Indian Journal of Tuberculosis最新文献

Background

One of the commonly abused drug substances in both rural and urban communities of the developing countries is tobacco. The slow poison is still present even though anti-tobacco laws has been implemented to eliminate this threat.

Objective

To measure the violation of Cigarettes and Other Tobacco Products Act (COTPA), 2003 under sections 4, 5, 7, 8, 9 & 10 in Puducherry.

Methodology

An observational cross-sectional survey was conducted over three months (June to August 2022) in 194 public places and 126 tobacco points-of-sale at Puducherry district. A multi-stage cluster sampling was employed. An observational checklist was used to record the violation of COTPA sections. The data were analyzed using SPSS-v16.

Results

Section 4 and 5 violations were 67% and 47% respectively, while other sections (7,8,9,10) were compliant with the law in >85% of the parameters observed exception being display of “Warning” in specified font and colour (10%). The COTPA compliance rate was quite low in the observed public places. “No smoking area” and “Smoking Here Is an Offense” signage was seldom displayed in most public places.

Conclusion

Despite the fact that the law has been carefully drafted, it has been implemented to a limited extent. For guaranteeing adherence and rigorous implementation of the act's provisions, the concerned authorities shall perform timely and routine compliance assessments.

Background

Pulmonary Mucormycosis (PM) is a relatively uncommon fungal disease, usually manifested in immunocompromised patients. It has an aggressive course, along with dilemmas in diagnosis and treatment. In view of the surge of Mucormycosis patients in COVID 19 pandemic, clinicians need to consider PM in suspected cases, and act in an expedited manner to avoid misdiagnosis and initiate prompt treatment.

Case presentation

In this case series, we present four cases of PM with varied presentation, clinical course and discuss management strategies.

Conclusions

A strong suspicion of PM based on epidemiological and clinical findings should be considered, to ensure appropriate and timely treatment. It should be accompanied by judicious use of corticosteroids and aggressive control of comorbid conditions to decrease preventable morbidity and mortality.

Background

Tuberculosis (TB) burden and the underreporting of TB remain major health challenges in Indonesia. Interest in the internet is growing extensively, and the introduction of the TB mandatory electronic notification system in 2017 engaged the public's interest to leverage digital traces regarding TB information in Indonesia.

Objective

To quantify the correlation between Google Trends data and Indonesian TB surveillance data before and after the implementation of a mandatory TB notification system.

Methods

Google Trends searches on TB information were used. We used two sets of time series data, including before and after the launch of the TB notification system. Pearson's correlation was used to measure the correlation between TB search terms and official TB reports.

Results

The moving average graph showed a linear pattern of TB information with TB reports after 2017. Pearson's correlation estimated a high correlation for TB definition, TB symptoms, and official TB reports with an R-value range of 0.97 to −1.00 (p ≤ 0.05) and showed an increasing trend in TB information searching after 2016.

Conclusion

Google Trends data can depict public interest in the TB epidemic. Validation of information-searching behavior is required to advocate the implementation of Google Trends for TB digital surveillance in Indonesia.

Background

Tuberculosis disease epidemiology is closely related to social and economic conditions which make its prevention, control and cure challenging. Early diagnosis and adequate treatment will help to prevent various tuberculosis related morbidities. Factors such as adverse effects of drugs, transportation cost, family support, distance to the treatment center, personal habits, co morbid conditions, and patients’ multiple obligations concerning to their employment, family and society have an impact on the treatment outcomes.

Objective

To know the factors affecting tuberculosis treatment outcome among newly diagnosed tuberculosis patients.

Materials and methods

A total of 261 Tuberculosis patients registered in NTEP under District tuberculosis centre were enrolled using universal sampling method. First follow up was done at the end of intensive phase i.e. End of 2 months. Second follow up was done after completion of treatment i.e., End of 6th month.

Results

Majority 59% participants were diagnosed as smear negative at 2nd month follow up and 45.21% and 28.73% participants were diagnosed as cured and treatment completed respectively at 6th month follow up. 73.95% participants had successful outcome.

Multivariate logistic regression analysis showed that treatment outcomes of tuberculosis were affected by type of house (pucca house), presence of cough, past history of tuberculosis, family support, supervision by family and support of supervisor.

Conclusion

Overall treatment success rate was 73.95%. The contributing factors for successful outcome of tuberculosis were age, past history of TB, type of house, presence of cough and fever, weight gain, family support, supervision by family and support of supervisor.

Background

Tuberculous mastitis (TBM), is an uncommon form of extra-pulmonary tuberculosis. Clinical and radiological overlap of tuberculous mastitis with malignancy and other granulomatous conditions, along with its paucibacillary nature, make it a diagnostic challenge. In our study, we aim to assess the radiological response of microbiologically negative granulomatous mastitis cases to anti-tuberculous treatment (ATT) in an endemic country.

Methods

Eighty-seven cases demonstrating granulomatous lesions on breast biopsy were identified. Of these, 49 patients who were treated with ATT and had at least two serial ultrasound follow-ups were included in our study. Mammogram and ultrasound were used for initial imaging. Subsequently, ultrasound was used for serial follow-up. Mantoux skin test, acid fast staining and histological examination of tissue sample were the other investigations used.

Results

Radiologically, on ultrasound, well-circumscribed hypoechoic masses were noted in 18 patients, followed by ill-defined collections with tubular extensions in 15 cases, abscesses in 8, and a focal heterogeneity in 8 patients. Following ATT, 17 patients showed radiological resolution in 4 weeks, 18 of them at 3 months, and nine of them in 6 months.

Conclusion

Excellent and prompt radiological response to ATT, indicates the need for a high degree of suspicion for tuberculous mastitis (TBM), in endemic countries, even though microbiological tests may turn out negative.

Background

An ambitious plan was set into motion with the aim of TB elimination from India in 2025. To achieve this, it is high time to give emphasis on other prevalent forms of TB, such as extra pulmonary TB (EPTB).

Objectives

The study aims to discern the differences in patient characteristics and management practices between pulmonary TB and EPTB using data from district Ambala.

Methods

This retrospective study used data of 12,985 TB patients from district Ambala, India. The differences in patient characteristics and management practices between pulmonary TB and EPTB were analyzed using the NIKSHAY database.

Results

In the studied population, extra pulmonary TB (EPTB) formed 29.7% of all TB cases. Among all EPTB cases, pleural TB was found to be the most common form, accounting for 27%. The study also revealed that female gender, young age, non-diabetic status, and high BMI were associated with an increased propensity to have EPTB. Interestingly, unlike pulmonary TB, which had increased odds for contracting the disease in diabetic individuals (OR – 2.02), there were no increased odds for contracting EPTB in diabetic individuals. However, HIV infection significantly increased the odds for both pulmonary TB and EPTB. The results also showed diagnostic discrepancies between the private and public sectors, along with a low microbiological confirmation rate of 7.1% in EPTB cases.

Conclusion

The study highlights the importance of focusing on EPTB in addition to pulmonary TB for effective TB elimination in India. The differences in patient characteristics and management practices warrant further investigation and targeted interventions for both forms of the disease. Efforts should be made to improve diagnostic accuracy and reduce discrepancies between the private and public sectors.

Background

District-based public private mix (DPPM) tuberculosis in Purwakarta district was strengthened by the MitraTB application. This research is aimed to explore perception of user about MitraTB application and measure their perception of this application in dimensions; design, usefulness, ease of use, and acceptance.

Methods

This study was exploratory sequential mixed methods research. A qualitative study was first conducted in order to gain an in-depth understanding about user's perception of MitraTB application through in-depth interviews. Data were analyzed through coding and categorizing. Based on qualitative finding, a questionnaire was developed and used in the following quantitative study. A cross sectional study was then conducted in quantitative phase. Data were analyzed using Rasch modeling.

Result

The design of the MitraTB application looks simple and attractive to users. This application is useful to make it easier for private practitioners to report TB cases and it is easy to use. Respondents can accept the MitraTB application well. Most respondents have good perception about MitraTB application in dimensions; design (56.25%), usefulness (69.79%), ease of use (55.20%), and acceptance (73.96%).

Conclusions

MitraTB application has a good design feature, useful, easy to use, and acceptable. This application facilitates the private sector to be involved in the TB program by reporting TB cases. Follow-up and local regulations are required for the continued use of this application.

Tuberculosis. a disease of great public concern, is spread through inhalation of micro-droplets from an infected person. Despite lungs being the primary site, there may be multisystemic involvement, very rarely involving bone marrow, a dreaded manifestation of disseminated tuberculosis, associated with high mortality and morbidity. We report a case of tuberculosis of bone marrow with concomitant secondary hemophagocytic lympho-histiocytosis, bringing into light the importance of clinical suspicion and evaluation of bone marrow being a primary site of involvement in patients of disseminated tuberculosis.