Background: Oman is a high-income, low prevalent country for tuberculosis disease. Although the rates have remained static over the last decade, the country is aiming for Tuberculosis (TB) elimination. Household conta...Background: Oman is a high-income, low prevalent country for tuberculosis disease. Although the rates have remained static over the last decade, the country is aiming for Tuberculosis (TB) elimination. Household contacts of pulmonary TB (PTB) patients form a high-risk group of susceptible individuals who could remain reservoirs of active disease. Objective: A retrospective study was conducted to estimate the prevalence of latent TB infection by Tuberculin Skin Test (TST) or Interferon-Gamma Release Assay (IGRA) screening tests among the household contacts of Omani patients with pulmonary tuberculosis. Design: A cross-sectional survey conducted between 2017 and 2018 of TB cases and their contacts in Muscat Governorate, Oman. Results: Out of the 278 contacts identified, 188 contacts fulfilled the inclusion criteria and were enrolled into the study. The prevalence of Latent Tuberculosis Infection (LTBI) was 22.8% (95% CI: 17.0 - 29.5) among household contacts. We found higher proportions of LTBI among females than males (28.7% vs. 15%, p = 0.027). Those who were exposed to Acid Fast Bacilli (AFB) smear positive cases were more likely to be LTBI (28.7% versus 15% in smear negative cases;p = 0.047). We also found an increasing trend of infection (32.3%) in the oldest age group (46 - 80 years). Conclusion: Besides children, female household contacts and older age contacts should be prioritized for screening as they are more likely to be infected and develop active disease.展开更多
A third of the world’s population is latently infected with TB with an increased risk of developing active TB. Household contacts (HHCs) of pulmonary TB cases are at a greater risk of developing disease. Early identi...A third of the world’s population is latently infected with TB with an increased risk of developing active TB. Household contacts (HHCs) of pulmonary TB cases are at a greater risk of developing disease. Early identification and treatment of latent TB infected individuals may reduce progression to active TB. This study aimed to determine latent TB infections (LTBI) point prevalence among HHCs and community contacts (CCs) using Tuberculin Skin Test (TST) and whole blood IFN-γ release assay in an area of high TB prevalence. In a prospective, longitudinal and community-based study and following informed consent, 768 volunteers (HHCs n = 245;CCs n = 523) were enrolled. Tuberculin Skin Test (TST), whole blood stimulation with PPD and IFN-γ levels determination using ELISA were performed. Mean ages of HHCs and the CCs were not significantly different (HHCs 35.6 ± 15.7 and CCs 30.6 ± 11.7 years;p = 0.99), with a Male:Female ratio of 1:2. Mean recruitment TST indurations were 4.6 ± 5.5 mm and 2.8 ± 3 mm for HHCs and CCs respectively (p = 0.000). Follow-up (Day 614) mean TST indurations increased significantly to 9.1 ± 7.2 mm and 4.4 ± 3.2 mm for HHCs and CCs respectively (p = 0.001). Using TST indurations ≥ 10 mm, LTBI point prevalence for HHCs and CCs was significantly different (HHCs 461/1000 and 367/1000 individuals, p = 0.03). The mean IFN-γ levels for HHCs and CCs at recruitment day (Day 0) were 0.66 ± 0.17 IU/ml and 0.06 ± 0.04 respectively. The mean of IFN-γ production levels dropped significantly at Day 614 for HHCs and CCs to 0.66 ± 0.15 IU/ml and 0.02 ± 0.02 respectively (p = 0.03) (p = 0.00001). Recruitment LTBI point prevalence using IFN-γ level ≥ 0.35 IU/ml for HHCs and CCs was 440/1000 and 203/1000 respectively (p = 0.000000001). No correlations between TST indurations and IFN-γ levels were detected among HHCs or CCs (p > 0.05). TST is a simple, efficient and cheap technique for LTBI diagnosis and triaging individuals for treatment.展开更多
The aim of this study was to analyze the combination of three kinds of in-house IFN-γ ELISPOT using peptide A53 and peptide mixtures (E6 + E7 and E6 + E7 + C14) with tuberculin skin test (TST) to detect latent TB inf...The aim of this study was to analyze the combination of three kinds of in-house IFN-γ ELISPOT using peptide A53 and peptide mixtures (E6 + E7 and E6 + E7 + C14) with tuberculin skin test (TST) to detect latent TB infection (LTBI) in China. A total of 788 healthy people were recruited and analyzed by three kinds of IFN-g ELISPOT, 581 of them had TST results, of which 147 samples were also compared with the T- SPOT.TB test. The positive detection rates for T- SPOT.TB and three kinds of IFN-γ ELISPOT with A53, E6 + E7 and E6 + E7 + C14 were 14.28% (21/147), 29.43% (171/581), 23.24% (135/581) and 28.40% (165/581), respectively. These results were significantly lower than the positive TST results, which were positive in 82.99% (122/147) and 75.73% (440/ 581), respectively. The positive detection rates of three kinds of IFN-γ ELISPOT (31.60%, 26.65% and 32.11% in 788 cases, respectively) could better reflect over 40.00% of Mycobacterium tuberculosis (MTB) infection rate in China. Detection rates between contacts and non-contacts by three kinds of IFN-γ ELIS-POT were not significantly different (p > 0.05). It can be seen that the three kinds of in-house IFN-γ ELIS- POT might be used as a complementary tool of T- SPOT.TB for detecting LTBI in the healthy population of China.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
Background: Ustekinumab is a human monoclonal antibody that binds to the shared P40 subunit of interleukin (IL)-12 and IL-23 and is approved for the treatment of moderate-to-severe psoriasis. Latent tuberculosis (LTBI...Background: Ustekinumab is a human monoclonal antibody that binds to the shared P40 subunit of interleukin (IL)-12 and IL-23 and is approved for the treatment of moderate-to-severe psoriasis. Latent tuberculosis (LTBI) was diagnosed based on a positive tuberculin skin test (TST) or QuantiFERON-TB test without evidence of active tuberculosis (TB). Aim: To evaluate the risk of active tuberculosis reinfection in patients with a history of psoriasis and LTBI after INH prophylaxis treated with Ustekinumab. Case Report: We are describing 3 patients with a history of moderate-to-severe plaque psoriasis and newly identified LTBI who have been treated with INH monotherapy before starting Ustekinumab therapy followed-up over 2 years for any sign of tuberculosis reinfection. Conclusion: Ustekinumab is an option for treating psoriasis and LTBI with minimal risk of reactivation after INH prophylaxis.展开更多
Introduction: Tuberculosis still characterizes till now a major respiratory insult with concurrent pulmonary manifestations and later disability. Aim of Work: To evaluate the level of exhaled fraction of nitric oxide ...Introduction: Tuberculosis still characterizes till now a major respiratory insult with concurrent pulmonary manifestations and later disability. Aim of Work: To evaluate the level of exhaled fraction of nitric oxide (FENO) and fraction of exhaled carbon monoxide (FECO) as markers of pulmonary tuberculosis TB activity in patients under chemotherapy in comparison to healthy negative patients and latent TB patients. Patients and Methods: This cross-sectional study was conducted on 130 patients recruited from the outpatient clinic of Mansoura Chest hospital during the period from May 2019 to December 2019. They were categorized into the three groups: 1) Pulmonary tuberculous patients PTB (group1) which included 48 cases with positive sputum for TB bacilli in the initiation phase after 1 month of starting anti-tuberculous chemotherapy;2) Latent patients (group 2): included 40 patients with positive tuberculin skin test (Mantoux test) > 10 mm. 3) Control patients (group 3) which included 42 healthy volunteers with negative sputum for TB bacilli. They were subjected to portable spirogram as well as exhaled fractional NO and CO measurement. Results: FECO and FENO levels prevailed in pulmonary TB patients followed by Latent TB patients and lastly healthy volunteers (42 ± 12.32/5 ± 0.16 & 38 ± 8.25/6 ± 2.25 and 23 ± 3.25/2 ± 0.40 respectively). Conclusion: Measurement of CO and NO level in expired air may correlate with active pulmonary TB infection in comparison to healthy negative tuberculous patients and latent tuberculous patients.展开更多
Objective： To understand the reactivity of purified protein derivative skin test（PPD test） in HIV-infected persons and to determine the influential factors associated with PPD. Methods： 174 HIV/AIDS patients regis...Objective： To understand the reactivity of purified protein derivative skin test（PPD test） in HIV-infected persons and to determine the influential factors associated with PPD. Methods： 174 HIV/AIDS patients registered in the local center for disease control and prevention（CDC） participated this study from April to June in 2006. Questionnaire,CD4 count and thoracic roentgenogram were performed for all participants. Results： In this study, response rate of questionnaires was 83.65%. The majority of these participants had a different degree of immunodeficiency that accounted for 93.64%. Female patients had a higher CD4 count than that of males. The total positive rate of PPD was 38.15%. Analysis of single factor in our study indicated that CD4 count, previous tubereulosis history, tuberculosis contact history and thoracic roentgenogram manifestation of patients were related to their PPD diameters. Further analysis of multiple factors also supports the previous conclusion that CD4 count and previous tuberculosis history of patients were risk factors in the PPD test. Conclusion： The PPD test of HIV/AIDS patients could be affected by several factors. For persons infected with HIV, the confirmation of latent tuberculosis infection （LTBI） should be considered the combination effect of previous MTB infection and body cellular immune function.展开更多
文摘Background: Oman is a high-income, low prevalent country for tuberculosis disease. Although the rates have remained static over the last decade, the country is aiming for Tuberculosis (TB) elimination. Household contacts of pulmonary TB (PTB) patients form a high-risk group of susceptible individuals who could remain reservoirs of active disease. Objective: A retrospective study was conducted to estimate the prevalence of latent TB infection by Tuberculin Skin Test (TST) or Interferon-Gamma Release Assay (IGRA) screening tests among the household contacts of Omani patients with pulmonary tuberculosis. Design: A cross-sectional survey conducted between 2017 and 2018 of TB cases and their contacts in Muscat Governorate, Oman. Results: Out of the 278 contacts identified, 188 contacts fulfilled the inclusion criteria and were enrolled into the study. The prevalence of Latent Tuberculosis Infection (LTBI) was 22.8% (95% CI: 17.0 - 29.5) among household contacts. We found higher proportions of LTBI among females than males (28.7% vs. 15%, p = 0.027). Those who were exposed to Acid Fast Bacilli (AFB) smear positive cases were more likely to be LTBI (28.7% versus 15% in smear negative cases;p = 0.047). We also found an increasing trend of infection (32.3%) in the oldest age group (46 - 80 years). Conclusion: Besides children, female household contacts and older age contacts should be prioritized for screening as they are more likely to be infected and develop active disease.
文摘A third of the world’s population is latently infected with TB with an increased risk of developing active TB. Household contacts (HHCs) of pulmonary TB cases are at a greater risk of developing disease. Early identification and treatment of latent TB infected individuals may reduce progression to active TB. This study aimed to determine latent TB infections (LTBI) point prevalence among HHCs and community contacts (CCs) using Tuberculin Skin Test (TST) and whole blood IFN-γ release assay in an area of high TB prevalence. In a prospective, longitudinal and community-based study and following informed consent, 768 volunteers (HHCs n = 245;CCs n = 523) were enrolled. Tuberculin Skin Test (TST), whole blood stimulation with PPD and IFN-γ levels determination using ELISA were performed. Mean ages of HHCs and the CCs were not significantly different (HHCs 35.6 ± 15.7 and CCs 30.6 ± 11.7 years;p = 0.99), with a Male:Female ratio of 1:2. Mean recruitment TST indurations were 4.6 ± 5.5 mm and 2.8 ± 3 mm for HHCs and CCs respectively (p = 0.000). Follow-up (Day 614) mean TST indurations increased significantly to 9.1 ± 7.2 mm and 4.4 ± 3.2 mm for HHCs and CCs respectively (p = 0.001). Using TST indurations ≥ 10 mm, LTBI point prevalence for HHCs and CCs was significantly different (HHCs 461/1000 and 367/1000 individuals, p = 0.03). The mean IFN-γ levels for HHCs and CCs at recruitment day (Day 0) were 0.66 ± 0.17 IU/ml and 0.06 ± 0.04 respectively. The mean of IFN-γ production levels dropped significantly at Day 614 for HHCs and CCs to 0.66 ± 0.15 IU/ml and 0.02 ± 0.02 respectively (p = 0.03) (p = 0.00001). Recruitment LTBI point prevalence using IFN-γ level ≥ 0.35 IU/ml for HHCs and CCs was 440/1000 and 203/1000 respectively (p = 0.000000001). No correlations between TST indurations and IFN-γ levels were detected among HHCs or CCs (p > 0.05). TST is a simple, efficient and cheap technique for LTBI diagnosis and triaging individuals for treatment.
文摘The aim of this study was to analyze the combination of three kinds of in-house IFN-γ ELISPOT using peptide A53 and peptide mixtures (E6 + E7 and E6 + E7 + C14) with tuberculin skin test (TST) to detect latent TB infection (LTBI) in China. A total of 788 healthy people were recruited and analyzed by three kinds of IFN-g ELISPOT, 581 of them had TST results, of which 147 samples were also compared with the T- SPOT.TB test. The positive detection rates for T- SPOT.TB and three kinds of IFN-γ ELISPOT with A53, E6 + E7 and E6 + E7 + C14 were 14.28% (21/147), 29.43% (171/581), 23.24% (135/581) and 28.40% (165/581), respectively. These results were significantly lower than the positive TST results, which were positive in 82.99% (122/147) and 75.73% (440/ 581), respectively. The positive detection rates of three kinds of IFN-γ ELISPOT (31.60%, 26.65% and 32.11% in 788 cases, respectively) could better reflect over 40.00% of Mycobacterium tuberculosis (MTB) infection rate in China. Detection rates between contacts and non-contacts by three kinds of IFN-γ ELIS-POT were not significantly different (p > 0.05). It can be seen that the three kinds of in-house IFN-γ ELIS- POT might be used as a complementary tool of T- SPOT.TB for detecting LTBI in the healthy population of China.
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.
文摘Background: Ustekinumab is a human monoclonal antibody that binds to the shared P40 subunit of interleukin (IL)-12 and IL-23 and is approved for the treatment of moderate-to-severe psoriasis. Latent tuberculosis (LTBI) was diagnosed based on a positive tuberculin skin test (TST) or QuantiFERON-TB test without evidence of active tuberculosis (TB). Aim: To evaluate the risk of active tuberculosis reinfection in patients with a history of psoriasis and LTBI after INH prophylaxis treated with Ustekinumab. Case Report: We are describing 3 patients with a history of moderate-to-severe plaque psoriasis and newly identified LTBI who have been treated with INH monotherapy before starting Ustekinumab therapy followed-up over 2 years for any sign of tuberculosis reinfection. Conclusion: Ustekinumab is an option for treating psoriasis and LTBI with minimal risk of reactivation after INH prophylaxis.
文摘Introduction: Tuberculosis still characterizes till now a major respiratory insult with concurrent pulmonary manifestations and later disability. Aim of Work: To evaluate the level of exhaled fraction of nitric oxide (FENO) and fraction of exhaled carbon monoxide (FECO) as markers of pulmonary tuberculosis TB activity in patients under chemotherapy in comparison to healthy negative patients and latent TB patients. Patients and Methods: This cross-sectional study was conducted on 130 patients recruited from the outpatient clinic of Mansoura Chest hospital during the period from May 2019 to December 2019. They were categorized into the three groups: 1) Pulmonary tuberculous patients PTB (group1) which included 48 cases with positive sputum for TB bacilli in the initiation phase after 1 month of starting anti-tuberculous chemotherapy;2) Latent patients (group 2): included 40 patients with positive tuberculin skin test (Mantoux test) > 10 mm. 3) Control patients (group 3) which included 42 healthy volunteers with negative sputum for TB bacilli. They were subjected to portable spirogram as well as exhaled fractional NO and CO measurement. Results: FECO and FENO levels prevailed in pulmonary TB patients followed by Latent TB patients and lastly healthy volunteers (42 ± 12.32/5 ± 0.16 & 38 ± 8.25/6 ± 2.25 and 23 ± 3.25/2 ± 0.40 respectively). Conclusion: Measurement of CO and NO level in expired air may correlate with active pulmonary TB infection in comparison to healthy negative tuberculous patients and latent tuberculous patients.
文摘Objective： To understand the reactivity of purified protein derivative skin test（PPD test） in HIV-infected persons and to determine the influential factors associated with PPD. Methods： 174 HIV/AIDS patients registered in the local center for disease control and prevention（CDC） participated this study from April to June in 2006. Questionnaire,CD4 count and thoracic roentgenogram were performed for all participants. Results： In this study, response rate of questionnaires was 83.65%. The majority of these participants had a different degree of immunodeficiency that accounted for 93.64%. Female patients had a higher CD4 count than that of males. The total positive rate of PPD was 38.15%. Analysis of single factor in our study indicated that CD4 count, previous tubereulosis history, tuberculosis contact history and thoracic roentgenogram manifestation of patients were related to their PPD diameters. Further analysis of multiple factors also supports the previous conclusion that CD4 count and previous tuberculosis history of patients were risk factors in the PPD test. Conclusion： The PPD test of HIV/AIDS patients could be affected by several factors. For persons infected with HIV, the confirmation of latent tuberculosis infection （LTBI） should be considered the combination effect of previous MTB infection and body cellular immune function.
