A Pirazinamida (Z), droga de primeira linha usada no tratamento da tuberculose, necessita ser hidrolisada pela enzima bacteriana pirazinamidase (PZase) para que o seu metabólito ativo, o ácido pirazinóico (POA), possa agir. O principal mecanismo molecular de resistência a esta droga envolve mutações no gene pncA, que codifica a PZase. Com base nestas informações e tendo em vista a ausência de estudos acerca de resistência à Z em isolados clínicos de M. tuberculosis em nosso país, o presente trabalho propôs caracterizar as mutações envolvendo o gene pncA, bem como relacioná-las com os resultados do teste de atividade da enzima PZase e da concentração inibitória mínima (CIM) de Z. A caracterização molecular dos isolados foi realizada por \"Spoligotyping\", sendo que, todos os isolados testados foram confirmados como pertencentes à espécie M. tuberculosis. A CIM foi realizada por três metodologias: técnica em microplaca utilizando o Alamar Azul como revelador (MABA), método de microdiluição em caldo (BMM), e método das proporções em Lowenstein-Jensen. Os resultados obtidos dão conta de uma boa associação entre as metodologias, e a determinação da CIM pelo método MABA mostrou-se uma nova e segura opção a ser utilizada para Z. A maioria dos isolados clínicos de M. tuberculosis resistentes à Z (88%), apresentaram também atividade de PZase negativa, bem como mutações no gene pncA. Algumas exceções foram encontradas, já que 12% dos isolados clínicos resistentes não apresentaram mutações no gene pncA e tiveram atividade da PZase positiva, sugerindo a existência de outro mecanismo envolvido com resistência à Z. Das 22 mutações encontradas no gene pncA, 9 estão sendo descritas apenas neste estudo. Registrou-se também a presença de 5 isolados clínicos apresentando fenótipo de monorresistência à Z. / Pyrazinamide (Z), a first-line antituberculous drug, is a prodrug that must be activated by bacterial pyrazinamidase (PZase) to the active form pyrazinoic acid, which kills M. tuberculosis. Many studies have shown that mutation in the gene encoding PZase (pncA) is the major mechanism of Z-resistance in M. tuberculosis. Based on this information and taking into consideration the absence of studies concerning Z-resistance in Brazilian M. tuberculosis strains, this study was aimed at characterizing pncA mutations and investigating its correlation with Z-resistance and PZase activity. The molecular characterization carried out by Spoligotyping revealed that all tested strains belong to M. tuberculosis species. The minimal inhibitory concentration (MIC) of Z was determined by three methods: microplate Alamar Blue assay (MABA), broth microdilution method (BMM) and method of proportions on Lowenstein-Jensen medium. The results showed a good association between the 3 methods, and MABA for MIC determination signalized a new and safe option to be used for Z. Most of Z-resistant strains (88%) presented pncA mutations as well as loss of PZase activity. Some exceptions were found since 12% of Z-resistant strains presented neither pncA mutations nor loss of PZase activity, what suggests the existence of another Z-resistance mechanism. Nine of 22 mutations found in pncA gene were described only in this study. During the course of this investigation were identified 5 Z-monoresistant M. tuberculosis strains.

O Mycobacterium tuberculosis é o agente causador da tuberculose, doença responsável por 26% das mortes passíveis de prevenção no mundo todo. No Brasil, são notificados anualmente 85 mil casos novos, e estima-se que 50 milhões de pessoas estejam infectadas pelo M. tuberculosis. A tuberculose é considerada prioritária para o controle de doenças e agravos pelo Ministério da Saúde. Para esse controle, é fundamental disponibilizar métodos e recursos para o pronto diagnóstico laboratorial. Os métodos utilizados para o diagnóstico da doença são bacterioscopia, análise histológica ou cultivo do micro-oganismo a partir de amostras de escarro. A bacterioscopia apresenta baixa sensibilidade, e o resultado da cultura demanda um período de tempo de até oito semanas. A PCR é uma técnica de amplificação de ácidos nucléicos que tem se mostrado promissor instrumento para o diagnóstico da tuberculose. O M. tuberculosis é um micro-organismo que tem tropismo pelas células (micro-organismo intracelular), e pode estar presente nas células do trato respiratório e da mucosa bucal. O esfregaço bucal, ao contrário do escarro, é obtido de forma fácil, sem constrangimentos, por procedimento não invasivo, e oferece menores riscos de contaminação por outros micro-organismos. Foram analisadas 80 amostras de esfregaço bucal de pacientes com diagnóstico confirmado de tuberculose, das quais 78 (97,4%) tiveram resultado positivo na PCR. Esse resultado permite concluir que a aplicação da PCR em amostras de esfregaço bucal é um método efetivo e confiável para detecção do M. tuberculosis. / Mycobacterium tuberculosis is the causing agent of the tuberculosis, responsible illness for 26% of the prevention deaths in the entire world. In Brazil 85000new cases are notified annually, being esteem 50 million people contaminated by the M. tuberculosis. It is considered priority disease for the control of illnesses for the Health department. For this control, it has to be reliable methods and resources for the ready laboratorial diagnosis. Bacterioscopiv, histological analysis or culture of the microrganism from samples of sputum are techniques normally used. The limitation of these methods is low sensitivity and long-winded 8 weeks. The PCR is one technique of amplification of DNA, that if has shown promising instrument for the diagnosis of the tuberculosis. The M. tuberculosis is a microorganism that has affinity for the cells (intracellular microorganism) and can be present in the cells of the respiratory treat and the oral mucosa. Oral swab, in contrast of sputum, is easily taken, not invasive and offering lesser risks of contamination for other microorganisms. We analyze 80 samples of oral swab of patients with confirmed diagnosis of tuberculosis, of these, 78 (97,4%) had resulted positive in the PCR. We conclude that the oral swab use and the application of the PCR are an effective and trustworthy method for tuberculosis detention of the M. tuberculosis.

Thesis (M. Cur.) -- University of Limpopo, 2014 / The present study presents data about the factors that are affecting the implementation of the National Tuberculosis Control Programme by the professional nurses in the Mogalakwena Municipality of the Waterberg District in the Limpopo Province. Despite the intervention by the then Waterberg District Department of Health and Social Development through continual training and workshops of professional nurses in respect of the NTCP, there are still more challenges observed in terms of TB management. Aim of the study The aim of the study was to identify and describe the factors that are affecting the implementation of the NTCP and the findings may be utilised to describe the strategies to increase TB cure rate in the Mogalakwena Municipality of the Waterberg District. Research Methodology A quantitative research approach was used to conduct this study. One hundred and thirty one professional nurses employed at 28 clinics of the Mogalakwena Municipality were selected to participate in the study. The researcher distributed the questionnaires at the clinics. A structured questionnaire with both open and closed-ended questions was administered. The questionnaire was pretested in the Mahwelereng Local Area which did not form part of the main study. Results Of the 131 respondents, 33.6% were the largest age group of between 40 – 50 years followed by 24.4% who were older than 50 years in contrast with the smallest age group of 18 – 28 years that comprised 18.3% of the population. Sixteen per cent of the respondents were male while 84.0% were female. The findings show that 83.2% of respondents held a diploma in nursing while 16.8% had a degree in nursing. The findings indicate that 98.4% of the respondents were reported to be having knowledge about TB while 1.6% reported not having knowledge. The findings v indicate that 98.4% of the respondents had knowledge about TB suspect screening according to the NTCP in contrast with 1.6% of the participants who did not have knowledge about TB screening. About 95.4% of the respondents reported tracing of TB defaulters while 4.6% of the respondents reported that TB defaulters were not traced. Sixty point three per cent 63.3% of the respondents thought that a negative attitude of professional nurses was the main cause of poor implementation of the NTCP while 30.5% of them disagreed with the statement. Conclusion Respondents demonstrated non-compliance to the implementation of the NTCP, ignorance to acquire skills and negative attitude towards the programme that was consistently significant with other similar studies. The study recommends an updated training programme of all TB trained nurses, as well as values clarification about the importance of the implementation of the NTCP in the management of the TB disease.

No description available.

No description available.

<p>Tuberculosis (TB) and Cancer are among the most devastating and therapeutically challenging diseases that need to be addressed in South Africa today. The development of muti-drug resistance in TB causing bacteria, Mycobacterium tuberculosis and cancerous cells has prompted the search for effective novel compounds. The present study focused on the synthesis and the evaluation of different analogues of diospyrin, a proven anti-TB and anti-cancer agent.</p>

Se evaluó aplicando el Test de Hamilton a 90 pacientes, portadores de tuberculosis, en sus diferentes tipos, y que vienen recibiendo el tratamiento correspondiente a través del Programa Nacional de Control de la Tuberculosis en los establecimientos de Salud que conforman la Red Nº 05 Arequipa Sur, durante el año 2002, con el objetivo de determinar la relación existente entre TUBERCULOSIS y DEPRESIÓN ; para lo cual se utilizo el Inventario para la Depresión de Hamilton, y los datos obtenidos a través de una ficha en la cual figuran los datos clínicos y sociodemográficos más importantes de cada paciente. Se encontró que la muestra en estudio está conformada en su mayoría (83.34%) por pacientes cuyas edades fluctúan entre los 15 y 44 años, que son afectados mayormente los varones (62.22%), más del 50% tienen estudios secundarios, son solteros, tienen un trabajo independiente y cuentan con los servicios básicos de salubridad. El 77% de los enfermos es portador de la enfermedad a nivel pulmonar y reciben por tratamiento el esquema I, el 6% de los casos es portador de tuberculosis multidrogorresistente y por lo tanto reciben el esquema estandarizado de retratamiento. Presentan niveles más intensos de depresión (36.745%) aquellos pacientes que cuentan con estudios primarios (73.33%), también se encuentran más deprimidos los enfermos que tienen un trabajo en su domicilio (71,43%), asimismo se deprimen más los pacientes que provienen de la región Arequipa (62.22%) seguido de los provenientes de Puno (53.85%). La tuberculosis afecta en orden de frecuencia a: los pulmones, la pleura, los riñones, y el sistema linfático, de ellos se deprime con niveles más intensos los portadores de la enfermedad a nivel renal en un 100%, seguido de los enfermos pulmonares en un 38.23%. Los pacientes que reciben el esquema de tratamiento para tuberculosis multidrogorresistente alcanzan cuadros depresivos más severos (60%), seguido del grupo de pacientes que reciben el esquema I (39.14%).A mayor tiempo de duración del tratamiento los niveles de depresión tienen mayor intensidad, es así que los que reciben la terapia por más de seis meses lo están en el 60%. De esta manera se comprueba lo planteado en la hipótesis, es decir que existe relación directa entre la Tuberculosis y la depresión en la población estudiada.

No description available.

<p>Tuberculosis (TB) and Cancer are among the most devastating and therapeutically challenging diseases that need to be addressed in South Africa today. The development of muti-drug resistance in TB causing bacteria, Mycobacterium tuberculosis and cancerous cells has prompted the search for effective novel compounds. The present study focused on the synthesis and the evaluation of different analogues of diospyrin, a proven anti-TB and anti-cancer agent.</p>

Orientador: Helenice Bosco de Oliveira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T00:26:46Z (GMT). No. of bitstreams: 1 Ferreira_EsterNogueiraWhyteAfonso_M.pdf: 5612471 bytes, checksum: 293938ba956e9881ed4b939f7fca47cd (MD5) Previous issue date: 2005 / Resumo: A distribuição geográfica da tuberculose tem forte relação com os indicadores socioeconômicos das diversas nações. Mesmo com os avanços no conhecimento e com a tecnologia disponível para seu controle, continua sendo grave problema mundial de saúde pública. Objetivo: Analisar a coorte de tratamento dos doentes inscritos no Programa de Controle da Tuberculose (PCT) na cidade de Campinas-SP, em 2003. Métodos: Foram analisados, segundo variáveis demográficas, clínicas e epidemiológicas, 494 doentes de uma coorte de 537 notificados no Sistema de Informação Nacional de Agravos de Notificação. Para determinar as diferenças entre as proporções e calcular as razões de chances (OR) foi utilizado o software Epi 1nfo versão 6. O valor de p foi considerado significativo quando inferior a 0,05. Resultados: Do total de doentes analisados 76,3% eram residentes no município de Campinas. O percentual de casos com a co-morbidade TB/Aids foi de 21,2% para os residentes em Campinas e de 24,8% para os residentes em outros municípios. O risco de adoecer por tuberculose em Campinas foi maior na área com piores níveis socioeconômicos. O sucesso de tratamento do grupo de doentes residentes em Campinas foi de 76,4% entre os que não apresentaram Aids e de apenas 48,8% naqueles com Aids. Os pacientes da forma clínica pulmonar com baciloscopia positiva apresentaram sucesso de 70%. O grupo constituído por pacientes que estavam em retratamento apresentou 2,1 vezes mais insucesso de tratamento comparado aos casos novos (OR = 2,14; IC 1,12 - 4,05). Entre aqueles pacientes com a co-morbidade TB/Aids a chance de insucessotambém foi maior (OR = 3,41; 1C 1,98 - 5,89). A proporção de tratamentos supervisionados foi de 35%. Conclusões: A efetividade do PCT de Campinas apresentou-se abaixo dos 85% proposto pela OMS em todas as estratificações estudadas e a incidência parece estar subdimensionada perante a baixa cobertura de baciloscopias de escarro (43,3%) nos sintomáticos respiratórios, sugerindo problemas na operacionalização do PCT de Campinas. Para melhorar o programa as atividades de busca de casos e as estratégias que asseguram a adesão ao tratamento, incluindo o tratamento supervisionado, devem ser aprimoradas / Abstract: The geographic distribution of tuberculosis has a strong relationship with socioeconomic indicators of different nations. Even with advances in knowledge and available technology for its control, it continues to be a serious worldwide public health problem. Objective: To analyze the treatment cohort of patients enrolled in the Tuberculosis Control Program (TCP) in the city of Campinas, SP, in 2003. Methods: In accordance with demographic, clinical and epidemiological variables, 494 patients IToma 537 cohort, who were notified by the National Disease Reporting Information System, were analyzed. In order to determine the differences among proportions and calculate the odds ratio (aR) the Epi Info version 6 software was used. A p value of less than 0.05 was considered significant. Results: Of the total patients analyzed, 76.3% were resident in the city of Campinas. The percentage of cases with TB/AIDS comorbidity for Campinas residents was 21.2% and for the residents in other cities, 24.8%. The risk for tuberculosis was higher in the areas with worse socioeconomic levels. The successful outcome for the treatment of the group of patients resident in Campinas was 76.4% among those who did not present Aids and only 48.8% for those who presented Aids. Patients with positive baciloscopy presented a success rate of 70%.The group of patients being retreated had a 2.1 times higher rate of unsuccessful treatment when compared to new cases (aR = 2.14; CI = 1.12 - 4.05). Among those patients with the TB/Aids comorbidity the chance of no unsuccessful was also higher (aR = 3.41; IC = 1.98 - 5.89). The proportion of supervised treatment was 35%. Conclusions: The effectiveness of the TCP in Campinas was below the 85% proposed by the WHO in all of the studies strata and the incidence seems to be underdimensioned in face of the low sputum bacilloscopy coverage (43.3%) of those presenting respiratory disease symptoms, which suggests problems in the TCP operation in Campinas. In order to improve the ~program, the activities of case search and supervised treatment should be enhanced. / Mestrado / Saude Coletiva / Mestre em Saude Coletiva