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Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Agibothu Kupparam Hemanth Kumar, Alok Kumar, Thiruvengadam Kannan, Rakesh Bhatia, Dipti Agarwal, Santosh Kumar, Rajeshwar Dayal, Sheo Pratap Singh, Geetha Ramachandran
We studied the pharmacokinetics of levofloxacin (LFX), pyrazinamide (PZA), ethionamide (ETH) and cycloserine (CS) in children with multidrug-resistant tuberculosis (MDR TB) being treated according to the Revised National TB Control Programme (RNTCP) guidelines in India. This observational, pharmacokinetic study was conducted in 25 children with MDR TB at the Sarojini Naidu Medical College, Agra, India who were being treated with a 24-month daily regimen. Serial blood samples were collected after directly observed administration of drugs...
February 20, 2018: Antimicrobial Agents and Chemotherapy
V G Rao, M Muniyandi, J Bhat, R Yadav, R Sharma
BACKGROUND: Tuberculosis (TB) remains a major public health problem in resource-poor countries including India. Scientific knowledge is used to guide policy and practice. There is however, a limited, systematically collected data required for guiding the scale-up of interventions particularly amongst vulnerable populations including tribal groups in the country. In view of this, a systematic review of the TB research studies carried out in tribal areas of different parts of the country was undertaken...
January 2018: Indian Journal of Tuberculosis
Jaya Ranjalkar, Sumith K Mathew, Valsan Philip Verghese, Anuradha Bose, Winsley Rose, Dulari Gupta, Denise H Fleming, Binu Susan Mathew
BACKGROUND: Sub-optimal plasma drug concentrations of Anti-Tubercular Therapy (ATT) could lead to delayed response and emergence of acquired drug-resistance. OBJECTIVES: To determine and compare the plasma concentrations of isoniazid and rifampicin in children treated for tuberculosis (TB) on daily or intermittent ATT regimen. To study the effect of the exposure of isoniazid and rifampicin on clinical outcome at the end of therapy. METHODS: Forty-one children aged 2 to 16 years, initiated on either daily or three-times a week (intermittent) ATT regimen were recruited into the study...
December 11, 2017: International Journal of Antimicrobial Agents
Lavanya Jayabal, Asha Frederick, Sanjay Mehendale, Velayutham Banurekha
Background: Pretreatment loss to follow-up (PTLFU) is used as performance indicator of Revised National Tuberculosis Control Programme (RNTCP) of India. Objective: To document the PTLFU, identify additional indicators and examine documentation of all the diagnosed sputum positive pulmonary tuberculosis (PTB) patients under RNTCP. Methodology: Tuberculosis (TB) laboratory, referral for treatment registers, and referral forms were perused for information on sputum positive PTB patients diagnosed from January to June 2014, in 3 TB Units in Chennai...
October 2017: Indian Journal of Community Medicine
Seema Oommen, Nandita Banaji
There have been rapid technological advances in the detection of Mycobacterium tuberculosis and its drug susceptibility in clinical samples. These include advances in microscopic examination, in vitro culture and application of molecular techniques. The World Health Organization (WHO) has played a large role in evaluating these technologies for their efficacy and feasibility, especially in the developing countries. Amongst these, the Revised National Tuberculosis Control Programme (RNTCP), through its national network of designated microscopy centres and intermediate reference laboratories, has adopted certain technologies that are currently implemented in India...
July 2017: Indian Journal of Medical Microbiology
George Sebastian, Sharath Burugina Nagaraja, Telagi Vishwanatha, Mamatha Voderhobli, Narayana Vijayalakshmi, Prahlad Kumar
AIMS: Non-Tuberculous Mycobacteria (NTM) are ubiquitous in nature. The data on prevalence of NTM under the RNTCP is scarce. Many NTM species have clinical significance, and hence their identification and speciation are important. METHODS AND RESULT: It is a cross-sectional study conducted at the five RNTCP accredited culture and drug susceptibility testing (CDST) laboratory. The culture isolates from AFB positive but Immunochromatographic test negative samples were taken for identification and speciation using HPLC...
October 9, 2017: Journal of Applied Microbiology
Neha Taneja, Vinoth Gnana Chellaiyan, Shailaja Daral, Mrinmoy Adhikary, Timiresh Kumar Das
INTRODUCTION: Multi Drug Resistant Tuberculosis (MDR TB) has emerged as a significant public health problem in India. The prolonged treatment duration in MDR TB is a challenge in achieving treatment completion and poses a threat to TB control in the country. Home based care is an approach accepted by patients because it helps in ameliorating their understanding of TB, improving the compliance and reducing stigma in the community. AIM: To assess the outcome of Home-Based Care (HC) versus No Home-Based Care (NHC) on the treatment of MDR TB patients registered at two chest clinics in Eastern Delhi...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
Tanu Anand, Nandini Sharma, Shivani Chandra, G K Ingle, Shekhar Grover
BACKGROUND: Burden of tuberculosis in India remains enormous. The Revised National Tuberculosis Control Programme (RNTCP), based on the Directly Observed Treatment Short course (DOTS) strategy, was launched in 1997 in India. The question of what DOTS has or has not accomplished over the past 15 years is a central technical question. OBJECTIVES: To assess the decadal impact of DOTS strategy on some epidemiological factors such as age and gender of new sputum positive (NSP) TB patients in Delhi...
October 2017: Indian Journal of Tuberculosis
Agibothu Kupparam Hemanth Kumar, Vedachalam Chandrasekaran, Angadi Kiran Kumar, M Kawaskar, J Lavanya, Soumya Swaminathan, Geetha Ramachandran
BACKGROUND & OBJECTIVES: Concomitant feeding and anti-tuberculosis (TB) drug administration are likely to reduce nausea and enhance compliance to treatment. However, food could lower plasma drug concentrations. This study was undertaken to examine the effect of food on two-hour plasma concentrations of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA), and pharmacokinetics of these drugs in adult TB patients. METHODS: Newly diagnosed adult TB patients were recruited from the Revised National Tuberculosis Control Programme (RNTCP) treatment centres in Chennai Corporation, Chennai, India...
April 2017: Indian Journal of Medical Research
Velayutham Banurekha, Tarun Bhatnagar, Swaminathan Savithri, Natarajan Dinesh Kumar, Boopathi Kangusamy, Sanjay Mehendale
BACKGROUND: Studies from India on sputum conversion and tuberculosis (TB) treatment outcomes among TB patients with diabetes are limited. OBJECTIVE: The objective of this study is to estimate the proportion of sputum smear conversion and successful treatment outcomes among diabetic-TB patients treated under Revised National TB Control Programme (RNTCP). METHODOLOGY: Information on TB disease, diabetes, sputum conversion, and treatment outcomes were collected from treatment cards of adult TB patients (age >18 years) treated in the District TB Centre TB Unit, Tiruchirapalli, Tamil Nadu from July 1, 2014, to October 31, 2015...
July 2017: Indian Journal of Community Medicine
Mahasweta Satpati, Sharath Burugina Nagaraja, Hemant Deepak Shewade, Prabhakaran Ottapura Aslesh, Blesson Samuel, Ashwani Khanna, Sarabjit Chadha
OBJECTIVE: To identify the challenges encountered by private health care providers (PHCP) to notify tuberculosis cases through a programme developed web-based portal mechanism called "NIKSHAY." Study Design. It is a descriptive qualitative study conducted at two revised national tuberculosis control programme (RNTCP) districts of New Delhi. The study included in-depth interviews of PHCP registered with "NIKSHAY" and RNTCP programme personnel. Grounded theory was used to conceptualise the latent social patterns in implementation of tuberculosis case notification process and promptly identifying their challenges...
2017: Tuberculosis Research and Treatment
Siddharth Sanjay Shah, Aakanksha Arvind Goregaonkar, Arvind Balkrishna Goregaonkar
INTRODUCTION: The emergence of extensively drug-resistant tuberculosis (XDR-TB) is a challenging paradigm shift faced by the TB control programs worldwide today. The treatment is further compounded with unique management difficulties faced in pediatric patients. Treatment of XDR-TB requires prolonged chemotherapy with second-line drugs which offer lesser potency and increased risk of drug-related side effects. We present a case of spinal XDR-TB in a child, managed with extended second-line antitubercular chemotherapy (ATT)...
March 2017: Journal of Orthopaedic Case Reports
Himanshu Vashistha, M Hanif, K K Chopra, Ashwani Khanna, Divya Shrivastava
BACKGROUND: The GenoType MTBDRplus, a commercial Line Probe Assay (LPA) kit from Hain Lifescience, Germany, is endorsed by India's RNTCP Program for diagnosis of DRTB cases among smear-positive sputum samples. Although the LPA has been studied in several laboratories, there is a wide variation in existing M. tuberculosis strains across the globe, and false results can occur due to the presence of unique genetic mutations in different settings. AIM AND OBJECTIVE: An attempt was made to carry out band pattern analysis using LPA and also to observe uncommon mutations in MDR strains...
July 2017: Indian Journal of Tuberculosis
V Indumati, V Vijay, D Krishnaswamy, V Rajeshwari, A Ramesh, D Shantala, A Shilpa
BACKGROUND: Upon diagnosis, Pulmonary Tuberculosis patients are treated for TB for a period of 6-9 months. At present, there exists very little indication of the efficacy of the particular treatment. A few previous studies have shown that soluble urokinase plasminogen activator receptor (SuPAR) may be used as treatment efficacy marker. SuPAR is a cellular receptor for serine protease urokinase plasminogen activator (uPA). Bacterial endotoxins and cytokines of the innate immune system stimulate the secretion of uPA in monocytes & neutrophils...
July 2017: Indian Journal of Tuberculosis
Vitull K Gupta, Jang Bahadur Singh, Ajesh Bansal, Meghna Gupta
This case of a 16-year-old female with moderately-differentiated squamous cell carcinoma of the esophagus with tracheo-esophageal fistula, hyperthyroidism and sputum positive pulmonary tuberculosis with RNTCP Category 1 DOTS is reported because of its rarity. The patient presented with cough, vomiting, weight loss and respiratory distress.
May 2017: Journal of the Association of Physicians of India
A K Hemanth Kumar, K Ramesh, T Kannan, V Sudha, Hemalatha Haribabu, J Lavanya, Soumya Swaminathan, Geetha Ramachandran
BACKGROUND & OBJECTIVES: Variations in the N-acetyltransferase (NAT2) gene among different populations could affect the metabolism and disposition of isoniazid (INH). This study was performed to genotype NAT2 gene polymorphisms in tuberculosis (TB) patients from Chennai, India, and compare plasma INH concentrations among the different genotypes. METHODS: Adult patients with TB treated in the Revised National TB Control Programme (RNTCP) in Chennai, Tamil Nadu, were genotyped for NAT2 gene polymorphism, and two-hour post-dosing INH concentrations were compared between the different genotypes...
January 2017: Indian Journal of Medical Research
Janmejaya Samal, Ranjit Kumar Dehury
INTRODUCTION: Of different methods of disease prevention, health education and awareness programmes can empower people regarding several aspects of disease management and thereby enabling them in accessing the right treatment, in right time, at right place. AIM: The aim of this study was to assess the impact of a structured Tuberculosis (TB) awareness strategy on the knowledge and behaviour of slum dwellers of Durg, Chhattisgarh, India. MATERIALS AND METHODS: A TB awareness intervention was implemented in terms of informing the houses of marginalized and vulnerable communities about TB, its symptoms, diagnosis, treatment and Revised National TB Control Program (RNTCP) services and the impact of the same was assessed through a survey questionnaire before and after the implementation of the intervention...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
Himanshu Negandhi, Ritika Tiwari, Anjali Sharma, Rajesh Nair, Sanjay Zodpey, Ramesh Reddy Allam, Ganesh Oruganti
INTRODUCTION: The Revised National Tuberculosis Control Program (RNTCP) is the largest tuberculosis (TB) control program in the world based on Directly Observed Treatment Short-Course (DOTS) strategy. Globally, most countries have been using a daily regimen and in India a shift towards a daily regimen for TB treatment has already begun. The daily strategy is known to improve program coverage along with compliance. Such strategic shifts have both management and operational implications...
2017: Global Health Action
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
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