Thesis (M.A. (Anthropology)) - Rhodes University, 2007.

Se caracterizaron los genotipos de cepas de M. tuberculosis resistente, multidrogorresistente (MDR), MDR asociada a resistencia a drogas de segunda línea (MDR plus) y sensible a las drogas que proceden de los distritos de Lima y Callao. Cuarenta y nueve pacientes con TB fueron incluidos en el estudio. Los genotipos de M. tuberculosis fueron establecidos por PCR usando el primer Mtb2 (5’-CGG-CGG-CAA-CGG-CGG-CA-3’) en combinación con primers situados inversamente en los flancos repetitivos de la IS6110. Se revisaron las historias clínicas de los pacientes para la obtención de información epidemiológica. La susceptibilidad a isoniacida, rifampicina, estreptomicina, etambutol, kanamicina, acido p-amin-salicilico, tioacetazona y pirazinamida fueron estudiados. / We characterise the genotypes of Mycobacterium tuberculosis both resistant, multidrug resistant (MDR), multidrug drug resistant plus (MDR plus) and susceptible to drugs strains come from to Lima and Callao. Forty-nine patients with TB were included in the study. The genotypes of the M. tuberculosis isolates were established by PCR using the primer Mtb2 (5’-CGG-CGG-CAA-CGG-CGG-CA-3’) in combination with primers sited at inverted repeats flanking IS6110. Were revised the clinical history of the patients for epidemiological information. The susceptibility to isoniacid, rifampicin, streptomycin, ethambutol, kanamycin, para-amin-salicylic acid, tioacetazon and pyrazinamide was studied.

No description available.

Dissertation (PhD)--University of Stellenbosch, 2005. / Bibliography. Also available via the Internet.

Background: Tuberculosis (TB) is a major public health problem in Swaziland aggravated by the escalating HIV epidemic. Health services in five of the major industries in Swaziland represent the potential for the highest quality of TB care in the country, arising from increased supervision and better case holding. The guidelines of the national TB control programme (TBCP) are mostly adhered to, but there is a tendency to rely on clinical and radiological parameters for diagnosis due to problems with sputum microscopy. Aim and Objectives: The aim of this study was to evaluate current TB management protocols by describing case management and treatment outcomes in these five industries. Specific objectives included the determination of quantitative outcomes (cure and treatment completion, smear conversion, treatment interruption and failure, and mortality). Patient knowledge of TB and its treatment as well as health worker practices were also assessed. Methods: Descriptive questionnaire survey. Results: The majority of TB patients (79%) were young (mean age 38 yrs) males. 81 % of patients were treated for TB for the first time. The HIV status of a third of patients was known, and 82.7% of these were positive. There were significant differences between the perceptions of health workers and patients on the delivery of TB care and the time lapse between diagnosis and treatment. Chest X-ray was the main diagnostic tool used. In more than 97% of cases the TBCP prescribed treatment regimen was used. Directly observed treatment was provided to 77.4% of patients. The majority of patients had some knowledge of TB and its spread. 73.4% of patients knew about available TB treatment, and 75% about treatment duration. Coughing was identified as an important symptom by 84.5% of patients. There was a significant difference between calculated and estimated adherence to treatment. In 55.6% of patients no sputum smear was done at two months. Treatment outcome was favourable in 83.7 % of patients, compared to only 62.1 % of TBCP patients in 2001. Outcome analysis showed that the participating industries had a highly successful TB control programme compared to the national TBCP, with outcome indicators meeting international standards. A serious deficiency detected was the lack of smear microscopy for diagnosis and treatment monitoring. Limitations: The possibility exists that patients presenting to the Health Centres were not registered sequentially. The usual limitations relating to questionnaires are applicable. Recommendations: Directly observed treatment coverage and supervision can be improved in industry as the patient group is well-defined and captive. Sputum microscopy should become the mainstay of diagnosis and monitoring. Health care providers should be primed to detect co-existing lung disease and HIV, and TB drug side effects. Accurate recording and reporting systems should be introduced without delay. Communication between the TBCP and the non-governmental health institutions in Swaziland needs improvement. / Dissertation (MMed)--University of Pretoria, 2005. / School of Health Systems and Public Health (SHSPH) / Unrestricted

The pathogenicity of mycobacteria is directly related to their ability to survIve within macrophages, thereby circumventing host defense responses. This ability to resist degradation in macrophage phagosomes/lysosomes derives in large part from the complex structure of the cell wall of Mycobacterium tuberculosis. Surface exposure of lipid and glycolipid components of the mycobacterial cell wall is considered to be a major factor in the virulence of the pathogen by orchestrating the dialogue with host cells. Their interactions and modulating properties on host macrophage functions may contribute to our understanding of the pathogenesis of tuberculosis. In this study the modulating properties on macrophage functions by the major mycobacterial cell wall lipids, mycolic acids, were investigated. The investigation focused not only on the physical changes induced in macrophages as a result of the interaction with mycolic acids but also on the modulation of macrophage functions involved in innate and adaptive immunity. It was concluded that MA was involved both in mechanisms of pathogenesis of M tuberculosis, as in induction of protective immunity. By opening up some of the secrets of pathogenesis and immunity of tuberculosis, it provided new avenues for research to pursue a timeous and efficient solution to the disease. / Dissertation (MSc (Biochemistry))--University of Pretoria, 2005. / Biochemistry / unrestricted

Thesis (M. Sc. (Medical Sciences)) -- University of Limpopo, 2015 / Tuberculosis (TB) patients may have mixed infections with both drug-susceptible and drug-resistant Mycobacterium tuberculosis (MTB) strains. This phenomenon termed heteroresistance presents a challenge TB management and is considered a preliminary stage to full resistance. Heteroresistance is more likely to occur in high TB incidence areas and in chronic patients as they have more opportunity to become infected with various strains of TB and has been proven to occur in new cases, treatment failure and relapse. Methods: Sputum samples were collected from new consulting and hospitalised patients who were on treatment for MDR TB. A total of 231 samples were run on MTBDRplus to determine heteroresistance of Mycobacterium tuberculosis to isoniazid and rifampicin. To determine heteroresistance to second-line drugs, 91 samples were run on MTBDRsl. Nineteen (19) samples that were heteroresistant to 2nd line drugs were subjected to spoligotyping to determine the families/lineages they belonged to. Results: A total of 66 were confirmed as Mycobacterium tuberculosis complex by the line probe assays. Out of the 66 MTBC, rifampicin resistance was found in 22 (10%) and 44 (19%) were reported susceptible. Isoniazid resistance was found in 39 (17%) and 27 (12%) were reported susceptible. Of the 66 MTBC positive samples, moxifloxacin resistance was found in 33 (16%) and 14 (7%) were reported susceptible. Kanamycin resistance was found in 17 (8%) and 30 (14%) were reported susceptible. Ethambutol resistance was found in 25 (12%) and 22 (10%) were reported susceptible. Heteroresistance was evident in 22 (10%) samples for the first-line and in 23 (11%) for the second-line drugs. Results of a total of 19 heteroresistant samples subjected to spoligotyping when compared to those in the international spolDB4 database indicated that 4 of them matched existing shared spoligotype international types, 15 were unknown (orphans). Eighteen (18) of 19 heteroresistant samples subjected to spoligotyping were also MDR. Fourteen of the samples that were resistant to both RIF and INH were orphans. Of the 14 MDR, 3 samples belonged to clades T1, T-H37RvV817 and LAM 3 with SITs: 879, 568 and 2301, respectively. One sample with SIT 1196 had an unknown clade was resistant to RIF but susceptible to INH. Conclusion: This study has shown that heteroresistance remains an important phenomenon in clinical tuberculosis, especially in highly endemic areas. According to the current study, heteroresistance was associated more with recurrent cases who are on initiation or continuation phase than new cases and a larger percentage of heteroresistance was reported in second-line drugs than there is in first-line drugs. The T1 genotype was found to be predominant amongst recurrent cases. The LAM3 and T-H37RvV817 lineages were found amongst the new cases. In the present study there was no significant association between heteroresistance and the patient’s treatment history as indicated by a P-value of 0.473 and between heteroresistance and spoligotype families (P-value, 0.991). The predominance of orphan SITs and unknown clades followed by non-Beijing strains in the study may be due to the migration of carriers from the neighboring countries as the Limpopo Province is flanked by Botswana, Zimbabwe and Mozambique. Further studies with larger numbers of patients should focus on the prevalence to associate heteroresistance with patients‟ treatment history and establish the contributing MTBC strain lineages.

La captación de sintomáticos respiratorios es una estrategia diseñada por la Organización Mundial de la Salud para erradicar la incidencia alta de tuberculosis y promover la salud, cuya responsabilidad recae no solo en el personal de enfermería, sino en todo el personal de salud. Por ende, es importante conocer cómo es que se realiza dicha actividad en dos centros de salud de Lima Metropolitana, según el análisis situacional de salud, la incidencia de pacientes con tuberculosis es alarmante. La investigación busca determinar el proceso de captación de sintomáticos respiratorios realizado por el personal de salud y los factores asociados a favorecer su cumplimiento en dos centros de salud de Lima Metropolitana, 2019. El tipo de estudio es cuantitativo, nivel aplicativo, método descriptivo y de corte transversal, teniendo como tamaño de muestra a 30 trabajadores de salud por formula finita cuyo grupo ocupacional fue seleccionado mediante muestreo estratificado. La técnica que se utilizó fue la encuesta. Los instrumentos fueron dos cuestionarios las cuales fueron categorizadas mediante la Prueba estadística de máximos y mínimos. Se evaluaron a 30 trabajadores de la salud, de los cuales el 83,30% fueron de sexo femenino y 53,33% eran de 20 a 35 años de edad. El 60,00% del personal de salud de ambos establecimientos realiza el proceso de captación de sintomáticos respiratorios adecuadamente, sin embargo, se evidencia la ausencia de factores institucionales asociados a favorecer su cumplimiento en 90,00%. Concluye que la mayoría del personal de salud de ambos establecimientos realiza el proceso de captación de sintomáticos respiratorios adecuadamente, sin embargo, hay ausencia de factores asociados a favorecer su cumplimiento, estando ausentes con mayor porcentaje la supervisión y las condiciones de trabajo en las que laboran el personal de salud. / Universidad Nacional Mayor de San Marcos (Lima). Vicerrectorado de Investigación y Posgrado / Tesis

INTRODUCCION: En la actualidad se acepta que la infección por tuberculosis es una enfermedad endémica de países en vías de desarrollo, de gran morbilidad y mortalidad. En los países en vías de desarrollo la tuberculosis en sus distintas formas continúa siendo un problema de salud pública, y se estima que la población con infección se encuentra en un 45% a la edad de 20 años.,6 En nuestro país la tuberculosis es una enfermedad de alta incidencia y prevalencia, debido a las malas condiciones socioeconómicas, deficiente alimentación y el hacinamiento en que vive gran parte de nuestra población. MATERIALES Y METODOS: Se realiza un estudio descriptivo retrospectivo. Se revisara las historias clínicas teniendo como población a los pacientes con diagnostico de Tuberculosis Urogenital hospitalizados en el servicio de Urología del Hospital Nacional Dos de Mayo excluyendo del estudio a los pacientes que no se les encontró la historia clínica o si dichas historias se encontraban incompletas. / Tesis de segunda especialidad

Se caracterizaron los genotipos de cepas de M. tuberculosis resistente, multidrogorresistente (MDR), MDR asociada a resistencia a drogas de segunda línea (MDR plus) y sensible a las drogas que proceden de los distritos de Lima y Callao. Cuarenta y nueve pacientes con TB fueron incluidos en el estudio. Los genotipos de M. tuberculosis fueron establecidos por PCR usando el primer Mtb2 (5’-CGG-CGG-CAA-CGG-CGG-CA-3’) en combinación con primers situados inversamente en los flancos repetitivos de la IS6110. Se revisaron las historias clínicas de los pacientes para la obtención de información epidemiológica. La susceptibilidad a isoniacida, rifampicina, estreptomicina, etambutol, kanamicina, acido p-amin-salicilico, tioacetazona y pirazinamida fueron estudiados. / --- We characterise the genotypes of Mycobacterium tuberculosis both resistant, multidrug resistant (MDR), multidrug drug resistant plus (MDR plus) and susceptible to drugs strains come from to Lima and Callao. Forty-nine patients with TB were included in the study. The genotypes of the M. tuberculosis isolates were established by PCR using the primer Mtb2 (5’-CGG-CGG-CAA-CGG-CGG-CA-3’) in combination with primers sited at inverted repeats flanking IS6110. Were revised the clinical history of the patients for epidemiological information. The susceptibility to isoniacid, rifampicin, streptomycin, ethambutol, kanamycin, para-amin-salicylic acid, tioacetazon and pyrazinamide was studied. / Tesis