amplification tests, microbial substitution, and abnormal radiological manifestations caused by NTM. Features of extrapulmonary NTM diseases, such as pleurisy, vertebral osteomyelitis, and disseminated disease, are different from the corresponding tuberculous diseases. Moreover, the immunological background of the patient (status of human immunodeficiency virus infection with or without antiviral therapy, continuation or discontinuation of immunosuppressive therapy, use of immune checkpoint inhibitor, pregnancy and delivery, etc.) influences the pathophysiology of mycobacterial diseases. This review describes the varying clinical presentations of NTM disease with emphasis on the differences from TB. J. Med. Invest. 68 : 220-227, August, 2021.


Assuntos
Infecções por Mycobacterium não Tuberculosas , Mycobacterium tuberculosis , Tuberculose Pulmonar , Tuberculose , Humanos , Infecções por Mycobacterium não Tuberculosas/diagnóstico por imagem , Micobactérias não Tuberculosas , Tuberculose Pulmonar/diagnóstico por imagem
5.
BMC Infect Dis ; 21(1): 1197, 2021 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-34837990

RESUMO

AIM: This study mainly evaluates the clinical characteristics and chest chest computed tomography (CT) findings of AFB-positive and AFB-negative pulmonary tuberculosis (PTB) patients to explore the relationship between AFB-positive and clinico-radiological findings. METHODS: A retrospective analysis of 224 hospitalized tuberculosis patients from 2018 to 2020 was undertaken. According to the AFB smear results, they were divided into AFB-positive pulmonary tuberculosis (positive by Ziehl-Neelsen staining) and AFB-negative pulmonary tuberculosis and patients' CT results and laboratory test results were analyzed. RESULTS: A total of 224 PTB patients were enrolled. AFB-positive (n = 94, 42%) and AFB-negative (n = 130, 58%). AFB-positive patients had more consolidation (77.7% vs. 53.8%, p < 0.01), cavity (55.3% vs. 34.6%, p < 0.01), calcification (38.3% vs. 20%, p < 0.01), bronchiectasis (7.5% vs. 1.5%, p < 0.05), bronchiarctia (6.4% vs. 0.8%, p < 0.05), and right upper lobe involvement (57.5% vs. 33.1%, p < 0.01), left upper lobe involvement (46.8% vs. 33.1%, p < 0.05) and lymphadenopathy (58.5% vs. 37.7%, p < 0.01). CONCLUSION: The study found that when pulmonary tuberculosis patients have consolidation, cavity, upper lobe involvement and lymphadenopathy on chest CT images, they may have a higher risk of AFB-positive tuberculosis.


Assuntos
Mycobacterium tuberculosis , Tuberculose Pulmonar , Humanos , Pulmão , Estudos Retrospectivos , Escarro , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico por imagem
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(7): 1240-1245, 2021 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814538

RESUMO

Objective: To understand the spatiotemporal distribution of pulmonary tuberculosis (TB) and influencing factors in Beijing from 2008 to 2018. Methods: The incidence data of pulmonary TB in Beijing from 2008 to 2018 were from Tuberculosis Information Management System of Chinese Disease Prevention and Control Information System. Software ArcGIS 10.2 was used to visualize the spatiotemporal distribution of pulmonary TB incidence. Getis's Gi* statistic was applied to analyze the spatial clustering of pulmonary TB incidence at street/township scale. Bayesian spatiotemporal model was applied to analyze factors affecting its spatiotemporal distribution, including urbanization rate, GDP per capita, number of hospital beds per thousand population, permanent migrant population and population density. Results: The reported pulmonary TB incidence showed a downward trend in the past 11 years in Beijing, from 58.64/100 000 to 30.43/100 000. The incidences were higher in Tongzhou, Changping and other newly developed urban districts, with the hot spots concentrated in local areas of these districts. The incidences of pulmonary TB were lower in Dongcheng, Xicheng and other old urban districts-with the cold spots also concentrated in these area. The risk for the incidence of pulmonary TB was associated with the urbanization rate and the permanent migrant population. For every 1% increase in the urbanization rate, the relative risk of pulmonary TB would increase by 1%. For every 10 000 person increase of permanent migrant population, the relative risk of pulmonary TB would increase by 0.6%. Conclusions: In Beijing, the current pulmonary TB prevention and control needs to be focused on the newly developed urban areas. Due to the accelerated process of urbanization, it is necessary to strengthen TB prevention and control in permanent migrant population to reduce the incidence of TB in Beijing.


Assuntos
Tuberculose Pulmonar , Tuberculose , Teorema de Bayes , Pequim , China/epidemiologia , Humanos , Incidência , Análise Espaço-Temporal , Tuberculose Pulmonar/epidemiologia
7.
BMC Infect Dis ; 21(1): 1052, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627188

RESUMO

BACKGROUND: Schizophyllum commune is a basidiomycete that lives in the environment and can cause infections, mainly those of the respiratory system. Although S. commune is increasingly reported as a cause of allergic bronchopulmonary mycosis and sinusitis, cases of fungal ball formation are extremely uncommon. Identification of S. commune is difficult using routine mycological diagnostic methods, and in clinically suspicious cases, internal transcribed spacer sequencing should be used for diagnosis. Here, we report a first case of lung cancer with a fungal ball formation of S. commune, confirmed by analyzing the internal transcribed spacer. CASE PRESENTATION: A 76-year-old man with diabetes and hypertension was admitted to the hospital with a chief complaint of hemosputum, which he had for about 19 months. A computed tomography image of the patient's chest showed a cavity and internal nodule in the left upper lobe of his lung. A left upper lobectomy was performed, and histopathological examination revealed squamous cell carcinoma of the lung and a fungal ball. The isolate from the surgical specimen was identified as S. commune by analyzing the internal transcribed spacer. The patient had no recurrence of the infection during 5 months of follow-up. CONCLUSIONS: Only three cases of lung fungal balls caused by S. commune have been previously reported, and this is the first case of lung cancer cavity with a fungal ball formation. In cases of fungal ball formation in the lung, S. commune should be considered a possible causative microorganism.


Assuntos
Aspergilose Pulmonar Invasiva , Neoplasias Pulmonares , Schizophyllum , Tuberculose Pulmonar , Idoso , Humanos , Masculino , Recidiva Local de Neoplasia , Schizophyllum/genética
8.
BMC Infect Dis ; 21(1): 1091, 2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34688261

RESUMO

BACKGROUND: Pulmonary tuberculosis (PTB) remains the world's deadliest infectious killer. Serum CA-125 test are useful in the diagnosis of PTB. Although studies on the relation between CA-125 and PTB have been reported, the specificity and sensitivity of serum CA-125 in diagnosing PTB vary widely among different studies. The present study was performed to evaluate the accuracy of CA-125 for the diagnosis of PTB via a meta-analysis of data obtained from previous studies. METHODS: English and Chinese medical electronic databases were searched for eligible studies published up to February 2020. STATA software was used to obtain a pooled estimation of the diagnostic accuracy of CA-125 and analyze the heterogeneity of the recruited studies. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of the obtained studies. RESULTS: A total of 16 articles were included in this study. The pooled sensitivity and specificity of CA-125 were 0.85 [95% confidence interval (CI) 0.75-0.91] and 0.87 (95% CI 0.78-0.93), respectively. Moreover, the pooled positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR) of CA-125 were 6.65 (95% CI 3.62-12.20), 0.18 (95% CI 0.10-0.31), and 37.82 (95% CI 13.17-108.60), respectively. The area under the summary receiver operating characteristic curve (AUC) was 0.93. CONCLUSIONS: Taken together, the results indicate that serum CA-125 presents potential practical value for diagnosing PTB, but its clinical applicability must be further examined.


Assuntos
Tuberculose Pulmonar , Humanos , Testes Imunológicos , Razão de Chances , Curva ROC , Sensibilidade e Especificidade , Tuberculose Pulmonar/diagnóstico
9.
Medicine (Baltimore) ; 100(39): e27387, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34596161

RESUMO

RATIONALE: Tuberculosis (TB) is one of the top 10 causes of death worldwide and is the leading infectious cause of death. The incidence of TB, especially active TB, is increased in pregnant and postpartum women. Newborns can be infected with TB from their mothers through several routes. Diagnosis of TB in pregnant women and infants is difficult. Here, we report the simultaneous postdelivery diagnosis of TB in a mother and infant pair. PATIENT CONCERNS: A 28-year-old woman presented with a sudden onset of convulsions, loss of consciousness, coughing, fever, and breathing difficulty. Her 18-day-old infant daughter developed cough and wheezing. DIAGNOSIS: The mother's chest computed tomography showed diffuse interstitial changes and both lungs' exudation. Enhanced cranial magnetic resonance imaging showed scattered nodular intracranial lesions. A tuberculin skin test and an interferon-gamma release assay were negative. Xpert MTB/RIF (Xpert) testing and acid-fast bacilli smear of bronchoalveolar lavage (BAL) fluid of the mother were negative. Loop-mediated isothermal amplification of BAL fluid was positive for Mycobacterium tuberculosis, and next-generation sequencing confirmed the diagnosis of TB. A biopsy specimen also showed characteristic TB findings. The mother was diagnosed with TB and TB encephalitis. The infant's BAL fluid was positive for acid-fast bacilli and Xpert and, therefore, was diagnosed with TB. INTERVENTIONS: The mother was treated with rifampicin and isoniazid for 9 months, ethambutol and pyrazinamide for 3 months, and prednisolone acetate for 8 weeks. The infant received ventilator-assisted ventilation for 10 days and anti-tuberculous therapy for 11 months. OUTCOMES: After anti-tuberculous therapy, the mother and infant both gradually recovered. The mother's chest computed tomography showed significant recovery 9 months after discharge. The infant developed normally during the 11-month follow-up. LESSONS: This mother-child case pair highlights the value of loop-mediated isothermal amplification and next-generation sequencing as new diagnostic technologies for diagnosing TB in patients with multiple negative tests.


Assuntos
Mycobacterium tuberculosis/genética , Tuberculose Pulmonar/diagnóstico , Adulto , Antibióticos Antituberculose/uso terapêutico , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Recém-Nascido , Isoniazida/uso terapêutico , Mycobacterium tuberculosis/isolamento & purificação , Técnicas de Amplificação de Ácido Nucleico , Rifampina/uso terapêutico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia
10.
BMJ Open ; 11(10): e050542, 2021 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-34686553

RESUMO

OBJECTIVE: To determine the prevalence and determinants of diabetes mellitus (DM) among tuberculosis (TB) patients and to assess the additional yield and number needed to screen (NNS) to obtain a newly diagnosed DM among TB patients. DESIGN: We undertook a cross-sectional analysis of the cohort data under Regional Prospective Observational Research for Tuberculosis-India consortium. Newly diagnosed TB patients recruited into the cohort between 2014 and 2018 were included. Pretested standardised questionnaires and tools were used for data collection. Prevalence of DM among TB patients was summarised as proportion with 95% CI. Type II DM was diagnosed if random blood sugar level was >200 mg/dL or if the participant had a documented history of DM. NNS by blood glucose testing to diagnose one new DM case among TB patients was also calculated. SETTING: Three districts of South India: Puducherry, Cuddalore and Villupuram SUBJECTS: Newly diagnosed sputum smear positive pulmonary TB patients aged ≥16 years RESULTS: In total, 1188 TB patients were included. Prevalence of DM among TB patients was 39% (95% CI: 36.2% to 41.8%). In unadjusted analysis, elderly TB, marital status, caste, gender, higher education level, household income and obesity had a significant association with DM. However, in adjusted analysis, only marital status (currently married aPR; 3.77 (95 CI: 2.20 to 6.49), widowed/separated/divorced aPR; 3.66 (95 CI: 1.96 to 6.83)) and body mass index category (normal weight aPR; 3.26 (95 CI: 2.55 to 4.16), overweight aPR; 3.86 (95 CI: 2.69 to 5.52), obesity aPR; 4.08 (95 CI: 2.81 to 5.94)) were found to be significant determinants. The number of TB patients needed to be screened to find a new DM case was 12. CONCLUSION: We found that one in three TB patients had coexisting DM. The number of TB patients needed to be screened to obtain a newly diagnosed DM patients was also determined. The study supports and highlights the need of RNTCP's effort in bidirectional screening of TB and DM.


Assuntos
Diabetes Mellitus , Tuberculose Pulmonar , Tuberculose , Idoso , Estudos Transversais , Diabetes Mellitus/epidemiologia , Humanos , Índia/epidemiologia , Prevalência , Tuberculose/epidemiologia
11.
Int J Tuberc Lung Dis ; 25(11): 911-916, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34686233

RESUMO

BACKGROUND: Recommended by the World Health Organization as an initial diagnostic test for TB in children, Xpert® MTB/RIF is widely implemented in many countries, including Kenya.METHODS: Three hundred HIV-positive and negative children (<5 years) were enrolled in Kisumu County, Kenya, from October 2013 to August 2015. Multiple specimen types were collected from each child and tested using Xpert, liquid culture, and phenotypic drug susceptibility testing (DST). Samples positive for rifampin (RIF) resistance on Xpert were tested using line-probe assay and sequencing.RESULTS: Of 32 children with bacteriologically confirmed TB, 27 had positive Xpert results. Of these, 3/27 (11%, 95% CI 4-28) had RIF resistance detected on Xpert, but not by phenotypic DST, line-probe assay, or sequencing. For these three children, five Xpert tests showed RIF resistance; all five tests had semi-quantitative "very low" results and delay or absence of probe D signal, whereas no Xpert results with higher semi-quantitative results showed RIF resistance. All three children responded well to standard TB treatment.CONCLUSIONS: False RIF resistance may be detected in pediatric specimens. Further study is needed to determine if false RIF resistance is associated with low bacterial load.


Assuntos
Antibióticos Antituberculose , Mycobacterium tuberculosis , Tuberculose Pulmonar , Antibióticos Antituberculose/uso terapêutico , Criança , Farmacorresistência Bacteriana , Humanos , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/genética , Rifampina/farmacologia , Sensibilidade e Especificidade , Tuberculose Pulmonar/tratamento farmacológico
13.
BMC Infect Dis ; 21(1): 1100, 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702208

RESUMO

BACKGROUND: Tuberculosis (TB) is an airborne chronic infectious disease mainly caused by Mycobacterium tuberculosis complex bacteria. Currently, about 1.7 billion (26%) of the world's population are considered to be infected with M. tuberculosis. The risk of acquiring tuberculosis is higher on some segments of societies including people with severe mental illness. As a result, World health organization (WHO) strongly recommends screening for tuberculosis in such risk groups and setting. METHODS: A cross-sectional study was conducted to assess the prevalence of active tuberculosis and associated factors among patients with chronic psychotic disorders admitted at St. Amanuel Mental Specialized Hospital and Gergesenon Mental rehabilitation center from February to June, 2020. All admitted patients were screened for any sign of TB as recommended by WHO. Presumptive TB cases were identified. Sputum samples were collected and tested by Xpert MTB/RIF assay. Data analysis was performed using SPSS version 25.0 statistical software and Chi square analysis was used to test the statistical association. RESULTS: From a total 3600 pschotic patients screened for TB, 250 (6.94%) presumptive tuberculosis cases were detected. From these, 27 (10.8%) were positive by Xpert MTB/RIF assay. Most of the patients were males (68.4%). The mean ± SD age of the participant was 36.5 ± 9.7 years. The overall prevalence of tuberculosis was found to be 750 per 100,000 population. The number of patients per room (p = 0.039) was associated with Xpert MTB/RIF positive active tuberculosis. CONCLUSION: The prevalence of active tuberculosis among chronic psychotic patients was high. Number of admitted patients per room was identified as risk factors for Xpert MTB/RIF positive active tuberculosis. Therefore, to control TB transmission in chronic mental health treatment facilities, efforts should be directed to periodic screening for early case detection and improving the number of patients per room.


Assuntos
Transtornos Mentais , Mycobacterium tuberculosis , Transtornos Psicóticos , Tuberculose Pulmonar , Tuberculose , Adulto , Estudos Transversais , Etiópia/epidemiologia , Hospitais Especializados , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos Psicóticos/epidemiologia , Centros de Reabilitação , Sensibilidade e Especificidade , Escarro , Tuberculose/epidemiologia , Tuberculose Pulmonar/epidemiologia
14.
Western Pac Surveill Response J ; 12(3): 25-33, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34703633

RESUMO

Objective: To determine the characteristics associated with mortality in patients with culture-positive pulmonary tuberculosis (PTB) in Airin, Osaka City, Japan. Methods: The characteristics of patients with culture-positive PTB registered between 2015 and 2018 in Airin, Osaka City, Japan, were compared between those who died of all causes before or during treatment and those who completed treatment. Results: Of the 241 culture-positive PTB patients eligible for this study, 170 completed treatment, with negative sputum culture tests, and 62 died. The all-cause case fatality rate was 26.7% (62/232). Multivariate analysis showed that mortality was associated with age 370 years, having a positive sputum smear, a body mass index of < 18.5 and serious comorbidities such as cancer and heart and renal disease. Detection of tuberculosis (TB) by screening or in an outpatient department (OPD) for other diseases was inversely associated with mortality. Discussion: Detection of PTB by chest X-ray screening and during regular visits to OPDs for other diseases was associated with non-fatal TB and might contribute to early case finding. Therefore, current active TB case finding and health education on regular visits to physicians for other diseases should be strengthened further for the urban poor population of Osaka City, Japan.


Assuntos
Tuberculose Pulmonar , Tuberculose , Idoso , Humanos , Japão/epidemiologia , Programas de Rastreamento , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , População Urbana
16.
PLoS One ; 16(10): e0259006, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34673822

RESUMO

OBJECTIVE: The proportion of COVID-19 patients having active pulmonary tuberculosis, and its impact on COVID-19 related patient outcomes, is not clear. We conducted this systematic review to evaluate the proportion of patients with active pulmonary tuberculosis among COVID-19 patients, and to assess if comorbid pulmonary tuberculosis worsens clinical outcomes in these patients. METHODS: We queried the PubMed and Embase databases for studies providing data on (a) proportion of COVID-19 patients with active pulmonary tuberculosis or (b) severe disease, hospitalization, or mortality among COVID-19 patients with and without active pulmonary tuberculosis. We calculated the proportion of tuberculosis patients, and the relative risk (RR) for each reported outcome of interest. We used random-effects models to summarize our data. RESULTS: We retrieved 3,375 citations, and included 43 studies, in our review. The pooled estimate for proportion of active pulmonary tuberculosis was 1.07% (95% CI 0.81%-1.36%). COVID-19 patients with tuberculosis had a higher risk of mortality (summary RR 1.93, 95% CI 1.56-2.39, from 17 studies) and for severe COVID-19 disease (summary RR 1.46, 95% CI 1.05-2.02, from 20 studies), but not for hospitalization (summary RR 1.86, 95% CI 0.91-3.81, from four studies), as compared to COVID-19 patients without tuberculosis. CONCLUSION: Active pulmonary tuberculosis is relatively common among COVID-19 patients and increases the risk of severe COVID-19 and COVID-19-related mortality.


Assuntos
COVID-19/mortalidade , Hospitalização , SARS-CoV-2 , Tuberculose Pulmonar/mortalidade , Humanos , Fatores de Risco , Tuberculose Pulmonar/virologia
17.
BMJ Open ; 11(10): e047986, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702728

RESUMO

BACKGROUND: Unrecognised transmission of tuberculosis is a main contributor of high epidemic of tuberculosis in low-income countries. Studies done in Ethiopia showed that delay in tuberculosis diagnosis and treatment is one of the major challenges to tuberculosis control programmes in the country. This study assessed factors which predict health system diagnostic delay of new pulmonary tuberculosis in Gurage and Siltie zones, South Ethiopia. METHODS: A health facility-based cross-sectional study was conducted among 204 adult patients with new pulmonary tuberculosis in Gurage and Siltie zones. Consecutive sampling technique was used to recruit participants. Data were collected by using a structured and pretested Amharic questionnaire. Data were entered into Epi-info V.7, processed and analysed by SPSS V.20. Health system diagnostic delay was dichotomised as either long or acceptable delay using median delay. RESULTS: Median (IQR) patient and health system diagnostic delays are almost equal which are 20 (10-34.5) and 20.5 (8.2-56.2) days, respectively. Results from logistic regression show that presence of long patient delays (adjusted OR (AOR)=2.85, 95% CI: 1.44 to 5.62; p=0.003) in seeking care, presence of sputum smear examination (AOR=0.37, 95% CI: 0.19 to 0.75; p=0.005) at the first visit to a health facility and multiple heath facility visit before diagnosis of tuberculosis (AOR=4.95, 95% CI: 1.98 to 12.40; p=0.001) were factors significantly associated with long health system diagnostic delay. CONCLUSIONS: Long patient delay and multiple health facility visits are positively associated with long health system diagnostic delay; whereas sputum smear examination at the first contact with a health facility is negatively associated with long health system tuberculosis diagnostic delay.


Assuntos
Diagnóstico Tardio , Tuberculose Pulmonar , Adulto , Estudos Transversais , Etiópia/epidemiologia , Humanos , Tempo para o Tratamento , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia
18.
Comput Math Methods Med ; 2021: 9463577, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630630

RESUMO

Objective: To investigate the effects of health education combined with dietary guidance on nutritional indicators, immune level, and quality of life of patients with pulmonary tuberculosis. Method: A total of 123 patients with pulmonary tuberculosis who were hospitalized to our hospital between October 2019 and October 2020 were chosen for the study and were separated into 60 control cases and 63 observation cases based on the ward they were assigned to. Patients in the two groups were compared in terms of nutritional risk, nutritional indicator levels in serum, immunological function, treatment compliance, sputum culture conversion rate, and quality of life. Result: With the prolongation of patients' illness, the total NRS 2002 score gradually increased in both groups and the total NRS 2002 score of patients in the control group was higher than that of patients in the observation group at the same time point after discharge. The difference between the total NRS 2002 score of patients in both groups was significant at 3 and 6 months after discharge. After the intervention, the Hb, ALB, CD4+, and CD4+/CD8+ levels of patients in both groups were higher than those at the time of admission, and the CD8+ levels were lower than those at the time of admission. At 6 months after discharge, the Hb, ALB, CD4+, and CD4+/CD8+ levels of patients in the observation group were significantly higher than those in the control group, and the CD8+ levels were significantly lower than those in the control group. The treatment compliance rate of patients in the observation group (96.83%) was significantly higher than that of the control group (75%), and the negative sputum culture transfer rate (85.71%) was significantly higher than that in the control group (60%). The overall quality of life scores of patients in the observation group was significantly higher than that in the control group. Conclusion: Health education combined with dietary guidance for patients with pulmonary tuberculosis can deepen patients' understanding of disease and nutritional knowledge, improve treatment compliance, improve their nutritional status, enhance their immune function, accelerate sputum bacterial conversion, enhance treatment effect, and improve their quality of life.


Assuntos
Educação em Saúde , Tuberculose Pulmonar/terapia , Adulto , Estudos de Casos e Controles , China , Biologia Computacional , Dieta , Feminino , Hemoglobinas/metabolismo , Humanos , Imunidade Celular , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Cooperação do Paciente , Qualidade de Vida , Albumina Sérica/metabolismo , Tuberculose Pulmonar/sangue , Tuberculose Pulmonar/imunologia
19.
PLoS One ; 16(10): e0247245, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34610012

RESUMO

BACKGROUND: Tuberculosis (TB) prevalence surveys add to the active case detection in the community level burden of TB both national and regional levels. The aim of this study was to assess the prevalence of bacteriologically confirmed pulmonary tuberculosis (PTB) in the community. METHODS: Household community-based tuberculosis disease survey was conducted targeting 69054 population from 43 villages of 5 blocks in Tiruvallure district adopting cluster sampling methodology of ≥15 years old adult rural population of South India during 2015-2018. All eligible individuals with suspected symptoms of PTB were screened with chest X-ray. Two sputum specimens (one spot and the other early morning sample) were collected for M.tb smear and culture examination. Conversely demographical, smoking and alcohol drinking habits information were also collected to explore the risk factor. Stepwise logistic regression was employed to associate risk factors for PTB. RESULTS: A total of 62494 were screened among 69054 eligible population, of whom 6340 were eligible for sputum specimen collection. Sputum for M.tb smear and culture examination were collected in 93% of participants. The derived prevalence of PTB was 307/100000 population (smear-positive 130; culture positive 277). As expected that PTB has decreased substantially compared to preceding surveys and it showed that older age, male, low BMI, diabetes, earlier history of TB and alcohol users were significantly associated (p < .0001) with an increased risk of developing PTB. CONCLUSION: Upshot of the active survey has established a reduction in the prevalence of PTB in the rural area which can be accredited to better programmatic implementation and success of the National TB Control Programme in this district. It also has highlighted the need for risk reduction interventions accelerate faster elimination of TB.


Assuntos
Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/patogenicidade , Prevalência , Fatores de Risco , População Rural , Escarro/microbiologia , Inquéritos e Questionários , Tuberculose Pulmonar/microbiologia , Adulto Jovem
20.
PLoS One ; 16(10): e0242446, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34637447

RESUMO

BACKGROUND: Mycobacterium tuberculosis (TB) is the deadliest disease that claims millions of deaths globally. Ethiopia is among the countries heavily hit by the disaster. Despite the effective directly observed treatment and TB infection control (TBIC) measures provided by the world health organization (WHO), the rate of new cases increased daily throughout the country. Healthcare workers (HCWs) are at highest risk serving without having the necessary facility in place while overcrowding of patients exacerbated TB transmission. The study aimed to assess TBIC implementation and analyze case notification rate (CNR) of smear-positive pulmonary TB in the selected health facilities at Dale district, Sidama Zone, Southern Ethiopia. METHODS: Seven health care facilities have been visited in the study area and smear-positive pulmonary TB notification rate was determined retrospectively during the years 2012 to 2014. Data on smear positive test results and demographic characteristics were collected from the TB unit registries. A structured questionnaire, facility survey, and observation checklists were used to assess the presence of TBIC plans at the health care facilities. RESULTS: The overall case notification rate of smear-positive pulmonary tuberculosis was 5.3% among all 7696 TB suspected patients. The odds of being diagnosed with smear-positive TB were 24% more in males than in females (adj OR = 1.24, 95% CI: (1.22, 1.55). Moreover, in the study area, only 28% of the facilities have been practiced TB infection control and 71% of the facilities assigned a focal person for the TBIC plan. The implementation of environmental control measures in the facilities was ranged between 16-83%. N95 particulate respirators were found only in 14% of the facilities. CONCLUSION: TB CNR in Dale district was low. Moreover, implementations of TBIC in Dale district health facilities were poor when the survey was done. Hence, urgent measures should be taken to reverse the burden of TB.


Assuntos
Instalações de Saúde/estatística & dados numéricos , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/patogenicidade , Estudos Retrospectivos , Inquéritos e Questionários , Organização Mundial da Saúde , Adulto Jovem
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