This research focuses on the effects of migration on the TB infection rate and its prevention in Saudi Arabia, which has a large number of expatriates from TB-affected countries. Despite, based on the current global s...This research focuses on the effects of migration on the TB infection rate and its prevention in Saudi Arabia, which has a large number of expatriates from TB-affected countries. Despite, based on the current global statistics of TB occurrence, it is evident that the national incidence of TB has reduced from 10.55 per 100,000 in 2015 to 8.36 per 100,000 in 2019;despite this, there are still some difficulties because migrants bring new strains of Mycobacterium tuberculosis. Hindrances, including language barriers and perceived immigration status, hinder patients from seeking medical attention or doctors from diagnosing diseases. Each patient and each cultural group need special attention to public health, enhancing living circumstances, and health care support. Community participation, inclusion of TB control programs into functional healthcare facilities, and the functioning of TB programs need to be stressed to address TB issues. Considering the focus on social, economic, and cultural approaches, the country can make severe advancements in TB control and population protection. This holistic analysis is critical for a long-term effective strategy to combat TB in the Kingdom.展开更多
Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) i...Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.展开更多
Objective:To investigate the genetic correlations between epithelial growth factor receptor(EGFR)mutation and FHIT methylation in patients diagnosed with lung adenocarcinoma(AC)and pulmonary tuberculosis(TB).Methods:T...Objective:To investigate the genetic correlations between epithelial growth factor receptor(EGFR)mutation and FHIT methylation in patients diagnosed with lung adenocarcinoma(AC)and pulmonary tuberculosis(TB).Methods:The presence of EGFR mutations and the methylation status of the FHIT gene in patients presenting with AC and TB were analyzed.The correlation between TB status and the observed genetic and epigenetic variations was also examined.Results:Among the 90 patients included in the study,38 exhibited EGFR mutations(14 among those with TB and 24 among those without TB),while 29 exhibited FHIT myelination(19 among those with TB and 10 among those without TB).Furthermore,the protein expression levels of EGFR and FHIT were significantly higher in patients diagnosed solely with AC compared to those presenting with both AC and TB.A robust inverse correlation was identified between TB status and the frequency of EGFR mutation(P<0.001).Moreover,significant associations were observed between TB status and FHIT methylation(P<0.01).Conclusion:The findings suggest a correlation between TB and the prevalence of EGFR mutation and FHIT methylation in the pathogenesis of AC.展开更多
Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed ...Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.展开更多
BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of sec...BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.展开更多
Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years fema...Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.展开更多
Objective:To explore the clinical efficacy of the integrated medical care model combined with psychological intervention in pulmonary tuberculosis patients with lung cancer.Methods:From January to December 2022,60 pul...Objective:To explore the clinical efficacy of the integrated medical care model combined with psychological intervention in pulmonary tuberculosis patients with lung cancer.Methods:From January to December 2022,60 pulmonary tuberculosis patients with lung cancer admitted to our hospital were selected as the research subjects.Using the random number table method,the patients were divided into two groups,a control group and a study group,with 30 cases in each group.The chest computed tomography(CT)examination results,mental state assessment(including depression scale and anxiety scale)scores,incidence of adverse reactions,treatment effect,and length of hospital stay were compared between the two groups.Results:The treatment effect of the patients in the study group was better than that of the patients in the control group(P<0.05);the duration of hospitalization,chest CT examination results,mental state assessment scores,and incidence of adverse reactions of the study group and the control group,were significantly different(P<0.05).Conclusion:The integrated medical care model combined with psychological intervention can effectively improve the treatment effect of pulmonary tuberculosis patients with lung cancer and prevent the occurrence of adverse reactions;thus,it should be promoted in clinical practice.展开更多
Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis ...Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis combined with lung cancer were admitted.All patients were diagnosed with pulmonary tuberculosis according to the Guidelines for the Diagnosis and Treatment of Pulmonary Tuberculosis and with lung cancer by pathology.The patients were randomly divided into two groups,with 30 cases in each group.The control group received daily nursing care,whereas the study group received integrated medical and nursing care.The sputum conversion rate,tumor remission rate,and quality of life of patients were observed and analyzed.Results:The item function score and symptom function score of the observation group were higher than those of the control group(P<0.05);the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the sputum conversion rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:For patients with pulmonary tuberculosis combined with lung cancer,the application of integrated medical and nursing care can help consolidate the treatment effect and improve the quality of life of patients;thus,it is worthy of promotion and application.展开更多
BACKGROUND Pulmonary tuberculosis(TB)and lung cancer(LC)are common diseases with a high incidence and similar symptoms,which may be misdiagnosed by radiologists,thus delaying the best treatment opportunity for patient...BACKGROUND Pulmonary tuberculosis(TB)and lung cancer(LC)are common diseases with a high incidence and similar symptoms,which may be misdiagnosed by radiologists,thus delaying the best treatment opportunity for patients.AIM To develop and validate radiomics methods for distinguishing pulmonary TB from LC based on computed tomography(CT)images.METHODS We enrolled 478 patients(January 2012 to October 2018),who underwent preoperative CT screening.Radiomics features were extracted and selected from the CT data to establish a logistic regression model.A radiomics nomogram model was constructed,with the receiver operating characteristic,decision and calibration curves plotted to evaluate the discriminative performance.RESULTS Radiomics features extracted from lesions with 4 mm radial dilation distances outside the lesion showed the best discriminative performance.The radiomics nomogram model exhibited good discrimination,with an area under the curve of 0.914(sensitivity=0.890,specificity=0.796)in the training cohort,and 0.900(sensitivity=0.788,specificity=0.907)in the validation cohort.The decision curve analysis revealed that the constructed nomogram had clinical usefulness.CONCLUSION These proposed radiomic methods can be used as a noninvasive tool for differentiation of TB and LC based on preoperative CT data.展开更多
Objective:More health workers die from infectious diseases such as tuberculosis(TB)than from any other infectious agent,so the current study is designed to assess TB treatment and preventive measures as they relate to...Objective:More health workers die from infectious diseases such as tuberculosis(TB)than from any other infectious agent,so the current study is designed to assess TB treatment and preventive measures as they relate to nursing care practice.Materials and Methods:A cross-sectional study was conducted among 82 nurses from December 2022 to January 2023.The data were collected through a self-developed questionnaire and analyzed by frequency table and analysis of variance(ANOVA)statistics.Results:The researchers found that nurses have sufficient knowledge on Infection Prevention and Control(IPC)policy,but not all nurses follow this management protocol,and the reason for their action is addressed in this study.The management and preventive measures used by the participants were identified as:proper cough etiquette/hygiene,working in a well-ventilated area,use of mask,appropriate disposal of used items and so on was reported.Moreover,this study also discovered that there is a positive correlation between nurses who had received training in IPC policy and their use of airborne preventive measures for TB patients(F=1.87,P=0.002)as well as a positive correlation between the availability of resources and their adherence to the proper use of airborne preventive measures when caring for TB patients(F=1.96,P˂0.001).Conclusion:We proposed infection and control training for nurses and adequate equipment supplies to the TB ward which are required in quick TB diagnosis,and must be carried out on a regular basis by health-care personnel,for efficient nursing practice.Ensuring proper safety equipment and isolation units should be available and assessable for nurses or other health workers showing sign or symptoms of TB.Similarly,it is necessary for government to put in place the control and regulations that will safeguard nurses and mandate them to adopt TB prevention protocols,which will aid in lowering the prevalence of TB among nurses.展开更多
We report a 43-year-old man who presented with a right painful shoulder mass and bilateral lung masses in computed tomography(CT).Scapular mass was excised and pathology report demonstrated high-grade metastatic tumor...We report a 43-year-old man who presented with a right painful shoulder mass and bilateral lung masses in computed tomography(CT).Scapular mass was excised and pathology report demonstrated high-grade metastatic tumor.Same side lung biopsy and histopathological study characterized tuberculosis but biopsy of the left lung lesion identified adenocarcinoma of the lung.The final diagnosis was right scapular metastatic lesion from left lung adenocarcinoma.Musculoskeletal symptoms are commonly encountered in lung malignancies due to paraneoplastic syndrome or hematogenous metastasis but scapular metastasis on the other side as the presentation of lung cancer is extremely rare.展开更多
Laryngeal tuberculosis is a rare entity. We consider the case of a woman of 62 who presented a one-year evolving chronic dysphonia chart associated with cough, febricula and general health damage. The nasofibroscopy s...Laryngeal tuberculosis is a rare entity. We consider the case of a woman of 62 who presented a one-year evolving chronic dysphonia chart associated with cough, febricula and general health damage. The nasofibroscopy showed a budding ulcerous lesion of the larynx a priori evoking a granulomatous lesion or cancer. The BAAR spits were strongly positive and the radiographic pictures of the thorax, typically evoked a pulmonary tuberculosis. Seeing the excellent therapeutic response to TB treatment in 4 months period, the bifocal tuberculosis diagnostic was confirmed.展开更多
Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including sys...Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.展开更多
Objective:To evaluate inhouse developed SEVA TB peroxidase enzyme immunoassay using cocktail of mycobacterial excretory-secretory antigens(ES-31,ES-43 & EST-6) for antibody detection and their affinity purified an...Objective:To evaluate inhouse developed SEVA TB peroxidase enzyme immunoassay using cocktail of mycobacterial excretory-secretory antigens(ES-31,ES-43 & EST-6) for antibody detection and their affinity purified antibodies for antigen detection in tuberculosis suspected patients.Methods:Inhouse developed SEVA TB peroxidase enzyme immunoassay was evaluated prospectively in 73 suspected pulmonary and 46 extra-pulmonary tuberculosis patients during November 2008~March 2009 in a tertiary hospital located in rural area.Results:Assay on prospective analysis showed 100% correlation of pulmonary tuberculosis(PTB) and extrapulmonary tuberculosis(EPTB) acid fast bacilli positivity and antitubercular treatment in 11 cases.Thirty nine PTB and 12 EPTB cases showed negative for EUSA test and were also not given antitubercular therapy.However 30 PTB and 27 EPTB cases showing ELISA positivity were neither acid fast bacilli positive nor antitubercular therapy treated.These cases may possibly have dormant infection and need further diagnosis.In EPTB cases ELISA was observed to be more useful than AFB smear test.Conclusions:This inhouse developed user-friendly peroxidase ELISA can be used as an adjunct test of smear microscopy or culture techniques for routine screening of patients suspected of PTB or EPTB.展开更多
Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: Th...Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: The purpose of the present study was to evaluate the accuracy of GeneX-pert MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampicin resistance. Methodology: This cross sectional study was done in the Department of Microbiology at Sir Salimullah Medical College, Dhaka and National Institute of Chest Disease & Hospital (NIDCH), Dhaka during the period of January 2014 to December 2014 for a period of 1 (one) year. Sputum samples from suspected MDR-TB patients were collected by purposive sampling technique from OPD of Sir Salimullah Medical College (SSMC) and NIDCH. Microscopy, liquid culture in liquid MGIT 960 media and GeneXpert MTB/RIF were done for MTB diagnosis and detection of rifampicin resistance. MGIT 960 media were also used for determination of drug resistance. Result: Liquid culture yielded higher growth (68%) from 100 samples while GeneXpert MTB assay showed similar result (67% positive and 33% negative). Drug susceptibility test in MGIT 960 media showed that out of 68 positive cases Rifampicin resistant cases were 15 (22.05%) whereas GeneXpert MTB assay detected 14 (20.89%) were Rifampicin resistant out of 67 MTB positive samples. When compared to liquid culture the calculated sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of GeneXpert MTB were 98.52%, 100%, 96.96%, 100% and 99%. Conclusion: GeneXpert MTB/RIF assay is high detection rate of pulmonary tuberculosis and multidrug resistant tuberculosis.展开更多
The Official Journal of the International Union Against Tuberculosis and Lung DiseaseEDITORIAL BOARDEditor-in-ChiefMICHAEL D ISEMAN National Jewish Center for Immunology and Respiratory Medicine 1400 Jackson Street, D...The Official Journal of the International Union Against Tuberculosis and Lung DiseaseEDITORIAL BOARDEditor-in-ChiefMICHAEL D ISEMAN National Jewish Center for Immunology and Respiratory Medicine 1400 Jackson Street, Denver CO 80206 USAAssociate EditorsNADIA AIT-KHALED (Algeria) MARCOS ESPINAL (Dominican Republic) ARIEL PABLOS-MENDEZ (Mexico)ISABELLA ANNESI-MAESANO (France) VICTORINO FARGA (Chile) RAMESH PANCHAGNULA (india)PER S BAKKE (Norway) PAUL E M FINE (UK) CHRISTIAN PERRONNE (France)MARGARET BECKLA.展开更多
The Official Journal of the International Union Against Tuberculosis and Lung DiseaseEDITORIAL BOARDEditor-in-ChiefMICHAEL D ISEMAN National Jewish Center for Immunology and Respiratory Medicine 1400 Jackson Street, D...The Official Journal of the International Union Against Tuberculosis and Lung DiseaseEDITORIAL BOARDEditor-in-ChiefMICHAEL D ISEMAN National Jewish Center for Immunology and Respiratory Medicine 1400 Jackson Street, Denver CO 80206 USAAssociate EditorsNADIA AIT-KHALED (Algeria) MARCOS ESPINAL (Dominican Republic) ARIEL PABLOS-MENDEZ (Mexico)ISABELLA ANNESI-MAESANO (France) VICTORINO FARGA (Chile) RAMESH PANCHAGNULA (India)PER S BAKKE (Norway) PAUL E M FINE (UK) CHRISTIAN PERRONNE (France)MARGARET BECKLA.展开更多
Introduction: Tuberculosis (TB) continues to be a global health challenge and currently only one licensed vaccine is available. For nearly 100 years, the Bacillus Calmette-Guérin (BCG) vaccine has been in use. Wh...Introduction: Tuberculosis (TB) continues to be a global health challenge and currently only one licensed vaccine is available. For nearly 100 years, the Bacillus Calmette-Guérin (BCG) vaccine has been in use. While it provides protection against disseminated TB in infants, its protection against adult and adolescent pulmonary tuberculosis (PTB) is variable. This literature review will provide an overview of the clinical status of candidate TB vaccines and discuss the challenges and future development trends of novel TB vaccine research, in combination with a general overview of the Tuberculosis (TB) disease and Mycobacterium tuberculosis itself. Methods: Bibliographic searches were carried out on medical journal databases, publishers, and aggregators. The most used databases were PubMed, NCBI and MDPI. Publications in English on these and other databases relating to novel TB vaccines were included in this review. Results: Currently, there are 12 main vaccine candidates in various phases of clinical trials, they include four protein or adjuvant vaccines, three viral-vectored vaccines, three mycobacterial whole cells or extract vaccines, and one each of the recombinant life and the attenuated Mycobacterium tuberculosis vaccine. Currently, the most likely candidate vaccines are the M72 + AS01E and Vaccae vaccines. M72 + AS01E is a recombinant fusion protein vaccine candidate, clinical trials showed that administering two doses of M72/AS01E was successful in reducing the development of active TB disease with 50% efficacy. Studies have also proven the efficacy of Vaccae (which is currently in phase III clinical trials) as an adjunctive therapy, with it being curative in conjunction with current therapy. Conclusion: Given the morbidity and mortality suffered globally by M. tuberculosis, it is time to realize the seriousness of the situation and accelerate our commitment and investment to the eradication of this infectious disease. With the number of vaccine candidates currently in clinical trials having promising results, it is imperative to continue these studies and accelerate towards phase III licensure trials if we are to achieve the milestone of “End TB Strategy” by 2035. Today, we are witnessing immense progress in both preclinical and clinical TB vaccine research despite disappointing results from some of the clinical efficacy trials like that of MVA85A. We can revisit the design of vaccines and learn from them. It is important not only to recognize and give credit to those that have tested well in human trials, such as M72 + AS01E, but to expedite and improve its efficacy through funding of its research.展开更多
Background: Despite the availability of highly effective treatment for decades, Tuberculosis (TB) remains a major health problem in Nigeria due to the increasing association between HIV and TB observed over the past t...Background: Despite the availability of highly effective treatment for decades, Tuberculosis (TB) remains a major health problem in Nigeria due to the increasing association between HIV and TB observed over the past three decades when HIV was discovered. However, the proportion of TB and or TB/HIV co-infected patients who have successful TB treatment outcome is not well known. This study determined the treatment outcome of TB/HIV co-infected patients with HIV negative patients in two states in Nigeria. Materials and Methods: A retrospective study of secondary data from eight Directly Observed Treatment Short (DOTS) course and Anti- Retroviral Therapy (ART) service providers in Benue and Federal Capital Territory (FCT), Nigeria, was carried out. The period under review covers January, 2010 to December, 2013. Results: Out of the total 5266 TB cases reviewed, the HIV prevalence rate was 52%. They were predominantly (53.3%) male with mean age of 34.4 years (SD = 15.1 years). More than two-third (72.5%) of HIV-negative patients had successful treatment compared to 1718 (62.7%) HIV-positive patients. Of the 2334 HIV co-infected patients, 19.5% defaulted, 11.5% had died, 5.6% were transferred out and 0.7% failed treatment compared to HIV-negative patients amongst whom 18.3% defaulted, 3.6% died, 3.9% were transferred out and 1.6% failed treatment (p Conclusion: The favourable treatment outcome of HIV-negative patients is more than that of HIV-positive patients and the most probable predictable factor responsible is the CD4 count of patient;indicating that TB/HIV co-infection has remained a major public health problem in Benue state and FCT. Hence there is the need for sustained strengthening and expansion of the national TB/HIV programmes.展开更多
文摘This research focuses on the effects of migration on the TB infection rate and its prevention in Saudi Arabia, which has a large number of expatriates from TB-affected countries. Despite, based on the current global statistics of TB occurrence, it is evident that the national incidence of TB has reduced from 10.55 per 100,000 in 2015 to 8.36 per 100,000 in 2019;despite this, there are still some difficulties because migrants bring new strains of Mycobacterium tuberculosis. Hindrances, including language barriers and perceived immigration status, hinder patients from seeking medical attention or doctors from diagnosing diseases. Each patient and each cultural group need special attention to public health, enhancing living circumstances, and health care support. Community participation, inclusion of TB control programs into functional healthcare facilities, and the functioning of TB programs need to be stressed to address TB issues. Considering the focus on social, economic, and cultural approaches, the country can make severe advancements in TB control and population protection. This holistic analysis is critical for a long-term effective strategy to combat TB in the Kingdom.
文摘Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.
文摘Objective:To investigate the genetic correlations between epithelial growth factor receptor(EGFR)mutation and FHIT methylation in patients diagnosed with lung adenocarcinoma(AC)and pulmonary tuberculosis(TB).Methods:The presence of EGFR mutations and the methylation status of the FHIT gene in patients presenting with AC and TB were analyzed.The correlation between TB status and the observed genetic and epigenetic variations was also examined.Results:Among the 90 patients included in the study,38 exhibited EGFR mutations(14 among those with TB and 24 among those without TB),while 29 exhibited FHIT myelination(19 among those with TB and 10 among those without TB).Furthermore,the protein expression levels of EGFR and FHIT were significantly higher in patients diagnosed solely with AC compared to those presenting with both AC and TB.A robust inverse correlation was identified between TB status and the frequency of EGFR mutation(P<0.001).Moreover,significant associations were observed between TB status and FHIT methylation(P<0.01).Conclusion:The findings suggest a correlation between TB and the prevalence of EGFR mutation and FHIT methylation in the pathogenesis of AC.
文摘Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.
基金Supported by The Science and Technology Innovation Program of Changde City.
文摘BACKGROUND Organizing pneumonia secondary to pulmonary tuberculosis is rare.Moreover,the temporal boundary between pulmonary tuberculosis and secondary organizing pneumonia has not been defined.We report a case of secondary organizing pneumonia associated with pulmonary tuberculosis occurring after nine months of antituberculosis treatment.CASE SUMMARY A 54 years old man,previously diagnosed with pulmonary tuberculosis and tuberculous pleurisy,underwent nine months of antituberculosis treatment.Follow-up lung computed tomography revealed multiple new subpleural groundglass opacities in both lungs,and a lung biopsy confirmed organizing pneumonia.Treatment continued with anti-tuberculosis agents and hormone therapy,and subsequent dynamic pulmonary computed tomography exams demonstrated improvement in lesion absorption.No disease recurrence was observed after corticosteroid therapy discontinuation.CONCLUSION When treating patients with active pulmonary tuberculosis,if an increase in lesions is observed during anti-tuberculosis treatment,it is necessary to consider the possibility of tuberculosis-related secondary organizing pneumonia,timely lung biopsy is essential for early intervention.
文摘Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.
文摘Objective:To explore the clinical efficacy of the integrated medical care model combined with psychological intervention in pulmonary tuberculosis patients with lung cancer.Methods:From January to December 2022,60 pulmonary tuberculosis patients with lung cancer admitted to our hospital were selected as the research subjects.Using the random number table method,the patients were divided into two groups,a control group and a study group,with 30 cases in each group.The chest computed tomography(CT)examination results,mental state assessment(including depression scale and anxiety scale)scores,incidence of adverse reactions,treatment effect,and length of hospital stay were compared between the two groups.Results:The treatment effect of the patients in the study group was better than that of the patients in the control group(P<0.05);the duration of hospitalization,chest CT examination results,mental state assessment scores,and incidence of adverse reactions of the study group and the control group,were significantly different(P<0.05).Conclusion:The integrated medical care model combined with psychological intervention can effectively improve the treatment effect of pulmonary tuberculosis patients with lung cancer and prevent the occurrence of adverse reactions;thus,it should be promoted in clinical practice.
基金Baoding Science and Technology Plan Project“The Effect of Medical-Nurse Integrated Nursing Model Combined with Psychological Intervention on the Clinical Curative Effect of Tuberculosis and Lung Cancer Patients”(Project number:2141ZF318).
文摘Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis combined with lung cancer were admitted.All patients were diagnosed with pulmonary tuberculosis according to the Guidelines for the Diagnosis and Treatment of Pulmonary Tuberculosis and with lung cancer by pathology.The patients were randomly divided into two groups,with 30 cases in each group.The control group received daily nursing care,whereas the study group received integrated medical and nursing care.The sputum conversion rate,tumor remission rate,and quality of life of patients were observed and analyzed.Results:The item function score and symptom function score of the observation group were higher than those of the control group(P<0.05);the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the sputum conversion rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:For patients with pulmonary tuberculosis combined with lung cancer,the application of integrated medical and nursing care can help consolidate the treatment effect and improve the quality of life of patients;thus,it is worthy of promotion and application.
基金Supported by Youth Science and Technology Innovation Leader Support Project,No.RC170497Shenyang Municipal Science and Technology Project,No.F16-206-9-23+5 种基金Natural Science Foundation of Liaoning Province of China,No.201602450National Key R&D Program of Ministry of Science and Technology of China,No.2016YFC1303002National Natural Science Foundation of China,No.81872363Major Technology Plan Project of Shenyang,No.17-230-9-07Supporting Fund for Big data in Health Care,No.HMB2019031012018 Key Research and Guidance Project of Liaoning Province,No.2018225038.
文摘BACKGROUND Pulmonary tuberculosis(TB)and lung cancer(LC)are common diseases with a high incidence and similar symptoms,which may be misdiagnosed by radiologists,thus delaying the best treatment opportunity for patients.AIM To develop and validate radiomics methods for distinguishing pulmonary TB from LC based on computed tomography(CT)images.METHODS We enrolled 478 patients(January 2012 to October 2018),who underwent preoperative CT screening.Radiomics features were extracted and selected from the CT data to establish a logistic regression model.A radiomics nomogram model was constructed,with the receiver operating characteristic,decision and calibration curves plotted to evaluate the discriminative performance.RESULTS Radiomics features extracted from lesions with 4 mm radial dilation distances outside the lesion showed the best discriminative performance.The radiomics nomogram model exhibited good discrimination,with an area under the curve of 0.914(sensitivity=0.890,specificity=0.796)in the training cohort,and 0.900(sensitivity=0.788,specificity=0.907)in the validation cohort.The decision curve analysis revealed that the constructed nomogram had clinical usefulness.CONCLUSION These proposed radiomic methods can be used as a noninvasive tool for differentiation of TB and LC based on preoperative CT data.
文摘Objective:More health workers die from infectious diseases such as tuberculosis(TB)than from any other infectious agent,so the current study is designed to assess TB treatment and preventive measures as they relate to nursing care practice.Materials and Methods:A cross-sectional study was conducted among 82 nurses from December 2022 to January 2023.The data were collected through a self-developed questionnaire and analyzed by frequency table and analysis of variance(ANOVA)statistics.Results:The researchers found that nurses have sufficient knowledge on Infection Prevention and Control(IPC)policy,but not all nurses follow this management protocol,and the reason for their action is addressed in this study.The management and preventive measures used by the participants were identified as:proper cough etiquette/hygiene,working in a well-ventilated area,use of mask,appropriate disposal of used items and so on was reported.Moreover,this study also discovered that there is a positive correlation between nurses who had received training in IPC policy and their use of airborne preventive measures for TB patients(F=1.87,P=0.002)as well as a positive correlation between the availability of resources and their adherence to the proper use of airborne preventive measures when caring for TB patients(F=1.96,P˂0.001).Conclusion:We proposed infection and control training for nurses and adequate equipment supplies to the TB ward which are required in quick TB diagnosis,and must be carried out on a regular basis by health-care personnel,for efficient nursing practice.Ensuring proper safety equipment and isolation units should be available and assessable for nurses or other health workers showing sign or symptoms of TB.Similarly,it is necessary for government to put in place the control and regulations that will safeguard nurses and mandate them to adopt TB prevention protocols,which will aid in lowering the prevalence of TB among nurses.
文摘We report a 43-year-old man who presented with a right painful shoulder mass and bilateral lung masses in computed tomography(CT).Scapular mass was excised and pathology report demonstrated high-grade metastatic tumor.Same side lung biopsy and histopathological study characterized tuberculosis but biopsy of the left lung lesion identified adenocarcinoma of the lung.The final diagnosis was right scapular metastatic lesion from left lung adenocarcinoma.Musculoskeletal symptoms are commonly encountered in lung malignancies due to paraneoplastic syndrome or hematogenous metastasis but scapular metastasis on the other side as the presentation of lung cancer is extremely rare.
文摘Laryngeal tuberculosis is a rare entity. We consider the case of a woman of 62 who presented a one-year evolving chronic dysphonia chart associated with cough, febricula and general health damage. The nasofibroscopy showed a budding ulcerous lesion of the larynx a priori evoking a granulomatous lesion or cancer. The BAAR spits were strongly positive and the radiographic pictures of the thorax, typically evoked a pulmonary tuberculosis. Seeing the excellent therapeutic response to TB treatment in 4 months period, the bifocal tuberculosis diagnostic was confirmed.
文摘Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.
基金supported by a research grant from Tuberculosis Association of India(Grant no.Res.4/2008)
文摘Objective:To evaluate inhouse developed SEVA TB peroxidase enzyme immunoassay using cocktail of mycobacterial excretory-secretory antigens(ES-31,ES-43 & EST-6) for antibody detection and their affinity purified antibodies for antigen detection in tuberculosis suspected patients.Methods:Inhouse developed SEVA TB peroxidase enzyme immunoassay was evaluated prospectively in 73 suspected pulmonary and 46 extra-pulmonary tuberculosis patients during November 2008~March 2009 in a tertiary hospital located in rural area.Results:Assay on prospective analysis showed 100% correlation of pulmonary tuberculosis(PTB) and extrapulmonary tuberculosis(EPTB) acid fast bacilli positivity and antitubercular treatment in 11 cases.Thirty nine PTB and 12 EPTB cases showed negative for EUSA test and were also not given antitubercular therapy.However 30 PTB and 27 EPTB cases showing ELISA positivity were neither acid fast bacilli positive nor antitubercular therapy treated.These cases may possibly have dormant infection and need further diagnosis.In EPTB cases ELISA was observed to be more useful than AFB smear test.Conclusions:This inhouse developed user-friendly peroxidase ELISA can be used as an adjunct test of smear microscopy or culture techniques for routine screening of patients suspected of PTB or EPTB.
文摘Background: The emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug- resistant tuberculosis (XDR-TB) has highlighted the need for early accurate detection and drug susceptibility. Objective: The purpose of the present study was to evaluate the accuracy of GeneX-pert MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampicin resistance. Methodology: This cross sectional study was done in the Department of Microbiology at Sir Salimullah Medical College, Dhaka and National Institute of Chest Disease & Hospital (NIDCH), Dhaka during the period of January 2014 to December 2014 for a period of 1 (one) year. Sputum samples from suspected MDR-TB patients were collected by purposive sampling technique from OPD of Sir Salimullah Medical College (SSMC) and NIDCH. Microscopy, liquid culture in liquid MGIT 960 media and GeneXpert MTB/RIF were done for MTB diagnosis and detection of rifampicin resistance. MGIT 960 media were also used for determination of drug resistance. Result: Liquid culture yielded higher growth (68%) from 100 samples while GeneXpert MTB assay showed similar result (67% positive and 33% negative). Drug susceptibility test in MGIT 960 media showed that out of 68 positive cases Rifampicin resistant cases were 15 (22.05%) whereas GeneXpert MTB assay detected 14 (20.89%) were Rifampicin resistant out of 67 MTB positive samples. When compared to liquid culture the calculated sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of GeneXpert MTB were 98.52%, 100%, 96.96%, 100% and 99%. Conclusion: GeneXpert MTB/RIF assay is high detection rate of pulmonary tuberculosis and multidrug resistant tuberculosis.
文摘The Official Journal of the International Union Against Tuberculosis and Lung DiseaseEDITORIAL BOARDEditor-in-ChiefMICHAEL D ISEMAN National Jewish Center for Immunology and Respiratory Medicine 1400 Jackson Street, Denver CO 80206 USAAssociate EditorsNADIA AIT-KHALED (Algeria) MARCOS ESPINAL (Dominican Republic) ARIEL PABLOS-MENDEZ (Mexico)ISABELLA ANNESI-MAESANO (France) VICTORINO FARGA (Chile) RAMESH PANCHAGNULA (india)PER S BAKKE (Norway) PAUL E M FINE (UK) CHRISTIAN PERRONNE (France)MARGARET BECKLA.
文摘The Official Journal of the International Union Against Tuberculosis and Lung DiseaseEDITORIAL BOARDEditor-in-ChiefMICHAEL D ISEMAN National Jewish Center for Immunology and Respiratory Medicine 1400 Jackson Street, Denver CO 80206 USAAssociate EditorsNADIA AIT-KHALED (Algeria) MARCOS ESPINAL (Dominican Republic) ARIEL PABLOS-MENDEZ (Mexico)ISABELLA ANNESI-MAESANO (France) VICTORINO FARGA (Chile) RAMESH PANCHAGNULA (India)PER S BAKKE (Norway) PAUL E M FINE (UK) CHRISTIAN PERRONNE (France)MARGARET BECKLA.
文摘Introduction: Tuberculosis (TB) continues to be a global health challenge and currently only one licensed vaccine is available. For nearly 100 years, the Bacillus Calmette-Guérin (BCG) vaccine has been in use. While it provides protection against disseminated TB in infants, its protection against adult and adolescent pulmonary tuberculosis (PTB) is variable. This literature review will provide an overview of the clinical status of candidate TB vaccines and discuss the challenges and future development trends of novel TB vaccine research, in combination with a general overview of the Tuberculosis (TB) disease and Mycobacterium tuberculosis itself. Methods: Bibliographic searches were carried out on medical journal databases, publishers, and aggregators. The most used databases were PubMed, NCBI and MDPI. Publications in English on these and other databases relating to novel TB vaccines were included in this review. Results: Currently, there are 12 main vaccine candidates in various phases of clinical trials, they include four protein or adjuvant vaccines, three viral-vectored vaccines, three mycobacterial whole cells or extract vaccines, and one each of the recombinant life and the attenuated Mycobacterium tuberculosis vaccine. Currently, the most likely candidate vaccines are the M72 + AS01E and Vaccae vaccines. M72 + AS01E is a recombinant fusion protein vaccine candidate, clinical trials showed that administering two doses of M72/AS01E was successful in reducing the development of active TB disease with 50% efficacy. Studies have also proven the efficacy of Vaccae (which is currently in phase III clinical trials) as an adjunctive therapy, with it being curative in conjunction with current therapy. Conclusion: Given the morbidity and mortality suffered globally by M. tuberculosis, it is time to realize the seriousness of the situation and accelerate our commitment and investment to the eradication of this infectious disease. With the number of vaccine candidates currently in clinical trials having promising results, it is imperative to continue these studies and accelerate towards phase III licensure trials if we are to achieve the milestone of “End TB Strategy” by 2035. Today, we are witnessing immense progress in both preclinical and clinical TB vaccine research despite disappointing results from some of the clinical efficacy trials like that of MVA85A. We can revisit the design of vaccines and learn from them. It is important not only to recognize and give credit to those that have tested well in human trials, such as M72 + AS01E, but to expedite and improve its efficacy through funding of its research.
文摘Background: Despite the availability of highly effective treatment for decades, Tuberculosis (TB) remains a major health problem in Nigeria due to the increasing association between HIV and TB observed over the past three decades when HIV was discovered. However, the proportion of TB and or TB/HIV co-infected patients who have successful TB treatment outcome is not well known. This study determined the treatment outcome of TB/HIV co-infected patients with HIV negative patients in two states in Nigeria. Materials and Methods: A retrospective study of secondary data from eight Directly Observed Treatment Short (DOTS) course and Anti- Retroviral Therapy (ART) service providers in Benue and Federal Capital Territory (FCT), Nigeria, was carried out. The period under review covers January, 2010 to December, 2013. Results: Out of the total 5266 TB cases reviewed, the HIV prevalence rate was 52%. They were predominantly (53.3%) male with mean age of 34.4 years (SD = 15.1 years). More than two-third (72.5%) of HIV-negative patients had successful treatment compared to 1718 (62.7%) HIV-positive patients. Of the 2334 HIV co-infected patients, 19.5% defaulted, 11.5% had died, 5.6% were transferred out and 0.7% failed treatment compared to HIV-negative patients amongst whom 18.3% defaulted, 3.6% died, 3.9% were transferred out and 1.6% failed treatment (p Conclusion: The favourable treatment outcome of HIV-negative patients is more than that of HIV-positive patients and the most probable predictable factor responsible is the CD4 count of patient;indicating that TB/HIV co-infection has remained a major public health problem in Benue state and FCT. Hence there is the need for sustained strengthening and expansion of the national TB/HIV programmes.