Biomedical subjects

M A Espinal

Publications and source records attributed to M A Espinal.

21 records · Page 2Linked to original sources

PubMed1996

Effect of pregnancy on the risk of developing active tuberculosis.

In a case-control study, the effect of recent pregnancy on the risk of developing active tuberculosis among women of reproductive age was investigated in Santo Domingo. Human immunodeficiency virus (HIV)-positive and HIV-negative women diagnosed with new-onset tuberculosis (TB) were compared, respectively, with HIV-positive and HIV-negative women without TB with regard to reproductive history, demographic characteristics, and risk factors for HIV infection. In neither HIV-positive nor HIV-negative women was recent pregnancy or childbirth associated with an increased risk of developing active TB. These results fail to confirm earlier suggestions that pregnancy increases the risk that a woman of child-bearing age infected with Mycobacterium tuberculosis will develop active TB.

Adolescent↗

PubMed1995

Screening for active tuberculosis in HIV testing centre.

In industrialised nations HIV-seropositive individuals can be offered skin testing for tuberculosis (TB) and isoniazid prophylaxis, but this approach is neither practicable nor affordable in most developing countries. In Santo Domingo, Dominican Republic, we offered skin testing and a brief clinical examination for active TB to people requesting HIV testing at one centre. 200 newly detected HIV-positive individuals and 200 age and sex-matched HIV-negative ones were compared. 39 (9.7%) of the 400 individuals seeking HIV testing had active TB; 29 were HIV positive and 10 were HIV negative (adjusted odds ratio 3.3, 95% CI 1.3-8.7; p = 0.01). In multivariate analysis, the strongest independent predictors of active TB were 10 mm or more of induration on skin testing, a history of chronic cough, lymphadenopathy, and HIV infection. Of the patients diagnosed with TB, 85% had one or more symptoms readily ascertainable in a brief screening questionnaire. Screening for TB at HIV-testing sites could be an effective approach to early detection of active TB among not just HIV-positive but also HIV-negative people. Integrating screening for TB into HIV testing schemes could help to reduce the spread of TB and allow patients with TB to be diagnosed and treated earlier.

Adolescent↗

PubMed1994

A hospital-based survey of BCG coverage in Santo Domingo, the Dominican Republic.

A cross-sectional study was conducted in April-June 1992 at the outpatient clinic of the Robert Reid Children's Hospital in Santo Domingo to assess BCG vaccination coverage and factors affecting BCG vaccination of children. A consecutive sample of 2,000 patients under 18 years of age was included in the study. The person accompanying the patient to the hospital was interviewed, using a standardized questionnaire, and both of the patient's arms were examined for the presence of a BCG scar. Overall, 67.7% of the participants were found to have the scar and 68.3% were said to have received a BCG vaccination. However, only 80.8% of those with the scar were said to have been vaccinated. Multivariate logistic regression analysis found that residence in Santo Domingo, the subject's age, and the education of the subject's legal guardian were all significant predictors of the scar's presence, but that the strongest predictor was a history of immunization (OR = 6.29, 95% CI = 5.01, 7.89). Despite various limitations of this study, the results support other data indicating that the BCG vaccination program in the Dominican Republic needs to be strengthened. While the situation may be no worse than that found in a number of other Latin American countries, it appears that many Dominican children are not benefiting from the preventive effect of BCG vaccination and are therefore running an unnecessarily high risk of contracting tuberculosis.

Adolescent↗