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1

Tuberculin sensitivity testing and treatment of latent tuberculosis remains effective for tuberculosis control in human immunodeficiency virus-infected patients in Hong Kong.  

PubMed

OBJECTIVE. To evaluate whether a policy to treat latent tuberculosis identified by annual tuberculin sensitivity testing is effective for tuberculosis control in human immunodeficiency virus-infected patients in Hong Kong. DESIGN. Historical cohort study. SETTING. Integrated Treatment Centre, Department of Health, Hong Kong. PATIENTS. Patients infected with human immunodeficiency virus without a history of tuberculosis were offered annual tuberculin sensitivity testing, coupled with treatment of latent tuberculosis if they tested positive. All such patients were followed for new tuberculosis. RESULTS. In all, 1154 patients on antiretroviral therapy, contributing to 5587 patient-years of observation, were analysed; 1032 patients (89%) received annual tuberculin sensitivity testing. Their baseline characteristics, including CD4 counts and other risk factors for tuberculosis, did not differ significantly from those who declined testing. The overall incidence rate of tuberculosis was 0.59 case per 100 patient-years. It was lower in those who received annual tuberculin sensitivity testing than those who did not (0.41 vs 3.85 per 100 patient-years; P<0.0001). Only a low baseline CD4 count and a history of tuberculin sensitivity testing were shown to be significant indicators of incident tuberculosis using multivariate analysis. The hazard ratio was 0.36 (95% confidence interval, 0.16-0.85; P=0.02) for those with a baseline CD4 count of 100/mm3 or above, and 0.26 (95% confidence interval, 0.08-0.77; P=0.016) for those who received annual tuberculin sensitivity testing. The incidence of tuberculosis was highest within 90 days of antiretroviral therapy initiation. CONCLUSION. The established policy continues to be effective. The high risk of tuberculosis during the early period of antiretroviral therapy supports early use of tuberculin sensitivity testing. Alternatively, the strategy of universal isoniazid preventive therapy at antiretroviral therapy initiation could be studied for those with very low baseline CD4 counts. PMID:23926172

Lin, A Wc; Chan, K Cw; Chan, W K; Wong, K H

2013-08-08

2

Tuberculosis  

MedlinePLUS

... resolves on its own when a child develops immunity over a 6- to 10-week period. But ... When conditions become favorable (for instance, a lowered immunity), the bacteria become active. Tuberculosis in older children ...

3

Detection and Molecular Characterization of 9000YearOld Mycobacterium tuberculosis from a Neolithic Settlement in the Eastern Mediterranean  

Microsoft Academic Search

Background: Mycobacterium tuberculosis is the principal etiologic agent of human tuberculosis. It has no environmental reservoir and is believed to have co-evolved with its host over millennia. This is supported by skeletal evidence of the disease in early humans, and inferred from M. tuberculosis genomic analysis. Direct examination of ancient human remains for M. tuberculosis biomarkers should aid our understanding

Israel Hershkovitz; Helen D. Donoghue; David E. Minnikin; Gurdyal S. Besra; Oona Y. C. Lee; Angela M. Gernaey; Ehud Galili; Vered Eshed; Charles L. Greenblatt; Eshetu Lemma; Gila Kahila Bar-Gal; Mark Spigelman

2008-01-01

4

Immune Responses of CD4 + T-Cells of MDR-TB Patients to M. Tuberculosis Total Lipid Antigens  

Microsoft Academic Search

Background: CD4 + T-cell have a central role in protective immune responses to Mycobacterium tuberculosis (M. tuberculosis) protein antigens, but function of these cells in response to M. tuberculosis total lipid antigens has remained unclear. The present study was undertaken to determine role of CD4 + T cells in the MDR-TB patients against M. tuberculosis total lipid antigens. Materials and

Ali Shams Shahemabadi; Ahmad Zavaran Hosseini; Majid Rayani; Mohammad Reza Masjedi

5

Molecular characterisation of Mycobacterium tuberculosis isolates in the First National Survey of Antituberculosis Drug Resistance from Venezuela  

Microsoft Academic Search

BACKGROUND: Molecular typing of Mycobacterium tuberculosis strains has become a valuable tool in the epidemiology of tuberculosis (TB) by allowing detection of outbreaks, tracking of epidemics, identification of genotypes and transmission events among patients who would have remained undetected by conventional contact investigation. This is the first genetic biodiversity study of M. tuberculosis in Venezuela. Thus, we investigated the genetic

Liselotte Aristimuño; Raimond Armengol; Alberto Cebollada; Mercedes España; Alexis Guilarte; Carmen Lafoz; María A Lezcano; María J Revillo; Carlos Martín; Carmen Ramírez; Nalin Rastogi; Janet Rojas; Albina Vázques de Salas; Christophe Sola; Sofía Samper

2006-01-01

6

Screening of new entrants for tuberculosis: responses to port notifications  

Microsoft Academic Search

Background Tuberculosis in England and Wales is associ- ated with recently arrived immigrants. Screening new entrants for tuberculosis has received considerable attention recently. Despite several calls to reorganize screening proc- esses for new entrants because of perceived ineffectiveness, some systems at ports have remained largely unchanged, including notification arrangements. Methods A postal questionnaire was sent to Consultants in Communicable Disease

Helen Hogan; Richard Coker; Alex Gordon; H. Pickles; M. Meltzer

2005-01-01

7

The gene expression data of Mycobacterium tuberculosis based on Affymetrix gene chips provide insight into regulatory and hypothetical genes  

Microsoft Academic Search

BACKGROUND: Tuberculosis remains a leading infectious disease with global public health threat. Its control and management have been complicated by multi-drug resistance and latent infection, which prompts scientists to find new and more effective drugs. With the completion of the genome sequence of the etiologic bacterium, Mycobacterium tuberculosis, it is now feasible to search for new drug targets by sieving

Li M Fu; Casey S Fu-Liu

2007-01-01

8

Tuberculosis (TB)  

MedlinePLUS

... email. » Register for ENews Home > Lung Disease > Tuberculosis Tuberculosis Tuberculosis (TB) is an infectious disease that usually infects ... can attack almost any part of the body. Tuberculosis is spread from person to person through the ...

9

Improving vaccines against tuberculosis  

Microsoft Academic Search

Tuberculosis remains a major cause of mortality and physical and economic deprivation worldwide. There have been significant recent advances in our understanding of the Mycobacterium tuberculosis genome, mycobacterial genetics and the host determinants of protective immunity. Nevertheless, the challenge is to harness this information to develop a more effective vaccine than BCG, the attenuated strain of Mycobacterium bovis derived by

Warwick J Britton; Umaimainthan Palendira

2003-01-01

10

Extensively drug resistant tuberculosis in a high income country: A report of four unrelated cases  

PubMed Central

Background Multi drug resistance of Mycobacterium tuberculosis (M. tuberculosis) remains a major threat to public health, reinforced by recent reports about the clinical course of patients infected with extensively drug resistant (XDR) strains in South Africa. There is little information about the clinical course of XDR tuberculosis patients in industrialised countries. Methods We evaluated all isolates of M. tuberculosis, in which drug susceptibility testing was performed at our institution since 1997, for multi and extensive drug resistance. Clinical courses of patients infected by strains fulfilling the recently revised criteria for XDR tuberculosis were analysed. Results Four XDR M. tuberculosis isolates were identified. All patients had immigrated to Germany from Russia, Georgia, and former Yugoslavia and none were infected by the human immunodeficiency virus. All patients where treated for tuberculosis for 5.5 to 15 years and for XDR tuberculosis for 1.9 to 2.5 years. They received inhospital treatment in Germany for 11 months, 4.5 years and twice for 6 years. Non-compliance was an important factor in all four patients, three patients had to be treated in Germanys only locked facility for tuberculosis treatment. One patient with XDR tuberculosis died, one patient had still open pulmonary tuberculosis at last contact and 2 patients were cured. Conclusion Cases of XDR tuberculosis have been treated in our region for several years. Even in a high income setting, XDR tuberculosis has a tremendous impact on quality of live, outcome and the total cost. All reasonable efforts to prevent the spread of XDR tuberculosis must be made and maintained.

Blaas, Stefan H; Mutterlein, Ralf; Weig, Johannes; Neher, Albert; Salzberger, Bernd; Lehn, Norbert; Naumann, Ludmila

2008-01-01

11

Mycobacterium tuberculosis ecology in Venezuela: epidemiologic correlates of common spoligotypes and a large clonal cluster defined by MIRU-VNTR-24  

Microsoft Academic Search

BACKGROUND: Tuberculosis remains an endemic public health problem, but the ecology of the TB strains prevalent, and their transmission, can vary by country and by region. We sought to investigate the prevalence of Mycobacterium tuberculosis strains in different regions of Venezuela. A previous study identified the most prevalent strains in Venezuela but did not show geographical distribution nor identify clonal

Edgar Abadía; Monica Sequera; Dagmarys Ortega; María Victoria Méndez; Arnelly Escalona; Omaira Da Mata; Elix Izarra; Yeimy Rojas; Rossana Jaspe; Alifiya S Motiwala; David Alland; Jacobus de Waard; Howard E Takiff

2009-01-01

12

Personal and Societal Health Quality Lost to Tuberculosis  

Microsoft Academic Search

BackgroundIn developed countries, tuberculosis is considered a disease with little loss of Quality-Adjusted Life Years (QALYs). Tuberculosis treatment is predominantly ambulatory and death from tuberculosis is rare. Research has shown that there are chronic pulmonary sequelae in a majority of patients who have completed treatment for pulmonary tuberculosis (PTB). This and other health effects of tuberculosis have not been considered

Thaddeus L. Miller; Scott J. N. McNabb; Peter Hilsenrath; Jotam Pasipanodya; Stephen E. Weis; James Holland Jones

2009-01-01

13

Spinal tuberculosis: with reference to the children of northern India  

Microsoft Academic Search

Background Tuberculosis is a necrotizing bacterial infection with protean manifestation and wide distribution. There has been a great fall in the prevalence of tuberculosis in the United States since 1990, although the impact of acquired immunodeficiency syndrome (AIDS) has increased the resurgence of tuberculosis (TB). Spinal tuberculosis is the commonest form of skeletal tuberculosis. In this article, an overview of

Raj Kumar

2005-01-01

14

Health State Utilities in Latent and Active Tuberculosis  

Microsoft Academic Search

BackgroundTuberculosis (TB) remains a major public health threat worldwide. Numerous cost-effectiveness analyses of TB screening and treatment strategies have been recently published, but none have utilized quality-adjusted life-years as recommended because of the lack of utilities for TB health states.

Na Guo; Carlo A. Marra; Fawziah Marra; Susanne Moadebi; R. Kevin Elwood; J. Mark FitzGerald

2008-01-01

15

[Esophageal tuberculosis].  

PubMed

Primary esophageal tuberculosis is virtually non-existent and there are few cases described of secondary esophageal tuberculosis. Esophageal tuberculosis should be suspected in patients with dysphagia, positive test results for tuberculin, active pulmonary disease or mediastinal adenopathies. Endoscopic or x-ray images could be indistinguishable from esophageal carcinomas, hence a diagnosis can prevent wrong treatments. Confirming the diagnosis requires isolation of tuberculosis bacillus. Treatment for a patient with esophageal tuberculosis is standard therapy. Key words: Tuberculosis, esophagus. PMID:16865167

Baños, Ramón; Serrano, Andrés; Alberca, Fernando; Alajarín, María; Albaladejo, Aquilino; Vargas, Angel; Molina, Joaquín

16

New issues in tuberculosis  

PubMed Central

Tuberculosis remains a major health problem worldwide. The disease is caused by Mycobacteriumtuberculosis whose preferred habitat is the host macrophage. The immune response against tuberculosis is mediated by different subsets of T cells including both conventional CD4 and CD8 T cells as well as unconventional CD1 restricted and ?? T cells. The CD1 restricted T cells are particularly remarkable because they recognise the glycolipids abundant in the mycobacterial cell wall. Although a vaccine, M.bovis BCG, is available which protects toddlers against miliary tuberculosis, it is ineffective in preventing pulmonary tuberculosis in adults. Therefore, a novel vaccine is urgently required. Knowledge about the functioning of different T cell populations during infection and disease provides the basis for rational vaccine design. We have constructed a recombinant BCG vaccine which, compared with wild-type BCG, induces superior protection not only against laboratory strains but also against clinical isolates of M. tuberculosis.

Kaufmann, S

2004-01-01

17

Peritoneal tuberculosis: diagnostic options.  

PubMed Central

BACKGROUND: Extrapulmonary tuberculosis has vague symptoms and few signs. It is essential to recognize and diagnose this curable disease prior to performing definitive surgery. Newer tests such as DNA or RNA amplification allow for early diagnosis but have limitations. CASE: We report a case of peritoneal tuberculosis in an immigrant woman. She had vague symptoms of low-grade fever, mild abdominal pain, obstipation, and bloating. Diagnostic laparoscopy was performed to establish the diagnosis. Tuberculosis was confirmed by DNA extraction from the frozen section specimen with subsequent analysis using polymerase chain reaction. CONCLUSION: Peritoneal tuberculosis is a disease that often simulates malignancies. With the increasing prevalence of human immunodeficiency virus in developed countries, tuberculosis is also on the rise and should be considered in the differential diagnosis of a patient with an abdominal/pelvic mass and ascites.

Lal, N; Soto-Wright, V

1999-01-01

18

Tuberculosis in the elderly  

Microsoft Academic Search

Summary   Tuberculosis (TB) today remains one of the world’s most lethal infectious diseases. An estimated one-third of the world’s\\u000a population is infected with the tubercle bacillus-Mycobacterium tuberculosis (Mtb), and 7 to 8 million people develop TB disease each year (27). For purpose of clarity, TB infection (latent TB) is defined\\u000a as harboring Mtb without evidence of active infection, and TB

S. Rajagopalan; T. T. Yoshikawa

2000-01-01

19

Multiple Cytokines Are Released When Blood from Patients with Tuberculosis Is Stimulated with Mycobacterium tuberculosis Antigens  

Microsoft Academic Search

BackgroundMycobacterium tuberculosis (Mtb) infection may cause overt disease or remain latent. Interferon gamma release assays (IGRAs) detect Mtb infection, both latent infection and infection manifesting as overt disease, by measuring whole-blood interferon gamma (IFN-?) responses to Mtb antigens such as early secreted antigenic target-6 (ESAT-6), culture filtrate protein 10 (CFP-10), and TB7.7. Due to a lack of adequate diagnostic standards

Kathryn L. Kellar; Jennifer Gehrke; Stephen E. Weis; Aida Mahmutovic-Mayhew; Blachy Davila; Margan J. Zajdowicz; Robin Scarborough; Philip A. LoBue; Alfred A. Lardizabal; Charles L. Daley; Randall R. Reves; John Bernardo; Brandon H. Campbell; William C. Whitworth; Gerald H. Mazurek

2011-01-01

20

Cutaneous Tuberculosis  

PubMed Central

Cutaneous tuberculosis occurs rarely, despite a high and increasing prevalence of tuberculosis worldwide. Mycobacterium tuberculosis, Mycobacterrium bovis, and the Bacille Calmette-Guérin vaccine can cause tuberculosis involving the skin. Cutaneous tuberculosis can be acquired exogenously or endogenously and present as a multitude of differing clinical morphologies. Diagnosis of these lesions can be difficult, as they resemble many other dermatological conditions that are often primarily considered. Further, microbiological confirmation is poor, despite scientific advances, such as the more frequent use of polymerase chain reaction. The authors report a case that illustrates the challenges faced by dermatologists when considering a diagnosis of cutaneous tuberculosis.

Frankel, Amylynne; Penrose, Carolin

2009-01-01

21

Serodiagnosis of childhood tuberculosis by ELISA  

Microsoft Academic Search

Objective: Diagnosis of childhood tuberculosis remains an enigma despite many recent technological developments. The present study\\u000a has been taken up with the aim to assess the diagnostic potential of mycobacterium tuberculosis excretory-secretory ES-31\\u000a antigen and affinity purified anti ES-31 antibodies in the serodiagnosis of different spectrum of childhood tuberculosis.Methods: Mycobacterium tuberculosis H37 Ra excretory-secretory antigen (ES-31) and affinity purified goat

A. S. Bhatia; Sonika Gupta; Neeraj Shende; Satish Kumar; B. C. Harinath

2005-01-01

22

[Imaging features of CNS tuberculosis].  

PubMed

CNS tuberculosis remains relatively frequent in endemic regions. Both CT and MRI are valuable for diagnosis. Even though non-specific, MRI including diffusion-weighted imaging and proton spectroscopy is more sensitive than CT for detection of some lesions. The purpose of this paper is to illustrate the imaging features of CNS tuberculosis. PMID:18354351

Semlali, S; El Kharras, A; Mahi, M; Hsaini, Y; Benameur, M; Aziz, N; Chaouir, S; Akjouj, S

2008-02-01

23

Combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without detectable systemic infection.  

PubMed

Purpose: To report a rare case of combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without systemic infection. Case Report: A young man presented with sudden onset of decreased vision in his left eye with combined optic disc swelling and central retinal artery occlusion in a background of vasculitic changes of the same eye. There were no signs or symptoms of active systemic tuberculosis infection. Chest X-ray and computed tomography thorax findings were normal and sputum cultures for tuberculosis were negative. The Mantoux and QuantiFERON-TB Gold tests were strongly positive. No tuberculosis polymerase chain reaction testing was done. Anti-tuberculosis therapy was initiated, based on the strong clinical evidence. Conclusion: The ocular findings improved remarkably with the anti-tuberculosis treatment, although the left eye vision remained poor. A high index of suspicion is required to diagnose ocular tuberculosis when all other systemic investigations are negative, especially in this part of the world where tuberculosis is endemic. PMID:21834697

Ooi, Y L; Tai, L Y; Subrayan, V; Tajunisah, I

2011-08-11

24

Category based Treatment of Tuberculosis in Children  

Microsoft Academic Search

Background: Childhood tuberculosis is treated with multiple regimens for different clinical manifestations. World Health Organization has suggested a category-based treatment of tuberculosis that focuses on adult type of illness. To include children as DOTS beneficiaries, there is a need to assess the feasibility of classification and treatment of various types of childhood tuberculosis in different categories. Methods: The study was

S. K. Kabra; Rakesh Lodha; V. Seth

25

Tuberculosis Fluoroscopy  

Cancer.gov

Follow-up though Dec 31, 2002 has been completed for a study of site-specific cancer mortality among tuberculosis patients treated with artificial lung collapse therapy in Massachusetts tuberculosis sanatoria (1930-1950).

26

Bovine Tuberculosis  

Technology Transfer Automated Retrieval System (TEKTRAN)

Tuberculosis (TB) in animals and humans may result from exposure to bacilli within the Mycobacterium tuberculosis complex (i.e., M. tuberculosis, M. bovis, M. africanum, M. pinnipedii, M. microti, M. caprae, or M. canetti). Mycobacterium bovis is the species most often isolated from tuberculous catt...

27

Molecular characterisation of Mycobacterium tuberculosis isolates in the First National Survey of Anti-tuberculosis Drug Resistance from Venezuela  

PubMed Central

Background Molecular typing of Mycobacterium tuberculosis strains has become a valuable tool in the epidemiology of tuberculosis (TB) by allowing detection of outbreaks, tracking of epidemics, identification of genotypes and transmission events among patients who would have remained undetected by conventional contact investigation. This is the first genetic biodiversity study of M. tuberculosis in Venezuela. Thus, we investigated the genetic patterns of strains isolated in the first survey of anti-tuberculosis drug-resistance realised as part of the Global Project of Anti-tuberculosis Drug Resistance Surveillance (WHO/IUATLD). Results Clinical isolates (670/873) were genotyped by spoligotyping. The results were compared with the international spoligotyping database (SpolDB4). Multidrug resistant (MDR) strains (14/18) were also analysed by IS6110-RFLP assays, and resistance to isoniazid and rifampicin was characterised. Spoligotyping grouped 82% (548/670) of the strains into 59 clusters. Twenty new spoligotypes (SITs) specific to Venezuela were identified. Eight new inter-regional clusters were created. The Beijing genotype was not found. The genetic network shows that the Latin American and Mediterranean family constitutes the backbone of the genetic TB population-structure in Venezuela, responsible of >60% of total TB cases studied. MDR was 0.5% in never treated patients and 13.5% in previously treated patients. Mutations in rpoB gene and katG genes were detected in 64% and 43% of the MDR strains, respectively. Two clusters were found to be identical by the four different analysis methods, presumably representing cases of recent transmission of MDR tuberculosis. Conclusion This study gives a first overview of the M. tuberculosis strains circulating in Venezuela during the first survey of anti-tuberculosis drug-resistance. It may aid in the creation of a national database that will be a valuable support for further studies.

Aristimuno, Liselotte; Armengol, Raimond; Cebollada, Alberto; Espana, Mercedes; Guilarte, Alexis; Lafoz, Carmen; Lezcano, Maria A; Revillo, Maria J; Martin, Carlos; Ramirez, Carmen; Rastogi, Nalin; Rojas, Janet; de Salas, Albina Vazques; Sola, Christophe; Samper, Sofia

2006-01-01

28

The Spectrum of Extrapulmonary Tuberculosis  

PubMed Central

The incidence of new cases of extrapulmonary tuberculosis has remained constant, despite the decline in new cases of active pulmonary tuberculosis. This might be due to a delay in recognition, and particularly a lack of consideration of tuberculosis when the presenting symptoms are other than respiratory. Extrapulmonary tuberculosis should be considered in the differential diagnosis of bone, joint, genitourinary tract and central nervous system (CNS) diseases. To determine factors that might delay recognition and identification, 62 patients having extrapulmonary tuberculosis during 1969-1972 at the Los Angeles County-University of Southern California Medical Center were studied. Three quarters of these patients had had CNS, skeletal or genitourinary tuberculosis in equal distribution or 25 percent each. CNS involvement was seen frequently in the disseminated form. Presenting symptoms were protean and not specific, such as fever, anorexia, weight loss, cough, lymphadenopathy and neurologic abnormalities. Roentgenograms of the chest were abnormal in most. When a roentgenogram of the chest suggests pulmonary tuberculosis, signs and symptoms in other body systems should suggest extrapulmonary tuberculosis. If no abnormalities are seen on a roentgenogram of the chest, however, this does not preclude the diagnosis of extrapulmonary tuberculosis. Neither does a negative tuberculin skin test exclude the condition. Abnormal laboratory findings are common, especially in disseminated tuberculosis. These include various anemias, bone marrow disorders, hyponatremia due to inappropriate antidiuretic hormone syndrome. Analyses of pleural, peritoneal, pericardial and joint fluid usually show an exudate high in lymphocytes and occasionally low in glucose. Similar findings are seen in spinal fluid. The histological features of caseous or noncaseous granulomas are suggestive of but not specific for tuberculosis. Only culture of mycobacteria from sputum, urine, spinal fluid, pleural and other effusions and tissue biopsy specimens will yield a definitive diagnosis. Physicians must have a high index of suspicion to diagnose extrapulmonary tuberculosis, as it can resemble any disease in any organ system. Immediate therapy in the disseminated variety, sometimes even before a definite diagnosis can be made, may be lifesaving.

Baydur, Ahmet

1977-01-01

29

Primary health care staff's perceptions of childhood tuberculosis: a qualitative study from Tanzania  

PubMed Central

Background Diagnosing tuberculosis in children remains a great challenge in developing countries. Health staff working in the front line of the health service delivery system has a major responsibility for timely identification and referral of suspected cases of childhood tuberculosis. This study explored primary health care staff's perception, challenges and needs pertaining to the identification of children with tuberculosis in Muheza district in Tanzania. Methods We conducted a qualitative study that included 13 semi-structured interviews and 3 focus group discussions with a total of 29 health staff purposively sampled from primary health care facilities. Analysis was performed in accordance with the principles of a phenomenological analysis. Results Primary health care staff perceived childhood tuberculosis to be uncommon in the society and tuberculosis was rarely considered as a likely differential diagnosis. Long duration and severe signs of disease together with known exposure to tuberculosis were decisive for the staff to suspect tuberculosis in children and refer them to hospital. None of the staff felt equipped to identify cases of childhood tuberculosis and they experienced lack of knowledge, applicable tools and guidelines as the main challenges. They expressed the need for more training, supervision and referral feedback to improving case identification. Conclusions Inadequate awareness of the burden of childhood tuberculosis, limited knowledge of the wide spectrum of clinical presentation and lack of clinical decision support strategies is detrimental to the health staff's central responsibility of suspecting and referring children with tuberculosis especially in the early disease stages. Activities to improve case identification should focus on skills required by primary health care staff to fulfil their responsibility and reflect primary health care level capacities and challenges.

2012-01-01

30

Diagnostic Accuracy and Optimal Use of Three Tests for Tuberculosis in Live Badgers  

Microsoft Academic Search

BackgroundAccurate diagnosis of tuberculosis (TB) due to infection with Mycobacterium bovis is notoriously difficult in live animals, yet important if we are to understand the epidemiology of TB and devise effective strategies to limit its spread. Currently available tests for diagnosing TB in live Eurasian badgers (Meles meles) remain unvalidated against a reliable gold standard. The aim of the present

Julian A. Drewe; Alexandra J. Tomlinson; Neil J. Walker; Richard J. Delahay; T. Mark Doherty

2010-01-01

31

Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead  

Microsoft Academic Search

BACKGROUND: Drug resistance has been a cause of concern for tuberculosis (TB) control in both developed and developing countries. Careful monitoring of the patterns and trends of drug resistance should remain a priority. METHODS: Strains were collected from 1824 diagnosed sputum smear positive pulmonary TB patients in Jiangsu province of China and then tested for drug susceptibility against rifampicin, isoniazid,

Yan Shao; Dandan Yang; Weiguo Xu; Wei Lu; Honghuan Song; Yaoyao Dai; Hongbing Shen; Jianming Wang

2011-01-01

32

Secretion Antigens of Mycobacterium tuberculosis  

Microsoft Academic Search

BackgroundThis study was carried out with the aim of detecting possible differences between proteins secreted by fresh wild isolates of Mycobacterium tuberculosis and from a reference strain of this microorganism, H37Rv TMCC 102.

Oscar Rojas-Espinosa; Javier Rangel-Moreno; Angélica Amador-Jiménez; Ruth Parra-Maldonado; Patricia Arce-Paredes; Javier Torres-López

1999-01-01

33

Challenging issues in tuberculosis in solid organ transplantation.  

PubMed

Solid organ transplant (SOT) recipients are at risk for opportunistic infections including tuberculosis. Although guidelines on the management of latent tuberculosis and active tuberculosis are available, there remain a number of clinical areas with limited guidance. We discuss challenges in the diagnosis, management, and treatment of latent and active tuberculosis in SOT candidates and recipients who reside in low-tuberculosis-prevalence areas. We discuss the diagnosis of latent tuberculosis in SOT candidates/recipients using tuberculin skin tests and interferon-? release assays and risk stratification of SOT candidates/recipients that would identify individuals at high risk for latent tuberculosis despite negative test results. Through a careful review of posttransplant tuberculosis cases, we identify a history of treated tuberculosis in SOT recipients as a risk factor for development of posttransplant active tuberculosis. Finally, we include comparisons of recommendations by several large transplant organizations and identify areas for future research. PMID:23899676

Horne, David J; Narita, Masahiro; Spitters, Christopher L; Parimi, Soumya; Dodson, Sherry; Limaye, Ajit P

2013-07-29

34

The tuberculosis challenge in a rural South African HIV programme  

Microsoft Academic Search

BACKGROUND: South Africa remains the country with the greatest burden of HIV-infected individuals and the second highest estimated TB incidence per capita worldwide. Within South Africa, KwaZulu-Natal has one of the highest rates of TB incidence and an emerging epidemic of drug-resistant tuberculosis. METHODS: Review of records of consecutive HIV-infected people initiated onto ART between 1st January 2005 and 31st

Catherine F Houlihan; Portia C Mutevedzi; Richard J Lessells; Graham S Cooke; Frank C Tanser; Marie-Louise Newell

2010-01-01

35

Increased Risk of Lung Cancer in Men with Tuberculosis in the Alpha- Tocopherol, Beta-Carotene Cancer Prevention Study  

PubMed Central

Background Lung cancer and tuberculosis cause significant morbidity and mortality worldwide. Tuberculosis may increase lung cancer risk through substantial and prolonged pulmonary inflammation. However, prospective data on tuberculosis and lung cancer risk are limited. Methods Our study included 29,133 Finnish male smokers followed prospectively in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (1985–2005). Lung cancers were identified through linkage with the Finish Cancer Registry, and hospital-treated tuberculosis cases were ascertained from the National Hospital Discharge Register. We assessed the association between tuberculosis and lung cancer risk with proportional hazards regression models, adjusting for age and cigarette smoking. Results Forty-four lung cancer cases occurred among 273 men with tuberculosis (incidence rate=1,786 per 100,000 person-years). Tuberculosis was associated with a two-fold elevation in lung cancer risk (hazard ratio [HR]=1.97; 95% confidence interval [CI] 1.46–2.65) with significant associations observed for both incident (HR=2.05; 95% CI 1.42–2.96) and prevalent tuberculosis (HR=1.82; 95% CI 1.09–3.02). Lung cancer risk was greatest in the two-year window after tuberculosis diagnosis (HR=5.01; 95% CI 2.96–8.48), but remained elevated at longer latencies (HR=1.53; 95% CI 1.07–2.20). Though tuberculosis was associated with an increased risk of squamous cell carcinoma (HR=3.71), adenocarcinoma (HR=1.71), small cell carcinoma (HR=1.72), and lung cancer of other (HR=1.23) and unknown histologies (HR=1.35), only the association for squamous cell carcinoma was statistically significant. Conclusions Tuberculosis is associated with increased lung cancer risk in male smokers. Impact statement Our results add to the growing body of evidence implicating chronic inflammation and pulmonary scarring in the etiology of lung cancer.

Shiels, Meredith S.; Albanes, Demetrius; Virtamo, Jarmo; Engels, Eric A.

2011-01-01

36

AB 74. Recurrence of pulmonary tuberculosis in a patient with undiagnosed kidney tuberculosis  

PubMed Central

Background Tuberculosis of the urinary system commonly complicates post-primary tuberculosis. In patients with active kidney tuberculosis, coincident lung disease often prevails in clinical picture, thus the diagnosis of urinary disease often escapes. Presentation of an interesting case of lung and kidney tuberculosis. Patients and Methods A 32 year-old female was referred to our clinic for investigation of possible kidney and lung tuberculosis. The patient reported two years of dysuric symptoms, with recurrent episodes of painless macroscopic haematuria. From recent history the patient reported two hospitalizations over a month due to fever and malaise, with laboratory findings of normochromic normocytic anemia, high ESR and microscopic hematuria and aseptic pyuria with normal renal function. Chest CT revealed scattered infiltrates in the middle and upper lung fields, ground-glass opacities and tree-in-bud pattern. CT scan of the abdomen showed hydronephrosis and hypodense areas in the left and right kidney, findings we also confirmed by kidney ultrasonography. Patient presented in our clinic with low grade fever and satisfactory respiratory function, while findings from the physical examination of the chest were insignificant. Mantoux test showed an infiltration of 15 mm. Direct sputum examination by Ziehl-Nielsen staining and PCR for M.Tuberculosis were negative. Ultimately, the diagnosis of lung disease and urinary tuberculosis were confirmed by positive Gen-probe results of gastric fluid and urine specimens and subsequent positive cultures. Prompt initiation of antituberculous therapy was followed by the patient’s marked clinical improvement within a few days and subsequent negative urine examination by Ziehl-Nielsen staining. Results Due to suspected hematogenous spread, the patient underwent fundoscopy and CT scan of the brain which revealed no pathological findings. To address hydronephrosis, a Pig-tail catheter was inserted in the left kidney. The patient received anti-tuberculous therapy for a year. During the follow-up period she remained in excellent general condition, with negative sputum and urine cultures and improvement of the imaging findings in the lungs and kidneys. Conclusions The initial presentation of urinary tract tuberculosis may be vague and the false interpretation of symptoms can result in great harm to the patient.

Fouka, Evangelia; Stephanopoulou, Pinelopi; Vlaikos, Dimosthenis; Loridas, Nikolaos; Kalaitzidou, Eftychia

2012-01-01

37

Remaining a Light Force.  

National Technical Information Service (NTIS)

The Marine Corps must embrace the light infantry concept to remain relevant on the modern battlefield. The light infantry unit requires less equipment and less logistics support but more training. Unfortunately, current Marine infantry units have moved mo...

S. L. Gosnell

2008-01-01

38

Propellant-Remaining Modeling.  

National Technical Information Service (NTIS)

A successful satellite mission is predicted upon the proper maintenance of the spacecraft's orbit and attitude. One requirement for planning and predicting the orbit and attitude is the accurate estimation of the propellant remaining onboard the spacecraf...

S. Torgovitsky

1991-01-01

39

Missed opportunities for tuberculosis diagnosis  

PubMed Central

SUMMARY BACKGROUND In high tuberculosis (TB) burden, resource-poor countries, sputum smear microscopy remains the mainstay of diagnosis. The low sensitivity of this test means that patients with smear-negative but culture-positive TB pass undetected through the health care system. Such clinical episodes are missed opportunities for diagnosis and interruption of transmission, which might be averted through the application of more sensitive diagnostic tests. OBJECTIVES To estimate the proportion of incident TB cases that might have been detected earlier than the actual date of diagnosis if a test more sensitive than smear microscopy had been used at an earlier presentation episode. METHOD Retrospective cohort study in urban Peru, investigating health care facility interactions for symptoms suggestive of TB prior to TB diagnosis through patient interviews and a review of clinical records. RESULTS Of 212 participants enrolled, 58% had one or more clinical interactions prior to their diagnostic episode. Of those with a prior episode, the median number of episodes was three. The median delay to diagnosis from first presentation was 26 days. CONCLUSION There are clear missed opportunities for earlier TB diagnosis, delaying treatment initiation and continued spread of Mycobacterium tuberculosis to the community. The implementation of sensitive diagnostic tests appropriate to resource-poor settings should be given high priority.

Bailey, S. L.; Roper, M. H.; Huayta, M.; Trejos, N.; Alarcon, V. Lopez; Moore, D. A. J.

2011-01-01

40

The Epidemic-level Impact of Preventing Nosocomial Transmission of Extensively Drug-Resistant (XDR) Tuberculosis in Rural South African District Hospitals  

PubMed Central

Background Extensively drug-resistant (XDR) tuberculosis has spread among hospitalized patients in South Africa, but the epidemic-level impact of hospital-based infection control strategies remains unknown. Methods We investigated the effect of administrative, environmental, and personal infection control measures on the epidemic trajectory of XDR tuberculosis in a rural South African community. Assessments were performed with a mathematical model, which incorporated inpatient airborne tuberculosis transmission and community tuberculosis and HIV transmission. Results If no new interventions are introduced, 1,300 cases of XDR tuberculosis are predicted to occur in the area of Tugela Ferry by the end of 2012. Over half of these cases are likely to be nosocomially transmitted. Mask use would avert less than 10% of overall cases, due to long inpatient exposure times and real-world face-seal leakage rates, but could reduce a significant proportion of hospital staff XDR tuberculosis cases. Combining mask use with reduced hospitalization time and a shift to outpatient therapy, however, could prevent nearly one-third of XDR tuberculosis cases. Supplementing this approach with improved ventilation, rapid drug resistance testing, HIV treatment, and tuberculosis isolation facilities could avert 48% of XDR tuberculosis cases (range 34-50%) by the end of 2012. Involuntary detention, however, could result in an unexpected rise in incidence, given limited isolation capacity. Conclusions In the face of rising XDR tuberculosis incidence, prevalence and burden on the health care system, a synergistic combination of available nosocomial infection control strategies may prevent nearly half of XDR tuberculosis cases, even in a resource-limited setting. XDR tuberculosis transmission will continue in the community in spite of such efforts, however, indicating the need to develop parallel community-based programs.

Andrews, Jason; Poolman, Eric M.; Gandhi, Neel R.; Shah, N. Sarita; Moll, Anthony; Galvani, Alison P.; Friedland, Gerald H.

2012-01-01

41

Influenza Virus NS Vectors Expressing the Mycobacterium tuberculosis ESAT-6 Protein Induce CD4+ Th1 Immune Response and Protect Animals against Tuberculosis Challenge  

Microsoft Academic Search

Infection with Mycobacterium tuberculosis remains a major cause of morbidity and mortality all over the world. Since the effectiveness of the only available tuberculosis vaccine, Mycobacterium bovis bacillus Calmette- Guerin (BCG), is suboptimal, there is a strong demand to develop new tuberculosis vaccines. As tuberculosis is an airborne disease, the intranasal route of vaccination might be preferable. Live influenza virus

Sabine Sereinig; Marina Stukova; Natalia Zabolotnyh; Boris Ferko; Christian Kittel; Julia Romanova; Tatiana Vinogradova; Hermann Katinger; Oleg Kiselev; Andrej Egorov

2006-01-01

42

[Social aspects in tuberculosis among mental patients].  

PubMed

A total of 206 patients with pulmonary tuberculosis and mental disorders from the Kirov Region were examined in 1997-1998. The results were compared with those obtained in 154 control patients with pulmonary tuberculosis without mental disorders. In both group males fell ill with tuberculosis in the prime of their life whereas females did at their old age. Males with mental disorders are more susceptible to tuberculosis than mentally healthy patients. In contrast, females with mental disorders are much less susceptible to tuberculosis than mentally healthy patients. Women of reproductive age are the least prone to tuberculosis particularly in the presence of mental disorders. The authors proposes to continue studies of the causes of female resistance to tuberculous infection, the specific features of the hormonal background in women having mental disorders and whether estrogens may be used in the therapy of tuberculosis. PMID:12593160

Rogacheva, M G

2002-01-01

43

Tuberculosis (TB): Treatment  

MedlinePLUS

Tuberculosis Diagnosing Tuberculosis Treating Tuberculosis TB Preventive Treatment Latent TB Infection Active TB Disease Drug-Resistant Tuberculosis ... to cooperate fully in the therapy program. Both latent TB infection and active TB disease are treated ...

44

Transmission of Mycobacterium tuberculosis between Farmers and Cattle in Central Ethiopia  

PubMed Central

Background Transmission of Mycobacterium tuberculosis (M. tuberculosis) complex could be possible between farmers and their cattle in Ethiopia. Methodology/Principal Findings A study was conducted in mixed type multi-purposes cattle raising region of Ethiopia on 287 households (146 households with case of pulmonary tuberculosis (TB) and 141 free of TB) and 287 herds consisting of 2,033 cattle belonging to these households to evaluate transmission of TB between cattle and farmers. Interview, bacteriological examinations and molecular typing were used for human subjects while comparative intradermal tuberculin (CIDT) test, post mortem and bacteriological examinations, and molecular typing were used for animal studies. Herd prevalence of CIDT reactors was 9.4% and was higher (p<0.01) in herds owned by households with TB than in herds owned by TB free households. Animal prevalence was 1.8% and also higher (p<0.01) in cattle owned by households with TB case than in those owned by TB free households. All mycobacteria (141) isolated from farmers were M. tuberculosis, while only five of the 16 isolates from cattle were members of the M. tuberculosis complex (MTC) while the remaining 11 were members of non-tuberculosis mycobacteria (NTM). Further speciation of the five MTC isolates showed that three of the isolates were M. bovis (strain SB1176), while the remaining two were M. tuberculosis strains (SIT149 and SIT53). Pathology scoring method described by “Vordermeier et al. (2002)” was applied and the average severity of pathology in two cattle infected with M. bovis, in 11 infected with NTM and two infected with M. tuberculosis were 5.5, 2.1 and 0.5, respectively. Conclusions/Significance The results showed that transmission of TB from farmers to cattle by the airborne route sensitizes the cows but rarely leads to TB. Similarly, low transmission of M. bovis between farmers and their cattle was found, suggesting requirement of ingestion of contaminated milk from cows with tuberculous mastitis.

Ameni, Gobena; Tadesse, Konjit; Hailu, Elena; Deresse, Yohannes; Medhin, Girmay; Aseffa, Abraham; Hewinson, Glyn; Vordermeier, Martin; Berg, Stefan

2013-01-01

45

Factors and Global Gene Regulation in Mycobacterium tuberculosis  

Microsoft Academic Search

Tuberculosis remains a worldwide threat despite the avail- ability of the BCG vaccine and antibiotic treatment. It is esti- mated that its etiologic agent, Mycobacterium tuberculosis, in- fects almost a third of the human population and kills two million people every year (27). The recent human immunode- ficiency virus pandemic, the selection of multidrug-resistant strains of M. tuberculosis, and the

Riccardo Manganelli; Roberta Proveddi; Sebastien Rodrigue; Jocelyn Beaucher; Luc Gaudreau; Issar Smith

2004-01-01

46

Multispacer Sequence Typing for Mycobacterium tuberculosis Genotyping  

Microsoft Academic Search

BackgroundGenotyping methods developed to survey the transmission dynamics of Mycobacterium tuberculosis currently rely on the interpretation of restriction and amplification profiles. Multispacer sequence typing (MST) genotyping is based on the sequencing of several intergenic regions selected after complete genome sequence analysis. It has been applied to various pathogens, but not to M. tuberculosis.Methods and FindingsIn M. tuberculosis, the MST approach

Zoheira Djelouadji; Catherine Arnold; Saheer Gharbia; Didier Raoult; Michel Drancourt; Niyaz Ahmed

2008-01-01

47

Regulation of Mycobacterium tuberculosis whiB3 in the Mouse Lung and Macrophages  

Microsoft Academic Search

Mycobacterium tuberculosis is a highly successful human pathogen, with 2 109 individuals infected globally. To understand the responses of M. tuberculosis to the in vivo environment, we studied the in vivo regulation of M. tuberculosis genes whose M. marinum homologs are induced in chronically infected frog tissues. The expression of 16S rRNA was shown to remain constant in M. tuberculosis

N. Banaiee; W. R. Jacobs; J. D. Ernst

2006-01-01

48

Genetic polymorphisms in TNF genes and tuberculosis in North Indians  

Microsoft Academic Search

BACKGROUND: Pulmonary tuberculosis, the most common clinical form of mycobacterial diseases, is a granulomatous disease of the lungs caused by Mycobaterium tuberculosis. A number of genes have been identified in studies of diverse origins to be important in tuberculosis. Of these, both tumor necrosis factor ? (TNF-?) and lymphotoxin ? (LT-?) play important immunoregulatory roles. METHODS: To investigate the association

Shilpy Sharma; Jaishriram Rathored; Balaram Ghosh; Surendra K Sharma

2010-01-01

49

Gamma\\/delta T lymphocytes in Mycobacterium tuberculosis infection  

Microsoft Academic Search

BACKGROUND: Data on the percentage of gamma\\/delta T lymphocytes in the peripheral blood of patients infected with Mycobacterium tuberculosis are few and contradictory. The percentage of gamma\\/delta T lymphocytes in the peripheral blood of tuberculin positive and tuberculin negative patients with Mycobacterium tuberculosis infection and healthy controls was compared. METHODS: Thirty six patients infected with Mycobacterium tuberculosis and 11 healthy

Z. Baliko; L. Szereday; J. Szekeres-Bartho

1997-01-01

50

Primary nasal Tuberculosis - A case report.  

PubMed

During the past two decades, Tuberculosis - both pulmonary and extrapulmonary have re-emerged as a major health problem worldwide. Nasal tuberculosis may be primary, or secondary to pulmonary tuberculosis or facial lupus. However all of them are rare entities. Nasal tuberculosis should be considered in the differential diagnosis of chronic nasal granulomas. We report a case of primary nasal tuberculosis in an adult female who presented with a polypoidal lesion in the nasal cavity. The diagnosis was based upon smear study, histopathology, culture & polymerase chain reaction. The patient successfully responded to antituberculous therapy and is presently disease free. Given the resurgence of tuberculosis in recent times, it is important that otolaryngologists remain aware of this rare clinical entity. PMID:23120401

Kameswaran, Mohan; Anand Kumar, R S; Murali, Sathiya; Raghunandan, S; Vijaya Krishnan, P

2007-04-26

51

Molecular characterization of Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients in Felege Hiwot Referral Hospital, northwest Ethiopia.  

PubMed

BACKGROUND: Tuberculosis (TB), caused by the Mycobacterium tuberculosis complex (MTBC), is a serious infection in humans and animals. Ethiopia is one of the countries in Sub-Saharan Africa with the highest burden of TB. However, limited information is available on the genotypic characteristics of M. tuberculosis strains infecting humans. The objective of the present study was to characterize the mycobacterial species isolated from pulmonary TB patients using molecular typing. MATERIALS AND METHODS: A cross-sectional study was conducted on 123 patients with smear-positive pulmonary TB, using Ziehl Neelsen staining and bacteriological culturing. Molecular characterizations of the mycobacterial isolates were performed using region of difference 9 (RD9) deletion typing and spoligotyping methods. RESULTS: The proportion of culture positivity was 95.9% (118/123). All the 118 isolates were confirmed to be M. tuberculosis by polymerase chain reaction-based RD9 deletion typing. Further characterization of all isolates using spoligotyping resulted in the identification of 36 different spoligotype patterns. Out of these, 32 (88.9%) patterns have already been reported in the SpolDB database, whereas the remaining four (11.1%) patterns were new and not registered in the database. The isolates were further grouped into 17 clustered (99 isolates) and 19 nonclustered patterns. The most predominant spoligotypes were SIT25 and SIT53, consisting of 22 isolates and 14 isolates, respectively. Classification of the spoligotype patterns using TB-insight RUN SPOTCLUST showed that the dominant lineages identified in the present study were Euro-American and Central Asian genotypes consisting of 64 isolates and 37 isolates, respectively. CONCLUSION: This study confirmed the presence of known M. tuberculosis strains and revealed new strains circulating in northwest Ethiopia and the distribution of the major phylogenetic families. It thus contributes to a better understanding of the genotypic profile of M. tuberculosis strains circulating in Ethiopia. PMID:23727395

Debebe, Tewodros; Admassu, Aschalew; Mamo, Gezahegne; Ameni, Gobena

2013-05-30

52

[Epidemiology of tuberculosis in France].  

PubMed

Tuberculosis remains one of the leading cause of death from infectious disease in the world. Tuberculosis control is one of the Word Health Organisation priority. One third of the population was estimated to be bacillus tuberculosis carrier responsible for 8 million of new tuberculosis cases occurring each year and nearly 2 million deaths. In Europe near 400,000 cases have been declared in 2001 with a west-east gradient in the incidence rate: 11 cases for 100,000 in west european countries, 41 per 100,000 in central european countries and 92 per 100,000 in east european countries. The number of tuberculosis cases decreased in France with an average annual decline of 7.5% between 1972 and 1988. This trend discontinued in 1989. Between 1991 and 1993 the number of reported tuberculosis increased. This excess of cases is attributable partly to HIV infection, but also to worsening in socio-economic conditions. From 1993 to 1997 the number of cases decreases again and the incidence rate is about 11 p. 100,000 and remains stable. In 2002, 6322 cases have been declared in France. There are important geographic differences. The Ile de France region has the highest incidence rate: 27.1 per 100,000. The rates of the other regions are much lower. The infection risk is different according to age, sex and nationality. People over 75 are one of the most affected age group. Children under 15 years of age represent 4.3% of cases with half of these cases before 5 years of age. As in adult, incidence rate of tuberculosis is 11 fold higher in migrants children than in french children. Less than 10 cases of tuberculous meningitis are reported annually under 15 years of age. Since 2003, mandatory notification includes tuberculous infection for children under 15 years of age. Data recorded in mandatory notification might be useful to improve tuberculosis control in France. PMID:16129331

Gaudelus, J; De Pontual, L

2005-08-01

53

Bilateral Mammary Tuberculosis Associated with a Borderline Ovarian Tumor  

Microsoft Academic Search

SummaryBackground: Mammary tuberculosis is rare in the Western world. It has no defined clinical or imaging features, and has to be differentiated from breast cancer and an abscess. Case Report: We present a case of mammary tuberculosis combined with borderline ovarian cancer. The bilateral breast tuberculosis was the first and only symptom of underlying tuberculosis with Ziehl-Neelsenpositive para-aortic lymph nodes.

Joachim Van Keirsbilck; Ine Riphagen; Hans Struyven; Andre Van den Eeckhout; Ann Cornelis; Patrick Neven; Frederic Amant; Ignace Vergote

2008-01-01

54

Postmenopausal Breast Tuberculosis - Report of 4 Cases  

PubMed Central

Background Breast tuberculosis is an uncommon disease even in countries where the incidence of tuberculosis is high. Case Report This is a case series concerning 4 postmenopausal breast tuberculosis cases encountered in Moulay Youssef Hospital between January 2007 and December 2010. Breast tuberculosis represents 0.25% of all hospitalized tuberculosis patients in our department. The mean age of our patients was 62.5 ± 5.8 years. Clinical findings were heterogeneous; 1 case was multifocal tuberculosis, and another case was coexistent tuberculosis and malignancy of the breast. Mammography and ultrasonography findings were suspicious for malignancy in all 4 cases. Fine needle aspiration was negative in 3 cases. The diagnosis was made in all patients by histological examination of biopsy specimens, which revealed typical tuberculous lesions. Anti-tuberculosis therapy formed the mainstay of treatment. Conclusion The clinical and radiological features of mammary tuberculosis can be very confusing and easily mistaken for breast cancer. Symptoms suggestive of tuberculosis warrant a biopsy to exclude possible cancer.

Bouti, Khalid; Soualhi, Mouna; Marc, Karima; Zahraoui, Rachida; Benamor, Jouda; Bourkadi, Jamal Eddine; Iraqi, Ghali

2012-01-01

55

Allergic Sensitisation in Tuberculosis and Leprosy Patients  

Microsoft Academic Search

Background: A negative association has been observed between infections and allergy in several studies. The aim of the present study was to examine whether tuberculosis and leprosy patients have more or fewer allergies than healthy individuals. Method:Sera from tuberculosis patients, leprosy patients and healthy controls were analysed by ELISA and Pharmacia Unicap® for serological markers for allergy and mycobacterial infection.

L. K. Ellertsen; H. G. Wiker; N. T. Egeberg; G. Hetland

2005-01-01

56

Mycobacterium tuberculosis Effects on Fibroblast Collagen Metabolism  

Microsoft Academic Search

Background: Type I collagen synthesis and degradation are important events during Mycobacterium tuberculosis (MTb) granuloma or cavity formation, and fibroblasts are cells involved in these processes. Objective: We examined the MTb effects on fibroblast collagen metabolism to understand the virulence factors involved in tuberculosis pathogenesis. Methods: Human lung fibroblasts were incubated with culture medium or sonicated MTb H37Ra (avirulent) or

Georgina González-Avila; Cuauhtemoc Sandoval; M. Teresa Herrera; Victor Ruiz; Bettina Sommer; Eduardo Sada; Carlos Ramos; M. Carmen Sarabia

2009-01-01

57

Genotyping and drug resistance patterns of M. tuberculosis strains in Pakistan  

PubMed Central

Background The incidence of tuberculosis in Pakistan is 181/100,000 population. However, information about transmission and geographical prevalence of Mycobacterium tuberculosis strains and their evolutionary genetics as well as drug resistance remains limited. Our objective was to determine the clonal composition, evolutionary genetics and drug resistance of M. tuberculosis isolates from different regions of the country. Methods M. tuberculosis strains isolated (2003–2005) from specimens submitted to the laboratory through collection units nationwide were included. Drug susceptibility was performed and strains were spoligotyped. Results Of 926 M. tuberculosis strains studied, 721(78%) were grouped into 59 "shared types", while 205 (22%) were identified as "Orphan" spoligotypes. Amongst the predominant genotypes 61% were Central Asian strains (CAS ; including CAS1, CAS sub-families and Orphan Pak clusters), 4% East African-Indian (EAI), 3% Beijing, 2% poorly defined TB strains (T), 2% Haarlem and LAM (0.2). Also TbD1 analysis (M. tuberculosis specific deletion 1) confirmed that CAS1 was of "modern" origin while EAI isolates belonged to "ancestral" strain types. Prevalence of CAS1 clade was significantly higher in Punjab (P < 0.01, Pearsons Chi-square test) as compared with Sindh, North West Frontier Province and Balochistan provinces. Forty six percent of isolates were sensitive to five first line antibiotics tested, 45% were Rifampicin resistant, 50% isoniazid resistant. MDR was significantly associated with Beijing strains (P = 0.01, Pearsons Chi-square test) and EAI (P = 0.001, Pearsons Chi-square test), but not with CAS family. Conclusion Our results show variation of prevalent M. tuberculosis strain with greater association of CAS1 with the Punjab province. The fact that the prevalent CAS genotype was not associated with drug resistance is encouraging. It further suggests a more effective treatment and control programme should be successful in reducing the tuberculosis burden in Pakistan.

Tanveer, Mahnaz; Hasan, Zahra; Siddiqui, Amna R; Ali, Asho; Kanji, Akbar; Ghebremicheal, Solomon; Hasan, Rumina

2008-01-01

58

Using statistical methods and genotyping to detect tuberculosis outbreaks  

PubMed Central

Background Early identification of outbreaks remains a key component in continuing to reduce the burden of infectious disease in the United States. Previous studies have applied statistical methods to detect unexpected cases of disease in space or time. The objectives of our study were to assess the ability and timeliness of three spatio-temporal methods to detect known outbreaks of tuberculosis. Methods We used routinely available molecular and surveillance data to retrospectively assess the effectiveness of three statistical methods in detecting tuberculosis outbreaks: county-based log-likelihood ratio, cumulative sums, and a spatial scan statistic. Results Our methods identified 8 of the 9 outbreaks, and 6 outbreaks would have been identified 1–52 months (median = 10 months) before local public health authorities identified them. Assuming no delays in data availability, 46 (59.7%) of the 77 patients in the 9 outbreaks were identified after our statistical methods would have detected the outbreak but before local public health authorities became aware of the problem. Conclusions Statistical methods, when applied retrospectively to routinely collected tuberculosis data, can successfully detect known outbreaks, potentially months before local public health authorities become aware of the problem. The three methods showed similar results; no single method was clearly superior to the other two. Further study to elucidate the performance of these methods in detecting tuberculosis outbreaks will be done in a prospective analysis.

2013-01-01

59

Feasibility and effect of integrating tuberculosis screening and detection in postnatal care services: an operations research study  

PubMed Central

Background Tuberculosis still remains a major cause of maternal and newborn morbidity and mortality. Integrating tuberculosis screening and detection into postnatal care services ensures prompt and appropriate treatment for affected mothers and their babies. This study therefore examined the feasibility and effect of screening and referral for tuberculosis within postnatal care settings from the perspective of providers. Methods This operations research study used a pre- and post-intervention design without a comparison group. The study was implemented between March 2009 and August 2010 in five health facilities located in low-income areas of Nairobi, Kenya, which were suspected to have relatively high prevalence of both tuberculosis and HIV. Descriptive statistics and significance tests were employed to determine changes in the indicators of interest between baseline and endline. Results Among the 12,604 postnatal care clients screened, 14 tuberculosis cases were diagnosed. The proportion of clients screened for at least one cardinal sign of tuberculosis rose from 4% to 66%, and 21% of clients were screened for all six tracer signs and symptoms. A comparison of 10 quality of postnatal care and tuberculosis screening components at baseline and endline showed a highly significant effect on all 10 components. Conclusions The findings demonstrate that using postnatal care services as a platform for tuberculosis screening and detection is acceptable and feasible. In addition, linking clients identified through screening to further treatment significantly improved. However, the actual number of cases detected was low. A policy debate on whether to link tuberculosis screening with reproductive health services is recommended before full scale-up of this intervention.

2013-01-01

60

The impact of antiretroviral therapy and isoniazid preventive therapy on tuberculosis incidence in HIV-infected patients in Rio de Janeiro, Brazil  

Microsoft Academic Search

Background: Tuberculosis is a common complication and leading cause of death in HIV infection. Antiretroviral therapy (ART) lowers the risk of tuberculosis, but may not be sufficient to control HIV-related tuberculosis. Isoniazid preventive therapy (IPT) reduces tuberculosis incidence significantly, but is not widely used. Methods: We analysed tuberculosis incidence in 11 026 HIV-infected patients receiving medical care at 29 public

Jonathan E. Golub; Valeria Saraceni; Solange C. Cavalcante; Antonio G. Pacheco; Lawrence H. Moulton; Bonnie S. King; Anne Efron; Richard D. Moore; Richard E. Chaisson; Betina Durovni

2007-01-01

61

Prevalence of tuberculosis in pigs slaughtered at two abattoirs in Ethiopia and molecular characterization of Mycobacterium tuberculosis isolated from tuberculous-like lesions in pigs  

PubMed Central

Background Tuberculosis (TB) is an infectious, granulomatous disease caused by acid-fast bacilli of the genus Mycobacterium. The disease affects practically all species of vertebrates. Although mammalian tuberculosis has been nearly controlled in many developed countries, it is still a serious problem in humans and domestic animals including pigs in developing countries. In Ethiopia, the prevalence of TB in pigs is not known. Therefore, this study was designed to estimate the prevalence of TB in pigs in central Ethiopia and to characterize the causative agents using molecular techniques. Results The estimated prevalence of TB was 5.8% (49/841). Age and origin of pigs were significantly associated (P<0.001) with the prevalence. In contrast, an association of sex, floor type and water source with the prevalence could not be shown. Culture positivity was confirmed in 30.6% (15/49) of the tuberculous-like lesions. Of the 15 isolates, 12 were acid fast positive while five of the latter were confirmed by multiplex PCR as members of the M. tuberculosis complex. Speciation of the five isolates further confirmed that they were M. tuberculosis, belonging to SIT1088 (two isolates) and SIT1195 (one isolate). The remaining two isolates belong to an identical spoligotype, the pattern of which was not found in the spoligotype database (SpolDB4). Conclusions The isolation of M. tuberculosis from pigs suggests a possible risk of transmission between humans and pigs. Hence, establishing feasible control methods is required.

2013-01-01

62

Tuberculosis: New Aspects of an Old Disease  

PubMed Central

Tuberculosis is an ancient infectious disease that remains a threat for public health around the world. Although the etiological agent as well as tuberculosis pathogenesis is well known, the molecular mechanisms underlying the host defense to the bacilli remain elusive. In this paper we focus on the innate immunity of this disease reviewing well-established and consensual mechanisms like Mycobacterium tuberculosis interference with phagosome maturation, less consensual mechanism like nitric oxide production, and new mechanisms, such as mycobacteria translocation to the cytosol, autophagy, and apoptosis/necrosis proposed mainly during the last decade.

Jordao, Luisa; Vieira, Otilia V.

2011-01-01

63

Extensively drug-resistant tuberculosis in India: A review  

PubMed Central

Background & objectives: Extensively drug resistant tuberculosis (XDR-TB) has become a new threat for the control of TB in many countries including India. Its prevalence is not known in India as there is no nation-wide surveillance. However, there have been some reports from various hospitals in the country. Methods: We have reviewed the studies/information available in the public domain and found data from 10 tertiary care centres in 9 cities in India. Results: A total of 598 isolates of XDR Mycobacterium tuberculosis have been reported in the studies included. However, the reliability of microbiological methods used in these studies was not checked and thus the XDR-TB data remained invalidated in reference laboratories. Interpretation & conclusions: Systematic surveillance and containment interventions are urgently needed.

Michael, Joy Sarojini; John, T. Jacob

2012-01-01

64

[Situation of tuberculosis in the world and the role expected of Japan in the global fight against tuberculosis].  

PubMed

The whole world is divided into 3 groups by the magnitude of tuberculosis problem: namely, developed countries in which tuberculosis is already a minor health problem and continues to decline; NIES and some oil-producing countries in which tuberculosis started to decline significantly; and most developing countries in which tuberculosis is still highly prevalent and no or only a slow decline. Number of new smear positive pulmonary tuberculosis in the whole world in a year is estimated at about 4.5 million, and adding smear negative pulmonary tuberculosis and extra-pulmonary tuberculosis, total number of new tuberculosis patients amounts to 9 to 10 million, and nearly 3 million persons die every year from tuberculosis, and 97% of these cases occur in developing countries. Failure of tuberculosis control in most developing countries could be explained by slow economic development of financial crisis, which caused poor allocation of budget for health including tuberculosis programme and slow development of primary health care. Activities of tuberculosis supervisory teams are weak. Tuberculosis programmes succeeded in developed countries could not be implemented easily in developing countries. New obstacles to the rapid decline of tuberculosis are the epidemic of AIDS, movement of population and lowering concern on tuberculosis problems, and tuberculosis will remain as one of serious global health problems at least for coming several decades. Maintenance of research and training facilities for tuberculosis is needed, however, they have been disappearing in developed countries. Facilities in developing countries might have difficulties to maintain unless financial and technical support is given from developed countries. Japan is the second biggest economic power in the world, and it is our duty to increase ODA for developing countries. In the field of health, Dr. Nakajima started to work as the director-general of WHO since 1988. We have to intensify our technical cooperation in health. As we succeeded to control tuberculosis in the past 40 years and still maintain research and training facilities for tuberculosis, they should be used for the sake of developing countries. Multi-and bi-lateral cooperation in tuberculosis control should also be intensified. The author would like to urge members of the Japanese Society for Tuberculosis to talk about the importance of tuberculosis problem and role expected to Japan in the global fight against tuberculosis to people outside the society so as to have appropriate understanding on global tuberculosis problems. PMID:2593463

Shimao, T

1989-11-01

65

Living with Tuberculosis  

MedlinePLUS

... for ENews Home > Lung Disease > Tuberculosis Living With Tuberculosis You will need regular checkups to make sure ... breathes the air. View in depth resources for tuberculosis A A A Share Print Online Caregiving Coordination ...

66

Tuberculosis and Diabetes  

MedlinePLUS

TUBERCULOSIS & DIABETES COLLABORATIVE FRAMEWORK FOR CARE AND CONTROL OF TUBERCULOSIS AND DIABETES © WHO Sept 2011 For more information: ... increase by 50% by 2030 THE LINKS BETWEEN TUBERCULOSIS AND DIABETES • People with a weak immune system, ...

67

Immunodominant PstS1 antigen of mycobacterium tuberculosis is a potent biological response modifier for the treatment of bladder cancer  

Microsoft Academic Search

BACKGROUND: Bacillus Calmette Guérin (BCG)-immunotherapy has a well-documented and successful clinical history in the treatment of bladder cancer. However, regularly observed side effects, a certain degree of nonresponders and restriction to superficial cancers remain a major obstacle. Therefore, alternative treatment strategies are intensively being explored. We report a novel approach of using a well defined immunostimulatory component of Mycobacterium tuberculosis

Christian Sänger; Andreas Busche; Gabriele Bentien; Ralf Spallek; Fatima Jonas; Andreas Böhle; Mahavir Singh; Sven Brandau

2004-01-01

68

Pulmonary tuberculosis among women with cough attending clinics for family planning and maternal and child health in Dar Es Salaam, Tanzania  

Microsoft Academic Search

BACKGROUND: Tuberculosis (TB) case detection in women has remained low in developing world. This study was conducted to determine the proportion of smear positive TB among women with cough regardless of the duration attending family Planning (FP) and Maternal and child health (MCH) clinics in Dar es Salaam. METHODS: We conducted a cross sectional study in all three municipal hospitals

Esther S Ngadaya; Godfrey S Mfinanga; Eliud R Wandwalo; Odd Morkve

2009-01-01

69

Evolution and expansion of the Mycobacterium tuberculosis PE and PPE multigene families and their association with the duplication of the ESAT-6 (esx) gene cluster regions  

Microsoft Academic Search

BACKGROUND: The PE and PPE multigene families of Mycobacterium tuberculosis comprise about 10% of the coding potential of the genome. The function of the proteins encoded by these large gene families remains unknown, although they have been proposed to be involved in antigenic variation and disease pathogenesis. Interestingly, some members of the PE and PPE families are associated with the

Nicolaas C Gey van Pittius; Samantha L Sampson; Hyeyoung Lee; Yeun Kim; Paul D van Helden; Robin M Warren

2006-01-01

70

Integration of Antiretroviral Therapy with Tuberculosis Treatment  

PubMed Central

Background We previously reported that integrating antiretroviral therapy (ART) with tuberculosis treatment reduces mortality. However, optimal time to initiate ART during tuberculosis treatment remains contentious. Methods To address this, we conducted a 3-arm, open-label randomized controlled trial in South Africa in acid-fast bacilli smear positive patients (n=642) with HIV and CD4+ counts <500 cells/mm3. Findings on the early therapy group (ART initiated within 4 weeks of tuberculosis treatment initiation, n=214) and late therapy group (ART initiated within the first 4 weeks of the continuation phase of tuberculosis treatment, n=215) are presented here. Results Median CD4+ count and viral load at baseline was 150 cells/mm3 and 161000 copies/ml, being similar in both groups. Incidence rate of AIDS or death was 6.9 (18/259.4) and 7.8 (19/244.2) per 100 person-years in the early and late therapy groups respectively (Incidence Rate Ratio (IRR)=0.89; 95%Confidence Interval (95%CI): 0.44,1.79; P=0.73). However, in patients with CD4+ counts <50 cells/mm3, the incidence rates of AIDS or death were 8.5 (early) and 26.3 (late) per 100 person-years (IRR=0.32; 95%CI: 0.07,1.13; P=0.06). Immune reconstitution inflammatory syndrome (IRIS) incidence rates were 20.2 (early) and 7.7 (late) per 100 person-years (IRR=2.62; 95%CI: 1.48,4.82; P<0.001). Adverse events requiring antiretroviral drug switches occurred in 10 (early) and 1 (late) patients (P=0.006). Conclusions The benefits of AIDS-free survival balanced against the risks of IRIS and ART-related adverse events, support early ART initiation in patients with CD4+ counts <50 cells/mm3 and deferred ART initiation to the continuation phase of tuberculosis treatment when CD4+ counts are higher.

Abdool Karim, Salim S.; Naidoo, Kogieleum; Grobler, Anneke; Padayatchi, Nesri; Baxter, Cheryl; Gray, Andrew L.; Gengiah, Tanuja; Gengiah, Santhanalakshmi; Naidoo, Anushka; Jithoo, Niraksha; Nair, Gonasagrie; El-Sadr, Wafaa M.; Friedland, Gerald; Abdool Karim, Quarraisha

2011-01-01

71

Patient-centred tuberculosis treatment delivery under programmatic conditions in Tanzania: a cohort study  

Microsoft Academic Search

BACKGROUND: Directly observed therapy (DOT) remains the cornerstone of the global tuberculosis (TB) control strategy. Tanzania, one of the 22 high-burden countries regarding TB, changed the first-line treatment regimen to contain rifampicin-containing fixed-dose combination for the full 6 months of treatment. As daily health facility-based DOT for this long period is not feasible for the patient, nor for the health

Saidi Egwaga; Abdallah Mkopi; Nyagosya Range; Vera Haag-Arbenz; Amuri Baraka; Penny Grewal; Frank Cobelens; Hassan Mshinda; Fred Lwilla; Frank van Leth

2009-01-01

72

Drug-resistant tuberculosis: time for visionary political leadership.  

PubMed

Two decades ago, WHO declared tuberculosis a global emergency, and invested in the highly cost-effective directly observed treatment short-course programme to control the epidemic. At that time, most strains of Mycobacterium tuberculosis were susceptible to first-line tuberculosis drugs, and drug resistance was not a major issue. However, in 2013, tuberculosis remains a major public health concern worldwide, with prevalence of multidrug-resistant (MDR) tuberculosis rising. WHO estimates roughly 630?000 cases of MDR tuberculosis worldwide, with great variation in the frequency of MDR tuberculosis between countries. In the past 8 years, extensively drug-resistant (XDR) tuberculosis has emerged, and has been reported in 84 countries, heralding the possibility of virtually untreatable tuberculosis. Increased population movement, the continuing HIV pandemic, and the rise in MDR tuberculosis pose formidable challenges to the global control of tuberculosis. We provide an overview of the global burden of drug-resistant disease; discuss the social, health service, management, and control issues that fuel and sustain the epidemic; and suggest specific recommendations for important next steps. Visionary political leadership is needed to curb the rise of MDR and XDR tuberculosis worldwide, through sustained funding and the implementation of global and regional action plans. PMID:23531391

Abubakar, Ibrahim; Zignol, Matteo; Falzon, Dennis; Raviglione, Mario; Ditiu, Lucica; Masham, Susan; Adetifa, Ifedayo; Ford, Nathan; Cox, Helen; Lawn, Stephen D; Marais, Ben J; McHugh, Timothy D; Mwaba, Peter; Bates, Matthew; Lipman, Marc; Zijenah, Lynn; Logan, Simon; McNerney, Ruth; Zumla, Adam; Sarda, Krishna; Nahid, Payam; Hoelscher, Michael; Pletschette, Michel; Memish, Ziad A; Kim, Peter; Hafner, Richard; Cole, Stewart; Migliori, Giovanni Battista; Maeurer, Markus; Schito, Marco; Zumla, Alimuddin

2013-03-24

73

The Beijing genotype and drug resistant tuberculosis in the Aral Sea region of Central Asia  

PubMed Central

Background After the collapse of the Soviet Union, dramatically increasing rates of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) have been reported from several countries. This development has been mainly attributed to the widespread breakdown of TB control systems and declining socio-economic status. However, recent studies have raised concern that the Beijing genotype of Mycobacterium tuberculosis might be contributing to the epidemic through its widespread presence and potentially enhanced ability to acquire resistance. Methods A total of 397 M. tuberculosis strains from a cross sectional survey performed in the Aral Sea region in Uzbekistan and Turkmenistan have been analysed by drug susceptibility testing, IS6110 fingerprinting, and spoligotyping. Results Fifteen isolates showed mixed banding patterns indicating simultaneous infection with 2 strains. Among the remaining 382 strains, 152 (40%) were grouped in 42 clusters with identical fingerprint and spoligotype patterns. Overall, 50% of all isolates were Beijing genotype, with 55% of these strains appearing in clusters compared to 25% of non-Beijing strains. The percentage of Beijing strains increased with increasing drug resistance among both new and previously treated patients; 38% of fully-susceptible isolates were Beijing genotype, while 75% of MDR-TB strains were of the Beijing type. Conclusion The Beijing genotype is a major cause of tuberculosis in this region, it is strongly associated with drug resistance, independent of previous tuberculosis treatment and may be strongly contributing to the transmission of MDR-TB. Further investigation around the consequences of Beijing genotype infection for both tuberculosis transmission and outcomes of standard short course chemotherapy are urgently needed.

Cox, Helen Suzanne; Kubica, Tanja; Doshetov, Daribay; Kebede, Yared; Rusch-Gerdess, Sabine; Niemann, Stefan

2005-01-01

74

[Tuberculosis epidemiology in Mayotte Island].  

PubMed

Mayotte is a French territory island, part of the Comoros Archipelago in the Indian Ocean with 200,000 inhabitants. The tuberculosis control program started in 1976, although available epidemiological data remains incomplete. We conducted a retrospective hospital-based survey in 202 outpatients and hospital medical records from the Hospital Centre of the main city to contribute to the epidemiological evaluation of tuberculosis patterns. The tuberculosis frequency remains unchanged since 2000. It affects a young population partly coming from the other neighbouring Comoro Islands (69%) with illegal immigrate status (53% in 2004). The systematic diagnostic screening efficiency of the condition appears marginal. Pulmonary involvement is the most frequent clinical manifestation (78%), although severe extrapulmonary manifestations are not exceptional. Co-infection with HIV and multi resistance to antituberculosis agents are not frequent. Up to 60% of cases have been proven to be bacteriologically linked. The notification rate remains critically low with an estimate of 39% of notifications to the local sanitary authorities in charge of secondary cases screening. The case coverage seems limited both by low socio-economical status and poor health facility accessibility The loss of follow up is dramatically high, 41% on the overall period, and up to 51% in 2004. Our results make mandatory the reinforcement of a tuberculosis survey and control involvement within the context of this French territory. Screening, care and follow up are to be implemented particularly for vulnerable and precarious groups and for patients. PMID:18956814

Woessner, J; Receveur, M C; Malvy, D; Taytard, A

2008-10-01

75

Impact of HIV infection on tuberculosis  

PubMed Central

Tuberculosis is increasing in prevalence in many countries and is now the leading infectious cause of death world wide, being responsible for three million deaths annually. Infection with HIV, likewise increasing in prevalence, has emerged as the most important predisposing factor for developing overt tuberculosis in people co-infected with Mycobacterium tuberculosis. Owing to the widespread geographical overlap of these two infections, it is estimated that in 1999, HIV related tuberculosis will reach one million cases and will cause 30% of the expected 2.5 million AIDS related deaths. Tuberculosis in HIV infected individuals may have unusual clinical features and can cause diagnostic difficulties. Despite the effectiveness of modern short course treatment, the mortality of HIV related tuberculosis during and after treatment remains high, and this may be due to other HIV related infections. The "cursed duet" of infection with both HIV and M tuberculosis is generating a threat to human health of unparalleled proportions which, if not taken seriously by health workers and decision makers, could become totally unmanageable.???Keywords: HIV; AIDS; tuberculosis

Zumla, A.; Malon, P.; Henderson, J.; Grange, J.

2000-01-01

76

[Tuberculosis, today].  

PubMed

Tuberculosis is still a major health and social problem because, on the one hand, we have witnessed the dismantling of the sanatoriums, with a reduced level of diagnostic suspicion, knowledge and expertise on the management of the disease, while, the other side, are considered migratory flows, the lower socio-economic faced by immigrants, the states of immunosuppression associated with HIV prevalence of malnutrition and other diseases, and the phenomenon of multidrug-resistance, which often turns out to be iatrogenic. The success of the strategy of control/elimination of tuberculosis promoted by the World Health Organization requires a well coordinated multidisciplinary approach in which everyone does their part, the general practitioner, the pulmonologist, the infectious disease specialist, and the microbiologist. PMID:22688374

Scala, Raffaele

2012-06-01

77

Abdominal tuberculosis.  

PubMed Central

Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13

Kapoor, V. K.

1998-01-01

78

Vaccination against tuberculosis: how can we better BCG?  

PubMed

Tuberculosis remains one of the most significant human diseases of the developing world, accounting for 3800 worldwide deaths per day. Although we currently have a vaccine for tuberculosis, BCG, this is insufficient at protecting from adult pulmonary tuberculosis in the parts of the world where a good vaccine is most needed. This has prompted the search for new vaccination strategies that can protect better than BCG, or can boost BCG-induced immunity. We discuss these subjects in line with what is known of the immune responses to BCG and Mycobacterium tuberculosis - the etiological agent of the disease, as well as the particular difficulties facing development of new vaccines against tuberculosis. A greater understanding of the factors constituting optimal protection against Mycobacterium tuberculosis infection, as well as which pathogenic factors facilitate active disease, will accelerate the delivery of safe vaccines able to restrict active tuberculosis and thus impede contagion. PMID:23257069

Pitt, Jonathan M; Blankley, Simon; McShane, Helen; O'Garra, Anne

2012-12-17

79

Duration of Anti-Tuberculosis Therapy and Timing of Antiretroviral Therapy Initiation: Association with Mortality in HIV-Related Tuberculosis  

PubMed Central

Background Antiretroviral therapy (ART) decreases mortality risk in HIV-infected tuberculosis patients, but the effect of the duration of anti-tuberculosis therapy and timing of anti-tuberculosis therapy initiation in relation to ART initiation on mortality, is unclear. Methods We conducted a retrospective observational multi-center cohort study among HIV-infected persons concomitantly treated with Rifamycin-based anti-tuberculosis therapy and ART in Latin America. The study population included persons for whom 6 months of anti-tuberculosis therapy is recommended. Results Of 253 patients who met inclusion criteria, median CD4+ lymphocyte count at ART initiation was 64 cells/mm3, 171 (68%) received >180 days of anti-tuberculosis therapy, 168 (66%) initiated anti-tuberculosis therapy before ART, and 43 (17%) died. In a multivariate Cox proportional hazards model that adjusted for CD4+ lymphocytes and HIV-1 RNA, tuberculosis diagnosed after ART initiation was associated with an increased risk of death compared to tuberculosis diagnosis before ART initiation (HR 2.40; 95% CI 1.15, 5.02; P = 0.02). In a separate model among patients surviving >6 months after tuberculosis diagnosis, after adjusting for CD4+ lymphocytes, HIV-1 RNA, and timing of ART initiation relative to tuberculosis diagnosis, receipt of >6 months of anti-tuberculosis therapy was associated with a decreased risk of death (HR 0.23; 95% CI 0.08, 0.66; P=0.007). Conclusions The increased risk of death among persons diagnosed with tuberculosis after ART initiation highlights the importance of screening for tuberculosis before ART initiation. The decreased risk of death among persons receiving > 6 months of anti-tuberculosis therapy suggests that current anti-tuberculosis treatment duration guidelines should be re-evaluated.

Cortes, Claudia P.; Wehbe, Firas H.; McGowan, Catherine C.; Shepherd, Bryan E.; Duda, Stephany N.; Jenkins, Cathy A.; Gonzalez, Elsa; Carriquiry, Gabriela; Schechter, Mauro; Padgett, Denis; Cesar, Carina; Madero, Juan Sierra; Pape, Jean W.; Masys, Daniel R.; Sterling, Timothy R.

2013-01-01

80

Use of T Cell-Based Diagnosis of Tuberculosis Infection to Optimize Interpretation of Tuberculin Skin Testing in Child Tuberculosis Contacts  

PubMed Central

Background Treatment of recent tuberculosis infection in children <2 years old is essential because of high risk of progression to disease, but diagnosis is hindered by the inaccuracy of the tuberculin skin test (TST). More accurate T cell-based tests for infection could enhance diagnosis by optimizing TST interpretation. Methods 979 child tuberculosis contacts in Istanbul underwent TST and enzyme-linked immunospot (ELISpot) testing. Using ELISpot results as a reference standard, we assessed the effect of age and BCG-vaccination on sensitivity and specificity of TST, and computed optimal TST cut-off points (OCPs) using receiver operator characteristic curves. Results Using a ?10mm TST cut-off point, sensitivity of TST was 66% in children <2y, lower than in older children (p=0.006). Specificity was 75% in BCG-vaccinated children, compared with 92% in unvaccinated children (p=0.001). OCPs improved TST specificity in children with 1 BCG scar with little loss of sensitivity. Despite use of OCPs, sensitivity of TST remained <70% in children <2y, specificity remained <87% in BCG-vaccinated children >2y and overall accuracy was low in children with >1 BCG scar. Conclusions Negative TST results cannot exclude tuberculosis infection in child tuberculosis contacts <2 years old, supporting use of preventive therapy regardless of TST results in this age group. In children >2 years old, accuracy of TST can be improved by adjustment of cut-off points in BCG-vaccinated children but remains poor in children with >1 BCG scar. This methodology can define optimal TST cut-off points for diagnosis of tuberculosis infection tailored to target populations.

Bakir, Mustafa; Dosanjh, Davinder P S; Deeks, Jonathan J; Soysal, Ahmet; Millington, Kerry A; Efe, Serpil; Aslan, Yasemin; Polat, Dilek; Kodalli, Nihat; Yagci, Aysegul; Barlan, Isil; Bahceciler, Nerin; Demiralp, Emel E; Lalvani, Ajit

2009-01-01

81

Abdominal tuberculosis in children  

Microsoft Academic Search

Four boys with abdominal tuberculosis, one of whom had acquired immunodeficiency syndrome, are presented. Abdominal imaging findings on plain radiography, ultrasonography, computed tomography, and gastrointestinal contrast studies included tuberculous peritonitis and ascites in all patients, tuberculous adenopathy in two, gastrointestinal tuberculosis in two, and omental tuberculosis in two. The radiographic features particularly characteristic of abdominal tuberculosis were: (1) low attenuating

D. S. Ablin; K. A. Jain; E. M. Azouz

1994-01-01

82

Epidemiology, diagnosis and treatment of tuberculosis  

Microsoft Academic Search

Tuberculosis (TB) remains a major cause of morbidity and mortality and represents the most frequent cause of death by a single infectious agent worldwide1. While the incidence of TB is slowly decreasing in Europe due to active case finding and targeted therapies, the emergence of multi-drug-resistant and extensive-drug resistant strains of Mycobacterium tuberculosis (Mtb) are a great concern for the

Christoph Lange

83

Tuberculosis diagnostics and biomarkers: needs, challenges, recent advances, and opportunities.  

PubMed

Tuberculosis is unique among the major infectious diseases in that it lacks accurate rapid point-of-care diagnostic tests. Failure to control the spread of tuberculosis is largely due to our inability to detect and treat all infectious cases of pulmonary tuberculosis in a timely fashion, allowing continued Mycobacterium tuberculosis transmission within communities. Currently recommended gold-standard diagnostic tests for tuberculosis are laboratory based, and multiple investigations may be necessary over a period of weeks or months before a diagnosis is made. Several new diagnostic tests have recently become available for detecting active tuberculosis disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. In the absence of effective prevention strategies, high rates of early case detection and subsequent cure are required for global tuberculosis control. Early case detection is dependent on test accuracy, accessibility, cost, and complexity, but also depends on the political will and funder investment to deliver optimal, sustainable care to those worst affected by the tuberculosis and human immunodeficiency virus epidemics. This review highlights unanswered questions, challenges, recent advances, unresolved operational and technical issues, needs, and opportunities related to tuberculosis diagnostics. PMID:22496353

McNerney, Ruth; Maeurer, Markus; Abubakar, Ibrahim; Marais, Ben; McHugh, Timothy D; Ford, Nathan; Weyer, Karin; Lawn, Steve; Grobusch, Martin P; Memish, Ziad; Squire, S Bertel; Pantaleo, Giuseppe; Chakaya, Jeremiah; Casenghi, Martina; Migliori, Giovanni-Batista; Mwaba, Peter; Zijenah, Lynn; Hoelscher, Michael; Cox, Helen; Swaminathan, Soumya; Kim, Peter S; Schito, Marco; Harari, Alexandre; Bates, Matthew; Schwank, Samana; O'Grady, Justin; Pletschette, Michel; Ditui, Lucica; Atun, Rifat; Zumla, Alimuddin

2012-04-10

84

The Relationship between Disease Pattern and Disease Burden by Chest Radiography, M. tuberculosis Load, and HIV Status in Patients with Pulmonary Tuberculosis in Addis Ababa  

Microsoft Academic Search

Background: We evaluated the impact of HIV coinfection on the chest radiographic pattern and extent of disease and its relation to the load of Mycobacterium tuberculosis in Ethiopian out-patients with pulmonary tuberculosis. Patients and Methods: A total of 168 patients with cultureverified pulmonary tuberculosis had their chest X-rays (CXR) reviewed for the site, pattern, and extent of disease and the

G. Aderaye; J. Bruchfeld; G. Assefa; D. Feleke; G. Källenius; M. Baat; L. Lindquist

2004-01-01

85

A Systematic Review of Clinical Diagnostic Systems Used in the Diagnosis of Tuberculosis in Children  

PubMed Central

Background. Tuberculosis (TB) is difficult to diagnose in children due to lack of a gold standard, especially in resource-limited settings. Scoring systems and diagnostic criteria are often used to assist in diagnosis; however their validity, especially in areas with high HIV prevalence, remains unclear. Methods. We searched online bibliographic databases, including MEDLINE and EMBASE. We selected all studies involving scoring systems or diagnostic criteria used to aid in the diagnosis of tuberculosis in children and extracted data from these studies. Results. The search yielded 2261 titles, of which 40 met selection criteria. Eighteen studies used point-based scoring systems. Eighteen studies used diagnostic criteria. Validation of these scoring systems yielded varying sensitivities as gold standards used ranged widely. Four studies evaluated and compared multiple scoring criteria. Ten studies selected for pulmonary tuberculosis. Five studies specifically evaluated the use of scoring systems in HIV-positive children, generally finding the specificity to be lower. Conclusions. Though scoring systems and diagnostic criteria remain widely used in the diagnosis of tuberculosis in children, validation has been difficult due to lack of an established and accessible gold standard. Estimates of sensitivity and specificity vary widely, especially in populations with high HIV co-infection.

Pearce, Emily C.; Woodward, Jason F.; Nyandiko, Winstone M.; Vreeman, Rachel C.; Ayaya, Samuel O.

2012-01-01

86

Abdominal tuberculosis.  

PubMed Central

The abdomen is involved in 10% to 30% of patients with pulmonary tuberculosis. The diagnosis is not difficult in societies where the disease is common and clinicians are aware of it. While previously rare in Western countries, the incidence is now rising among immigrants, and patients with AIDS. In HIV-infected patients, the disease is of a rapidly progressive nature, often fatal through usually treatable, but the diagnosis is difficult and often delayed. Treatment is essentially medical but occasionally surgical operation is necessary.

Ahmed, M. E.; Hassan, M. A.

1994-01-01

87

Measuring health-related quality of life in tuberculosis: a systematic review  

Microsoft Academic Search

INTRODUCTION: Tuberculosis remains a major public health problem worldwide. In recent years, increasing efforts have been dedicated to assessing the health-related quality of life experienced by people infected with tuberculosis. The objectives of this study were to better understand the impact of tuberculosis and its treatment on people's quality of life, and to review quality of life instruments used in

Na Guo; Fawziah Marra; Carlo A Marra

2009-01-01

88

Identification of gene targets against dormant phase Mycobacterium tuberculosis infections  

Microsoft Academic Search

Background  \\u000a Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), infects approximately 2 billion people worldwide and is the leading cause of mortality\\u000a due to infectious disease. Current TB therapy involves a regimen of four antibiotics taken over a six month period. Patient\\u000a compliance, cost of drugs and increasing incidence of drug resistant M. tuberculosis strains have added urgency to the

Dennis J Murphy; James R Brown

2007-01-01

89

Overt diabetes mellitus among newly diagnosed Ugandan tuberculosis patients: a cross sectional study  

PubMed Central

Background There is a documented increase of diabetes mellitus in Sub Saharan Africa, a region where tuberculosis is highly endemic. Currently, diabetes mellitus is one of the recognised risk factors of tuberculosis. No study has reported the magnitude of diabetes mellitus among tuberculosis patients in Uganda, one of the countries with a high burden of tuberculosis. Methods This was a cross-sectional study conducted among 260 consenting adult patients with a confirmed diagnosis of tuberculosis admitted on the pulmonology wards of Mulago national referral and teaching hospital in Kampala, Uganda to determine the prevalence of diabetes mellitus and associated clinical factors. Laboratory findings as well as the socio-demographic and clinical data collected using a validated questionnaire was obtained. Point of care random blood sugar (RBS) testing was performed on all the patients prior to initiation of anti tuberculosis treatment. Diabetes mellitus was diagnosed if the RBS level was ? 200mg/dl in the presence of the classical symptoms of diabetes mellitus. Results The prevalence of diabetes mellitus among the admitted patients with tuberculosis was 8.5%. Only 5 (1.9%) patients with TB had a known diagnosis of diabetes mellitus at enrolment. Majority of the study participants with TB-DM co-infection had type 2 diabetes mellitus (n=20, 90.9%). At bivariate analysis, raised mean ALT concentrations of ?80 U/L were associated with DM (OR-6.1, 95% CI 1.4-26.36, p=0.032) and paradoxically, HIV co-infection was protective of DM (OR-0.32, 95% CI 0.13-0.79, P=0.016). The relationship between DM and HIV as well as that with ALT remained statistically significant at multivariate analysis (HIV: OR- 0.17 95%CI 0.06-0.51, p=0.002 and ALT: OR-11.42 95%CI 2.15-60.59, p=0.004). Conclusion This study demonstrates that diabetes mellitus is common among hospitalized tuberculosis patients in Uganda. The significant clinical predictors associated with diabetes mellitus among tuberculosis patients were HIV co-infection and raised mean serum alanine transaminase concentrations.

2013-01-01

90

Insights into ancient leprosy and tuberculosis using metagenomics.  

PubMed

Leprosy and tuberculosis were widespread in the past and remain significant diseases today. Comparison of ancient and modern genomes of Mycobacterium leprae and Mycobacterium tuberculosis gives insight into their evolution and a calibration of the timescale for observed changes. Recently, whole genome sequencing has revealed genotypes and mixed-strain infections. PMID:23932433

Donoghue, Helen D

2013-08-08

91

Current management options for latent tuberculosis: a review  

PubMed Central

Tuberculosis remains the world’s second leading infectious cause of death, with nearly one-third of the global population latently infected. Treatment of latent tuberculosis infection is a mainstay of tuberculosis-control efforts in low-to medium-incidence countries. Isoniazid monotherapy has been the standard of care for decades, but its utility is impaired by poor completion rates. However, new, shorter-course regimens using rifamycins improve completion rates and are cost-saving compared with standard isoniazid monotherapy. We review the currently available therapies for latent tuberculosis infection and their toxicities and include a brief economic comparison of the different regimens.

Norton, Brianna L; Holland, David P

2012-01-01

92

A simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis  

Microsoft Academic Search

BackgroundThe grading of radiological severity in clinical trials in tuberculosis (TB) remains unstandardised. The aim of this study was to generate and validate a numerical score for grading chest x-ray (CXR) severity and predicting response to treatment in adults with smear-positive pulmonary TB.MethodsAt a TB clinic in Papua, Indonesia, serial CXRs were performed at diagnosis, 2 and 6 months in

Anna P Ralph; Muhamed Ardian; Andri Wiguna; Graeme P Maguire; Niels G Becker; Glen Drogumuller; Michael J Wilks; Govert Waramori; Emiliana Tjitra; Sandjaja; Enny Kenagalem; Gysje J Pontororing; Nicholas M Anstey; Paul M Kelly

2010-01-01

93

Multidrug-Resistant Tuberculosis in Admitted Patients at a Tertiary Referral Hospital of Bangladesh  

PubMed Central

Background This study was set out to investigate the magnitude, patterns and molecular characterization of drug-resistant Mycobacterium tuberculosis strains at a tertiary referral hospital in Bangladesh. Methods Pulmonary tuberculosis (TB) patients admitted at National Institute of Diseases of the Chest and Hospital from February 2002 to September 2005 with or without previous history of TB and/or other complications were randomly interviewed. Among 265 participants enrolled, M. tuberculosis isolates from 189 patients were finally tested for susceptibility to rifampicin (RMP), isoniazid (INH), ethambutol (ETM) and streptomycin (STM). Genotyping of M. tuberculosis was done using deletion analysis and spoligotyping. Results Eighty-eight percent (n?=?167) of the patients had history of previous anti-TB treatment while the remaining 12% were new TB cases. Of the 189 isolates, 9% were fully susceptible to the first line anti-TB drugs and 73.5% were multi-drug resistant TB. Other susceptibility results showed 79.4%, 77.2%, 76.7% and 78.8% resistance to INH, RMP, ETM and STM respectively. Multi-drug resistance was significantly higher among the 130 (78%) patients with previous history of anti-tuberculosis treatment (95% confidence interval, p?=?0.001). Among the 189 analyzed isolates, 69% were classified as “modern” M. tuberculosis strains (i.e. TbD1- strains, lacking the M. tuberculosis-deletion region TbD1), whereas the remaining 31% were found to belong to the “ancestal” TbD1+ M. tuberculosis lineages. One hundred and five different spoligotype patterns were identified in which 16 clusters contained 100 strains and 89 strains had unique pattern. Strains with a spoligotype characteristic for the “Beijing” cluster were predominant (19%) and most of these strains (75%) were multi-drug resistant (MDR). Conclusions A high level of drug resistance observed among the re-treatment patients poses a threat of transmission of resistant strains to susceptible persons in the community. Proper counseling of patients and attention towards the completion of the anti-TB treatment is needed.

Banu, Sayera; Mahmud, Asif Mujtaba; Rahman, Md. Toufiq; Hossain, Arman; Uddin, Mohammad Khaja Mafij; Ahmed, Tahmeed; Khatun, Razia; Akhanda, Wahiduzzaman; Brosch, Roland

2012-01-01

94

Osteoarticular tuberculosis mimicking rheumatoid arthritis.  

PubMed

Tuberculosis (TB) remains a global burden despite extensive efforts to control it. TB arthritis commonly manifest as monoarthritis of weight-bearing joints. We report a rare presentation of osteoarticular TB involving multiple small joints of the hands, which mimicked rheumatoid arthritis (RA). Magnetic resonance imaging showed tenosynovitis. The patient was initially treated for seronegative RA but failed to respond. Subsequently, synovial biopsy led to the diagnosis. Antituberculosis treatment was given for 1 year. PMID:22399018

Seung, Ong Ping; Sulaiman, Wahinuddin

2012-03-08

95

Risk factors for multidrug resistant tuberculosis in Europe: a systematic review  

Microsoft Academic Search

Background: The resurgence of tuberculosis (TB) in western countries has been attributed to the HIV epidemic, immigration, and drug resistance. Multidrug resistant tuberculosis (MDR-TB) is caused by the transmission of multidrug resistant Mycobacterium tuberculosis strains in new cases, or by the selection of single drug resistant strains induced by previous treatment. The aim of this report is to determine risk

A Faustini; A J Hall; C A Perucci

2006-01-01

96

Vegetarian diet as a risk factor for tuberculosis in immigrant south London Asians  

Microsoft Academic Search

BACKGROUND--In a previous retrospective study of tuberculosis in south London among Asian immigrants from the Indian subcontinent Hindu Asians were found to have a significantly increased risk for tuberculosis compared with Muslims. This finding has been further investigated by examining the role of socioeconomic and lifestyle variables, including diet, as risk factors for tuberculosis in Asian immigrants from the Indian

D P Strachan; K J Powell; A Thaker; F J Millard; J D Maxwell

1995-01-01

97

Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia  

Microsoft Academic Search

BACKGROUND: Delay in the diagnosis of tuberculosis may worsen the disease, increase the risk of death and enhance tuberculosis transmission in the community. This study aims to determine the length of delay between the onset of symptoms and patients first visit to health care (patient delay), and the length of delay between health care visit and the diagnosis of tuberculosis

Meaza Demissie; Bernt Lindtjorn; Yemane Berhane

2002-01-01

98

The experience of college students with pulmonary tuberculosis in Shaanxi, China: a qualitative study  

Microsoft Academic Search

BACKGROUND: The prevalence of pulmonary tuberculosis among college students in Shaanxi is high. Although tuberculosis leaves much psychological and social impact on patients, little is known about its impact on college students. The objective of this study is to explore the experiences and psychological process of college students with pulmonary tuberculosis in Shaanxi, China. METHODS: 17 college students with pulmonary

Shao-Ru Zhang; Hong Yan; Jin-Jing Zhang; Tian-Hua Zhang; Xiao-Hong Li; Yin-Ping Zhang

2010-01-01

99

Epidemiology of Tuberculosis in a High HIV Prevalence Population Provided with Enhanced Diagnosis of Symptomatic Disease  

Microsoft Academic Search

BackgroundDirectly observed treatment short course (DOTS), the global control strategy aimed at controlling tuberculosis (TB) transmission through prompt diagnosis of symptomatic smear-positive disease, has failed to prevent rising tuberculosis incidence rates in Africa brought about by the HIV epidemic. However, rising incidence does not necessarily imply failure to control tuberculosis transmission, which is primarily driven by prevalent infectious disease. We

Elizabeth L. Corbett; Tsitsi Bandason; Yin Bun Cheung; Shungu Munyati; Peter Godfrey-Faussett; Richard Hayes; Gavin Churchyard; Anthony Butterworth; Peter Mason

2007-01-01

100

CD209 Genetic Polymorphism and Tuberculosis Disease  

PubMed Central

Background Tuberculosis causes significant morbidity and mortality worldwide, especially in sub-Saharan Africa. DC-SIGN, encoded by CD209, is a receptor capable of binding and internalizing Mycobacterium tuberculosis. Previous studies have reported that the CD209 promoter single nucleotide polymorphism (SNP)-336A/G exerts an effect on CD209 expression and is associated with human susceptibility to dengue, HIV-1 and tuberculosis in humans. The present study investigates the role of the CD209 -336A/G variant in susceptibility to tuberculosis in a large sample of individuals from sub-Saharan Africa. Methods and Findings A total of 2,176 individuals enrolled in tuberculosis case-control studies from four sub-Saharan Africa countries were genotyped for the CD209 -336A/G SNP (rs4804803). Significant overall protection against pulmonary tuberculosis was observed with the -336G allele when the study groups were combined (n?=?914 controls vs. 1262 cases, Mantel-Haenszel 2x2 ?2?=?7.47, P?=?0.006, odds ratio?=?0.86, 95%CI 0.77–0.96). In addition, the patients with -336GG were associated with a decreased risk of cavitory tuberculosis, a severe form of tuberculosis disease (n?=?557, Pearson's 2×2 ?2?=?17.34, P?=?0.00003, odds ratio?=?0.42, 95%CI 0.27–0.65). This direction of association is opposite to a previously observed result in a smaller study of susceptibility to tuberculosis in a South African Coloured population, but entirely in keeping with the previously observed protective effect of the -336G allele. Conclusion This study finds that the CD209 -336G variant allele is associated with significant protection against tuberculosis in individuals from sub-Saharan Africa and, furthermore, cases with -336GG were significantly less likely to develop tuberculosis-induced lung cavitation. Previous in vitro work demonstrated that the promoter variant -336G allele causes down-regulation of CD209 mRNA expression. Our present work suggests that decreased levels of the DC-SIGN receptor may therefore be protective against both clinical tuberculosis in general and cavitory tuberculosis disease in particular. This is consistent with evidence that Mycobacteria can utilize DC-SIGN binding to suppress the protective pro-inflammatory immune response.

Vannberg, Fredrik O.; Tosh, Kerrie; Floyd, Sian; Jackson-Sillah, Dolly; Crampin, Amelia; Sichali, Lifted; Bah, Boubacar; Gustafson, Per; Aaby, Peter; McAdam, Keith P. W. J.; Bah-Sow, Oumou; Lienhardt, Christian; Sirugo, Giorgio; Fine, Paul; Hill, Adrian V. S.

2008-01-01

101

A Mycobacterium tuberculosis cluster demonstrating the use of genotyping in urban tuberculosis control  

PubMed Central

Background DNA fingerprinting of Mycobacterium tuberculosis isolates offers better opportunities to study links between tuberculosis (TB) cases and can highlight relevant issues in urban TB control in low-endemic countries. Methods A medium-sized molecular cluster of TB cases with identical DNA fingerprints was used for the development of a visual presentation of epidemiologic links between cases. Results Of 32 cases, 17 (53%) were linked to the index case, and 11 (34%) to a secondary case. The remaining four (13%) could not be linked and were classified as possibly caused by the index patient. Of the 21 cases related to the index case, TB developed within one year of the index diagnosis in 11 patients (52%), within one to two years in four patients (19%), and within two to five years in six patients (29%). Conclusion Cluster analysis underscored several issues for TB control in an urban setting, such as the recognition of the outbreak, the importance of reinfections, the impact of delayed diagnosis, the contribution of pub-related transmissions and its value for decision-making to extend contact investigations. Visualising cases in a cluster diagram was particularly useful in finding transmission locations and the similarities and links between patients.

2009-01-01

102

[Tuberculosis treatment in adults].  

PubMed

The quadritherapy by isoniazid, rifampicin, pyrazinamide and ethambutol, is still the gold standard for the treatment of tuberculosis disease. Except for severe presentations, the treatment remains based on a 6 months therapy with a 2 months induction phase. During the first health care contact, looking for an immunosupression and risk factors of hepatotoxicity and multiresistant strains is necessary. A close supervision by medical staff is recommended during all treatment duration. Rifampicin expose to drug interactions. In France, once the diagnosis is made, the referent practitioner and the biologist must notify the case to the local Health Authorities which is in charge of finding and treat, if needed, the newly infected case contacts. In order to prevent transmission, a respiratory isolation must be performed for smear positive patients. In case of renal or hepatic previous impairment, a multidisciplinary and closely supervision is recommended. Treatment of extensively and multi drug resistant (MDR) tuberculosis is based on combination of 2nd line drugs, and a prolonged treatment is advised. Expert supervision is necessary for case management. PMID:22641888

Gatey, Caroline; Bouvet, Elisabeth

2012-04-01

103

A Refined Symptom-Based Approach to Diagnose Pulmonary Tuberculosis in Children  

Microsoft Academic Search

BACKGROUND.Tuberculosis control programs place an almost exclusive emphasis on adults with sputum smear-positive tuberculosis, because they are most infectious. However, children contribute a significant proportion of the global tuberculosis caseload and experience considerable tuberculosis-related morbidity and mortal- ity, but few children in endemic areas have access to antituberculosis treatment. The diagnostic difficulty experienced in endemic areas with limited resources has

Ben J. Marais; Robert P. Gie; Anneke C. Hesseling; H. Simon Schaaf; Carl Lombard; Donald A. Enarson

104

Identification of T-Cell Antigens Specific for Latent Mycobacterium Tuberculosis Infection  

Microsoft Academic Search

BackgroundT-cell responses against dormancy-, resuscitation-, and reactivation-associated antigens of Mycobacterium tuberculosis are candidate biomarkers of latent infection in humans.Methodology\\/Principal FindingsWe established an assay based on two rounds of in vitro restimulation and intracellular cytokine analysis that detects T-cell responses to antigens expressed during latent M. tuberculosis infection. Comparison between active pulmonary tuberculosis (TB) patients and healthy latently M. tuberculosis-infected donors

Sebastian D. Schuck; Henrik Mueller; Frank Kunitz; Albert Neher; Harald Hoffmann; Kees L. C. M. Franken; Dirk Repsilber; Tom H. M. Ottenhoff; Stefan H. E. Kaufmann; Marc Jacobsen; Derya Unutmaz

2009-01-01

105

[Thinking about tuberculosis in Osaka City].  

PubMed

The incidence rate of tuberculosis in Osaka City (104.2 per 100,000 population) is extremely high, namely 3 times higher than the national average. Why the tuberculosis situation of Osaka City is so bad? The reason could be summarized as follows: Before the end of the World War II (1945), it was the sequelae of high prevalence observed in the era of Meiji, Taisho and early years of Showa. However, after the World War II, especially from the Heisei era (1989-), it is deeply affected by the influence of socio-economic background in Japan. Osaka City is characterized as the city of merchants and small enterprises. And therefore, the city substantially has the nature of the locality that brings in or produces some kinds of social vulnerability such as temporary laborers and homeless people. Of the tuberculosis patients in Osaka City, about 20% are homeless. In addition, patients of the smear positive infectious tuberculosis are often discovered among temporary laborers who change their residences and job sites from place to place and contact widely with citizens. These two are the most difficult problems in tuberculosis control program of Osaka City. In the meantime, there are many citizens who are careless of their health and do not follow the law or social rule, and this has apparently no direct connection with the problems of tuberculosis. However, it might be one of the factors of an undesirable trend of tuberculosis in Osaka City. In order to improve such a unfavorable tuberculosis situation in Osaka City, effective and strong supporting activities to the tuberculosis program are essentially needed. And these activities must be done from the standpoint of health-promotion, namely, health education for citizens and improvement of social environmental conditions to maintain healthy and cultural life. PMID:11201140

Kameda, K

2000-12-01

106

Drug-resistant tuberculosis: controversies and challenges in pediatrics.  

PubMed

Tuberculosis remains one of the top two causes of death caused by a single infectious disease worldwide, despite curative therapy. Children with tuberculosis are especially difficult to detect, since acid fast bacilli smears and cultures are usually negative and clinical signs are nonspecific or lacking. Multidrug-resistant tuberculosis, or tuberculosis resistant to at least isoniazid and rifampin, has emerged in most areas of the world over the past 20 years. Treatment of multidrug-resistant tuberculosis is more expensive and difficult. The second-line tuberculosis medications required for treatment are more toxic and less efficacious than standard treatment. These medications are not readily available in many areas of the world where drug resistance is most common. Fluoroquinolones are one of the most promising classes of second-line medications, but are not generally recommended for use in children. Ethambutol is recommended in the initial treatment of tuberculosis in children treated in areas where there is a risk of drug-resistant disease and the susceptibility of the source case is not known. Some experts have been hesitant to use ethambutol due to the risk of visual impairment associated with the drug and the difficulties in monitoring vision in young children. Pediatric drug formulations are not available for most antituberculosis medications, even the first-line tuberculosis drugs. Treatment of children exposed, infected or ill with multidrug-resistant tuberculosis is reviewed with special emphasis on second-line drugs, including recommended dosage, available formulations and necessary monitoring. While new cases of multidrug-resistant tuberculosis have decreased in most developed countries over the past 10 years, cases continue to increase in many developing countries and among immigrants from high-risk areas. Tuberculosis and multidrug-resistant tuberculosis are serious threats requiring worldwide strategies to control and treat. Better diagnostic tests, medications, public health strategies and vaccines will all be needed to eliminate tuberculosis. PMID:16307511

Smith, Kim Connelly; Seaworth, Barbara J

2005-12-01

107

Improved tuberculosis infection control practices in Maryland acute care hospitals  

Microsoft Academic Search

Background: In 1992 and 1993, the Maryland Hospital Association and the Maryland Department of Health and Mental Hygiene conducted 2 surveys of tuberculosis prevention practices in Maryland hospitals that showed poor compliance with the 1990 Centers for Disease Control and Prevention's guidelines for preventing transmission of tuberculosis in health care facilities.Objective: The objective of this study was to assess compliance

Elizabeth P. Fuss; Ebenezer Israel; Nancy Baruch; Mary-Claire Roghmann

2000-01-01

108

DNA Fingerprint Changes in Tuberculosis: Reinfection, Evolution, or Laboratory Error?  

Microsoft Academic Search

3 Karonga Prevention Study, Chilumba, Malawi Background. DNA fingerprint patterns of Mycobacterium tuberculosis strains vary within individuals and between epidemiologically linked individuals because of pattern evolution, new infections, and laboratory error. We explored the importance of these factors. Methods. Cultures from individuals in northern Malawi who had been diagnosed with tuberculosis (TB) during 1996-2001 were fingerprinted with restriction fragment-length polymorphism

Sian Floyd; Caroline Murphy

2004-01-01

109

Pulmonary impairment after tuberculosis and its contribution to TB burden  

Microsoft Academic Search

BACKGROUND: The health impacts of pulmonary impairment after tuberculosis (TB) treatment have not been included in assessments of TB burden. Therefore, previous global and national TB burden estimates do not reflect the full consequences of surviving TB. We assessed the burden of TB including pulmonary impairment after tuberculosis in Tarrant County, Texas using Disability-adjusted Life Years (DALYs). METHODS: TB burden

Jotam G Pasipanodya; Scott JN McNabb; Peter Hilsenrath; Sejong Bae; Kristine Lykens; Edgar Vecino; Guadalupe Munguia; Thaddeus L Miller; Gerry Drewyer; Stephen E Weis

2010-01-01

110

Clinical presentation of abdominal tuberculosis in HIV seronegative adults  

Microsoft Academic Search

BACKGROUND: The accurate diagnosis of abdominal tuberculosis usually takes a long time and requires a high index of suspicion in clinic practice. Eighty-eight immune-competent patients with abdominal tuberculosis were grouped according to symptoms at presentation and followed prospectively in order to investigate the effect of symptomatic presentation on clinical diagnosis and prognosis. METHODS: Based upon the clinical presentation, the patients

Cengiz Bolukbas; Fusun F Bolukbas; Tulin Kendir; Remzi A Dalay; Nihat Akbayir; Mehmet H Sokmen; Ali T Ince; Mithat Guran; Erkan Ceylan; Guray Kilic; Oya Ovunc

2005-01-01

111

Bayesian mapping of pulmonary tuberculosis in Antananarivo, Madagascar  

Microsoft Academic Search

BACKGROUND: Tuberculosis (TB), an infectious disease caused by the Mycobacterium tuberculosis is endemic in Madagascar. The capital, Antananarivo is the most seriously affected area. TB had a non-random spatial distribution in this setting, with clustering in the poorer areas. The aim of this study was to explore this pattern further by a Bayesian approach, and to measure the associations between

Rindra V Randremanana; Vincent Richard; Fanjasoa Rakotomanana; Philippe Sabatier; Dominique J Bicout

2010-01-01

112

Risk factors for tuberculosis  

Microsoft Academic Search

Risk factors for tuberculosis. P.D.O. Davies. The risk of developing tuberculosis is dependent on both the risk of being infected and the risk of infection lead- ing on to active disease. The former will depend on the inci- dence of tuberculosis in the community where the individual lives or works. The latter will depend on many factors im- pinging on

P. D. O. Davies

2005-01-01

113

Tuberculosis of the cuneiform  

Microsoft Academic Search

A case report discusses the presentation, diagnosis and treatment of a 22-year-old male who presented with extra-pulmonary tuberculosis of the foot involving the cuneiform bones. Tuberculosis of the foot is extremely rare and accounts for less than 10% of ostearticular tuberculosis. Radiographic and MRI correlations are introduced.

J. Terrence Jose Jerome; Mathew Varghese; Balu Sankaran

2007-01-01

114

Parasite remains in archaeological sites.  

PubMed

Organic remains can be found in many different environments. They are the most significant source for paleoparasitological studies as well as for other paleoecological reconstruction. Preserved paleoparasitological remains are found from the driest to the moistest conditions. They help us to understand past and present diseases and therefore contribute to understanding the evolution of present human sociality, biology, and behavior. In this paper, the scope of the surviving evidence will be briefy surveyed, and the great variety of ways it has been preserved in different environments will be discussed. This is done to develop to the most appropriated techniques to recover remaining parasites. Different techniques applied to the study of paleoparasitological remains, preserved in different environments, are presented. The most common materials used to analyze prehistoric human groups are reviewed, and their potential for reconstructing ancient environment and disease are emphasized. This paper also urges increased cooperation among archaeologists, paleontologists, and paleoparasitologists. PMID:12687762

Bouchet, Françoise; Guidon, Niéde; Dittmar, Katharina; Harter, Stephanie; Ferreira, Luiz Fernando; Chaves, Sergio Miranda; Reinhard, Karl; Araújo, Adauto

2003-01-01

115

The Decomposition of Human Remains  

Microsoft Academic Search

The end result of decomposition of humans is more intimately familiar and perhaps of greater interest to forensic pathologists\\u000a than to any other group whose duties include the evaluation and investigation of postmortem remains on a routine basis. From\\u000a such remains, the forensic pathologist may be asked to make an evaluation of the cause and manner of death and, perhaps,

Robert H. Powers

116

Background Information  

Center for Biologics Evaluation and Research (CBER)

Text VersionPage 1. Background Information ... These have been labeled to remove fluid from patients suffering from volume overload. ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

117

A Critical Role for CD8 T Cells in a Nonhuman Primate Model of Tuberculosis  

PubMed Central

The role of CD8 T cells in anti-tuberculosis immunity in humans remains unknown, and studies of CD8 T cell–mediated protection against tuberculosis in mice have yielded controversial results. Unlike mice, humans and nonhuman primates share a number of important features of the immune system that relate directly to the specificity and functions of CD8 T cells, such as the expression of group 1 CD1 proteins that are capable of presenting Mycobacterium tuberculosis lipids antigens and the cytotoxic/bactericidal protein granulysin. Employing a more relevant nonhuman primate model of human tuberculosis, we examined the contribution of BCG- or M. tuberculosis-elicited CD8 T cells to vaccine-induced immunity against tuberculosis. CD8 depletion compromised BCG vaccine-induced immune control of M. tuberculosis replication in the vaccinated rhesus macaques. Depletion of CD8 T cells in BCG-vaccinated rhesus macaques led to a significant decrease in the vaccine-induced immunity against tuberculosis. Consistently, depletion of CD8 T cells in rhesus macaques that had been previously infected with M. tuberculosis and cured by antibiotic therapy also resulted in a loss of anti-tuberculosis immunity upon M. tuberculosis re-infection. The current study demonstrates a major role for CD8 T cells in anti-tuberculosis immunity, and supports the view that CD8 T cells should be included in strategies for development of new tuberculosis vaccines and immunotherapeutics.

Wang, Richard C.; Shen, Ling; Zeng, Gucheng; Yao, Shuyun; Shen, Yun; Halliday, Lisa; Fortman, Jeff; McAllister, Milton; Estep, Jim; Hunt, Robert; Vasconcelos, Daphne; Du, George; Porcelli, Steven A.; Larsen, Michelle H.; Jacobs, William R.; Haynes, Barton F.; Letvin, Norman L.; Chen, Zheng W.

2009-01-01

118

Tuberculosis and nutrition  

PubMed Central

Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. These two problems tend to interact with each other. Tuberculosis mortality rates in different economic groups in a community tend to vary inversely with their economic levels. Similarly, nutritional status is significantly lower in patients with active tuberculosis compared with healthy controls. Malnutrition can lead to secondary immunodeficiency that increases the host's susceptibility to infection. In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis. It has been found that malnourished tuberculosis patients have delayed recovery and higher mortality rates than well-nourished patients. Nutritional status of patients improves during tuberculosis chemotherapy. High prevalence of human immunodeficiency (HIV) infection in the underdeveloped countries further aggravates the problem of malnutrition and tuberculosis. Effect of malnutrition on childhood tuberculosis and tuberculin skin test are other important considerations. Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world.

Gupta, Krishna Bihari; Gupta, Rajesh; Atreja, Atulya; Verma, Manish; Vishvkarma, Suman

2009-01-01

119

Content and Access Remain Key  

ERIC Educational Resources Information Center

|It is impossible to review the year's outstanding government publication landscape without acknowledging that change remains paramount. Just as striking, however, is that these changes go hand in hand with some familiar constants. Within this shifting environment, there are the consistency and dependability of government information itself,…

Johnson, Linda B.

2007-01-01

120

Biological Background  

Microsoft Academic Search

Drug resistance of human tumors to a variety of chemotherapeutic agents remains the major cause of cancer treatment failure.\\u000a Although multiple mechanisms of drug resistance may occur in parallel or sequentially at all different levels of drug action,\\u000a one resistance mechanism was identified within the last two decades that very likely represents the most frequent cause for\\u000a the development of

Ulrike S. Stein; Wolfgang Walther; Peter M. Schlag

121

The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system -a multiple case study  

PubMed Central

Background Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. Methods We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. Results The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Conclusion Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human resources, HIS and technical capacity of DHs indicates that the NTCP supports, rather than strengthens, the local health system. Moreover, there is potential for this support to be enhanced. Positive synergies between the NTCP and district health systems can be achieved if opportunities to strengthen the district health system are seized. The question remains, however, of why managers do not take advantage of the opportunities to strengthen the health system.

2013-01-01

122

Multispacer Sequence Typing for Mycobacterium tuberculosis Genotyping  

PubMed Central

Background Genotyping methods developed to survey the transmission dynamics of Mycobacterium tuberculosis currently rely on the interpretation of restriction and amplification profiles. Multispacer sequence typing (MST) genotyping is based on the sequencing of several intergenic regions selected after complete genome sequence analysis. It has been applied to various pathogens, but not to M. tuberculosis. Methods and Findings In M. tuberculosis, the MST approach yielded eight variable intergenic spacers which included four previously described variable number tandem repeat loci, one single nucleotide polymorphism locus and three newly evaluated spacers. Spacer sequence stability was evaluated by serial subculture. The eight spacers were sequenced in a collection of 101 M. tuberculosis strains from five phylogeographical lineages, and yielded 29 genetic events including 13 tandem repeat number variations (44.82%), 11 single nucleotide mutations (37.93%) and 5 deletions (17.24%). These 29 genetic events yielded 32 spacer alleles or spacer-types (ST) with an index of discrimination of 0.95. The distribution of M. tuberculosis isolates into ST profiles correlated with their assignment into phylogeographical lineages. Blind comparison of a further 93 M. tuberculosis strains by MST and restriction fragment length polymorphism-IS6110 fingerprinting and mycobacterial interspersed repetitive units typing, yielded an index of discrimination of 0.961 and 0.992, respectively. MST yielded 41 different profiles delineating 16 related groups and proved to be more discriminatory than IS6110-based typing for isolates containing <8 IS6110 copies (P<0.0003). MST was successfully applied to 7/10 clinical specimens exhibiting a Cts ? 42 cycles in internal transcribed spacer-real time PCR. Conclusions These results support MST as an alternative, sequencing-based method for genotyping low IS6110 copy-number M. tuberculosis strains. The M. tuberculosis MST database is freely available (http://ifr48.timone.univ-mrs.fr/MST_MTuberculosis/mst).

Djelouadji, Zoheira; Arnold, Catherine; Gharbia, Saheer; Raoult, Didier; Drancourt, Michel

2008-01-01

123

Community Coauthoring: Whose Voice Remains?  

ERIC Educational Resources Information Center

This article examines how texts are collaboratively produced in community development work when coauthors come from multiple racial, ethnic, and class backgrounds as well as business and other work experiences. We found that the term "wordsmithing" became a discursive tool that limited resident input and shaped the Plan toward an external…

Larson, Joanne; Webster, Stephanie; Hopper, Mindy

2011-01-01

124

Dinosaur Remains Found in Oregon  

NSDL National Science Digital Library

Two amateur paleontologists kept their eyes to the ground in Oregon on one of their recent hikes and discovered what are believed to be the first remains of a marine reptile called the plesiosaur to be unearthed in the Pacific Northwest. This radio broadcast reports on the discovery and what it could mean to the understanding of dinosaurs in the area. The clip is 5 minutes and 6 seconds in length.

125

Influenza Virus NS Vectors Expressing the Mycobacterium tuberculosis ESAT-6 Protein Induce CD4+ Th1 Immune Response and Protect Animals against Tuberculosis Challenge  

PubMed Central

Infection with Mycobacterium tuberculosis remains a major cause of morbidity and mortality all over the world. Since the effectiveness of the only available tuberculosis vaccine, Mycobacterium bovis bacillus Calmette-Guérin (BCG), is suboptimal, there is a strong demand to develop new tuberculosis vaccines. As tuberculosis is an airborne disease, the intranasal route of vaccination might be preferable. Live influenza virus vaccines might be considered as potential vectors for mucosal immunization against various viral or bacterial pathogens, including M. tuberculosis. We generated several subtypes of attenuated recombinant influenza A viruses expressing the 6-kDa early secretory antigenic target protein (ESAT-6) of M. tuberculosis from the NS1 reading frame. We were able to demonstrate the potency of influenza virus NS vectors to induce an M. tuberculosis-specific Th1 immune response in mice. Moreover, intranasal immunization of mice and guinea pigs with such vectors induced protection against mycobacterial challenge, similar to that induced by BCG vaccination.

Sereinig, Sabine; Stukova, Marina; Zabolotnyh, Natalia; Ferko, Boris; Kittel, Christian; Romanova, Julia; Vinogradova, Tatiana; Katinger, Hermann; Kiselev, Oleg; Egorov, Andrej

2006-01-01

126

Tuberculosis Facts - Testing for TB  

MedlinePLUS

... STD, and TB Prevention Division of Tuberculosis Elimination Tuberculosis (TB) Facts Testing for TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ...

127

Tuberculosis in the lung (image)  

MedlinePLUS

Tuberculosis is caused by a group of organisms Mycobacterium tuberculosis, M. bovis, M. africanum and a few other rarer subtypes. Tuberculosis usually appears as a lung (pulmonary) infection. However, ...

128

Tuberculosis Facts - Exposure to TB  

MedlinePLUS

... STD, and TB Prevention Division of Tuberculosis Elimination Tuberculosis (TB) Facts Exposure to TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ...

129

Social scientists and the new tuberculosis  

Microsoft Academic Search

In much of the world, tuberculosis (TB) remains the leading killer of young adults, in spite of the fact that effective chemotherapy has existed for 50 years. The epidemiology of TB, with its persistence in poor countries and resurgence among the poor of many industrialized nations, causes consternation among those charged with protecting the public's health. Two factors, ostensibly biological

Paul Farmer

1997-01-01

130

Childhood tuberculosis and malnutrition.  

PubMed

Despite the burden of both malnutrition and tuberculosis in children worldwide, there are few studies on the mechanisms that underlie this relationship. From available research, it appears that malnutrition is a predictor of tuberculosis disease and is associated with worse outcomes. This is supported through several lines of evidence, including the role of vitamin D receptor genotypes, malnutrition's effects on immune development, respiratory infections among malnourished children, and limited work specifically on pediatric tuberculosis and malnutrition. Nutritional supplementation has yet to suggest significant benefits on the course of tuberculosis in children. There is a critical need for research on childhood tuberculosis, specifically on how nutritional status affects the risk and progression of tuberculosis and whether nutritional supplementation improves clinical outcomes or prevents disease. PMID:23033147

Jaganath, Devan; Mupere, Ezekiel

2012-10-02

131

Mycobacterium tuberculosis septum site determining protein, Ssd encoded by rv3660c , promotes filamentation and elicits an alternative metabolic and dormancy stress response  

Microsoft Academic Search

Background  Proteins that are involved in regulation of cell division and cell cycle progression remain undefined in Mycobacterium tuberculosis. In addition, there is a growing appreciation that regulation of cell replication at the point of division is important in\\u000a establishing a non-replicating persistent state. Accordingly, the objective of this study was to use a systematic approach\\u000a consisting of consensus-modeling bioinformatics, ultrastructural

Kathleen England; Rebecca Crew; Richard A Slayden

2011-01-01

132

Tuberculosis in HIV-Negative and HIV-Infected Patients in a Low-Incidence Country: Clinical Characteristics and Treatment Outcomes  

Microsoft Academic Search

BackgroundIn Switzerland and other developed countries, the number of tuberculosis (TB) cases has been decreasing for decades, but HIV-infected patients and migrants remain risk groups. The aim of this study was to compare characteristics of TB in HIV-negative and HIV-infected patients diagnosed in Switzerland, and between coinfected patients enrolled and not enrolled in the national Swiss HIV Cohort Study (SHCS).Methods

Lukas Fenner; Sebastien Gagneux; Jean-Paul Janssens; Jan Fehr; Matthias Cavassini; Matthias Hoffmann; Enos Bernasconi; Jacques Schrenzel; Thomas Bodmer; Erik C. Böttger; Peter Helbling; Matthias Egger

2012-01-01

133

Molecular Epidemiology, Drug Susceptibility and Economic Aspects of Tuberculosis in Mubende District, Uganda  

PubMed Central

Background Tuberculosis (TB) remains a global public health problem whose effects have major impact in developing countries like Uganda. This study aimed at investigating genotypic characteristics and drug resistance profiles of Mycobacterium tuberculosis isolated from suspected TB patients. Furthermore, risk factors and economic burdens that could affect the current control strategies were studied. Methods TB suspected patients were examined in a cross-sectional study at the Mubende regional referral hospital between February and July 2011. A questionnaire was administered to each patient to obtain information associated with TB prevalence. Isolates of M. tuberculosis recovered during sampling were examined for drug resistance to first line anti-TB drugs using the BACTEC-MGIT960TMsystem. All isolates were further characterized using deletion analysis, spoligotyping and MIRU-VNTR analysis. Data were analyzed using different software; MIRU-VNTR plus, SITVITWEB, BioNumerics and multivariable regression models. Results M. tuberculosis was isolated from 74 out of 344 patients, 48 of these were co-infected with HIV. Results from the questionnaire showed that previously treated TB, co-infection with HIV, cigarette smoking, and overcrowding were risk factors associated with TB, while high medical related transport bills were identified as an economic burden. Out of the 67 isolates that gave interpretable results, 23 different spoligopatterns were detected, nine of which were novel patterns. T2 with the sub types Uganda-I and Uganda-II was the most predominant lineage detected. Antibiotic resistance was detected in 19% and multidrug resistance was detected in 3% of the isolates. Conclusion The study detected M. tuberculosis from 21% of examined TB patients, 62% of whom were also HIV positive. There is a heterogeneous pool of genotypes that circulate in this area, with the T2 lineage being the most predominant. High medical related transport bills and drug resistance could undermine the usefulness of the current TB strategic interventions.

Muwonge, Adrian; Malama, Sydney; Johansen, Tone B.; Kankya, Clovice; Biffa, Demelash; Ssengooba, Willy; Godfroid, Jacques; Dj?nne, Berit; Skjerve, Eystein

2013-01-01

134

Silica, silicosis and tuberculosis.  

PubMed

Exposure to crystalline silica dust causes multiple diseases, but silicosis and silica dust-associated tuberculosis (TB), in particular, are the two diseases that remain high on the list of occupational health priorities in low-income countries and that still occur in some high-income countries. The prevalence of silica-related TB is exacerbated by the human immunodeficiency virus (HIV) epidemic in low-income countries. This review describes the morphology of silica and the variable potency of the different forms. Sources of crystalline silica are discussed, with emphasis on less commonly recognised sources, such as small-scale mining operations and agriculture. Trends in the prevalence of silicosis are also presented. Although efforts have been made for many years in most countries to reduce silica dust levels, silicosis continues to occur even in young people. The clinical and pathological features and diagnosis of silicosis, with emphasis on chest radiography, are described. The high risk of mycobacterial infection in silica-exposed individuals is given particular attention, with emphasis on control. Treatment for latent TB is recommended. The management of silicosis and silica-associated TB, including monitoring for early detection of disease and surveillance to identify disease-causing workplaces, are discussed in detail. Prevention of disease, in the form of dust control, remains the focus of the World Health Organization and International Labour Office Global Elimination of Silicosis Campaign. However, clinicians must be aware that silica-associated diseases will be around for many years to come. PMID:17439668

Rees, D; Murray, J

2007-05-01

135

[Tuberculosis: yesterday, today, tomorrow].  

PubMed

The historical aspects of phisiology are briefly outlined. The main factors that promote the prevalence of tuberculosis are characterized. The present-day tuberculosis epidemiological situation makes one to correct antituberculous measures and with the use of new investigations and developments to improve the identification of patients with tuberculosis, primarily those with contagious types of the disease, to introduce the currently available short-term regimens of 2-stage drug therapy, to design novel agents and depot formulations of the well known ones. Further investigations are required to search for a new tuberculosis vaccine. PMID:9503920

Khomenko, A G

1997-01-01

136

Treatment of childhood tuberculosis.  

PubMed

The aim of tuberculosis treatment is to cure the individual patient with antituberculosis drugs (ATT) in a short time without emergence of drug resistance. The anti tuberculosis drugs are selected in a combination to attack all the subpopulations of tubercle bacilli with first line drugs which include isoniazid, rifampicin, pyrazinamide, and ethambutol. Intermittent ATT regimens have been documented to be as effective as daily regimen. World Health Organization (WHO) has suggested a category based treatment of tuberculosis given in two phases, intensive phase and continuation phase. As per WHO, Revised National Tuberculosis Control Programme (RNTCP) recommends directly observed therapy short course strategy (DOTS) for the treatment of both adult and pediatric tuberculosis. In DOTS the patient is asked to swallow ATT under the direct observation of health personnel. Drug dosage for daily and intermittent therapy varies. To simplify the prescription, fixed drug combination (FDC) and patient-wise boxes (PWB) are available under RNTCP, free of cost. Each patient's management plan should be individualized to incorporate measures that facilitate adherence. The knowledge of drug resistant tuberculosis, HIV-related tuberculosis, and latent tuberculosis infection are the areas that need to be updated. Private practioners may play a significant role by referring the children with tuberculosis to the DOTS centers early which will not only benefit the affected family but also the society. PMID:21049292

Vijayasekaran, D

2010-10-29

137

Psychotherapy Improves Compliance with Tuberculosis Treatment  

Microsoft Academic Search

Background: Low treatment completion rate in tuberculosis (TB) patients is a major concern. Physicians have always been striving for better treatment adherence in such patients. The present study is one such attempt in this direction. Objectives: The study was aimed to evaluate the role of behavior modification by psychotherapy in improving compliance with short-course anti-TB chemotherapy in India. Methods: It

A. K. Janmeja; S. K. Das; R. Bhargava; B. S. Chavan

2005-01-01

138

Paleopathology of Human Tuberculosis and the Potential Role of Climate  

PubMed Central

Both origin and evolution of tuberculosis and its pathogens (Mycobacterium tuberculosis complex) are not fully understood. The paleopathological investigation of human remains offers a unique insight into the molecular evolution and spread including correlative data of the environment. The molecular analysis of material from Egypt (3000–500 BC), Sudan (200–600 AD), Hungary (600–1700 AD), Latvia (1200–1600 AD), and South Germany (1400–1800 AD) urprisingly revealed constantly high frequencies of tuberculosis in all different time periods excluding significant environmental influence on tuberculosis spread. The typing of various mycobacteria strains provides evidence for ancestral M. tuberculosis strains in Pre- to early Egyptian dynastic material (3500–2650 BC), while typical M. africanum signatures were detected in a Middle Kingdom tomb (2050–1650 BC). Samples from the New Kingdom to Late Period (1500–500 BC) indicated modern M. tuberculosis strains. No evidence was seen for M. bovis in Egyptian material while M. bovis signatures were first identified in Siberian biomaterial dating 2000 years before present. These results contraindicates the theory that M. tuberculosis evolved from M. bovis during early domestication in the region of the “Fertile Crescent,” but supports the scenario that M. tuberculosis probably derived from an ancestral progenitor strain. The environmental influence of this evolutionary scenario deserves continuing intense evaluation.

Nerlich, Andreas G.; Losch, Sandra

2009-01-01

139

Tuberculosis among American Indians of the contiguous United States.  

PubMed Central

Paleopathologic findings provide strong evidence for the existence of tuberculosis in Andean populations of pre-Columbian America. Indirect evidence is available also to suggest its possible endemicity among some American Indian tribes who lived within the present-day contiguous United States before the arrival of Europeans. The available data suggest that tuberculosis became a major health problem in some tribes with increased population density and cultural changes after increased contact with European civilization, paralleling the deterioration in living conditions after relocation of the tribes to reservations. By 1900, tuberculosis had become one of the most serious health problems among North American Indians. Tuberculosis control was hampered by the lack of a specific treatment, and only the advent of specific chemotherapy in an ambulatory setting brought a breakthrough. Mortality, morbidity, and risk of infection have all sharply decreased over the past three decades. However, tuberculosis incidence rates among American Indians remain well above rates in the white population. An intensified effort to identify those with tuberculosis and those at risk of tuberculosis as well as to develop compliance-enhancing strategies with treatment regimens will be necessary to eliminate tuberculosis from Indian reservations.

Rieder, H L

1989-01-01

140

American Experience: We Shall Remain  

NSDL National Science Digital Library

Whether watching their TV shows on television or on the computer, PBS always provides a worthy presentation. With an extensive collection of PBS programs available online, the number of topics they cover be fully appreciated. The American Experience series titled "We Shall Remain" consists of five episodes "spanning three hundred years [that] tell the story of pivotal moments in U.S. history from the Native American perspective." The "Reel Native" and "Beyond Broadcast" tabs offer Native Americans telling their experiences and also provide activities for teachers. In addition to viewing the full episodes online, visitors to the website can go "Behind the Scenes" by clicking that tab, and can see such features as the "cast and crew", "featured videos", and "photo gallery". Furthermore, the "Get Involved" part of "Behind the Scenes" informs visitors of "native organizations and tribes, libraries, historical societies, museums, schools and other groups to plan and sponsor activities that promote understanding of local Native history and contemporary life." This area also provides an interactive map that allows a visitor to plot "shoot locations", "tribal colleges", "coalitions", and "native radio stations", by clicking on each corresponding tab.

141

Immunotherapeutical potential of Mycobacterium vaccae on M. tuberculosis infection in mice.  

PubMed

Tuberculosis remains the worldwide infectious disease. To identify the therapeutic potential of M. vaccae in treating tuberculosis, M. vaccae was injected into Mycobacterium tuberculosis (M. tuberculosis) infected mice. The optimal dose of M. vaccae (22.5 microg/mouse) treated mice showed lower pathological change index, spleen weight index, lung weight index and vital M. tuberculosis count than those of the untreated group. Treatment with M. vaccae enhanced the percentages of CD3+ and CD4+ T cells, IFN-gamma+CD4+ T cells, innate immune cells including NK cells, NK1.1+ T cells and gammadeltaT cells, and reduced the percentage of IL-4+CD4+ T cells. Therefore, M. vaccae could protect the mice from M. tuberculosis infection and improve mouse innate and adaptive cell-mediated immunity, suggesting that M. vaccae is a potential immunotherapeutic agent in pulmonary tuberculosis. PMID:19254482

Xu, Li Jun; Wang, Yan Yan; Zheng, Xiao Dong; Gui, Xiang Dong; Tao, Li Feng; Wei, Hai Ming

2009-02-01

142

Assessment of Diagnostic Techniques of Urinary Tuberculosis  

PubMed Central

Early diagnosis of active tuberculosis remains an elusive challenge. In addition, one third of the world’s population is latently infected with Mycobacterium tuberculosis (Mtb) and up to 10% of infected individuals develop tuberculosis (TB) in their lifetime. In this investigation, the incidence of urinary tuberculosis among renal patients was studied. Three hundreds urine samples were processed for detection of Mtb by Ziehl-Neelsen (ZN) smear examination, Lowenstein Jensen (LJ) medium, radiometric BACTEC460 system as well as polymerase chain reaction (PCR) followed by DNA Enzyme Immunoassay (DEIA) test. Out of 300 urine samples, 2 were positive by both ZN smears and LJ medium with incidence rate of 0.66 %, 3 positive samples by BACTEC460 culture system with incidence of 1%. PCR assay gave more positive results than smear and culture examination (i.e. 8 positive samples with incidence rate of 2.6%). The specificities were 25% for both ZN smears and LJ medium, 37.5% for BACTEC460 culture system, and 100% for PCR test, while sensitivities of all assays were 100%. Thus PCR is a rapid and sensitive method for the early diagnosis of urinary tuberculosis.

Ghaleb, Khaled; Afifi, Magdy; El-Gohary, Mohamad

2013-01-01

143

Characterization of the genetic diversity of Mycobacterium tuberculosis in S?o Paulo city, Brazil  

PubMed Central

Background Tuberculosis is a major health problem in São Paulo, Brazil, which is the most populous and one of the most cosmopolitan cities in South America. To characterize the genetic diversity of Mycobacterium tuberculosis in the population of this city, the genotyping techniques of spoligotyping and MIRU were applied to 93 isolates collected in two consecutive years from 93 different tuberculosis patients residing in São Paulo city and attending the Clemente Ferreira Institute (the reference clinic for the treatment of tuberculosis). Findings Spoligotyping generated 53 different spoligotype patterns. Fifty-one isolates (54.8%) were grouped into 13 spoligotyping clusters. Seventy- two strains (77.4%) showed spoligotypes described in the international databases (SpolDB4, SITVIT), and 21 (22.6%) showed unidentified patterns. The most frequent spoligotype families were Latin American Mediterranean (LAM) (26 isolates), followed by the T family (24 isolates) and Haarlem (H) (11 isolates), which together accounted for 65.4% of all the isolates. These three families represent the major genotypes found in Africa, Central America, South America and Europe. Six Spoligo-International-types (designated SITs by the database) comprised 51.8% (37/72) of all the identified spoligotypes (SIT53, SIT50, SIT42, SIT60, SIT17 and SIT1). Other SITs found in this study indicated the great genetic diversity of M. tuberculosis, reflecting the remarkable ethnic diversity of São Paulo city inhabitants. The MIRU technique was more discriminatory and did not identify any genetic clusters with 100% similarity among the 93 isolates. The allelic analysis showed that MIRU loci 26, 40, 23 and 10 were the most discriminatory. When MIRU and spoligotyping techniques were combined, all isolates grouped in the 13 spoligotyping clusters were separated. Conclusions Our data indicated the genomic stability of over 50% of spoligotypes identified in São Paulo and the great genetic diversity of M. tuberculosis isolates in the remaining SITs, reflecting the large ethnic mix of the São Paulo city inhabitants. The results also indicated that in this city, M. tuberculosis isolates acquired drug resistance independently of genotype and that resistance was more dependent on the selective pressure of treatment failure and the environmental circumstances of patients.

2011-01-01

144

Complex sputum microbial composition in patients with pulmonary tuberculosis  

PubMed Central

Background An increasing number of studies have implicated the microbiome in certain diseases, especially chronic diseases. In this study, the bacterial communities in the sputum of pulmonary tuberculosis patients were explored. Total DNA was extracted from sputum samples from 31 pulmonary tuberculosis patients and respiratory secretions of 24 healthy participants. The 16S rRNA V3 hyper-variable regions were amplified using bar-coded primers and pyro-sequenced using Roche 454 FLX. Results The results showed that the microbiota in the sputum of pulmonary tuberculosis patients were more diverse than those of healthy participants (p<0.05). The sequences were classified into 24 phyla, all of which were found in pulmonary tuberculosis patients and 17 of which were found in healthy participants. Furthermore, many foreign bacteria, such as Stenotrophomonas, Cupriavidus, Pseudomonas, Thermus, Sphingomonas, Methylobacterium, Diaphorobacter, Comamonas, and Mobilicoccus, were unique to pulmonary tuberculosis patients. Conclusions This study concluded that the microbial composition of the respiratory tract of pulmonary tuberculosis patients is more complicated than that of healthy participants, and many foreign bacteria were found in the sputum of pulmonary tuberculosis patients. The roles of these foreign bacteria in the onset or development of pulmonary tuberculosis shoud be considered by clinicians.

2012-01-01

145

"Tuberculosis Case Management" Training.  

ERIC Educational Resources Information Center

|The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to practice acquired skills in a simulated…

Knebel, Elisa; Kolodner, Jennifer

2001-01-01

146

Seasonality of Tuberculosis  

PubMed Central

Objectives: This study was designed to review previous studies and analyse the current knowledge and controversies related to seasonal variability of tuberculosis (TB) to examine whether TB has an annual seasonal pattern. Study Design and Methods: Systematic review of peer reviewed studies identified through literature searches using online databases belonging to PubMed and the Cochrane library with key words “Tuberculosis, Seasonal influence” and “Tuberculosis, Seasonal variation”. The search was restricted to articles published in English. The references of the identified papers for further relevant publications were also reviewed. Results: Twelve studies conducted between the period 1971 and 2006 from 11 countries/regions around the world (South Western Cameroon, South Africa, India, Hong Kong, Japan, Kuwait, Spain, UK, Ireland, Russia, and Mongolia) were reviewed. A seasonal pattern of tuberculosis with a mostly predominant peak is seen during the spring and summer seasons in all of the countries (except South Western Cameroon and Russia). Conclusions: The observation of seasonality leads to assume that the risk of transmission of M. tuberculosis does appear to be the greatest during winter months. Vitamin D level variability, indoor activities, seasonal change in immune function, and delays in the diagnosis and treatment of tuberculosis are potential stimuli of seasonal tuberculosis disease. Additionally, seasonal variation in food availability and food intake, age, and sex are important factors which can play a role in the tuberculosis notification variability. Prospective studies regarding this topic and other related subjects are highly recommended.

Fares, Auda

2011-01-01

147

Tuberculosis of the knee  

PubMed Central

Extrapulmonary manifestations of tuberculosis are reported in less than one in five cases with the knee affected in 8% after the spine and hip. We report a case of isolated highly erosive tuberculosis of the knee presenting in a previously fit Vietnamese woman. The difficulties of diagnosis, modalities of chemotherapeutic management, and surgical treatment are discussed.

Lidder, Surjit; Lang, Kathryn; Haroon, Mallick; Shahidi, Mitra; El-Guindi, Magdi

2009-01-01

148

Tuberculosis: Latency and Reactivation  

Microsoft Academic Search

Tuberculosis is a major cause of death around the world, with most of the 1.5 million deaths per year attributable to the disease occurring in developing countries. This disease is caused by Mycobacterium tuberculosis, an acid-fast bacillus that is transmitted primarily via the respiratory route. Infection occurs in the lungs, but the organism can seed any organ via hematogenous spread.

JOANNE L. FLYNN; JOHN CHAN

2001-01-01

149

The diagnosis of tuberculosis.  

PubMed

Childhood tuberculosis accounts for a significant proportion of the global tuberculosis disease burden. However, tuberculosis in children is difficult to diagnose, because disease tends to be paucibacillary and sputum samples are often not easy to obtain. The diagnosis of tuberculosis in children is traditionally based on chest radiography, tuberculin skin testing, and mycobacterial staining/culture from appropriate samples. Newer diagnostic strategies have included improved bacteriologic and molecular methods, as well as new methods for sample collection from children. Recently, immune-based diagnostics, such as the interferon-gamma release assays, have been introduced for clinical use. These tests do not offer substantial improvements in sensitivity over tuberculin skin testing for the diagnosis of active disease but may be useful in excluding false-positive tuberculin skin tests. Further research is needed to develop better diagnostic tests for tuberculosis in children. PMID:22330167

Shingadia, Delane

2012-03-01

150

[Tuberculosis Control Law of Japan: current issues and prospects of tuberculosis control plan].  

PubMed

Prevention and control measures against tuberculosis still remain a contemporary issue in Japan. In April 2005, the Tuberculosis Control Law was revised, which has newly been with particular emphasis on medical screening. However, the present law has been indicated to have issues in the fields of such as public health, human rights, and legislation. Although the Tuberculosis Control Law will be integrated into the Infectious Diseases Law on the basis of those issues, the aim of the integration of these laws are mainly for the establishment of pathogen control system to prevent biological terrorism and the accidental spread of infectious diseases and for the comprehensive control of infectious diseases based on the latest medical knowledge. In March 2006, the draft for the revised the Infectious Diseases Law was approved by the Cabinet of government. The combination of the two laws is expected to improve the program quality for the control of tuberculosis and infectious diseases but some issues remains to be resolved. This paper will review the combination of the Tuberculosis Control Law and the Infectious Diseases Law in light of what has been done, what will be intended, and what will change after the combination. PMID:17240919

Tsukahara, Tarou

2006-12-01

151

Risk Factors for Tuberculosis After Highly Active Antiretroviral Therapy Initiation in the United States and Canada: Implications for Tuberculosis Screening  

PubMed Central

Background.?Screening for tuberculosis prior to highly active antiretroviral therapy (HAART) initiation is not routinely performed in low-incidence settings. Identifying factors associated with developing tuberculosis after HAART initiation could focus screening efforts. Methods.?Sixteen cohorts in the United States and Canada contributed data on persons infected with human immunodeficiency virus (HIV) who initiated HAART December 1995–August 2009. Parametric survival models identified factors associated with tuberculosis occurrence. Results.?Of 37845 persons in the study, 145 were diagnosed with tuberculosis after HAART initiation. Tuberculosis risk was highest in the first 3 months of HAART (20 cases; 215 cases per 100000 person-years; 95% confidence interval [CI]: 131–333 per 100000 person-years). In a multivariate Weibull proportional hazards model, baseline CD4+ lymphocyte count <200, black race, other nonwhite race, Hispanic ethnicity, and history of injection drug use were independently associated with tuberculosis risk. In addition, in a piece-wise Weibull model, increased baseline HIV-1 RNA was associated with increased tuberculosis risk in the first 3 months; male sex tended to be associated with increased risk. Conclusions.?Screening for active tuberculosis prior to HAART initiation should be targeted to persons with baseline CD4 <200 lymphocytes/mm3 or increased HIV-1 RNA, persons of nonwhite race or Hispanic ethnicity, history of injection drug use, and possibly male sex.

Lau, Bryan; Zhang, Jinbing; Freeman, Aimee; Bosch, Ronald J.; Brooks, John T.; Deeks, Steven G.; French, Audrey; Gange, Stephen; Gebo, Kelly A.; John Gill, M.; Horberg, Michael A.; Jacobson, Lisa P.; Kirk, Gregory D.; Kitahata, Mari M.; Klein, Marina B.; Martin, Jeffrey N.; Rodriguez, Benigno; Silverberg, Michael J.; Willig, James H.; Eron, Joseph J.; Goedert, James J.; Hogg, Robert S.; Justice, Amy C.; McKaig, Rosemary G.; Napravnik, Sonia; Thorne, Jennifer; Moore, Richard D.

2011-01-01

152

Posterior listhesis of a lumbar vertebra in spinal tuberculosis  

Microsoft Academic Search

The management of spinal tuberculosis, especially in children, is controversial. In children, vertebral destruction is more\\u000a severe than adults because of the cartilaginous nature of their bone. Modern chemotherapy has significantly decreased mortality\\u000a in spinal tuberculosis, but morbidity remains high. Without early surgery, patients can develop severe kyphosis leading to\\u000a respiratory insufficiency, painful costopelvic impingement and paraplegia. Lumbar kyphosis results

Matthew Anthony Kirkman; Krishnamurthy Sridhar

2011-01-01

153

Characterisation of Potential Antimicrobial Targets for Tuberculosis. 1. Methionine Adenosyltransferase in Mycobacterium Tuberculosis and M. Smegmatis.  

National Technical Information Service (NTIS)

Tuberculosis remains a key concern for the Canadian Forces in its overseas deployments. As drug- resistant forms of the disease continue to spread, there is a need to discover and characterize new drug targets in the organism. The enzyme methionine adenos...

B. J. Berger M. H. Knodel

2003-01-01

154

Is Mycobacterium tuberculosis stressed out? A critical assessment of the genetic evidence  

PubMed Central

Mycobacterium tuberculosis is an obligate human intracellular pathogen which remains a major killer worldwide. A remarkable feature of M. tuberculosis infection is the ability of the pathogen to persist within the host for decades despite an impressive onslaught of stresses. In this review we seek to outline the host inflicted stresses experienced by Mycobacterium tuberculosis, the bacterial strategies used to withstand these stresses, and how this information should guide our efforts to combat this global pathogen.

Stallings, Christina L.; Glickman, Michael S.

2010-01-01

155

Evaluation of an immunochromatographic test for discrimination between Mycobacterium tuberculosis complex & non tuberculous mycobacteria in clinical isolates from extra-pulmonary tuberculosis  

PubMed Central

Background & objectives: Accurate diagnosis of tuberculosis (TB) is crucial to facilitate early treatment of the patients, and to reduce its spread. Clinical presentation of Mycobacterium tuberculosis complex (MTBC) and non tuberculous mycobacteria (NTM) may or may not be the same, but the treatment regimen is always different for both the infections. Differentiation between MTBC and NTM by routine laboratory methods is time consuming and cumbersome. This study was aimed to evaluate an immunochromatographic test (ICT), based on mouse monoclonal anti-MPT64, for simple and rapid discrimination between MTBC and NTM in clinical isolates from extra-pulmonary tuberculosis cases. Methods: A total of 800 clinical samples were collected from patients suspected to have extra-pulmonary tuberculosis. Preliminary diagnosis has been done by direct Ziehl–Neelsen (ZN) staining followed by culture in BACTEC system. A total of 150 clinical isolates, which were found positive in BD 460 TB system during September 2009 to September 2010 were selected for the screening by ICT test. p-nitro-?-acetylamino- ?-hydroxy propiophenone (NAP) test was performed for differentiation of MTBC and NTM. M. tuberculosis complex was further confirmed by IS6110 PCR of BACTEC culture positive isolates, this served as the reference method for MTBC identification and comparative evaluation of the ICT kit. Results: Of the 150 BACTEC culture positive isolates tested by ICT kit, 101 (67.3%) were found positive for MTBC and remaining 49 (32.7%) were considered as NTM. These results were further confirmed by IS6110 PCR that served as the reference method for detection of MTBC. H37Rv reference strain was taken as a control for ICT test and IS6110 PCR. The reference strain showed the presence of MPT64 antigen band in the ICT test. Similar bands were formed in 101 of 102 MTBC isolates tested, proving 99.1 per cent sensitivity and no bands were detected in 48 (100%) NTM isolates tested, proving 100 per cent specificity of the ICT kit. Interpretation & conclusions: Our findings show that ICT test can be used on direct culture positive specimens. It does not require any special equipment, is simple and less time consuming. It can easily discriminate between MTBC and NTM and thus can help in appropriate management of tuberculosis.

Maurya, Anand Kumar; Nag, Vijaya Lakshmi; Kant, Surya; Kushwaha, Ram Aawadh Singh; Kumar, Manoj; Mishra, Vikas; Rahman, W.; Dhole, Tapan N.

2012-01-01

156

Tuberculosis and subsequent risk of lung cancer in Xuanwei, China  

SciTech Connect

Tobacco and indoor air pollution from smoky coal are major causes of lung cancer in rural Xuanwei County, China. Tuberculosis has been suggested to increase lung cancer risk, but data from prior studies are limited. We conducted an analysis of data from a retrospective cohort study of 42,422 farmers in Xuanwei. In 1992, interviewers administered a standardized questionnaire that included lifetime medical history, including tuberculosis. Subjects were followed from 1976, with deaths from lung cancer ascertained through 1996. We used proportional hazards regression to assess the association between tuberculosis and subsequent lung cancer mortality. Tuberculosis was reported by 246 subjects (0.6%), and 2,459 (5.8%) died from lung cancer during follow-up. Lung cancer mortality was substantially higher in subjects with tuberculosis than in those without (25 vs. 3.1 per 1,000 person-years). The association was especially pronounced in the first 5 years after tuberculosis diagnosis (hazard ratios (HRs) ranging 6.7-13) but remained strong 5-9.9 years (HR 3.4, 95% CI 1.3-9.1) and 10+ years (HR 3.0, 95% CI 1.3-7.3) after tuberculosis. These associations were similar among men and women and among smoky coal users (70.5% of subjects). Adjustment for demographic characteristics, lung disease and tobacco use did not affect results. In Xuanwei, China, tuberculosis is an important risk factor for lung cancer. The increased lung cancer risk, persisting years after a tuberculosis diagnosis, could reflect the effects of chronic pulmonary inflammation and scarring arising from tuberculosis.

Engels, E.A.; Shen, M.; Chapman, R.S.; Pfeiffer, R.M.; Yu, Y.Y.; He, X.Z.; Lan, Q. [NCI, Rockville, MD (USA). Infectious and Immunoepidemiology Branch

2009-03-15

157

The production of consumption: addressing the impact of mineral mining on tuberculosis in southern Africa  

PubMed Central

Background Miners in southern Africa experience incident rates of tuberculosis up to ten times greater than the general population. Migration to and from mines may be amplifying tuberculosis epidemics in the general population. Discussion Migration to and from mineral mines contributes to HIV risks and associated tuberculosis incidence. Health and safety conditions within mines also promote the risk of silicosis (a tuberculosis risk factor) and transmission of tuberculosis bacilli in close quarters. In the context of migration, current tuberculosis prevention and treatment strategies often fail to provide sufficient continuity of care to ensure appropriate tuberculosis detection and treatment. Reports from Lesotho and South Africa suggest that miners pose transmission risks to other household or community members as they travel home undetected or inadequately treated, particularly with drug-resistant forms of tuberculosis. Reducing risky exposures on the mines, enhancing the continuity of primary care services, and improving the enforcement of occupational health codes may mitigate the harmful association between mineral mining activities and tuberculosis incidence among affected communities. Summary Tuberculosis incidence appears to be amplified by mineral mining operations in southern Africa. A number of immediately-available measures to improve continuity of care for miners, change recruitment and compensation practices, and reduce the primary risk of infection may critically mitigate the negative association between mineral mining and tuberculosis.

Basu, Sanjay; Stuckler, David; Gonsalves, Gregg; Lurie, Mark

2009-01-01

158

Mycobacterium tuberculosis Induces Interleukin-32 Production through a Caspase- 1/IL-18/Interferon-?-Dependent Mechanism  

PubMed Central

Background Interleukin (IL)–32 is a newly described proinflammatory cytokine that seems likely to play a role in inflammation and host defense. Little is known about the regulation of IL-32 production by primary cells of the immune system. Methods and Findings In the present study, freshly obtained human peripheral blood mononuclear cells were stimulated with different Toll-like receptor (TLR) agonists, and gene expression and synthesis of IL-32 was determined. We demonstrate that the TLR4 agonist lipopolysaccharide induces moderate (4-fold) production of IL-32, whereas agonists of TLR2, TLR3, TLR5, or TLR9, each of which strongly induced tumor necrosis factor ? and IL-6, did not stimulate IL-32 production. However, the greatest amount of IL-32 was induced by the mycobacteria Mycobacterium tuberculosis and M. bovis BCG (20-fold over unstimulated cells). IL-32-induced synthesis by either lipopolysaccharide or mycobacteria remains entirely cell-associated in monocytes; moreover, steady-state mRNA levels are present in unstimulated monocytes without translation into IL-32 protein, similar to other cytokines lacking a signal peptide. IL-32 production induced by M. tuberculosis is dependent on endogenous interferon-? (IFN?); endogenous IFN? is, in turn, dependent on M. tuberculosis–induced IL-18 via caspase-1. Conclusions In conclusion, IL-32 is a cell-associated proinflammatory cytokine, which is specifically stimulated by mycobacteria through a caspase-1- and IL-18-dependent production of IFN?.

Netea, Mihai G; Azam, Tania; Lewis, Eli C; Joosten, Leo A. B; Wang, Maorong; Langenberg, Dennis; Meng, Xianzhong; Chan, Edward D; Yoon, Do-Young; Ottenhoff, Tom; Kim, Soo-Hyun; Dinarello, Charles A

2006-01-01

159

AIDS-Related Tuberculosis in Rio de Janeiro, Brazil  

Microsoft Academic Search

BackgroundWe studied the incidence of tuberculosis, AIDS, AIDS deaths and AIDS-TB co-infection at the population level in Rio de Janeiro, Brazil where universal and free access to combination antiretroviral therapy has been available since 1997.Methodology\\/Principal FindingsThis was a retrospective surveillance database match of Rio de Janeiro databases from 1995–2004. Proportions of tuberculosis occurring within 30 days and between 30 days

Antonio G. Pacheco; Betina Durovni; Solange C. Cavalcante; L. M. Lauria; Richard D. Moore; Lawrence H. Moulton; Richard E. Chaisson; Jonathan E. Golub; Arachu Castro

2008-01-01

160

Serodiagnosis of Tuberculosis in Children Using A60 Antigen  

Microsoft Academic Search

Background: Measurement of antimycobacterial antibody may be used as an accurate diagnostic tool in childhood tuberculosis. Materials and Methods: This study was conducted to evaluate the value of IgG, IgA, and IgM levels against A60 antigen by using ELISA method for diagnosis of tuberculosis. 238 children aged from 6 months to 18 years old, divided into 4 groups; group A(n=51),patients

Soheila Khalilzadeh; Mojgan Yazdanpanah; Mostafa Hosseini; Nooshin Baghaie; Ali Akbar Velayati; Mohammad Reza Masjedi

161

Mycobacterium tuberculosis interactome analysis unravels potential pathways to drug resistance  

Microsoft Academic Search

Background  Emergence of drug resistant varieties of tuberculosis is posing a major threat to global tuberculosis eradication programmes.\\u000a Although several approaches have been explored to counter resistance, there has been limited success due to a lack of understanding\\u000a of how resistance emerges in bacteria upon drug treatment. A systems level analysis of the proteins involved is essential\\u000a to gain insights into

Karthik Raman; Nagasuma Chandra

2008-01-01

162

Quantification of Airborne Mycobacterium tuberculosis in Health Care Setting Using Real-Time qPCR Coupled to an Air-Sampling Filter Method  

Microsoft Academic Search

Mycobacterium tuberculosis infection remains one of the major public health issues worldwide. Current qualitative assays (only positive or negative results) do not provide comprehensive information regarding health risk of M. tuberculosis. This study attempted to develop a quantitative assay to measure air concentration of M. tuberculosis in a health care setting.A total of 22 air samples were taken from the

Pei-Shih Chen; Chih-Shan Li

2005-01-01

163

Prevalence of Mycobacterium tuberculosis in the samples referred to the tuberculosis research laboratory in Mashhad Ghaem Hospital during 2005-2006  

Microsoft Academic Search

Background: Tuberculosis continues to be a serious public health problem causing nearly three million deaths per year all over the world. Despite major improvement in diagnosis, it is not possible to control the disease in the absence of surveillance treatment, and follow-up programs. Objectives: This research was designed to study the frequency of Mycobacterium tuberculosis among specimens referred to the

Safdari H; Sadeghi A; Ghazvini K; Mohammadi S; Derakhshan M

164

Attitudes towards tuberculosis and sources of tuberculosis-related information: study on patients in outpatient settings in Split, Croatia.  

PubMed

Attitudes towards tuberculosis may have severe impact on individuals and their families as well as on the effectiveness of tuberculosis control programs. The purpose of this study was to describe these attitudes and explore the sources of tuberculosis information available to the general population in Croatia through a cross-sectional survey based on structured questionnaire using convenience sampling among 386 subjects aged 18 years and over. Data were stratified by sex, age groups, educational background, personal monthly income and contact with tuberculosis patient. Being near to a tuberculosis patient would be uncomfortable for 39.9% of respondents and 26.4% of subjects would avoid any contact. If they were sick of tuberculosis, 9.6% of respondents would keep it from the society. Less than 10% of study subjects would be ashamed of their own or potential tuberculosis in their family. Almost twice less subjects with high education would hide the disease (P=0.049), or be ashamed if sick in comparison with less educated respondents (P=0.036). The subjects who were not in contact were less likely to feel uncomfortable about being near to a tuberculosis patient (P=0.042). As the source of tuberculosis information, 61% of the subjects reported TV, radio and journals. Internet was the least used source (13.2%). The subjects in contact received information from the family or friends (P=0.025), while those without contact were informed through mass media (P<0.001). Study results revealed high stigma-generating attitudes towards tuberculosis. The strong potential of mass media capable of reaching different population groups should be used as part of the stigma-reduction strategies. PMID:22034782

Jurcev-Savicevi?, Anamarija

2011-03-01

165

53. INTERIOR VIEW LOOKING NORTH NORTHEAST SHOWING THE REMAINS OF ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

53. INTERIOR VIEW LOOKING NORTH NORTHEAST SHOWING THE REMAINS OF A WOODEN SETTLING BOX IN THE BACKGROUND RIGHT. AMALGAMATING PANS IN THE FOREGROUND. - Standard Gold Mill, East of Bodie Creek, Northeast of Bodie, Bodie, Mono County, CA

166

Adherence to anti-tuberculosis treatment among pulmonary tuberculosis patients: a qualitative and quantitative study  

Microsoft Academic Search

BACKGROUND: Tuberculosis (TB) patients have difficulty following a long-term treatment regimen. Efforts to improve treatment outcomes require better understanding of adherence as a complex behavioral issue and of the particular barriers to and facilitators of patient adherence. METHODS: This study was carried out in Jiangsu Province of China with both quantitative and qualitative approaches. For the quantitative study, 780 sputum-smear

Weiguo Xu; Wei Lu; Yang Zhou; Limei Zhu; Hongbing Shen; Jianming Wang

2009-01-01

167

Tuberculosis burden in an urban population: a cross sectional tuberculosis survey from Guinea Bissau  

Microsoft Academic Search

BACKGROUND: Little is known about the prevalence of pulmonary tuberculosis (TB) in low income countries. We conducted a cross sectional survey for pulmonary TB and TB symptoms in Bissau, Guinea-Bissau, in an urban cohort with known HIV prevalence. TB surveillance in the area is routinely based on passive case finding. METHODS: Two cohorts were selected based on a previous HIV

Morten Bjerregaard-Andersen; Zacarias J da Silva; Pernille Ravn; Morten Ruhwald; Paul L Andersen; Morten Sodemann; Per Gustafson; Peter Aaby; Christian Wejse

2010-01-01

168

Cost-effectiveness of tuberculosis evaluation and treatment of newly-arrived immigrants  

Microsoft Academic Search

BACKGROUND: Immigrants to the U.S. are required to undergo overseas screening for tuberculosis (TB), but the value of evaluation and treatment following entry to the U.S. is not well understood. We determined the cost-effectiveness of domestic follow-up of immigrants identified as tuberculosis suspects through overseas screening. METHODS: Using a stochastic simulation for tuberculosis reactivation, transmission, and follow-up for a hypothetical

Travis C Porco; Bryan Lewis; Elliot Marseille; Jennifer Grinsdale; Jennifer M Flood; Sarah E Royce

2006-01-01

169

Hyperendemic pulmonary tuberculosis in peri-urban areas of Karachi, Pakistan  

Microsoft Academic Search

BACKGROUND: Currently there are very limited empirical data available on the prevalence of pulmonary tuberculosis among residents of marginalized settings in Pakistan. This study assessed the prevalence of pulmonary tuberculosis through active case detection and evaluated predictors of pulmonary tuberculosis among residents of two peri-urban neighbourhoods of Karachi, Pakistan. METHODS: A cross-sectional study was conducted in two peri-urban neighbourhoods from

Saeed Akhtar; Franklin White; Rumina Hasan; Shafquat Rozi; Mohammad Younus; Faiza Ahmed; Sara Husain; Bilquis Sana Khan

2007-01-01

170

Expanding the epidemiologic profile: risk factors for active tuberculosis in people immigrating to Ontario  

Microsoft Academic Search

Background: Many people immigrating to Canada come from countries with a high burden of tuberculosis. The aim of this study was to develop a detailed epi- demiologic profile of foreign-born people with tuberculosis living in Ontario. Methods: In this population-based case-control study, cases of tuberculosis diag- nosed in 1994-1995 were identified from the database of the Ontario Re- portable Disease

Wendy L. Wobeser; Lilian Yuan; Monika Naus; Paul Corey; Jeff Edelson; Neil Heywood; D. Linn Holness

171

Low-cost rapid detection of rifampicin resistant tuberculosis using bacteriophage in Kampala, Uganda  

Microsoft Academic Search

BACKGROUND: Resistance to anti-tuberculosis drugs is a serious public health problem. Multi-drug resistant tuberculosis (MDR-TB), defined as resistance to at least rifampicin and isoniazid, has been reported in all regions of the world. Current phenotypic methods of assessing drug susceptibility of M. tuberculosis are slow. Rapid molecular methods to detect resistance to rifampicin have been developed but they are not

Hamidou Traore; Sam Ogwang; Kim Mallard; Moses L Joloba; Francis Mumbowa; Kalpana Narayan; Susan Kayes; Edward C Jones-Lopez; Peter G Smith; Jerrold J Ellner; Roy D Mugerwa; Kathleen D Eisenach; Ruth McNerney

2007-01-01

172

Tuberculosis in Household Contacts of Infectious Cases in Kampala, Uganda  

PubMed Central

Tuberculosis remains a serious threat to public health, especially in sub-Saharan Africa. To determine the host and environmental factors responsible for tuberculosis in African households, the authors performed a prospective cohort study of 1,206 household contacts of 302 index cases with tuberculosis enrolled in Uganda between 1995 and 1999. All contacts were systematically evaluated for active tuberculosis and risk factors for active disease. Among the 1,206 household contacts, 76 secondary cases (6%) of tuberculosis were identified. Of these cases, 51 were identified in the baseline evaluation, and 25 developed during follow-up. Compared with index cases, secondary cases presented more often with minimal disease. The risk for secondary tuberculosis was greater among young children than adults (10% vs. 1.9%) and among human immunodeficiency virus-seropositive than -seronegative contacts (23% vs. 3.3%). Host risk factors could not be completely separated from the effects of environmental risk factors, suggesting that a household may represent a complex system of interacting risks for tuberculosis.

Guwatudde, D.; Nakakeeto, M.; Jones-Lopez, E. C.; Maganda, A.; Chiunda, A.; Mugerwa, R. D.; Ellner, J. J.; Bukenya, G.; Whalen, C. C.

2010-01-01

173

Extensively drug-resistant tuberculosis: experience at the Tuberculosis Research Centre, Chennai, India.  

PubMed

Ten extensively drug-resistant tuberculosis (XDR-TB) patients were identified among 104 human immunodeficiency virus negative multidrug-resistant tuberculosis (MDR-TB) patients treated at the Tuberculosis Research Centre, Chennai, India, in two different cohorts between 1999-2003 and 2006-2007. They were managed with individualised treatment regimens. At the time of diagnosis of MDR-TB, one patient had XDR-TB and three had initial ofloxacin resistance. One patient who had had a lobectomy in addition to chemotherapy became bacteriologically negative, three died, three defaulted and the remaining three, who are bacteriologically positive, are still continuing treatment. Although based on a small number of patients, our results have not been encouraging. PMID:22283888

Thomas, A; Joseph, P; Nair, D; Rao, D V B; Rekha, V V B; Selvakumar, N; Jaggarajamma, K; Balambal, R

2011-10-01

174

Nanoparticle Delivery of Anti-Tuberculosis Chemotherapy as a Potential Mediator Against Drug-Resistant Tuberculosis  

PubMed Central

Drug-resistant tuberculosis is quickly emerging as one of the largest threats to the global health community. Current chemotherapy for tuberculosis dates back to the 1950s and is arduous, lengthy, and remains extremely difficult to complete in many of the highest burdened areas. This causes inadequate or incomplete treatment, resulting in genetic selection of drug-resistant strains. With a dearth of novel anti-TB drug candidates in the development pipeline, nanoparticle technology allows us to take current chemotherapies and deliver them more efficaciously, reducing the frequency and duration of treatment and increasing bioavailability. This approach can improve patient adherence, reduce pill burden, and shorten time to completion, all which are at the heart of drug resistance. This review examines the multiple advantages of nanoparticle drug delivery of tuberculosis chemotherapy and summarizes the challenges in implementation.

Smith, Jonathan Paul

2011-01-01

175

CCL2 Responses to Mycobacterium tuberculosis Are Associated with Disease Severity in Tuberculosis  

PubMed Central

Background Leucocyte activating chemokines such as CCL2, CCL3, and CXCL8 together with proinflammatory IFN?, TNF? and downmodulatory IL10 play a central role in the restriction of M. tuberculosis infections, but is unclear whether these markers are indicative of tuberculosis disease severity. Methodology We investigated live M. tuberculosis- and M. bovis BCG- induced peripheral blood mononuclear cell responses in patients with tuberculosis (TB) and healthy endemic controls (ECs, n?=?36). TB patients comprised pulmonary (PTB, n?=?34) and extrapulmonary groups, subdivided into those with less severe localized extrapulmonary TB (L-ETB, n?=?16) or severe disseminated ETB (D-ETB, n?=?16). Secretion of CCL2, IFN?, IL10 and CCL3, and mRNA expression of CCL2, TNF?, CCL3 and CXCL8 were determined. Results M. tuberculosis- and BCG- induced CCL2 secretion was significantly increased in both PTB and D-ETB (p<0.05, p<0.01) as compared with L-ETB patients. CCL2 secretion in response to M. tuberculosis was significantly greater than to BCG in the PTB and D-ETB groups. M. tuberculosis-induced CCL2 mRNA transcription was greater in PTB than L-ETB (p?=?0.023), while CCL2 was reduced in L-ETB as compared with D-ETB (p?=?0.005) patients. M. tuberculosis –induced IFN? was greater in L-ETB than PTB (p?=?0.04), while BCG-induced IFN? was greater in L-ETB as compared with D-ETB patients (p?=?0.036). TNF? mRNA expression was raised in PTB as compared with L-ETB group in response to M. tuberculosis (p?=?0.02) and BCG (p?=?0.03). Mycobacterium-induced CCL3 and CXCL8 was comparable between TB groups. Conclusions The increased CCL2 and TNF? in PTB patients may support effective leucocyte recruitment and M. tuberculosis localization. CCL2 alone is associated with severity of TB, possibly due to increased systemic inflammation found in severe disseminated TB or due to increased monocyte infiltration to lung parenchyma in pulmonary disease.

Hasan, Zahra; Cliff, Jacqueline M.; Dockrell, Hazel M.; Jamil, Bushra; Irfan, Muhammad; Ashraf, Mussarat; Hussain, Rabia

2009-01-01

176

Tuberculosis: distribution, risk factors, mortality.  

PubMed

About a century after Koch's discovery of the TB bacilli the tuberculosis epidemic which had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through the improved living standards and, eventually, the availability and use of effective antibiotics. While tuberculosis gradually disappeared from the health agenda in the western world it remained a big killer throughout the century and in 1992 an estimated 2.7 million TB deaths occurred; 30 million will die from TB during the 1990s if current trends are not reversed. The annual number of new cases will increase from 7.5 million estimated in 1990 to more than 10 million in the year 2000. The main factors for this increase are demographic forces, population movements, the HIV epidemic and increasing drug resistance. The impact of the HIV epidemic is already felt in many sub-Saharan African countries and now threatens Asia where almost two-thirds of the world's TB infected population live and where HIV is spreading. Tuberculosis has also reemerged as a major public health problem in industrialized countries due to international migration, the breakdown of health services, including TB services etc. The control of the epidemic can only be through a concerted action to reinstate TB as priority among health concerns, reflected in national and international resources. A coalition of public and private supporters must be mobilized to support the effort to fight the disease. Governments, non-governmental organizations, the business community, refugee organizations, medical institutions, and other UN agencies are invited to join with WHO in this effort. PMID:7713546

Kochi, A

1994-10-01

177

Tuberculosis Endometrial Polyp  

PubMed Central

Tuberculosis can cause infertility when it infects the genital tract (e.g., endometritis). A 31-year-old woman (origin: Algeria) was referred to our academic gynecological institute for unexplained primary infertility. The patient presented with no complaint. Hysteroscopy showed a 10?mm sized endometrial polyp. The polyp was removed. Pathology showed lymphocytic and plasmacytic chronic inflammatory modification, granulomatous modification, and gigantocellular modification,which lead to the diagnosis of tuberculosis. No acid fast organism was seen on Ziehl-Neelsen staining. A chest thorax X-ray revealed no sign of pulmonary tuberculosis. The patient underwent antituberculosis therapy during one year. Posttreatment hysteroscopy revealed no abnormality. This is the first reported case of endometrial tuberculosis diagnosed following removal of a polyp with classical benign appearance.

Seror, Julien; Faivre, Erika; Prevot, Sophie; Deffieux, Xavier

2013-01-01

178

Tuberculosis in tropical Africa  

PubMed Central

Up to the end of the nineteenth century the tubercle bacillus apparently had little opportunity of disseminating among the rather isolated tribes of tropical Africa. With the creation of large centres of trade and industry in the wake of European colonization, tuberculosis seems to have spread rapidly over the continent and is today found everywhere. In a number of tuberculosis prevalence surveys conducted by WHO during 1955-60, randomly selected population groups were tuberculin tested, X-rayed and had sputa examined by direct microscopy. The three methods of examination were applied independently of one another. Data collected during the surveys have been analysed with a view to discovering common epidemiological features of tuberculosis in tropical Africa, assessing the reliability of the diagnostic methods employed and discussing their usefulness in future tuberculosis control programmes.

Roelsgaard, E.; Iversen, E.; Bl?cher, C.

1964-01-01

179

Tuberculosis (For Parents)  

MedlinePLUS

... resolves on its own as a child develops immunity over a 6- to 10-week period. But ... conditions become favorable (for instance, due to lowered immunity), the bacteria become active. Tuberculosis in older kids ...

180

Diversity of Mycobacterium tuberculosis Isolates from New Pulmonary Tuberculosis Cases in Addis Ababa, Ethiopia  

PubMed Central

Understanding the genetic diversity of Mycobacterium tuberculosis is needed for a better understanding of the epidemiology of TB and could have implications for the development of new diagnostics, drugs, and vaccines. M. tuberculosis isolates were characterized using spoligotyping and were compared with the SpoIDB4 database of the Pasteur Institute of Guadeloupe. A total of 53 different patterns were identified among 192 isolates examined. 169 of the isolates were classified into one of the 33 shared SITs, whereas the remaining 23 corresponded to 20 orphan patterns. 54% of the isolates were ascribed to the T family, a family which has not been well defined to date. Other prominent families were CAS, Haarlem, LAM, Beijing, and Unknown comprising 26%, 13%, 2.6%, 0.5%, and 2.1%, respectively. Among HIV-positive patients, 10 patterns were observed among 25 isolates. The T (38.5%), H (26.9%), and CAS (23.1%) families were the most common among HIV-positive individuals. The diversity of the M. tuberculosis strains found in this study is very high, and there was no difference in the distribution of families in HIV-positive and HIV-negative TB patients except the H family. Tuberculosis transmission in Addis Ababa is due to only the modern M. tuberculosis families (CAS, LAM, T, Beijing, Haarlem, and U).

Mihret, Adane; Bekele, Yonas; Loxton, Andre G.; Jordan, Annemie M.; Yamuah, Lawrence; Aseffa, Abraham; Howe, Rawleigh; Walzl, Gerhard

2012-01-01

181

The Consumption of the PoorTuberculosis in the 21st Century  

Microsoft Academic Search

In an era in which we have effective therapies, why has tuberculosis remained the leading infectious cause of young adult deaths in much of the world? This article argues that in order to answer such a question, we must explore not only the life experiences of those sick with tuberculosis, but also the larger social contexts in which they become

Paul E. Farmer

2000-01-01

182

High level expression of recombinant Mycobacterium tuberculosis culture filtrate protein CFP32 in Pichia pastoris  

Microsoft Academic Search

Difficulty in obtaining large quantities of Mycobacterium tuberculosis (MTB) proteins remains a major obstacle in the development of subunit vaccines and diagnostic reagents for tuberculosis.\\u000a A major reason is because Escherichia coli has not proven to be an optimal host for the expression of MTB genes. In this article, we used the yeast Pichia pastoris to express high levels of

C. Benabdesselem; M. R. Barbouche; M. A. Jarboui; K. Dellagi; J. L. Ho; D. M. Fathallah

2007-01-01

183

Use of Isoniazid for Latent Tuberculosis Infection in a Public Health Clinic  

Microsoft Academic Search

Isoniazid is an efficacious treatment for latent tuberculosis. Con- cerns remain, however, regarding hepatotoxicity associated with this medication. In addition, adherence may be suboptimal because at least 6 months of treatment is required. We extracted information from our latent tuberculosis treatment database to determine ad- verse effects and treatment completion rates associated with the use of isoniazid at a county

Philip A. LoBue; Kathleen S. Moser

184

Factors influencing quality of life in patients with active tuberculosis in Pakistan  

Microsoft Academic Search

Evidently Tuberculosis remains a major threat to public health globally. Latterly academia with exertion dedication has tried to extract the health related quality of life of the people with active tuberculosis. Meager studies in Pakistan have tried to explore the factors that influences patient’s health related quality of life besides the disease. The intentions of this study were to scrutinize

Sarwar Awan Masood; Waqas Muhammad; Amir Aslam Muhammad

2012-01-01

185

The impact of badger removal on the control of tuberculosis in cattle herds in Ireland  

Microsoft Academic Search

In Ireland, the herd prevalence of bovine tuberculosis has remained stable for several decades, and in common with several other countries, progress towards eradication has stalled. There is evidence in support of the potential role of infected badgers (Meles meles, a protected species) in bovine tuberculosis in Ireland and Britain. However, this evidence on its own has not been sufficient

J. M. Griffin; D. H. Williams; G. E. Kelly; T. A. Clegg; I. O’Boyle; J. D. Collins; S. J. More

2005-01-01

186

Regulatory T Cells Depress Immune Responses to Protective Antigens in Active Tuberculosis  

Microsoft Academic Search

Rationale: Tuberculosis (TB) remains a leading cause of death, and the role of T-cell responses to control Mycobacterium tuberculosis infections is well recognized. Patients with latent TB infection de- velop strong IFN- responses to the protective antigen heparin- binding hemagglutinin (HBHA), whereas patients with active TB do not. Objectives: We investigated the mechanism of this difference and evaluated the possible

Jean-Michel Hougardy; Marc Hildebrand; Annie Drowart; Anne-Sophie Debrie; Camille Locht; Francoise Mascart

2007-01-01

187

[Primary nasopharyngeal tuberculosis].  

PubMed

A 59-year-old female was complaining of sore throat, right otorrhea, and hearing impairment. There were no abnormal findings suggestive of pulmonary tuberculosis on her chest XP and CT. Nasopharyngoscopic examination detected a lesion coated with white mass on her nasopharynx, and a biopsy-specimen from this lesion revealed histopathological findings compatible with tuberculosis and the presence of acid-fast bacilli. PCR was positive for Mycobacterium tuberculosis complex. Therefore, we diagnosed the case as primary nasopharyngeal tuberculosis and treated her by 4-drug combination regimen with daily isoniazid, rifampicin, ethambutol and pyrazinamide. Later, low degree of resistance was noticed, isoniazid was replaced by levofloxacin. After the anti-tuberculosis chemotherapy, her symptoms almost completely diminished and the mass in her nasopharynx disappeared. As far as we can search, 23 Japanese cases of primary nasopharyngeal tuberculosis, including this case, have been reported in the literatures. We summarized the clinical features of these cases in Table. Nasopharyngeal tuberculosis is a rather rare disease. But, recently, due to the advances in diagnostic technology, the number of the case-reports has been increasing. Difficulties in detecting tubercle bacilli in nasopharyngeal lesion sometimes delayed definite diagnosis and treatment. If a patient complains the symptoms compatible with this disease, such as sore throat, pharyngeal pain and otorrhea, which are refractory to the general antibiotic therapy, we should be aware of the existence of this disease and repeat bacteriological and/or molecular examinations to prove tubercle bacilli to be able to start timely anti-tuberculosis chemotherapy. PMID:23882729

Takagi, Ayaka; Nagayasu, Fumihiro; Sugama, Yoshimi; Shiraishi, Satoshi

2013-05-01

188

Tuberculosis and poverty  

Microsoft Academic Search

OBJECTIVE--To examine whether the historical link between tuberculosis and poverty still exists. DESIGN--Retrospective study examining the notifications of all forms of tuberculosis by council ward over a six year period and correlating this with four indices of poverty; council housing, free school meals, the Townsend overall deprivation index, and the Jarman index. SETTING--The 33 electoral wards of the city of

D P Spence; J Hotchkiss; C S Williams; P D Davies

1993-01-01

189

Macronodular hepatosplenic tuberculosis  

PubMed Central

Hepatosplenic involvement is a rare manifestation of abdominal tuberculosis in children. We describe the case of a 7-year-old girl with persistent fever, cough, and hepatosplenomegaly. Typical lesions were shown in the liver and spleen by ultrasound and computed tomography. Colonoscopy showed a nodular, ulcerated mass that partially obstructed the cecum. Microbiological and histopathological findings of intestinal and liver biopsy confirmed the clinical suspicion of tuberculosis.

Guidi, Roberto; Bolli, Valeria; Lanza, Cecilia; Biagetti, Chiara; Osimani, Patrizia; de Benedictis, Fernando Maria

2012-01-01

190

Tuberculosis and Pregnancy  

Microsoft Academic Search

Tuberculosis (TB) is a common infectious disease caused by Mycobacterium tuberculosis, which commonly attacks the lungs (as pulmonary TB) but can also affect other organ systems. Over one third of the world’s\\u000a population now carries the TB bacterium. Not everyone infected develops active TB, and latent (asymptomatic) infection is\\u000a common. TB is a problem not only in the developing world

John B. Bass; James N. Byrd

191

Tuberculosis in England and Wales in 1993: results of a national survey. Public Health Laboratory Service\\/British Thoracic Society\\/Department of Health Collaborative Group  

Microsoft Academic Search

BACKGROUND: A national survey of tuberculosis notifications in England and Wales was carried out in 1993 to determine the notification rate of tuberculosis and the trends in the occurrence of disease by ethnic group in comparison with the findings of similar surveys in 1978\\/79, 1983, and 1988. The prevalence of HIV infection in adults notified with tuberculosis in the survey

D. Kumar; J. M. Watson; A. Charlett; S. Nicholas; J. H. Darbyshire

1997-01-01

192

[Population migration and tuberculosis].  

PubMed

Characteristic features of a migratory process of tuberculosis patients in the Republic of Moldova were subjected to study. Two tendencies have been revealed: growth of a number of the arriving subjects and deterioration of the structure of pulmonary tuberculosis among them. Patients who arrived from the places of confinement where morbidity persists on a high level constitute a particular hazard concerning tuberculosis dissemination. Certain organization measures have been taken. The epidemiologic situation for tuberculosis in the penitentiary-labour establishments at the republican Ministry of Internal Affairs was subjected to a comprehensive analysis with subsequent discussion of the results at a meeting of the staff of the Ministry of Public Health; instruction and plan of measures to be taken have been compiled by both ministries; a permanent board has been instituted for rendering help to medical workers of the penitentiary establishments; all law-protective organs have been involved in tuberculosis control; a specialized institution has been set up with a hospital for 200 beds intended for skilled examination and treatment of patients. As a result, the index of tuberculosis morbidity in the republican penitentiary-labour establishments reduced by more than half to promote an improvement of the epidemiologic situation in the republic. PMID:1409515

Degtiarev, V P; Evtodiev, V S; Bylich, F G

1992-01-01

193

EXPERIMENTAL EPIDEMIOLOGY OF TUBERCULOSIS  

PubMed Central

1. Guinea pigs living in the same room but not in the same cage with tuberculous animals acquire tuberculosis, characterized by a chronic course, a marked involvement of the lungs, often with cavity formation and a massive tuberculosis of the tracheobronchial nodes; the mesenteric and cervical nodes are slightly or not at all affected. 2. The route of infection in these guinea pigs is almost always the respiratory tract. 3. Of 103 guinea pigs exposed for a period of up to 32 months 15 or 14.5 per cent developed tuberculosis. The shortest period of exposure leading to fatal tuberculosis was 8 months. 4. The incidence of this tuberculosis acquired by air-borne contagion increases with the duration and intensity of the exposure up to a certain point. 5. A large percentage of the guinea pigs weathered a continuous exposure to the tubercle bacillus for 32 months without becoming tuberculous. This may be due to an innate natural resistance against tuberculosis, or to an acquired immunity resulting from the continuous exposure to the contagion.

Lurie, Max B.

1930-01-01

194

Tuberculosis Outbreak Investigations in the United States, 2002-2008  

PubMed Central

To understand circumstances of tuberculosis transmission that strain public health resources, we systematically reviewed Centers for Disease Control and Prevention (CDC) staff reports of US outbreaks in which CDC participated during 2002–2008 that involved >3 culture-confirmed tuberculosis cases linked by genotype and epidemiology. Twenty-seven outbreaks, representing 398 patients, were reviewed. Twenty-four of the 27 outbreaks involved primarily US-born patients; substance abuse was another predominant feature of outbreaks. Prolonged infectiousness because of provider- and patient-related factors was common. In 17 outbreaks, a drug house was a notable contributing factor. The most frequently documented intervention to control the outbreak was prioritizing contacts according to risk for infection and disease progression to ensure that the highest risk contacts were completely evaluated. US-born persons with reported substance abuse most strongly characterized the tuberculosis outbreaks in this review. Substance abuse remains one of the greatest challenges to controlling tuberculosis transmission in the United States.

Oeltmann, John E.; Ijaz, Kashef; Haddad, Maryam B.

2011-01-01

195

Variable host-pathogen compatibility in Mycobacterium tuberculosis  

PubMed Central

Mycobacterium tuberculosis remains a major cause of morbidity and mortality worldwide. Studies have reported human pathogens to have geographically structured population genetics, some of which have been linked to ancient human migrations. However, no study has addressed the potential evolutionary consequences of such longstanding human–pathogen associations. Here, we demonstrate that the global population structure of M. tuberculosis is defined by six phylogeographical lineages, each associated with specific, sympatric human populations. In an urban cosmopolitan environment, mycobacterial lineages were much more likely to spread in sympatric than in allopatric patient populations. Tuberculosis cases that did occur in allopatric hosts disproportionately involved high-risk individuals with impaired host resistance. These observations suggest that mycobacterial lineages are adapted to particular human populations. If confirmed, our findings have important implications for tuberculosis control and vaccine development.

Gagneux, Sebastien; DeRiemer, Kathryn; Van, Tran; Kato-Maeda, Midori; de Jong, Bouke C.; Narayanan, Sujatha; Nicol, Mark; Niemann, Stefan; Kremer, Kristin; Gutierrez, M. Cristina; Hilty, Markus; Hopewell, Philip C.; Small, Peter M.

2006-01-01

196

Early and Long-term Outcomes of Pneumonectomy for Treating Sequelae of Pulmonary Tuberculosis  

PubMed Central

Background Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (?50 years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (<1.2 L, p=0.02). Conclusion Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.

Byun, Chun Sung; Narm, Kyoung Sik; Lee, Jin Gu; Hong, Daejin; Lee, Chang Young

2012-01-01

197

Failure to Recognize Nontuberculous Mycobacteria Leads to Misdiagnosis of Chronic Pulmonary Tuberculosis  

PubMed Central

Background Nontuberculous mycobacterial (NTM) infections cause morbidity worldwide. They are difficult to diagnose in resource-limited regions, and most patients receive empiric treatment for tuberculosis (TB). Our objective here is to evaluate the potential impact of NTM diseases among patients treated presumptively for tuberculosis in Mali. Methods We re-evaluated sputum specimens among patients newly diagnosed with TB (naïve) and those previously treated for TB disease (chronic cases). Sputum microscopy, culture and Mycobacterium tuberculosis drug susceptibility testing were performed. Identification of strains was performed using molecular probes or sequencing of secA1 and/or 16S rRNA genes. Results Of 142 patients enrolled, 61 (43%) were clinically classified as chronic cases and 17 (12%) were infected with NTM. Eleven of the 142 (8%) patients had NTM disease alone (8 M. avium, 2 M. simiae and 1 M. palustre). All these 11 were from the chronic TB group, comprising 11/61 (18%) of that group and all were identified as candidates for second line treatment. The remaining 6/17 (35.30%) NTM infected patients had coinfection with M. tuberculosis and all 6 were from the TB treatment naïve group. These 6 were candidates for the standard first line treatment regimen of TB. M. avium was identified in 11 of the 142 (8%) patients, only 3/11 (27.27%) of whom were HIV positive. Conclusions NTM infections should be considered a cause of morbidity in TB endemic environments especially when managing chronic TB cases to limit morbidity and provide appropriate treatment.

Diallo, Souleymane; Diarra, Bassirou; Traore, Brehima; Shea, Yvonne R.; Zelazny, Adrian M.; Dembele, Bindongo P. P.; Goita, Drissa; Kassambara, Hamadoun; Hammond, Abdulrahman S.; Polis, Michael A.; Tounkara, Anatole

2012-01-01

198

Increased Levels of BAFF and APRIL Related to Human Active Pulmonary Tuberculosis  

PubMed Central

Background Despite great efforts to improve diagnosis and treatment, tuberculosis (TB) remains a major health problem worldwide, especially in developing countries. Lack of concrete immune markers is still the obstacle to properly evaluate active TB. Therefore, identification of more validated biomarkers and phenotypic signatures is imperative. In particular, T cell-related biomarkers are more significant. Methodology To understand the nature of CD4+ T cell-derived signatures involved in infection and disease development, we examined and analyzed whole genome expression profiles of purified CD4+ T cells from healthy individuals (HD), two distinct populations with latent infection (with low or high IFN-? levels, LTBL/LTBH) and untreated TB patients. Following, we validated the expression profiles of genes in the peripheral CD4+ T cells from each group and examined secretion levels of distinct cytokines in serum and pleural effusion. Principal Findings Our bio-informatic analyses indicate that the two latent populations and clinical TB patients possess distinct CD4+ T cell gene expression profiles. Furthermore, The mRNA and protein expression levels of B cell activating factor (BAFF), which belongs to the TNF family, and a proliferation-inducing ligand (APRIL) were markedly up-regulated at the disease stage. In particular, the dramatic enhancement of BAFF and APRIL in the pleural effusion of patients with tuberculosis pleurisy suggests that these proteins may present disease status. In addition, we found that the BAFF/APRIL system was closely related to the Th1 immune response. Our study delineates previously unreported roles of BAFF and APRIL in the development of tuberculosis, and these findings have implications for the diagnosis of the disease. Our study also identifies a number of transcriptional signatures in CD4+ T cells that have the potential to be utilized as diagnostic and prognostic tools to combat the tuberculosis epidemic.

Liu, Kai; Zhang, Yan; Hu, Shizong; Yu, Yang; Yang, Qianting; Jin, Dongdong; Chen, Xinchun; Jin, Qi; Liu, Haiying

2012-01-01

199

Mycobacterium tuberculosis activates the DNA-dependent cytosolic surveillance pathway within macrophages  

PubMed Central

Summary Cytosolic bacterial pathogens activate the cytosolic surveillance pathway (CSP) and induce innate immune responses, but how the host detects vacuolar pathogens like Mycobacterium tuberculosis is poorly understood. We show that M. tuberculosis also initiates the CSP upon macrophage infection via limited perforation of the phagosome membrane mediated by the ESX-1 secretion system. Although the bacterium remains within the phagosome, this permeabilization results in phagosomal and cytoplasmic mixing and allows extracellular mycobacterial DNA to access host cytosolic receptors, thus blurring the distinction between “vacuolar” and “cytosolic” pathogens. Activation of cytosolic receptors induces signaling through the STING/TBK1/IRF3 axis, resulting in IFN-? production. Surprisingly, IRF3?/? mice, which cannot respond to cytosolic DNA, are resistant to long-term M. tuberculosis infection, suggesting that the CSP promotes M. tuberculosis infection. Thus, cytosolic sensing of mycobacterial DNA plays a key role in M. tuberculosis pathogenesis and likely contributes to the high type I IFN signature in tuberculosis.

Manzanillo, Paolo S.; Shiloh, Michael U.; Portnoy, Daniel A.; Cox, Jeffery S.

2013-01-01

200

[The detection and diagnosis of pulmonary tuberculosis in an investigatory isolation ward].  

PubMed

The purpose of the study was to examine the implication of radiation and microbiological methods in the timely detection and diagnosis of pulmonary tuberculosis in untried prisoners in an investigatory isolation ward. Fluorographic films made in 12,298 convicts were analyzed. Abnormal fluorograms were revealed in 14 and 7.7% of the untried prisoners in 2005 and 2006, respectively; the changes were tuberculosis-associated in 70.2% of cases. Fluorescence microscopy and inoculation were used to carry out sputum tests for Mycobacterium tuberculosis in 41.1% of the convicts with abnormal fluorograms and complaints about productive cough. Early diagnosis of pulmonary tuberculosis was made by microscopy in 14.9% of the prisoners; the diagnosis of tuberculosis was verified by the inoculation test in 34.5% of negative microscopy patients. In the remaining patients, the diagnosis of tuberculosis was based on X-ray studies and the results of treatment. PMID:19110767

Aksenova, K I; Mishin, V Iu; Chernyshev, S I; Iurkevich, O A; Sidorova, S V

2008-01-01

201

Advances in the diagnosis of pulmonary tuberculosis in HIV-infected and HIV-uninfected children.  

PubMed

The identification of improved diagnostic tests for tuberculosis has been identified as a global research priority. Over the past decade, there has been renewed interest in the development and validation of novel diagnostic tools for pulmonary tuberculosis that are applicable to resource-poor settings. These techniques are aimed primarily at improving detection of the organism or a specific host immune response. Although most studies have focused on determining the accuracy of novel tests in adults, it is likely they will also have the capacity to significantly improve the diagnosis of childhood tuberculosis. Improving the quality of clinical samples obtained from children with suspected tuberculosis remains an important research priority while awaiting validation of novel diagnostic tests. This review will focus on a number of recent developments for the diagnosis of tuberculosis, with a specific emphasis on the application of these new tests to children in settings where tuberculosis is endemic. PMID:21996697

Connell, Tom G; Zar, Heather J; Nicol, Mark P

2011-11-15

202

Genetic Diversity and Population Structure of Mycobacterium tuberculosis in Casablanca, a Moroccan City with High Incidence of Tuberculosis  

PubMed Central

Although lower-resource countries have by far the highest burden of tuberculosis, knowledge of Mycobacterium tuberculosis population structure and genetic diversity in these regions remains almost nonexistent. In this paper, 150 Moroccan M. tuberculosis isolates circulating in Casablanca were genotyped by random amplified polymorphic DNA analysis using 10 different primers and by mycobacterial interspersed repetitive units-variable number of tandem repeats typing at 12 loci. The population genetic tests revealed a basically clonal structure for this population, without excluding rare genetic exchanges. Genetic analysis also showed a notable genetic polymorphism for the species M. tuberculosis, a weak cluster individualization, and an unexpected genetic diversity for a population in such a high-incidence community. Phylogenetic analyses of this Moroccan sample also supported that these isolates are genetically heterogeneous.

Tazi, Loubna; El Baghdadi, Jamila; Lesjean, Sarah; Locht, Camille; Supply, Philip; Tibayrenc, Michel; Banuls, Anne-Laure

2004-01-01

203

Congenital tuberculosis presenting as ascites.  

PubMed

Congenital tuberculosis is a rare disease of which the most common presentations include respiratory distress, fever, and organomegaly. We report a case of congenital tuberculosis presenting with ascites. PMID:21529114

Aelami, Mohammad Hassan; Qhodsi Rad, Mohammad Ali; Sasan, Mohammad Saeed; Ghazvini, Kiarash

2011-05-01

204

Laryngeal Tuberculosis: A Case Report  

PubMed Central

A case of laryngeal tuberculosis, in a 21-year-old female, is presented. The pathophysiology and natural course of the disease are discussed. The incidence of apical tuberculosis and associated laryngeal spread is noted. ImagesFigure 1

Jones, Christine E.; Jones, Beulah D.

1979-01-01

205

Health Care Workers and Tuberculosis  

MedlinePLUS

... Active tuberculosis is much less common than a tuberculosis infection, which your immune system can suppress on its own. If I had bacille Calmette-Guérin (BCG) vaccine, do I need to have a skin test? ...

206

[Gastrointestinal tuberculosis: a deceptive disease].  

PubMed

Incidence of tuberculosis has increased in the Netherlands in recent years, especially among immigrants. Nearly half of all patients with tuberculosis have extrapulmonary disease; in 5% of these patients it is localized in the gastrointestinal tract. Despite the low incidence of gastrointestinal tuberculosis we recently established this diagnosis in three of our patients, who demonstrated tuberculosis within the oesophagus, colon and pancreas, respectively. They were successfully treated, but only after a long diagnostic process. PMID:23739601

Schrauwen, Ruud; Richter, Clemens; Vrolijk, Jan Maarten

2013-01-01

207

Tuberculosis Surveillance Using a Hidden Markov Model  

PubMed Central

Background: Routinely collected data from tuberculosis surveillance system can be used to investigate and monitor the irregularities and abrupt changes of the disease incidence. We aimed at using a Hidden Markov Model in order to detect the abnormal states of pulmonary tuberculosis in Iran. Methods: Data for this study were the weekly number of newly diagnosed cases with sputum smear-positive pulmonary tuberculosis reported between April 2005 and March 2011 throughout Iran. In order to detect the unusual states of the disease, two Hidden Markov Models were applied to the data with and without seasonal trends as baselines. Consequently, the best model was selected and compared with the results of Serfling epidemic threshold which is typically used in the surveillance of infectious diseases. Results: Both adjusted R-squared and Bayesian Information Criterion (BIC) reflected better goodness-of-fit for the model with seasonal trends (0.72 and ?1336.66, respectively) than the model without seasonality (0.56 and ?1386.75). Moreover, according to the Serfling epidemic threshold, higher values of sensitivity and specificity suggest a higher validity for the seasonal model (0.87 and 0.94, respectively) than model without seasonality (0.73 and 0.68, respectively). Conclusion: A two-state Hidden Markov Model along with a seasonal trend as a function of the model parameters provides an effective warning system for the surveillance of tuberculosis.

Rafei, A; Pasha, E; Jamshidi Orak, R

2012-01-01

208

Direct susceptibility testing for multi drug resistant tuberculosis: A meta-analysis  

Microsoft Academic Search

BACKGROUND: One of the challenges facing the tuberculosis (TB) control programmes in resource-limited settings is lack of rapid techniques for detection of drug resistant TB, particularly multi drug resistant tuberculosis (MDR TB). Results obtained with the conventional indirect susceptibility testing methods come too late to influence a timely decision on patient management. More rapid tests directly applied on sputum samples

Freddie Bwanga; Sven Hoffner; Melles Haile; Moses L Joloba

2009-01-01

209

Mycobacterium tuberculosis infection and the subsequent development of asthma and allergic conditions  

Microsoft Academic Search

Background: Epidemiologic studies have suggested that certain viral infections, as well as exposure to Mycobacterium tuberculosis in early life, could, at least to some extent, prevent the subsequent development of atopic disease. Objective: We investigated whether M tuberculosis infection in childhood or adolescence has any effect on the development of asthma and allergic conditions in later life. Methods: The study

Leena von Hertzen; T. Klaukka; H. Mattila; T. Haahtela

1999-01-01

210

Genomic Diversity among Drug Sensitive and Multidrug Resistant Isolates of Mycobacterium tuberculosis with Identical DNA Fingerprints  

Microsoft Academic Search

BackgroundMycobacterium tuberculosis complex (MTBC), the causative agent of tuberculosis (TB), is characterized by low sequence diversity making this bacterium one of the classical examples of a genetically monomorphic pathogen. Because of this limited DNA sequence variation, routine genotyping of clinical MTBC isolates for epidemiological purposes relies on highly discriminatory DNA fingerprinting methods based on mobile and repetitive genetic elements. According

Stefan Niemann; Claudio U. Köser; Sebastien Gagneux; Claudia Plinke; Susanne Homolka; Helen Bignell; Richard J. Carter; R. Keira Cheetham; Anthony Cox; Niall A. Gormley; Paula Kokko-Gonzales; Lisa J. Murray; Roberto Rigatti; Vincent P. Smith; Felix P. M. Arends; Helen S. Cox; Geoff Smith; John A. C. Archer; Niyaz Ahmed

2009-01-01

211

Identifi cation of diagnostic markers for tuberculosis by proteomic fi ngerprinting of serum  

Microsoft Academic Search

Summary Background We investigated the potential of proteomic fi ngerprinting with mass spectrometric serum profi ling, coupled with pattern recognition methods, to identify biomarkers that could improve diagnosis of tuberculosis. Methods We obtained serum proteomic profi les from patients with active tuberculosis and controls by surface-enhanced laser desorption ionisation time of fl ight mass spectrometry. A supervised machine-learning approach based

Dan Agranoff; Delmiro Fernandez-Reyes; Marios C Papadopoulos; Sergio A Rojas; Mark Herbster; Alison Loosemore; Edward Tarelli; Jo Sheldon; Achim Schwenk; Richard Pollok; Charlotte F J Rayner; Sanjeev Krishna

2006-01-01

212

The role of entry screening in case finding of tuberculosis among asylum seekers in Norway  

Microsoft Academic Search

BACKGROUND: Most new cases of active tuberculosis in Norway are presently caused by imported strains and not transmission within the country. Screening for tuberculosis with a Mantoux test of everybody and a chest X-ray of those above 15 years of age is compulsory on arrival for asylum seekers. We aimed to assess the effectiveness of entry screening of a cohort

Ingunn Harstad; Geir W Jacobsen; Einar Heldal; Brita A Winje; Saeed Vahedi; Anne-Sofie Helvik; Sigurd L Steinshamn; Helge Garåsen

2010-01-01

213

Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study  

Microsoft Academic Search

BACKGROUND: Delayed diagnosis and treatment of tuberculosis (TB) results in severe disease and a higher mortality. It also leads to an increased period of infectivity in the community. The objective of this study was to determine the length of delays, and analyze the factors affecting the delay from onset of symptoms of pulmonary tuberculosis (PTB) until the commencement of treatment.

Solomon Yimer; Gunnar Bjune; Getu Alene

2005-01-01

214

Nonlinear pattern of pulmonary tuberculosis among migrants at entry in Kuwait: 1997–2006  

Microsoft Academic Search

BACKGROUND: There is a paucity of published data on the pattern of pulmonary tuberculosis among migrant workers entering Middle Eastern countries particularly Kuwait. The objectives of this study were to use routine health surveillance data i) to estimate the prevalence of pulmonary tuberculosis among migrant workers at entry in Kuwait and ii) to determine the occurrence of any time trends

Saeed Akhtar; Hameed GHH Mohammad

2008-01-01

215

Field test of a novel detection device for Mycobacterium tuberculosis antigen in cough  

Microsoft Academic Search

BACKGROUND: Tuberculosis is a highly infectious disease that is spread from person to person by infected aerosols emitted by patients with respiratory forms of the disease. We describe a novel device that utilizes immunosensor and bio-optical technology to detect M. tuberculosis antigen (Ag85B) in cough and demonstrate its use under field conditions during a pilot study in an area of

Ruth McNerney; Beyene A Wondafrash; Kebede Amena; Ato Tesfaye; Elaine M McCash; Nicol J Murray

2010-01-01

216

BCG Vaccination and Active Tuberculosis Prevention: A Three-Year Study  

Microsoft Academic Search

Background: Six to eight million people are infected with tuberculosis (TB) annually throughout the world, out of which 2 to 3 million die. BCG vaccination and its efficacy are always used in tuberculosis control planning. There are different rates of BCG vaccination efficacy in the world from 0 to 80%. BCG vaccine has different efficacy in endemic and non-endemic areas.

Masoomeh Alimagham; Saeid Aminiafshar; Siamak Farahmand; Parviz Vahdani; Mostafa Alavi; Kamran Sharafi

217

Reversion of the ELISPOT test after treatment in Gambian tuberculosis cases  

Microsoft Academic Search

BACKGROUND: New tools are required to improve tuberculosis (TB) diagnosis and treatment, including enhanced ability to compare new treatment strategies. The ELISPOT assay uses Mycobacterium tuberculosis-specific antigens to produce a precise quantitative readout of the immune response to pathogen. We hypothesized that TB patients in The Gambia would have reduced ELISPOT counts after successful treatment. METHODS: We recruited Gambian adults

Alexander M Aiken; Philip C Hill; Annette Fox; Keith PWJ McAdam; Dolly Jackson-Sillah; Moses D Lugos; Simon A Donkor; Richard A Adegbola; Roger H Brookes

2006-01-01

218

Tuberculosis. Part I.  

PubMed

Tuberculosis has been a disease of human beings for thousands of years. In recent times it has waxed to become the feared White Plague of the eighteenth and nineteenth centuries and waned under the impact of effective chemotherapy until its elimination seemed possible by the early twenty-first century. The resurgence of tuberculosis in the past 10 to 15 years, caused by unanticipated events such as the appearance of the human immunodeficiency virus and deteriorating social conditions, also brought with it the problem of multiple drug resistance. Control measures such as tuberculin skin testing, perhaps somewhat forgotten when tuberculosis seemed to be a disease of the past, again became first-line defenses against spread of the disease. Environmental controls must be well understood and used effectively. Diagnosis of tuberculosis requires knowledge of the strengths and shortcomings of the various diagnostic methods and experience in their use. Practitioners are cautioned to remember that no diagnostic method, by itself, can be relied on to confirm or rule out tuberculosis. Well-tested diagnostic methods of chest radiograph, tuberculin skin testing, smear, and culture have been recently supplemented by rapid diagnostic tests based on amplification of bacterial RNA and DNA. More invasive diagnostic methods are sometimes required to diagnose extrapulmonary disease. Two-drug up to seven-drug therapy may be indicated for a case of tuberculosis, depending on evidence of the presence of multiple drug resistance. Duration of treatment can range from 6 to 12 months, also depending on identification of drug-sensitive or drug-resistant organisms. Failure of compliance can be a significant problem in patients who are homeless, or drug abusers, or who for various reasons cannot or will not complete a course of therapy. Directly observed therapy is strongly recommended for these patients, and for assistance in its administration the physician must cooperate with the local or state health department. The health department also must be notified whenever a case of tuberculosis is identified. PMID:9105282

McDermott, L J; Glassroth, J; Mehta, J B; Dutt, A K

1997-03-01

219

Tuberculosis among Children in Alaska.  

ERIC Educational Resources Information Center

|The incidence of tuberculosis among Alaskan children under 15 was more than twice the national rate, with Alaska Native children showing a much higher incidence. Children with household exposure to adults with active tuberculosis had a high risk of infection. About 22 percent of pediatric tuberculosis cases were identified through school…

Gessner, Bradford D.

1997-01-01

220

Tuberculosis: A Problem for Lifeguards?  

ERIC Educational Resources Information Center

|Lifeguards run the risk of workplace infection by tuberculosis-carrying swimmers. Even if they work in ventilated, sunlit areas (which reduces risk), they can contract tuberculosis when performing respiratory resuscitation. Without appropriate precautions, lifeguards may be unnecessarily exposed. A tuberculosis infection control plan is needed in…

Skaros, Susan

1996-01-01

221

Childhood Tuberculosis, Still with Us...  

ERIC Educational Resources Information Center

|The first section of this report on childhood tuberculosis in developed and developing countries discusses the epidemiology of tuberculosis in children. Information is presented on: (1) sources and prevalence of infection; (2) risks, frequency, and types of tuberculosis; (3) mortality rates; and (4) the relation of poverty and AIDS to…

Chaulet, Pierre; And Others

1992-01-01

222

Chylothorax due to Mycobacterium tuberculosis.  

PubMed Central

Chylothorax in an adult is a rare cause of pleural effusion. Mycobacterium tuberculosis may cause chylous effusion, but usually in association with extensive intrapulmonary involvement. A case of chylothorax is presented in which M tuberculosis was isolated from the pleural fluid and was the only intrathoracic manifestation of tuberculosis.

Anton, P A; Rubio, J; Casan, P; Franquet, T

1995-01-01

223

Oral tuberculosis involving maxillary gingiva  

PubMed Central

Tuberculosis (TB) is a communicable disease caused by Mycobacterium tuberculosis, which is transmitted by aerosolized saliva droplets among individuals in close contact with expelled sputum of a diseased patient. However, TB lesions of the oral cavity are often overlooked in the differential diagnosis. We report here a case of tuberculosis of oral cavity affecting the gingiva of a 24-year-old male.

Jaiswal, Rohit; Singh, Anil; Badni, Manjunath; Singh, Priyanka

2011-01-01

224

Multiple Cytokines Are Released When Blood from Patients with Tuberculosis Is Stimulated with Mycobacterium tuberculosis Antigens  

PubMed Central

Background Mycobacterium tuberculosis (Mtb) infection may cause overt disease or remain latent. Interferon gamma release assays (IGRAs) detect Mtb infection, both latent infection and infection manifesting as overt disease, by measuring whole-blood interferon gamma (IFN-?) responses to Mtb antigens such as early secreted antigenic target-6 (ESAT-6), culture filtrate protein 10 (CFP-10), and TB7.7. Due to a lack of adequate diagnostic standards for confirming latent Mtb infection, IGRA sensitivity for detecting Mtb infection has been estimated using patients with culture-confirmed tuberculosis (CCTB) for whom recovery of Mtb confirms the infection. In this study, cytokines in addition to IFN-? were assessed for potential to provide robust measures of Mtb infection. Methods Cytokine responses to ESAT-6, CFP-10, TB7.7, or combinations of these Mtb antigens, for patients with CCTB were compared with responses for subjects at low risk for Mtb infection (controls). Three different multiplexed immunoassays were used to measure concentrations of 9 to 20 different cytokines. Responses were calculated by subtracting background cytokine concentrations from cytokine concentrations in plasma from blood stimulated with Mtb antigens. Results Two assays demonstrated that ESAT-6, CFP-10, ESAT-6+CFP-10, and ESAT-6+CFP-10+TB7.7 stimulated the release of significantly greater amounts of IFN-?, IL-2, IL-8, MCP-1 and MIP-1? for CCTB patients than for controls. Responses to combination antigens were, or tended to be, greater than responses to individual antigens. A third assay, using whole blood stimulation with ESAT-6+CFP-10+TB7.7, revealed significantly greater IFN-?, IL-2, IL-6, IL-8, IP-10, MCP-1, MIP-1?, and TNF-? responses among patients compared with controls. One CCTB patient with a falsely negative IFN-? response had elevated responses with other cytokines. Conclusions Multiple cytokines are released when whole blood from patients with CCTB is stimulated with Mtb antigens. Measurement of multiple cytokine responses may improve diagnostic sensitivity for Mtb infection compared with assessment of IFN-? alone.

Kellar, Kathryn L.; Gehrke, Jennifer; Weis, Stephen E.; Mahmutovic-Mayhew, Aida; Davila, Blachy; Zajdowicz, Margan J.; Scarborough, Robin; LoBue, Philip A.; Lardizabal, Alfred A.; Daley, Charles L.; Reves, Randall R.; Bernardo, John; Campbell, Brandon H.; Whitworth, William C.; Mazurek, Gerald H.

2011-01-01

225

Direct molecular detection of Mycobacterium tuberculosis complex from clinical samples - An adjunct to cultural method of laboratory diagnosis of tuberculosis  

PubMed Central

Background: Tuberculosis, a communicable disease with significant morbidity and mortality, is the leading cause of death in the world from bacterial infectious disease. Because of its public health importance, there is need for rapid and definitive method of detecting the causative organism. Several approaches have been attempted, but the molecular methods, especially Polymerase Chain Reaction assays are the most promising for rapid detection of Mycobacterium tuberculosis complex from clinical samples. Aim: This study was aimed at using Polymerase Chain Reaction for detection of Mycobacterium tuberculosis complex from clinical samples using universal sample processing methodology. Subjects and Methods: Two hundred clinical samples sent to Tuberculosis laboratories in Ibadan and Osogbo, Nigeria, were enrolled in this study. The samples were processed by universal sample processing methodology for PCR; smear microscopy was carried out on sputum samples by Ziehl Nelseen staining technique; and cultured on Middlebrook agar medium containing oleic acid albumin dextrose complex supplement after decontamination of samples. Results: Ninety six (48%) samples were detected positive for M. tuberculosis complex by polymerase chain reaction using the combination of boiling and vortexing and microscopy detected 72 (36%) samples positive for acid fast bacilli. Using culture method as gold standard, it was found that polymerase chain reaction assay was more sensitive (75.5%) and specific (94.8%) than microscopy (sensitivity of 48.5% and specificity of 85.7%) in detecting M. tuberculosis complex from clinical samples. There was significant difference in detecting M. tuberculosis from clinical samples when compared to microscopy (p<0.05). Conclusion: The study recommends that direct molecular detection of M. tuberculosis complex is sensitive and specific and polymerase chain reaction method should be used as an adjunct to other methods of laboratory diagnosis of tuberculosis.

Alli, Oyebode A. T.; Ogbolu, Olusoga D.; Alaka, Olubunmi O.

2011-01-01

226

Factors associated with default from treatment among tuberculosis patients in nairobi province, Kenya: A case control study  

PubMed Central

Background Successful treatment of tuberculosis (TB) involves taking anti-tuberculosis drugs for at least six months. Poor adherence to treatment means patients remain infectious for longer, are more likely to relapse or succumb to tuberculosis and could result in treatment failure as well as foster emergence of drug resistant tuberculosis. Kenya is among countries with high tuberculosis burden globally. The purpose of this study was to determine the duration tuberculosis patients stay in treatment before defaulting and factors associated with default in Nairobi. Methods A Case-Control study; Cases were those who defaulted from treatment and Controls those who completed treatment course between January 2006 and March 2008. All (945) defaulters and 1033 randomly selected controls from among 5659 patients who completed treatment course in 30 high volume sites were enrolled. Secondary data was collected using a facility questionnaire. From among the enrolled, 120 cases and 154 controls were randomly selected and interviewed to obtain primary data not routinely collected. Data was analyzed using SPSS and Epi Info statistical software. Univariate and multivariate logistic regression analysis to determine association and Kaplan-Meier method to determine probability of staying in treatment over time were applied. Results Of 945 defaulters, 22.7% (215) and 20.4% (193) abandoned treatment within first and second months (intensive phase) of treatment respectively. Among 120 defaulters interviewed, 16.7% (20) attributed their default to ignorance, 12.5% (15) to traveling away from treatment site, 11.7% (14) to feeling better and 10.8% (13) to side-effects. On multivariate analysis, inadequate knowledge on tuberculosis (OR 8.67; 95% CI 1.47-51.3), herbal medication use (OR 5.7; 95% CI 1.37-23.7), low income (OR 5.57, CI 1.07-30.0), alcohol abuse (OR 4.97; 95% CI 1.56-15.9), previous default (OR 2.33; 95% CI 1.16-4.68), co-infection with Human immune-deficient Virus (HIV) (OR 1.56; 95% CI 1.25-1.94) and male gender (OR 1.43; 95% CI 1.15-1.78) were independently associated with default. Conclusion The rate of defaulting was highest during initial two months, the intensive phase of treatment. Multiple factors were attributed by defaulting patients as cause for abandoning treatment whereas several were independently associated with default. Enhanced patient pre-treatment counseling and education about TB is recommended.

2011-01-01

227

Kinetics and Ligand-Binding Preferences of Mycobacterium tuberculosis Thymidylate Synthases, ThyA and ThyX  

PubMed Central

Background Mycobacterium tuberculosis kills approximately 2 million people each year and presents an urgent need to identify new targets and new antitubercular drugs. Thymidylate synthase (TS) enzymes from other species offer good targets for drug development and the M. tuberculosis genome contains two putative TS enzymes, a conventional ThyA and a flavin-based ThyX. In M. tuberculosis, both TS enzymes have been implicated as essential for growth, either based on drug-resistance studies or genome-wide mutagenesis screens. To facilitate future small molecule inhibitors against these proteins, a detailed enzymatic characterization was necessary. Methodology/Principal Findings After cloning, overexpression, and purification, the thymidylate-synthesizing ability of ThyA and ThyX gene products were directly confirmed by HPLC analysis of reaction products and substrate saturation kinetics were established. 5-Fluoro-2?-deoxyuridine 5?-monophosphate (FdUMP) was a potent inhibitor of both ThyA and ThyX, offering important clues to double-targeting strategies. In contrast, the folate-based 1843U89 was a potent inhibitor of ThyA but not ThyX suggesting that it should be possible to find ThyX-specific antifolates. A turnover-dependent kinetic assay, combined with the active-site titration approach of Ackermann and Potter, revealed that both M. tuberculosis enzymes had very low kcat values. One possible explanation for the low catalytic activity of M. tuberculosis ThyX is that its true biological substrates remain to be identified. Alternatively, this slow-growing pathogen, with low demands for TMP, may have evolved to down-regulate TS activities by altering the turnover rate of individual enzyme molecules, perhaps to preserve total protein quantities for other purposes. In many organisms, TS is often used as a part of larger complexes of macromolecules that control replication and DNA repair. Conclusions/Significance Thus, the present enzymatic characterization of ThyA and ThyX from M. tuberculosis provides a framework for future development of cell-active inhibitors and the biological roles of these TS enzymes in M. tuberculosis.

Hunter, Joshua H.; Gujjar, Ramesh; Pang, Cullen K. T.; Rathod, Pradipsinh K.

2008-01-01

228

Review of cigarette smoking and tuberculosis in China: intervention is needed for smoking cessation among tuberculosis patients  

Microsoft Academic Search

BACKGROUND: As a risk factor of tuberculosis (TB), tobacco smoking has increased substantially over the past three decades, especially in developing countries. However, the association between smoking and TB, which has been shown to exist in different studies with different ethnic background, has not yet received sufficient attention in terms of TB care standards and research in China. METHODS: An

Jianming Wang; Hongbing Shen

2009-01-01

229

EXPERIMENTAL EPIDEMIOLOGY OF TUBERCULOSIS  

PubMed Central

1. Ultraviolet irradiation of the air of a room exercises a protective influence against natural air-borne contagion of tuberculosis in rabbits. 2. When the radiant energy is of low intensity it reduces considerably the incidence of tuberculosis. (a) It completely protects rabbits of high natural resistance from acquiring demonstrable disease though they become tuberculin sensitive. (b) It fails to protect a small proportion of rabbits of low natural resistance from fatal tuberculosis. 3. When the radiant energy is of high intensity all rabbits, whether of high or of low natural resistance, are almost completely protected from a contagion so severe that it is fatal to the great majority of rabbits of the same genetic constitution not protected by these rays. The protected rabbits do not develop tuberculin sensitivity. 4. The contagion of tuberculosis in these studies is air-borne and the radiant energy exercises its protective influence by its bactericidal properties. It is probable that ultraviolet irradiation may control air-borne contagion of human tuberculosis.

Lurie, Max B.

1944-01-01

230

[Urogenital tuberculosis today].  

PubMed

In order to analyze the structure of urogenital tuberculosis, retrospective analysis of medical records of 131 patients with newly diagnosed urogenital tuberculosis observed in the Novosibirsk Regional TB Dispensary from 2009 to 2011 was performed. The renal tuberculosis is main form in the structure is urotuberculosis, detected in 75% of patients, and widespread destructive forms of the disease were diagnosed in more than half of cases. Isolated nephrotuberculosis was more often diagnosed in women--56.8%. 15.9% of patients had asymptomatic nephrotuberculosis; one-third of patients complained of pain in the lumbar region and frequent painful urination (35.2 and 39.8%, respectively); symptoms of intoxication were present in 17% of patients, renal colic--in 9.1%, and gross hematuria--in 7.9% of patients. Mycobacteriuria in isolated nephrotuberculosis was detected in 31.8% of cases. Acute tuberculous orchiepididymitis developed in 35.7% of patients, hemospermia was observed in 7.1% of patients, dysuria was in 35.7% of patients. The pain in the perineum, frequent painful urination (both by 31.6%), hemospermia (26.3%) were main complaints in prostate tuberculosis. Mycobacteria was detected in 10.5% of cases. It was found that urogenital tuberculosis has no pathognomonic symptoms; the most alarming manifestations include long-term dysuria, hematuria, hemospermia. PMID:23662488

Zhukova, I I; Kul'chavenia, E V; Kholtobin, D P; Brizhatiuk, E V; Khomiakov, V T; Osadchi?, A V

231

Pathogenesis of Central Nervous System Tuberculosis  

Microsoft Academic Search

Central Nervous System (CNS) tuberculosis is a serious, often fatal form of tuberculosis, predomi- nantly affecting young children. HIV co-infection and drug resistant strains of Mycobacterium tuberculosis are making the diagnosis and treatment of CNS tuberculosis more complicated. Current concepts about the pat- hogenesis of CNS tuberculosis are based on necropsy studies done in 1933, which suggest that tuberculous meningitis

Nicholas A. Be; Kwang Sik Kim; William R. Bishai; Sanjay K. Jain

2009-01-01

232

The Singapore Tuberculosis Elimination Programme: the first five years.  

PubMed Central

The Singapore Tuberculosis Elimination Programme (STEP) was launched in 1997 because the incidence of the disease had remained between 49 and 56 per 100,000 resident population for the preceding 10 years. STEP involves the following key interventions: directly observed therapy (DOT) in public primary health care clinics; monitoring of treatment progress and outcome for all cases by means of a National Treatment Surveillance Registry; and preventive therapy for recently infected close contacts of infectious tuberculosis cases. Among other activities are the revamping of the National Tuberculosis Notification Registry, the discontinuation of BCG revaccination for schoolchildren, the tightening up of defaulter tracing, and the education of the medical community and the public. Future plans include an outreach programme for specific groups of patients who are unable to attend their nearest public primary care clinics for DOT, the detention of infectious recalcitrant defaulters for treatment under the Infectious Diseases Act, the molecular fingerprinting of tuberculosis isolates, and targeted screening of high-risk groups. The incidence of tuberculosis fell from 57 per 100,000 population in 1998 to 48 per 100,000 in 1999 and continued to decline to 44 per 100,000 in 2001. With political will and commitment and the support of the medical community and the public it is hoped that STEP will achieve further progress towards the elimination of tuberculosis in Singapore.

Chee, Cynthia B. E.; James, Lyn

2003-01-01

233

The global emergency of tuberculosis: what is the cause?  

PubMed

The treatment of tuberculosis is cheap and highly effective, yet worldwide the disease remains a serious cause of illness and death; so serious as to have been declared a 'global emergency' in 1993. It is principally a disease of poverty, with 95% of cases and 98% of deaths occurring in developing countries. The incidence of tuberculosis is increasing worldwide, partly due to poverty and inequity and partly to the HIV/AIDS pandemic, which greatly increases the risk of infection proceeding to overt disease. Around 30% of AIDS-related deaths are due to tuberculosis. The emergence of multidrug resistant tuberculosis (MDRTB) is an increasing threat to tuberculosis control. Although treatable with alternative drugs, the cost is enormous and, accordingly, not undertaken in many poor nations. While the overall global incidence of MDRTB is low, it occurs in certain 'hotspots' including Russian prisons. Due to adverse socio-economic factors, London has not escaped the general rise in incidence and, without the introduction of active control strategies, there could be a serious epidemic as occurred in New York City ten years ago which required an enormous financial outlay for its control. In view of the global emergency of tuberculosis, the WHO 'Stop TB' campaign has called for the universal adoption of its directly observed therapy, short course (DOTS) strategy. Also, though the Massive Effort Against Diseases of Poverty, several international agencies are urging the establishment of effective control programmes worldwide. London should take the lead and set an example. PMID:12134771

Grange, J M; Zumla, A

2002-06-01

234

Immunodiagnosis of tuberculosis: new questions, new tools conference 2008  

PubMed Central

Human infection with Mycobacterium tuberculosis exists as a spectrum of conditions ranging from asymptomatic infection to active disease. Novel, accurate tuberculosis immunodiagnostics have been introduced over the last decade, but it remains challenging to timely diagnose active disease and to accurately distinguish asymptomatic M. tuberculosis infection from immune memory resulting from a prior infection eradicated by the host response. The conference titled Immunodiagnosis of Tuberculosis: New Questions, New Tools, which was held on September 21-23, 2008 in Virginia Beach, Virginia, United States, brought together basic scientists and clinical experts to discuss recent progress in tuberculosis research and diagnosis. Global analyses of M. tuberculosis biology and the host immune response, with emphasis on systems approaches to the study of host-pathogen interactions, were presented. Moreover, conference participants discussed new tests in the pipeline and reviewed new technologies leading to novel assay formats. The discussion included technologies ranging from simple, inexpensive point-of-care tests to automated molecular platforms for detection of multiple infections based on the “lab on a chip” concept. It was also recognized that the utility of any new diagnostic relies on laboratory capacity, accessibility, costs, and test deployment. The conference included lessons from the field. For example, the application of existing technologies to neglected areas, such as diagnosis in children and HIV+ populations, was discussed.

2010-01-01

235

CT of abdominal tuberculosis  

SciTech Connect

Intraabdominal tuberculosis (TB) presents with a wide variety of clinical and radiologic features. Besides the reported computed tomographic (CT) finding of high-density ascites in tuberculous peritonitis, this report describes additional CT features highly suggestive of abdominal tuberculosis in eight cases: (1) irregular soft-tissue densities in the omental area; (2) low-density masses surrounded by thick solid rims; (3) a disorganized appearance of soft-tissue densities, fluid, and bowel loops forming a poorly defined mass; (4) low-density lymph nodes with a multilocular appearance after intravenous contrast administration; and (5) possibly high-density ascites. The differential diagnosis of these features include lymphoma, various forms of peritonitis, peritoneal carcinomatosis, and peritoneal mesothelioma. It is important that the CT features of intraabdominal tuberculosis be recognized in order that laparotomy be avoided and less invasive procedures (e.g., laparoscopy, biopsy, or a trial of antituberculous therapy) be instituted.

Epstein, B.M. (Univ. of the Witwatersrand, Johannesburg, South Africa); Mann, J.H.

1982-11-01

236

Spectrum of urogenital tuberculosis.  

PubMed

Urogenital tuberculosis (UGTB) plays an important role because its complications may be fatal, it significantly reduces quality of life, and it is often associated with AIDS. Diagnosis of UGTB is often delayed. We analyzed 131 case histories of UGTB patients from the years 2009-2011. Gender, age, and the clinical form and main features of the disease were taken into account. The most common form was kidney tuberculosis (74.8 %). Isolated kidney tuberculosis (KTB) more often occurs in women: 56.8 %. Patients of middle and old age more often showed the stage of cavernous KTB; younger patients had smaller forms. Among all cases, an asymptomatic course was seen in 12.2 % and, among cases of KTB, in 15.9 %. Every third patient complained of flank pain and dysuria (35.2 % and 39.8 %, respectively); 17 % presented with toxicity symptoms, 9.1 % with renal colic, and 7.9 % with gross hematuria. Mycobacterium tuberculosis (MTB) in urine was found in 31.8 % of cases in all levels of isolated KTB. UGTB has no specific symptom; even sterile pyuria occurs only in 25 %. The acute onset of tuberculous orchiepididymitis was seen in 35.7 % of patients, hemospermia in 7.1 %, and dysuria in 35.7 %. The most common complaints for prostate tuberculosis were perineal pain (31.6 %), dysuria (also 31.6 %), and hemospermia (26.3 %). MTB in prostate secretion/ejaculate was revealed in 10.5 % of this group. All urogenital tract infections should be suspected as UGTB in patients who are living in a region with a high incidence rate, who have had contact with tuberculosis infection, and who have a recurrence of the disease that is resistant to standard therapy. PMID:23526041

Kulchavenya, Ekaterina; Zhukova, Irina; Kholtobin, Denis

2013-03-25

237

Expression of TNF-Alpha-Dependent Apoptosis-Related Genes in the Peripheral Blood of Malagasy Subjects with Tuberculosis  

PubMed Central

The majority of Mycobacterium tuberculosis (Mtb) infections remain asymptomatic with only up to 10% progressing to clinical tuberculosis. However, the constituents of the effective “protective immunity” against tuberculosis responsible for containing most infections remain unknown. Evaluating gene transcriptional profiles in tuberculosis clinical cohorts is one approach to understanding the spectrum of tuberculosis progression. It is clear that apoptosis plays a role in the control of tuberculosis but the utility of apoptosis-related genes as surrogate markers of protection against tuberculosis has not been well investigated. To characterize potential surrogate markers that could discriminate different phases of the clinical tuberculosis spectrum, we investigated gene expression of several TNF-alpha dependent apoptotic genes (TNFR1, TNFR2, FLICE, FLIPs) by real-time RT-PCR of peripheral blood cells from cohorts of individuals with active tuberculosis or potential exposure to tuberculosis. Newly diagnosed tuberculosis patients (n?=?23), their close household contacts (n?=?80), and community controls (n?=?46) were tested at intervals over a period of up to two years. Latent infection or previous Mtb contact was assessed by ELISPOT and TST and complete blood counts were performed during the follow up. Results showed significant upregulation of FLIPs expression by infected individuals regardless of clinical status at entry to the study. A higher percentage of lymphocytes was found in the infected household contacts that remained healthy. In contrast, in individuals with active TB, a significant upregulation of TNFR2 expression, a significantly higher percentage of monocytes and a significantly decreased lymphocyte count were seen, compared to subjects that remained healthy. Moreover, the household contacts who subsequently developed signs of TB also had a significantly high number of monocytes. These data suggest tuberculosis may be associated with decreased T-cell survival (perhaps due to apoptosis) while inhibition of apoptosis in monocytes could lead to a relative increase in these cells: a situation predicted to favour Mtb.

Rakotosamimanana, Niaina; Doherty, T. Mark; Andriamihantasoa, Lova H.; Richard, Vincent; Gicquel, Brigitte; Soares, Jean-Louis; Zumla, Alimuddin; Razanamparany, Voahangy Rasolofo

2013-01-01

238

Activated B cells in the granulomas of nonhuman primates infected with Mycobacterium tuberculosis.  

PubMed

In an attempt to contain Mycobacterium tuberculosis, host immune cells form a granuloma as a physical and immunological barrier. To date, the contribution of humoral immunity, including antibodies and specific functions of B cells, to M. tuberculosis infection in humans remains largely unknown. Recent studies in mice show that humoral immunity can alter M. tuberculosis infection outcomes. M. tuberculosis infection in cynomolgus macaques recapitulates essentially all aspects of human tuberculosis. As a first step toward understanding the importance of humoral immunity to control of M. tuberculosis infection in primates, we characterized the B-cell and plasma-cell populations in infected animals and found that B cells are present primarily in clusters within the granuloma. The B-cell clusters are in close proximity to peripheral node addressin-positive cells and contain cells positive for Ki-67, a proliferation marker. Granuloma B cells also express CXCR5 and have elevated HLA-DR expression. Tissues containing M. tuberculosis bacilli had higher levels of M. tuberculosis-specific IgG, compared with uninvolved tissue from the same monkeys. Plasma cells detected within the granuloma produced mycobacteria-specific antibodies. Together, these data demonstrate that B cells are present and actively secreting antibodies specific for M. tuberculosis antigens at the site of infection, including lung granulomas and thoracic lymph nodes. These antibodies likely have the capacity to modulate local control of infection in tissues. PMID:22721647

Phuah, Jia Yao; Mattila, Joshua T; Lin, Philana L; Flynn, JoAnne L

2012-06-19

239

Human phagosome processing of Mycobacterium tuberculosis antigens is modulated by interferon-? and interleukin-10.  

PubMed

Intracellular pathogens, such as Mycobacterium tuberculosis, reside in the phagosomes of macrophages where antigenic processing is initiated. Mycobacterial antigen-MHC class II complexes are formed within the phagosome and are then trafficked to the cell surface. Interferon-? (IFN-?) and interleukin-10 (IL-10) influence the outcome of M. tuberculosis infection; however, the role of these cytokines with regard to the formation of M. tuberculosis peptide-MHC-II complexes remains unknown. We analysed the kinetics and subcellular localization of M. tuberculosis peptide-MHC-II complexes in M. tuberculosis-infected human monocyte-derived macrophages (MDMs) using autologous M. tuberculosis-specific CD4(+) T cells. The MDMs were pre-treated with either IFN-? or IL-10 and infected with M. tuberculosis. Cells were mechanically homogenized, separated on Percoll density gradients and manually fractionated. The fractions were incubated with autologous M. tuberculosis -specific CD4(+) T cells. Our results demonstrated that in MDMs pre-treated with IFN-?, M. tuberculosis peptide-MHC-II complexes were detected early mainly in the phagosomal fractions, whereas in the absence of IFN-?, the complexes were detected in the endosomal fractions. In MDMs pre-treated with IL-10, the M. tuberculosis peptide-MHC-II complexes were retained in the endosomal fractions, and these complexes were not detected in the plasma membrane fractions. The results of immunofluorescence microscopy demonstrated the presence of Ag85B associated with HLA-DR at the cell surface only in the IFN-?-treated MDMs, suggesting that IFN-? may accelerate M. tuberculosis antigen processing and presentation at the cell membrane, whereas IL-10 favours the trafficking of Ag85B to vesicles that do not contain LAMP-1. Therefore, IFN-? and IL-10 play a role in the formation and trafficking of M. tuberculosis peptide-MHC-II complexes. PMID:22924705

Bobadilla, Karen; Sada, Eduardo; Jaime, Maria E; González, Yolanda; Ramachandra, Lakshmi; Rojas, Roxana E; Pedraza-Sánchez, Sigifredo; Michalak, Colette; González-Noriega, Alfonso; Torres, Martha

2013-01-01

240

Tuberculosis Facts - TB and HIV/AIDS  

MedlinePLUS

... STD, and TB Prevention Division of Tuberculosis Elimination Tuberculosis (TB) Facts TB and HIV/AIDS What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ...

241

Tuberculosis Facts - TB Can Be Treated  

MedlinePLUS

... STD, and TB Prevention Division of Tuberculosis Elimination Tuberculosis (TB) Facts TB Can Be Treated What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ...

242

Tuberculosis Facts - You Can Prevent TB  

MedlinePLUS

... STD, and TB Prevention Division of Tuberculosis Elimination Tuberculosis (TB) Facts You Can Prevent TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ...

243

Treatment of Mycobacterium Tuberculosis with Antisense Oligonucleotides.  

National Technical Information Service (NTIS)

Methods of inhibiting the proliferation of Mycobacterium tuberculosis comprising contacting Mycobacterium tuberculosis with an effective amount of a polynucleotide complementary to an mRNA transcript expressed by Mycobacterium tuberculosis are provided. T...

D. Tabatadze G. Harth M. A. Horwitz P. C. Zamecnik

2002-01-01

244

Cost implications of delays to tuberculosis diagnosis among pulmonary tuberculosis patients in Ethiopia  

PubMed Central

Background Delays seeking care worsen the burden of tuberculosis and cost of care for patients, families and the public health system. This study investigates costs of tuberculosis diagnosis incurred by patients, escorts and the public health system in 10 districts of Ethiopia. Methods New pulmonary tuberculosis patients ? 15 years old were interviewed regarding their health care seeking behaviour at the time of diagnosis. Using a structured questionnaire patients were interviewed about the duration of delay at alternative care providers and the public health system prior to diagnosis. Costs incurred by patients, escorts and the public health system were quantified through patient interview and review of medical records. Results Interviews were held with 537 (58%) smear positive patients and 387 (42%) smear negative pulmonary patients. Of these, 413 (45%) were female; 451 (49%) were rural residents; and the median age was 34 years. The mean (median) days elapsed for consultation at alternative care providers and public health facilities prior to tuberculosis diagnosis was 5 days (0 days) and 3 (3 days) respectively. The total median cost incurred from first consultation to diagnosis was $27 per patient (mean = $59). The median costs per patient incurred by patient, escort and the public health system were $16 (mean = $29), $3 (mean = $23) and $3 (mean = $7) respectively. The total cost per patient diagnosed was higher for women, rural residents; those who received government food for work support, patients with smear negative pulmonary tuberculosis and patients who were not screened for TB in at least one district diagnostic centers. Conclusions The costs of tuberculosis diagnosis incurred by patients and escorts represent a significant portion of their monthly income. The costs arising from time lost in seeking care comprised a major portion of the total cost of diagnosis, and may worsen the economic position of patients and their families. Getting treatment from alternative sources and low index of suspicion public health providers were key problems contributing to increased cost of tuberculosis diagnosis. Thus, the institution of effective systems of referral, ensuring screening of suspects across the district public health system and the involvement of alternative care providers in district tuberculosis control can reduce delays and the financial burden to patients and escorts.

2010-01-01

245

Control and prevention of tuberculosis in the United Kingdom: Code of Practice 2000  

PubMed Central

BACKGROUND—The guidelines on control and prevention of tuberculosis in the United Kingdom have been reviewed and updated.?METHODS—A subcommittee was appointed by the Joint Tuberculosis Committee (JTC) of the British Thoracic Society to revise the guidelines published in 1994 by the JTC, including representatives of the Royal College of Nursing, Public Health Medicine Environmental Group, and Medical Society for Study of Venereal Diseases. In preparing the revised guidelines the authors took account of new published evidence and graded the strength of evidence for their recommendations. The guidelines have been approved by the JTC and the Standards of Care Committee of the British Thoracic Society.?RECOMMENDATIONS—Tuberculosis services in each district should have staffing and resources to fulfil both the control and prevention recommendations in this document and to ensure adequate treatment monitoring. Notification of tuberculosis is required for surveillance and to initiate contact tracing (where appropriate). The following areas are discussed and recommendations made where appropriate: (1) public health law in relation to tuberculosis; (2) the organisational requirements for tuberculosis services; (3) measures for control of tuberculosis in hospitals, including segregation of patients; (4) the requirements for health care worker protection, including HIV infected health care workers; (5) measures for control of tuberculosis in prisons; (6) protection for other groups with potential exposure to tuberculosis; (7) awareness of the high rates of tuberculosis in the homeless together with local plans for detection and action; (8) detailed advice on contact tracing; (9) contact tracing required for close contacts of bovine tuberculosis; (10) management of tuberculosis in schools; (11) screening of new immigrants and how this should be performed; (12) outbreak contingency investigation; and (13) BCG vaccination and the management of positive reactors found in the schools programme.??

Joint, T

2000-01-01

246

Estimates of the impact of diabetes on the incidence of pulmonary tuberculosis in different ethnic groups in England  

Microsoft Academic Search

BackgroundThere is good evidence that diabetes is a risk factor for pulmonary tuberculosis. In England, the rates of both diabetes and tuberculosis vary markedly by ethnic group.ObjectiveTo estimate the proportion of incident cases of pulmonary tuberculosis attributable to diabetes (population attributable fraction, PAF) for Asian, black and white men and women aged ?15 years in England.MethodsAn epidemiological model was constructed

Caron Walker; Nigel Unwin

2010-01-01

247

Tuberculosis in fennec foxes.  

PubMed

Fennec foxes (Fennecus zerda) in 2 zoos were found on necropsy to have lesions typical of those found in canine tuberculosis. Histologic examination revealed numerous acid-fast bacilli in lesions of liver, portal lymph node, spleen, kidney, and lung. Mycobacterium bovis isolated from tissues was identified by biochemical methods and by pathogenicity tests in guinea pigs and rabbits. PMID:7005205

Himes, E M; Luchsinger, D W; Jarnagin, J L; Thoen, C O; Hood, H B; Ferrin, D A

1980-11-01

248

Iron, mycobacteria and tuberculosis  

Microsoft Academic Search

The role of iron in the growth and metabolism of M. tuberculosis and other mycobacteria is discussed in relation to the acquisiton of iron from host sources, such as transferrin, lactoferrin and ferritin, and its subsequent assimilation and utilization by the bacteria. Key components involved in the acquisition of iron (as ferric ion) and its initial transport into the mycobacterial

Colin Ratledge

2004-01-01

249

Tuberculosis and HIV  

MedlinePLUS

... to address TB and HIV coinfection around the world? The Presidentâ??s U.S. President's Emergency Plan for AIDS ... of those suffering from HIV/AIDS around the world. PEPFARâ??s Global Fund to Fight AIDS, Tuberculosis and ...

250

[New era in molecular epidemiology of tuberculosis in Japan].  

PubMed

Molecular epidemiology of tuberculosis (TB) is a science to study TB transmission dynamics and to enhance our understanding of the epidemiology of TB by utilizing molecular typing methods as an adjunct to classical epidemiological approach. Before the era of molecular epidemiology, it was quite difficult to ascertain the source of the infections since M. tuberculosis is spread by air-borne droplets of respiratory secretions expelled by an infectious person to a susceptible host and it can remain latent as an asymptomatic infection for years. Now a day, our understanding of TB transmission dynamics has been refined by genotyping of M. tuberculosis strains. The methods of molecular epidemiology, especially IS6110 RFLP of M. tuberculosis, were first introduced to outbreak investigations and then gradually been expanded its application to population-based study in Japan. IS6110 RFLP is obviously a powerful tool for strain differentiation of M. tuberculosis but its labor-intensiveness limits the achievable throughput and makes it less useful for long-term prospective studies. Recently, apart from IS6110 RFLP, DNA amplification-based method, i.e., variable number of tandem repeats (VNTR) has appeared as a substitute for or adjunct to the IS6110 RFLP. In this symposium, we have invited four opinion leaders in molecular epidemiology of TB from different fields: Mycobacterium reference center, basic science, clinical practice, and public health practice. We, as the chairpersons of this symposium, hope that this symposium would trigger the development of molecular epidemiological network of TB in Japan. 1. Achievement and problem of molecular epidemiologic study with IS6110-RFLP analyses of tuberculosis in Okinawa: Shinji MAEDA (Mycobacterium Reference Center, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association) The long-term RFLP analyses of tuberculosis in Okinawa showed that endemic M. tuberculosis might be present. This is one of the achievements of our project study. On the other hand, for more effective examination of contact persons, information of molecular epidemiology should be used actively. Therefore because the analysis report needs to be sent back quickly, the PCR-based VNTR method should substitute for the RFLP analysis. 2. Basic knowledge and application of Variable Numbers of Tandem Repeats: Kei NISHIMORI (Department of epidemiology, National Institute of Animal Health) Genomic loci of Variable Numbers of Tandem Repeats (VNTR loci) in Mycobacterium tuberculosis complex and Mycobacterium avium, the history of analysis of VNTR loci, the hypothetical mechanisms of increase or decrease of number of repeats, the structures of the loci, and the necessity of standardizing the VNTR typing were introduced. 3. Clinical application of VNTR: Tomoshige MATSUMOTO, and Hiromi ANO (Department of Clinical Research and Development, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases) Tuberculosis genotyping was first introduced to outbreak investigations and population-based studies. The advent of Variable Numbers of Tandem Repeats (VNTR) can be applied to clinical fields of not only Mycobacterium tuberculosis but also of Mycobacterium avium. In Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, clinical application of VNTR was first introduced in Japan to determine whether Mycobacterium tuberculosis or avium disease was caused by reactivation or reinfection when relapsed. We showed some examples about usefulness of the clinical application of VNTR. 4. Molecular epidemiology of tuberculosis to improve TB prevention and control activities: Tomotada IWAMOTO (Department of microbiology, Kobe Institute of Health), Riyo FUJIYAMA, Noriko TANAKA, Yasuto KAWAKAMI (Kobe City Public Health Center), Chika SHIRAI (Hyogo-ku Health and Welfare Department, Kobe) M. tuberculosis isolates in Kobe have been characterized as: a) Beijing family strains are highly prevalent (77%), b) two major MIRU profiles in Beijing family were found, one is global

Takashima, Tetsuya; Iwamoto, Tomotada

2006-11-01

251

Ghost Remains After Black Hole Eruption  

NASA Astrophysics Data System (ADS)

NASA's Chandra X-ray Observatory has found a cosmic "ghost" lurking around a distant supermassive black hole. This is the first detection of such a high-energy apparition, and scientists think it is evidence of a huge eruption produced by the black hole. This discovery presents astronomers with a valuable opportunity to observe phenomena that occurred when the Universe was very young. The X-ray ghost, so-called because a diffuse X-ray source has remained after other radiation from the outburst has died away, is in the Chandra Deep Field-North, one of the deepest X-ray images ever taken. The source, a.k.a. HDF 130, is over 10 billion light years away and existed at a time 3 billion years after the Big Bang, when galaxies and black holes were forming at a high rate. "We'd seen this fuzzy object a few years ago, but didn't realize until now that we were seeing a ghost", said Andy Fabian of the Cambridge University in the United Kingdom. "It's not out there to haunt us, rather it's telling us something - in this case what was happening in this galaxy billions of year ago." Fabian and colleagues think the X-ray glow from HDF 130 is evidence for a powerful outburst from its central black hole in the form of jets of energetic particles traveling at almost the speed of light. When the eruption was ongoing, it produced prodigious amounts of radio and X-radiation, but after several million years, the radio signal faded from view as the electrons radiated away their energy. HDF 130 Chandra X-ray Image of HDF 130 However, less energetic electrons can still produce X-rays by interacting with the pervasive sea of photons remaining from the Big Bang - the cosmic background radiation. Collisions between these electrons and the background photons can impart enough energy to the photons to boost them into the X-ray energy band. This process produces an extended X-ray source that lasts for another 30 million years or so. "This ghost tells us about the black hole's eruption long after it has died," said co-author Scott Chapman, also of Cambridge University. "This means we don't have to catch the black holes in the act to witness the big impact they have." This is the first X-ray ghost ever seen after the demise of radio-bright jets. Astronomers have observed extensive X-ray emission with a similar origin, but only from galaxies with radio emission on large scales, signifying continued eruptions. In HDF 130, only a point source is detected in radio images, coinciding with the massive elliptical galaxy seen in its optical image. This radio source indicates the presence of a growing supermassive black hole. People Who Read This Also Read... Milky Way's Super-efficient Particle Accelerators Caught in The Act NASA Joins "Around the World in 80 Telescopes" Celebrate the International Year of Astronomy Galaxies Coming of Age in Cosmic Blobs "This result hints that the X-ray sky should be littered with such ghosts," said co-author Caitlin Casey, also of Cambridge, "especially if black hole eruptions are as common as we think they are in the early Universe." The power contained in the black hole eruption was likely to be considerable, equivalent to about a billion supernovas. The energy is dumped into the surroundings and transports and heats the gas. "Even after the ghost disappears, most of the energy from the black hole's eruption remains", said Fabian. "Because they're so powerful, these eruptions can have profound effects lasting for billions of years." The details of Chandra's data of HDF 130 helped secure its true nature. For example, in X-rays, HDF 130 has a cigar-like shape that extends for some 2.2 million light years. The linear shape of the X-ray source is consistent with the shape of radio jets and not with that of a galaxy cluster, which is expected to be circular. The energy distribution of the X-rays is also consistent with the interpretation of an X-ray ghost. NASA's Marshall Space Flight Center in Huntsville, Ala., manages the Chandr

2009-05-01

252

Branched-chain amino acid aminotransferase and methionine formation in Mycobacterium tuberculosis  

PubMed Central

Background Tuberculosis remains a major world-wide health threat which demands the discovery and characterisation of new drug targets in order to develop future antimycobacterials. The regeneration of methionine consumed during polyamine biosynthesis is an important pathway present in many microorganisms. The final step of this pathway, the conversion of ketomethiobutyrate to methionine, can be performed by aspartate, tyrosine, or branched-chain amino acid aminotransferases depending on the particular species examined. Results The gene encoding for branched-chain amino acid aminotransferase in Mycobacterium tuberculosis H37Rv has been cloned, expressed, and characterised. The enzyme was found to be a member of the aminotransferase IIIa subfamily, and closely related to the corresponding aminotransferase in Bacillus subtilis, but not to that found in B. anthracis or B. cereus. The amino donor preference for the formation of methionine from ketomethiobutyrate was for isoleucine, leucine, valine, glutamate, and phenylalanine. The enzyme catalysed branched-chain amino acid and ketomethiobutyrate transamination with a Km of 1.77 – 7.44 mM and a Vmax of 2.17 – 5.70 ?mol/min/mg protein, and transamination of ketoglutarate with a Km of 5.79 – 6.95 mM and a Vmax of 11.82 – 14.35 ?mol/min/mg protein. Aminooxy compounds were examined as potential enzyme inhibitors, with O-benzylhydroxylamine, O-t-butylhydroxylamine, carboxymethoxylamine, and O-allylhydroxylamine yielding mixed-type inhibition with Ki values of 8.20 – 21.61 ?M. These same compounds were examined as antimycobacterial agents against M. tuberculosis and a lower biohazard M. marinum model system, and were found to completely prevent cell growth. O-Allylhydroxylamine was the most effective growth inhibitor with an MIC of 78 ?M against M. marinum and one of 156 ?M against M. tuberculosis. Conclusion Methionine formation from ketomethiobutyrate is catalysed by a branched-chain amino acid aminotransferase in M. tuberculosis. This enzyme can be inhibited by selected aminooxy compounds, which also have effectiveness in preventing cell growth in culture. These compounds represent a starting point for the synthesis of branched-chain aminotransferase inhibitors with higher activity and lower toxicity.

Venos, Erik S; Knodel, Marvin H; Radford, Cynthia L; Berger, Bradley J

2004-01-01

253

Credit PSR. View looking north northeast (12°) across surface remains ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Credit PSR. View looking north northeast (12°) across surface remains of North Base swimming pool. The southeast edge of the pool appearing in the foreground may seem to be a sidewalk to the casual observer; the wavy inside edge of this walk matches the pool side visible in historic construction photos (See HAER photo CA-170-Q-2). The telephone pole in the midground of the view is inside the pool proper. Building 4312 (Liquid Oxygen Repair Facility) appears in left background, Building 4456 (Fire House No. 4) in middle background, and Building 4444 (Communications Building) in right background - Edwards Air Force Base, North Base, Swimming Pool, Second Street, Boron, Kern County, CA

254

Migratory journeys and tuberculosis risk.  

PubMed

After decades of decline, tuberculosis case rates in New York City more than tripled between 1978 and 1992. While the number of cases of those born in the United States declined after 1992, the proportion of immigrant tuberculosis cases continued to increase and reached 58 percent in 1999. This article questions the biomedical explanation of immigrant tuberculosis as being imported from immigrants' countries of origin. Illness narratives of illegal Chinese immigrants with tuberculosis detailing risks associated with migratory journeys are presented. The social and cultural nature of the concept of risk, as well as the adverse implication of biomedical identification of immigrants as being at higher risk of tuberculosis, are also discussed. The author concludes that the dominant biomedical explanation of immigrant tuberculosis could be modified with the incorporation of the migratory process as a risk factor. PMID:14716918

Ho, Ming-Jung

2003-12-01

255

Remaining driving range estimation of electric vehicle  

Microsoft Academic Search

Remaining driving range estimation, as one of telematics basic services, is especially important for electric vehicle. Due to many factors, the range is difficult to calculate accurately. This paper introduces an estimation method, in which nine factors are considered, including vehicle current location, remaining battery energy, road network topology, road grade, road link travel speed, acceleration and deceleration, wind speed,

Yuhe Zhang; Wenjia Wang; Yuichi Kobayashi; Keisuke Shirai

2012-01-01

256

Dental remains of fossil elephants from Turkey  

Microsoft Academic Search

Turkey is at the crossroads of Africa, Asia and Europe, and occupies an important position for the migration of mammals such as elephantids. Nonetheless, there has been no detailed study of fossil elephants from Turkey. In this study, elephant remains from five localities were examined. Mammuthus meridionalis, Mammuthus trogontherii, Elephas maximus and probably Palaeoloxodon antiquus were identified. M. meridionalis remains from

Ebru Albayrak; Adrian M. Lister

257

Variations in the occurrence of specific rpoB mutations in rifampicin-resistant Mycobacterium tuberculosis isolates from patients of different ethnic groups in Kuwait  

PubMed Central

Background & objectives: Frequency of resistance-conferring mutations vary among isoniazid- and ethambutol-resistant Mycobacterium tuberculosis isolates obtained from patients of various ethnic groups. This study was aimed to determine the occurrence of specific rpoB mutations in rifampicin-resistant M. tuberculosis isolates from tuberculosis patients of various ethnic groups in Kuwait. Methods: Rifampicin-resistant M. tuberculosis isolates (n=119) from South Asian (n=55), Southeast Asian (n=23), Middle Eastern (n=39) and other (n=2) patients and 107 rifampicin-susceptible isolates were tested. Mutations in rpoB were detected by DNA sequencing. Polymorphisms at katG463 and gyrA95 were detected by PCR-RFLP for genetic group assignment. Results: None of rifampicin-susceptible but 116 of 119 rifampicin-resistant isolates showed rpoB mutation(s). Mutations among isolates from South Asian patients were distributed at rpoB516 (20%), rpoB526 (24%) and rpoB531 (27%) while 78 and 51 per cent of isolates from Southeast Asian and Middle Eastern patients, respectively, contained a mutated rpoB531. All isolates with rpoB N-terminal and cluster II mutations were obtained from Middle Eastern and South Asian patients. Most isolates from South Asian (84%) and Southeast Asian (70%) patients belonged to genetic group I while nearly all remaining isolates belonged to genetic group II. Isolates from Middle Eastern patients were distributed among genetic group I (46%), genetic group II (33%) and genetic group III (21%). Interpretation & conclusions: The occurrence of specific rpoB mutations varied considerably in rifampicin-resistant M. tuberculosis isolates obtained from patients of different ethnic groups within the same country. The present data have important implications for designing region-specific rapid methods for detecting majority of rifampicin-resistant strains.

Ahmad, Suhail; Al-Mutairi, Noura M.; Mokaddas, Eiman

2012-01-01

258

Combining COLD-PCR and high-resolution melt analysis for rapid detection of low-level, rifampin-resistant mutations in Mycobacterium tuberculosis.  

PubMed

Multidrug-resistant Mycobacterium tuberculosis (M. tuberculosis) remains a serious threat to public health. Mutational analysis of the gene encoding the beta subunit of RNA polymerase (rpoB) is an established and widely used surrogate marker for multidrug-resistant tuberculosis (MDR-TB). The rpoB-based drug-resistant assay requires relatively less time to detect drug resistance in M. tuberculosis, yet it fails to detect low-level mutations in wild-type DNA. Here, we describe a low-level mutation detection method that combines co-amplification at lower denaturation temperature polymerase chain reaction (COLD-PCR) with high-resolution melting (HRM) analysis, aimed at detecting low-level, rifampin-resistant mutations in M. tuberculosis. Compared to conventional polymerase chain reaction (PCR), dilution experiments demonstrated a four- to eightfold improvement in selectivity using COLD-PCR/HRM to detect low-level, rifampin-resistant mutations. The mutation detection limit of conventional PCR/HRM was approximately 20%, whereas COLD-PCR/HRM had a mutation detection limit of 2.5%. Using traditional PCR/HRM and DNA sequencing, we found rpoB mutation in 110 rifampin-resistant isolates. The use of COLD-PCR/HRM allowed us to detect 10 low-level, rifampin-resistant mutations in 16 additional drug-resistant isolates. The sensitivity of COLD-PCR/HRM (95.2%) is significantly higher than that of PCR/HRM (87.3%). Our findings demonstrate that combined use of COLD-PCR with HRM can provide a sensitivity of at least 5% in detecting rpoB-mutated populations in a wild-type background, decreasing the delay in drug-resistant TB diagnosis and leading to faster, cheaper, more efficient, and more personalized antibiotic treatment, especially for low-level drug resistance mutations among the excess wild-type DNA. PMID:23396215

Pang, Yu; Liu, Guan; Wang, Yufeng; Zheng, Suhua; Zhao, Yan-Lin

2013-02-08

259

Killer Cell Lectin-Like Receptor G1 Deficiency Significantly Enhances Survival after Mycobacterium tuberculosis Infection  

PubMed Central

The expression of T cell differentiation markers is known to increase during Mycobacterium tuberculosis infection, and yet the biological role of such markers remains unclear. We examined the requirement of the T cell differentiation marker killer cell lectin-like receptor G1 (KLRG1) during M. tuberculosis infection using mice deficient in KLRG1. KLRG1?/? mice had a significant survival extension after M. tuberculosis infection compared to wild-type controls, and maintained a significantly lower level of pulmonary M. tuberculosis throughout chronic infection. Improved control of M. tuberculosis infection was associated with an increased number of activated pulmonary CD4+ T cells capable of secreting gamma interferon (IFN-?). Our report is the first to show an in vivo impact of KLRG1 on disease control.

Cyktor, Joshua C.; Carruthers, Bridget; Stromberg, Paul; Flano, Emilio; Pircher, Hanspeter

2013-01-01

260

Alcohol Exacerbates Murine Pulmonary Tuberculosis  

Microsoft Academic Search

Alcohol consumption has been described as a risk factor for infection with Mycobacterium tuberculosis, but its contribution to tuberculosis has been difficult to isolate from other adverse socioeconomic factors. Our objec- tive was to evaluate the impact of alcohol consumption on pulmonary infection with M. tuberculosis in a murine model. BALB\\/c mice were maintained on the Lieber-DeCarli liquid ethanol diet

Carol M. Mason; Elizabeth Dobard; Ping Zhang; Steve Nelson

2004-01-01

261

Changing patterns in pulmonary tuberculosis  

SciTech Connect

The authors reviewed the initial chest roentgenograms of 182 consecutive adult patients with proven active tuberculosis. Less than 50% of all cases were known or suspected at the time of initial presentation. There is a low degree of correlation between radiologically discernible active pulmonary tuberculosis and extrapulmonary tuberculosis. A high percentage of cases represent uncommon pulmonary locations. The frequency of occurrence of four common pulmonary patterns is presented. 21 references, 4 figures, 5 tables.

Tytle, T.L.; Johnson, T.H.

1984-10-01

262

Tuberculosis masquerading as oral malignancy  

PubMed Central

Tuberculosis of the oral cavity is a rare condition. A 55-year-old labourer was referred as a case of oral cancer for further management. The patient had no systemic symptoms. Biopsy of the lesion revealed caseating granulomatous inflammation. Chest X-ray and sputum revealed evidence of asymptomatic pulmonary tuberculosis. The purpose of this paper is to sensitize clinicians to consider oral tuberculosis as a differential diagnosis in patients with an Non-healing oral cavity ulcer.

Kannan, S.; Thakkar, Purvi; Dcruz, Anil K.

2011-01-01

263

Novel human genetic variants associated with extrapulmonary tuberculosis: a pilot genome wide association study  

PubMed Central

Background Approximately 5-10% of persons infected with M. tuberculosis develop tuberculosis, but the factors associated with disease progression are incompletely understood. Both linkage and association studies have identified human genetic variants associated with susceptibility to pulmonary tuberculosis, but few genetic studies have evaluated extrapulmonary disease. Because extrapulmonary and pulmonary tuberculosis likely have different underlying pathophysiology, identification of genetic mutations associated with extrapulmonary disease is important. Findings We performed a pilot genome-wide association study among 24 persons with previous extrapulmonary tuberculosis and well-characterized immune defects; 24 pulmonary tuberculosis patients and 57 patients with M. tuberculosis infection served as controls. The Affymetrix GeneChip Human Mapping Xba Array was used for genotyping; after careful quality control, genotypes at 44,175 single nucleotide polymorphisms (SNPs) were available for analysis. Eigenstrat quantified population stratification within our sample; logistic regression, using results of the Eigenstrat analysis as a covariate, identified significant associations between groups. Permutation testing controlled the family-wise error rate for each comparison between groups. Four SNPs were significantly associated with extrapulmonary tuberculosis compared to controls with M. tuberculosis infection; one (rs4893980) in the gene PDE11A, one (rs10488286) in KCND2, and one (rs2026414) in PCDH15; one was in chromosome 7 but not associated with a known gene. Two additional variants were significantly associated with extrapulmonary tuberculosis compared with pulmonary tuberculosis; one (rs340708) in the gene FAM135B and one in chromosome 13 but not associated with a known gene. The function of all four genes affects cell signaling and activity, including in the brain. Conclusions In this pilot study, we identified 6 novel variants not previously known to be associated with extrapulmonary tuberculosis, including two SNPs more common in persons with extrapulmonary than pulmonary tuberculosis. This provides some support for the hypothesis that the pathogenesis and genetic predisposition to extrapulmonary tuberculosis differs from pulmonary tuberculosis. Further study of these novel SNPs, and more well-powered genome-wide studies of extrapulmonary tuberculosis, is warranted.

2011-01-01

264

Usefulness of ultrasound in the diagnosis of peritoneal tuberculosis.  

PubMed

The peritoneum is one of the most common extrapulmonary sites of tuberculous infection. We report a case of peritoneal tuberculosis (TB) in a 25-year-old man. In this case, ultrasound of the abdomen played an important role in the diagnostic process. The diagnosis of this disease, however, remains a challenge because of its insidious nature, the variability of its presentation, and the limitations of available diagnostic tests. A high index of suspicion should be considered, particularly in high-risk patients with unexplained ascites. In our case ultrasound guided the diagnosis by rapidly identifying abnormal signs, which in high-prevalence settings are extremely suggestive of peritoneal tuberculosis. PMID:23276743

Atzori, Sebastiana; Vidili, Gianpaolo; Delitala, Giuseppe

2012-12-15

265

[Treatment of latent tuberculosis infection].  

PubMed

Latent tuberculosis infection is a key stage in the natural history of tuberculosis, and provides an important period where strategies to prevent the development of disease may be implemented. The treatment of latent tuberculosis infection is well described in many national guidelines. In this review, we attempt to help pneumonologists to implement these guidelines accurately and appropriately, prescribing preventive treatment when the benefit-risk ratio is optimal, providing treatment most safely, performing therapeutic education and incorporating preventive treatment into the full array of measures against tuberculosis. PMID:22542415

Fraisse, P

2012-03-27

266

Molecular epidemiology and transmission dynamics of Mycobacterium tuberculosis in Northwest Ethiopia: new phylogenetic lineages found in Northwest Ethiopia  

PubMed Central

Background Although Ethiopia ranks seventh among the world’s 22 high-burden tuberculosis (TB) countries, little is known about strain diversity and transmission. In this study, we present the first in-depth analysis of the population structure and transmission dynamics of Mycobacterium tuberculosis strains from Northwest Ethiopia. Methods In the present study, 244 M. tuberculosis isolates where analysed by mycobacterial interspersed repetitive unit - variable number tandem repeat 24-loci typing and spoligotyping methods to determine phylogenetic lineages and perform cluster analysis. Clusters of strains with identical genotyping patterns were considered as an indicator for the recent transmission. Results Of 244 isolates, 59.0% were classified into nine previously described lineages: Dehli/CAS (38.9%), Haarlem (8.6%), Ural (3.3%), LAM (3.3%), TUR (2.0%), X-type (1.2%), S-type (0.8%), Beijing (0.4%) and Uganda II (0.4%). Interestingly, 31.6% of the strains were grouped into four new lineages and were named as Ethiopia_3 (13.1%), Ethiopia_1 (7.8%), Ethiopia_H37Rv like (7.0%) and Ethiopia_2 (3.7%) lineages. The remaining 9.4% of the isolates could not be assigned to the known or new lineages. Overall, 45.1% of the isolates were grouped in clusters, indicating a high rate of recent transmission. Conclusions This study confirms a highly diverse M. tuberculosis population structure, the presence of new phylogenetic lineages and a predominance of the Dehli/CAS lineage in Northwest Ethiopia. The high rate of recent transmission indicates defects of the TB control program in Northwest Ethiopia. This emphasizes the importance of strengthening laboratory diagnosis of TB, intensified case finding and treatment of TB patients to interrupt the chain of transmission.

2013-01-01

267

Coexistence of borderline tuberculoid Hansen's disease with tuberculosis verrucosa cutis in a child--a rare case.  

PubMed

M. leprae is a more prevalent cause of cutaneous infections as compared M. tuberculosis, though both belong to the same family of organisms; their co-existence is a rare entity in children. It has been suggested that cross-immunity exists between tuberculosis and leprosy with reports of BCG vaccine giving some protection against leprosy. In spite of epidemiological, clinical and microbiological evidences; the exact relationship between tuberculosis and leprosy still remains unclear. It is imperative to rule out coexistence of cutaneous tuberculosis and leprosy as therapy with rifampicin in treatment of leprosy can lead to drug resistance in management of tuberculosis and the use of steroid in leprosy can aggravate cutaneous tuberculosis. PMID:21434512

Ravindra, K; Sugareddy; Ramachander, T

268

An unconventional hexacoordinated flavohemoglobin from Mycobacterium tuberculosis.  

PubMed

Being an obligate aerobe, Mycobacterium tuberculosis faces a number of energetic challenges when it encounters hypoxia and environmental stress during intracellular infection. Consequently, it has evolved innovative strategies to cope with these unfavorable conditions. Here, we report a novel flavohemoglobin (MtbFHb) from M. tuberculosis that exhibits unique features within its heme and reductase domains distinct from conventional FHbs, including the absence of the characteristic hydrogen bonding interactions within the proximal heme pocket and mutations in the FAD and NADH binding regions of the reductase domain. In contrast to conventional FHbs, it has a hexacoordinate low-spin heme with a proximal histidine ligand lacking imidazolate character and a distal heme pocket with a relatively low electrostatic potential. Additionally, MtbFHb carries a new FAD binding site in its reductase domain similar to that of D-lactate dehydrogenase (D-LDH). When overexpressed in Escherichia coli or Mycobacterium smegmatis, MtbFHb remained associated with the cell membrane and exhibited D-lactate:phenazine methosulfate reductase activity and oxidized D-lactate into pyruvate by converting the heme iron from Fe(3+) to Fe(2+) in a FAD-dependent manner, indicating electron transfer from D-lactate to the heme via FAD cofactor. Under oxidative stress, MtbFHb-expressing cells exhibited growth advantage with reduced levels of lipid peroxidation. Given the fact that D-lactate is a byproduct of lipid peroxidation and that M. tuberculosis lacks the gene encoding D-LDH, we propose that the novel D-lactate metabolizing activity of MtbFHb uniquely equips M. tuberculosis to balance the stress level by protecting the cell membrane from oxidative damage via cycling between the Fe(3+)/Fe(2+) redox states. PMID:22437825

Gupta, Sanjay; Pawaria, Sudesh; Lu, Changyuan; Hade, Mangesh Dattu; Singh, Chaahat; Yeh, Syun-Ru; Dikshit, Kanak L

2012-03-21

269

Evaluation of Clinical Parameters to Predict Mycobacterium tuberculosis in Inpatients  

Microsoft Academic Search

Background: Respiratory isolation has been recom- mended for all patients with suspected tuberculosis (TB) to avoid transmission to other patients and health care personnel. In implementing these guidelines, patients with and without TB are frequently isolated, significantly in- creasing hospital costs. The objective of this study was to derive a clinical rule to predict the need for respira- tory isolation

Juan P. Wisnivesky; Jennifer Kaplan; Claudia Henschke; Thomas G. McGinn; Ronald G. Crystal

2000-01-01

270

Factors influencing quality of life in patients with active tuberculosis  

Microsoft Academic Search

BACKGROUND: With effective treatment strategies, the focus of tuberculosis (TB) management has shifted from the prevention of mortality to the avoidance of morbidity. As such, there should be an increased focus on quality of life (QoL) experienced by individuals being treated for TB. The objective of our study was to identify areas of QoL that are affected by active TB

Carlo A Marra; Fawziah Marra; Victoria C Cox; Anita Palepu; J Mark Fitzgerald

2004-01-01

271

Prospects for advancing tuberculosis control efforts through novel therapies  

Microsoft Academic Search

Background Development of new, effective, and affordable tuberculosis ( TB) therapies has been identified as a critical priority for global TB control. As new candidates emerge from the global TB drug pipeline, the potential impacts of novel, shorter regimens on TB incidence and mortality have not yet been examined. Methods and Findings We used a mathematical model of TB to

Joshua A. Salomon; James O. Lloyd-Smith; Wayne M. Getz; Stephen Resch; M. S. Sanchez; Travis C. Porco; Martien W. Borgdorff

2006-01-01

272

Outbreak of isoniazid resistant tuberculosis in north London  

Microsoft Academic Search

Background: A description is given of a major outbreak of isoniazid monoresistant tuberculosis (TB) chiefly in north London, including prisons. The earliest case was diagnosed in 1995 with most cases appearing after 1999.Methods: Confirmation of a local cluster of cases was confirmed by restriction fragment length polymorphism (RFLP IS6110) typing or “rapid epidemiological typing” (RAPET). Further cases were found by

M C Ruddy; A P Davies; M D Yates; S Yates; S Balasegaram; Y Drabu; B Patel; S Lozewicz; S Sen; M Bahl; E James; M Lipman; G Duckworth; J M Watson; M Piper; F A Drobniewski; H Maguire

2004-01-01

273

Investigation of geo-spatial hotspots for the occurrence of tuberculosis in Almora district, India, using GIS and spatial scan statistic  

PubMed Central

Background The World Health Organization has declared tuberculosis a global emergency in 1993. It has been estimated that one third of the world population is infected with Mycobacterium tuberculosis, the causative agent of tuberculosis. The emergence of TB/HIV co-infection poses an additional challenge for the control of tuberculosis throughout the world. The World Health Organization is supporting many developing countries to eradicate tuberculosis. It is an agony that one fifth of the tuberculosis patients worldwide are in India. The eradication of tuberculosis is the greatest public health challenge for this developing country. The aim of the present population based study on Mycobacterium tuberculosis is to test a large set of tuberculosis cases for the presence of statistically significant geographical clusters. A spatial scan statistic is used to identify purely spatial and space-time clusters of tuberculosis. Results Significant (p < 0.05 for primary clusters and p < 0.1 for secondary clusters) high rate spatial and space-time clusters were identified in three areas of the district. Conclusion There is sufficient evidence about the existence of statistically significant tuberculosis clusters in Almora district of Uttaranchal, India. The spatial scan statistics methodology used in this study has a potential use in surveillance of tuberculosis for detecting the true clusters of the disease.

Tiwari, Neeraj; Adhikari, CMS; Tewari, Ajoy; Kandpal, Vineeta

2006-01-01

274

Epidemiologic Consequences of Microvariation in Mycobacterium tuberculosis  

PubMed Central

Background.?Evidence from genotype-phenotype studies suggests that genetic diversity in pathogens have clinically relevant manifestations that can impact outcome of infection and epidemiologic success. We studied 5 closely related Mycobacterium tuberculosis strains that collectively caused extensive disease (n = 862), particularly among US-born tuberculosis patients. Methods.?Representative isolates were selected using population-based genotyping data from New York City and New Jersey. Growth and cytokine/chemokine response were measured in infected human monocytes. Survival was determined in aerosol-infected guinea pigs. Results.?Multiple genotyping methods and phylogenetically informative synonymous single nucleotide polymorphisms showed that all strains were related by descent. In axenic culture, all strains grew similarly. However, infection of monocytes revealed 2 growth phenotypes, slower (doubling ?55 hours) and faster (?25 hours). The faster growing strains elicited more tumor necrosis factor ? and interleukin 1? than the slower growing strains, even after heat killing, and caused accelerated death of infected guinea pigs (?9 weeks vs 24 weeks) associated with increased lung inflammation/pathology. Epidemiologically, the faster growing strains were associated with human immunodeficiency virus and more limited in spread, possibly related to their inherent ability to induce a strong protective innate immune response in immune competent hosts. Conclusions.?Natural variation, with detectable phenotypic changes, among closely related clinical isolates of M. tuberculosis may alter epidemiologic patterns in human populations.

Mathema, Barun; Kurepina, Natalia; Yang, Guibin; Shashkina, Elena; Manca, Claudia; Mehaffy, Carolina; Bielefeldt-Ohmann, Helle; Ahuja, Shama; Fallows, Dorothy A.; Izzo, Angelo; Bifani, Pablo; Dobos, Karen; Kaplan, Gilla

2012-01-01

275

RD Antigen Based Nanovaccine Imparts Long Term Protection by Inducing Memory Response against Experimental Murine Tuberculosis  

PubMed Central

Background The absence of certain genomic loci that are present in most of the virulent strains of Mycobacterium tuberculosis as well as lack of lasting memory responses are some of the major causes attributed to the non effectiveness of Bacille Calmette-Gue'rin (BCG) vaccine. Immunization schedules addressing these issues can offer better strategy for protection against tuberculosis. Methods The immunological responses evoked upon administration of archaeosome based antigen delivery system comprising T cell antigen, Rv3619c (an ESAT-6 family protein), has been assessed against experimental murine tuberculosis in BALB/c mice. Results Archaeosome based subunit vaccine has been found to elicit type-1 cytokines in the immunized mice. Besides effective T cell memory response, the Rv3619c based vaccine was able to reduce mycobacterial burden in the animals challenged with Mycobacterium tuberculosis infection. Conclusion The data of the present study suggest that archaeosome encapsulated RD gene products offer substantial protection against M. tuberculosis infection.

Ansari, Mairaj Ahmed; Zubair, Swaleha; Mahmood, Anjum; Gupta, Pushpa; Khan, Aijaz A.; Gupta, Umesh D.; Arora, Ashish; Owais, Mohammad

2011-01-01

276

Tuberculosis associated with Mycobacterium tuberculosis Beijing and non-Beijing genotypes: a clinical and immunological comparison  

PubMed Central

Background The Mycobacterium tuberculosis Beijing genotype is biologically different from other genotypes. We aimed to clinically and immunologically compare human tuberculosis caused by Beijing and non-Beijing strains. Methods Pulmonary tuberculosis patients were prospectively enrolled and grouped by their M. tuberculosis genotypes. The clinical features, plasma cytokine levels, and cytokine gene expression levels in peripheral blood mononuclear cells (PBMC) were compared between the patients in Beijing and non-Beijing groups. Results Patients in the Beijing group were characterized by significantly lower frequency of fever (odds ratio, 0.12, p = 0.008) and pulmonary cavitation (odds ratio, 0.2, p = 0.049). Night sweats were also significantly less frequent by univariate analysis, and the duration of cough prior to diagnosis was longer in Beijing compared to non-Beijing groups (medians, 60 versus 30 days, p = 0.048). The plasma and gene expression levels of interferon (IFN) ? and interleukin (IL)-18 were similar in the two groups. However, patients in the non-Beijing group had significantly increased IL-4 gene expression (p = 0.018) and lower IFN-? : IL-4 cDNA copy number ratios (p = 0.01). Conclusion Patients with tuberculosis caused by Beijing strains appear to be less symptomatic than those who have disease caused by other strains. Th1 immune responses are similar in patients infected with Beijing and non-Beijing strains, but non-Beijing strains activate more Th2 immune responses compared with Beijing strains, as evidenced by increased IL-4 expression.

Sun, Yong-Jiang; Lim, TK; Ong, Adrian Kheng Yeow; Ho, Benjamin Choon Heng; Seah, Geok Teng; Paton, Nicholas I

2006-01-01

277

Recombinant live vaccine candidates against tuberculosis.  

PubMed

Tuberculosis (TB) remains among the most deadly health threats to humankind despite availability of several potent antibiotics and a vaccine, bacille Calmette-Guérin (BCG). BCG partially protects children but not adults from the disease. Growing knowledge of the molecular basis of infection, immunity, and pathology in TB has driven various approaches, which strive to complement or replace BCG with more effective vaccines. Three recombinant live TB vaccine candidates have entered clinical trials. These candidates have been genetically engineered to be attenuated, to overexpress TB antigens and/or to secrete bacterial perforins, ultimately seeking to trigger a robust immune response thereby providing long-lasting protection against TB. PMID:22483201

Kaufmann, Stefan H E; Gengenbacher, Martin

2012-04-04

278

Discovery of Q203, a potent clinical candidate for the treatment of tuberculosis.  

PubMed

New therapeutic strategies are needed to combat the tuberculosis pandemic and the spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) forms of the disease, which remain a serious public health challenge worldwide. The most urgent clinical need is to discover potent agents capable of reducing the duration of MDR and XDR tuberculosis therapy with a success rate comparable to that of current therapies for drug-susceptible tuberculosis. The last decade has seen the discovery of new agent classes for the management of tuberculosis, several of which are currently in clinical trials. However, given the high attrition rate of drug candidates during clinical development and the emergence of drug resistance, the discovery of additional clinical candidates is clearly needed. Here, we report on a promising class of imidazopyridine amide (IPA) compounds that block Mycobacterium tuberculosis growth by targeting the respiratory cytochrome bc1 complex. The optimized IPA compound Q203 inhibited the growth of MDR and XDR M. tuberculosis clinical isolates in culture broth medium in the low nanomolar range and was efficacious in a mouse model of tuberculosis at a dose less than 1 mg per kg body weight, which highlights the potency of this compound. In addition, Q203 displays pharmacokinetic and safety profiles compatible with once-daily dosing. Together, our data indicate that Q203 is a promising new clinical candidate for the treatment of tuberculosis. PMID:23913123

Pethe, Kevin; Bifani, Pablo; Jang, Jichan; Kang, Sunhee; Park, Seijin; Ahn, Sujin; Jiricek, Jan; Jung, Juyoung; Jeon, Hee Kyoung; Cechetto, Jonathan; Christophe, Thierry; Lee, Honggun; Kempf, Marie; Jackson, Mary; Lenaerts, Anne J; Pham, Ha; Jones, Victoria; Seo, Min Jung; Kim, Young Mi; Seo, Mooyoung; Seo, Jeong Jea; Park, Dongsik; Ko, Yoonae; Choi, Inhee; Kim, Ryangyeo; Kim, Se Yeon; Lim, SeungBin; Yim, Seung-Ae; Nam, Jiyoun; Kang, Hwankyu; Kwon, Haejin; Oh, Chun-Taek; Cho, Yoojin; Jang, Yunhee; Kim, Junghwan; Chua, Adeline; Tan, Bee Huat; Nanjundappa, Mahesh B; Rao, Srinivasa P S; Barnes, Whitney S; Wintjens, René; Walker, John R; Alonso, Sylvie; Lee, Saeyeon; Kim, Jungjun; Oh, Soohyun; Oh, Taegwon; Nehrbass, Ulf; Han, Sung-Jun; No, Zaesung; Lee, Jinhwa; Brodin, Priscille; Cho, Sang-Nae; Nam, Kiyean; Kim, Jaeseung

2013-08-04

279

Towards new tuberculosis vaccines.  

PubMed

According to WHO, about one third of the world's population is infected with bacteria of the Mycobacterium tuberculosis complex. Currently there is globally 9.15 million recorded cases of overt tuberculosis (TB) annually and due to lack of adequate diagnostics presumably a large but unknown number of non-recorded cases. TB is estimated to cause 1.65 million deaths per annum which accounts for one-fifth of all deaths by infectious diseases of adults in low-income countries. During recent years a rapid spread of multi-drug resistant bacteria causing about 0.5 million TB cases per year has worsened the problem. The live attenuated Bacillus Calmette-Guérin (BCG) vaccine which is the only currently available TB vaccine does not confer any significant protection against the most common and contagious form of TB-adult pulmonary TB. PMID:20372087

Svenson, Stefan; Källenius, Gunilla; Pawlowski, Andrzej; Hamasur, Beston

2010-04-19

280

Tuberculosis of spine  

PubMed Central

Tuberculosis of the spine is one of the most common spine pathology in India. Over last 4 decades a lot has changed in the diagnosis, medical treatment and surgical procedures to treat this disorder. Further developments in diagnosis using molecular genetic techniques, more effective antibiotics and more aggressive surgical protocols have become essential with emergence of multidrug resistant TB. Surgical procedures such as single stage anterior and posterior stabilization, extrapleral dorsal spine anterior stabilization and endoscopic thoracoscopic surgeries have reduced the mortality and morbidity of the surgical procedures. is rapidly progressing. It is a challenge to treat MDR-TB Spine with late onset paraplegia and progressive deformity. Physicians must treat tuberculosis of spine on the basis of Culture and sensitivity.

Agrawal, Vinod; Patgaonkar, P. R.; Nagariya, S. P.

2010-01-01

281

Whole Blood Interferon-Gamma Responses to Mycobacterium tuberculosis Antigens in Young Household Contacts of Persons with Tuberculosis in Uganda  

Microsoft Academic Search

BackgroundDue to immunologic immaturity, IFN-?-producing T cell responses may be decreased in young children compared to adults, thus we hypothesized that IFN-? responses to mycobacterial antigens in household contacts exposed to Mycobacterium tuberculosis (Mtb) would be impaired in young children relative to adults. The objective of this study was to compare whole blood IFN-? production in response to mycobacterial antigens

Deborah A. Lewinsohn; Sarah Zalwango; Catherine M. Stein; Harriet Mayanja-Kizza; Alphonse Okwera; W. Henry Boom; Roy D. Mugerwa; Christopher C. Whalen; Tom G. Connell

2008-01-01

282

[Meningoencephalitis tuberculosis--primary isolation of resistant M. tuberculosis].  

PubMed

Tuberculosis is one of the main causes of serious diseases in developing countries. Despite of decreasing tuberculosis in industrial countries, diseases is not eradicated. In last fifth years the picture of diseases is changed with large number atypical cases. Factor that is responsible for this are variable and includes primary infection in old ages, or problems that are in relation with immigration of populations. Tuberculosis meningitis disease witch appears mostly in childhood with high incidence in first three years of life. Most cases tuberculosis meningitis are caused with human types of tuberculosis bacillus, while bovines type is responsible for less than 5% of cases, but there are also reported cases of tuberculosis meningitis caused 3% atypical mycobacterium. In report is described a girl in age of two years sick of tuberculosis meningitis, she come from Kosovo, with positive epidemiological anamnesis. When she came to the hospital diseases had all clinical manifestation of serious meningoencefalitis. Very soon signs of decompensate hydrocephalus are developed. In the culture of cerebrospinalis fluid isolated Mycobacterium tuberculosis primary resistant on etambutol and rifampicin. PMID:16528937

Bajramovi?, Nermina; Koluder, Nada; Dautovi?, Sajma; Muratovi?, Planinka

2006-01-01

283

Endobronchial tuberculosis: histopathological subsets and microbiological results  

PubMed Central

Background Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. Bronchoscopic appearances of EBTB have been divided into seven subtypes: actively caseating, edematous-hyperemic, fibrostenotic, tumorous, granular, ulcerative, and nonspecific bronchitic. However, information for establishing a definite microbiological diagnosis in each of these categories is lacking. We aimed to present bronchoscopic appearances and percentages for the EBTB subtypes and to compare bronchoscopic appearances with microbiological positivity in bronchial lavage fluid. Methods From 2003 to 2009, 23 biopsy-proven EBTB patients were enrolled in the study. Diagnosis of EBTB was histopathologically confirmed in all patients. Results The commonest subtype was the edematous-hyperemic type (34.7%); other subtypes in order of occurrence were: tumorous (21.7%), granular (17.3%), actively caseating (17.3%), fibrostenotic (4.3%), and nonspecific bronchitic (4.3%). Although all patients were sputum-smear-negative for acid-fast bacilli (AFB), 26% of patients were smear-positive for AFB in the bronchial lavage fluid. The bronchial lavage fluid grew Mycobacterium tuberculosis in 39.1% of all patients. The bronchial lavage smear positivity for AFB in the bronchial lavage fluid was 75%, 25%, 20%, 12.5%, 0%, and 0% for the granular, actively caseating, tumorous, edematous-hyperemic, fibrostenotic, and nonspecific bronchitic subtypes of EBTB, respectively. Culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid was 75%, 50%, 40%, 25%, 0%, and 0%, respectively. Conclusion The commonest subtype of EBTB was the edematous-hyperemic subtype. The granular type had the highest smear positivity and culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid. Bronchoscopy should be performed in all patients suspected to have EBTB.

2012-01-01

284

Moxifloxacin versus ethambutol in the initial treatment of tuberculosis: a double-blind, randomised, controlled phase II trial  

Microsoft Academic Search

Summary Background New treatments are needed to shorten the time required to cure tuberculosis and to treat drug-resistant strains. The fl uoroquinolone moxifl oxacin is a promising new agent that might have additive activity to existing antituberculosis agents. We assessed the activity and safety of moxifl oxacin in the initial stage of tuberculosis treatment. Methods We undertook a phase II,

Marcus B Conde; Anne Efron; Carla Loredo; Gilvan R Muzy De Souza; Nadja P Graça; Michelle C Cezar; Malathi Ram; Mohammad A Chaudhary; William R Bishai; Afranio L Kritski; Richard E Chaisson

2009-01-01

285

Obstacles for optimal tuberculosis case detection in primary health centers (PHC) in Sidoarjo district, East Java, Indonesia  

Microsoft Academic Search

BACKGROUND: Pulmonary tuberculosis (TB) is a major health problem worldwide. Detection of the most infectious cases of tuberculosis – sputum smear-positive pulmonary cases – by passive case finding is an essential component of TB control. The district of Sidoarjo in East Java reported a low case detection rate (CDR) of 14% in 2003. We evaluated the diagnostic process for TB

Chatarina U Wahyuni; Budiono; Lutfia Dwi Rahariyani; Muji Sulistyowati; Tety Rachmawati; Djuwari; Sri Yuliwati; Marieke J van der Werf

2007-01-01

286

Randomized controlled trial of nutritional supplementation in patients with newly diagnosed tuberculosis and wasting1-3  

Microsoft Academic Search

Background: Nutritional support is often recommended as part of the treatment of tuberculosis, but it has never been properly tested. Objective: We assessed the effects of early nutritional intervention on lean mass and physical function in patients with tuberculosis and wasting. Design: Patients who started antituberculous therapy within the previous 2 wk were randomly assigned to receive standard nutri- tional

Nicholas I Paton; Yueh-Khim Chua; Arul Earnest; Cynthia BE Chee

287

Outbreak of drug-resistant tuberculosis with second-generation transmission in a high school in California  

Microsoft Academic Search

Background: In spring 1993, four students in a high school were diagnosed with tuberculosis resistant to isoniazid, streptomycin, and ethionamide. Methods: To investigate potential transmission of drug-resistant tuberculosis, a retrospective cohort study with case investigation and screening by tuberculin skin tests and symptom checks was conducted in a high school of approximately 1400 students. Current and graduated high-school students were

Renée Ridzon; Joseph H. Kent; Sarah Valway; Penny Weismuller; Roberta Maxwell; Maryellen Elcock; Jody Meador; Sarah Royce; Abigail Shefer; Philip Smith; Charles Woodley; Ida Onorato

1997-01-01

288

Arthritis associated with tuberculosis  

Microsoft Academic Search

There has been a resurgence in tuberculosis (TB) worldwide. Approximately 2 billion people have latent infection, 8 million would develop active TB annually, and 2–3 million would die due to TB. With this resurgence, cases with extrapulmonary TB have also shown an increase. Approximately 10–11% of extrapulmonary TB involves joints and bones, which is approximately 1–3% of all TB cases.

P. P Kotwal

2003-01-01

289

John Keats and tuberculosis.  

PubMed

John Keats was trained as an apothecary, the general practitioner of the day. Precocious in his sensibilities and fluent in his imagery, he also was the model of the romantic poet. That he was a physician and a poet makes his early death from tuberculosis poignant and revealing. This history traces his life and death against the backdrop of medicine at the turn of the 19th century. PMID:11368115

Radetsky, M

2001-05-01

290

Sensing the Killer - Tuberculosis  

NSDL National Science Digital Library

Thirty-fourth monthly installment of our "What A Year!" website project, introducing life science breakthroughs to middle and high school students and their teachers. About 2 billion people are walking around infected by tuberculosis. But they don't it, because they don't have any symptoms of this terrible disease. The trick with TB is to catch it early and prevent ever-widening circles of infection.

2010-01-04

291

21 CFR 866.3370 - Mycobacterium tuberculosis immunofluorescent reagents.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Mycobacterium tuberculosis immunofluorescent reagents...Reagents § 866.3370 Mycobacterium tuberculosis immunofluorescent reagents...a) Identification. Mycobacterium tuberculosis...

2010-04-01

292

21 CFR 866.3370 - Mycobacterium tuberculosis immunofluorescent reagents.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Mycobacterium tuberculosis immunofluorescent reagents...Reagents § 866.3370 Mycobacterium tuberculosis immunofluorescent reagents...a) Identification. Mycobacterium tuberculosis...

2009-04-01

293

An adult zebrafish model for preclinical tuberculosis vaccine development.  

PubMed

Tuberculosis remains a major global health challenge despite extensive vaccination schemes with the current live vaccine, Bacillus Calmette-Guérin. Tuberculosis vaccine research has been hampered by a scarcity of animal models which replicate human disease and are suitable for large-scale studies. We have shown recently that Mycobacterium marinum, a close relative of Mycobacterium tuberculosis, causes an infection resembling human tuberculosis in adult zebrafish (Danio rerio). In the present study we use this model to show that BCG vaccination as well as DNA vaccination with selected mycobacterial antigens (Ag85B, CFP-10 and ESAT-6) protects adult zebrafish from mycobacterial infection. Using a low-dose (?20-30 bacteria) intraperitoneal M. marinum infection, both the number of granulomas and the amount of infected organs were reduced in the DNA vaccinated fish. Likewise, when infecting with a lethal infection dose (?20,000-27,000 bacteria), vaccination significantly reduced both mortality and bacterial counts in a manner dependent on the adaptive immune response. Protective effects of vaccination were associated with enhanced expression of interferon gamma. Our results indicate that the zebrafish is a promising new model for preclinical tuberculosis vaccine research. PMID:24055305

Oksanen, Kaisa E; Halfpenny, Nicholas J A; Sherwood, Eleanor; Harjula, Sanna-Kaisa E; Hammarén, Milka M; Ahava, Maarit J; Pajula, Elina T; Lahtinen, Marika J; Parikka, Mataleena; Rämet, Mika

2013-09-20

294

Bioaerosol Mass Spectrometry for Rapid Detection of Individual Airborne Mycobacterium tuberculosis H37Ra Particles  

PubMed Central

Single-particle laser desorption/ionization time-of-flight mass spectrometry, in the form of bioaerosol mass spectrometry (BAMS), was evaluated as a rapid detector for individual airborne, micron-sized, Mycobacterium tuberculosis H37Ra particles, comprised of a single cell or a small number of clumped cells. The BAMS mass spectral signatures for aerosolized M. tuberculosis H37Ra particles were found to be distinct from M. smegmatis, Bacillus atrophaeus, and B. cereus particles, using a distinct biomarker. This is the first time a potentially unique biomarker was measured in M. tuberculosis H37Ra on a single-cell level. In addition, M. tuberculosis H37Ra and M. smegmatis were aerosolized into a bioaerosol chamber and were sampled and analyzed using BAMS, an aerodynamic particle sizer, a viable Anderson six-stage sampler, and filter cassette samplers that permitted direct counts of cells. In a background-free environment, BAMS was able to sample and detect M. tuberculosis H37Ra at airborne concentrations of >1 M. tuberculosis H37Ra-containing particles/liter of air in 20 min as determined by direct counts of filter cassette-sampled particles, and concentrations of >40 M. tuberculosis H37Ra CFU/liter of air in 1 min as determined by using viable Andersen six-stage samplers. This is a first step toward the development of a rapid, stand-alone airborne M. tuberculosis particle detector for the direct detection of M. tuberculosis bioaerosols generated by an infectious patient. Additional instrumental development is currently under way to make BAMS useful in realistic environmental and respiratory particle backgrounds expected in tuberculosis diagnostic scenarios.

Tobias, Herbert J.; Schafer, Millie P.; Pitesky, Maurice; Fergenson, David P.; Horn, Joanne; Frank, Matthias; Gard, Eric E.

2005-01-01

295

Primary tuberculosis in a malnourished adolescent  

PubMed Central

Although the overall prevalence of tuberculosis has decreased in the United States, with the increasing prevalence of tuberculosis globally, higher rates of tuberculosis in some states and localities have been reported, with some component probably related to immigrant populations. We report a case of primary pulmonary tuberculosis in a malnourished adolescent.

Zawaideh, Mazen; Chao, Cherng; Poole, Patricia; Naheedy, John

2012-01-01

296

Diagnosis and outcome of isolated rectal tuberculosis  

Microsoft Academic Search

PURPOSE: Segmental colonic tuberculosis commonly involves the ascending, transverse, or sigmoid colon. Rectal involvement in tuberculosis is uncommon and poorly characterized. This study describes the clinical presentation, endoscopic features, and outcome of isolated rectal tuberculosis. METHODS: Isolated rectal tuberculosis was defined as focal lesions of the rectum in the absence of radiologically demonstrable lesions in the small and large bowel

A. S. Puri; J. C. Vij; A. Chaudhary; Nirmal Kumar; A. Sachdev; V. Malhotra; V. K. Malik; S. L. Broor

1996-01-01

297

Tuberculosis of the urachal cyst  

PubMed Central

Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst.

Kamal, Mir Reza; Jha, Jayesh Kumar

2013-01-01

298

Tuberculosis of the urachal cyst.  

PubMed

Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst. PMID:23346004

Jindal, Tarun; Kamal, Mir Reza; Jha, Jayesh Kumar

2012-12-28

299

Rare presentation of osteoarticular tuberculosis.  

PubMed

The varied clinical presentation of osteoarticular tuberculosis makes the diagnosis an enigma. This report underlines the fact that osteoarticular tuberculosis can present in the most atypical pattern. It also emphasises the need for a high index of clinical suspicion and the low threshold for tissue biopsy for establishing the diagnosis. PMID:16305093

Kakarala, Gopikrishna; Rajan, Daniel

2005-10-01

300

[Prognosis of patients with tuberculosis].  

PubMed

The global incidence of tuberculosis peaked around the year 2003 and is currently declining gradually. However, the worldwide incidence of new tuberculosis cases is still estimated to be 8.8 million/year, with 1.5 million deaths occurring per year. Considering that previous studies have determined the risk factors for death due to tuberculosis, we aimed at reviewing the literature to collectively evaluate these risk factors. According our literature review of 12 articles published in English language and 7 articles published in Japanese, the risk factors for death due to tuberculosis are age, human immunodeficiency virus (HIV) co-infection, multi-drug resistant tuberculosis (MDR-TB), malnutrition, low activities of daily living, co-morbidities, unemployment, and drug injection. We developed a scoring system to calculate the Tuberculosis Prognostic Score using 4 risk factors, namely, age, serum albumin level, oxygen requirement, and activities of daily living, after assessing several cohorts in Japan, in which HIV co-infection and MDR-TB are rare and their associations with mortality due to tuberculosis patients are unclear. This scoring system was successfully able to estimate life prognosis of inpatients with newly diagnosed, smear-positive, lung tuberculosis without MDR-TB and/or HIV virus co-infection. PMID:23898497

Horita, Nobuyuki; Miyazawa, Naoki; Yoshiyama, Takashi; Ishigatsubo, Yoshiaki

2013-06-01

301

Multiplex PCR for Rapid Diagnosis of Gastrointestinal Tuberculosis  

PubMed Central

Background: Rapid and specific diagnosis of gastrointestinal tuberculosis (GITB) is of utmost importance. Aim: To evaluate Multiplex PCR (MPCR) using MPB64 and IS6110 primers specific for M. tuberculosis for rapid diagnosis of GITB. Materials and Methods: MPCR was performed on colonoscopy biopsy specimens on 11 GITB confirmed (culture/AFB/histopathology was positive), 29 GITB suspected and 30 Non GITB (control group) patients. Results: MPB64 PCR had sensitivity and specificity of 90% and 100% for confirmed GITB cases. In 29 clinically diagnosed but unconfirmed GITB cases, MPCR was positive in 72.41%. MPCR was negative in all control group patients. The overall sensitivity and specificity of microscopy, culture, histopathology and MPCR was 5%, 2% 20% and 77.5% and 100%, 100%, 100% and 100% respectively. Conclusion: MPCR has good sensitivity and specificity in diagnosing gastrointestinal tuberculosis.

Sharma, Kusum; Sinha, Saroj Kant; Sharma, Aman; Nada, Ritambra; Prasad, Kaushal K; Goyal, Kapil; Rana, Surinder Singh; Bhasin, Deepak Kumar; Sharma, Meera

2013-01-01

302

Characterization of a Novel Esterase Rv0045c from Mycobacterium tuberculosis  

PubMed Central

Background It was proposed that there are at least 250 enzymes in M. tuberculosis involved in lipid metabolism. Rv0045c was predicted to be a hydrolase by amino acid sequence similarity, although its precise biochemical characterization and function remained to be defined. Methodology/Principal Findings We expressed the Rv0045c protein to high levels in E. coli and purified the protein to high purity. We confirmed that the prepared protein was the Rv0045c protein by mass spectrometry analysis. Circular dichroism spectroscopy analysis showed that the protein possessed abundant ?-sheet secondary structure, and confirmed that its conformation was stable in the range pH 6.0–10.0 and at temperatures ?40°C. Enzyme activity analysis indicated that the Rv0045c protein could efficiently hydrolyze short chain p-nitrophenyl esters (C2–C8), and its suitable substrate was p-nitrophenyl caproate (C6) with optimal catalytic conditions of 39°C and pH 8.0. Conclusions/Significance Our results demonstrated that the Rv0045c protein is a novel esterase. These experiments will be helpful in understanding ester/lipid metabolism related to M. tuberculosis.

Xu, Lipeng; Liu, Zhongyuan; Xu, Kehui; Li, Shentao; Wen, Tingyi; Liu, Siguo; Pang, Hai

2010-01-01

303

System-level strategies for studying the metabolism of Mycobacterium tuberculosis  

PubMed Central

Despite decades of research many aspects of the biology of Mycobacterium tuberculosis remain unclear and this is reflected in the antiquated tools available to treat and prevent tuberculosis and consequently this disease remains a serious public health problem. Important discoveries linking M. tuberculosis's metabolism and pathogenesis have renewed interest in this area of research. Previous experimental studies were limited to the analysis of individual genes or enzymes whereas recent advances in computational systems biology and high throughput experimental technologies now allow metabolism to be studied on a genome scale. Here we discuss the progress being made in applying system level approaches to studying the metabolism of this important pathogen. The information from these studies will fundamentally change our approach to tuberculosis research and lead to new targets for therapeutic drugs and vaccines.

Beste, Dany J. V.

2010-01-01

304

Observational Study of QuantiFERON(R)-TB Gold In-Tube Assay in Tuberculosis Contacts in a Low Incidence Area  

PubMed Central

Background QuantiFERON®-TB Gold in-Tube (QFT) assay is a recently developed test to assess latent tuberculosis infection in contagious tuberculosis (TB) contact subjects. To assess the QFT assay in recently exposed contacts of active tuberculosis patients in a French area with low TB incidence but high Bacille Calmette-Guerin coverage, and evaluate progression rates to TB disease. Methodology/Principal Findings Between January 2007 and December 2009, 687 contacts of culture-confirmed tuberculosis cases underwent the QFT assay, with tuberculin skin test (TST) in 473, and a 34 months mean follow-up. Of 687 contacts, 148 were QFT positive, while 526 were negative and 13 indeterminate. QFT was positive in 35% of individuals with TST ?10 mm, 47.5% with TST ?15 mm or phlyctenular, but in 21% of cases in which two-step TST (M0 and M3) remained negative. Conversely, QFT was negative in 69% of cases with two-step TST showing conversion from negative to positive. All indeterminate QFT were associated with TST induration <10 mm in diameter. For 29 QFT-positive subjects, no chemoprophylaxis was given due to medical contraindications. Of the remaining 119 QFT-positive contacts, 97accepted chemoprophylaxis (81.5%), and 79 (81.4%) completed the treatment. Two contacts progressed to TB disease: one subject was QFT positive and had declined chemoprophylaxis, while the other one was QFT negative. QFT positive predictive value for progression to TB was 1.96% (1/51) with a 99.8% (525/526) negative predictive value. Conclusions/Significance Our results confirm the safety of the QFT-based strategy for assessing the TB chemoprophylaxis indication, as only one contact developed TB disease out of 526 QFT-negative subjects.

Bergot, Emmanuel; Haustraete, Eglantine; Magnier, Romain; Salaun, Marie-Anne; Zalcman, Gerard

2012-01-01

305

M. tuberculosis in Lymph Node Biopsy Paraffin-Embedded Sections  

PubMed Central

Background. Tuberculosis lymphadenitis is one of the most common forms of all extrapulmonary tuberculosis. Objective. To evaluate the magnitude of M. tuberculosis from lymph node biopsy paraffin-embedded sections among suspected patients visiting the Jimma University Specialized Hospital. Method. A cross-sectional study design of histological examination among lymph node biopsy paraffin-embedded sections by Ziehl-Neelsen and hematoxylin/eosin staining technique was conducted from December, 2009, to October, 2010, at the Department of Medical Laboratory Science and Pathology. Result. Histopathological examination of the specimens by hematoxylin and eosin staining technique revealed the presence of granulomas. But for the caseation and necrosis they were present in 85% cases of nodal tissue biopsies. From those, 56.7% were from females. The presence of acid-fast bacilli was microscopically confirmed by ZN staining in 37 (61.7%) of the nodal tissue biopsies. Conclusion and Recommendation. Tuberculosis lymphadenitis is significantly more common in females. Hence, attention should be given for control and prevention of extrapulmonary tuberculosis.

Eshete, Abdurehman; Zeyinudin, Ahmed; Ali, Solomon; Abera, Solomon; Mohammed, Mona

2011-01-01

306

pncA Mutations in the Specimens from Extrapulmonary Tuberculosis  

PubMed Central

Background Pyrazinamide (PZA) is an effective antitubercular drug that becomes toxic to Mycobacterium tuberculosis when converted to pyrazinoic acid by pyrazinamidase (PZase), encoded by mycobacterial pncA. A strong association was noted between the loss of PZase activity and PZA resistance. The causative organisms in extrapulmonary tuberculosis are rarely cultured and isolated. To detect pncA mutations in specimens from extrapulmonary tuberculosis as confirmative diagnosis of mycobacterial infection and alternative susceptibility test to PZA. Methods Specimens were collected from clinically proven extrapulmonary tuberculosis. pncA was sequenced and compared with wild-type pncA. Results pncA from 30 specimens from 23 donors were successfully amplified (56.6% in specimens, 59% in donors). Six mutations in pncA were detected (20.0% in amplified specimens, 26.1% in specimen donors) at nucleotide positions of 169, 248 and 419. The mutation at position 169 results in substitution of aspartic acid for histidine, a possible allelic variation of M. bovis that have intrinsic PZA resistance. The mutation at position 248 changes proline into arginine and that at position 419, arginine into histidine. Conclusion DNA-based diagnosis using pncA may be simultaneously useful for the early diagnosis of mycobacterial infection and the rapid susceptibility to PZA in extrapulmonary tuberculosis. A potential implication of pncA allelic variation at 169 might be suggested as a rapid diagnostic test for M. bovis infection or Bacille Calmette-Guérin (BCG) reactivation.

Lee, Jaechun; Yun, Yeo-Jun; Kqueen, Cheah Yoke; Lee, Jong Hoo; Kim, Hee-Youn; Kim, Young Ree; Kook, Yoon-Hoh

2012-01-01

307

Detection of Mycobacterium tuberculosis directly from sputum specimens & phenotypic drug resistance pattern of M. tuberculosis isolates from suspected tuberculosis patients in Chennai  

PubMed Central

Background & objectives: mRNA is more rapidly destroyed in cells than rRNA or genomic DNA, an assay targeting bacterial mRNA would provide a better guide to mycobacterial viability than amplification tests directed at DNA or rRNA targets. This study was carried out to standardize reverse transcriptase PCR (RT-PCR) targeting 85B gene for the rapid detection of viable Mycobacterium tuberculosis from sputum specimens of suspected TB patients at Chennai, South India and to detect MDR-TB circulating in this population. Methods: Sputum samples from clinically suspected tuberculosis patients (n=301) and 78 controls were included in the study. The sputum samples were collected in sterile diethyl pyrocarbonate (DEPC) treated containers and transported in ice to the laboratory within 2 h to prevent degradation of RNA. RT-PCR targeting 85B gene, mycobacterial culture and phenotypic drug susceptibility testing for the first line drugs streptomycin (S), isoniazid (H), rifampicin (R), ethambutol (E) and pyrazinamide (Z) were performed by BACTEC microMGIT culture system for all the sputum specimens. Results: All the 78 controls were negative for culture and RT-PCR. Among the 301 sputum specimens from patients, 231 (76.8%) were RT-PCR positive and 70 (23.2%) were negative. There were 166 M. tuberculosis isolates, of which 11 (2.9%) were MDR-TB, 33 (8.7%) were polyresistant, 31 (8.2%) were monoresistant and 91 (30.2%) were sensitive to all five first line anti-tuberculous drugs by phenotypic drug susceptibility testing. Monoresistance was higher with Z [20 (20.8%)], followed by S [6 (3%)]. Interpretation & conclusions: RT-PCR targeting 85B gene of M. tuberculosis was a specific, rapid, reliable technique to detect the M. tuberculosis directly from sputum specimens. Our results showed that 2.9 per cent of M. tuberculosis isolates in the study population of Chennai were MDR.

Therese, K. Lily; Gayathri, R.; Dhanurekha, L.; Sridhar, R.; Meenakshi, N.; Madhavan, H. N.; Manoj, S. Edwin; Vinayagam, A. Kamala

2012-01-01

308

Tuberculosis in Sudan: a study of Mycobacterium tuberculosis strain genotype and susceptibility to anti-tuberculosis drugs  

PubMed Central

Background Sudan is a large country with a diverse population and history of civil conflict. Poverty levels are high with a gross national income per capita of less than two thousand dollars. The country has a high burden of tuberculosis (TB) with an estimated 50,000 incident cases during 2009, when the estimated prevalence was 209 cases per 100,000 of the population. Few studies have been undertaken on TB in Sudan and the prevalence of drug resistant disease is not known. Methods In this study Mycobacterium tuberculosis isolates from 235 patients attending three treatment centers in Sudan were screened for susceptibility to isoniazid, rifampicin, ethambutol and streptomycin by the proportion method on Lowenstein Jensen media. 232 isolates were also genotyped by spoligotyping. Demographic details of patients were recorded using a structured questionnaire. Statistical analyses were conducted to examine the associations between drug resistance with risk ratios computed for a set of risk factors (gender, age, case status - new or relapse, geographic origin of the patient, spoligotype, number of people per room, marital status and type of housing). Results Multi drug-resistant tuberculosis (MDR-TB), being resistance to at least rifampicin and isoniazid, was found in 5% (95% CI: 2,8) of new cases and 24% (95% CI: 14,34) of previously treated patients. Drug resistance was associated with previous treatment with risk ratios of 3.51 (95% CI: 2.69-4.60; p < 0.001) for resistance to any drug and 5.23 (95% CI: 2.30-11.90; p < 0.001) for MDR-TB. Resistance was also associated with the geographic region of origin of the patient, being most frequently observed in patients from the Northern region and least in the Eastern region with risk ratios of 7.43 (95%CI:3.42,16.18; p: < 0.001) and 14.09 (95%CI:1.80,110.53; p:0.026) for resistance to any drug and MDR-TB. The major genotype observed was of the Central Asia spoligotype family (CAS1_Delhi), representing 49% of the 232 isolates examined. Conclusions We conclude that emergence of drug resistant tuberculosis has the potential to be a serious public health problem in Sudan and that strengthened tuberculosis control and improved monitoring of therapy is needed. Further surveillance is required to fully ascertain the extent of the problem.

2011-01-01

309

Reinfection and Mixed Infection Cause Changing Mycobacterium tuberculosis Drug-Resistance Patterns  

Microsoft Academic Search

Rationale:MultipleinfectionswithdifferentstrainsofMycobacterium tuberculosis may occur in settings where the infection pressure is high. The relevance of mixed infections for the patient, clinician, and control program remains unclear. Objectives: This study aimed to describe reinfection and mixed infection as underlying mecha- nisms of changing drug-susceptibility patterns in serial sputum cul- tures. Methods: Serial M. tuberculosis sputum cultures from patients diagnosed with multi-drug-resistant

Annelies van Rie; Thomas C. Victor; Madalene Richardson; Gian D. van der Spuy; Emma J. Murray; Nico C. Gey van Pittius; Paul D. van Helden; Robin M. Warren

2005-01-01

310

Protein targets for structure-based anti- Mycobacterium tuberculosis drug discovery  

Microsoft Academic Search

Mycobacterium tuberculosis, which belongs to the genus Mycobacterium, is the pathogenic agent for most tuberculosis (TB). As TB remains one of the most rampant infectious diseases, causing morbidity\\u000a and death with emergence of multi-drug-resistant and extensively-drug-resistant forms, it is urgent to identify new drugs\\u000a with novel targets to ensure future therapeutic success. In this regards, the structural genomics of M.

Zhiyong Lou; Xiaoxue Zhang

2010-01-01

311

DAHP synthase from Mycobacterium tuberculosis H37Rv: cloning, expression, and purification of functional enzyme  

Microsoft Academic Search

Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains the leading cause of mortality due to a bacterial pathogen. According to the 2004 Global TB Control Report of the World Health Organization, there are 300,000 new cases per year of multi-drug resistant strains (MDR-TB), defined as resistant to isoniazid and rifampicin, and 79% of MDR-TB cases are now “super strains,” resistant to

Caroline Rizzi; Jeverson Frazzon; Fernanda Ely; Patrícia G. Weber; Isabel O. da Fonseca; Michelle Gallas; Jaim S. Oliveira; Maria A. Mendes; Bibiana M. de Souza; Mário S. Palma; Diógenes S. Santos; Luiz A. Basso

2005-01-01

312

Identification of ancient remains through genomic sequencing.  

PubMed

Studies of ancient DNA have been hindered by the preciousness of remains, the small quantities of undamaged DNA accessible, and the limitations associated with conventional PCR amplification. In these studies, we developed and applied a genomewide adapter-mediated emulsion PCR amplification protocol for ancient mammalian samples estimated to be between 45,000 and 69,000 yr old. Using 454 Life Sciences (Roche) and Illumina sequencing (formerly Solexa sequencing) technologies, we examined over 100 megabases of DNA from amplified extracts, revealing unbiased sequence coverage with substantial amounts of nonredundant nuclear sequences from the sample sources and negligible levels of human contamination. We consistently recorded over 500-fold increases, such that nanogram quantities of starting material could be amplified to microgram quantities. Application of our protocol to a 50,000-yr-old uncharacterized bone sample that was unsuccessful in mitochondrial PCR provided sufficient nuclear sequences for comparison with extant mammals and subsequent phylogenetic classification of the remains. The combined use of emulsion PCR amplification and high-throughput sequencing allows for the generation of large quantities of DNA sequence data from ancient remains. Using such techniques, even small amounts of ancient remains with low levels of endogenous DNA preservation may yield substantial quantities of nuclear DNA, enabling novel applications of ancient DNA genomics to the investigation of extinct phyla. PMID:18426903

Blow, Matthew J; Zhang, Tao; Woyke, Tanja; Speller, Camilla F; Krivoshapkin, Andrei; Yang, Dongya Y; Derevianko, Anatoly; Rubin, Edward M

2008-04-21

313

Odor analysis of decomposing buried human remains  

Microsoft Academic Search

This study, conducted at the University of Tennessee's Anthropological Research Facility (ARF), lists and ranks the primary chemical constituents which define the odor of decomposition of human remains as detected at the soil surface of shallow burial sites. Triple sorbent traps were used to collect air samples in the field and revealed eight major classes of chemicals which now contain

Arpad Alexander Vass; Rob R. Smith; Cyril V. Thompson; Michael N. Burnett; Nishan Dulgerian; Brian A. Eckenrode

2008-01-01

314

Juveniles' Motivations for Remaining in Prostitution  

ERIC Educational Resources Information Center

Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

Hwang, Shu-Ling; Bedford, Olwen

2004-01-01

315

Juveniles' Motivations for Remaining in Prostitution  

ERIC Educational Resources Information Center

|Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

Hwang, Shu-Ling; Bedford, Olwen

2004-01-01

316

Odor analysis of decomposing buried human remains  

SciTech Connect

This study, conducted at the University of Tennessee's Anthropological Research Facility (ARF), lists and ranks the primary chemical constituents which define the odor of decomposition of human remains as detected at the soil surface of shallow burial sites. Triple sorbent traps were used to collect air samples in the field and revealed eight major classes of chemicals which now contain 478 specific volatile compounds associated with burial decomposition. Samples were analyzed using gas chromatography-mass spectrometry (GC-MS) and were collected below and above the body, and at the soil surface of 1.5-3.5 ft. (0.46-1.07 m) deep burial sites of four individuals over a 4-year time span. New data were incorporated into the previously established Decompositional Odor Analysis (DOA) Database providing identification, chemical trends, and semi-quantitation of chemicals for evaluation. This research identifies the 'odor signatures' unique to the decomposition of buried human remains with projected ramifications on human remains detection canine training procedures and in the development of field portable analytical instruments which can be used to locate human remains in shallow burial sites.

Vass, Arpad Alexander [ORNL; Smith, Rob R [ORNL; Thompson, Cyril V [ORNL; Burnett, Michael N [ORNL; Dulgerian, Nishan [ORNL; Eckenrode, Brian A [ORNL

2008-01-01

317

Uncertainties remain in predicting paraffin deposition  

SciTech Connect

Current methods for predicting paraffin deposition in flow lines are useful for providing a design engineer with a feel for the magnitude of the potential problem, but a number of uncertainties remain. This conclusion of a two-part series describes paraffin, asphaltene, and multiphase flow problems in subsea flow lines, and the available computer simulators for predicting paraffin formation.

Hunt, A. [Texaco Ltd., London (United Kingdom)

1996-07-29

318

Coal remains a hot commodity for Australia  

SciTech Connect

Based largely on analyses by the Australian Bureau of Agricultural and Resource Economics in late 2005 and early 2006, the article looks at the recent and near future export market for Australian coal. Demand in Asia is growing; European demand remains steady. Developments existing and new mines in Queensland are summarised in the article. 3 tabs.

Bram, L.

2006-02-15

319

Odor analysis of decomposing buried human remains.  

PubMed

This study, conducted at the University of Tennessee's Anthropological Research Facility (ARF), lists and ranks the primary chemical constituents which define the odor of decomposition of human remains as detected at the soil surface of shallow burial sites. Triple sorbent traps were used to collect air samples in the field and revealed eight major classes of chemicals which now contain 478 specific volatile compounds associated with burial decomposition. Samples were analyzed using gas chromatography-mass spectrometry (GC-MS) and were collected below and above the body, and at the soil surface of 1.5-3.5 ft. (0.46-1.07 m) deep burial sites of four individuals over a 4-year time span. New data were incorporated into the previously established Decompositional Odor Analysis (DOA) Database providing identification, chemical trends, and semi-quantitation of chemicals for evaluation. This research identifies the "odor signatures" unique to the decomposition of buried human remains with projected ramifications on human remains detection canine training procedures and in the development of field portable analytical instruments which can be used to locate human remains in shallow burial sites. PMID:18366571

Vass, Arpad A; Smith, Rob R; Thompson, Cyril V; Burnett, Michael N; Dulgerian, Nishan; Eckenrode, Brian A

2008-03-01

320

Archaeological Remains on the Southern Somali Coast  

Microsoft Academic Search

This article describes a series of sites and their architectural remains (notably mosques, tombs—both with and without pillars—and town walls) on what can be described as the heartland of the Bajun coast in the extreme south of Somalia (fig. 1). The imported pottery collected from these sites suggests that none are earlier than the fourteenth or fifteenth century. Most of

Hilary Costa Sanseverino

1983-01-01

321

The case for fencing remains intact.  

PubMed

Creel et al. argue against the conservation effectiveness of fencing based on a population measure that ignores the importance of top predators to ecosystem processes. Their statistical analyses consider, first, only a subset of fenced reserves and, second, an incomplete examination of 'costs per lion.' Our original conclusions remain unaltered. PMID:23962143

Packer, C; Swanson, A; Canney, S; Loveridge, A; Garnett, S; Pfeifer, M; Burton, A C; Bauer, H; Macnulty, D

2013-08-20

322

Predicting the remaining service life of concrete  

SciTech Connect

Nuclear power plants are providing, currently, about 17 percent of the U.S. electricity and many of these plants are approaching their licensed life of 40 years. The U.S. Nuclear Regulatory Commission and the Department of Energy`s Oak Ridge National Laboratory are carrying out a program to develop a methodology for assessing the remaining safe-life of the concrete components and structures in nuclear power plants. This program has the overall objective of identifying potential structural safety issues, as well as acceptance criteria, for use in evaluations of nuclear power plants for continued service. The National Institute of Standards and Technology (NIST) is contributing to this program by identifying and analyzing methods for predicting the remaining life of in-service concrete materials. This report examines the basis for predicting the remaining service lives of concrete materials of nuclear power facilities. Methods for predicting the service life of new and in-service concrete materials are analyzed. These methods include (1) estimates based on experience, (2) comparison of performance, (3) accelerated testing, (4) stochastic methods, and (5) mathematical modeling. New approaches for predicting the remaining service lives of concrete materials are proposed and recommendations for their further development given. Degradation processes are discussed based on considerations of their mechanisms, likelihood of occurrence, manifestations, and detection. They include corrosion, sulfate attack, alkali-aggregate reactions, frost attack, leaching, radiation, salt crystallization, and microbiological attack.

Clifton, J.F.

1991-11-01

323

Creep damage assessment and remaining life evaluation  

Microsoft Academic Search

The approach of Kachanov and Rabotnov to the assessment of damage has been related to the creep of components at elevated\\u000a temperature. The relation between the damage function and void formation is discussed, together with recent developments in\\u000a which remaining life can be estimated using available materials constants and strain rate measurements.

I. Le May; H. C. Furtado

1999-01-01

324

On multivariate mean remaining life functions  

Microsoft Academic Search

The concept of the mean remaining life function is extended to the multivariate case. Some general characterization properties of multivariate mean remaning life functions (mmrl) are studied, it is shown that they determine the joint pdf uniquely. Inter alia a basic convergence result is proved for a sequence of mmrl functions. The multivariate loss of memory property of a pdf

Barry C. Arnold; Hassan Zahedi

1988-01-01

325

Remaining Relevant in the 21st Century.  

National Technical Information Service (NTIS)

Is the Marine Corps operational concept 'Operational Maneuver from the Sea' and the 31st Commandant's Planning Guidance the direction in which the Marine Corps should be going to remain relevant in the 21st century political and military environment. Are ...

C. L. Hudson

1996-01-01

326

Remaining issues for hazardous waste incineration  

SciTech Connect

While thermal destruction represents the most effective and widely applicable control technology available today for the disposal or organic hazardous waste, a number of issues remain concerning its use in the long term. These include: Destruction effectiveness on untested/unique wastes; Control of metal emissions; Emissions of combustion byproducts; Detection of process failure; Real-time performance assurance; and Role of innovative technology.

Dempsey, C.R.

1993-10-01

327

[New tuberculosis drugs in resistant and multiresistant tuberculosis].  

PubMed

Drug-resistant tuberculosis is a globally emerging problem with a rising incidence. According to the WHO in 2008, 17% of strains of Mycobacterium tuberculosis, in untreated cases were resistant to at least one drug and 3.6% were resistant to rifampicin and isoniazid, which is called multidrug-resistant tuberculosis. The problem is greater in patients previously treated and in some countries, where rates of multidrug resistance reach 60%. Approximately 5% of multidrug-resistant tuberculosis patients are also resistant to any fluoroquinolone and at least one injectable drug, being called extensively drug-resistant tuberculosis. The treatment of these forms of tuberculosis requires the use of second-line drugs, which causes higher cost, higher toxicity and a longer duration of treatment. There is a need for new compounds with efficacy and safety profiles better than those currently used to treat these forms of tuberculosis. In the last decade different drugs have being reassessed and appeared, which are at different stages of development. PMID:23540388

Ramírez Lapausa, Marta; Pascual Pareja, José Francisco; Noguerado Asensio, Arturo

2013-03-26

328

Characteristics of multidrug-resistant tuberculosis in Namibia  

PubMed Central

Background To describe the epidemiology and possible risk factors for the development of multidrug-resistant tuberculosis (MDR-TB) in Namibia. Methods Using medical records and patient questionnaires, we conducted a case-control study among patients diagnosed with TB between January 2007 and March 2009. Cases were defined as patients with laboratory-confirmed MDR-TB; controls had laboratory-confirmed drug-susceptible TB or were being treated with WHO Category I or Category II treatment regimens. Results We enrolled 117 MDR-TB cases and 251 TB controls, of which 100% and 2% were laboratory-confirmed, respectively. Among cases, 97% (113/117) had been treated for TB before the current episode compared with 46% (115/251) of controls (odds ratio [OR] 28.7, 95% confidence interval [CI] 10.3–80.5). Cases were significantly more likely to have been previously hospitalized (OR 1.9, 95% CI 1.1–3.5) and to have had a household member with MDR-TB (OR 5.1, 95% CI 2.1–12.5). These associations remained significant when separately controlled for being currently hospitalized or HIV-infection. Conclusions MDR-TB was associated with previous treatment for TB, previous hospitalization, and having had a household member with MDR-TB, suggesting that TB control practices have been inadequate. Strengthening basic TB control practices, including expanding laboratory confirmation, directly observed therapy, and infection control, are critical to the prevention of MDR-TB.

2012-01-01

329

Some social and forensic aspects of exhumation and reinterment of industrial revolution remains.  

PubMed

The aetiological aspects of exhumed remains from two burial sites were examined using 1839 and 1879 as years of comparison. We tried to discover whether the sample of recovered remains was representative of those buried. The state of the remains varied according to the type of soil and coffin material in which they were buried. At the earlier date most deaths were caused by infectious lesions rather than degenerative ones and 76% of those who died were below employable age-whereas in 1879 the commonest causes of death were tuberculosis ("phthisis") and bronchitis, and 42% died before they could be employed. The registration of deaths were recorded more accurately at the later date, and it was easier to build up a picture of the age, sex, and occupation of the people who died. PMID:4593709

Duff, E J; Johnson, J S

1974-03-23

330

[Tuberculosis Annual Report 2010--(3) Childhood tuberculosis].  

PubMed

The number of newly notified childhood tuberculosis (TB) cases (TB in patients aged 0-14 years) in Japan in 2010 was 89, which corresponds to a notification rate of 0.53 per 100,000 population. The annual notified numbers and rates of childhood TB decreased steadily until 2006, after which the number dropped to below 100 and have since remained stable. Among the 89 childhood TB patients notified in 2010, 30 (33.7%) were aged 0-4 years, 26 (29.2%) were 5-9 years, and 33 (37.1%) were 10-14 years. In 2010, the number and proportion of TB patients aged 10-14 years were remarkably increased as compared to those in previous years. In the same year, 25 (28.1%) extrapulmonary TB cases were reported in children, while no TB meningitis or miliary TB cases were reported. The number of foreigners with childhood TB increased from 5 in 2008 and 3 in 2009 to 9 (10.1%) in 2010. In 2010, 30 patients (33.7%) with TB symptoms were identified at medical institutions, and 40 (44.9%) were identified by contact investigation of household members. These accounted for nearly 80% of the childhood TB cases detected, similar to the trend in previous years. Of the 47 prefectures in Japan, 15 reported no cases of childhood TB in 2010. Childhood TB cases were concentrated in the metropolitan areas such as the Tokyo Metropolitan Area (23 cases) and Kanagawa Prefecture (9 cases). In recent years, the number and rate of childhood TB cases in Japan have remained low; however, further efforts to eliminate childhood TB will require early detection and treatment of infectious cases, efficient contact investigations, and sustaining good TB prevention practices. PMID:23025015

2012-08-01

331

Relationship between mutation of serine residue at 315th position in M. tuberculosis catalase-peroxidase enzyme and Isoniazid susceptibility: An in silico analysis  

Microsoft Academic Search

Remarkable advances have been made in the drug therapy of tuberculosis. However much remains to be learned about the molecular\\u000a and structural basis of drug resistance in Mycobacterium tuberculosis. It is known that, activation of Isoniazid (INH) is mediated by Mycobacterium tuberculosis catalase-peroxidase (MtBKatG) and mutation at position 315 (serine to threonine) leads to resistance. We have conducted studies on

Rituraj Purohit; Vidya Rajendran; Rao Sethumadhavan

2011-01-01

332

Mycobacterium tuberculosis Hip1 Dampens Macrophage Proinflammatory Responses by Limiting Toll-Like Receptor 2 Activation?  

PubMed Central

Mycobacterium tuberculosis is a highly successful human pathogen that evades host innate immunity by interfering with macrophage functions. In addition to avoiding macrophage microbicidal activities, M. tuberculosis triggers secretion of proinflammatory cytokines and chemokines in macrophages. The levels of proinflammatory cytokines induced by clinical M. tuberculosis isolates are thought to play an important role in determining tuberculosis disease progression and severity, but the mechanisms by which M. tuberculosis modulates the magnitude of inflammatory responses remain unclear. Here we show that M. tuberculosis restricts robust macrophage activation and dampens proinflammatory responses through the cell envelope-associated serine hydrolase Hip1 (hydrolase important for pathogenesis 1). By transcriptionally profiling macrophages infected with either wild-type or hip1 mutant bacteria, we found that the hip1 mutant induced earlier and significantly higher levels of several proinflammatory cytokines and chemokines. We show that increased activation of Toll-like receptor 2 (TLR2)- and MyD88-dependent signaling pathways mediates the enhanced cytokine secretion induced by the hip1 mutant. Thus, Hip1 restricts the onset and magnitude of proinflammatory cytokines by limiting TLR2-dependent activation. We also show that Hip1 dampens TLR2-independent activation of the inflammasome and limits secretion of interleukin-18 (IL-18). Dampening of TLR2 signaling does not require viable M. tuberculosis or phagocytosis but does require Hip1 catalytic activity. We propose that M. tuberculosis restricts proinflammatory responses by masking cell surface interactions between TLR2 agonists on M. tuberculosis and TLR2 on macrophages. This strategy may allow M. tuberculosis to evade early detection by host immunity, delay the onset of adaptive immune responses, and accelerate disease progression.

Madan-Lala, Ranjna; Peixoto, Katia Vitorello; Re, Fabio; Rengarajan, Jyothi

2011-01-01

333

Extragalactic Background Radiation  

NASA Astrophysics Data System (ADS)

Contents; Preface; List of participants; 1. Introduction P. J. E. Peebles; 2. Extragalactic gamma-ray background N. Gehrels and C. Cheung; 3. The X-ray background (observations) G. Zamorani; 4. Extragalactic ultraviolet background radiation R. C. Henry and J. Murthy; 5. Ultraviolet background (theory) P. Jakobsen; 6. The optical extragalactic background radiation J. A. Tyson; 7. Infrared background (observations) M. G. Hauser; 8. The infrared background (theory) C. J. Lonsdale; 9. Microwave background radiation (observations) J. C. Mather; 10. Detection of degree scale anisotropy P. M. Lubin; 11. Cosmic microwave background anisotropies and structure formation in the universe N. Vittorio; The radio background emission - the long and short of it M. S. Longair; 13. The radio background: radio-loud galaxies at high and low redshifts J. A. Peacock; 14. Conference summary M. J. Rees.

Calzetti, Daniela; Livio, Mario; Madau, Piero

1995-01-01

334

Distribution and characteristics of hematogenous disseminated tuberculosis within the abdomen on contrast-enhanced CT  

Microsoft Academic Search

Background  The incidence of abdominal tuberculous lymphadenopathy never appears low. In addition to infecting the abdominal lymph nodes\\u000a through the digestive tract, the tuberculosis bacteria can also infect the abdominal lymph nodes and extra-nodal organs through\\u000a hematogenous dissemination. This study investigated contrast-enhanced CT features and anatomic locations of hematogenous disseminated\\u000a tuberculosis involving abdominal organs.\\u000a \\u000a \\u000a \\u000a Methods  Thirteen patients with documented hematogenous disseminated tuberculosis

Yuan Li; Zhi-Gang Yang; Ying-Kun Guo; Peng-Qiu Min; Jian-Qun Yu; En-Sen Ma; Jian Hu

2007-01-01

335

Remaining questions about clinical variola major.  

PubMed

After the recent summary of World Health Organization-authorized research on smallpox, several clinical issues remain. This policy review addresses whether early hemorrhagic smallpox is disseminated intravascular coagulation and speculates about the cause of the high mortality rate among pregnant women and whether ocular smallpox is partly the result of trachoma or vitamin A deficiency. The joint destruction common in children with smallpox might be prevented by antiviral drugs, but intraarticular infusion of antiviral drugs is unprecedented. Development of highly effective antiviral drugs against smallpox raises the issue of whether postexposure vaccination can be performed without interference by an antiviral drug. Clinicians should consider whether patients with smallpox should be admitted to general hospitals. Although an adequate supply of second-generation smallpox vaccine exists in the United States, its use is unclear. Finally, political and ethical forces suggest that destruction of the remaining stocks of live smallpox virus is now appropriate. PMID:21470458

Lane, J Michael

2011-04-01

336

Healthcare stocks expected to remain strong.  

PubMed

While healthcare stocks are likely to remain at the top of Wall Street's list of favorites, healthcare analysts and money managers say they don't expect to see the same quality of healthcare companies issuing stock the rest of the year. They say that in the coming months, more companies of lesser quality will sell stock at inflated prices, compared with their earnings. PMID:10110753

Pallarito, K

1991-05-27

337

Why the glass transition problem remains unsolved?  

Microsoft Academic Search

Glass-forming substances are made of units having nontrivial mutual interactions. Therefore, structural relaxation of glass-formers is a many-body relaxation problem, which unfortunately is still an unsolved problem in statistical mechanics. Conventional theories and models of glass transition bypass solution of this problem, and hence glass transition also remains an unsolved problem. There are plenty of experimental evidences for the many-body

K. L. Ngai

2007-01-01

338

Direct Dating of Hominids Remains In Eurasia  

NASA Astrophysics Data System (ADS)

When archaeological sites are associated with human remains, it is relevant to be able to date those valuable remains for different reasons. The main one is that it avoids the stratigraphical problems which can be due to intrusive burials in the sequence. The other reason consists in the fact that human bones may be encountered out of established stratigraphical context. On the other hand, the majority of dating methods currently used are destructive and can not be applied on these precious samples particularly when they are older than 40,000 years and can not be dated by radiocarbon. Since several years, we have developped a completely non-destructive method which consists in the measurement of human remains using the gamma -ray spectrometry. This technique has been used recently by other laboratories. We present here two important cases for the knowledge of human evolution in Eurasia. The first example is Qafzeh site in Israel where many human skeletons have been unearthed from burials associated with fauna and lithic artefacts. This site has been dated by several independent radiometric methods. So, it was possible to compare our gamma results with the other results yielded by the different methods. The second case concerns the most evolved Homo erectus found in Java, Indonesia, at Ngandong site, close to the Solo river. A recent debate has been focused on the age of these fossils and their direct dating is of outmost importance for the knowledge of settlement of Modern Humans in South-East Asia.

Yokoyama, Y.; Falguères, C.

339

Mycobacterium tuberculosis Prevents Inflammasome Activation  

PubMed Central

SUMMARY Mycobacterium tuberculosis parasitizes host macrophages and subverts host innate and adaptive immunity. A number of cytokines elicited by the tubercle bacilli have been recognized as mediators of mycobacterial clearance or pathology in tuberculosis. Surprisingly, interleukin-1? (IL-1?), a major pro-inflammatory cytokine activated by processing upon assembly of a specialized protein complex termed the inflammasome, has not been implicated in host-pathogen interactions in tuberculosis. Here, we show that M. tuberculosis prevents inflammasome activation and IL-1? processing, and that a functional M. tuberculosis zmp1 gene is required for this process. Infection of macrophages with the zmp1 null M. tuberculosis triggered activation of caspase-1/IL-1? inflammasome, resulting in increased secretion of IL-1?, enhanced mycobacterial phagosome maturation into phagolysosomes, improved mycobacterial clearance by macrophages, and lower bacterial burden in the lungs of aerosol-infected mice. Thus, we uncovered the previously masked role for IL-1? in control of M. tuberculosis, and the existence of a mycobacterial system that prevents IL-1?/inflammasome activation.

Master, Sharon S.; Davis, Alexander. S.; Rampini, Silvana K.; Keller, Christine; Ehlers, Stefan; Springer, Burkhardt; Sander, Peter; Deretic, Vojo

2013-01-01

340

Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test.  

PubMed

Rapid progress has been made in the development of new diagnostic assays for tuberculosis in recent years. New technologies have been developed and assessed, and are now being implemented. The Xpert MTB/RIF assay, which enables simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance, was endorsed by WHO in December, 2010. This assay was specifically recommended for use as the initial diagnostic test for suspected drug-resistant or HIV-associated pulmonary tuberculosis. By June, 2012, two-thirds of countries with a high tuberculosis burden and half of countries with a high multidrug-resistant tuberculosis burden had incorporated the assay into their national tuberculosis programme guidelines. Although the development of the Xpert MTB/RIF assay is undoubtedly a landmark event, clinical and programmatic effects and cost-effectiveness remain to be defined. We review the rapidly growing body of scientific literature and discuss the advantages and challenges of using the Xpert MTB/RIF assay in areas where tuberculosis is endemic. We also review other prospects within the developmental pipeline. A rapid, accurate point-of-care diagnostic test that is affordable and can be readily implemented is urgently needed. Investment in the tuberculosis diagnostics pipeline should remain a major priority for funders and researchers. PMID:23531388

Lawn, Stephen D; Mwaba, Peter; Bates, Matthew; Piatek, Amy; Alexander, Heather; Marais, Ben J; Cuevas, Luis E; McHugh, Timothy D; Zijenah, Lynn; Kapata, Nathan; Abubakar, Ibrahim; McNerney, Ruth; Hoelscher, Michael; Memish, Ziad A; Migliori, Giovanni Battista; Kim, Peter; Maeurer, Markus; Schito, Marco; Zumla, Alimuddin

2013-03-24

341

Well defined symptoms are of value in the diagnosis of childhood pulmonary tuberculosis  

PubMed Central

Background: The diagnosis of childhood pulmonary tuberculosis presents a major challenge as symptoms traditionally associated with tuberculosis are extremely common in children from endemic areas. The natural history of tuberculosis in children shows that progressive disease is associated with symptoms which have a persistent, non-remitting character. The aims of this study were to investigate whether improved symptom definition is possible in a clinical setting, and whether use of these well defined symptoms has improved value in the diagnosis of childhood pulmonary tuberculosis. Methods: A prospective, community based study was conducted in two suburbs of Cape Town, South Africa. All children (<13 years) presenting to the local community clinic with a cough of >2 weeks duration, were referred to the investigator. Parents completed a symptom based questionnaire, whereafter reported symptoms were characterised in a standard fashion. Results: Of the 151 children enrolled, 21 (15.6%) reported symptoms with a persistent, non-remitting character. Tuberculosis was diagnosed in 16 (10.5%) children, all of whom reported these symptom characteristics. A persistent, non-remitting cough was reported in 15/16 (93.8%) children with tuberculosis and in 2/135 (1.5%) children without tuberculosis, indicating a specificity of 98.5% (135/137). Persistent fatigue of recent onset was also sensitive (13/16, 81.3%) and specific (134/135, 99.3%). Persistent fever and/or chest pain were exclusively reported in children with tuberculosis, but were present in only 4/16 (25.0%) children with tuberculosis. Conclusion: The use of well defined symptoms is feasible, even in resource limited settings, and may offer significantly improved value in the diagnosis of childhood pulmonary tuberculosis.

Marais, B; Gie, R; Obihara, C; Hesseling, A; Schaaf, H; Beyers, N

2005-01-01

342

Prognostic Value of a T-Cell-Based Interferon-Gamma Biomarker in Child Tuberculosis Contacts  

PubMed Central

Background Enzyme-linked-immunospot (ELISpot) is an increasingly widely-used interferon-gamma release assay (IGRA) for diagnosing tuberculosis infection but it is unknown whether positive results are prognostic of active tuberculosis. Objective To determine the prognostic value of this T-cell-based interferon-gamma biomarker. Design Longitudinal cohort study of child tuberculosis contacts recruited from October 2002 to April 2004. Setting Community-based contact investigations in Turkey. Patients 908 children and adolescents with recent household tuberculosis exposure. Intervention ELISpot, incorporating Early Secretory Antigenic Target-6 and Culture Filtrate Protein-10, and tuberculin skin test (TST) were performed at baseline. Measurements Incidence rates of progression to active tuberculosis for contacts with positive TST and ELISpot results and relative incidence rates comparing test-positive and test-negative contacts. Results 688 (76%) contacts received isoniazid preventive therapy in accordance with local guidelines. Fifteen contacts developed active tuberculosis over 1201 person-years follow-up. Of 381 ELISpot-positive contacts, 11 developed active tuberculosis over 536 person-years follow-up (incidence rate 21 per 1000 person-years [95% CI 10.2, 36.7]) and of 550 TST-positive contacts, 12 developed active tuberculosis over 722 person-years of follow-up (17 per 1000 person-years [95% CI 8.6, 29.0]). Limitations Only 3 of the 15 incident cases were culture-confirmed. Conclusion Although tuberculosis contacts with positive ELISpot results have a similar incidence rate of tuberculosis compared to contacts with positive TST results, ELISpot testing could allow more focussed targeting of preventive therapy to fewer contacts.

Bakir, Mustafa; Millington, Kerry A; Soysal, Ahmet; Deeks, Jonathan J; Efee, Serpil; Aslan, Yasemin; Dosanjh, Davinder P S; Lalvani, Ajit

2009-01-01

343

Isoniazid prophylactic therapy for tuberculosis in HIV-seropositive patients--a least-cost analysis.  

PubMed

The expected upsurge in the number of new cases of tuberculosis resulting from the HIV/AIDS epidemic prompted an examination of the feasibility of prevention strategies to limit the increase in clinical tuberculosis. A computer spreadsheet model was developed to estimate the costs and benefits that would result from isoniazid chemoprophylaxis for tuberculosis in a hypothetical cohort of 100,000 HIV-seropositive people in South Africa over a period of 8 years. At a 50% prevalence of tuberculosis infection among those at high background risk, and 5-10% among those at low risk, there would have been 34,000 cases of active tuberculosis in the cohort and their contacts if no prophylactic therapy had been used. On the other hand, a chemoprophylaxis policy would have meant only 12,200 cases of tuberculosis, if a patient compliance rate of 68.5% had been assumed. Such a policy would have prevented 21,800 cases of active tuberculosis. The estimated total discounted cost of a chemoprophylaxis programme would have been R51.3 million. In the absence of preventive therapy the discounted cost of treating patients with active tuberculosis would have been R91.9 million over the 8-year period. Therefore, if the benefits of chemoprophylaxis were defined in terms of averted health care costs, such a policy would have resulted in net savings of R40.6 million. This study did not estimate losses in production associated with tuberculosis treatment or the value of preventing tuberculosis per se, though such indirect costs would have increased the benefit of the prevention programme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7597538

Masobe, P; Lee, T; Price, M

1995-02-01

344

[Future tuberculosis care in Japan].  

PubMed

In Japan, the care of patients with tuberculosis has been mainly dependent on the state of hospital wards. The number of patients that have tuberculosis has steadily declined over the years, and we are now on the way to low prevalence state of tuberculosis. However there is a need for discussion about how future care for patients with tuberculosis should take place. The problems of present tuberculosis care system are as follows: (i) there is inefficiency and difficulty in maintaining the tuberculosis wards because of the declining number of patients and specialists; (ii) there are difficulties in treating complications such as renal insufficiency which requires blood dialysis, delivery, psychiatric diseases in tuberculosis beds; (iii) there is a high proportion of elderly patients that require substantial nursing care and long-term admission in the hospital; (iv) there is not only insufficient patient care but also financial support for patients with socioeconomic problems such as foreign-born worker or homelessness, (v) in addition to the medical care for patients of MDR-TB being insufficient, there are also inappropriate environment and amenities for long-term hospitalization. Moreover the public subsidy system for medical treatment requires patients to pay 5% of expense cost in the outpatient clinic. The following points should be discussed for the future tuberculosis care system: (i) general hospitals should take more part in caring for patients with complications and there should be a close cooperation among general hospitals, tuberculosis specialists and the administration; (ii) there should be a limited number of hospitals maintained for the integrated treatment of MDR-TB including surgical treatment and suitable circumstances for long-term hospital care. Additionally, there should be a system of detention for non-adherent patients or home isolation for adherent patient; (iii) there should be reinforcement of public commitment for patients with socioeconomic problems or MDR patients such as public subsidized full coverage of medical expense, free treatment in regional health centers PMID:21404573

Shigeto, Eriko

2010-12-01

345

Changing trends in childhood tuberculosis.  

PubMed

Several changes have been observed in the epidemiology, clinical manifestations, diagnostic modalities and treatment of tuberculosis. Emergence of HIV epidemic and drug resistance have posed significant challenges. With increase in the number of diseased adults and spread of HIV infection, the infection rates in children are likely to increase. It is estimated that in developing countries, the annual risk of tuberculosis infection in children is 2.5%. Nearly 8-20% of the deaths caused by tuberculosis occur in children. Extra pulmonary tuberculosis has increased over last two decades. HIV infected children are at an increased risk of tuberculosis, particularly disseminated disease. In last two decades, drug resistant tuberculosis has increased gradually with emergence of MDR and XDR-TB. The rate of drug resistance to any drug varied from 20% to 80% in different geographic regions. Significant changes have occurred in TB diagnostics. Various diagnostic techniques such as fluorescence LED microscopy, improved culture techniques, antigen detection, nucleic acid amplification, line probe assays and IGRAs have been developed and evaluated to improve diagnosis of childhood tuberculosis. Serodiagnosis is an attractive investigation but till date none of the tests have desirable sensitivity and specificity. Tests based on nucleic acid amplification are a promising advance but relatively less experience in children, need for technical expertise and high cost are limiting factors for their use in children with tuberculosis. Short-course chemotherapy for childhood tuberculosis is well established. Directly observed treatment strategy (DOTS) have shown encouraging result. DOTS plus strategy has been introduced for MDR TB. PMID:21161446

Mukherjee, Aparna; Lodha, Rakesh; Kabra, S K

2010-12-15

346

Phage lysin to control the overgrowth of normal flora in processed sputum samples for the rapid and sensitive detection of Mycobacterium tuberculosis by luciferase reporter phage assay  

PubMed Central

Background Phage lysin, extracted from three bacteriophages was used in place of antibiotics to control the overgrowth of normal flora in processed sputum samples leading to the sensitive detection of Mycobacterium tuberculosis using diagnostic luciferase reporter phage assay (DLRPA). Methods A total of 129 sputum samples were processed by modified Petroff’s method. Two Lowenstein Jensen slopes were inoculated from the processed sputum deposit thus obtained. The remaining deposits were transferred to 7 ml of Middlebrook 7H9 complete medium supplemented with phage lysin and incubated at 37°C. DLRPA was done using phAE129 at days 7, 9, 14 and 21. At the end of day 21, the samples were centrifuged and the pellets were inoculated on to 2 more LJ slopes to validate DLRPA results. Results The sensitivity and specificity of DLRPA in detecting M. tuberculosis from sputum specimens was 90% and 81% respectively compared to conventional LJ culture. The agreement between the methods was 87%. The rate of contamination for DLRPA using phage lysin was 9.3%. Conclusion Phage lysin can be used to decontaminate sputum samples for the detection of M. tuberculosis by DLRPA directly from processed sputum specimens.

2013-01-01

347

Reconstructing Tuberculosis Services after Major Conflict: Experiences and Lessons Learned in East Timor  

Microsoft Academic Search

BackgroundTuberculosis (TB) is a major public health problem in developing countries. Following the disruption to health services in East Timor due to violent political conflict in 1999, the National Tuberculosis Control Program was established, with a local non-government organisation as the lead agency. Within a few months, the TB program was operational in all districts.Methods and FindingsUsing the East Timor

Nelson Martins; Paul M Kelly; Jocelyn A Grace; Anthony B Zwi

2006-01-01

348

Helminth Coinfection Does Not Affect Therapeutic Effect of a DNA Vaccine in Mice Harboring Tuberculosis  

Microsoft Academic Search

BackgroundHelminthiasis and tuberculosis (TB) coincide geographically and there is much interest in exploring how concurrent worm infections might alter immune responses against bacilli and might necessitate altered therapeutic approaches. A DNA vaccine that codifies heat shock protein Hsp65 from M. leprae (DNAhsp65) has been used in therapy during experimental tuberculosis. This study focused on the impact of the co-existence of

Fabiani G. Frantz; Rogério S. Rosada; Camila Peres-Buzalaf; Franciele R. T. Perusso; Vanderlei Rodrigues; Simone G. Ramos; Steven L. Kunkel; Célio L. Silva; Lúcia H. Faccioli

2010-01-01

349

The Effects of Ciprofloxacin on Chest Radiographic Regression in Patients with Drug Intolerance or Resistant Tuberculosis  

Microsoft Academic Search

Background: The aim of this study was to identify the clinical efficacy of ciprofloxacin as a second-line anti-tuberculosis agent in pulmonary tuberculosis patients with drug intolerance or resistance. Methods: There were 20 patients with drug related adverse effects or drug resistance enrolled in the ciprofloxacin treatment group (CG). There were also 32 patients enrolled in the non-ciprofloxacin treatment group (NCG)

Chao-Kai Yang; Horng-Chyuan Lin; Kang-Yun Lee; Shu-Min Lin; Chih-Teng Yu; Han-Pin Kuo

350

MPT 64 Antigen detection for Rapid confirmation of M.tuberculosis isolates  

Microsoft Academic Search

Background  A new rapid Immunochromatographic test kit(SD MPT64TB Ag Kit) for detection of MPT 64 Antigen in M. tuberculosis isolates using mouse monoclonal MPT 64 Antibody developed by SD Bioline, South Korea was evaluated for rapid identification\\u000a of M. tuberculosis isolates. We also assessed the sensitivity, specificity and predictive values of this kit. The test kit has an excellent\\u000a sensitivity, specificity,

Vijay GS Kumar; Tejashree A Urs; Rajani R Ranganath

2011-01-01

351

Role of P27 - P55 operon from Mycobacterium tuberculosis in the resistance to toxic compounds  

Microsoft Academic Search

Background  The P27-P55 (lprG-Rv1410c) operon is crucial for the survival of Mycobacterium\\u000a tuberculosis, the causative agent of human tuberculosis, during infection in mice. P55 encodes an efflux pump that has been shown to provide Mycobacterium smegmatis and Mycobacterium bovis BCG with resistance to several drugs, while P27 encodes a mannosylated glycoprotein previously described as an antigen that modulates the immune response

María V Bianco; Federico C Blanco; Belén Imperiale; Marina A Forrellad; Roxana V Rocha; Laura I Klepp; Angel A Cataldi; Nora Morcillo; Fabiana Bigi

2011-01-01

352

Comparison of pulmonary and extrapulmonary tuberculosis in Nepal a hospital-based retrospective study  

Microsoft Academic Search

BACKGROUND: Studies from developed countries have reported on host-related risk factors for extra-pulmonary tuberculosis (EPTB). However, similar studies from high-burden countries like Nepal are lacking. Therefore, we carried out this study to compare demographic, life-style and clinical characteristics between EPTB and PTB patients. METHODS: A retrospective analysis was carried out on 474 Tuberculosis (TB) patients diagnosed in a tertiary care

Chandrashekhar T Sreeramareddy; Kishore V Panduru; Sharat C Verma; Hari S Joshi; Michael N Bates

2008-01-01

353

Evolution and Diversity of Clonal Bacteria: The Paradigm of Mycobacterium tuberculosis  

Microsoft Academic Search

BackgroundMycobacterium tuberculosis complex species display relatively static genomes and 99.9% nucleotide sequence identity. Studying the evolutionary history of such monomorphic bacteria is a difficult and challenging task.Principal FindingsWe found that single-nucleotide polymorphism (SNP) analysis of DNA repair, recombination and replication (3R) genes in a comprehensive selection of M. tuberculosis complex strains from across the world, yielded surprisingly high levels of

Tiago Dos Vultos; Olga Mestre; Jean Rauzier; Marcin Golec; Nalin Rastogi; Voahangy Rasolofo; Tone Tonjum; Christophe Sola; Ivan Matic; Brigitte Gicquel; Niyaz Ahmed

2008-01-01

354

Evolution and Diversity of Clonal Bacteria: The Paradigm of Mycobacterium tuberculosis  

Microsoft Academic Search

Background. Mycobacterium tuberculosis complex species display relatively static genomes and 99.9% nucleotide sequence identity. Studying the evolutionary history of such monomorphic bacteria is a difficult and challenging task. Principal Findings. We found that single-nucleotide polymorphism (SNP) analysis of DNA repair, recombination and replication (3R) genes in a comprehensive selection of M. tuberculosis complex strains from across the world, yielded surprisingly

Tiago Dos Vultos; Olga Mestre; Jean Rauzier; Marcin Golec; Nalin Rastogi; Voahangy Rasolofo; Tone Tonjum; Christophe Sola; Ivan Matic; Brigitte Gicquel

2008-01-01

355

Tuberculosis among HealthCare Workers in Low and Middle-Income Countries: A Systematic Review  

Microsoft Academic Search

BackgroundThe risk of transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is a neglected problem in many low- and middle-income countries (LMICs). Most health-care facilities in these countries lack resources to prevent nosocomial transmission of tuberculosis (TB).Methods and FindingsWe conducted a systematic review to summarize the evidence on the incidence and prevalence of latent TB infection (LTBI) and

Rajnish Joshi; Arthur L Reingold; Dick Menzies; Madhukar Pai

2006-01-01

356

Integrating intensified case finding of tuberculosis into HIV care: an evaluation from rural Swaziland  

Microsoft Academic Search

Background  Swaziland has the highest HIV prevalence in the world and the highest estimated tuberculosis incidence rate in the world.\\u000a An estimated 80% of TB patients are also infected with HIV. TB detection through intensified case finding (ICF) has yet to\\u000a become a routine aspect of integrated tuberculosis and HIV care. The purpose of this study was to evaluate implementation\\u000a of

Susan Elden; Timothy Lawes; Søren Kudsk-Iversen; Joris Vandelanotte; Sabelo Nkawanyana; William Welfare; John Walley; John Wright

2011-01-01

357

Comparison of Mantoux and Tine Tuberculin Skin Tests in BCG-Vaccinated Children Investigated for Tuberculosis  

Microsoft Academic Search

BackgroundTuberculin skin tests (TSTs) are long-established screening methods for tuberculosis (TB). We aimed to compare agreement between the intradermal Mantoux and multipuncture percutaneous Tine methods and to quantify risk factors for a positive test result.Methodology\\/Principal Findings1512 South African children younger than 5 years of age who were investigated for tuberculosis (TB) during a Bacille Calmette Guerin (BCG) trial were included

Wenli Pan; Lyness Matizirofa; Lesley Workman; Tony Hawkridge; Willem Hanekom; Hassan Mahomed; Gregory Hussey; Mark Hatherill; Madhukar Pai

2009-01-01

358

Primary antimicrobial resistance among Mycobacterium tuberculosis isolates from HIV seropositive and HIV seronegative patients in Dar es Salaam Tanzania  

PubMed Central

Background The United Republic of Tanzania is one of the 22 high M. tuberculosis burden countries. Data collected between 2002 and 2007 indicate that the global prevalence of drug-resistant M. tuberculosis including MDR vary greatly. The varied drug-resistance patterns make continuous surveillance of drug resistance an essential component of tuberculosis control program. Findings M. tuberculosis isolates were obtained from consenting adult tuberculosis patients involved in a placebo-controlled study to evaluate the efficacy of multivitamin supplements on response to anti-Tb treatment in Dar es Salaam, Tanzania. Antimicrobial susceptibility testing was done on four antimicrobial agents namely streptomycin, isoniazid, ethambutol and rifampicin. HIV testing and CD4+ T lymphocytes enumeration were also done. A total of 280 M. tuberculosis isolates from 191 (68%) males and 89 (32%) female patients with no previous history of anti-tuberculosis treatment exceeding 4 weeks in the previous 12 months were tested. Among these, 133 (47%) patients were HIV seropositive. Fourteen (5.0%) isolates were resistant to any of the anti-tuberculosis drugs. The prevalence of primary resistance was 5.0%, 0.7%, 0.4% and 0% for isoniazid, streptomycin, rifampicin and ethambutol respectively. One isolate (0.4%) was MDR, with resistance to isoniazid, streptomycin and rifampicin. Conclusion M. Tb primary resistance rate in a selected population in Dar es Salaam Tanzania is low and efforts should be undertaken to support the Tuberculosis program.

Urassa, Willy; Mugusi, Ferdinand; Villamor, Eduardo; Msamanga, Gernard; Moshiro, Candida; Bosch, Ronald; Saathoff, Elmar; Fawzi, Wafaie

2008-01-01

359

Concomitant acromioclavicular and miliary tuberculosis.  

PubMed

A 48-year-old man was being treated unsuccessfully for miliary tuberculosis for 5 months until he presented with acromioclavicular joint swelling. Imaging of the shoulder revealed destruction of the acromioclavicular joint and the patient was brought to the operating theatre and underwent the excision of the distal end of the clavicle, synovectomy and drainage of the abscess. Surgery was followed by prompt clinical, functional and radiological improvement. Histopathology confirmed the diagnosis of acromioclavicular tuberculosis. Resistance to appropriate antituberculous treatment in patients with miliary tuberculosis can sometimes be a result of undiagnosed extrapulmonary site of infection. PMID:23813516

Agathangelidis, Filon; Boutsiadis, Achilleas; Fouka, Evangelia; Karataglis, Dimitrios

2013-06-21

360

The prevalence of symptoms associated with pulmonary tuberculosis in randomly selected children from a high burden community  

PubMed Central

Background: Diagnosis of childhood tuberculosis is problematic and symptom based diagnostic approaches are often promoted in high burden settings. This study aimed (i) to document the prevalence of symptoms associated with tuberculosis among randomly selected children living in a high burden community, and (ii) to compare the prevalence of these symptoms in children without tuberculosis to those in children with newly diagnosed tuberculosis. Methods: A cross sectional, community based survey was performed on a 15% random sample of residential addresses. A symptom based questionnaire and tuberculin skin test (TST) were completed in all children. Chest radiographs were performed according to South African National Tuberculosis Control Program guidelines. Results: Results were available in 1415 children of whom 451 (31.9%) were TST positive. Tuberculosis was diagnosed in 18 (1.3%) children. Of the 1397 children without tuberculosis, 253 (26.4%) reported a cough during the preceding 3 months. Comparison of individual symptoms (cough, dyspnoea, chest pain, haemoptysis, anorexia, weight loss, fatigue, fever, night sweats) in children with and without tuberculosis revealed that only weight loss differed significantly (OR = 4.5, 95% CI 1.5 to 12.3), while the combination of cough and weight loss was most significant (OR = 5.4, 95% CI 1.7 to 16.9). Children with newly diagnosed tuberculosis reported no symptoms in 50% of cases. Conclusion: Children from this high burden community frequently reported symptoms associated with tuberculosis. These symptoms had limited value to differentiate children diagnosed with tuberculosis from those without tuberculosis. Improved case definitions and symptom characterisation are required when evaluating the diagnostic value of symptoms.

Marais, B; Obihara, C; Gie, R; Schaaf, H; Hesseling, A; Lombard, C; Enarson, D; Bateman, E; Beyers, N

2005-01-01

361

Poor prognostic significance of Mycobacterium tuberculosis infection during bortezomib-containing chemotherapy in patients with multiple myeloma  

PubMed Central

Background Bortezomib administration leads to a transient decrease in CD4+ T cells, increasing the susceptibility to opportunistic infections. The activation and proliferation of CD4+ T cells are particularly important in the host's defense against tuberculosis infection. The aim of this study was to determine the incidence and clinical significance of tuberculosis infection in patients with multiple myeloma (MM) treated with a bortezomib-containing regimen. Methods We retrospectively investigated the incidence of Mycobacterium tuberculosis in 115 patients with MM who were given a bortezomib-containing regimen and studied the disease prognosis. Results All patients received chemotherapy prior to bortezomib administration, and the median duration from diagnosis to bortezomib administration was 12.4 months (range, 0.2-230). We diagnosed tuberculosis in 8 patients (8/115, 7%): 7 patients had a pulmonary granulomatous lesion prior to chemotherapy and 1 developed reactivation of tuberculosis, but none of them died of uncontrolled tuberculosis infection. In 50% of patients with tuberculosis, bortezomib-containing therapy was interrupted. This resulted in significantly lower response rates to the bortezomib-containing therapy (P<0.05) and significantly shorter overall survival times amongst tuberculosis vs. non-tuberculosis patients (P=0.017). Conclusion Tuberculosis infection was not uncommon among the patients with MM who were treated with bortezomib-containing therapy, and tuberculosis infection in these patients resulted in an interruption of bortezomib administration, which significantly affected patient outcomes. Therefore, early diagnosis and treatment of tuberculosis infection are critical to avoid worsening outcomes in such patients.

Ahn, Jae-Sook; Rew, Sung Yoon; Yang, Deok-Hwan; Jung, Sung-Hoon; Kang, Seung-Ji; Kim, Mi-Young; Lee, Seung-Shin; Kim, Yeo-Kyeoung; Kim, Hyeoung-Joon

2013-01-01

362

Basis for treatment of tuberculosis among HIV-infected patients in Tanzania: the role of chest x-ray and sputum culture  

Microsoft Academic Search

BACKGROUND: Active tuberculosis (TB) is common among HIV-infected persons living in tuberculosis endemic countries, and screening for tuberculosis (TB) is recommended routinely. We sought to determine the role of chest x-ray and sputum culture in the decision to treat for presumptive TB using active case finding in a large cohort of HIV-infected patients. METHODS: Ambulatory HIV-positive subjects with CD4 counts

Muhammad Bakari; Robert D Arbeit; Lillian Mtei; Johnson Lyimo; Richard Waddell; Mecky Matee; Bernard F Cole; Susan Tvaroha; C Robert Horsburgh; Hanna Soini; Kisali Pallangyo; C Fordham von Reyn

2008-01-01

363

Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system  

Microsoft Academic Search

BACKGROUND: The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV\\/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis

Dermot Maher

2010-01-01

364

High-sensitive and rapid detection of Mycobacterium tuberculosis infection by IFN-? release assay among HIV-infected individuals in BCG-vaccinated area  

Microsoft Academic Search

BACKGROUND: An accurate test for Mycobacterium tuberculosis infection is urgently needed in immunosuppressed populations. The aim of this study was to investigate the diagnostic power of enzyme-linked immunospot (ELISPOT)-based IFN-? release assay in detecting active and latent tuberculosis in HIV-infected population in bacillus Calmette-Guerin (BCG)-vaccinated area. A total of 100 HIV-infected individuals including 32 active tuberculosis patients were recruited. An

Weimin Jiang; Lingyun Shao; Ying Zhang; Shu Zhang; Chengyan Meng; Yunya Xu; Lingli Huang; Yun Wang; Ying Wang; Xinhua Weng; Wenhong Zhang

2009-01-01

365

HIV and tuberculosis in Durban, South Africa: adherence to two medication regimens  

Microsoft Academic Search

Given that antiretroviral (ARV) medication adherence has been shown to be high in resource-limited countries, the question remains as to whether adherence will remain at that level as medications become more widely available. Comparing adherence to tuberculosis (TB) medications, which have been readily available, and ARV medications may help to indicate the likely future adherence to ARVs as access to

Inge B. Corless; Dean Wantland; Busi Bhengu; Patricia McInerney; Busi Ncama; Patrice K. Nicholas; Chris McGibbon; Emily Wong; Sheila M. Davis

2009-01-01

366

Delayed consultation among pulmonary tuberculosis patients: a cross sectional study of 10 DOTS districts of Ethiopia  

PubMed Central

Background Delays seeking care increase transmission of pulmonary tuberculosis and hence the burden of tuberculosis, which remains high in developing countries. This study investigates patterns of health seeking behavior and determines risk factors for delayed patient consultation at public health facilities in 10 districts of Ethiopia. Methods New pulmonary TB patients ? 15 years old were recruited at 18 diagnostic centres. Patients were asked about their health care seeking behaviour and the time from onset of symptoms to first consultation at a public health facility. First consultation at a public health facility 30 days or longer after onset of symptoms was regarded as prolonged patient delay. Results Interviews were held with 924 pulmonary patients. Of these, 537 (58%) were smear positive and 387 (42%) were smear negative; 413 (45%) were female; 451 (49%) were rural residents; and the median age was 34 years. Prior to their first consultation at a public health facility, patients received treatment from a variety of informal sources: the Orthodox Church, where they were treated with holy water (24%); private practitioners (13%); rural drug vendors (7%); and traditional healers (3%). The overall median patient delay was 30 days (mean = 60 days). Fifty three percent [95% Confidence Intervals (CI) (50%, 56%)] of patients had delayed their first consultation for ? 30 days. Patient delay for women was 54%; 95% CI (54%, 58%) and men 51%; 95% CI (47%, 55%). The delay was higher for patients who used informal treatment (median 31 days) than those who did not (15 days). Prolonged patient delay (? 30 days) was significantly associated with both patient-related and treatment-related factors. Significant patient-related factors were smear positive pulmonary disease [Adjusted Odds Ratio (AOR) 1.4; 95% CI (1.1 to 1.9)], rural residence [AOR 1.4; 95% CI (1.1 to 1.9)], illiteracy [AOR 1.7; 95% CI (1.2 to 2.4)], and lack of awareness/misperceptions of causes of pulmonary TB. Significant informal treatment-related factors were prior treatment with holy water [AOR 3.5; 95% CI (2.4 to 5)], treatment by private practitioners [AOR 1.7; 95% CI (1.1 to 2.6)] and treatment by drug vendors [AOR 1.9; 95% CI (1.1 to 3.5)]. Conclusion Nearly half of pulmonary tuberculosis patients delayed seeking health care at a public health facility while getting treatment from informal sources. The involvement of religious institutions and private practitioners in early referral of patients with pulmonary symptoms and creating public awareness about tuberculosis could help reduce delays in starting modern treatment.

Mesfin, Mengiste M; Newell, James N; Walley, John D; Gessessew, Amanuel; Madeley, Richard J

2009-01-01

367

The PCR-Based Diagnosis of Central Nervous System Tuberculosis: Up to Date  

PubMed Central

Central nervous system (CNS) tuberculosis, particularly tuberculous meningitis (TBM), is the severest form of Mycobacterium tuberculosis (M.Tb) infection, causing death or severe neurological defects in more than half of those affected, in spite of recent advancements in available anti-tuberculosis treatment. The definitive diagnosis of CNS tuberculosis depends upon the detection of M.Tb bacilli in the cerebrospinal fluid (CSF). At present, the diagnosis of CNS tuberculosis remains a complex issue because the most widely used conventional “gold standard” based on bacteriological detection methods, such as direct smear and culture identification, cannot rapidly detect M.Tb in CSF specimens with sufficient sensitivity in the acute phase of TBM. Recently, instead of the conventional “gold standard”, the various molecular-based methods including nucleic acid amplification (NAA) assay technique, particularly polymerase chain reaction (PCR) assay, has emerged as a promising new method for the diagnosis of CNS tuberculosis because of its rapidity, sensitivity and specificity. In addition, the innovation of nested PCR assay technique is worthy of note given its contribution to improve the diagnosis of CNS tuberculosis. In this review, an overview of recent progress of the NAA methods, mainly highlighting the PCR assay technique, was presented.

Takahashi, Teruyuki; Tamura, Masato; Takasu, Toshiaki

2012-01-01

368

Biomarkers and diagnostics for tuberculosis: progress, needs, and translation into practice.  

PubMed

Human infection with Mycobacterium tuberculosis can progress to active disease, be contained as latent infection, or be eradicated by the host response. Tuberculosis diagnostics classify a patient into one of these categories. These are not fixed distinct states, but rather are continua along which patients can move, and are affected by HIV infection, immunosuppressive therapies, antituberculosis treatments, and other poorly understood factors. Tuberculosis biomarkers-host or pathogen-specific-provide prognostic information, either for individual patients or study cohorts, about these outcomes. Tuberculosis case detection remains difficult, partly because of inaccurate diagnostic methods. Investments have yielded some progress in development of new diagnostics, although the existing pipeline is limited for tests for sputum-smear-negative cases, childhood tuberculosis, and accurate prediction of reactivation of latent tuberculosis. Despite new, sensitive, automated molecular platforms for detection of tuberculosis and drug resistance, a simple, inexpensive point-of-care test is still not available. The effect of any new tests will depend on the method and extent of their introduction, the strength of the laboratories, and the degree to which access to appropriate therapy follows access to diagnosis. Translation of scientific progress in biomarkers and diagnostics into clinical and public health programmes is possible-with political commitment, increased funding, and engagement of all stakeholders. PMID:20488517

Wallis, Robert S; Pai, Madhukar; Menzies, Dick; Doherty, T Mark; Walzl, Gerhard; Perkins, Mark D; Zumla, Alimuddin

2010-05-18

369

Molecular diversity of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mozambique  

PubMed Central

Background Mozambique is one of the countries with the highest burden of tuberculosis (TB) in Sub-Saharan Africa, and information on the predominant genotypes of Mycobacterium tuberculosis circulating in the country are important to better understand the epidemic. This study determined the predominant strain lineages that cause TB in Mozambique. Results A total of 445 M. tuberculosis isolates from seven different provinces of Mozambique were characterized by spoligotyping and resulting profiles were compared with the international spoligotyping database SITVIT2. The four most predominant lineages observed were: the Latin-American Mediterranean (LAM, n = 165 or 37%); the East African-Indian (EAI, n = 132 or 29.7%); an evolutionary recent but yet ill-defined T clade, (n = 52 or 11.6%); and the globally-emerging Beijing clone, (n = 31 or 7%). A high spoligotype diversity was found for the EAI, LAM and T lineages. Conclusions The TB epidemic in Mozambique is caused by a wide diversity of spoligotypes with predominance of LAM, EAI, T and Beijing lineages.

2010-01-01

370

Biological functions of Mycobacterium tuberculosis-specific CD4+T cells were impaired by tuberculosis pleural fluid.  

PubMed

The local milieu at the site of Mycobacterium tuberculosis infection that modulates T-cell functions is the main battleground for the host to build counter-M. tuberculosis immune responses. CD4+T cells are enriched predominantly in tuberculosis pleurisy and their roles are of considerable importance, but their nature and functional profiles linked with local condition remain elusive. Here we evaluated the functions of M. tuberculosis-specific CD4+T cells from the major three profiles: cytokines production, cell activation and division. Results showed that pleural fluid (PF) from tuberculosis patients in a dose dependent manner inhibited the production of IFN-?, IL-2 and TNF-? by M. tuberculosis-specific peptides or BCG activated CD4+T cells from pleural fluid mononuclear cells (PFMCs). Surface staining for activation molecules indicated that PF could also blunt cell activation process. CFSE labeling showed that antigen-specific CD4+T cell division ceased following co-incubation with PF. Pre- or post-treatment with PF could disturb subsequent cell activities. The strong inhibitory effect mediated by PF on CD4+T cells was functional predominance. Moreover, application of inhibitors of IDO, adenosine, neutralizing Abs to IL-10 and TGF-? could partially reverse IFN-? production. Our current research provided novel information that the functions of antigen-specific CD4+T cells coincubated with PF were apparently impaired, which were distinct from cells that cultured in fresh culture medium. We concluded that CD4+T cell mediated antigen-specific cellular immune response that occurred locally might be impaired by PF. PMID:21549757

Li, Qin; Li, Li; Liu, Yun; Fu, Xiaoying; Wang, Hui; Lao, Suihua; Yang, Binyan; Wu, Changyou

2011-04-27

371

Diabetic control and risk of tuberculosis: a cohort study.  

PubMed

Diabetes mellitus is associated with tuberculosis. A cohort of 42,116 clients aged 65 years or more, enrolled at 18 Elderly Health Service centers in Hong Kong in 2000, were followed up prospectively through the territory-wide tuberculosis registry for development of tuberculosis from 3 months after enrollment to December 31, 2005, by use of their identity card numbers as unique identifier. The effects of diabetes mellitus and diabetic control on tuberculosis risk were assessed with adjustment for sociodemographic and other background variables. Diabetes mellitus was associated with a modest increase in the risk of active, culture-confirmed, and pulmonary (with or without extrapulmonary involvement) but not extrapulmonary (with or without pulmonary involvement) tuberculosis, with adjusted hazard ratios of 1.77 (95% confidence interval: 1.41, 2.24), 1.91 (95% confidence interval: 1.45, 2.52), 1.89 (95% confidence interval: 1.48, 2.42), and 1.00 (95% confidence interval: 0.54, 1.86), respectively. Diabetic subjects with hemoglobin A1c <7% at enrollment were not at increased risk. Among diabetic subjects, higher risks of active, culture-confirmed, and pulmonary but not extrapulmonary tuberculosis were observed with baseline hemoglobin A1c > or =7% (vs. <7%), with adjusted hazard ratios of 3.11 (95% confidence interval: 1.63, 5.92), 3.08 (95% confidence interval: 1.44, 6.57), 3.63 (95% confidence interval: 1.79, 7.33), and 0.77 (95% confidence interval: 0.18, 3.35), respectively. PMID:18400769

Leung, Chi C; Lam, Tai H; Chan, Wai M; Yew, Wing W; Ho, Kin S; Leung, Gabriel M; Law, Wing S; Tam, Cheuk M; Chan, Chi K; Chang, Kwok C

2008-04-08

372

The identification of submerged skeletonized remains.  

PubMed

Examination was undertaken of skeletonized remains contained within 2 rubber boots dredged by a fishing boat from a depth of 145 m, approximately 185 km off the southern Australian coast in the Great Australian Bight. The boots had been manufactured in Australia in July 1993 and were of a type commonly used by local fishermen. Examination of the lower legs and feet revealed well-preserved bones with arthritic changes in keeping with an older male. DNA analyses using reference samples taken from relatives of fishermen who had disappeared in the area resulted in the identification of the victim as a 52-year-old prawn fisherman who had been swept off a boat over a decade earlier. DNA stability had been maintained by the low light, cold temperatures, and alkaline pH of the ocean floor. Integration of pathologic, anthropologic, and biologic analyses with police investigations enabled a positive identification to be made despite the unusual nature of the location of the remains and the time lapse since the disappearance of the victim. PMID:19749621

Byard, Roger W; Both, Katrin; Simpson, Ellie

2008-03-01

373

The Genotypic Population Structure of Mycobacterium tuberculosis Complex from Moroccan Patients Reveals a Predominance of Euro-American Lineages  

PubMed Central

Background Tuberculosis (TB) remains a major health problem in Morocco. Characterization of circulating Mycobacterium tuberculosis genotypic lineages, important to understand the dynamic of the disease, was hereby addressed for the first time at a national level. Methodology/Principal Findings Spoligotyping was performed on a panel of 592 M. tuberculosis complex strains covering a 2-year period (2004–2006). It identified 129 patterns: 105 (n?=?568 strains) corresponded to a SIT number in the SITVIT2 database, while 24 patterns were labeled as orphan. A total of 523 (88.3%) strains were clustered vs. 69 or 11.7% unclustered. Classification of strains within 3 large phylogenetical groups was as follows: group 1– ancestral/TbD1+/PGG1 (EAI, Bovis, Africanum), group 2– modern/TbD1?/PGG1 group (Beijing, CAS), group 3– evolutionary recent/TbD1?/PGG2/3 (Haarlem, X, S, T, LAM; alternatively designated as the Euro-American lineage). As opposed to group 3 strains (namely LAM, Haarlem, and T) that predominated (86.5% of all isolates), 6 strains belonged to group 2 (Beijing n?=?5, CAS n?=?1), and 3 strains (BOV_1 n?=?2, BOV_4-CAPRAE) belonged to ancestral group 1 (EAI and AFRI lineage strains were absent). 12-loci MIRU-VNTR typing of the Casablanca subgroup (n?=?114 strains) identified 71 patterns: 48 MITs and 23 orphan patterns; it allowed to reduce the clustering rate from 72.8% to 29.8% and the recent transmission rate from 64% to 20.2%. Conclusion The M. tuberculosis population structure in Morocco is highly homogeneous, and is characterized by the predominance of the Euro-American lineages, namely LAM, Haarlem, and T, which belong to the “evolutionary recent” TbD1?/PGG2/3 phylogenetic group. The combination of spoligotyping and MIRUs decreased the clustering rate significantly, and should now be systematically applied in larger studies. The methods used in this study appear well suited to monitor the M. tuberculosis population structure for an enhanced TB management program in Morocco.

Lahlou, Ouafae; Millet, Julie; Chaoui, Imane; Sabouni, Radia; Filali-Maltouf, Abdelkarim; Akrim, Mohammed; El Mzibri, Mohammed; Rastogi, Nalin; El Aouad, Rajae

2012-01-01

374

Acetaminophen: Background and Overview  

Center for Biologics Evaluation and Research (CBER)

Text Version1 Acetaminophen: Background and Overview Gerald J. Dal Pan, MD, MHS ... Page 86. 86 Background 1953 NDA 08-717 (acetaminophen tablet) ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

375

IR Background Suppression Studies.  

National Technical Information Service (NTIS)

A brief description of the background suppression scheme is described, and results obtained using the defocussing technique are presented. It has been demonstrated that a background suppression ratio of two orders of magnitudes can be obtained.

O. Shepherd W. P. Reidy T. F. Zehnpfennig G. A. Vanasse A. T. Stair

1977-01-01

376

Tuberculosis affecting multiple vertebral bodies.  

PubMed

Spinal tuberculosis usually occurs in a single vertebral body or two to three adjacent vertebrae; it rarely occurs in multiple vertebral bodies. Surgery is indicated in cases that do not improve with conservative therapy, or when paralysis is evident. Two cases regarding patients with spinal tuberculosis in multiple vertebral bodies on whom surgery was performed are reported. Case 1, the patient was a 77-year-old woman with spinal tuberculosis in four vertebral bodies from the lower thoracic to the lumbar spine. As she had pronounced lower back pain, posterolateral fusion with a pedicle screw was performed. Case 2, the patient was a 29-year-old Indonesian man with spinal tuberculosis in 17 vertebral bodies of the spine who was unable to stand due to paralysis of both legs, thus posterolateral fusion with a pedicle screw was performed. Good results were obtained from tuberculostatic drug therapy and surgical instrumentation. PMID:24066219

Baba, Hideo; Tagami, Atsushi; Adachi, Shinji; Hiura, Takeshi; Osaki, Makoto

2013-09-04

377

[Gallbladder tuberculosis associated with cholelithiasis].  

PubMed

Tuberculosis of the gallbladder is rare, even in our country known for being an endemic area. The positive diagnosis depends on suspicion of tuberculosis, peroperative findings and histological examination. From a review of the literature, the physiopathology of this infection is discussed, emphasizing the role of lithiasis in the development of tuberculous lesions. The authors report a case of gallbladder tuberculosis in a female patient who presented with a clinical picture of chronic cholelithiasis. The diagnosis of gallbladder tuberculosis was reached only after surgery and proven by histopathology. In our case, the presence of stones associated with non specific inflammatory alterations and possibly low resistance against tubercle bacillus, is believed to have been of importance for the development of the tuberculous infection. PMID:14978850

Rouas, L; Mansouri, F; Jahid, A; Zouaidia, F; Saïdi, H; Nabih, N; Benabdellah, M; Laraqui, L; Mahassini, N; Bernoussi, Z; Elhachimi, A

2003-12-01

378

Tuberculosis Affecting Multiple Vertebral Bodies  

PubMed Central

Spinal tuberculosis usually occurs in a single vertebral body or two to three adjacent vertebrae; it rarely occurs in multiple vertebral bodies. Surgery is indicated in cases that do not improve with conservative therapy, or when paralysis is evident. Two cases regarding patients with spinal tuberculosis in multiple vertebral bodies on whom surgery was performed are reported. Case 1, the patient was a 77-year-old woman with spinal tuberculosis in four vertebral bodies from the lower thoracic to the lumbar spine. As she had pronounced lower back pain, posterolateral fusion with a pedicle screw was performed. Case 2, the patient was a 29-year-old Indonesian man with spinal tuberculosis in 17 vertebral bodies of the spine who was unable to stand due to paralysis of both legs, thus posterolateral fusion with a pedicle screw was performed. Good results were obtained from tuberculostatic drug therapy and surgical instrumentation.

Baba, Hideo; Tagami, Atsushi; Adachi, Shinji; Hiura, Takeshi

2013-01-01

379

Outlook remains dim for waste solution  

SciTech Connect

When Congress selected Yucca Mountain as the proposed site for storing the nation`s high-level nuclear waste, this isolated piece of real estate in Nevada became the focus of national debate about the long-term safety and feasibility of underground storage, writes Frank L. Parker, a professor in environmental engineering at Vanderbilt University. {open_quotes}While scientific knowledge will increase in the future, it is unlikely that we will ever achieve full understanding of the long-term movement of radioactive waste that must remain buried for hundreds of thousands of years,{close_quotes} says Parker. Parker maintains that the battle over the future of Yucca Mountain has proved that local communities should have a strong voice in the site-selection process, and, once a site is chosen, people who live nearby should be compensated for the burden they bear.

Parker, F.L.

1994-12-31

380

Tuberculosis in ageing: high rates, complex diagnosis and poor clinical outcomes  

PubMed Central

Background: worldwide, the frequency of tuberculosis among older people almost triples that observed among young adults. Objective: to describe clinical and epidemiological consequences of pulmonary tuberculosis among older people. Methods: we screened persons with a cough lasting more than 2 weeks in Southern Mexico from March 1995 to February 2007. We collected clinical and mycobacteriological information (isolation, identification, drug-susceptibility testing and IS6110-based genotyping and spoligotyping) from individuals with bacteriologically confirmed pulmonary tuberculosis. Patients were treated in accordance with official norms and followed to ascertain treatment outcomes, retreatment, and vital status. Results: eight hundred ninety-three tuberculosis patients were older than 15 years of age; of these, 147 (16.5%) were 65 years of age or older. Individuals ?65 years had significantly higher rates of recently transmitted and reactivated tuberculosis. Older age was associated with treatment failure (OR = 5.37; 95% CI: 1.06–27.23; P = 0.042), and death due to tuberculosis (HR = 3.52; 95% CI: 1.78–6.96; P < 0.001) adjusting for sociodemographic and clinical variables. Conclusions: community-dwelling older individuals participate in chains of transmission indicating that tuberculosis is not solely due to the reactivation of latent disease. Untimely and difficult diagnosis and a higher risk of poor outcomes even after treatment completion emphasise the need for specific strategies for this vulnerable group.

Cruz-Hervert, Luis Pablo; Garcia-Garcia, Lourdes; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Cano-Arellano, Bulmaro; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Baez-Saldana, Renata; Tellez-Vazquez, Norma; Nava-Mercado, Ariadna; Juarez-Sandino, Luis; Delgado-Sanchez, Guadalupe; Fuentes-Leyra, Cesar Alejandro; Montero-Campos, Rogelio; Martinez-Gamboa, Rosa Areli; Small, Peter M.; Sifuentes-Osornio, Jose; Ponce-de-Leon, Alfredo

2012-01-01

381

Perinatal tuberculosis associated hemophagocytic lymphohistiocytosis.  

PubMed

Hemophagocytic lymphohistiocytosis [HLH] is a reactive disorder characterized by generalised non-malignant histiocytic proliferation with prominent hemophagocytosis. It may be either primary [familial (FLH)] or secondary [infection or malignancy associated]. Organisms incriminated for infection associated hemophagocytic syndrome (IAHS) include viruses, bacteria, spirochetes, fungi and parasites. Reports of IAHS associated with tuberculosis in neonates are rare. The authors report a case of perinatal tuberculosis presenting as hemophagocytic lymphohistiocytosis. PMID:22246612

Maheshwari, Prabhat; Chhabra, Rajiv; Yadav, Padam

2012-01-14

382

A mobile health approach to tuberculosis contact tracing in resource-limited settings.  

PubMed

Tuberculosis remains a leading cause of morbidity and mortality worldwide. In 2011, there were 8.7 million new cases and 1.4 million deaths from the disease, with >95% of these deaths taking place in low- and middle-income countries [1]. Contact tracing prevents the spread of tuberculosis by identifying and screening a case's contacts and referring symptomatic individuals to health care providers. Traditionally, contact tracing has been conducted with paper forms, which can lead to considerable inefficiencies in data collection, storage, and retrieval. These inefficiencies are problematic as tuberculosis can continue to spread if disruption of disease transmission is delayed. Mobile health approaches to tuberculosis contact tracing remain largely unaddressed and limited to management and monitoring of multidrug-resistant tuberculosis [2].To address these limitations, a mobile health application that digitizes and automates contact tracing was developed. This poster presents work currently underway to evaluate this new approach in Botswana, which has the tenth highest incidence rate of tuberculosis in the world [3]. Operational considerations for implementing a mobile health approach to contact tracing in resource-limited settings are also presented. PMID:23920962

Ha, Yoonhee P; Littman-Quinn, Ryan; Antwi, Cynthia; Seropola, Gorewang; Green, Rebecca S; Tesfalul, Martha A; Ho-Foster, Ari; Luberti, Anthony A; Holmes, John H; Steenhoff, Andrew P; Kovarik, Carrie L

2013-01-01

383

Alcohol Exacerbates Murine Pulmonary Tuberculosis  

PubMed Central

Alcohol consumption has been described as a risk factor for infection with Mycobacterium tuberculosis, but its contribution to tuberculosis has been difficult to isolate from other adverse socioeconomic factors. Our objective was to evaluate the impact of alcohol consumption on pulmonary infection with M. tuberculosis in a murine model. BALB/c mice were maintained on the Lieber-DeCarli liquid ethanol diet or a liquid control diet and infected intratracheally with low-dose M. tuberculosis H37Rv. Lung organism burdens, lung and lung-associated lymph node CD4+- and CD8+- lymphocyte numbers and rates of proliferation, and CD4+-lymphocyte cytokine production levels were compared between the groups. The alcohol-consuming mice had significantly higher lung organism burdens than the control mice, and the CD4+- and CD8+-lymphocyte responses to pulmonary infection with M. tuberculosis were blunted in the alcohol group. Lymphocyte proliferation and production of gamma interferon were decreased in the CD4+ lymphocytes from the alcohol-consuming mice. Additionally, lung granulomas were significantly smaller in the alcohol-consuming mice. In conclusion, murine alcohol consumption is associated with decreased control of pulmonary infection with M. tuberculosis, which is accompanied by alterations in the region-specific CD4+- and CD8+-lymphocyte responses and defective lung granuloma formation.

Mason, Carol M.; Dobard, Elizabeth; Zhang, Ping; Nelson, Steve

2004-01-01

384

International Monetary Fund Programs and Tuberculosis Outcomes in Post-Communist Countries  

PubMed Central

Background Previous studies have indicated that International Monetary Fund (IMF) economic programs have influenced health-care infrastructure in recipient countries. The post-communist Eastern European and former Soviet Union countries experienced relatively similar political and economic changes over the past two decades, and participated in IMF programs of varying size and duration. We empirically examine how IMF programs related to changes in tuberculosis incidence, prevalence, and mortality rates among these countries. Methods and Findings We performed multivariate regression of two decades of tuberculosis incidence, prevalence, and mortality data against variables potentially influencing tuberculosis program outcomes in 21 post-communist countries for which comparative data are available. After correcting for confounding variables, as well as potential detection, selection, and ecological biases, we observed that participating in an IMF program was associated with increased tuberculosis incidence, prevalence, and mortality rates by 13.9%, 13.2%, and 16.6%, respectively. Each additional year of participation in an IMF program was associated with increased tuberculosis mortality rates by 4.1%, and each 1% increase in IMF lending was associated with increased tuberculosis mortality rates by 0.9%. On the other hand, we estimated a decrease in tuberculosis mortality rates of 30.7% (95% confidence interval, 18.3% to 49.5%) associated with exiting the IMF programs. IMF lending did not appear to be a response to worsened health outcomes; rather, it appeared to be a precipitant of such outcomes (Granger- and Sims-causality tests), even after controlling for potential political, socioeconomic, demographic, and health-related confounders. In contrast, non-IMF lending programs were connected with decreased tuberculosis mortality rates (?7.6%, 95% confidence interval, ?1.0% to ?14.1%). The associations observed between tuberculosis mortality and IMF programs were similar to those observed when evaluating the impact of IMF programs on tuberculosis incidence and prevalence. While IMF programs were connected with large reductions in generalized government expenditures, tuberculosis program coverage, and the number of physicians per capita, non-IMF lending programs were not significantly associated with these variables. Conclusions IMF economic reform programs are associated with significantly worsened tuberculosis incidence, prevalence, and mortality rates in post-communist Eastern European and former Soviet countries, independent of other political, socioeconomic, demographic, and health changes in these countries. Future research should attempt to examine how IMF programs may have related to other non-tuberculosis–related health outcomes.

Stuckler, David; King, Lawrence P; Basu, Sanjay

2008-01-01

385

Evaluation of the Xpert MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis in Uganda: a cross-sectional diagnostic study  

PubMed Central

Background The diagnosis of childhood tuberculosis remains a challenge worldwide. The Xpert MTB/RIF test, a rapid mycobacteria tuberculosis diagnostic tool, was recommended for use in children based on data from adult studies. We evaluated the performance of the Xpert MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis using one induced sputum sample and described clinical characteristics associated with a positive Xpert MTB/RIF test. The sputum culture on both Lowenstein-Jensen (LJ) and Mycobacteria Growth Indicator Tube (MGIT) was the gold standard. Methods We consecutively enrolled 250 Ugandan children aged 2?months to 12?years with suspected pulmonary tuberculosis between January 2011 and January 2012 into a cross-sectional diagnostic study at a tertiary care facility in Uganda. Results We excluded data from 15 children (13 contaminated culture and 2 indeterminate MTB/RIF test results) and analysed 235 records. The Xpert MTB/RIF test had a sensitivity of 79.4% (95% CI 63.2 - 89.7) and a specificity of 96.5% (95% CI 93 – 98.3). The Xpert MTB/RIF test identified 13 of the 14 (92.9%) smear positive-culture positive and 14 of the 20 (70%) smear negative -culture positive cases. The Xpert MTB/RIF identified twice as many cases as the smear microscopy (79.4% Vs 41.2%). Age?>?5?years (OR 3.3, 95% CI 1.4 – 7.4, p value 0.005), a history of Tuberculosis (TB) contact (OR 2.4, 95% CI 1.1 – 5.2, p value 0.03), and a positive tuberculin skin test (OR 4.1, 95% CI 1.7 – 10, p value 0.02) was associated with a positive Xpert MTB/RIF test. The median time to TB detection was 49.5?days (IQR 38.4-61.2) for LJ, and 6?days (IQR 5 – 11.5) for MGIT culture and 2?hours for the Xpert MTB/RIF test. Conclusion The Xpert MTB/RIF test on one sputum sample rapidly and correctly identified the majority of children with culture confirmed pulmonary tuberculosis with high specificity.

2013-01-01

386

Mycobacterium tuberculosis septum site determining protein, Ssd encoded by rv3660c, promotes filamentation and elicits an alternative metabolic and dormancy stress response  

PubMed Central

Background Proteins that are involved in regulation of cell division and cell cycle progression remain undefined in Mycobacterium tuberculosis. In addition, there is a growing appreciation that regulation of cell replication at the point of division is important in establishing a non-replicating persistent state. Accordingly, the objective of this study was to use a systematic approach consisting of consensus-modeling bioinformatics, ultrastructural analysis, and transcriptional mapping to identify septum regulatory proteins that participate in adaptive metabolic responses in M. tuberculosis. Results Septum site determining protein (Ssd), encoded by rv3660c was discovered to be an ortholog of septum site regulating proteins in actinobacteria by bioinformatics analysis. Increased expression of ssd in M. smegmatis and M. tuberculosis inhibited septum formation resulting in elongated cells devoid of septa. Transcriptional mapping in M. tuberculosis showed that increased ssd expression elicited a unique response including the dormancy regulon and alternative sigma factors that are thought to play a role in adaptive metabolism. Disruption of rv3660c by transposon insertion negated the unique transcriptional response and led to a reduced bacterial length. Conclusions This study establishes the first connection between a septum regulatory protein and induction of alternative metabolism consisting of alternative sigma factors and the dormancy regulon that is associated with establishing a non-replicating persistent intracellular lifestyle. The identification of a regulatory component involved in cell cycle regulation linked to the dormancy response, whether directly or indirectly, provides a foundation for additional studies and furthers our understanding of the complex mechanisms involved in establishing a non-replicating state and resumption of growth.

2011-01-01

387

Mycobacterium tuberculosis Complex Mycobacteria as Amoeba-Resistant Organisms  

PubMed Central

Background Most environmental non-tuberculous mycobacteria have been demonstrated to invade amoebal trophozoites and cysts, but such relationships are largely unknown for members of the Mycobacterium tuberculosis complex. An environmental source has been proposed for the animal Mycobacterium bovis and the human Mycobacterium canettii. Methodology/Principal Findings Using optic and electron microscopy and co-culture methods, we observed that 89±0.6% of M. canettii, 12.4±0.3% of M. tuberculosis, 11.7±2% of M. bovis and 11.2±0.5% of Mycobacterium avium control organisms were phagocytized by Acanthamoeba polyphaga, a ratio significantly higher for M. canettii (P?=?0.03), correlating with the significantly larger size of M. canetti organisms (P?=?0.035). The percentage of intraamoebal mycobacteria surviving into cytoplasmic vacuoles was 32±2% for M. canettii, 26±1% for M. tuberculosis, 28±2% for M. bovis and 36±2% for M. avium (P?=?0.57). M. tuberculosis, M. bovis and M. avium mycobacteria were further entrapped within the double wall of <1% amoebal cysts, but no M. canettii organisms were observed in amoebal cysts. The number of intracystic mycobacteria was significantly (P?=?10?6) higher for M. avium than for the M. tuberculosis complex, and sub-culturing intracystic mycobacteria yielded significantly more (P?=?0.02) M. avium organisms (34×104 CFU/mL) than M. tuberculosis (42×101 CFU/mL) and M. bovis (35×101 CFU/mL) in the presence of a washing fluid free of mycobacteria. Mycobacteria survived in the cysts for up to 18 days and cysts protected M. tuberculosis organisms against mycobactericidal 5 mg/mL streptomycin and 2.5% glutaraldehyde. Conclusions/Significance These data indicate that M. tuberculosis complex organisms are amoeba-resistant organisms, as previously demonstrated for non-tuberculous, environmental mycobacteria. Intercystic survival of tuberculous mycobacteria, except for M. canettii, protect them against biocides and could play a role in their life cycle.

Mba Medie, Felix; Ben Salah, Iskandar; Henrissat, Bernard; Raoult, Didier; Drancourt, Michel

2011-01-01

388

[Endoscopic diagnosis and clinical experience of colonic tuberculosis].  

PubMed

From February 1979 to May 1994, 18 cases of colonic tuberculosis were detected by colonscopy at Chang Gung Momorial Hospital, Linkou Medical Center. There were 10 males and 8 females, with mean age of 43.6. In ten, the diagnosis was confirmed histologically or bacteriologically in colonic biopsy material and post-operated lymph nodes. The remaining 8 patients was suspected on colonoscopy, and had good response to antituberculous therapy. The major symptoms were abdominal pain (83%), diarrhea (67%), and body weight loss (61%). Average duration from symptoms to diagnosis was 4.1 months. Chest X-ray revealed active pulmonary tuberculosis in 14 of 18 patients (78%), 4 of 14 patients were military type. The colonic tuberculosis involved in ileocecal area in 6, ileocecum and contiguous colonic regions in 7, segmental colonic involvement in 4, and pancolitis in 1 patient. Multiple ulceration and ulcerohypertrophic lesions were the major colonoscopic findings. Typical caseating granuloma were found in 5 cases (36%) from colonoscopic biopsy, the other 5 from surgical resected specimens. Antituberculous therapy produced remarkable symptomatic improvement in all patients except 2 cases complicated with intestinal obstruction necessitating laparotomy. Colonoscopy with biopsy is a useful diagnostic tool in early diagnosis and avoiding unnecessary laparotomy in colonic tuberculosis. PMID:9041758

Lin, C J; Wu, C S; Chen, P C; Kuo, Y C; Chang, K Y; Wu, S S; Tung, S Y

1996-12-01

389

Towards a new tuberculosis drug: pyridomycin - nature's isoniazid  

PubMed Central

Tuberculosis, a global threat to public health, is becoming untreatable due to widespread drug resistance to frontline drugs such as the InhA-inhibitor isoniazid. Historically, by inhibiting highly vulnerable targets, natural products have been an important source of antibiotics including potent anti-tuberculosis agents. Here, we describe pyridomycin, a compound produced by Dactylosporangium fulvum with specific cidal activity against mycobacteria. By selecting pyridomycin-resistant mutants of Mycobacterium tuberculosis, whole-genome sequencing and genetic validation, we identified the NADH-dependent enoyl- (Acyl-Carrier-Protein) reductase InhA as the principal target and demonstrate that pyridomycin inhibits mycolic acid synthesis in M. tuberculosis. Furthermore, biochemical and structural studies show that pyridomycin inhibits InhA directly as a competitive inhibitor of the NADH-binding site, thereby identifying a new, druggable pocket in InhA. Importantly, the most frequently encountered isoniazid-resistant clinical isolates remain fully susceptible to pyridomycin, thus opening new avenues for drug development.

Hartkoorn, Ruben C; Sala, Claudia; Neres, Joao; Pojer, Florence; Magnet, Sophie; Mukherjee, Raju; Uplekar, Swapna; Boy-Rottger, Stefanie; Altmann, Karl-Heinz; Cole, Stewart T

2012-01-01

390

Strain specific transcriptional response in Mycobacterium tuberculosis infected macrophages  

PubMed Central

Background Tuberculosis (TB), a bacterial infection caused by Mycobacterium tuberculosis (Mtb) remains a significant health problem worldwide with a third of the world population infected and nearly nine million new cases claiming 1.1 million deaths every year. The outcome following infection by Mtb is determined by a complex and dynamic host-pathogen interaction in which the phenotype of the pathogen and the immune status of the host play a role. However, the molecular mechanism by which Mtb strains induce different responses during intracellular infection of the host macrophage is not fully understood. To explore the early molecular events triggered upon Mtb infection of macrophages, we studied the transcriptional responses of murine bone marrow-derived macrophages (BMM) to infection with two clinical Mtb strains, CDC1551 and HN878. These strains have previously been shown to differ in their virulence/immunogenicity in the mouse and rabbit models of pulmonary TB. Results In spite of similar intracellular growth rates, we observed that compared to HN878, infection by CDC1551 of BMM was associated with an increased global transcriptome, up-regulation of a specific early (6 hours) immune response network and significantly elevated nitric oxide production. In contrast, at 24 hours post-infection of BMM by HN878, more host genes involved in lipid metabolism, including cholesterol metabolism and prostaglandin synthesis were up-regulated, compared to infection with CDC1551. In association with the differences in the macrophage responses to infection with the 2 Mtb strains, intracellular CDC1551 expressed higher levels of stress response genes than did HN878. Conclusions In association with the early and more robust macrophage activation, intracellular CDC1551 cells were exposed to a higher level of stress leading to increased up-regulation of the bacterial stress response genes. In contrast, sub-optimal activation of macrophages and induction of a dysregulated host cell lipid metabolism favored a less stressful intracellular environment for HN878. Our findings suggest that the ability of CDC1551 and HN878 to differentially activate macrophages during infection probably determines their ability to either resist host cell immunity and progress to active disease or to succumb to the host protective responses and be driven into a non-replicating latent state in rabbit lungs.

2012-01-01

391

Perforated tuberculosis lymphadenitis.  

PubMed

A 26-year-old man (human immunodeficiency virus-positive and not taking highly active antiretroviral treatment [HAART]) presented to the emergency room with 2 months of malaise, 20 kg weight loss, high spiking fevers, generalized lymph nodes, night sweats, dry cough, and chest pain when swallowing. On physical examination, he had multiple cervical lymphadenopathies. Suspecting a systemic opportunistic infection, a contrasted chest computed tomography (CT) was done, showing an esophageal to mediastinum fistulae. Two days after admission, a fluoroscopic contrasted endoscopy was done that showed two esophageal fistulae from scrofula to esophagus and then, to mediastinum. A bronchoalveolar lavage and a cervical lymphadenopathy biopsy were done, both showing multiple acid-fast bacillae, where cultures grew Mycobacterium tuberculosis. PMID:23740190

Cataño, Juan; Cardeño, John

2013-06-01

392

Tuberculosis Drug Development  

PubMed Central

An unprecedented number of new tuberculosis (TB) medications are currently in development, and there will be great pressure to deploy these new drugs among all populations after their efficacy is demonstrated. People living with HIV experience a large burden of TB and have a particularly pressing need for TB treatments that are shorter and less toxic. In addition, all people living with HIV now require antiretroviral therapy during TB treatment. A roadmap of the research, programmatic, and regulatory considerations includes the following: (1) inclusion of people living with HIV early in clinical trials for treatment and prevention using new TB medications, (2) prioritization of key studies of HIV–TB drug interactions and interactions between new TB agents, and (3) optimization of clinical trial infrastructure, laboratory capacity, and drug susceptibility testing.

Getahun, Haileyesus; Chamie, Gabriel; Lienhardt, Christian; Havlir, Diane V.

2011-01-01

393

HIV-Associated Tuberculosis  

PubMed Central

The intersecting HIV and Tuberculosis epidemics in countries with a high disease burden of both infections pose many challenges and opportunities. For patients infected with HIV in high TB burden countries, the diagnosis of TB, ARV drug choices in treating HIV-TB coinfected patients, when to initiate ARV treatment in relation to TB treatment, managing immune reconstitution, minimising risk of getting infected with TB and/or managing recurrent TB, minimizing airborne transmission, and infection control are key issues. In addition, given the disproportionate burden of HIV in women in these settings, sexual reproductive health issues and particular high mortality rates associated with TB during pregnancy are important. The scaleup and resource allocation to access antiretroviral treatment in these high HIV and TB settings provide a unique opportunity to strengthen both services and impact positively in meeting Millennium Development Goal 6.

Naidoo, Kogieleum; Naidoo, Kasavan; Padayatchi, Nesri; Abdool Karim, Quarraisha

2011-01-01

394

HIV-Associated Tuberculosis.  

PubMed

The intersecting HIV and Tuberculosis epidemics in countries with a high disease burden of both infections pose many challenges and opportunities. For patients infected with HIV in high TB burden countries, the diagnosis of TB, ARV drug choices in treating HIV-TB coinfected patients, when to initiate ARV treatment in relation to TB treatment, managing immune reconstitution, minimising risk of getting infected with TB and/or managing recurrent TB, minimizing airborne transmission, and infection control are key issues. In addition, given the disproportionate burden of HIV in women in these settings, sexual reproductive health issues and particular high mortality rates associated with TB during pregnancy are important. The scaleup and resource allocation to access antiretroviral treatment in these high HIV and TB settings provide a unique opportunity to strengthen both services and impact positively in meeting Millennium Development Goal 6. PMID:20871843

Naidoo, Kogieleum; Naidoo, Kasavan; Padayatchi, Nesri; Abdool Karim, Quarraisha

2010-09-13

395

Spatial Dependency of Tuberculosis Incidence in Taiwan  

PubMed Central

Tuberculosis (TB) disease can be caused by either recent transmission from infectious patients or reactivation of remote latent infection. Spatial dependency (correlation between nearby geographic areas) in tuberculosis incidence is a signature for chains of recent transmission with geographic diffusion. To understand the contribution of recent transmission in the TB endemic in Taiwan, where reactivation has been assumed to be the predominant mode of pathogenesis, we used spatial regression analysis to examine whether there was spatial dependency between the TB incidence in each township and in its neighbors. A total of 90,661 TB cases from 349 townships in 2003–2008 were included in this analysis. After adjusting for the effects of confounding socioeconomic variables, including the percentages of aboriginals and average household income, the results show that the spatial lag parameter remains positively significant (0.43, p<0.001), which indicates that the TB incidences of neighboring townships had an effect on the TB incidence in each township. Townships with substantial spatial spillover effects were mainly located in the northern, western and eastern parts of Taiwan. Spatial dependency implies that recent transmission plays a significant role in the pathogenesis of TB in Taiwan. Therefore, in addition to the current focus on improving the cure rate under directly observed therapy programs, more resource need to be allocated to active case finding in order to break the chain of transmission.

Ng, In-Chan; Wen, Tzai-Hung; Wang, Jann-Yuan; Fang, Chi-Tai

2012-01-01

396

Macrophages in tuberculosis: friend or foe.  

PubMed

Tuberculosis (TB) remains one of the greatest threats to human health. The causative bacterium, Mycobacterium tuberculosis (Mtb), is acquired by the respiratory route. It is exquisitely human adapted and a prototypic intracellular pathogen of macrophages, with alveolar macrophages (AMs) being the primary conduit of infection and disease. The outcome of primary infection is most often a latently infected healthy human host, in whom the bacteria are held in check by the host immune response. Such individuals can develop active TB later in life with impairment in the immune system. In contrast, in a minority of infected individuals, the host immune response fails to control the growth of bacilli, and progressive granulomatous disease develops, facilitating spread of the bacilli via infectious aerosols coughed out into the environment and inhaled by new hosts. The molecular details of the Mtb-macrophage interaction continue to be elucidated. However, it is clear that a number of complex processes are involved at the different stages of infection that may benefit either the bacterium or the host. Macrophages demonstrate tremendous phenotypic heterogeneity and functional plasticity which, depending on the site and stage of infection, facilitate the diverse outcomes. Moreover, host responses vary depending on the specific characteristics of the infecting Mtb strain. In this chapter, we describe a contemporary view of the behavior of AMs and their interaction with various Mtb strains in generating unique immunologic lung-specific responses. PMID:23864058

Guirado, Evelyn; Schlesinger, Larry S; Kaplan, Gilla

2013-07-18

397

Turbidite plays` immaturity means big potential remains  

SciTech Connect

The international exploration and production industry is increasingly focusing on deepwater plays. Turbidites are not the only reservoir type that occurs in deepwater frontiers, but they are the primary reservoir type of those plays. A worldwide data base assembled from published information on 925 fields and discoveries with deepwater clastic reservoirs (turbidites sensu lato) has been employed to investigate the large-scale exploration and production trends. Coverage of the Former Soviet Union, China, and the Indian subcontinent has been minor, but with the large data base of fields and discoveries from the rest of the world, the broad conclusions should remain valid. This article describes the global turbidite play in terms of: (1) basins of the world where turbidite fields have been discovered; (2) the five largest basins in terms of total discovered resources; and (3) a summary of trap type, which is a critical geological factor in turbidite fields. The second article will summarize a population of the world`s 43 largest turbidite fields and discoveries.

Pettingill, H.S. [Repsol Exploracion SA, Madrid (Spain)

1998-10-05

398

Spatial patterning of vulture scavenged human remains.  

PubMed

This article presents the results of a pilot study on the effects of vulture modification to human remains. A donated body from the Willed Body Donation Program was placed at the Forensic Anthropology Research Facility (FARF), an outdoor human decomposition laboratory located at Texas State University-San Marcos. The effects of vulture scavenging on the timing and sequence, and the rate of skeletonization, disarticulation, and dispersal were observed via a motion sensing camera and direct observation. Using GIS (Geographic Information Systems) and GPS (Global Positioning System) technologies and spatial analytical methods, the transport of skeletal elements was mapped in order to analyze dispersal and terrain-influenced patterns of active vulture scavenging. Results showed that the initial scavenging took place 37 days after placement at FARF. This delay in scavenging differs from previous research. After the initial appearance of the vultures, the body was reduced from a fully-fleshed individual to a skeleton within only 5h. This underscores the potential for errors in postmortem interval estimations made at vulture scavenged scenes. Additionally, spatial analysis showed that skeletal elements were dispersed by vultures to lower elevations, and that the disarticulation and dispersal of the skeletal elements occurs early in the scavenging sequence. PMID:22204892

Spradley, M Katherine; Hamilton, Michelle D; Giordano, Alberto

2011-12-26

399

Population remains top priority for China.  

PubMed

China, whose population was 430 million in 1840, is facing a population total of 1.3 billion in 2000. Population increased rapidly in the country during the 1950s, but early efforts at population control were abandoned from the start of the Cultural Revolution in 1966 until the 1970s. Today, the importance of family planning (FP) is recognized throughout Chinese society. With 20 million newborns adding 13 million people to the population each year, controlling the population increase will remain a top priority of China's population policy. Other priorities include 1) increasing the quality of life of the population by improving health, promoting literacy, and developing human resources; 2) facing the impact of population aging; 3) struggling to overcome the poverty experienced by 50 million people; and 4) dealing with the imbalanced sex ratio of newborns. China has been attempting to institute strategies to implement the Program of Action adopted by the 1994 International Conference on Population and Development and is attempting to adopt an integrated approach to population programs that combines FP with development measures and the delivery of multiple services to enhance reproductive health. Since 1984, China has worked with Japan's JOICFP on an Integrated Project that offers FP, maternal and child health services, and parasite control. PMID:12348548

Li, H

1998-04-01

400

Multidrug-resistant tuberculosis.  

PubMed

Despite the efforts made worldwide to reduce the number of cases of drug-susceptible tuberculosis, multidrug-resistant tuberculosis (MDR-TB) constitutes an important public health issue. Around 440,000 new cases of MDR-TB are estimated annually, although in 2008 only 7% of these (29,423 cases) were notified. The laboratory tests for diagnosing resistance may be phenotypic (based on culture growth in the presence of drugs) or genotypic (i.e. identification of the presence of mutations that confer resistance). The urgent need for a rapid means of detecting resistance to anti-TB drugs has resulted in the development of many genotypic methods over recent years. The treatment of MDR-TB is expensive, complex, prolonged (18-24 months) and associated with a higher incidence of adverse reactions. Some basic principles must be observed when prescribing an adequate treatment regimen for MDR-TB: (a) the association of at least four drugs (three of which should not have been used previously); (b) use of a fluoroquinolone; and (c) use of an injectable anti-TB drug. In Brazil, the therapeutic regimen for MDR-TB has been standardized and consists of five drugs: terizidone, levofloxacin, pyrazinamide, ethambutol and an aminoglycoside (streptomycin or amikacin). Pulmonary resection is an important tool in the coadjuvant treatment of MDR-TB. While a recent meta-analysis revealed an average cure rate of MDR-TB of 69%, clinical studies are currently being conducted with new drugs and with drugs already available on the market but with a new indication for TB, with encouraging results that will enable more effective treatment regimens to be planned in the future. PMID:23477764

Lemos, Antônio Carlos Moreira; Matos, Eliana Dias

2013-03-09

401

A Functional Single-Nucleotide Polymorphism in the Promoter of the Gene Encoding Interleukin 6 Is Associated With Susceptibility to Tuberculosis  

PubMed Central

Background Genetic variation influences susceptibility or resistance to tuberculosis. Interleukin 6 (IL-6) contributes to protection against tuberculosis in mice. However, its role in regulating susceptibility or resistance to tuberculosis in humans is unclear. Methods Genotyping of polymorphisms in IL-6 and IL-6R (CD126) genes was performed in 2 independent cohorts, an experimental population (495 cases and 358 controls) and a validation population (1383 cases and 1149 controls). The associations of the variants with tuberculosis were tested using 2 case-control association studies. In addition, the regulatory effects of single-nucleotide polymorphism rs1800796 (-572C > G) on IL-6 production in plasma and CD14+ monocyte cultures stimulated with a Mycobacterium tuberculosis (M. tuberculosis) product were assessed. Results The rs1800796 polymorphism is associated with increased resistance to tuberculosis (odds ratio [OR], 0.771; 95% confidential interval, .684–.870). The rs1800796GG genotype is strongly associated with reduced risk to tuberculosis (OR, 0.621; 95% CI, .460–.838). Interestingly, CD14+ monocytes isolated from individuals with rs1800796GG genotype produced significantly less IL-6 in response to M. tuberculosis 19-kDa lipoprotein than those with CC or CG genotype. Conclusions We identified a genetic polymorphism in the IL-6 promoter that regulates cytokine production and host resistance to pulmonary tuberculosis in Chinese populations.

Zhang, Guoliang; Zhou, Boping; Wang, Wenfei; Zhang, Mingxia; Zhao, Yahua; Wang, Zheng; Yang, Lin; Zhai, Jingnan; Feng, Carl G.; Wang, Junwen; Chen, Xinchun

2012-01-01

402

Development of Low-Cost Inverted Microscope to Detect Early Growth of Mycobacterium tuberculosis in MODS Culture  

PubMed Central

Background The microscopic observation drug susceptibility (MODS) assay for rapid, low-cost detection of tuberculosis and multidrug resistant tuberculosis depends upon visualization of the characteristic cording colonies of Mycobacterium tuberculosis in liquid media. This has conventionally required an inverted light microscope in order to inspect the MODS culture plates from below. Few tuberculosis laboratories have this item and the capital cost of $5,000 for a high-end microscope could be a significant obstacle to MODS roll-out. Methodology We hypothesized that the precise definition provided by costly high-specification inverted light microscopes might not be necessary for pattern recognition. Significance In this work we describe the development of a low-cost artesenal inverted microscope that can operate in both a standard or digital mode to effectively replace the expensive commercial inverted light microscope, and an integrated system that could permit a local and remote diagnosis of tuberculosis.

Zimic, Mirko; Velazco, Abner; Comina, German; Coronel, Jorge; Fuentes, Patricia; Luna, Carmen G.; Sheen, Patricia; Gilman, Robert H.; Moore, David A. J.

2010-01-01

403

Extrapulmonary Tuberculosis by Nationality, the Netherlands, 1993-2001  

PubMed Central

This study describes the epidemiology of extrapulmonary tuberculosis (TB) in the Netherlands from 1993 through 2001. We assessed whether the increasing numbers of inhabitants with a non-Western ethnic background had an effect on the number of extrapulmonary patients. We used data from the Netherlands Tuberculosis Register and included all cases of TB diagnosed in the Netherlands between January 1, 1993, and December 31, 2001. Information on age, sex, nationality, year of diagnosis, culture result, anatomic location of the site of disease, and HIV status was retrieved from the register. Of 13,258 patients with TB, 8,216 (62%) had pulmonary TB, and 5,042 (38%) had extrapulmonary TB. Non-Dutch nationals were more likely to have most types of extrapulmonary TB. The growth of the number of inhabitants with a non-Western ethnic background in the Netherlands explains the proportional growth of extrapulmonary TB. Physicians need to be aware of the changing clinical picture of TB.

te Beek, Lowieke A.M.; Richter, Clemens; Borgdorff, Martien W.

2006-01-01

404

Automatic identification of mycobacterium tuberculosis with conventional light microscopy.  

PubMed

This article presents an automatic identification method of mycobacterium tuberculosis with conventional microscopy images based on Red and Green color channels using global adaptive threshold segmentation. Differing from fluorescence microscopy, in the conventional microscopy the bacilli are not easily distinguished from the background. The key to the bacilli segmentation method employed in this work is the use of Red minus Green (R-G) images from RGB color format. In this image, the bacilli appear as white regions on a dark background. Some artifacts are present in the (R-G) segmented image. To remove them we used morphological, color and size filters. The best sensitivity achieved was about 76.65%. The main contribution of this work was the proposal of the first automatic identification method of tuberculosis bacilli for conventional light microscopy. PMID:19162673

Costa, Marly G F; Costa Filho, Cícero F F; Sena, Juliana F; Salem, Julia; de Lima, Mari O

2008-01-01

405

Complications of Antiretroviral Therapy Initiation in Hospitalised Patients with HIV-Associated Tuberculosis  

PubMed Central

Background HIV-associated tuberculosis is a common coinfection in Sub-Saharan Africa, which causes high morbidity and mortality. A sub-set of HIV-associated tuberculosis patients require prolonged hospital admission, during which antiretroviral therapy initiation may be required. The aim of this study was to document the causes of clinical deterioration of hospitalised patients with HIV-associated tuberculosis starting antiretroviral therapy in order to inform healthcare practice in low- to middle-income countries. Methods Prospective, observational cohort study of adult inpatients with HIV-associated tuberculosis starting antiretroviral therapy in a dedicated tuberculosis hospital in Cape Town, South Africa. Causes of clinical deterioration and outcome were recorded in the first 12 weeks of antiretroviral therapy. Patients with rifampicin-resistant tuberculosis were excluded. Results Between May 2009 and November 2010, 112 patients (60% female), with a median age of 32 years were enrolled. At baseline the median CD4 count was 55 cells/mm3 (IQR 31–106) and HIV viral load 5.6 log copies/mL. All patients had significant comorbidity: 82% were bed-bound, 65% had disseminated tuberculosis and 27% had central nervous system tuberculosis. Seventy six patients (68%) developed 144 clinical events after starting antiretroviral therapy. TB-IRIS, hospital-acquired infections and significant drug toxicities occurred in 42%, 20.5% and 15% of patients respectively. A new opportunistic disease occurred in 15% of patients and a thromboembolic event in 8%. Mortality during the 12 week period was 10.6%. Conclusions High rates of TB-IRIS, hospital-acquired infections and drug toxicities complicate the course of patients with HIV-associated tuberculosis starting antiretroviral therapy in hospital. Despite the high morbidity, mortality was relatively low. Careful clinical management and adequate resources are needed in hospitalised HIV-TB patients in the 1st three months following ART initiation.

van der Plas, Helen; Meintjes, Graeme; Schutz, Charlotte; Goliath, Rene; Myer, Landon; Baatjie, Dorothea; Wilkinson, Robert J.; Maartens, Gary; Mendelson, Marc

2013-01-01

406

Vitamin D status and antimicrobial peptide cathelicidin (LL-37) concentrations in patients with active pulmonary tuberculosis  

PubMed Central

Background: Vitamin D insufficiency is common in industrialized and developing nations. Recent studies have shown that vitamin D insufficiency is associated with a higher risk of active tuberculosis. Laboratory studies provided a mechanism for this link on the basis of findings that vitamin D metabolites regulate the expression of cathelicidin (LL-37), which is an endogenous antimicrobial peptide with activity against Mycobacterium tuberculosis. Little information is available on the clinical relation between vitamin D, LL-37 concentrations, and disease severity in patients with tuberculosis. Objective: The primary objective of the study was to evaluate the relation between vitamin D nutriture, serum LL-37 concentrations, and tuberculosis by using samples stored in the Tuberculosis Trials Consortium serum repository. Design: We measured 25-hydroxyvitamin D [25(OH)D] and LL-37 concentrations in 95 serum specimens from patients with culture-confirmed pulmonary tuberculosis and correlated these concentrations to clinical and demographic variables. Results: The prevalence of vitamin D insufficiency [serum 25(OH)D concentration lt 30 ng/mL] in patients with active tuberculosis was 86% (n = 95) with a mean baseline serum 25(OH)D concentration of 20.4 ng/mL. Factors associated with vitamin D insufficiency were black race and indoor lifestyle. The mean ( plusmn SD) baseline LL-37 concentration was 49.5 plusmn 23.8 ng/mL. Higher LL-37 concentrations correlated with acid fast bacilli sputum smear positivity and weight gt 10% below ideal body weight. Serum vitamin D status of the study subjects did not correlate with serum LL-37 concentrations. Conclusion: More prospectively designed studies are needed to evaluate the clinical implications of vitamin D insufficiency in patients with tuberculosis and the utility of circulating LL-37 as a potential biomarker in patients with active tuberculosis disease. The parent trial was registered at clinicaltrials.gov as NCT00023335.

Yamshchikov, Alexandra V; Kurbatova, Ekaterina V; Kumari, Meena; Blumberg, Henry M; Ziegler, Thomas R; Ray, Susan M; Tangpricha, Vin

2010-01-01

407

Spoligotyping and Drug Resistance Analysis of Mycobacterium tuberculosis Strains from National Survey in China  

PubMed Central

Background Tuberculosis (TB), caused by Mycobacterium tuberculosis complex (MTBC), is one of the major causes of death in the world today. Although China has the second largest global case rate of tuberculosis, a systematic study of TB prevalence in China has not been completed. From 2006 to 2007, the base line surveillance of tuberculosis was carried out by Ministry of Health, and more than 4000 representative strains were selected from 31 provinces in China. Methodology/Principal Findings The aim of the present research was to survey the genotypes of representative Mycobacterium tuberculosis (M. tuberculosis) strains from China using spacer oligonucleotide typing (spoligotyping), and to analyze the relationship between genotype and drug resistance for the first time. A total of 4017 clinical isolates were collected from 2007 to 2008 throughout China. Among those M. tuberculosis isolates, 2500 (62.2%) isolates were Beijing genotypes. The percentage of Beijing genotypes in northern China was higher than in southern China (76.5% vs. 53.2%). Additionally, the frequencies of rifampin-resistant, ofloxacin-resistant and multidrug-resistant isolates were significantly higher in Beijing genotype strains than non-Beijing strains. Furthermore, a novel genotype named “China Southern genotype (CS)” was only isolated from Fujian and Guangdong provinces. Hence, it is very practical to uncover the reason for prevalence of the CS type in southern China. Conclusions/Significance In conclusion, Beijing family genotypes were still the predominant genotype throughout China, which exhibited a greater correlation with rifampin-resistance, ofloxacin-resistance and MDR phenotypes than other TB spoligotypes, and some regions of China showed several unique characters in the distribution of M. tuberculosis genotypes. Our research represents an important contribution for the TB control and research community, which completes broad pictures on drug resistance levels and distribution of M. tuberculosis strain types over China.

Liu, Guan; Jiang, Guanglu; Xia, Hui; Song, Yuanyuan; Shang, Yuanyuan; Wang, Shengfen; Zhao, Yan-lin

2012-01-01

408

Burden of tuberculosis in Kampala, Uganda  

Microsoft Academic Search

Objective To determine the prevalence and incidence of tuberculosis in one of Uganda's poor peri-urban areas. Methods Multi-stage sampling was used to select a sample of households whose members were evaluated for presence of signs and\\/or symptoms of active tuberculosis; history of tuberculosis treatment; and relevant demographic, socioeconomic, and household environment characteristics. Patients with suspected tuberculosis underwent standardized evaluation for

David Guwatudde; Sarah Zalwango; Moses R. Kamya; Sara M. Debanne; Mireya I. Diaz; Alphonse Okwera; Roy D. Mugerwa; Charles King; Christopher C. Whalen

2003-01-01

409

Unsuspected and extensive transmission of a drug-susceptible Mycobacterium tuberculosis strain  

PubMed Central

Background A large and unsuspected tuberculosis outbreak involving 18.7% of the total of the tuberculosis cases studied, was detected in a population-based molecular epidemiological study performed in Zaragoza (Spain) from 2001 to 2004. Methods The Mycobacterium tuberculosis drug-susceptible strain, named MTZ strain, was genetically characterized by IS6110-RFLP, Spoligotyping and by MIRU-VNTR typing and the genetic patterns obtained were compared with those included in international databases. The characteristics of the affected patients, in an attempt to understand why the MTZ strain was so highly transmitted among the population were also analyzed. Results The genetic profile of the MTZ strain was rare and not widely distributed in our area or elsewhere. The patients affected did not show any notable risk factor for TB. Conclusion The M. tuberculosis strain MTZ, might have particular transmissibility or virulence properties, and we believe that greater focus should be placed on stopping its widespread dissemination.

Lopez-Calleja, Ana Isabel; Gavin, Patricia; Lezcano, Ma Antonia; Vitoria, Ma Asuncion; Iglesias, Ma Jose; Guimbao, Joaquin; Lazaro, Ma Angeles; Rastogi, Nalin; Revillo, Ma Jose; Martin, Carlos; Samper, Sofia

2009-01-01

410

The Cosmic Background Explorer.  

ERIC Educational Resources Information Center

|Outlines the Cosmic Background Explorer (COBE) mission to measure celestial radiation. Describes the instruments used and experiments involving differential microwave radiometers, and a far infrared absolute spectrophotometer. (YP)|

Gulkis, Samuel; And Others

1990-01-01

411

The Cosmic Background Explorer.  

ERIC Educational Resources Information Center

Outlines the Cosmic Background Explorer (COBE) mission to measure celestial radiation. Describes the instruments used and experiments involving differential microwave radiometers, and a far infrared absolute spectrophotometer. (YP)

Gulkis, Samuel; And Others

1990-01-01

412

Phospholipase C in Beijing strains of Mycobacterium tuberculosis  

PubMed Central

Background and Objectives Phospholipase of Mycobacterium tuberculosis plays an important role in pathogenesis through breaking up phospholipids and production of diacylglycerol. In this study, we examined the Beijing strains of Mycobacterium tuberculosis isolated from Iranian patients for the genes encoding this enzyme. Materials and Methods DNA extraction was performed using CTAB (cetyltrimethylammonium bromide) from positive culture specimens in tuberculosis patients. PCR was then used to amplify the plcA, plcB, plcC genes of Beijing strain, and non-Beijing strains were identified by spoligotyping. Results Of 200 specimens, 19 (9.5%) were Beijing strain and 181 (90.5%) were non-Beijing strains. The results of PCR for Beijing strains were as follows: 16 strains (84.2%) were positive for plcA, 17 (89.4%) were positive for plcB and 17 (89.4%) were positive for plcC genes. The standard strain (H37RV) was used as control. Conclusion The majority of Beijing strains have phospholipase C genes which can contribute to their pathogenesis but we need complementary studies to confirm the role of phospholipase C in pathogenecity of Mycobacterium tuberculosis.

Mirsamadi, ES; Farnia, P; Jahani Sherafat, S; Esfahani, M; Faramarzi, N

2010-01-01

413

No associations of human pulmonary tuberculosis with Sp110 variants  

PubMed Central

Background After a recent report on the role of the Ipr1 gene in mediating innate immunity in a mouse model of Mycobacterium tuberculosis infection, the human Ipr1 homologue, Sp110, was considered a promising candidate for an association study in human tuberculosis. Methods In a sample of >1000 sputum positive, HIV negative West African patients with pulmonary tuberculosis and >1000 exposed, apparently healthy controls, we have genotyped 21 Sp110 gene variants that were either available from public databases, including HapMap data, or identified by DNA re?sequencing. Results No significant differences in the frequencies of any of the 21 variants were observed between patients and controls. This applied also for HapMap tagging variants and the corresponding haplotypes, when including sliding window analyses with three adjacent variants, and when stratifying controls for positivity and negativity according to the results of intradermal tuberculin (purified protein derivative, PPD) skin tests. DNA re?sequencing revealed 13 novel Sp110 variants in the 5??UTR, exons, and adjacent intronic regions. Conclusions Based on the results obtained in this case?control study, the hypothesis that Sp110 variants and haplotypes might be associated with distinct phenotypes of human M tuberculosis infection is doubtful.

Thye, T; Browne, E N; Chinbuah, M A; Gyapong, J; Osei, I; Owusu-Dabo, E; Niemann, S; Rusch-Gerdes, S; Horstmann, R D; Meyer, C G

2006-01-01

414

Triple valve endocarditis by mycobacterium tuberculosis. A case report  

PubMed Central

Background Granulomas caused by Mycobacterium Tuberculosis have been observed at autopsy in the heart, pre-dominantly in the myocardium and endocardium, but rarely involving the coronary vessels and valvular structures. Mycobacterium tuberculosis valvular endocarditis is extremely rare, with most reports coming from autopsy series. Case presentation We report the case of a 17 year old immunocompetent girl who presented with history of fever, malaise, foot gangrene and a left sided hemiparesis. On investigation she was found to have infective endocarditis involving the aortic, mitral and tricuspid valves. She had developed a right middle cerebral artery stroke. She underwent dual valve replacement and tricuspid repair. The vegetations showed granulomatous inflammation but blood cultures and other biological specimen cultures were negative for any organisms. She was started on antituberculous treatment and anticoagulation. Conclusion This is the first reported case of triple valve endocarditis by Mycobacterium Tuberculosis in an immunocompetent host. Especially important is the fact that the right heart is involved which has been historically described in the setting of intravenous drug abuse. This implies that Tuberculosis should be considered in cases of culture negative endocarditis in endemic areas like Pakistan even in immunocompetent hosts.

2012-01-01

415

APIC and CDC survey of Mycobacterium tuberculosis isolation and control practices in hospitals caring for children Part 2: Environmental and administrative controls  

Microsoft Academic Search

Background: The 1994 Centers for Disease Control and Prevention draft Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities did not exempt pediatric facilities from instituting controls to prevent nosocomial tuberculosis (TB) transmission. Many researchers contend that TB disease in children does not require such rigid controls. We surveyed acute-care pediatric facilities in the United States to determine

Scott E. Kellerman; Dawn Simonds; Shailen Banerjee; Jerilynn Towsley; Beth H. Stover; William Jarvis

1998-01-01

416

Paradoxical Tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) in HIV Patients with Culture Confirmed Pulmonary Tuberculosis in India and the Potential Role of IL-6 in Prediction  

PubMed Central

Background The incidence, manifestations, outcome and clinical predictors of paradoxical TB-IRIS in patients with HIV and culture confirmed pulmonary tuberculosis (PTB) in India have not been studied prospectively. Methods HIV+ patients with culture confirmed PTB started on anti-tuberculosis therapy (ATT) were followed prospectively after anti-retroviral therapy (ART) initiation. Established criteria for IRIS diagnosis were used including decline in plasma HIV RNA at IRIS event. Pre-ART plasma levels of interleukin (IL)-6 and C-reactive protein (CRP) were measured. Univariate and multivariate logistic regression models were used to evaluate associations between baseline variables and IRIS. Results Of 57 patients enrolled, 48 had complete follow up data. Median ATT-ART interval was 28 days (interquartile range, IQR 14–47). IRIS events occurred in 26 patients (54.2%) at a median of 11 days (IQR: 7–16) after ART initiation. Corticosteroids were required for treatment of most IRIS events that resolved within a median of 13 days (IQR: 9–23). Two patients died due to CNS TB-IRIS. Lower CD4+ T-cell counts, higher plasma HIV RNA levels, lower CD4/CD8 ratio, lower hemoglobin, shorter ATT to ART interval, extra-pulmonary or miliary TB and higher plasma IL-6 and CRP levels at baseline were associated with paradoxical TB-IRIS in the univariate analysis. Shorter ATT to ART interval, lower hemoglobin and higher IL-6 and CRP levels remained significant in the multivariate analysis. Conclusion Paradoxical TB–IRIS frequently complicates HIV-TB therapy in India. IL-6 and CRP may assist in predicting IRIS events and serve as potential targets for immune interventions.

Porter, Brian O.; Chandrasekhar, Chockalingam; Venkatesan, Perumal; Menon, Pradeep A.; Subramanian, Sudha; Anbalagan, Selvaraj; Bhavani, Kannabiran P.; Sekar, Sathiyavelu; Padmapriyadarshini, Chandrasekaran; Kumar, Satagopan; Ravichandran, Narayanan; Raja, Krishnaraj; Bhanu, Kesavamurthy; Mahilmaran, Ayyamperumal; Sekar, Lakshmanan; Sher, Alan; Sereti, Irini; Swaminathan, Soumya

2013-01-01

417

Tuberculosis in asylum seekers in Belgium  

Microsoft Academic Search

Countries with a low incidence of tuberculosis have recently been faced with the problem of tuberculosis (TB) in asylum seekers from countries with a high TB prevalence. We report on the tuberculosis case notification rate (TBCNR) in Belgium in 1993, and on the results of active screening in a group of asylum seekers. The TBCNR in Belgium in 1993 increased

P. Van den Brande; M. Uydebrouck; P. Vermeire; M. Demedts; U. Z. Gasthuisberg; Dienst Longziekten

1997-01-01

418

38 CFR 3.959 - Tuberculosis.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Tuberculosis. 3.959 Section 3.959 Pensions...Compensation Protection § 3.959 Tuberculosis. Any veteran who, on August...for active or inactive (arrested) tuberculosis may receive compensation under...

2013-07-01

419

Are adolescents ready for tuberculosis vaccine trials?  

Microsoft Academic Search

Tuberculosis (TB) vaccine trials are planned in adolescents in a high tuberculosis burden rural area near Cape Town, South Africa. To determine the knowledge and attitudes of adolescents about tuberculosis, vaccines and vaccine trials, a representative sample of adolescent learners was chosen from high schools in the trial area. A questionnaire was administered and focus group discussions held with the

H. Mahomed; J. Shea; F. Kafaar; T. Hawkridge; W. A. Hanekom; G. D. Hussey

2008-01-01

420

Old Testament biblical references to tuberculosis.  

PubMed

Two probable references to tuberculosis are found in Old Testament books of the Bible dating to a time when the Israelites lived in Egypt, which is known from archeological evidence to be an area where tuberculosis was then prevalent. Other putative biblical references to tuberculosis are less credible. PMID:10585812

Daniel, V S; Daniel, T M

1999-12-01

421

Mycobacterium tuberculosis monoarthritis in a child  

PubMed Central

A child with isolated Mycobacterium tuberculosis monoarthritis, with features initially suggesting oligoarthritis subtype of juvenile idiopathic arthritis, is presented. This patient illustrates the need to consider the possibi