SEARCH · PubMed Health

Results for “TUBERCULOSIS, STATISTICS AND CONTROL”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources

PubMedDate not supplied

Demographic pattern and clinical characteristics of patients with smear- positive pulmonary tuberculosis in kuwait.

OBJECTIVE: The aim of this study was to document various clinical factors that are likely to be of help in the control of tuberculosis in Kuwait. SUBJECTS AND METHODS: Details of patients with sputum positive for acid-fast bacilli in the period from January 1998 to December 2000 were collected retrospectively from the case records and population statistics from government sources. The data were then tabulated and analyzed. RESULTS: Of the 526 cases, 83.5% were expatriates and 16.5% Kuwaiti; 373 (70.9%) were male. Of the expatriates, 66.7% were from Asia and the Far East, 5.7% were > or =60 years. The annual incidence was 8.34 per 100,000 population. The lowest incidence was observed in the Jahrah governorate with an overall incidence of 5 (2.0 among Kuwaitis and 6.4 among expatriates) per 100,000 population. The highest incidence overall (10.2) and among Kuwaitis (4.1) was observed in the Farwaniya governorate, while the highest incidence among expatriates was seen in the Capital governorate (13.4). Radiologically, 94 (19.5%) had minimal, 246 (51.5%) had moderately advanced and 141 (29.3%) far-advanced disease. The majority of the patients (72%) had only + status for AFB in the smear. Hypercalcemia (25.7%), hyponatremia (22.15%) and hyperglycemia (29.9%) were common in the patients. Mean serum albumin was low (28.7 +/- 5.5 g/l). Two hundred and forty-seven (47.2%) were declared cured while 116 (22.2%) completed treatment. Comparison between nationals and expatriates showed a significant difference only for age, smoking status, defaulter rate and place of residence. CONCLUSION: The lowest regional incidence was found in the Jahrah governorate. Both biochemical abnormalities and radiologically advanced presentations were common. Disease pattern and response to treatment was purely individual and did not differ with respect to nationality or race.

Adult↗

PubMed2000

[Intravesical BCG-therapy: comparison of side effects of Connaught (Toronto) and Pasteur (Paris) strains].

INTRODUCTION: Urologists have felt that the adverse effects of intravesical BCG-therapy have been more serious and more frequent since the use of the Connaught strain. The objective of this retrospective study was to compare the toxicity of this new strain with that previously used in France (Pasteur strain). MATERIAL AND METHODS: After endoscopic resection, 89 patients with stage Ta grade 1-2 recurrent or T1 grade 3 and/or CIS bladder tumour were treated with 6 instillations of 150 mg of BCG Pasteur from 1992 to 1996 (50 patients: group 1) or 81 mg of BCG Connaught from January 1997 to December 1998 (39 patients: group 2). Adverse effects were classified as minor, lasting less than 48 hours (bladder irritation syndrome and/or macroscopic haematuria and/or fever less than 38 degrees C), moderate (requiring symptomatic treatment, reduction of the dose or an increased interval between instillations), and major (contraindication to continuation of treatment). RESULTS: 74% of patients in group 1 presented at least one adverse effect versus 77% in group 2. The reasons for permanent discontinuation of BCG-therapy in groups 1 and 2, respectively, were as follows: malaise during instillation (1 vs 0), bladder irritation syndrome not controlled by symptomatic treatment (4 vs 5) and epididymitis (0 vs 1). Pulmonary tuberculosis was diagnosed in one patient from group 2, one year after the last instillation. The frequency and severity of adverse effects were not statistically different between the two groups. The number of patients discontinuing BCG-therapy because of severe complications was also not statistically different between the two groups. CONCLUSION: This study did not reveal any difference of toxicity between Connaught and Pasteur strain in intravesical BCG-therapy of superficial bladder tumours.

Adjuvants, Immunologic↗

PubMed2001

Tuberculosis among never-jailed drug abusers.

The best way to control tuberculosis in a community is active case-finding and treatment among high-risk groups. Upon admission to a correctional centre in 1997, 319 never-jailed drug addicts were enrolled in the present study. Statistically significant differences in skin-test positivity were found among males over 40 years old, those unemployed and injecting drug abusers. Among the sample, 8 cases of pulmonary tuberculosis were found. This is approximately 170 times the rate in the general population. Because of cost and time, we recommend the screening of drug addicts by mini-radiography instead of tuberculin skin test at admission.

Adult↗

PubMed1999

Impacts of interleukin-12 on multiplication of Mycobacterium tuberculosis and Mycobacterium avium complex in mice.

OBJECTIVE: To evaluate the potential impacts of exogenous administration of murine recombinant interleukin-12 (IL-12) on multiplication of Mycobacterium tuberculosis and M. avium complex (MAC) in murine models. METHODS: Swiss or beige mice were infected intravenously with M. tuberculosis H37Rv or MAC respectively, and were treated by subcutaneous injection with various doses of IL-12, either alone or in combination with chemotherapy. Effectiveness of treatment was assessed by the enumeration of CFUs in the spleens and lungs, together with other indicators. RESULTS: Multiplication of M. tuberculosis was reduced by IL-12 in a dose-dependent manner if the treatment began at day 1, whereas no statistically significant suppression was observed if the treatment began at day 14. Combination with IL-12 did not enhance the bactericidal activity of antituberculosis chemotherapy. The growth curves of MAC in IL-12-treated mice were almost identical to those of untreated controls, indicating that IL-12 did not affect the multiplication of MAC in beige mice. In both experiments, the dosing of IL-12 approached levels of severe toxicity for the mouse strains used. CONCLUSIONS: IL-12 had a positive affect on early multiplication of M. tuberculosis. It had no effect on early multiplication of M. avium complex.

Journal Article↗

PubMed1996

Cigarette smoking as a risk factor for tuberculosis in young adults: a case-control study.

SETTING: The association between smoking and pulmonary tuberculosis has not often been studied. OBJECTIVE: To assess the influence of cigarette smoking on the development of active pulmonary tuberculosis in young people who were close contacts of new cases of smear-positive pulmonary tuberculosis. DESIGN: A case-control study in which 46 'cases' (patients with active pulmonary tuberculosis: isolation of Mycobacterium tuberculosis or clinical and/or radiographic evidence of current pulmonary tuberculosis, with a positive tuberculin skin test) and 46 'controls' (persons with positive tuberculin reaction, negative bacteriological test and without clinical and/or radiological evidence of pulmonary tuberculosis) were included. Smoking habits were investigated by questionnaire. Univariate and multivariate analysis was performed, and odds ratio (OR) was adjusted for age, gender and socio-economic status. RESULTS: Statistically significant differences were found in active smokers (occasional and daily smokers) (OR: 3.65; 95% CI, 1.46 and 9.21; P < 0.01), daily smokers (OR: 3.53; 95% CI, 1.34 and 9.26; P < 0.05), and individuals who were both passive and active smokers (OR: 5.10; 95% CI, 1.97 and 13.22; P < 0.01) and passive and daily smokers (OR: 5.59; 95% CI, 2.07 and 15.10; P < 0.001). There was a dose-response relationship between the number of cigarettes smoked daily and the risk of active pulmonary tuberculosis. CONCLUSIONS: The data studied show that cigarette smoking is a risk factor for pulmonary tuberculosis in young people, with a dose-response relationship with the number of cigarettes consumed daily.

Adolescent↗

PubMed2004

Total antioxidant levels are low during active TB and rise with anti-tuberculosis therapy.

In tuberculosis, oxidative stress is a result of tissue inflammation, poor dietary intake of micronutrients due to illness, free radical burst from activated macrophages, and anti-tuberculosis drugs. These free radicals may in turn contribute towards pulmonary inflammation if not neutralized by antioxidants. The total antioxidant status (TAS) of individuals is a function of dietary, enzymatic, and other systemic antioxidants and is therefore an indicator of the free radical load. Our aim was to evaluate the TAS of healthy and M. tuberculosis-infected persons from a high TB incidence community, as well as tuberculosis patients at various stages of antituberculosis drug treatment and to correlate results with plasma micronutrient levels. Blood plasma samples from TB infected patients and following antituberculosis drug treatment were assayed for TAS, vitamins A, E and Zinc. Statistical analysis of results was by one-way ANOVA and the Tukey multiple comparison post test. Active TB patients showed a significantly lower TAS (P < 0.001) compared to the community controls. We also show that TAS values increase during therapy. Results correlated with micronutrients vitamin A and zinc but vitamin E remained unaffected. We suggest that total antioxidant status of TB patients should be considered for more effective disease control and that diets low in antioxidants may render individuals susceptible to tuberculosis.

Antioxidants↗

PubMed1990

[Decrease in tuberculosis mortality--a credit to medicine or sequela of an improved standard of living].

Tuberculosis was the major cause of death in 19th century Europe. A fall in the incidence of the disease was first observed in England. In Germany this reduced incidence - along with industrialization - did not take place until the time of the Reich. Scientists in the 19th century recognised various factors as being responsible for the decrease in incidence of the disease. Those who believed in the contagiousness of the disease hoped to be able to control it with preventive and hygienic measures resulting from their findings on the bacteriology of the epidemic. Constitutionalists, on the other hand, attached importance to hereditary factors and believed that "evolution by natural selection" would bring the disease under control. Social hygienists, whose findings at the beginning of the 20th century were a subject of wide discussion, found the disease to be chiefly influenced by eating, working, and living conditions. These assumptions were confirmed by a statistical analysis of the relationship between living conditions and the mortality associated with tuberculosis. It follows that better living conditions would help to reduce the number of deaths from tuberculosis better than any medical preventive measure.

Cross-Sectional Studies↗

PubMed1983

Growth status and the risk of contracting primary tuberculosis.

A case of open tuberculous infection in a member of staff at a primary school resulted in an outbreak in which nearly a quarter of the children in the school contracted a primary infection. The growth status of these children was compared with that in the non-infected children before the outbreak and on two occasions after the outbreak. The children with tuberculous infection were taller and fatter than the controls before and after the outbreak but differences were not always statistically significant. Among children with a good nutritional status the thin and small child is at no greater risk of contracting primary tuberculous infection than other children.

Body Constitution↗

PubMed2001

Safety and bactericidal activity of rifalazil in patients with pulmonary tuberculosis.

Rifalazil, also known as KRM-1648 or benzoxazinorifamycin, is a new semisynthetic rifamycin with a long half-life of approximately 60 h. Rifalazil has potent bactericidal activity against Mycobacterium tuberculosis in vitro and in animal models of tuberculosis (TB). Prior studies in healthy volunteers showed that once-weekly doses of 25 to 50 mg of rifalazil were well tolerated. In this randomized, open-label, active-controlled phase II clinical trial, 65 subjects with sputum smear-positive pulmonary TB received one of the following regimens for the first 2 weeks of therapy: 16 subjects received isoniazid (INH) (5 mg/kg of body weight) daily; 16 received INH (5 mg/kg) and rifampin (10 mg/kg) daily; 17 received INH (5 mg/kg) daily plus 10 mg of rifalazil once weekly; and 16 received INH (5 mg/kg) daily and 25 mg of rifalazil once weekly. All subjects were then put on 6 months of standard TB therapy. Pretreatment and day 15 sputum CFU of M. tuberculosis were measured to assess the bactericidal activity of each regimen. The number of drug-related adverse experiences was low and not significantly different among treatment arms. A transient decrease in absolute neutrophil count to less than 2,000 cells/mm(3) was detected in 10 to 20% of patients in the rifalazil- and rifampin-containing treatment arms without clinical consequences. Decreases in CFU counts were comparable among the four treatment arms; however, the CFU results were statistically inconclusive due to the variability in the control arms. Acquired drug resistance did not occur in any patient. Studies focused on determining a maximum tolerated dose will help elucidate the full anti-TB effect of rifalazil.

Adolescent↗

PubMed2006

Host susceptibility to tuberculosis: CARD15 polymorphisms in a South African population.

Tuberculosis (TB) is one of the leading causes of death worldwide. The nucleotide-binding oligomerisation domain 2 protein (NOD2) has recently been recognised as a non-redundant recognition mechanism of Mycobacterium tuberculosis. The caspase recruitment domain-containing protein 15 gene (CARD15), which encodes the NOD2 protein, is a susceptibility gene for Crohn's disease (CD), a granulomatous, chronic inflammatory disorder. CARD15 was therefore investigated as a candidate gene in TB. We genotyped the R702W, G908R and 1007fs variants, previously associated with CD, in TB cases and controls from the admixed South African Coloured population. No statistically significant differences between cases and controls were observed for these variants. We determined that the CD-associated mutations occur at very low frequencies in this population. Our results indicate that CARD15 is not a major susceptibility gene for TB in the South African Coloureds.

Genetic Predisposition to Disease↗

PubMedDate not supplied

[Short term projections of infection by the human immunodeficiency (HIV) and the acquired immunodeficiency syndrome (AIDS) in Cameroon].

As of December 1991, Cameroon has reported 827 cases of AIDS. The results from the Sentinel Surveillance System show a seroprevalence of 1.3% HIV1 among pregnant women, 2.5% in people attending STD clinic and 3.5% in tuberculosis patients. The World Health Organization projection model was used to make a short term projection of HIV infection and AIDS cases. Results show that the number estimated of HIV infected populations varies between 24 to 45,000 people by the year 1995. Results show also an estimated 8,500 cumulative AIDS cases. Even in a low prevalence country as Cameroon the impact of the HIV epidemic is important and will result in a burden for the health care system.

Acquired Immunodeficiency Syndrome↗

PubMed1989

[The temperamental basis of personality and the degree of tuberculosis progression and its treatment in epidemiological studies].

Using a Sheet of personality Self-estimation of Le Senne eight subgroups were isolated from a group of patients with sputum-positive pulmonary tuberculosis, and analogous subgroups were isolated from healthy subjects which served as control subgroups. By the inquiry method and by the Test of Sentence Completion IG the clinical form of tuberculosis, degree of pulmonary tissue damage, extent and location of pulmonary lesions, and the intensity of conflict areas were determined. The statistical analysis showed that no temperament type was an epidemiological barrier protecting the organism against invasion by and development of M. tuberculosis. As compared to other temperament types the sentimentalists showed most intense conflict areas which was reflected in antituberculosis treatment. Attention is called to the usefulness of psychological testing for epidemiological studies on tuberculosis and to the necessity of their more widespread use in the programmes of postgraduate studies.

Adult↗

PubMed2000

Factors predicting non-completion of tuberculosis treatment among HIV-infected patients in Barcelona (1987-1996).

OBJECTIVE: To determine the predictive factors of non-completion of tuberculosis (TB) treatment among patients infected with the human immunodeficiency virus (HIV). DESIGN: Between 1987 and 1996, 2201 HIV-infected TB patients were detected by the Barcelona Tuberculosis Prevention and Control Programme. Patients who completed treatment were compared to those who abandoned. Bivariate analysis was made by chi(2) test to compare qualitative variables. Associations were measured by means of odds ratios (OR) with 95% confidence intervals (CI). Variables showing a statistically significant association were analysed at multivariate level by means of a logistic regression model. RESULTS: Treatment was carried to completion by 1065 patients (48.4%), 289 (13.1%) abandoned, 648 (29.5%) died during treatment, and 142 (6.5%) moved out of the city. Final outcome could not be established in 57 (2.5%). Intravenous drug users (IDU) represented 76.2% of patients. The rate of non-completion between 1987 and 1992 was 26.3% and for 1993-1996 it was 15.1%, a decrease of 42.6%. Living in neighbourhoods of a low socio-economic level (OR 1.61; 95% CI 1.222.13), homelessness (OR 3.56; 95% CI 2.01-6.31), history of TB (OR 1.61; 95% CI 1.12-2.33), and having presented with a current TB episode in 1987-1992 (OR 1.42; 95% CI 1.01-2.00), were risk factors for abandoning TB treatment. CONCLUSIONS: Social and health factors together influence non-completion of TB treatment in HIV-infected patients, while health interventions can improve treatment completion.

AIDS-Related Opportunistic Infections↗

PubMed1988

Leprosy in Malawi. 2. Background, design and prospects of the Karonga Prevention Trial, a leprosy vaccine trial in northern Malawi.

The Karonga Prevention Trial is the largest vaccine trial ever mounted in Africa. It is designed to test two hypotheses: (i) whether the addition of killed Mycobacterium leprae can increase the protection against leprosy (and tuberculosis) imparted by BCG alone; and (ii) whether repeating a BCG vaccination can increase upon the protection provided by an initial dose. The rationale and design of the trial are discussed in relation to the history of vaccination against leprosy and to several contending arguments which determined the ultimate protocol. The potential of the trial to reveal statistically significant differences between the vaccines being compared is discussed, as are the implications of possible results for future research and control of leprosy.

Adolescent↗

PubMedDate not supplied

[Occupational exposure to multiresistant Mycobacterium bovis in a hospital in Saragossa, Spain].

BACKGROUND: Those working in a hospital environment are exposed to different occupational risks, although more specifically biological ones. One of the major risks is that of exposure by airborne transmission, more specifically, tuberculosis. This study is aimed at providing a description and analysis of the results of the implementation of an evaluation and surveillance protocol following occupational exposure to Multiresistant mycobacterium bovis (MRMb). METHOD: A male patient was diagnosed with MRMb infection at the Miguel Servet Hospital in Zaragoza in 1999 following ten days without respiratory isolation. During this period, he came into contact with 167 employees from different hospital departments. A surveillance and contact control protocol was prepared based on: completing a survey and undergoing an initial Mantoux (if the employee had previously tested negative for tuberculin), followed three months later by a chest X-ray and then a two-year clinical follow-up (check-ups every three months) for those having tested positive for tuberculin and no administering of chemoprophylaxis even though signs of infection were to have been found. RESULTS: Information was gathered on 160 employees (96%). A total of 94 employees (59%) had previously undergone a Mantoux, seven (7) having had tuberculosis. It was necessary for a follow-up to be conducted on sixty-one (61) employees who tested positive (29 previously positive and 32 detected in the initial Mantoux). No employee who had tested negative on an initial Mantoux tested positive on repeated testing three months later nor showed any symptoms indicative of transmission during the follow-up period. Some variables, such as age or working in the Infectious Disease Unit were related, on a statistically significant basis, to follow-up being required. CONCLUSIONS: The risk of occupational transmission following contact with MRMb might be similar to M. Tuberculosis, although further experience would be required in order to confirm this fact. Early diagnosis and availing of a protocol for implementing measures aimed at preventing and controlling this type of occupational exposure are of importance.

Adult↗

PubMed2005

Selection of rifampicin-resistant Staphylococcus aureus during tuberculosis therapy: concurrent bacterial eradication and acquisition of resistance.

BACKGROUND AND OBJECTIVES: Acquired antimicrobial resistance is commonly attributed to regimens that expose bacteria to subinhibitory concentrations; consequently, eradication of susceptible cells is advocated. The mutant selection window hypothesis predicts that resistance can be acquired even when inhibitory concentrations are exceeded and susceptible bacteria are eradicated. The objective was to test that prediction clinically. METHODS: Tuberculosis patients (n = 372) were sampled for nasal colonization by Staphylococcus aureus at the beginning of anti-tuberculosis therapy with rifampicin-containing regimens and again after 2 and 4 weeks. Rifampicin susceptibility of S. aureus was determined, and S. aureus isolates from patients developing acquired resistance were examined by molecular strain typing. Diabetes patients (n = 200) served as untreated controls. RESULTS: Nasal colonization was 17% and 20% for the tuberculosis and diabetes patients, respectively. Four patients were initially colonized with rifampicin-resistant S. aureus and were excluded from further sampling. Initiation of anti-tuberculosis therapy eradicated S. aureus nasal colonization in 53/58 tuberculosis patients while allowing acquisition of rifampicin resistance in 5/58. Pulsed-field gel electrophoresis (PFGE) band patterns and protein A repeat sequence determination differed in S. aureus isolated from different patients but was identical in isolates obtained from the same patient before and after acquisition of resistance. No resistance was acquired in untreated control patients, which differed statistically from treated patients (P = 0.025). CONCLUSIONS: Acquired resistance and eradication of susceptible bacteria can occur concurrently; restricting acquired resistance may require direct suppression of mutant growth and viability in addition to elimination of susceptible bacteria.

Adolescent↗

PubMed1993

Spinal fluid lymphocytes from a subgroup of multiple sclerosis patients respond to mycobacterial antigens.

Immune responses to heat shock or stress proteins are observed in several chronic autoimmune diseases. Such proteins are major antigens of many bacteria, especially mycobacteria. To determine whether immune responses to stress proteins occur in chronic inflammatory diseases of the central nervous system such as multiple sclerosis (MS) we measured proliferative responses of lymphocytes from spinal fluids and bloods of patients with MS and other neurological diseases to a sonicate of M. tuberculosis, an acetone extract of M. tuberculosis, a recombinant 65-kd heat shock protein of M. leprae, and tetanus toxoid as a control recall antigen. Significantly increased spinal fluid lymphocyte responses to mycobacterial sonicate, relative to responses from paired peripheral blood lymphocytes, were present in 14 of 20 specimens from patients with MS (p < 0.025) and 2 of 9 specimens from patients with other neurological diseases. Spinal fluid lymphocytes also responded to tetanus toxoid, but differences between blood and spinal fluid were not statistically significant. Lymphocytes from 1 patient with MS responded only to M. leprae. There were no proliferative responses to the M. tuberculosis acetone extract. When patients with MS were classified according to duration of disease (< 2- or > 2-yr duration) 9 of 10 patients with recent onset had cerebrospinal fluid cells that responded to M. tuberculosis compared with 5 of 10 with longer duration symptoms (p < 0.012). Our data suggest a selective recruitment and/or expansion of mycobacterial reactive cells to the central nervous system of a subpopulation of patients with MS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2004

[Randomized control study on domestic fixed-dose combinations in the initial treatment of smears positive tuberculosis].

OBJECTIVE: To explore the feasibility of domestic fixed-dose combinations as antituberculosis therapy applied in the National Tuberculosis Program. METHODS: A randomized control trial was conducted and 422 smear-positive pulmonary tuberculosis patients were randomly distributed into 2 groups. The trial group was treated daily with rifampicin, isoniazid and pyrazinamide tablets (including 120 mg rifampicin, 80 mg isoniazid and 250 mg pyrazinamide) in the first 2 months and rifampicin and isoniazid tables (including 300 mg rifampicin, 150 mg isoniazid) in the subsequent 4 months. The control group was treated by full 6-month standard regimens (2HRZE/4H3R3). RESULTS: The demographic data and the disease status were similar between the 2 groups before treatment. The rate of conversion from positive to negative cases in the trial group after therapy was 91.6% at 2 months, 97.2% at 3 months, and 97.7% at 6 months, while that of the control group was 87.3%, 97.5%, and 98.0% respectively. The difference in the conversion rates between the two groups was not statistically significant (chi2 = 2. 05, chi2 = 0.03, chi2 = 0.04, P > 0.05). The incidence of skin rash as an adverse effect was less common in the trial group as compared to the control group (Fisher's exact P = 0.024 33) . CONCLUSIONS: Domestic fixed-dose combinations as supplementary anti-tuberculous therapy could be used in the National Tuberculosis Program, but further study is needed for widespread application.

Adolescent↗