Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding g...Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding general population. However, in many developing countries with high TB burden, passive case-finding remains the usual approach to case detection of TB in prisons. On this premise, the Abia State TB Control Programme conducted a pilot study to assess the contribution of active case finding to tuberculosis control in Aba Federal Prison. Methods: The inmates were clinically screened and those with symptoms suggestive of TB cases were tested by sputum smear microscopy. Results: Out of the total number of 477 prison inmates present in the prison at the time of study, 449 (94.1%) were clinically screened for history of cough of 2 weeks’ duration;52 (10.42%) met the inclusion criteria for sputum smear microscopy. Eleven of the 52 (21.15%) tested for acid fast bacilli (AFB) by direct smear light microscopy were positive for AFB. One inmate was on anti-tuberculosis therapy;this with the 11 cases detected in the course of this study gave a total of 12 inmates of Aba prison with active pulmonary tuberculosis at the time of this study. This gives a minimum point prevalence rate of 2405 cases per 100,000 prison inmates. Four of the 11 prison cells had at least one smear positive case with 7 of the 11 cases concentrated in two cells. The age group of 25 - 34 years had the highest number of sputum positive cases. Conclusion: Active case-finding resulted in detection of 11 new cases of sputum positive tuberculosis (an increase in detection rate of 1100%) and the prevalence of sputum positive TB is very high (2405 cases per 100,000 prison inmates) in Aba prison. There is an urgent need to institute more effective TB case-finding and control in the prison.展开更多
Tuberculosis (TB), diabetes mellitus and HIV co-morbidity is a rare and interrelated health condition with associated high morbidity and mortality especially in developing countries with high prevalence of TB. It has ...Tuberculosis (TB), diabetes mellitus and HIV co-morbidity is a rare and interrelated health condition with associated high morbidity and mortality especially in developing countries with high prevalence of TB. It has become an emerging concern to epidemiologists and TB control programs due to complexities in its control and management. Managing MDR-TB, DM and HIV comorbidity is challenging, with risk of unfavorable outcome;consequently, close monitoring is necessary. Individuals with weak immunity resulting from diseases such as uncontrolled Diabetes Mellitus (DM) and HIV have a higher risk of developing TB or progression from latent to active TB. We present a 65-year old known diabetic patient who presented to Royal Cross Hospital Ugwueke Abia State, Nigeria with a one-year history of recurrent productive cough with associated night sweats, low grade fever and marked weight loss. A diagnosis of drug-resistant TB with DM/HIV co-morbidity was made and co-managed by experts from the respective clinics and the State TB control program. The patient was declared cured (7 months consecutive negative cultures each taken 30 days apart) after completing 20 months of conventional MDR-TB treatment. The patient showed remarkable clinical improvement including weight gain, good diabetic control and significant increase in CD4 (700 cells). Managing MDR-TB patients with diabetes and HIV is challenging, however, appropriate treatment, psychosocial support, adequate blood sugar control as well as monthly monitoring of patients with requisite investigations are vital in achieving good treatment outcome.展开更多
Tuberculosis (TB) is a chronic disease that has impacted negatively on human history. The biology of the mycobacterium tuberculosis is complicated and has affected the control as well as elimination of the disease. Ni...Tuberculosis (TB) is a chronic disease that has impacted negatively on human history. The biology of the mycobacterium tuberculosis is complicated and has affected the control as well as elimination of the disease. Nigeria is one of the countries with high incidence and prevalence of TB. The late and low case detection has been a major problem with National TB control program, caused by passive case finding strategy practiced by the country. A shift from the passive and active case search has been recommended for detection of missing cases of TB and improved program performance. The proximity of TB contact is a major determinant of disease transmission. However, maximizing early case detection and prompt treatment of notified cases is very useful in (TB) control especially in high burden countries. The tracking of TB contacts provides a good platform for early diagnosis, educating the household on TB disease and infection control as well as breaking the chain of transmission. The objective of the study is to ascertain effectiveness of contact tracing on Tuberculosis case detection. The study is a retrospective quasi experimental with quantitative arm. The study was conducted in Abia State, one of the South Eastern States of Nigeria. A pre-tested questionnaire was used for data collection and analyzed with SPSS. A total of 168 and 162 index cases of TB were recruited for both intervention and control facilities. The 168 index TB cases yielded 301 TB contacts. The result revealed 55% contact/index ratio, presumptive TB yield of 130 (43.2%) and TB yield of 68 (22.6%). The cases registered in the State increased from 336 to 417 and p value = 0.001, while presumptive TB and BCG vaccination were major predictors. The study shows that tracing contact of index TB cases is an effective and complementary method of finding undetected cases of TB.展开更多
文摘Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding general population. However, in many developing countries with high TB burden, passive case-finding remains the usual approach to case detection of TB in prisons. On this premise, the Abia State TB Control Programme conducted a pilot study to assess the contribution of active case finding to tuberculosis control in Aba Federal Prison. Methods: The inmates were clinically screened and those with symptoms suggestive of TB cases were tested by sputum smear microscopy. Results: Out of the total number of 477 prison inmates present in the prison at the time of study, 449 (94.1%) were clinically screened for history of cough of 2 weeks’ duration;52 (10.42%) met the inclusion criteria for sputum smear microscopy. Eleven of the 52 (21.15%) tested for acid fast bacilli (AFB) by direct smear light microscopy were positive for AFB. One inmate was on anti-tuberculosis therapy;this with the 11 cases detected in the course of this study gave a total of 12 inmates of Aba prison with active pulmonary tuberculosis at the time of this study. This gives a minimum point prevalence rate of 2405 cases per 100,000 prison inmates. Four of the 11 prison cells had at least one smear positive case with 7 of the 11 cases concentrated in two cells. The age group of 25 - 34 years had the highest number of sputum positive cases. Conclusion: Active case-finding resulted in detection of 11 new cases of sputum positive tuberculosis (an increase in detection rate of 1100%) and the prevalence of sputum positive TB is very high (2405 cases per 100,000 prison inmates) in Aba prison. There is an urgent need to institute more effective TB case-finding and control in the prison.
文摘Tuberculosis (TB), diabetes mellitus and HIV co-morbidity is a rare and interrelated health condition with associated high morbidity and mortality especially in developing countries with high prevalence of TB. It has become an emerging concern to epidemiologists and TB control programs due to complexities in its control and management. Managing MDR-TB, DM and HIV comorbidity is challenging, with risk of unfavorable outcome;consequently, close monitoring is necessary. Individuals with weak immunity resulting from diseases such as uncontrolled Diabetes Mellitus (DM) and HIV have a higher risk of developing TB or progression from latent to active TB. We present a 65-year old known diabetic patient who presented to Royal Cross Hospital Ugwueke Abia State, Nigeria with a one-year history of recurrent productive cough with associated night sweats, low grade fever and marked weight loss. A diagnosis of drug-resistant TB with DM/HIV co-morbidity was made and co-managed by experts from the respective clinics and the State TB control program. The patient was declared cured (7 months consecutive negative cultures each taken 30 days apart) after completing 20 months of conventional MDR-TB treatment. The patient showed remarkable clinical improvement including weight gain, good diabetic control and significant increase in CD4 (700 cells). Managing MDR-TB patients with diabetes and HIV is challenging, however, appropriate treatment, psychosocial support, adequate blood sugar control as well as monthly monitoring of patients with requisite investigations are vital in achieving good treatment outcome.
文摘Tuberculosis (TB) is a chronic disease that has impacted negatively on human history. The biology of the mycobacterium tuberculosis is complicated and has affected the control as well as elimination of the disease. Nigeria is one of the countries with high incidence and prevalence of TB. The late and low case detection has been a major problem with National TB control program, caused by passive case finding strategy practiced by the country. A shift from the passive and active case search has been recommended for detection of missing cases of TB and improved program performance. The proximity of TB contact is a major determinant of disease transmission. However, maximizing early case detection and prompt treatment of notified cases is very useful in (TB) control especially in high burden countries. The tracking of TB contacts provides a good platform for early diagnosis, educating the household on TB disease and infection control as well as breaking the chain of transmission. The objective of the study is to ascertain effectiveness of contact tracing on Tuberculosis case detection. The study is a retrospective quasi experimental with quantitative arm. The study was conducted in Abia State, one of the South Eastern States of Nigeria. A pre-tested questionnaire was used for data collection and analyzed with SPSS. A total of 168 and 162 index cases of TB were recruited for both intervention and control facilities. The 168 index TB cases yielded 301 TB contacts. The result revealed 55% contact/index ratio, presumptive TB yield of 130 (43.2%) and TB yield of 68 (22.6%). The cases registered in the State increased from 336 to 417 and p value = 0.001, while presumptive TB and BCG vaccination were major predictors. The study shows that tracing contact of index TB cases is an effective and complementary method of finding undetected cases of TB.
