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PubMed2004

[Epidemiologic aspects of tuberculosis in the Suruí Indians, Brazilian Amazon].

Tuberculosis persists as a serious public health problem in Brazil. Prevalence rates are alarming in certain social groups, including indigenous peoples. This article presents an epidemiological analysis of records for the Suruí Indians available at the Tuberculosis Control Program in the Municipality of Cacoal, Rondônia. The study includes a descriptive statistical analysis of cases reported from 1975 to 2002. There is evidence that the Suruí have an increased risk of acquiring and dying from tuberculosis as compared to other indigenous groups in Rondônia as well as non-Indians. The average incidence coefficient for tuberculosis in the Suruí was 2518.9 per 100,000 inhabitants in the period 1991-2002. It was observed that 45% of the cases were diagnosed in children < 15 years old. Over half of the cases (63.3%) were reported in men. Only 43.2% of the cases were confirmed by sputum microscopy. The use of PPD skin tests, histopathological exams or bacteriological culture were not reported throughout the period. Attention is called to the need for prevention and control measures specifically tailored to the reality of indigenous peoples.

Adolescent↗
PubMed1964

EPIDEMIOLOGICAL BASIS OF TUBERCULOSIS ERADICATION. 2. DYNAMICS OF TUBERCULOSIS MORBIDITY AND MORTALITY.

In most countries there have been signs in recent years of an accelerated decline in tuberculosis, but only the most superficial knowledge exists of what underlies the remarkable changes. It is therefore imperative to document the changing picture of tuberculosis by means of parameters that are not only descriptive but will also serve as guidelines for the development of methods to eradicate the disease.The authors describe the present system of tuberculosis reporting and control in Denmark, where the requisite conditions for obtaining meaningful statistics are, to a large extent, fulfilled, discussing its potentialities for depicting the forces behind the recent changes and pointing out its inherent deficiencies.The advantages of the Danish system, in which rates for the prevalence and incidence of respiratory tuberculosis are broken down into those for new cases and those for relapses, are stressed, as is the significance of the recently introduced practice of reporting cures and thus obtaining cure rates on a nation-wide scale.As an indicator of the lethal effect of tuberculosis in a country, the mortality rate suffers from several limitations, which will play an increasingly important role as the downward trend in tuberculosis continues. The authors suggest that a more objective measure than the specific mortality rate would be the so-called "lethality index" - an index based on all deaths occurring among persons with active tuberculosis, irrespective of whether they were attributed directly to the disease.

Communicable Disease Control↗
PubMed2000

Polymerase chain reaction for detection of Mycobacterium tuberculosis in epiretinal membrane in Eales' disease.

PURPOSE: Tuberculous etiology has been suggested in Eales' disease. Because epiretinal membrane (ERM) is formed on the inner surface of the retina in Eales' disease, it could be the most appropriate intraocular specimen for investigation. Therefore, a nested polymerase chain reaction (nPCR), which detects MPB64 gene of Mycobacterium tuberculosis on the archival specimens of ERM of well-documented Eales' and non-Eales' patients, was applied and the results compared. METHODS: nPCR technique was standardized, and the sensitivity and specificity of the primers were determined. nPCR technique was applied to tissue sections obtained from formalin-fixed and paraffin-embedded tissues of ERM from 23 patients with Eales' disease and 27 noninfective and non-Eales' disease patients as controls. RESULTS: nPCR technique was specific for M. tuberculosis genome and sensitive enough to detect 0.25 fg (corresponding to the presence of a single bacillus). Eleven (47.8%) ERM of 23 Eales' disease and 3 (11.1%) of 27 controls were positive for M. tuberculosis genome. The difference between the two groups was statistically significant (P = 0.001), indicating association of this bacterium with Eales' disease. CONCLUSIONS: The demonstration of the presence of M. tuberculosis DNA by nPCR technique in significant number of ERM of Eales' disease compared with the controls further emphasizes the probable role of this bacterium in the pathogenesis of this enigmatic clinical condition.

Antigens, Bacterial↗
PubMed1995

Previous lung disease and risk of lung cancer among lifetime nonsmoking women in the United States.

The authors conducted a population-based case-control study of lung cancer in nonsmoking women in five metropolitan areas of the United States between December 1, 1985, and November 30, 1990. In-person interviews were conducted with 412 lung cancer cases and 1,253 population controls, yielding information on history of nonmalignant lung diseases that were diagnosed by a physician. When lung cancer cases were compared with controls, history of any previous lung disease was associated with a significant increased risk of lung cancer (adjusted odds ratio (AOR) = 1.56, 95% confidence interval (CI) 1.2-2.0). Several lung diseases, including asthma, chronic bronchitis, pneumonia, and tuberculosis, were reported more often by lung cancer cases than by controls, and the difference was statistically significant for asthma (AOR = 1.67, 95% CI 1.1-2.5) and chronic bronchitis (AOR = 1.60, 95% CI 1.1-2.4). Since significant increased risks were observed for asthma and tuberculosis diagnosed before age 21 years, it is unlikely that reported prior lung diseases were prediagnostic manifestations of lung cancers. The increased risks associated with previous lung disease were observed for adenocarcinomas and other carcinomas of the lung; the point estimates were generally higher for the latter category. The risks associated with previous lung diseases remained unchanged after adjustment for potential confounders, including environmental tobacco smoke exposure during childhood and adult life and dietary factors.

Adenocarcinoma↗
PubMed2006

Analysis of DC-SIGN (CD209) functional variants in patients with tuberculosis.

Several lines of evidence suggest that host genetic factors controlling the immune response influence infection by Mycobacterium tuberculosis. Recently, DC-SIGN has been shown to be the major M. tuberculosis receptor on dendritic cells (DCs). The aim of this study was to investigate the influence of DC-SIGN functional polymorphisms -336G/A SNP in the promoter region and insertion/deletion in the "neck" region on the predisposition to tuberculosis. We performed an association study in 110 HIV-negative tuberculosis patients and 299 matched controls. In addition, a total of 155 healthy controls were screened for the tuberculin skin test (TST). DC-SIGN -336 SNP detection was performed by the real-time polymerase chain reaction technology, using the TaqMan 5' allele. The insertion/deletion in the "neck" region was analyzed by polymerase chain reaction with specific primers. Although an increased frequency of the G allele in tuberculosis patients (23%), as compared with controls (19%), was observed, differences were not statistically significant (OR = 1.31, 95% CI = 0.89-1.94, P = 0.14). On the other hand, DC-SIGN repeat polymorphism in the "neck" region had a very low frequency in the analyzed population. We conclude that the studied polymorphisms are not relevant risk factors for developing tuberculosis in Northwestern Colombian individuals.

Adult↗
PubMed1989

Evaluation of an enzyme-linked immunosorbent assay (ELISA) using an IgG antibody to Mycobacterium tuberculosis antigen 5 in the diagnosis of active tuberculosis in children.

An enzyme-linked immunosorbent assay (ELISA) using Mycobacterium tuberculosis antigen 5 has been evaluated as a serodiagnostic test for active tuberculosis in children. Forty children of either sex, ages 1 to 14 yr, were studied, including 21 bacteriologically confirmed tuberculous patients and 19 control subjects who were evaluated for tuberculosis and found to be free of disease. At a 1:20 dilution, the test showed a sensitivity of 0.857 and a specificity of 1.000, with an accuracy value of 0.925, a positive predictive value of 1.000, and a negative predictive value of 0.864. The prevalence of disease calculated directly from the data of the study was found to be of 0.525. The geometric mean ELISA titer of the tuberculosis group was 1:58, and the difference in antibody titers between patient and control groups was found to be statistically significant (p less than 0.001). From our results, we conclude that ELISA using M. tuberculosis antigen 5 may be useful in those situations of high prevalence of disease when children suspected of tuberculosis are being evaluated.

Adolescent↗
PubMed1991

C-reactive protein in sarcoidosis.

Sarcoidosis is characterized by granuloma formation, the macrophage being the most important building block. The activated macrophage in sarcoidosis produces interleukin-1 (II-1). It is well known that interleukin-1, among other functions, stimulates the hepatic production of C-reactive protein. We therefore prospectively measured the serum C-reactive protein in 17 patients with active pulmonary sarcoidosis, 10 patients with other chronic interstitial lung diseases of unknown etiology, 11 patients with active lung tuberculosis, and 10 healthy volunteers. Serum C-reactive protein was assayed by enzymoimmunodiffusion test. The serum C-reactive protein was negative in 13 patients suffering from active sarcoidosis and positive in four. Patients with other interstitial lung diseases had negative results in 7 and positive in 3 cases. The analyses of C-reactive protein in patients with sputum positive lung tuberculosis were positive in 10 cases. All the healthy controls had negative C-reactive protein measurements. The difference between the groups was statistically significant when sarcoidosis and tuberculosis serum C-reactive protein measurements were compared (p less than 0.01), as well as the difference between the group of other interstitial lung diseases and tuberculosis (p less than 0.01). In this respect, the measurements of serum C-reactive protein are valuable in the differentiation of sarcoidosis and other chronic interstitial lung diseases of unknown etiology from tuberculosis and other diseases which are known to induce an acute phase response.

Adult↗
PubMed2003

[Serum adenosine deaminase activity in pulmonary tuberculosis].

Adenosine deaminase (ADA) activity has been helpful for the diagnosis of tuberculous pleurisy. However, there are few studies about the role of ADA in the diagnosis and follow-up of pulmonary tuberculosis. In our study, serum ADA activity was determined in order to investigate the role of the enzyme in the diagnosis of pulmonary tuberculosis and monitoring the efficiency of therapy. The ADA activity was (mean +/- SD) 21.77 +/- 8.51 U/L in pulmonary tuberculosis patients (n= 44), 6.24 +/- 3.25 U/L in old tuberculosis patients (n= 24), 8.58 +/- 4.38 U/L in healthy control subjects (n= 20), whereas the mean for the patients with bronchial cancer (n= 20) was 18.51 +/- 7.85 U/L. There was no statistical difference between the results of pulmonary tuberculosis patients and the patients with bronchial cancer. On the contrary, the result of these two group were significantly different from both old tuberculosis patients and healthy control subjects (p< 0.001 for both). In 10 pulmonary tuberculosis patients, ADA activities were determined both before and after treatment and a significant decrease was observed in ADA activities after treatment (p< 0.001). In conclusion, serum ADA activity is increased in pulmonary tuberculosis patients, therefore it may be a helpful parameter for monitoring therapy.

Adenosine Deaminase↗
PubMed1999

Adenosine deaminase in childhood pulmonary tuberculosis: diagnostic value in serum.

The diagnostic value of serum adenosine deaminase (ADA) activity was evaluated in childhood pulmonary tuberculosis. Serum ADA levels were measured in 20 children diagnosed with pulmonary tuberculosis (group 1) and 150 children (group 2) including 128 with tuberculosis infection (Mantoux test positive) and 22 healthy children. In group 1, the mean serum ADA activity was 74.06 +/- 18.5 U/l, which was significantly (p < 0.001) higher than that of group 2 (40.36 +/- 12.0 U/l). A serum ADA level of > or = 53.76 U/l had a sensitivity of 100 per cent, specificity of 90.7 per cent, positive predictive value of 58.8 per cent, and a negative predictive value of 100 per cent in children with tuberculosis disease. To conclude, measurement of serum ADA activity was a useful diagnostic tool in childhood pulmonary tuberculosis.

Adenosine Deaminase↗
PubMed1977

Palmar creases and diseases: cancer and tuberculosis.

The palmar flexion creases of fully diagnosed patients of throat cancer (n = 120) and tuberculosis (n = 80) have been compared with a control group (n = 150) of the same stock. The palmar flexion creases of cancer and tuberculosis patients are significantly different from those of the control population.

Dermatoglyphics↗
PubMed1998

Evaluation of infection control parameters according to the 1994 Centers for Disease Control and Prevention Tuberculosis guidelines: a 2-year experience.

BACKGROUND: Because of classification as a high-risk institution for potential Mycobacterium tuberculosis exposure and an employee purified protein derivative conversion rate of 2.7%, a large university-affiliated county hospital enhanced administrative and engineering controls, as recommended by its tuberculosis task force in early 1994. METHODS: For 1994 and 1995 the medical records of all patients with culture-confirmed M. tuberculosis were reviewed according to the 1994 Centers for Disease Control and Prevention guidelines for case surveillance and risk assessment (infection control parameters). The chi 2-test was used to compare 1994 and 1995 infection control parameters for statistical significance (p < or = 0.05). RESULTS: In 1994 and 1995 there were 253 patients with tuberculosis, 85% of whom (214/253) had pulmonary-site tuberculosis. The "representative" patient with pulmonary tuberculosis was profiled, along with institution-specific surveillance data on diagnostics, medication regimens, and airborne isolation practices. Between 1994 and 1995 there was a trend toward increased numbers of homeless patients with tuberculosis, from 8.2% to 17% (p = 0.07). Decreases in the numbers of HIV seropositive patients with tuberculosis from 35% in 1994 to 24% in 1995 (p = 0.2) and of jailed patients with tuberculosis from 9.8% to 5% (p = 0.5) were not significant. Drug-resistance patterns increased from 13% to 24%, with borderline significance (p = 0.06). The employee purified protein derivative testing compliance rate increased from 49% in 1994 to 74% in 1995, with the purified protein derivative conversion rate also increasing from 2.7% to 3.5%. CONCLUSION: The infection control parameter data were beneficial in identification of institution-specific risk factors for our population with tuberculosis. Although labor-intensive, the annual tuberculosis reports supported requests for administrative and engineering controls; however, efficacy of the 1994 tuberculosis control plan was difficult to assess from purified protein derivative conversion rates alone, because the testing compliance rate also increased.

Adult↗