Pub Date : 2017-08-03DOI: 10.4172/2161-1068.1000247
I. Uwimana, E. Kamanzi, Elyse Mukamukwiye, E. Kayigi, A. Rucogoza, E. I. Mwikarago, F. Birungi, J. Ntaganira, C. Muvunyi
Introduction: New molecular assays for rapid Multidrug-Resistant Tuberculosis (MDR-TB) detection continue to be developed. Rwanda has recently introduced the line probe assay for early TB and MDR-TB diagnosis. We aimed to assess the performance of GenoType® MTBDRplus test before its implementation in the routine testing. Methods: Sputum samples from suspected MDR-TB patients received and processed at Rwanda National Reference Laboratory from 2010-2012 were included in this study. The performance of Genotype® MTBDRplus assay was evaluated versus the standard phenotypic conventional Drug Susceptibility Testing (DST) on Lowenstein Jensen. Sensitivity, specificity and predictive values (positive and negative) were calculated. Statistical analyses were performed using Epi Info version 3.5.3. P-values were derived from χ2 tests applying Fisher Exact where appropriate. Results: A total of 1548 participants were enrolled in this study, 463 (29.9%) were from new patients and 1085 (70.1%) patients were from retreated patients. The GenoType® MTBDRplus assay correctly identified 37 of 39 Isoniazid resistant strains; 33 of 36 Rifampicin resistant; and 30 of 32 MDR-TB strains for both tests. Compared to the reference standard, the sensitivity of the GenoType® MTBDRplus assay was 94.8% (95% CI: 79.2-99.2%) to detect Isoniazid resistance, 91.7% (95% CI: 77.5-98.2%) for Rifampicin and 93.8% (95% CI: 79.2-99.2%) for the combination of both, MDR-TB. The specificity was 99.3% for Isoniazid, 98.6% for Rifampicin and 99% for MDR-TB. Positive Predictive Value of GenoType® MTBDRplus assay was 96.8% for MDR-TB and its Negative Predictive value 98.6%. The GenoType® MTBDRplus performed well in identifying MDR-TB. Conclusion: GenoType® MTBDRplus assay is a rapid and reliable test in detecting MDR-TB cases in Rwanda. Therefore, GenoType®MTBDRplus assay can be recommended for detecting MDR-TB in our setting to speed out MDR-TB detection in order to institute early treatment.
引言：用于快速检测耐多药结核病（MDR-TB）的新分子分析法仍在开发中。卢旺达最近推出了用于早期结核病和耐多药结核病诊断的线探针分析法。我们旨在评估GenoType®MTBDRplus测试在常规测试中实施之前的性能。方法：将2010-2012年在卢旺达国家参考实验室接受和处理的疑似耐多药结核病患者的痰液样本纳入本研究。Genotype®MTBDRplus检测的性能与Lowenstein-Jensen的标准表型常规药物敏感性测试（DST）进行了评估。计算敏感性、特异性和预测值（阳性和阴性）。使用Epi Info 3.5.3版进行统计分析。P值来源于χ2检验，在适当情况下应用Fisher Exact。结果：共有1548名参与者参与了这项研究，463名（29.9%）来自新患者，1085名（70.1%）来自复发患者。GenoType®MTBDRplus测定法正确鉴定了39株异烟肼抗性菌株中的37株；36例中有33例对利福平耐药；32株耐多药结核病菌株中有30株用于两种测试。与参考标准相比，GenoType®MTBDRplus检测异烟肼耐药性的灵敏度为94.8%（95%CI:79.2-99.2%），检测利福平的灵敏度为91.7%（95%CI:77.5-98.2%），同时检测耐多药结核病的灵敏度为93.8%（95%CI:99.2-9.2%）。异烟肼、利福平和耐多药结核病的特异性分别为99.3%、98.6%和99%。GenoType®MTBDRplus检测对耐多药结核病的阳性预测值为96.8%，阴性预测值为98.6%。结论：GenoType®MTBDRplus检测法是一种快速可靠的检测卢旺达耐多药结核病病例的方法。因此，在我们的环境中，GenoType®MTBDRplus检测法可以被推荐用于检测耐多药结核病，以加快耐多药结核的检测，从而进行早期治疗。
{"title":"Performance Assessment of the GenoType®MTBDRplus Assay for Rapid Detection of Multidrug-Resistant Tuberculosis among Clinical Isolates in Low Tuberculosis Burden Setting","authors":"I. Uwimana, E. Kamanzi, Elyse Mukamukwiye, E. Kayigi, A. Rucogoza, E. I. Mwikarago, F. Birungi, J. Ntaganira, C. Muvunyi","doi":"10.4172/2161-1068.1000247","DOIUrl":"https://doi.org/10.4172/2161-1068.1000247","url":null,"abstract":"Introduction: New molecular assays for rapid Multidrug-Resistant Tuberculosis (MDR-TB) detection continue to be developed. Rwanda has recently introduced the line probe assay for early TB and MDR-TB diagnosis. We aimed to assess the performance of GenoType® MTBDRplus test before its implementation in the routine testing. Methods: Sputum samples from suspected MDR-TB patients received and processed at Rwanda National Reference Laboratory from 2010-2012 were included in this study. The performance of Genotype® MTBDRplus assay was evaluated versus the standard phenotypic conventional Drug Susceptibility Testing (DST) on Lowenstein Jensen. Sensitivity, specificity and predictive values (positive and negative) were calculated. Statistical analyses were performed using Epi Info version 3.5.3. P-values were derived from χ2 tests applying Fisher Exact where appropriate. Results: A total of 1548 participants were enrolled in this study, 463 (29.9%) were from new patients and 1085 (70.1%) patients were from retreated patients. The GenoType® MTBDRplus assay correctly identified 37 of 39 Isoniazid resistant strains; 33 of 36 Rifampicin resistant; and 30 of 32 MDR-TB strains for both tests. Compared to the reference standard, the sensitivity of the GenoType® MTBDRplus assay was 94.8% (95% CI: 79.2-99.2%) to detect Isoniazid resistance, 91.7% (95% CI: 77.5-98.2%) for Rifampicin and 93.8% (95% CI: 79.2-99.2%) for the combination of both, MDR-TB. The specificity was 99.3% for Isoniazid, 98.6% for Rifampicin and 99% for MDR-TB. Positive Predictive Value of GenoType® MTBDRplus assay was 96.8% for MDR-TB and its Negative Predictive value 98.6%. The GenoType® MTBDRplus performed well in identifying MDR-TB. Conclusion: GenoType® MTBDRplus assay is a rapid and reliable test in detecting MDR-TB cases in Rwanda. Therefore, GenoType®MTBDRplus assay can be recommended for detecting MDR-TB in our setting to speed out MDR-TB detection in order to institute early treatment.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-1068.1000247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49457013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-24DOI: 10.4172/2161-1068.1000244
J. Cervantes, L. Paul
After receiving less attention compared to other body sites, the study of the lung microbiota has started to emerge during the past few years. It is still unclear if changes in the lung microbiota composition are associated with Pulmonary Tuberculosis (TB). The limited number of studies on the sputum microbiota on TB patients and controls available so far has reported somewhat contradictory results. This could be due to technological difficulties related to obtaining reliable samples as compared to other body niches, or due to differences in the geographical origin of these samples. Despite the inconsistencies they do suggest that the lung microbiota in TB patients differs from healthy individuals. Understanding the composition of the lung microbiota in health and comparing it to that of pulmonary TB cases may elicit clues into the pathogenesis of Mycobacterium tuberculosis infection at the pulmonary alveolus, and may help design treatment options for TB with potential direct benefits for patients and public health.
{"title":"Lung Microbiota in Tuberculosis. There are No Small Roles, Only Small Actors","authors":"J. Cervantes, L. Paul","doi":"10.4172/2161-1068.1000244","DOIUrl":"https://doi.org/10.4172/2161-1068.1000244","url":null,"abstract":"After receiving less attention compared to other body sites, the study of the lung microbiota has started to emerge \u0000 during the past few years. It is still unclear if changes in the lung microbiota composition are associated with \u0000 Pulmonary Tuberculosis (TB). The limited number of studies on the sputum microbiota on TB patients and controls \u0000 available so far has reported somewhat contradictory results. This could be due to technological difficulties related to \u0000 obtaining reliable samples as compared to other body niches, or due to differences in the geographical origin of \u0000 these samples. Despite the inconsistencies they do suggest that the lung microbiota in TB patients differs from \u0000 healthy individuals. Understanding the composition of the lung microbiota in health and comparing it to that of \u0000 pulmonary TB cases may elicit clues into the pathogenesis of Mycobacterium tuberculosis infection at the pulmonary \u0000 alveolus, and may help design treatment options for TB with potential direct benefits for patients and public health.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-1068.1000244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44651796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-24DOI: 10.4172/2161-1068.1000246
D. Pham, Thach N. Nguyen, Quyet Do
Background: Ventilator-Associated Pneumonia (VAP) is the most common hospital acquired infection in the intensive care unit with high mortality rate. The role of the clinical symptoms for the VAP diagnosis is limited. Procalcitonin (PCT), currently interested biomarkers, plays an important role in the diagnosis and the outcome of the ventilator-associated pneumonia patients. Objective: To evaluate the changes of serum procalcitonin level for the diagnosis and the prognosis of the ventilator-associated pneumonia patients. Materials and Methods: One hundred twenty two mechanical ventilated cases at Intensive Care Unit were divided into the VAP group (n=63) and the non-VAP group (n=59) depending on whether the patients developed VAP after 48 hour of endotracheal intubations and mechanical ventilation or not. The serum procalcitonin level, Clinical Pulmonary Infection Score (CPIS) described by Pugin et al. Or Schurink et al. were determined at the following times: The starting of mechanical ventilation, the VAP onset, at days 3, 5, 7 after VAP. Results: Serum procalcitonin level>0.5 ng/ ml had a role at quite good VAP diagnosis with the Sensitivity (Se) 68.25% and the Specificity (Sp) 89.83%. When both Pugin’s CPIS and procalcitonin were positive, the diagnostic efficiency were Se 59.58% and Sp 97.06%. When both Schurink’s CPIS and procalcitonin were positive, the diagnostic efficiency were Se 51.99% and Sp 92.07%. Mortality rate was 5% at serum procalcitonin level<0.5 ng/ ml but it was 75% at serum procalcitonin level>10 ng/ ml. Conclusions: Procalcitonin has both the diagnosis value in the ventilator- associated pneumonia patients and the prognostic value in their treatment outcome and the mortality rate. Serum procalcitonin concentration >0.5 ng/ml had a role at quite good VAP diagnosis with the sensitivity 68.25% and the specificity 89.83%. The higher serum procalcitonin level was associated with the higher mortality rate and the mortality rate was 75% at serum procalcitonin level>10 ng/ ml in ventilator-associated pneumonia.
{"title":"Researching the Changes of Serum Procalcitonin Levels in Ventilator-Associated Pneumonia Patients","authors":"D. Pham, Thach N. Nguyen, Quyet Do","doi":"10.4172/2161-1068.1000246","DOIUrl":"https://doi.org/10.4172/2161-1068.1000246","url":null,"abstract":"Background: Ventilator-Associated Pneumonia (VAP) is the most common hospital acquired infection in the \u0000 intensive care unit with high mortality rate. The role of the clinical symptoms for the VAP diagnosis is limited. \u0000 Procalcitonin (PCT), currently interested biomarkers, plays an important role in the diagnosis and the outcome of the \u0000 ventilator-associated pneumonia patients. \u0000Objective: To evaluate the changes of serum procalcitonin level for the diagnosis and the prognosis of the \u0000 ventilator-associated pneumonia patients. \u0000Materials and Methods: One hundred twenty two mechanical ventilated cases at Intensive Care Unit were \u0000 divided into the VAP group (n=63) and the non-VAP group (n=59) depending on whether the patients developed \u0000 VAP after 48 hour of endotracheal intubations and mechanical ventilation or not. The serum procalcitonin level, \u0000 Clinical Pulmonary Infection Score (CPIS) described by Pugin et al. Or Schurink et al. were determined at the \u0000 following times: The starting of mechanical ventilation, the VAP onset, at days 3, 5, 7 after VAP. \u0000Results: Serum procalcitonin level>0.5 ng/ ml had a role at quite good VAP diagnosis with the Sensitivity (Se) \u0000 68.25% and the Specificity (Sp) 89.83%. When both Pugin’s CPIS and procalcitonin were positive, the diagnostic \u0000 efficiency were Se 59.58% and Sp 97.06%. When both Schurink’s CPIS and procalcitonin were positive, the \u0000 diagnostic efficiency were Se 51.99% and Sp 92.07%. Mortality rate was 5% at serum procalcitonin level<0.5 ng/ ml \u0000 but it was 75% at serum procalcitonin level>10 ng/ ml. \u0000Conclusions: Procalcitonin has both the diagnosis value in the ventilator- associated pneumonia patients and \u0000 the prognostic value in their treatment outcome and the mortality rate. Serum procalcitonin concentration >0.5 ng/ml \u0000 had a role at quite good VAP diagnosis with the sensitivity 68.25% and the specificity 89.83%. The higher serum \u0000 procalcitonin level was associated with the higher mortality rate and the mortality rate was 75% at serum \u0000 procalcitonin level>10 ng/ ml in ventilator-associated pneumonia.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":"7 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-1068.1000246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43544254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-21DOI: 10.4172/2161-1068.1000245
M. Corti
Mycobacterium kansasii disease present epidemiological, clinical and radiological features similar to Mycobacterium tuberculosis. Mycobacterium kansasii is the second most frequent mycobacteria isolated in human immunodeficiency virus infected patients. Confirmed diagnosis is often difficult according with the American Thoracic Society criteria. Here we describe a patient with AIDS that developed a severe lung compromise due to Mycobacterium kansasii. Epidemiological, clinical, radiological and diagnosis methods are analyzed.
{"title":"Severe Lung Disease due to Mycobacterium kansasii: Report of a Case and Review of the Literature","authors":"M. Corti","doi":"10.4172/2161-1068.1000245","DOIUrl":"https://doi.org/10.4172/2161-1068.1000245","url":null,"abstract":"Mycobacterium kansasii disease present epidemiological, clinical and radiological features similar to \u0000 Mycobacterium tuberculosis. Mycobacterium kansasii is the second most frequent mycobacteria isolated in human \u0000 immunodeficiency virus infected patients. Confirmed diagnosis is often difficult according with the American Thoracic \u0000 Society criteria. Here we describe a patient with AIDS that developed a severe lung compromise due to Mycobacterium kansasii. Epidemiological, clinical, radiological and diagnosis methods are analyzed.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-1068.1000245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48804726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-30DOI: 10.4172/2161-1068.1000243
Kush Kumar
Natural history of posterior spinal tuberculosis has been described. Classifications of the posterior spinal tuberculosis disease process and principles of management based upon the clinical behavior of the disease has been highlighted and emphasized. A thorough review of literature was conducted with the aim to provide the clinicoradiological correlation of the natural history of posterior spinal tuberculosis in described. Management strategy is developed based upon the severity of the clinical behavior of the disease. In anterior spinal tuberculosis, motor fibers are compressed first as they are placed anterior to the sensory tracts in the spinal cord. The sensory fibers are therefore involved in late stages. Ironically, in posterior spinal tuberculosis when compression is predominantly from the posterior aspect of the cord, we again find that motor fibers are involved prior to the sensory fibers. This is in contradiction to the general belief. It is difficult to offer any simple explanation to this apparent paradox. In general, motor fibers are considered more susceptible to pressure effect, whereas sensory fibers are more susceptible to ischemia. That is why in compression paraplegia, signs and symptoms of motor loss appear prior to the sensory loss, as collaterals prevent ischemia for quite some times. In posterior spinal tuberculosis when compression is from the posterior aspect of the cord, at first pressure is exerted on the column of cerebrospinal fluid (CSF) surrounding the cord and gets transmitted to the ligamentum denticulatum. Motor fibers in the close vicinity, get pulled and show early involvement. Secondly, in compression from the posterior aspect of the cord, the cord is displaced anteriorly and anteriorly placed motor fibers are compressed against the anterior wall of the bony spinal canal causing early motor fiber functional loss. Therefore similar classification of paraplegia predominantly based upon the progressive motor weakness is valid for paraplegia noted following posterior spinal tuberculosis. Neurological deficit grading based management is developed. Grade 1 and 2, conservative treatment, grade 3, gray zone and grade 4, operative treatment is emphasized. The five stages of natural history of tuberculosis of spine have been developed from the clinician’s point of view. However, indications of surgery are different than what are described for the anterior spinal tuberculosis. Principles of management with role of rest, braces, chemotherapy and surgery are discussed. Management of posterior spinal tuberculosis of spine, in general, it is no different than management of soft tissue tuberculosis, in HIV negative or positive patients. Role of surgery is very different than anterior spinal tubercolosis. Management of posterior spinal tubercular paraplegia, is simple, logical, efficient and easy to understand and remember by any orthopedic/treating surgeon.
{"title":"Posterior Spinal Tuberculosis: A Review","authors":"Kush Kumar","doi":"10.4172/2161-1068.1000243","DOIUrl":"https://doi.org/10.4172/2161-1068.1000243","url":null,"abstract":"Natural history of posterior spinal tuberculosis has been described. Classifications of the posterior spinal \u0000 tuberculosis disease process and principles of management based upon the clinical behavior of the disease has \u0000 been highlighted and emphasized. A thorough review of literature was conducted with the aim to provide the clinicoradiological \u0000 correlation of the natural history of posterior spinal tuberculosis in described. Management strategy is \u0000 developed based upon the severity of the clinical behavior of the disease. In anterior spinal tuberculosis, motor \u0000 fibers are compressed first as they are placed anterior to the sensory tracts in the spinal cord. The sensory fibers are \u0000 therefore involved in late stages. Ironically, in posterior spinal tuberculosis when compression is predominantly from \u0000 the posterior aspect of the cord, we again find that motor fibers are involved prior to the sensory fibers. This is in \u0000 contradiction to the general belief. It is difficult to offer any simple explanation to this apparent paradox. In general, \u0000 motor fibers are considered more susceptible to pressure effect, whereas sensory fibers are more susceptible to \u0000 ischemia. \u0000That is why in compression paraplegia, signs and symptoms of motor loss appear prior to the sensory loss, as \u0000 collaterals prevent ischemia for quite some times. In posterior spinal tuberculosis when compression is from the \u0000 posterior aspect of the cord, at first pressure is exerted on the column of cerebrospinal fluid (CSF) surrounding the \u0000 cord and gets transmitted to the ligamentum denticulatum. Motor fibers in the close vicinity, get pulled and show \u0000 early involvement. Secondly, in compression from the posterior aspect of the cord, the cord is displaced anteriorly \u0000 and anteriorly placed motor fibers are compressed against the anterior wall of the bony spinal canal causing early \u0000 motor fiber functional loss. Therefore similar classification of paraplegia predominantly based upon the progressive \u0000 motor weakness is valid for paraplegia noted following posterior spinal tuberculosis. Neurological deficit grading \u0000 based management is developed. Grade 1 and 2, conservative treatment, grade 3, gray zone and grade 4, \u0000 operative treatment is emphasized. The five stages of natural history of tuberculosis of spine have been developed \u0000 from the clinician’s point of view. However, indications of surgery are different than what are described for the \u0000 anterior spinal tuberculosis. Principles of management with role of rest, braces, chemotherapy and surgery are \u0000 discussed. Management of posterior spinal tuberculosis of spine, in general, it is no different than management of \u0000 soft tissue tuberculosis, in HIV negative or positive patients. Role of surgery is very different than anterior spinal \u0000 tubercolosis. Management of posterior spinal tubercular paraplegia, is simple, logical, efficient and easy to \u0000 understand and remember by any orthopedic/treating surgeon.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-1068.1000243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41942923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-27DOI: 10.4172/2161-1068.1000242
G. Tesfaye, Alemzewud Wondimu, Getahun Asebe, F. Regasa, G. Mamo
A cross-sectional study was carried out on bovine brucellosis in and around kombolcha form November 2006 to April 2007, in the Amhara Regional State. A total of 240 blood samples were collected from semi-intensively and extensively managed cattle. The Rose Bengal Plate Test (RBPT) was used as a screening test. Those serum samples reacting positively to (RBPT) detected 9 of 240 (3.75%) of the samples as brucellosis positive. The positive sera when further retested using CFT 5 out of 9 RBPT positive sera were confirmed to be positive. The prevalence of brucellosis based on CFT in and around kombolcha was 2.08%, and all positive sera were from old aged female cattle. An attempt was also made to investigate the prevalence rate of abortion and fetal membrane retention in both extensive and semi-intensively management systems. A higher prevalence rate of abortion was recorded in extensively managed cows (10.8) than semi-intensively managed cows (2.08%). The difference in prevalence rate was statistically significant (P<0.05). A relatively higher prevalence rate of retained fetal membrane was found in extensive managed cattle (13.8%) than semi-intensively managed cattle (4.1%). The difference in prevalence rate was statistically significant (p<0.05). In conclusion, the prevalence rate of brucellosis is low in and around kombolcha. However, this low infection of bovine brucellosis may be spreaded in the study area and may cause economic loss and human infection unless control strategy should be conducted.
{"title":"Sero-prevalence of Bovine Brucellosis in and Around Kombolcha, AmharaRegional State, Ethiopia","authors":"G. Tesfaye, Alemzewud Wondimu, Getahun Asebe, F. Regasa, G. Mamo","doi":"10.4172/2161-1068.1000242","DOIUrl":"https://doi.org/10.4172/2161-1068.1000242","url":null,"abstract":"A cross-sectional study was carried out on bovine brucellosis in and around kombolcha form November 2006 to April 2007, in the Amhara Regional State. A total of 240 blood samples were collected from semi-intensively and extensively managed cattle. The Rose Bengal Plate Test (RBPT) was used as a screening test. Those serum samples reacting positively to (RBPT) detected 9 of 240 (3.75%) of the samples as brucellosis positive. The positive sera when further retested using CFT 5 out of 9 RBPT positive sera were confirmed to be positive. The prevalence of brucellosis based on CFT in and around kombolcha was 2.08%, and all positive sera were from old aged female cattle. An attempt was also made to investigate the prevalence rate of abortion and fetal membrane retention in both extensive and semi-intensively management systems. A higher prevalence rate of abortion was recorded in extensively managed cows (10.8) than semi-intensively managed cows (2.08%). The difference in prevalence rate was statistically significant (P<0.05). A relatively higher prevalence rate of retained fetal membrane was found in extensive managed cattle (13.8%) than semi-intensively managed cattle (4.1%). The difference in prevalence rate was statistically significant (p<0.05). In conclusion, the prevalence rate of brucellosis is low in and around kombolcha. However, this low infection of bovine brucellosis may be spreaded in the study area and may cause economic loss and human infection unless control strategy should be conducted.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-1068.1000242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48525786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01Epub Date: 2017-05-31DOI: 10.4172/2161-1068.1000241
Misaki Wayengera, Ivan Mwebaza, Johnson Welishe, Cynthia Nakimuli, David P Kateete, Eddie Wampande, Samuel Kirimunda, Lois Bayigga, Carol Musubika, Peace Babirye, Benon Asiimwe, Moses L Joloba
Background: Clinical and laboratory diagnosis of Active Tuberculosis (ATB) and latent Mycobacterium Tuberculosis (M. tuberculosis) infections (LTBI) among people living with HIV/AIDS (PLWHA) presents formidable challenges. In the past, WHO issued an advisory against the use of existing TB sero-diagnostics. Emerging evidence, however, points to a precision of TB sero-diagnostics based on secretory rather than structural M. tuberculosis antigens. We hypothesized that secretory levels of M. tuberculosis thymidylate kinase (TMKmt) can Designate ATBI from LTBI and no TB (NTB). Here, we report in-house validation studies of levels of TMKmt antigen (Ag) and host specific TMKmt antibody (Ab) amongst HIV +ve and HIV -ve participants.
Methods and results: Direct TMKmt Ag and host specific IgG Ab detection EIAs were conducted on broadly consented, stored serum (N=281[Ag] vs. 214 [Ab] respective) samples stratified as either HIV +ve or HIV-ve ATB relative to LTBI and No TB. On one hand, UG-peptide 1 and its PAb-based EIAs accurately diagnosed ATB relative to LTBI and NTB among HIV +ve subjects {irrespectively: (a) Ag detection ATB=OD>0.490; 95% CI: 0.7446 to 0.8715 vs. LTBI=OD<0.490; 95% CI 0.4325 to 0.4829 vs. NTB=OD<0.26; 95% CI 0.1675 to 0.2567 and (b) TMKmt specific IgG detection ATB=OD>1.00; 95% CI 1.170 to 1.528 [HIV +ve] and 2.044 to 2.978 [HIV -ve] respectively vs. LTBI=OD<1.00; 95% CI 0.2690 to 0.6396 vs. NTB=OD<; 95% CI 0.1527 to 0.8751}. HIV -ve ATB presented with Ag levels greater than NTB and less than LTBI (i.e. ATB -ve=<0.490 ODs>0.26), but displayed better ant-TMKmt IgG responses (OD>2.00; 95% CI 2.044 to 2.978) relative to HIV +ve ATB (OD<1.600; 95% CI 1.170 to 1.528); suggesting a better control of M. tuberculosis-septicemia. On the other hand, UG-peptide 2 and its PAb-based EIAs did not demonstrate ATB diagnostic potential regardless of HIV sero-status, except towards designating NTB.
Conclusions: TMKmt Ab and Ag detecting EIAs based on UG-peptide 1 and its derivative PAb can accurately demarcate ATB from LTBI and NTB among HIV +ve subjects.
背景：对艾滋病毒/艾滋病感染者（PLWHA）中活动性结核病（ATB）和潜伏结核分枝杆菌感染（LTBI）的临床和实验室诊断是一项艰巨的挑战。过去，世卫组织曾建议不要使用现有的结核病血清诊断方法。然而，新出现的证据表明，基于分泌型而非结构型结核杆菌抗原的结核病血清诊断方法是精确的。我们假设，结核杆菌胸苷酸激酶（TMKmt）的分泌水平可以将 ATBI 与 LTBI 和非结核病（NTB）区分开来。在此，我们报告了对 HIV +ve 和 HIV -ve 参与者的 TMKmt 抗原（Ag）和宿主特异性 TMKmt 抗体（Ab）水平的内部验证研究：直接检测 TMKmt 抗原（Ag）和宿主特异性 IgG 抗体（Ab）的 EIA 经广泛同意后对储存的血清样本（N=281[Ag] vs. 214 [Ab]）进行了检测。一方面，在 HIV +ve 受试者中，UG-肽 1 及其基于 PAb 的 EIA 相对于 LTBI 和 NTB 能准确诊断 ATB {分别为：(a) Ag 检测 ATB=OD>0.490; 95% CI: 0.7446 to 0.8715 vs. LTBI=ODvs. NTB=OD1.00; 95% CI 1.NTB=OD0.26），但相对于 HIV +ve ATB（ODM.结核-败血症）显示出更好的抗 TMKmt IgG 反应（OD>2.00；95% CI 2.044 至 2.978）。另一方面，UG-肽2及其基于PAb的EIAs并没有显示出ATB诊断潜力，无论HIV血清状态如何，但在确定NTB方面除外：结论：基于 UG 肽 1 及其衍生物 PAb 的 TMKmt Ab 和 Ag 检测 EIA 可以准确地将 ATB 与艾滋病毒感染者中的 LTBI 和 NTB 区分开来。
{"title":"Sero-diagnosis of Active <i>Mycobacterium tuberculosis</i> Disease among HIV Co-infected Persons using Thymidylate Kinase based Antigen and Antibody Capture Enzyme Immuno-Assays.","authors":"Misaki Wayengera, Ivan Mwebaza, Johnson Welishe, Cynthia Nakimuli, David P Kateete, Eddie Wampande, Samuel Kirimunda, Lois Bayigga, Carol Musubika, Peace Babirye, Benon Asiimwe, Moses L Joloba","doi":"10.4172/2161-1068.1000241","DOIUrl":"10.4172/2161-1068.1000241","url":null,"abstract":"<p><strong>Background: </strong>Clinical and laboratory diagnosis of Active Tuberculosis (ATB) and latent <i>Mycobacterium Tuberculosis</i> (<i>M. tuberculosis</i>) infections (LTBI) among people living with HIV/AIDS (PLWHA) presents formidable challenges. In the past, WHO issued an advisory against the use of existing TB sero-diagnostics. Emerging evidence, however, points to a precision of TB sero-diagnostics based on secretory rather than structural <i>M. tuberculosis</i> antigens. We hypothesized that secretory levels of <i>M. tuberculosis</i> thymidylate kinase (TMKmt) can Designate ATBI from LTBI and no TB (NTB). Here, we report in-house validation studies of levels of TMKmt antigen (Ag) and host specific TMKmt antibody (Ab) amongst HIV +ve and HIV -ve participants.</p><p><strong>Methods and results: </strong>Direct TMKmt Ag and host specific IgG Ab detection EIAs were conducted on broadly consented, stored serum (N=281[Ag] <i>vs</i>. 214 [Ab] respective) samples stratified as either HIV +ve or HIV-ve ATB relative to LTBI and No TB. On one hand, UG-peptide 1 and its PAb-based EIAs accurately diagnosed ATB relative to LTBI and NTB among HIV +ve subjects {irrespectively: (a) Ag detection ATB=OD>0.490; 95% CI: 0.7446 to 0.8715 <i>vs</i>. LTBI=OD<0.490; 95% CI 0.4325 to 0.4829 <i>vs</i>. NTB=OD<0.26; 95% CI 0.1675 to 0.2567 and (b) TMKmt specific IgG detection ATB=OD>1.00; 95% CI 1.170 to 1.528 [HIV +ve] and 2.044 to 2.978 [HIV -ve] respectively <i>vs</i>. LTBI=OD<1.00; 95% CI 0.2690 to 0.6396 <i>vs</i>. NTB=OD<; 95% CI 0.1527 to 0.8751}. HIV -ve ATB presented with Ag levels greater than NTB and less than LTBI (i.e. ATB -ve=<0.490 ODs>0.26), but displayed better ant-TMKmt IgG responses (OD>2.00; 95% CI 2.044 to 2.978) relative to HIV +ve ATB (OD<1.600; 95% CI 1.170 to 1.528); suggesting a better control of <i>M. tuberculosis</i>-septicemia. On the other hand, UG-peptide 2 and its PAb-based EIAs did not demonstrate ATB diagnostic potential regardless of HIV sero-status, except towards designating NTB.</p><p><strong>Conclusions: </strong>TMKmt Ab and Ag detecting EIAs based on UG-peptide 1 and its derivative PAb can accurately demarcate ATB from LTBI and NTB among HIV +ve subjects.</p>","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35363271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-30DOI: 10.4172/2161-1068.1000240
Gebrehiwet Tesfahuneygn
Background: Tuberculosis (TB) leftovers the leading cause of death among a curable infectious disease, regardless of the availability of short-course therapy that can be both inexpensive and effective. The aim of the present study was to assess the level of knowledge about TB in clients who were initiating anti-TB drug treatment in Alamata District, northeast Ethiopia. Methods: A cross-sectional study was conducted in TB patients who were initiating anti-TB drug treatment in the district. Study participants were interviewed using a structured questionnaire to evaluate level of knowledge about TB. Data was entered and cleared using SPSS version 16. Results: A total of 200 study participants were interviewed, of whom 116 (58.0%) were male TB patients and 84 (42.0%) female TB patients. Among the study participants, 77.5% were new cases. 50% of them were extra pulmonary TB (EPTB) case, 23.5% were smear-positive pulmonary TB (SPPTB) cases and 26.5% were smearnegative PTB (SNPTB) cases and. The overall knowledge about TB of the study participants was 36.5%. Conclusions: There is significant knowledge breach in the study area among TB patients registered on treatment. Consolidation the awareness of TB patients using health education by health care providers on TB throughout the time of enrollment to treatment possibly will increase patients’ knowledge thus upgrading in treatment outcomes and overall TB control.
{"title":"Knowledge and Practice of TB Patients on TB and its Treatment in AlamataDistrict Tigray Region Northeast Ethiopia","authors":"Gebrehiwet Tesfahuneygn","doi":"10.4172/2161-1068.1000240","DOIUrl":"https://doi.org/10.4172/2161-1068.1000240","url":null,"abstract":"Background: Tuberculosis (TB) leftovers the leading cause of death among a curable infectious disease, regardless of the availability of short-course therapy that can be both inexpensive and effective. The aim of the present study was to assess the level of knowledge about TB in clients who were initiating anti-TB drug treatment in Alamata District, northeast Ethiopia. \u0000Methods: A cross-sectional study was conducted in TB patients who were initiating anti-TB drug treatment in the district. Study participants were interviewed using a structured questionnaire to evaluate level of knowledge about TB. Data was entered and cleared using SPSS version 16. \u0000Results: A total of 200 study participants were interviewed, of whom 116 (58.0%) were male TB patients and 84 (42.0%) female TB patients. Among the study participants, 77.5% were new cases. 50% of them were extra pulmonary TB (EPTB) case, 23.5% were smear-positive pulmonary TB (SPPTB) cases and 26.5% were smearnegative PTB (SNPTB) cases and. The overall knowledge about TB of the study participants was 36.5%. \u0000Conclusions: There is significant knowledge breach in the study area among TB patients registered on treatment. Consolidation the awareness of TB patients using health education by health care providers on TB throughout the time of enrollment to treatment possibly will increase patients’ knowledge thus upgrading in treatment outcomes and overall TB control.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-1068.1000240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41456087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.4172/2161-1068.1000238
A. Tiago, D. Pizzol
Tuberculosis (TB) is one of the leading causes of death worldwide and, although great efforts have already been made, the way to defeat this disease is still long [1]. The burden of TB is higher in Sub-Saharan Africa and low income countries where, another increasing plague, the diabetes mellitus (DM) is affecting more and more people. The rapid increase of DM and its coexistence with TB and HIV is a clear example of overlap and interaction between communicable and noncommunicable diseases requiring a multidisciplinary and integrated approach [2]. The association between TB and DM, in particular in low and medium income countries, has been showed to cause a mutual worsening of the natural history of both diseases. Although the pathophysiological mechanism is still unclear, it has been observed that each disease may adversely affect the outcomes of the other, in terms of delayed diagnosis and healing, severity of symptoms, mortality [2]. However, to date, contrasting data are available regarding TB prevalence in diabetes and vice versa and, recent findings suggest a high burden of diabetes among TB patients but low prevalence of TB among DM patients [3]. Apparently, this is a contrast that could be partially explained by social determinants of health (SDH). In fact, growing evidence suggests that the lack of efficacy in containing TB and the presence of multi drug resistance (MDR), is due to many factors including SDH [4]. SDH are defined as conditions in which people are born, grow, live, work and get old having an immediate impact on health and are greatly influenced by the distribution of money, power and resources [5]. In particular, low education, low income and alcohol abuse are significant predictors of therapy failure and MDR in people with TB.
{"title":"Prevalence of Tuberculosis and Diabetes","authors":"A. Tiago, D. Pizzol","doi":"10.4172/2161-1068.1000238","DOIUrl":"https://doi.org/10.4172/2161-1068.1000238","url":null,"abstract":"Tuberculosis (TB) is one of the leading causes of death worldwide and, although great efforts have already been made, the way to defeat this disease is still long [1]. The burden of TB is higher in Sub-Saharan Africa and low income countries where, another increasing plague, the diabetes mellitus (DM) is affecting more and more people. The rapid increase of DM and its coexistence with TB and HIV is a clear example of overlap and interaction between communicable and noncommunicable diseases requiring a multidisciplinary and integrated approach [2]. The association between TB and DM, in particular in low and medium income countries, has been showed to cause a mutual worsening of the natural history of both diseases. Although the pathophysiological mechanism is still unclear, it has been observed that each disease may adversely affect the outcomes of the other, in terms of delayed diagnosis and healing, severity of symptoms, mortality [2]. However, to date, contrasting data are available regarding TB prevalence in diabetes and vice versa and, recent findings suggest a high burden of diabetes among TB patients but low prevalence of TB among DM patients [3]. Apparently, this is a contrast that could be partially explained by social determinants of health (SDH). In fact, growing evidence suggests that the lack of efficacy in containing TB and the presence of multi drug resistance (MDR), is due to many factors including SDH [4]. SDH are defined as conditions in which people are born, grow, live, work and get old having an immediate impact on health and are greatly influenced by the distribution of money, power and resources [5]. In particular, low education, low income and alcohol abuse are significant predictors of therapy failure and MDR in people with TB.","PeriodicalId":74235,"journal":{"name":"Mycobacterial diseases : tuberculosis & leprosy","volume":"2017 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48733901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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