Thesis (doctoral)--Turun, 1978.

Thesis (doctoral)--Turku, 1983.

Thesis (doctoral)--Universiteit van Amsterdam, 1897.

The morbidity and mortality from tuberculosis may be influenced by the delay from the onset of symptoms until diagnosis. This study was performed to investigate patient and health services delays in the diagnosis o f pulmonary tuberculosis, and the patients’ explanations for these delays.

Thesis ( M Med( Family Medicine ))--University of Limpopo, 2010. / Tuberculosis (TB) is a major health problem in South Africa especially in this era of high prevalence of human immune deficiency virus (HIV) infection. South Africa is currently ranked fourth among the twenty-two high burden countries worldwide with an incidence of 940/100 000 population/year and mortality of 218/100 000 population/year. The notational tuberculosis control programme NTCP) was established in response to this growing burden. The aim of this study is to evaluate the TB programme at Matlala District hospital and to make recommendations that could improve its effectiveness. The study was a descriptive cross-sectional study. Retrospective data of all adults ≥15yrs diagnosed with pulmonary TB (PTB) were collated from the TB register and patients’ records between 01/01/2008 and 31/12/2008. Children <15years and extra-pulmonary TB were excluded because of the challenges in diagnosis. Follow-up was done until end of treatment to determine the outcome. The outcomes were cured, completed treatment, failed treatment, died, defaulted treatment, transferred out and not evaluated based on the NTCP criteria.A total of 482 patients (266 females and 216 males) were included in the study with a median age 40.91 (standard deviation (SD) 14.65; 95% CI 39.59-42.22). Women with mean age 38.35 years (SD 15.03; 95% CI 36.54-40.16) were significantly younger (P value <0.00001) than men with mean age 44.05 (SD 13.55; 95% CI 42.23-45.87). There were 399 (82.78%) new cases and 83 (17.22%) re-treatment cases. 130 (26.97%) patients were co-infected with HIV while 236 (48.96%) patients did not know their status. In all, 193 (40%) were cured, 63 (13.07%) completed treatment, 4 (0.83%) failed treatment, 43 (8.92%) died, 27 (5.60%) defaulted, 141 (29.25%) were transferred out and 11 (2.28%) were not evaluated. The treatment success rate was 53.11%. The treatment success rate in this study is well below the 85% target in the NTCP. A large number of the patients did not know their status and the outcome could not be determined in significant number of patients (not evaluated and transferred out). A systematic referral and recording process; and a collaborative effort between TB and HIV services is therefore necessary to face this challenge. It may also be important to re-open the TB ward to prevent nosocomial transmission.

Thesis (MPH)--University of Limpopo (Medunsa Campus), 2011 / Background and aim: Smear-negative pulmonary tuberculosis (SNPTB) has become an increasingly important clinical and public health problem, especially in areas that are affected by the dual infection of TB and human immunodeficiency virus (HIV) (Mello et al, 2006; WHO, 2006; Harries et al, 1998). There are recommended guidelines for diagnosing SNPTB to reduce misdiagnosis in sub-Saharan Africa, but there is little information on whether these guidelines are followed correctly (Harries et al, 1998). The aim of this study was to investigate the clinical diagnosis of SNPTB in HIV-positive patients at Athlone Hospital in Botswana. Methods: This was a quantitative, descriptive study which used two sources of data and data collection methods: a 4 year retrospective records review and questionnaires for clinicians. All clinicians responsible for treating HIV-positive patients (n=8) were asked to complete a questionnaire on self-reported (1) compliance with the guidelines (2) use of other methods to diagnose SNPTB and (3) reasons for not complying with the guidelines. All records on SNPTB in HIV-positive patients from 2006 to 2009 (n=281) were reviewed to establish the compliance and use of other methods to exclude other respiratory infections. Results: The response rate for clinicians was 87.5% (7/8). All clinicians (100% [7/7]) reported (a) always complying with using chest x-rays (CXRs), but (b) only sometimes complying with using 3 sputum results. Most clinicians (a) considered the duration of cough before making a diagnosis of SNPTB (57.1% [4/7]), and (b) placed patients on a trial of broad spectrum antibiotics before starting PTB treatment (85.7% [6/7]). The main reasons for non-compliance were: the inability of patients to submit sputum (100% [7/7]), delays in the laboratory (71.43% [5/7]), and lack of feedback from Botswana National Tuberculosis Program (BNTP) (57.14% [4/7]). Only 2.1% (6/281) of the records showed that other methods were used to rule out other respiratory infections, and overall compliance with the recommended guidelines was only 13.5% (40/281). Conclusion: The compliance with the recommended guidelines in making a diagnosis of SNPTB was very poor in this study. The unavailability of user-friendly and fast diagnostic methods resulted in many cases being treated for SNPTB with inadequate investigations.

Thesis (M.P.H.M.)--Mahidol University, 1999.

A research report submitted to the Faculty of Heath Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in the field of Tropical Diseases (Epidemiology & Biostatistics) Johannesburg, / Objective. The aim of this paper was to systematically evaluate available evidence on tobacco smoking as a risk factor for pulmonary tuberculosis. Methods. Relevant reports were identified by a systematic electronic search of Medline, Pubmed, Nioshtic, Toxline and Embasse. Methodological quality of all selected publications was assessed using a standardized checklist. Information was collected on all major study characteristics. Inter-study heterogeneity was examined qualitatively and statistically using the DerSimonian and Laird method. Results. Five case-control studies and 1 cohort study were included in the systematic review. All the 6 studies revealed a relationship between tobacco smoking and pulmonary tuberculosis. Heterogeneity across studies hampered overall statistical pooling of results, however pooled risk ratios for sub-groups were determined / IT2018

A dissertation submitted to the Faculty of Medicine, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the Degree of Master of Medicine. J o h a n n e s b u r g 1988 / Infections can cause autoantibody production. The purpose of this study was to determine the prevalence of autoantibodies in chronic mycobacterial infections in Johannesburg. Sera from 41 leprosy patients and from 49 untreated and 73 treated tuberculosis patients were tested for rheumatoid factor, antibodies against a panel of nuclear antigens, anticardiolipin antibodies and syphilis serology. The antinuclear antibody was positive in 7.3% of the leprosy group, 6.1% of the untreated TB group and 15% of the treated tuberculosis patients (p=0.0125). Antinuclear antibody positivity correlated with duration of treatment (p=0.025). The antinuclear antibody titres were low and there was no specific pattern. / IT2018

Published also as a thesis, Universit́e de Paris, with title: Indications et résultats de la chirurgie d'exérèse dans le traitement de la tuberculose pulmonaire.