SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS最新文献

{"title":"Comparison of CD4 and CD8 Counts in HIV negative Pulmonary Tuberculosis Patients with Normal Healthy Controls in and around Prayagraj","authors":"M. Tariq, A. Chandra, A. Verma, Vakeel Ahmad, V. Pandey, S. Akarsh, P. Kumar, Jitendra Agarwal","doi":"10.3126/saarctb.v19i1.39949","DOIUrl":"https://doi.org/10.3126/saarctb.v19i1.39949","url":null,"abstract":"Anti-tuberculosis immunity involves a cellular immune response for their control. A critical marker of immunologic integrity is the CD4 and CD8 cell counts. Tuberculosis may be a cause of non-HIV associated CD4 and CD8-T cell lymphopenia. This study compares mean CD4, CD8 cell count and CD4:CD8 Ratio in pulmonary tuberculosis patients never had treatment for tuberculosis, pulmonary tuberculosis patients had received anti-tuberculosis treatment for more than one month and normal healthy controls. A case control study done in Prayagraj from October 2019 to October 2020 includes HIV negative, sputum positive pulmonary tuberculosis patients never had treatment for tuberculosis(n=25), pulmonary tuberculosis patients had received anti-tuberculosis treatment for more than one month(n=24), and normal healthy controls(n=36). We collected details including age, sex, symptoms of pulmonary tuberculosis, anti-tuberculosis treatment and investigated for HIV testing by ELISA, Sputum for AFB, Sputum for CBNAAT, CD4 and CD8 cell count determined by flow cytometrically.\u0000The mean CD4 and CD8 cell count was significantly lower in HIV negative pulmonary tuberculosis patients never had treatment for tuberculosis than in normal healthy controls (p value<0.001) and CD4:CD8 ratio also lower (p value=0.013). The mean CD4 and CD8 cell count higher in pulmonary tuberculosis patients who have received anti-tuberculosis treatment for more than one month than in pulmonary tuberculosis patients never had treatment for tuberculosis (p value<0.001) and CD4:CD8 ratio also higher (p value=0.013). CD4 and CD8 lymphopenia is an acceptable phenomenon in HIV negative pulmonary tuberculosis patients and such lymphopenia improves with anti-tuberculosis drug regimens as per protocol. This study highlights the importance of CD4, CD8 cellular immune response conducted by T- lymphocytes in outcome of pulmonary tuberculosis.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121584707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Miliary Tuberculosis: A Descriptive Study in West Gujarat","authors":"C. Purohit, Kaplesh Patel, Parth M Patel","doi":"10.3126/saarctb.v19i1.39951","DOIUrl":"https://doi.org/10.3126/saarctb.v19i1.39951","url":null,"abstract":"Introduction: Almost 10 million patients suffer from tuberculosis all over the world. Miliary tuberculosis accounts for hardly 1-2 % of total tuberculosis cases but is usually fatal if left untreated. With global epidemic of human immunodeficiency virus (HIV) infection chances of developing tuberculosis disease has also increased. In last few decades MTB has shifted to young adults and elderly who are the most productive members of the society.\u0000Fifteen adults were diagnosed to have military tuberculosis during last one year and their data were analysed. Persons living with HIV(PLHIV) accounted for 46% of all cases of military TB. Twelve out of 15 were males. None had meningeal involvement. There was no mortality during hospital stay or follow up till date.\u0000High index of suspicion in classical clinical settings and early institution of anti-TB treatment can save lives of patients. Sputum for CBNAAT is very helpful in reaching the diagnosis.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117023035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review on the Diagnostic Accuracy of Line Probe Assay in the Rapid Diagnosis of Drug Resistant Tuberculosis in Indian Scenario","authors":"B. Suzana, K. Reddy, S. Bhargava, M. Chauhan","doi":"10.3126/saarctb.v19i1.39927","DOIUrl":"https://doi.org/10.3126/saarctb.v19i1.39927","url":null,"abstract":"Owing to the drastic increase in the number of patients with drug resistant TB around the world, it is important to increase the testing for it. Line probe assay (LPA) is the rapid diagnostic tool to detect drug resistant TB and it was endorsed by WHO for testing first line drugs such as Isoniazid (INH) and Rifampicin (RIF). This systematic review evaluated the accuracy of this LPA by analysing its sensitivity and specificity against the phenotypic drug susceptibility testing (DST) methods like LJ and liquid culture DST. A total of 4774 samples were included in this review from 19 articles. The average sensitivity and specificity for the detection of RIF resistance from 17 articles was 95.79% and 96.71% and for INH resistance it was 89.85% and 97.33% respectively when compared to phenotypic DST. Out of 19 articles included, 2 articles have mentioned the sensitivity and specificity for multi-drug resistant TB (MDR TB) and the average was 98.50 % and 97 % respectively. The accuracy for RIF resistance detection through first line LPA was good and the sensitivity detection for INH was less across the studies. This could be improved further in future generation assays. Our finding supports the use of LPA especially on smear positive specimens but use on smear negative specimens still be considered as studies have shown some interpretable results.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126171885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervention Strategies to Mitigate Psychosocial Challenges and Improve the Quality of Life of MDR-TB Patients - An Evaluation Study","authors":"E. Thiruvalluvan, S. Sellappan, Basilea Watson, M. Muniyandi","doi":"10.3126/saarctb.v18i1.34132","DOIUrl":"https://doi.org/10.3126/saarctb.v18i1.34132","url":null,"abstract":"Introduction: The psychosocial well-being and treatment outcome in MDR-TB is far undesirable as the treatment is characterized by a rigorous treatment regimen for a long duration, adverse side effects, lower cure rate, and high treatment costs. This study aimed to devise an intervention strategy and test its feasibility and effectiveness to ensure the patients’ quality of life (QOL) and to promote adherence.\u0000Methodology: The study population included all MDR-TB patients, of age 18 years and above registered in 16 tuberculosis units (TUs) under Chennai Corporation for treatment during the year 2014. Researchers have devised an intervention strategy package that included motivational interview (MI) module, counseling support as well as nutritional support. Participants were included in the study after getting informed consent. Motivational interviewing was offered at five times during the study period. Each participant received minimum 15 individual counselling sessions. All participants but two received nutritional flour packet weighing half kilogram every month.\u0000Results: Of 35 participants enrolled in the study, one third was women. Poor QOL was experienced by 19 participants out of 35 at the start of treatment that came down to 2 after the study. QOL scores in all four domains were significantly high and depression level score was significantly lowered at the end of the treatment. At the start of the treatment twenty, four out of thirty-five participants were dissatisfied with their health that came down to five at the end of treatment.\u0000Conclusion: Intervention strategy not only had a great impact on the QOL of study participants but also contributed to better treatment adherence and desirable treatment outcome. Therefore, researchers emphasize the need to adopt this Intervention Strategy through the provision of trained, professional MDR-TB counsellors. Further, larger studies of multi-state/ multi-site may be taken up to standardize the intervention strategies adopted in this study.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122987503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Childhood TB Management in Nepal: challenges, progress and lesson learned","authors":"Suvesh Shrestha, R. Bhattarai, Tara Chettry, R. Basnet, R. Bhattarai, A. Thapa, B. S. Tinkari, S. Sharma, S. Rajbhandari, A. Bhattachan","doi":"10.3126/saarctb.v18i1.34136","DOIUrl":"https://doi.org/10.3126/saarctb.v18i1.34136","url":null,"abstract":"Introduction: Childhood tuberculosis has always been in shadows as Nepal’s Tuberculosis Program focused mainly on adults TB resulting in under diagnose with less than 10% of total TB cases notified. Lack of political commitment; absence of guideline and working group, qualified health personnel and diagnostics tool were major implementation challenges. \u0000Methodology: Assessment of childhood TB program was done and critical gap were identified. Childhood TB was prioritized in National TB strategic plan (2016-21). Collaborate with both international and national child experts, public and private organizations to develop guideline, building capacity of health care providers and establishing national working group. Childhood TB focused interventions were implemented in 40 high burden districts since March,2017 focusing on contact tracing, diagnosis, Prevention Therapy, malnourished children in the community and major hospitals. \u0000Results : Political commitment and multi-sectoral involvement, to manage childhood TB was achieved. A total of 93 doctors were trained in the Childhood TB management training and were identified as focal persons to manage childhood TB in their respective regions. Child focused intervention from March 2018-19 resulted in the diagnosis of 521 TB cases among 38,987 malnourished children and1,764 children were enrolled under TPT after contact tracing of 59,742 family members. With political commitment, prioritization of childhood TB, collaboration of both government and non-government sectors and interventions focusing childhood TB, a significant achievement can be attained in childhood TB management. \u0000Conclusion: Nepal has shown childhood TB management program can be strengthen if NTP prioritizes it, child focused interventions are implemented and collaborate with Child health division, pediatrics association, other government and non-government organizations to increase and strengthen the  program.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132596131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial 18(1)","authors":"Bibek Kumar Lal","doi":"10.3126/saarctb.v18i1.49113","DOIUrl":"https://doi.org/10.3126/saarctb.v18i1.49113","url":null,"abstract":"No  available.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125320166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Treatment Adherence among Tuberculosis Patients in Gandaki Province of Nepal","authors":"R. Yadav, Hari Prasad Kaphle, D. Yadav, S. Gurung, Elina Khatri, S. Baral","doi":"10.3126/saarctb.v18i1.34128","DOIUrl":"https://doi.org/10.3126/saarctb.v18i1.34128","url":null,"abstract":"Introduction: Poor adherence to the treatment regimen is a major cause of treatment failure and the emergence of drug resistance among TB patients. The emergence of resistance to anti-tuberculosis drugs and particularly of multi-drug resistance (MDR), Pre-extensively drug resistance tuberculosis (Pre-XDR) and extensively drug resistance (XDR) tuberculosis have become a major public health problem in several countries and an obstacle to effective global TB control. \u0000Methodology: This research was health facility based cross-sectional study and carried out among TB patients registered under DOTS and receiving treatment more than or equal to 60 days from health facilities of Gandaki province of Nepal. Structured interview schedule and validated questionnaires were used for data collection. Treatment Adherence was assessed by using Nepali version of Morisky treatment adherence scale (MMSA-8) questionnaires. Data were entered in Epi-data software and analysis was performed with the help of the Statistical Package for Social Science (SPSS). The odds ratio with a 95%CI was calculated and a P-value of <0.05 was considered as cut off for statistical significance. \u0000Results: A total 180 TB patients were participated in this study. The overall prevalence of treatment adherence among tuberculosis participants was 79.4%. Participants who haven’t living with comorbidities were more than four times more likely to adhere with medicine compared to participants who had living with co-morbidities. Similarly, who had friendly relationship with health workers were more than forty six and half times likely to adhere to medicine with compared to participants who had unfriendly relationship with health workers. \u0000Conclusion: The supportive factors for treatment adherence among Tuberculosis patients were socioeconomic factors (Hilly region, hindu religion, nuclear family, literate), life style related factors (no prior alcohol consumption, not habit smokeless tobacco previously), diseases related factors (delay of confirming TB diagnosis, Not experienced side effects, aware about TB symptoms, no co-infection) and accessibility to health care facilities related factors (confirm TB diagnosis cost, favourable time for DOTS centre, health workers supervision during the medication, friendly relationship with health workers, know about the length of the treatment, TB status disclose).","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"21 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130945594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis and Stigma in India: Evidence from a Nationally Representive Survey","authors":"Paramita Barman","doi":"10.3126/saarctb.v18i1.34140","DOIUrl":"https://doi.org/10.3126/saarctb.v18i1.34140","url":null,"abstract":"Introduction: Infectious nature of pulmonary tuberculosis (TB) is one of the major reasons behind the prevailing stigma and negative attitude towards the disease. These factors stand in the way of seeking an early diagnosis or continuing treatment following a positive diagnosis. This study aims at exploring the shares of adult men and women conforming to TB related stigma in India, a high TB burden nation, and the causal factors behind the same. \u0000Methodology: The study uses unit level data on adult men and women from the nationally representative survey NFHS-3 (2005-06). Simple tools for descriptive statistics and logistic regression analysis have been employed. \u0000Results: Factors affecting TB related stigma among Indian men are age, religion, economic class ,education level, family structure and marital status. In case of women age plays no role. However, place of residence, social group and employment status emerge as significant factors impacting stigma among Indian women. Further, stigma levels vary across Indian states for both genders. \u0000Conclusion: Socio-economic and demographic factors that have a role to play in shaping people’s attitude towards disease and related health seeing behaviour need to be acknowledged and incorporated in policies targeted towards elimination of TB.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116481559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Onset Still’s Disease Presenting with Tuberculous Bronchopneumonia: A Case Study","authors":"Rassaiah Manmathan, A. Rathnapala, A. Siribaddana","doi":"10.3126/saarctb.v18i1.34142","DOIUrl":"https://doi.org/10.3126/saarctb.v18i1.34142","url":null,"abstract":"Introduction: The occurrence of Post primary Tuberculosis [TB] can be due to reactivation of previous infection or reinfection. Reactivation of TB could occur due to many conditions including immunosuppressive drug therapy and immunosuppressive diseases. In countries where latent TB is common a good vigilance is needed for early detection of TB when such conditions are managed.\u0000Adult onset Still’s disease (AOSD) is a rare systemic disorder of unknown etiology where fever, rash, lymphadenopathy and multi organ involvement occur. ASOD is a challenging condition to diagnose as there are no pathognomonic physical signs or markers. Early diagnosis and initiation of treatment is important as diagnostic delays could lead to serious consequences.\u0000Occurrence of tuberculosis in a patient with AOSD has not been documented in literature to-date. Here we describe a 46-year-old male who presented with low grade fever and arthralgia for more than one month with organomegaly and pericardial effusion managed as AOSD, later developed Tuberculous bronchopneumonia.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"215 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134454184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Challenges and Clinical Profile of Spine Tuberculosis – An Experience from Medium Sized Health Care Center, South India","authors":"S. Krishna, S. Kaiwar, Catherine Selvarajan, Amrithlal A. Mascrenhas, A. Flynn","doi":"10.3126/saarctb.v18i1.34099","DOIUrl":"https://doi.org/10.3126/saarctb.v18i1.34099","url":null,"abstract":"Introduction: Skeletal tuberculosis accounts for 10-35% of Extra-Pulmonary Tuberculosis (EPTB) and 3% of all cases of tuberculosis. Spine is involved in about 50% cases of skeletal tuberculosis. The diagnosis of Spine TB in the developing world until recently has been carried out by clinical presentation and neuro imaging modalities like X-ray/CT/MRI. Until the molecular era, the diagnostic tests at laboratories had mostly remained less contributory with low reliability and accuracy. The objective of the study was to review the spinal cases of TB and present an overview of the different methods of microbiological diagnosis in patients with Spine TB at our center.\u0000Methodology: Retrospective study (April 2016 – April 2019) of all consecutive patients suspected with pyogenic or Spine TB was undertaken with relevant clinical details. With the radiological screen the probable TB patients were sampled (tissue, pus, abscess fluids and exudates) and were processed for ZN stain, Culture (conventional), Xpert RIF/MTB assay (at reference lab) and Histopathology. Anti-Tubercular Therapy (ATT) was administered to all definitive cases with or without surgery.\u0000Results: A total of 26 patients of Definite TB were identified out of 42 suspected. The mean age was47 years (14-78 range). Fever (n=17) and pain (n=18) were most common symptoms reported by over 80% of the patients. The twenty-six patients characteristically had positive radiological changes in MRI. Lumbar (n=6) and thoracic (n=6) vertebrae were equally involved and over 50% (n=14) had two or more vertebral involvement. All 26 spine samples were negative for Acid Fast Bacilli (AFB) by ZN staining. Individually, the positive detection rate by Xpert MTB/RIF was 88% (n=23), by HPE was 65% (n=17) and by culture was 42% (n= 11) respectively. Xpert MTB/RIF was 82.3% sensitive and 64% specific when compared with Histopathological Evidence (HPE) alone and the sensitivity and specificity rose up 81% on comparing with cross HPE and or culture.\u0000Conclusion: Improved case detection of Spine TB was noted by using Xpert MTB/RIF assay at our center. We recommend Xpert MTB/RIF molecular test as the first-line investigation at laboratories for all the suspected cases of Spine TB and for confirmation when the clinical and MRI findings are inconclusive or unavailable. Staining and culture have proved less contributory. Age-old Histopathological evidence may no longer be viewed as a reference standard and needs more evaluation. Small and medium sized hospitals may gradually scale-down the Spine TB processing by AFB stain, and consider establishing on-site molecular infrastructure.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129691721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}