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

{"title":"Clinical Profile and Management of Empyema Thoracis: Experience from Eastern Nepal","authors":"D. R. Mishra, N. Bhatta, P. Koirala, R. Ghimire, B. Bista, N. Shah","doi":"10.3126/SAARCTB.V16I1.23242","DOIUrl":"https://doi.org/10.3126/SAARCTB.V16I1.23242","url":null,"abstract":"Introduction: The management of Empyema Thoracis is challenging. It requires specialist medical and surgical care at the same time. There are of lack of data regarding the clinical profile and the steps of day to day management, hence this study aims to identify these parameters and focus on the gaps in management that is commonplace in our setting and that are representative of other resource limited settings as well. \u0000Methods: Clinical profile, etiological agents, hospital course and outcome of 30 patients with empyema thoracis treated from 2012 to 2014 in B.P. Koirala Institute of Health Sciences was analyzed. All patients were diagnosed on the basis of aspiration of frank pus from pleural cavity. \u0000Results: 28 cases (93.3%) were Male and the mean age was 42.07±18.28 years. 73.3% of the empyema was Right sided and 60% were classified as medium sized and 40% as small sized. 60% of the patients were smokers. 80% of the case were diagnosed as bacterial infection whereas 20% were presumed tubercular on clinical basis and responded to treatment. Fever was the commonest presentation in 80% of the cases followed by shortness of breath (66.7%), cough (60%), chest pain (53.3%) and sputum production (20%). On investigation, pH was not measured in the fear of clogging the ABG machine. Pleural fluid glucose was below 40 mg/dl in all the cases. The median ADA value was 54.30 (15-350) and ADA was higher than 40 U/l in 10 cases with non-tubercular empyema. All cases were managed with Chest tube insertion and antibiotics. Four patients had to be referred for BPF closure whereas five for decortications. In all cases requiring decortications, a “pleural peel” could be identified in Chest Xrays. Since the patients were being managed in different units the outcome of referred patients could not be ascertained. \u0000Conclusion: The gaps in the management of empyema in resource limited setting starts from inappropriate early treatment, inadequate diagnostic facilities, delayed referral and lack of early and appropriate surgical intervention. All these factors combine to the increased morbidity and mortality associated with the management of Empyema thoracis.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124651812","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":"Association of Socio-Demographic Profile with Prevalence of Multi Drug Resistant Tuberculosis among Retreated Pulmonary Tuberculosis Patients in North India","authors":"A. Chaudhary, T. Mahmood, A. Shukla, A. Shreenivasa, V. Arvind, K. Ahmad, A. Verma","doi":"10.3126/SAARCTB.V16I1.23238","DOIUrl":"https://doi.org/10.3126/SAARCTB.V16I1.23238","url":null,"abstract":"Methods: An observational cross sectional study, which includes 116 patients of sputum smear positive pulmonary TB of age 18 or above. Further, detailed history taking regarding different demographic profile was done. Also, they were subjected to CB-NAAT and rifampicin resistant cases were considered as MDR-TB. \u0000Results: Proportion of MDR-TB was 31.89% among retreatment TB cases. 56.75 % (n=21) of MDR-TB cases were between the age group of 21-40 years. Proportion of MDR-TB was higher among males (75.67%), married (59.45%) and rural dwellers 59.45%. Proportion was 61.76% among patients with BMI <16; 31.57% with BMI 16-16.99, 28.57% with BMI 17-18.49 and 5.7% with BMI 18.50-24.99. MDRTB proportion was less 29.72% (n=11) in patients with history of TB contact in family. Pulmonary TB including MDR-TB was more common among illiterates (37.83% among MDR). \u0000Conclusion: Proportion of MDR-TB was high among retreatment cases in north India. Among them low BMI and education status are modifiable factor and this study signifies that MDR-TB burden can be reduced by improving health and education status of patient.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130531107","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":"Barriers to Directly Observed Treatment for Multi Drug Resistant Tuberculosis Patients in Nepal - Qualitative Study","authors":"R. P. Bichha, K. Karki, K. K. Jha, V. Salhotra, A. Weerakoon","doi":"10.3126/SAARCTB.V16I1.23239","DOIUrl":"https://doi.org/10.3126/SAARCTB.V16I1.23239","url":null,"abstract":"Introduction: To prevent the multi drug resistant tuberculosis (MDR-TB) is important to adhere long duration of drug regimen. There are many factors or barriers that are likely to affect adherence to the long treatment regimen. \u0000Objectives: To find out the barriers for adherence to MDR –TB treatment. \u0000Methods: The study was conducted as an institutional based qualitative study, using a convenient sampling technique. Data was collected from 50 current MDR-TB patients by trained field health workers using semi structured interviewer administered questionnaire in all regions in Nepal. Twenty five focus group discussions (FGD) were also conducted with MDR-TB patients, cured MDR-TB patients, DOTS Committee Members, health workers and close relatives of MDR-TB patients to supplement the findings. \u0000Results: Out of 50 respondents 19 were females and 31 were males. Their age varied from 22 years to 61 years. Majority of patients had a previous history of irregular TB treatment. Forty out of fifty patients (80%) were living in either rented houses or hostels (in Mid Western Region). Knowledge about TB and MDR-TB was satisfactory in majority of participants in both studies. Majority of participants were satisfied with facilities and services provided by MDR-TB clinics. There is a very little stigma associated with MDR-TB in Nepal. FGD revealed the onset of MDR-TB was attributed to causes such as smoking, alcohol abuse, poor nutrition, and contact with TB patients. Lack of money to go to health facility daily for treatment was reported as major barriers to adhere to MDR-TB treatment. \u0000Conclusion: Financial constraints were the major barrier for these patients. To sustain proper MDRTB programme, Government of Nepal and other organization should provide social support to these patients.  ","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130996708","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 Vol.16(1)","authors":"R. P. Nichha","doi":"10.3126/saarctb.v16i1.23237","DOIUrl":"https://doi.org/10.3126/saarctb.v16i1.23237","url":null,"abstract":"No abstract available.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129191943","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 Measure of Transmission of Tuberculosis Infection among Children in Household Contact","authors":"K. R. Sharma, N. Bhatta, S. Niraula, R. Gurung, P. Pokharel","doi":"10.3126/SAARCTB.V16I1.23241","DOIUrl":"https://doi.org/10.3126/SAARCTB.V16I1.23241","url":null,"abstract":"Introduction: Tuberculosis (TB) is transmitted through droplets from patients having pulmonary TB, Young children living in the same household are at higher risk Tuberculosis, with great potential to benefit from screening and preventive treatment. This study was conducted with the objectives to estimate the prevalence of TB infection among under five years old children in household contact with pulmonary tuberculosis patients, and assess the factors associated with transmission of TB. \u0000Methods: Pulmonary TB patients receiving treatment from the DOTS Centres in Sunsari District (Index Case-IC) were visited in their household to identify and assess contacts below five years of age. Transverse induration greater than10 mm was defined as a positive Mantoux test suggestive of tubercular infection. \u0000Results: Among 190 household contacts, Mantoux was positive in 13.7% (95%CI: 11.2-16.2). Higher sputum bacillary load (adjusted OR=3.03; 95% CI 1.01-9.1) and spitting habits of Index Cases (aOR=3.1; 95% CI 1.2-7.7), first-degree relationship (aOR=3.5; 95%CI 1.4-8.7) and longer duration of contact (aOR- 6.7; 95% CI 1.4-32.2), were factors significantly associated with positive Mantoux test in the under-five years old household contact. \u0000Conclusion: The prevalence of tuberculosis infection among under-five children in contact with pulmonary tuberculosis patients was 13.7%, which is nearly double than the results of first national tuberculin survey (7%), conducted by National Tuberculosis Centre. This highlights the need for a competent & functioning contact tracing mechanism to halt the chain of transmission of infection. Social and behavioral factors existing in the household were significantly associated with the transmission of Tuberculosis infection.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128921401","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":"Study on Culture Positivity among Sputum Smear Negative Tuberculosis Suspects attending the National Tuberculosis Centre, Nepal","authors":"R. P. Bichha, K. Karki, R. Sultana, K. K. Jha, V. Salhotra, D. Khadka, A. Weerakoon","doi":"10.3126/SAARCTB.V16I1.23244","DOIUrl":"https://doi.org/10.3126/SAARCTB.V16I1.23244","url":null,"abstract":"Background: Globally, more than half of all TB cases are not detected. If they are not diagnosed and get treatment infection transmission may continue and patients suffer and may eventually die. Pulmonary TB either smear positive or negative is normally diagnosed by Ziehl-Neelsen stained sputum smear examination microscopy. Since the culture is the gold standard, evaluation of smear negative TB cases by this method is likely to detect more cases. \u0000Objectives: The objective of this study is to find out culture positivity among smear negative patients. \u0000Methods: All the three sputum samples reported negative by Ziehl-Neelsen microscopy from a total of 138 new TB suspected cases more than 15 years of age at NTC Laboratory. Nepal were cultured on Lowenstein-Jensen media. Tubes showing sufficient growth (culture positive) were recorded and all the culture positive results were informed to NTC. The culture positive samples were processed for DST on first line drugs using proportion method. \u0000Results: The culture positivity rate was 5.1% (7 of 138 cases) All the positive cultures were processed for DST on first line anti-TB drugs and none showed resistance of the total 138 suspected Tuberculosis patients, 94 (68.1%) were males and 44 were females (31.9%) with male: female ratio 1:047. The mean age of the total patients were 30.69. Nearly 42% of them belonged to 31-50 years. Mean age of the male patients was significantly higher than total of the female (p<.001). \u0000Conclusions: Seven smear negative cases among the total of 138 suspected TB patients attending NTC were culture positive. Similar study has to be done in other parts of the country.","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125766438","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 Study of HIV/AIDS Co-Infections and Coping Strategies of Key Population of Nepal","authors":"B. B. Subba Phudong, N. Rimal","doi":"10.3126/SAARCTB.V16I1.23240","DOIUrl":"https://doi.org/10.3126/SAARCTB.V16I1.23240","url":null,"abstract":"Introduction: Nepal is considered as a concentrated HIV epidemic among key population like Migrant Labour Worker (MLW), Sex Worker (SW), Injecting Drug User (IDU) and Spouse of Migrant Labour Worker (SMLW). Hence, the HIV infection has significantly contributed to be HIV/TB co-infected among key population. Intervention of Anti Retroviral Therapy (ART) and Direct Observed Short Course (DOTS) have significantly reduced HIV associated morbidity and mortality in Nepal. The objective of this study was to analyze coping strategies to access the HIV/TB services in relation to socio-economic status of key study population. \u0000Methods: The study was conducted in five districts Jhapa, Morang, Sunsari, Kavre and Parsa of Nepal. The HIV/TB respondents were selected from previous background of key population: MLW, SW, IDU, and SMLW. 343 respondents were selected through snowballing and convenient sampling technique. The data were collected through face to face interview using pretested questionnaire. Descriptive statistics, Chi-square, and ANOVA test were applied to analyze the collected data. \u0000Results: Among 343 HIV/TB co-infected respondents, more than two fifth (44.3%) were belonged to MLW, followed by one third (34.1%) of respondents were SMLW. Therefore, the HIV/TB co-infection was significant association (p=0.001) with employment status and key study population. In addition to this, the study showed that there was significant difference between facing stigma/discrimination and study districts (F=11.03, p=0.001) of respondents. Similarly, there was significant difference between used of previous saving and occupation of family (F=10.461, p=0.001) as coping strategies to access HIV/TB services. \u0000Conclusion: Despite the existing stigma and discrimination, the key study population had used various coping strategies to access the health care services in relation to their socio-economic status.  ","PeriodicalId":175434,"journal":{"name":"SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133066996","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}