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https://www.readbyqxmd.com/read/28432172/why-tuberculosis-control-programmes-fail-role-of-microlevel-and-macrolevel-factors-an-analysis-from-india
#1
Sudip Bhattacharya, Amarjeet Singh
India accounts for one-fourth of the global tuberculosis (TB) burden. The National TB Program was started in 1962. Over a period of time, some lacunae such as poor case detection rate and incomplete treatment were observed. Later, the government formulated the Revised National Tuberculosis Control Program (RNTCP), which achieved a case detection rate of 70% and a cure rate of 85%. Still, the problem of relapse and defaulter cases persists. In 2014, 6% defaulter cases were reported from India. RNTCP has also focused on microlevel aspects, that is, newer diagnostics such as GenXpert, line probe assay and medicines such as bedaquiline for drug-resistant TB...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28430807/diagnosis-of-smear-negative-tuberculosis-is-greatly-improved-by-xpert-mtb-rif
#2
Giulia Lombardi, Valentina Di Gregori, Nicolò Girometti, Marina Tadolini, Francesco Bisognin, Paola Dal Monte
BACKGROUND: Diagnosis of pulmonary (PTB) and extra-pulmonary tuberculosis (EPTB) in smear-negative patients can be difficult. We assessed retrospectively the performance of Xpert MTB/RIF system (Xpert, Cepheid) in diagnosing smear-negative tuberculosis (TB), which represents the most common form of TB in a low incidence setting. METHODS: Performance of Xpert was compared to acid-fast microscopic examination using Ziehl-Neelsen (ZN) stain in patients with culture-confirmed TB...
2017: PloS One
https://www.readbyqxmd.com/read/28429162/involvement-of-methylated-hbha-expressed-from-mycobacterium-smegmatis-in-an-ifn-%C3%AE-release-assay-to-aid-discrimination-between-latent-infection-and-active-tuberculosis-in-bcg-vaccinated-populations
#3
H-L Wen, C-L Li, G Li, Y-H Lu, H-C Li, T Li, H-M Zhao, K Wu, D B Lowrie, J-X Lv, S-H Lu, X-Y Fan
IFN-γ release assays (IGRAs) based on region of difference 1 (RD1) antigens have improved diagnosis of Mycobacterium tuberculosis (M. tb) infection. However, IGRAs with these antigens cannot discriminate between active tuberculosis (ATB) and latent tuberculosis infection (LTBI). M. tb heparin-binding-hemagglutinin (HBHA) induces relatively high IFN-γ responses in LTBI individuals and low responses in ATB patients, but purification of the native methylated HBHA from cultures of M. tb for immunological tests is complex and time-consuming...
April 20, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28425873/rapid-detection-of-mycobacterium-tuberculosis-and-rifampicin-resistance-in-extrapulmonary-tuberculosis-and-sputum-smear-negative-pulmonary-suspects-using-xpert-mtb-rif
#4
Irfan Ullah, Arshad Javaid, Haleema Masud, Mazhar Ali, Anila Basit, Waqas Ahmad, Faisal Younis, Rehana Yasmin, Afsar Khan, Abdul Jabbar, Masroor Husain, Zahid Ahmad Butt
BACKGROUND: Tuberculosis (TB) is a serious public health problem in developing countries such as Pakistan. Rapid diagnosis of TB and detection of drug resistance are very important for timely and appropriate management of multidrug-resistant TB (MDR-TB). OBJECTIVE: The purpose of this study was to determine the diagnostic efficacy of the Xpert MTB/RIF assay for rapid diagnosis of TB and detection of rifampicin (RIF) resistance in extrapulmonary and smear-negative pulmonary TB suspects...
April 21, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28425207/bcg-vaccination-induced-suppurative-lymphadenitis-four-signs-to-pay-attention-to
#5
Sang Oon Baek, Hyo Sun Ko, Hyun Ho Han
Suppurative lymphadenitis is one of the severe complication after BCG vaccination, but its diagnostic criteria and treatment guidelines have not yet been established. In this article, we describe a case of suppurative lymphadenitis caused by BCG vaccination and propose diagnostic criteria and treatment guidelines of the disease. The lymphadenitis was presented as skin involving mass and was completely extirpated. Pathological evaluation revealed a necrotising lymphadenitis, consistent with the diagnosis of BCG lymphadenitis...
April 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28424495/significance-of-genetic-polymorphisms-in-long-non-coding-rna-ac079767-4-in-tuberculosis-susceptibility-and-clinical-phenotype-in-western-chinese-han-population
#6
Zhenzhen Zhao, Mei Zhang, Jun Ying, Xuejiao Hu, Jingya Zhang, Yanhong Zhou, Yi Zhou, Xingbo Song, Binwu Ying
Recent studies have implicated long non-coding RNA, AC079767.4, as a highly susceptible gene in tuberculosis. The aim of the study was to preliminarily explore the possible association of single nucleotide polymorphisms (SNPs) in AC079767.4 gene with clinical phenotypes and TB susceptibility in Western Chinese Han population. The improved multiplex ligation detection reaction (iMLDR) method was employed to genotype 4 SNPs in AC079767.4 in 554 tuberculosis patients and 561 healthy individuals. In subgroup analysis, only the C allele for rs12477677 was associated with the decreased susceptibility to pulmonary TB with a p-value of 0...
April 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28424035/coexistence-of-tuberculosis-and-malignancy-a-mere-coincidence-or-a-causal-association
#7
Mukta Pujani, Zeeba S Jairajpuri, Sabina Khan, Mohd Jaseem Hassan, Sujata Jetley, Safia Rana
Tuberculosis (TB) and malignancy are among the most important current global health problems. Many authors suggest that their coexistence is a chance association owing to their high prevalence. There is, however, enough evidence that one condition may predispose the other. In our retrospective report of two cases, TB in draining lymph nodes was discovered incidentally on histopathology, following surgical resection for malignancy. The possibility of coexistent lesions, especially in regions endemic for TB, mandate a detailed histopathological examination to prevent the chances of diagnostic failure and thus therapeutic error...
April 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28422850/tuberculosis-associated-hemophagocytic-lymphohistiocytosis-with-initial-presentation-of-fever-of-unknown-origin-in-a-general-hospital-an-analysis-of-8-clinical-cases
#8
Yun Zhang, Guangyu Liang, Hongli Qin, Yuanjie Li, Xuejun Zeng
The study aimed to investigate the clinical features and prognoses of patients with tuberculosis (TB) who had secondary hemophagocytic lymphohistiocytosis (HLH).Patients first presenting with fever of unknown origin, who were ultimately diagnosed with TB-associated secondary HLH, were assessed retrospectively. We summarized and analyzed clinical manifestations, laboratory examinations, diagnoses, treatments, and prognoses of patients using clinical data, outpatient follow-up, and telephone follow-up in combination with literature review...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28415989/evaluation-of-genotype-mtbdrplus-ver-2-0-line-probe-assay-for-the-detection-of-mdr-tb-in-smear-positive-and-negative-sputum-samples
#9
Abyot Meaza, Abebaw Kebede, Zelalem Yaregal, Zekarias Dagne, Shewki Moga, Bazezew Yenew, Getu Diriba, Helina Molalign, Mengistu Tadesse, Desalegn Adisse, Muluwork Getahun, Kassu Desta
BACKGROUND: Multi drug resistant tuberculosis (MDR-TB) poses formidable challenges to TB control due to its complex diagnostic and treatment challenges and often associated with a high rate of mortality. Accurate and rapid detection of MDR-TB is critical for timely initiation of treatment. Line Probe Assay (LPA) is a qualitative in vitro diagnostic test based on DNA-STRIP technology for the identification of the M. tuberculosis complex and its resistance to rifampicin (RMP) and/or isoniazid (INH)...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28415587/detection-of-a-combination-of-serum-igg-and-iga-antibodies-against-selected-mycobacterial-targets-provides-promising-diagnostic-signatures-for-active-tb
#10
Dolapo O Awoniyi, Ralf Baumann, Novel N Chegou, Belinda Kriel, Ruschca Jacobs, Martin Kidd, Andre G Loxton, Susanne Kaempfer, Mahavir Singh, Gerhard Walzl
Immunoglobulin G (IgG) based tests for the diagnosis of active tuberculosis (TB) disease often show a lack of specificity in TB endemic regions, which is mainly due to a high background prevalence of LTBI. Here, we investigated the combined performance of the responses of different Ig classes to selected mycobacterial antigens in primary healthcare clinic attendees with signs and symptoms suggestive of TB. The sensitivity and specificity of IgA, IgG and/or IgM to LAM and 7 mycobacterial protein antigens (ESAT-6, Tpx, PstS1, AlaDH, MPT64, 16kDa and 19kDa) and 2 antigen combinations (TUB, TB-LTBI) in the plasma of 63 individuals who underwent diagnostic work-up for TB after presenting with symptoms and signs compatible with possible active TB were evaluated...
March 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28413722/performance-of-interferon-%C3%AE-release-assay-in-the-diagnosis-of-tuberculous-lymphadenitis-a-meta-analysis
#11
Qianqian Liu, Wenzhang Li, Yunfeng Chen, Xinmiao Du, Chengdi Wang, Binmiao Liang, Yin Tang, Yulin Feng, Chuanmin Tao, Jian-Qing He
BACKGROUND: The diagnostic values of interferon-gamma release assays (IGRA) in tuberculosis (TB) vary a lot with different site of infections, with especially higher sensitivities in chronic forms of TB such as tuberculosis of the lymph node. We conducted a meta-analysis to comprehensively evaluate the overall accuracy of diagnostic IGRA for tuberculous lymphadenitis. METHODS: Pubmed, Web of Science, EMBASE, Wanfang and CNKI databases up to February 17, 2017 were searched to identify published studies...
2017: PeerJ
https://www.readbyqxmd.com/read/28413638/serologic-testing-of-a-panel-of-five-antibodies-in-inflammatory-bowel-diseases-diagnostic-value-and-correlation-with-disease-phenotype
#12
Zhi-Zhi Wang, Ke Shi, Jie Peng
The aim of the present study was to evaluate the diagnostic value of five serological antibodies, perinuclear antineutrophil cytoplasmic antibody (pANCA), anti-Saccharomyces cerevisiae antibodies [ASCA; ASCA-immunoglobulin (IgG)and ASCA-IgA], Escherichia coli outer membrane porin C antibody (anti-OmpC) and CBir1 flagellin antibody for detection in inflammatory bowel diseases. Whether the antibody status correlated with the disease phenotype was also evaluated. Sera from 71 patients with Crohn's disease (CD), 41 patients with ulcerative colitis (UC), 78 patients with other gastrointestinal diseases and 31 healthy control subjects were investigated...
April 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28410706/conventional-tbna-experience-over-a-10-year-period-diagnostic-yield-and-associated-limitations-in-a-tertiary-care-government-set-up
#13
Varinder Saini, Kranti Garg, Uma Handa, Ritisha Bhatt
INTRODUCTION: It is challenging for pulmonologists to sample mediastinal lymph nodes or some endobronchial lesions because of safety concerns. C-TBNA (conventional transbronchial needle aspiration) is a procedure to sample such sites, but is underutilized. We present a retrospective review of patients subjected to C-TBNA through fibre-optic bronchoscopy over a 10-year period. MATERIALS AND METHODS: Year-wise statistics of C-TBNA was reviewed and results were analyzed with regard to sampling sites and type of intraluminal lesions encountered, diagnosis made and their correlation with sampling sites, sex and age...
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28410693/clinical-and-radiological-spectrum-of-intracranial-tuberculosis-a-hospital-based-study-in-northeast-india
#14
Baiakmenlang Synmon, Marami Das, Ashok K Kayal, Munindra Goswami, Jogesh Sarma, Lakshya Basumatary, Suvorit Bhowmick
Central nervous system tuberculosis (TB) is the most severe extra pulmonary TB having a high mortality and morbidity. OBJECTIVE: To study the various clinical, biochemical, and radiological spectrum of intracranial TB. MATERIALS AND METHOD: Ninety-three patients were enrolled in this prospective study after ethical clearance and consent from August 2013 to May 2015. The entire clinical course with complications and predictors of mortality were assessed. RESULTS: 36 females (38...
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28409551/musculoskeletal-tuberculosis
#15
Michael K Leonard, Henry M Blumberg
Musculoskeletal tuberculosis (TB) accounts for approximately 10% of all extrapulmonary TB cases in the United States and is the third most common site of extrapulmonary TB after pleural and lymphatic disease. Vertebral involvement (tuberculous spondylitis, or Pott's disease) is the most common type of skeletal TB, accounting for about half of all cases of musculoskeletal TB. The presentation of musculoskeletal TB may be insidious over a long period and the diagnosis may be elusive and delayed, as TB may not be the initial consideration in the differential diagnosis...
April 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28404672/increased-tuberculosis-patient-mortality-associated-with-mycobacterium-tuberculosis-mutations-conferring-resistance-to-second-line-antituberculous-drugs
#16
Sophia B Georghiou, Marva Seifert, Donald G Catanzaro, Richard S Garfein, Timothy C Rodwell
Rapid molecular diagnostics have great potential to limit the spread of multi- and extensively drug-resistant tuberculosis (M/XDR-TB). These technologies detect mutations in the Mycobacterium tuberculosis (Mtb) genome that confer phenotypic drug resistance. However, there is little data published regarding the relationships between the detected Mtb resistance mutations and M/XDR-TB treatment outcomes, limiting our current ability to exploit the full potential of molecular diagnostics. We analyzed clinical, microbiological and sequencing data for 451 patients and their clinical isolates collected in a multinational, observational cohort study to determine if there was an association between Mtb resistance mutations and patient mortality...
April 12, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28404233/molecular-detection-of-drug-resistance-to-ofloxacin-and-kanamycin-in-mycobacterium-tuberculosis-by-using-multiplex-allele-specific-pcr
#17
Richa Kumari, Tuhina Banerjee, Shampa Anupurba
Drug resistance in tuberculosis (TB) is the biggest global health challenge as it hinders the tuberculosis control program and makes the disease more worsen. Molecular methods interrupt the spread of drug resistance by facilitating the appropriate anti- tuberculosis therapy at correct time through rapid diagnosis of multi drug resistant (MDR) and extensively drug resistant tuberculosis (XDR-TB). In this study we standardized and evaluated the diagnostic utility of multiplex allele specific PCR (MAS-PCR) targeting gyrA D94G and rrs A1401G mutations for detection of resistance against two key drugs (ofloxacin and kanamycin) of second line anti tuberculosis treatment...
April 9, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28399975/survey-of-health-care-worker-knowledge-about-childhood-tuberculosis-in-high-burden-centers-in-botswana
#18
T Arscott-Mills, L Masole, R Ncube, A P Steenhoff
BACKGROUND: Quantifying health care workers' (HCWs') knowledge about tuberculosis (TB) informs educational interventions. We assessed HCWs' knowledge about childhood TB in Botswana. METHODS: Semi-structured interviews were conducted with HCWs at 46 sites around Botswana using a piloted instrument. Transcripts were double-coded using a coding schema. Discrepancies were resolved by consensus and a systematic thematic analysis was performed. RESULTS: The sites (42 clinics and 4 hospitals) were urban (n = 9, 20%), semi-urban (n = 10, 22%) and rural (n = 27, 58%)...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28399966/validated-methods-for-identifying-tuberculosis-patients-in-health-administrative-databases-systematic-review
#19
L A Ronald, D I Ling, J M FitzGerald, K Schwartzman, G Bartlett-Esquilant, J-F Boivin, A Benedetti, D Menzies
BACKGROUND: An increasing number of studies are using health administrative databases for tuberculosis (TB) research. However, there are limitations to using such databases for identifying patients with TB. OBJECTIVE: To summarise validated methods for identifying TB in health administrative databases. METHODS: We conducted a systematic literature search in two databases (Ovid Medline and Embase, January 1980-January 2016). We limited the search to diagnostic accuracy studies assessing algorithms derived from drug prescription, International Classification of Diseases (ICD) diagnostic code and/or laboratory data for identifying patients with TB in health administrative databases...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28399964/pooling-sputum-samples-to-improve-the-feasibility-of-xpert-%C3%A2-mtb-rif-in-systematic-screening-for-tuberculosis
#20
J Ho, P Jelfs, P T B Nguyen, V Sintchenko, G J Fox, G B Marks
SETTING: Systematic screening for tuberculosis (TB) using Xpert® MTB/RIF. OBJECTIVE: To determine whether pooling sputum samples for Xpert testing may improve the feasibility and cost-effectiveness of Xpert by reducing the number of Xpert tests required. DESIGN: Mycobacterium tuberculosis-spiked sputum samples at low organism concentrations were used to mimic samples that are more likely to be found in the screening, compared to the diagnostic, setting...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
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