[Statistical results of systematic radiological detection of tuberculosis in the same group of people from 1949 to 1957 and comparison with other social groups].
Explore the source record for details and available documents.
Biometry↗
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.
Epidemiological transition of tuberculosis and future agenda of control in Japan: results of the Ad-Hoc National Survey of Tuberculosis 2000.
SETTING: In Japan, the incidence of tuberculosis (TB), which had improved continuously from 1951, has shown an upturn since 1997. OBJECTIVE: An Ad-Hoc National Survey was conducted to review the issues of TB control in Japan and to discuss the future direction of change. METHODS: TB registries kept at health centres in all prefectures were reviewed for the year 1998. Vital statistics and BCG vaccination records were reviewed separately. RESULTS: The survey revealed a 34.7% under-estimation of TB deaths in TB registers, and a 11.2% over-estimation of TB cases registered due to a change in diagnosis after registration. For treatment, the four-drug regimen advocated for smear-positive cases was used in only 54.8% of indicated cases, and treatment duration was very long; for example, 18.4% of first-time hospitalised cases over 15 years of age received in-patient care for more than 6 months and 29.8% continued treatment for more than 12 months. Apart from an increasingly elderly population, other factors contributing to an increase in TB included underlying health risk factors for increased susceptibility to TB and socio-economic risk factors for treatment failure. Regarding preventive measures, active case finding by health screening contributed to detection of only 8.7% of new cases aged over 60 years, but BCG vaccination appeared to be preventive among infants under 1 year of age. CONCLUSION: The National Survey revealed a changing profile of TB in Japan and suggested a need to review and revitalise the TB control programme.
Adolescent↗
Does B.C.G. vaccination prevent or postpone the occurrence of tuberculous meningitis?
The reported efficiency of B.C.G. vaccine in prevention of primary childhood or sputum positive adult tuberculosis vary widely but it is believed to offer significant protection against hematogenous forms of tuberculosis. The present hospital-based, case control study was aimed at evaluation of impact of B.C.G. vaccination on one of the hematogenous forms of tuberculosis i.e. Tuberculous meningitis (TBM). Records of cases of TBM admitted in the pediatric wards of Lok Nayak Hospital, Delhi, over one year were analyzed retrospectively for B.C.G. positivity status and age distribution. The results were compared with similar data obtained from a control group comprising of non-TBM cases in pediatric wards of same hospital, recruited on 2 days, separated by an interval of three weeks. No statistically significant difference was found in B.C.G. positivity status of cases and control groups. However, there was an obvious trend in age distribution among cases of TBM with respect to the B.C.G. status, with a significantly higher proportion of B.C.G. vaccinated children in over 5-year age group, as compared to those in under 5 year age group. The results, therefore, indicate probable effectiveness of B.C.G. against TBM only for a limited duration i.e. single B.C.G. immunization only postpones rather than prevent the occurrence of TBM.
Adult↗
Tuberculosis and human immunodeficiency virus infection during the 1990's.
Among the many infectious complications of infection with human immunodeficiency virus (HIV), tuberculosis is now recognized as one of the most important. Coexisting HIV infection is believed responsible for the soaring incidence of tuberculosis in Africa, and for the increase in the number of reported cases in the United States. As HIV-induced immunosuppression worsens, tuberculosis may supervene by reactivation of remotely acquired infection or failure to defend against newly acquired Mycobacterium tuberculosis. Both mechanisms undoubtedly occur in Africa where the rate of exposure is high; the former prevails in the United States. The risk of tuberculous infection progressing to tuberculous disease is about six times higher in HIV seropositive than seronegative persons. Although not incontrovertibly established, tuberculosis probably also has a deleterious effect on coexisting HIV infection, either by accelerating the rate of destruction of CD4+ lymphocytes and/or promoting the release of new virions from HIV-infected macrophages. Tuberculosis, whether HIV-linked or not, can be controlled by the traditional means of case-finding and treatment, vaccination with BCG, and chemoprophylaxis. HIV infection can be controlled by eliminating high-risk behavior, and using uncontaminated blood and other medical supplies. An extensive campaign is needed to prevent further spread of these dual scourges that are overwhelming already meager health resources in many parts of the world.
Africa↗
Host-pathogen interactions in emerging and re-emerging infectious diseases: a genomic perspective of tuberculosis, malaria, human immunodeficiency virus infection, hepatitis B, and cholera.
On exposure to a pathogen, a host may resist infection, become subclinically infected, or progress through several stages from mild to severe infection. Chronic sequelae may or may not occur. Host factors, particularly host genes, influence many of these stages. We have used a model of the continuum of pathogenesis of infectious diseases to consider the effect of host genes on five pathogens of significant public health burden: Mycobacterium tuberculosis, Plasmodium species, human immunodeficiency virus, hepatitis B virus, and Vibrio cholerae. The relationships between these infections and polymorphisms in human leukocyte antigen, cytokines, other immune response, or pathogen receptor genes are reviewed. We discuss gene-gene interactions and their effects in complex settings, such as coinfections with several pathogens. Priorities for prevention and control of these pathogens include vaccines and antimicrobial drugs. Research on how host genes can influence vaccine responses and the efficacy of drugs or other interventions, as well as further research into the relationship of host genes to infectious disease outcomes, may lead to new strategies for prevention and control.
Cholera↗
Corticosteroids and peptic ulcer: meta-analysis of adverse events during steroid therapy.
OBJECTIVES: This meta-analysis was performed to determine whether corticosteroid therapy induces the development of peptic ulcer and other putative complications of steroid therapy. DESIGN: A retrospective investigation in which we analysed all the randomized, double-blind, controlled trials (RDBCT) in which steroids had been administered that we were able to identify. The number of episodes of peptic ulcer, dermatological effects, sepsis, diabetes, hypertension, osteoporosis, psychosis and tuberculosis reported in both the placebo and steroid groups were compared. SETTING: The international medical literature was analysed for any RDBCT in which any steroid or ACTH had been administered in any dosage for any duration, and any putative complication of steroid therapy was reported. SUBJECTS: Of 1857 articles, 93 satisfied our requirements and were analysed by the meta-analytic techniques of Peto, DerSimonian and Laird. A total of 6602 patients were included. MAIN OUTCOME MEASURES: The relative frequencies of each of these eight 'complications' were compared in the placebo and steroid groups using conventional statistics and meta-analysis. The relative frequencies of 'annualized' subgroups of patients who received treatment for 1 to 7 days, 1 week to 1 month, 1 to 3 months and more than 3 months, were similarly analysed. RESULTS: Nine of 3267 patients in the placebo group (0.3%) and 13 of 3335 patients in the steroid group (0.4%) were reported to develop peptic ulcer (P > 0.05). The dermatological cosmetic effects of steroid therapy were observed more frequently in the steroid group (P < 0.001), as was diabetes (P < 0.001), hypertension (P < 0.01) and psychosis (P < 0.001). Sepsis, osteoporosis and tuberculosis all occurred more frequently in the steroid than in the placebo group, but the differences are not statistically significant. CONCLUSIONS: Peptic ulcer is a rare complication of corticosteroid therapy that should not be considered a contraindication when steroid therapy is indicated.
Adrenal Cortex Hormones↗
Adrenocortical reserve and morphology in tuberculosis.
Ninety seven patients (63 males, mean age 31.8 years, SD 2.3) with various forms of tuberculosis were studied. All of them were HIV negative. Thirty normal control subjects (16 males, mean age 36.4 years, SD 1.8) were also studied. Fifty-eight of the 97 patients (59.8%) were malnourished (BMI < 18 kg/m2). The mean basal serum cortisol was lower in the TB group (n = 91) (351 nmol/1; SD 150) as compared to the normal control group (n = 8) (402 nmol/1; SD 93) but this difference did not attain statistical significance. Following administration of synthetic ACTH (cosyntropin), the 30 and 60 minutes mean serum cortisol values in the TB group were significantly lower as compared to the normal control group (p < 0.05). Forty five of the 91 patients (49.5%) who underwent the ACTH stimulation test had compromised adrenal reserve. Fourteen of the 86 patients (16.3%) in whom adrenal morphology was studied revealed adrenal gland enlargement on abdominal CT scan. ACTH stimulation was done in 12 of these 14 patients and eight of them had compromised adrenal reserve. Repeat ACTH stimulation done six months to one year after treatment in 13 patients revealed significantly increased 30 minutes (p < 0.05) and 60 minutes (p < 0.05) serum cortisol values. While nine of these 13 patients were negative responders before treatment, only three of them had evidence of compromised adrenal reserve after one year of antituberculosis treatment, (p < 0.05). Serum cortisol values in patients with drug-sensitive and drug-resistant tuberculosis did not differ significantly. Patients with drug-resistant tuberculosis had a higher prevalence of adrenal gland enlargement (7 of the 30) as compared to those with drug-sensitive tuberculosis (7 of the 56) (p = NS). Subclinical adrenal insufficiency is prevalent in a significant number of patients with both drug-sensitive and drug-resistant tuberculosis, and in some of these it is associated with adrenal gland enlargement. The compromised adrenal reserve and enlargement seem to reverse with therapy.
Adrenal Cortex Hormones↗
Age transition of tuberculosis incidence and mortality in Brazil.
OBJECTIVE: Before the Aids pandemic, demographic transition and control programs prompted a shift in the age of incidence of tuberculosis from adults to older people in many countries. The objective of the study is to evaluate this transition in Brazil. METHODS: Tuberculosis incidence and mortality data from the Ministry of Health and population data from the Brazilian Bureau of Statistics were used to calculate age-specific incidence and mortality rates and medians. RESULTS: Among reported cases, the proportion of older people increased from 10.5% to 12% and the median age from 38 to 41 years between the period of 1986 and 1996. The smallest decrease in the incidence rate occurred in the 30 - 49 and 60+ age groups. The median age of death increased from 53 to 55 years between 1980 and 1996. The general decline in mortality rates from 1986 to 1991 became less evident in the 30+ age group during the period of 1991 to 1996. A direct correlation between age and mortality rates was observed. The largest proportion of bacteriologically unconfirmed cases occurred in older individuals. CONCLUSIONS: The incidence of tuberculosis has begun to shift to the older population. This shift results from the decline in the annual risk of infection as well as the demographic transition. An increase in reactivation tuberculosis in older people is expected, since this population will grow from 5% to 14% of the Brazilian population over the next 50 years. A progressive reduction in HIV-related cases in adults will most likely occur. The difficulty in diagnosing tuberculosis in old age leads to increased mortality.
Acquired Immunodeficiency Syndrome↗
Interleukin-4 and its alternatively spliced variant (IL-4delta2) in patients with atopic asthma.
The interleukin-4 (IL-4) splice variant (IL-4delta2) is known to antagonize many biological activities of IL-4, and this challenges our understanding of the role of IL-4 in asthma. Studies that have used nonspecific antibodies, probes, and/or primers to quantify IL-4 in clinical samples would not have distinguished the expression of IL-4 from IL-4delta2. This is the first study to examine patients with chronic asthma and atopy for IL-4delta2 mRNA in their peripheral blood mononuclear cells without antigen stimulation, using a quantitative nested reverse-transcription polymerase chain reaction (RT-PCR) protocol. The median IL-4 mRNA copy number in cells from the patients with asthma was 2.8 logs higher than in a comparator group of patients with tuberculosis (p = 0.0005) and 4.5 logs higher (p = 0.0004) than in healthy control subjects. In contrast, IL-4delta2 expression in cells from patients with asthma was similar to that seen in cells from patients with tuberculosis. Hence, the median ratio of IL-4 to IL-4delta2 was 500-fold higher in the patients with asthma when compared with either patients with tuberculosis or healthy control subjects. The relative expression of IL-4 and IL-4delta2 may be a reason for the functional diversity of Th2 cells in different clinical conditions, and a hitherto unexplored mechanism for the pulmonary pathology in patients with atopic asthma.
Adolescent↗
Induction of oxidative stress in antitubercular drug-induced hepatotoxicity.
BACKGROUND AND AIM: Oxidative stress could play a role in the pathogenesis of antitubercular drug (ATD)-induced hepatotoxicity. We therefore studied the plasma level of reduced glutathione (GSH) and malondialdehyde (MDA) in patients with ATD-induced hepatotoxicity (cases), ATD-treated controls (disease controls) and in healthy volunteers. METHODS: This study was carried out in a case-control design. Twenty-one cases, 21 age- and sex-matched disease controls, and 10 healthy volunteers were enrolled. Plasma levels of GSH and MDA were measured. RESULTS: Plasma levels of GSH (median [range] 11.5 [6.2-21.2] mmol/dL) and MDA (1390 [560-2310] nmol/dL) of cases were significantly different (p<0.01) from GSH (18.4 [10.5-24.4]) and MDA (290 [240-550]) of disease controls. Further, plasma GSH and MDA levels of both the ATD-treated groups were different from those in healthy controls. CONCLUSION: Lower levels of plasma GSH and higher levels of MDA may be due to oxidative stress resulting from ATD therapy.
Adult↗
[HIV infection at the Central Military Hospital of Madrid].
UNLABELLED: We describe the infection by HIV observed in the scope of the Military Hospital and we evaluate the clinical usefulness of the current classification systems. We have retrospectively studied (1986-1993) 80 confirmed cases of infection by HIV: 21 women and 59 men (age range: 17-65 years). Quarterly clinico-biological controls. Initial and final classification according to CDC 87/93 systems. STATISTICAL ANALYSIS: RSIGMA. We have detected in 26% of the patients heterosexual contagion; in 55%, toxicomania and in 17%, homosexuality; 39% had less than 200 CD4/microL upon admission. During the follow-up, 35 patients fulfilled AIDS criteria (17% due to tuberculosis); 17 died (21%) and 30 gave up (37%). CONCLUSIONS: HIV infection is less frequent in the military sociofamiliar environment, with lower incidence of tuberculosis. There is a greater proportion of women, heterosexual transmission and asymptomatic patients. CDC-93 classification is the system best adapted to the natural history of the HIV infection.
Adolescent↗
Use of spatial statistics and monitoring data to identify clustering of bovine tuberculosis in Argentina.
The spatial distribution of endemic bovine tuberculosis (TB) in Argentine cattle herds was described using recorded information on the detection of TB-like lesions in cattle slaughtered between March 1995 and 1997 at 126 slaughterhouses with federal inspection. Approximately, 47% (9472396 cattle) of the estimated total number of cattle slaughtered in Argentina during this period was included in the study. Information on the number of cattle per source herd consigned to slaughter, number of cattle with TB-like lesions per herd and the geographical location of counties from which cattle originated was used to investigate spatial clustering of TB. Overall, no evidence of clustering of TB prevalence by county was detected (Moran's autocorrelation statistic I=0.009, P=0.089). However, first- (Cuzick and Edwards' test statistic, T(k)=87, P=0.036) and second-order (T(k)=170, P=0.038) nearest-neighbor case-counties (TB prevalence>median prevalence of all counties, 6.7%) were clustered. Using the spatial scan test based on a Bernoulli model, the most-likely cluster (P=0.001) identified during the study period included 5793 cases of TB (5.2 per 1000 km(2)) in five counties. This cluster coincided with Santa Fe Province, which contains 21% of all dairy cows in Argentina and accounts for 34% of the country's milk production. Several secondary clusters of TB-also located in dairy districts-were identified. Study results demonstrate that bovine TB is clustered in Argentina, and these clusters coincide with dairy cattle production. Identification of clustering can assist efforts to eradicate bovine TB from Argentina. Further spatial investigations need to focus on the reasons why TB is clustered in Argentina. In particular, the relationship between TB clustering and management practices-such as grazing density and production systems-need to be described to assist in the development of disease-control programs. The use of spatial statistics and geographical information systems could meet these needs.
Abattoirs↗
Influence of disease severity on nitrite and cytokine production by peripheral blood mononuclear cells (PBMC) from patients with pulmonary tuberculosis (TB).
Earlier studies in patients with pulmonary TB have revealed a higher production of Th1 cell type cytokines in moderate TB, with predominant Th2-like responses in advanced disease. Given the influence of IL-12 in T cell differentiation, as well as the roles of transforming growth factor-beta (TGF-beta), nitric oxide and tumour necrosis factor-alpha (TNF-alpha) in the immune response against intracellular pathogens, we decided to analyse the interferon-gamma (IFN-gamma), IL-4, IL-12, TGF-beta, TNF-alpha and nitrite concentrations in culture supernatants of PBMC from TB patients showing different degrees of lung involvement. The sample population comprised 18 untreated TB patients with either moderate (n = 9) or advanced (n = 9) disease and 12 age- and sex-matched healthy controls (total population (patients and controls) 12 women, 18 men, aged 37 +/- 13 years (mean +/- s.d.)). PBMC were stimulated with whole sonicate from Mycobacterium tuberculosis and the supernatants were collected on day 4 for measurement of cytokine and nitrite levels. Antigen-stimulated IFN-gamma, TGF-beta and TNF-alpha production was found to be significantly increased in TB patients, both moderate and advanced, compared with the controls. Levels of IFN-gamma were significantly higher in moderate disease than advanced cases, whereas advanced cases showed significantly higher IL-12, TGF-beta and TNF-alpha concentrations when compared with cases of moderate TB. Nitrite levels were also increased in TB patients and the increase was statistically significant when advanced cases were compared with controls. These findings may contribute to a clearer picture of the net effect of cytokine interactions in TB, essential for a better understanding of the immunopathological mechanisms underlying the distinct clinical forms of the disease.
Adolescent↗
Pentoxifylline therapy in human immunodeficiency virus-seropositive persons with tuberculosis: a randomized, controlled trial.
Macrophage activation and tumor necrosis factor-alpha (TNF-alpha) production are critical in tuberculosis immunity but may result in increased human immunodeficiency virus (HIV) expression and accelerated HIV disease progression in HIV-infected persons. Pentoxifylline inhibits expression of TNF-alpha and HIV. A double-blind, placebo-controlled study of adjunctive therapy with pentoxifylline (1800 mg/day) as a timed-release formulation was done in Ugandan HIV-infected patients with pulmonary tuberculosis. Subjects had early HIV disease (mean CD4 cell count, 380/microL) and did not receive other antiretroviral drugs. Pentoxifylline resulted in decreased plasma HIV RNA and serum beta 2-microglobulin and, in a subset of moderately anemic patients, improved blood hemoglobin levels. Trends were noted toward reduced TNF-alpha production in vitro and improved performance scores, but these did not reach statistical significance. No effect was noted on body mass, CD4 cell count, or survival. Additional studies of more potent TNF-alpha inhibitors in HIV-positive subjects with tuberculosis are warranted.
Adult↗
[Clinical statistics and results of mass photofluorographic studies performed at the Experimental Center in 5 years].
Explore the source record for details and available documents.
Humans↗
Long-term efficacy of BCG vaccine in American Indians and Alaska Natives: A 60-year follow-up study.
CONTEXT: The duration of protection from tuberculosis of BCG vaccines is not known. OBJECTIVE: To determine the long-term duration of protection of a BCG vaccine that was previously found to be efficacious. DESIGN: Retrospective record review using Indian Health Service records, tuberculosis registries, death certificates, and supplemental interviews with trial participants. SETTING AND PARTICIPANTS: Follow-up for the period 1948-1998 among American Indians and Alaska Natives who participated in a placebo-controlled BCG vaccine trial during 1935-1938 and who were still at risk of developing tuberculosis. Data from 1483 participants in the BCG vaccine group and 1309 in the placebo group were analyzed. MAIN OUTCOME MEASURES: Efficacy of BCG vaccine, calculated for each 10-year interval using a Cox regression model with time-dependent variables based on tuberculosis events occurring after December 31, 1947 (end of prospective case finding). RESULTS: The overall incidence of tuberculosis was 66 and 138 cases per 100 000 person-years in the BCG vaccine and placebo groups, respectively, for an estimate of vaccine efficacy of 52% (95% confidence interval, 27%-69%). Adjustments for age at vaccination, tribe, subsequent BCG vaccination, chronic medical illness, isoniazid use, and bacille Calmette-Guérin strain did not substantially affect vaccine efficacy. There was slight but not statistically significant waning of the efficacy of BCG vaccination over time, greater among men than women. CONCLUSION: In this trial, BCG vaccine efficacy persisted for 50 to 60 years, suggesting that a single dose of an effective BCG vaccine can have a long duration of protection.
BCG Vaccine↗
Risk factors for community-acquired pneumonia in adults: a population-based case-control study.
Although community-acquired pneumonia (CAP) remains a major cause of hospitalization and death, few studies on risk factors have been performed. A population-based case-control study of risk factors for CAP was carried out in a mixed residential-industrial urban area of 74,610 adult inhabitants in the Maresme (Barcelona, Spain) between 1993 and 1995. All patients living in the area and clinically suspected of having CAP at primary care facilities and hospitals were registered. In total, 205 patients with symptoms, signs and radiographic infiltrate compatible with acute CAP participated in the study. They were matched by municipality, sex and age with 475 controls randomly selected from the municipal census. Risk factors relating the subject's characteristics and habits, housing conditions, medical history and treatments were investigated by means of a questionnaire. In the univariate analysis, an increased risk of CAP was associated with low body mass index, smoking, respiratory infection, previous pneumonia, chronic lung disease, lung tuberculosis, asthma, treated diabetes, chronic liver disease, and treatments with aminophiline, aerosols and plastic pear-spacers. In multivariate models, the only statistically significant risk factors were current smoking of >20 cigarettes x day(-1) (odds ratio (OR)=2.77; 95% confidence interval (CI) 1.14-6.70 compared with never-smokers), previous respiratory infection (OR=2.73; 95% CI 1.75-4.26), and chronic bronchitis (OR=2.22; 95% CI 1.13-4.37). Benzodiazepines were found to be protective in univariate and multivariate analysis (OR=0.46; 95% CI 0.23-0.94). This population-based study provides new and better established evidence on the factors associated with the occurrence of pneumonia in the adult community.
Case-Control Studies↗
Pneumoconioses: the situation in developing countries.
In developing countries, the incidence and prevalence of pneumoconioses are high and appear to be increasing. The rapid expansion of mining, mineral extraction, construction, and other industries places many new workers at risk each year. The hygienically poor working conditions often expose workers to high concentrations of respirable dust, so that pneumoconioses can develop with rapid progression after a short latency period. The health risk is increased by the high prevalence of tuberculosis in most of those countries. Accurate statistical data on occupational diseases in developing countries are rare. Although some prevalence data are available from cross-sectional studies, incidence figures and risk estimates are usually lacking because of the absence of reliable information about the size of the population at risk and exposure measurements. Some figures on pneumoconioses from countries in Africa, Asia, and South America are presented. To prevent pneumoconioses, hygienic conditions at the workplaces should be controlled and improved and appropriate dust standards developed. Medical surveillance of exposed workers should be organized. Finally, research in the field of pneumoconioses in developing countries should be promoted.
Adult↗