Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of pu...Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the catastrophic costs DRTB patients incur.展开更多
Introduction: Pleural effusion (PF) is a common clinical presentation in several diseases. Tuberculosis is one of the most frequent causes of exudative pleural effusions in immunocompetent patients. Tuberculosis is th...Introduction: Pleural effusion (PF) is a common clinical presentation in several diseases. Tuberculosis is one of the most frequent causes of exudative pleural effusions in immunocompetent patients. Tuberculosis is the leading cause of morbidity and mortality from an infectious disease in developing countries. Pakistan is ranked fifth in the world in terms of tuberculosis high-burden countries. Various pleural fluid parameters have been used to identify the cause of pleural effusion. It has been discovered that tuberculous pleural effusions had a greater alkaline phosphatase (ALP) concentration than transudative effusions. This study used pleural fluid alkaline phosphatase levels to distinguish between tuberculous pleural effusion and malignant pleural effusion because there is little information from tuberculosis-high burden nations like Pakistan. Study Design: A descriptive cross-sectional study conducted at the Jinnah Postgraduate Medical Center in Karachi between October 2016 and October 2017. Material and Methods: The study comprised all patients who were admitted to the department of chest medicine at Jinnah post graduate medical centre (JPMC) of either gender between the ages of 18 and 70 who had exudative lymphocytic pleural effusions lasting two weeks or more included in the study. Non probability consecutive sampling was used to collect data. Patients who have tonsillitis, pharyngitis, pneumonia, asthma, Chronic obstructive pulmonary disease (COPD), or a history of hemoptysis, Bleeding disorders like, platelet function disorder, thrombocytopenia, Liver cirrhosis and Pregnant women were excluded. Parents’ informed consent was obtained after being informed of the study’s protocol, hazards, and advantages. Each patient had their level of pleural fluid alkaline phosphate (PALP) assessed. In order to evaluate the patient’s pleural effusion, a pre-made questionnaire was used. All the collected data were entered into the SPSS 20. An independent sample t-test was used to recognize alkaline phosphate levels association with pleural fluid secondary to tuberculosis or malignancy. Results: In this Descriptive Cross-Sectional Study, the total of 156 patients with age Mean ± SD of was 41.96 ± 17.05 years. The majority of patients 110 (70.5%) were male and 46 (29.5%) were female. Advanced age was associated with raised pleural fluid alkaline phosphatase. The difference of pleural fluid alkaline phosphate level between tuberculous v/s malignant group was found to be (38.03 ± 45.97) v/s (82.77 ± 61.80) respectively with P-value (P = 0.0001). Conclusion: Malignant pleural effusions had elevated PALP when compared to tuberculous pleural effusions in exudative lymphocytic pleural effusions;better differences are seen in older ages and shorter disease durations.展开更多
Introduction: Spontaneous pneumothorax is a rare but serious complication of tuberculosis. Miliary tuberculosis (MT) is a severe form of tuberculosis secondary to hematogenous spread of Mycobacterium tuberculosis. Obj...Introduction: Spontaneous pneumothorax is a rare but serious complication of tuberculosis. Miliary tuberculosis (MT) is a severe form of tuberculosis secondary to hematogenous spread of Mycobacterium tuberculosis. Objective: To report a case of MT complicated by pneumothorax. Methodology: This was a 25-year-old patient, farmer, followed up at the Pneumo-phtisiology department of the CHU du Point G for MT whose condition was improving after the introduction of anti-tuberculosis chemotherapy. He consulted again after experiencing chest pain. Clinical and imaging revealed a Spontaneous pneumothorax complicating MT. The treatment combined anti-tuberculosis chemotherapy, chest drainage and respiratory physiotherapy. Outcome was favorable with improvement of clinical and radiological signs. Conclusion: Pneumothorax complicating MT requires a reflective diagnostic approach and rapid management to improve its prognosis.展开更多
Background: Efforts to combat tuberculosis in Nigeria focus on evaluation of strategies for treatment and prevention, with little attention paid to the impact of the burden of illness and its therapy on the HRQoL of T...Background: Efforts to combat tuberculosis in Nigeria focus on evaluation of strategies for treatment and prevention, with little attention paid to the impact of the burden of illness and its therapy on the HRQoL of TB patients. This study evaluated the quality of life (QoL) of TB patients in relation to their financial, psychological and social well-being. Method: In 2011, following an active case finding for TB in Akwa Ibom State of Nigeria, a structured questionnaire for evaluating HRQoL was distributed to TB patients who had been on treatment in four DOTs centres of the state for at least three months. The questions were to elicit responses that conveyed the respondents’ perspective of the disease. One hundred and eight TB patients (54 males and 54 females) aged 15 - 80 years were studied. Results: Negative emotions including fear, frustration and worry characterized the reactions of all subjects following news of their diagnosis with TB. However, following treatment, 62% of subjects expressed high expectation of being cured. Inability to continue functioning in their roles at home or as heads of households was recorded in 48.1% (52/108) and 59% (23/39) of respondents respectively and contributed to the negative emotions expressed above. Lack of basic supplies such as food and finances to meet personal and family needs constituted the most important socio-economic challenges. Socio-economic status of respondents revealed that 61% had no regular means of income with at least 94% earning less than $50 (8000 naira) a month. Subsistent farmers and petty traders constituted more than 66% of the respondents: 98% obtained less than or equivalent of high school education. Socially, all health workers and 87% of family members were sympathetic and supportive compared to friends, with 42% exhibiting stigmatization. The most frequent forms of support from family members were financial (25%) and provision of food (37%). Up to 28% were regularly prompted by family to take their medication. Conclusion: In the midst of obvious socio-economic challenges confronting TB patients in this study, the initial negative emotions declined following the supportive roles of mainly health care workers and family members. Patients were optimistic of achieving cure at the end of the treatment.展开更多
Bovine tuberculosis is one of the zoonoses which has a very significant socio-economic importance due to the losses in agribusiness and hampers commercial exchange of animals and products. The present study highlights...Bovine tuberculosis is one of the zoonoses which has a very significant socio-economic importance due to the losses in agribusiness and hampers commercial exchange of animals and products. The present study highlights the risk of considerable potential economic and health impacts of this major zoonosis. It was carried out at the Bobo-Dioulasso slaughterhouse, in Burkina Faso over 3 years. A retrospective study was conducted based on bovine tuberculosis suspected carcass seizures during primary meat production between January 1st, 2020 and December 31st, 2022. The diagnosis and the criteria for suspecting bovine tuberculosis were addressed by post-mortem inspection. All carcasses were examined for tuberculosis lesions detection. All cattle slaughtered in the abattoir for primary meat production during the study period were included. Economic losses were determined from recorded seizure data and we included all the cattle slaughtered during the study period. Three thousand two hundred ten (3210) bovine carcasses were seized on a total of 180,827 cattle slaughteredwith a prevalence of 19.48%. Economic loss was estimated to be 53,505,000 F CFA, while the average quantity of animal protein lost was 4746 kg, 435 kg, and 13,445 kg for the carcass, livers, and lungs, respectively. The various results show a real health issue linked to exposure to M. bovis for agents and stakeholders in the primary meat production chain, processors and consumers. In addition, the survey conducted over the study period, reveals important material seized and destroyed. This leads to significant loss in rural agriculture and also in the primary meat production industry for the population. The figures are enormous and impact both the nutritional intake linked to animal protein consumption and the livelihood of the beef industry. The Burkinabe administration should invest in biosecurity and biosafety measures to minimize the risks of the disease and also provide compensation for losses recorded among breeders and butchers.展开更多
Objective To investigate the effects of different cytokines (IL-22,IL-17,IFN-γ) on proliferation and apoptosis of human pleural mesothelial cells (PMC) during Mycobacterium tuberculosis infection.Methods
Objective To compare the diagnostic performance of interferon gamma releasing assays(T-SPOT.TB)and adenosine deaminase(ADA)in pleural tuberculosis,and therefore to evaluate the value of T-SPOT.TB in a high tuberculosi...Objective To compare the diagnostic performance of interferon gamma releasing assays(T-SPOT.TB)and adenosine deaminase(ADA)in pleural tuberculosis,and therefore to evaluate the value of T-SPOT.TB in a high tuberculosis burden country.Methods From June 2011to November 2012,111 patients with pleural fluid in Beijing Chest Hospital,Capital Medical University展开更多
Background:Tuberculosis(TB)patients in China still face a number of barriers in seeking diagnosis and treatment.There is evidence that the economic burden on TB patients and their households discourages treatment comp...Background:Tuberculosis(TB)patients in China still face a number of barriers in seeking diagnosis and treatment.There is evidence that the economic burden on TB patients and their households discourages treatment compliance.Methods:A cross-sectional study was conducted in three cities of China.Patients were selected using probability proportional to size(PPS)cluster sampling of rural townships or urban streets,followed by list sampling from a patient register.Data were collected using a questionnaire survey,key informant interviews and focus group discussions with TB patients to gain an understanding of the economic burden of TB and implications of this burden for treatment compliance.Results:A total of 797 TB patients were surveyed,of which 60 were interviewed in-depth following the survey.More than half had catastrophic health expenditure.TB patients with higher household incomes were less likely to report non-compliance(OR 0.355,95%CI 0.140–0.830)and patients who felt that the economic burden relating to TB treatment was high more likely to report non-compliance(OR 3.650,95%CI 1.278–12.346).Those who had high costs for transportation,lodging and food were also more likely to report non-compliance(OR 4.150,95%CI 1.804–21.999).The findings from the qualitative studies supported those from the survey.Conclusion:The economic burden associated with seeking diagnosis and treatment remains a barrier for TB patients in China.Reducing the cost of treatment and giving patients subsidies for transportation,lodging and food is likely to improve treatment compliance.Improving doctors’salary system to cut off the revenue-oriented incentive,and expanding current insurance’s coverage can be helpful to reduce patients’actual burden or anticipated burden.Future research on this issue is needed.展开更多
Objective To compare the immune responses of Mycobacterium tuberculosis(M.tb)-specific T lymphocy between the peripheral blood and pleural effusion in patients with tuberculous pleurisy.Methods Twelve initially treate...Objective To compare the immune responses of Mycobacterium tuberculosis(M.tb)-specific T lymphocy between the peripheral blood and pleural effusion in patients with tuberculous pleurisy.Methods Twelve initially treated cases of tuberculous pleurisy who were hospitalized in Wuxi No.5 People’s Hospital from Oct 2012 to Apr展开更多
Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer. Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology o...Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer. Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination. All patients were divided into two groups。展开更多
Back ground: Pleural effusion is a common clinical problem with different causes. Objective: To demonstrate clinical features and outcome of pleural effusion. Methods: Prospective descriptive study was conducted invol...Back ground: Pleural effusion is a common clinical problem with different causes. Objective: To demonstrate clinical features and outcome of pleural effusion. Methods: Prospective descriptive study was conducted involving 110 patients with pleural effusion admitted to a resource limited hospital in Ethiopia. Results: Males and females were almost equally represented. Cough, fever and weight loss were prominent presenting symptoms accounting 90, 77.3 and 77.3 percent respectively. Right side effusion was the common presentation 50 (45.5%). Forty (37.4%) patients had HIV infection among 107 tested. Tuberculosis was the commonest cause 78 (70.9%) followed by parapneumonic effusion 36 (32.7%) and empyema 27 (24.5%). Malignant pleural effusion was detected only in one patient. Eighty one (73.6%) improved from their illness and 7 (6.4%) died. Lympocytic pleural effusion found to be associated with tuberculosis (OR = 3.942 (1.527 - 10.179), P = 0.005. There were no associations between HIV infection, anemia, elevated ESR and side of pleural effusion with tuberculosis. Conclusion: Tuberculosis was the leading cause of pleural effusion in our setup even though etiologic diagnosis was difficult. Strengthening the laboratory and pathology services in the area is strongly recommended.展开更多
文摘Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the catastrophic costs DRTB patients incur.
文摘Introduction: Pleural effusion (PF) is a common clinical presentation in several diseases. Tuberculosis is one of the most frequent causes of exudative pleural effusions in immunocompetent patients. Tuberculosis is the leading cause of morbidity and mortality from an infectious disease in developing countries. Pakistan is ranked fifth in the world in terms of tuberculosis high-burden countries. Various pleural fluid parameters have been used to identify the cause of pleural effusion. It has been discovered that tuberculous pleural effusions had a greater alkaline phosphatase (ALP) concentration than transudative effusions. This study used pleural fluid alkaline phosphatase levels to distinguish between tuberculous pleural effusion and malignant pleural effusion because there is little information from tuberculosis-high burden nations like Pakistan. Study Design: A descriptive cross-sectional study conducted at the Jinnah Postgraduate Medical Center in Karachi between October 2016 and October 2017. Material and Methods: The study comprised all patients who were admitted to the department of chest medicine at Jinnah post graduate medical centre (JPMC) of either gender between the ages of 18 and 70 who had exudative lymphocytic pleural effusions lasting two weeks or more included in the study. Non probability consecutive sampling was used to collect data. Patients who have tonsillitis, pharyngitis, pneumonia, asthma, Chronic obstructive pulmonary disease (COPD), or a history of hemoptysis, Bleeding disorders like, platelet function disorder, thrombocytopenia, Liver cirrhosis and Pregnant women were excluded. Parents’ informed consent was obtained after being informed of the study’s protocol, hazards, and advantages. Each patient had their level of pleural fluid alkaline phosphate (PALP) assessed. In order to evaluate the patient’s pleural effusion, a pre-made questionnaire was used. All the collected data were entered into the SPSS 20. An independent sample t-test was used to recognize alkaline phosphate levels association with pleural fluid secondary to tuberculosis or malignancy. Results: In this Descriptive Cross-Sectional Study, the total of 156 patients with age Mean ± SD of was 41.96 ± 17.05 years. The majority of patients 110 (70.5%) were male and 46 (29.5%) were female. Advanced age was associated with raised pleural fluid alkaline phosphatase. The difference of pleural fluid alkaline phosphate level between tuberculous v/s malignant group was found to be (38.03 ± 45.97) v/s (82.77 ± 61.80) respectively with P-value (P = 0.0001). Conclusion: Malignant pleural effusions had elevated PALP when compared to tuberculous pleural effusions in exudative lymphocytic pleural effusions;better differences are seen in older ages and shorter disease durations.
文摘Introduction: Spontaneous pneumothorax is a rare but serious complication of tuberculosis. Miliary tuberculosis (MT) is a severe form of tuberculosis secondary to hematogenous spread of Mycobacterium tuberculosis. Objective: To report a case of MT complicated by pneumothorax. Methodology: This was a 25-year-old patient, farmer, followed up at the Pneumo-phtisiology department of the CHU du Point G for MT whose condition was improving after the introduction of anti-tuberculosis chemotherapy. He consulted again after experiencing chest pain. Clinical and imaging revealed a Spontaneous pneumothorax complicating MT. The treatment combined anti-tuberculosis chemotherapy, chest drainage and respiratory physiotherapy. Outcome was favorable with improvement of clinical and radiological signs. Conclusion: Pneumothorax complicating MT requires a reflective diagnostic approach and rapid management to improve its prognosis.
文摘Background: Efforts to combat tuberculosis in Nigeria focus on evaluation of strategies for treatment and prevention, with little attention paid to the impact of the burden of illness and its therapy on the HRQoL of TB patients. This study evaluated the quality of life (QoL) of TB patients in relation to their financial, psychological and social well-being. Method: In 2011, following an active case finding for TB in Akwa Ibom State of Nigeria, a structured questionnaire for evaluating HRQoL was distributed to TB patients who had been on treatment in four DOTs centres of the state for at least three months. The questions were to elicit responses that conveyed the respondents’ perspective of the disease. One hundred and eight TB patients (54 males and 54 females) aged 15 - 80 years were studied. Results: Negative emotions including fear, frustration and worry characterized the reactions of all subjects following news of their diagnosis with TB. However, following treatment, 62% of subjects expressed high expectation of being cured. Inability to continue functioning in their roles at home or as heads of households was recorded in 48.1% (52/108) and 59% (23/39) of respondents respectively and contributed to the negative emotions expressed above. Lack of basic supplies such as food and finances to meet personal and family needs constituted the most important socio-economic challenges. Socio-economic status of respondents revealed that 61% had no regular means of income with at least 94% earning less than $50 (8000 naira) a month. Subsistent farmers and petty traders constituted more than 66% of the respondents: 98% obtained less than or equivalent of high school education. Socially, all health workers and 87% of family members were sympathetic and supportive compared to friends, with 42% exhibiting stigmatization. The most frequent forms of support from family members were financial (25%) and provision of food (37%). Up to 28% were regularly prompted by family to take their medication. Conclusion: In the midst of obvious socio-economic challenges confronting TB patients in this study, the initial negative emotions declined following the supportive roles of mainly health care workers and family members. Patients were optimistic of achieving cure at the end of the treatment.
文摘Bovine tuberculosis is one of the zoonoses which has a very significant socio-economic importance due to the losses in agribusiness and hampers commercial exchange of animals and products. The present study highlights the risk of considerable potential economic and health impacts of this major zoonosis. It was carried out at the Bobo-Dioulasso slaughterhouse, in Burkina Faso over 3 years. A retrospective study was conducted based on bovine tuberculosis suspected carcass seizures during primary meat production between January 1st, 2020 and December 31st, 2022. The diagnosis and the criteria for suspecting bovine tuberculosis were addressed by post-mortem inspection. All carcasses were examined for tuberculosis lesions detection. All cattle slaughtered in the abattoir for primary meat production during the study period were included. Economic losses were determined from recorded seizure data and we included all the cattle slaughtered during the study period. Three thousand two hundred ten (3210) bovine carcasses were seized on a total of 180,827 cattle slaughteredwith a prevalence of 19.48%. Economic loss was estimated to be 53,505,000 F CFA, while the average quantity of animal protein lost was 4746 kg, 435 kg, and 13,445 kg for the carcass, livers, and lungs, respectively. The various results show a real health issue linked to exposure to M. bovis for agents and stakeholders in the primary meat production chain, processors and consumers. In addition, the survey conducted over the study period, reveals important material seized and destroyed. This leads to significant loss in rural agriculture and also in the primary meat production industry for the population. The figures are enormous and impact both the nutritional intake linked to animal protein consumption and the livelihood of the beef industry. The Burkinabe administration should invest in biosecurity and biosafety measures to minimize the risks of the disease and also provide compensation for losses recorded among breeders and butchers.
文摘Objective To investigate the effects of different cytokines (IL-22,IL-17,IFN-γ) on proliferation and apoptosis of human pleural mesothelial cells (PMC) during Mycobacterium tuberculosis infection.Methods
文摘Objective To compare the diagnostic performance of interferon gamma releasing assays(T-SPOT.TB)and adenosine deaminase(ADA)in pleural tuberculosis,and therefore to evaluate the value of T-SPOT.TB in a high tuberculosis burden country.Methods From June 2011to November 2012,111 patients with pleural fluid in Beijing Chest Hospital,Capital Medical University
基金The study upon which this paper was written is part of the large program entitled“China National Health and Family Planning Commission and the Gates Foundation TB Project”,a collaboration between the Government of China and the Melinda and Bill Gates Foundation(Grant No.51914),and implemented by the China Center of Disease Control and Prevention(CDC).The Duke Global Health Institute,USA/Duke Kunshan University in China,and Nanjing Medical University,Huazhong University of Science and Technology and Xi’an Jiaotong University in China were contracted by the Foundation and China CDC to undertake the baseline survey,and monitoring and evaluation of innovative financial models of TB/MDRTB control and care in China.In addition,the authors express their deep appreciation to all the staffs in the research areas,as well as the Chinese Center for Disease Control and Prevention for allowing this study to be conducted in the selected health facilities.The authors would also like to acknowledge Chee-Ruey Hsieh,Professor of Duke Kunshan University,and Shenglan Tang,Professor of Duke University,for their critical review and comments on the manuscriptThis study was also supported by the project“Research on Economic Risk of Major Diseases and the Protection Effect Model of Rural Residents in the Central and Western Regions of China”supported by the National Natural Science Foundation of China(Grant No.71203068).
文摘Background:Tuberculosis(TB)patients in China still face a number of barriers in seeking diagnosis and treatment.There is evidence that the economic burden on TB patients and their households discourages treatment compliance.Methods:A cross-sectional study was conducted in three cities of China.Patients were selected using probability proportional to size(PPS)cluster sampling of rural townships or urban streets,followed by list sampling from a patient register.Data were collected using a questionnaire survey,key informant interviews and focus group discussions with TB patients to gain an understanding of the economic burden of TB and implications of this burden for treatment compliance.Results:A total of 797 TB patients were surveyed,of which 60 were interviewed in-depth following the survey.More than half had catastrophic health expenditure.TB patients with higher household incomes were less likely to report non-compliance(OR 0.355,95%CI 0.140–0.830)and patients who felt that the economic burden relating to TB treatment was high more likely to report non-compliance(OR 3.650,95%CI 1.278–12.346).Those who had high costs for transportation,lodging and food were also more likely to report non-compliance(OR 4.150,95%CI 1.804–21.999).The findings from the qualitative studies supported those from the survey.Conclusion:The economic burden associated with seeking diagnosis and treatment remains a barrier for TB patients in China.Reducing the cost of treatment and giving patients subsidies for transportation,lodging and food is likely to improve treatment compliance.Improving doctors’salary system to cut off the revenue-oriented incentive,and expanding current insurance’s coverage can be helpful to reduce patients’actual burden or anticipated burden.Future research on this issue is needed.
文摘Objective To compare the immune responses of Mycobacterium tuberculosis(M.tb)-specific T lymphocy between the peripheral blood and pleural effusion in patients with tuberculous pleurisy.Methods Twelve initially treated cases of tuberculous pleurisy who were hospitalized in Wuxi No.5 People’s Hospital from Oct 2012 to Apr
文摘Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer. Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination. All patients were divided into two groups。
文摘Back ground: Pleural effusion is a common clinical problem with different causes. Objective: To demonstrate clinical features and outcome of pleural effusion. Methods: Prospective descriptive study was conducted involving 110 patients with pleural effusion admitted to a resource limited hospital in Ethiopia. Results: Males and females were almost equally represented. Cough, fever and weight loss were prominent presenting symptoms accounting 90, 77.3 and 77.3 percent respectively. Right side effusion was the common presentation 50 (45.5%). Forty (37.4%) patients had HIV infection among 107 tested. Tuberculosis was the commonest cause 78 (70.9%) followed by parapneumonic effusion 36 (32.7%) and empyema 27 (24.5%). Malignant pleural effusion was detected only in one patient. Eighty one (73.6%) improved from their illness and 7 (6.4%) died. Lympocytic pleural effusion found to be associated with tuberculosis (OR = 3.942 (1.527 - 10.179), P = 0.005. There were no associations between HIV infection, anemia, elevated ESR and side of pleural effusion with tuberculosis. Conclusion: Tuberculosis was the leading cause of pleural effusion in our setup even though etiologic diagnosis was difficult. Strengthening the laboratory and pathology services in the area is strongly recommended.
